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Sample records for clinical follow-up study

  1. Micropulse diode laser trabeculoplasty (MDLT: A phase II clinical study with 12 months follow-up

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    Antonio Maria Fea

    2008-06-01

    Full Text Available Antonio Maria Fea, Alex Bosone, Teresa Rolle, Beatrice Brogliatti, Federico Maria GrignoloIstituto di Fisiopatologia Clinica, Clinica Oculistica dell’ Università di Torino, Torino, ItalyObjective: This pilot study evaluates the pressure lowering potential of subthreshold micropulse diode laser trabeculoplasty (MDLT for a clinically meaningful duration in patients with medically uncontrolled open angle glaucoma (OAG.Design: prospective interventional case series.Participants: Thirty-two eyes of 20 consecutive patients with uncontrolled OAG (12 bilateral and 8 unilateral.Methods: Confluent subthreshold laser applications over the inferior 180° of the anterior TM using an 810 nm diode laser in a micropulse operating mode. The intraocular pressure (IOP was measured at baseline and at 1 hour, 1 day, 1 week, 3, 6, 9, and 12 months post-treatment. Flare was measured with a Kowa FM 500 flare-meter at baseline and at 3 hours, 1 day, 1 week, and 12 months post-treatment. After treatment, the patients were maintained on their pre-treatment drug regimen.Main outcome measures: Criteria for treatment response were IOP reduction ≥3 mm Hg and IOP ≤21 mm Hg within the first week after MDLT. Eyes not complying to the above criteria during the follow-up were considered treatment failure. Mean IOP change and percentage of IOP reduction during the follow-up were calculated.Results: One eye was analyzed for bilateral patients. A total of 20 eyes were thus included. Four eyes (20% did not respond to treatment during the first week. One additional eye failed at the 6 month visit. The treatment was successful in 15 eyes (75% at 12 months. The IOP was significantly lower throughout follow-up (p < 0.01. At 12 months, the mean percentage of IOP reduction in the 15 respondent eyes was 22.1% and 12 eyes (60% had IOP reduction higher than 20%. During the first two postoperative days, one eye with pigmentary glaucoma experienced a significant increase of flare

  2. Objective structured clinical examination and its impact on clinical and interpersonal skills: Follow-up study

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    Manoj Kumar Sharma; Chandra, Prabha S.; Chaturvedi, S.K.

    2013-01-01

    Background: Objective structured clinical examination is being used for assessing the clinical skills as well as their knowledge for various skills. Aim: The present work assess the role of exposure to objective structured clinical examination (OSCE) based skills in enhancement of clinical and interpersonal skills at 1 year interval among mental health trainees. Materials and Methods: Fifty five mental health trainees got exposure to weekly OSCE training on various aspects of clinical work. T...

  3. Fate of clinical research studies after ethical approval--follow-up of study protocols until publication.

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    Anette Blümle

    Full Text Available BACKGROUND: Many clinical studies are ultimately not fully published in peer-reviewed journals. Underreporting of clinical research is wasteful and can result in biased estimates of treatment effect or harm, leading to recommendations that are inappropriate or even dangerous. METHODS: We assembled a cohort of clinical studies approved 2000-2002 by the Research Ethics Committee of the University of Freiburg, Germany. Published full articles were searched in electronic databases and investigators contacted. Data on study characteristics were extracted from protocols and corresponding publications. We characterized the cohort, quantified its publication outcome and compared protocols and publications for selected aspects. RESULTS: Of 917 approved studies, 807 were started and 110 were not, either locally or as a whole. Of the started studies, 576 (71% were completed according to protocol, 128 (16% discontinued and 42 (5% are still ongoing; for 61 (8% there was no information about their course. We identified 782 full publications corresponding to 419 of the 807 initiated studies; the publication proportion was 52% (95% CI: 0.48-0.55. Study design was not significantly associated with subsequent publication. Multicentre status, international collaboration, large sample size and commercial or non-commercial funding were positively associated with subsequent publication. Commercial funding was mentioned in 203 (48% protocols and in 205 (49% of the publications. In most published studies (339; 81% this information corresponded between protocol and publication. Most studies were published in English (367; 88%; some in German (25; 6% or both languages (27; 6%. The local investigators were listed as (co-authors in the publications corresponding to 259 (62% studies. CONCLUSION: Half of the clinical research conducted at a large German university medical centre remains unpublished; future research is built on an incomplete database. Research resources are

  4. Pectus excavatum; a clinical study with long term postoperavtive follow-up.

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    Gyllenswärd, A; Irnell, L; Michaëlsson, M; Qvist, O; Sahlstedt, B

    1975-01-01

    There are divergent views about the harm that pectus excavatum and related chest deformities does to the respiratory and heart function. The indications for surgery and the optimal age for surgical intervention are debatable. In this study 37 operated and 38 nonoperated cases of about the same severity have been followed for more than ten years and examined after the age of 18 years. The examination included socio-economic, cosmetic and cardio-pulmonary function aspects. It could be shown that from the psychological aspect there were no significant differences between the operated and the non-operated cases. The tendency to contract bronchopneumonia is not influenced by operation. The physical working capacity was the same in the two groups. The operated cases have slightly lower pulmonary function values that the non-operated in spite of the fact that the non-operated group at the time of follow-up included the more seveee cases. Age at operation did not seem to be of any importance for the long-term results. The lower pulmonary function capacity in the operated cases is thought to be attributed to a restriction secondary to the operation. There are also indications that pectus excavatum tends to become less pronounced with increasing age. The study supports a restrictive attitude towards surgery. PMID:1058627

  5. Clinical and radiographic results of cervical artificial disc arthroplasty: over three years follow-up cohort study

    Institute of Scientific and Technical Information of China (English)

    TIAN Wei; HAN Xiao; LIU Bo; LI Qin; HU Lin; LI Zhi-yu; YUAN Qiang; HE Da; XING Yong-gang

    2010-01-01

    Background Theoretic advantages of cervical disc arthroplasty include preservation of normal motion and biomechanics in the cervical spine, and reduction of adjacent-segment degeneration. The clinical and radiographic effects of cervical disc arthroplasty in short term have been ascertained. The aim of this study is to research the data of mid-term results.Methods In this prospective cohort study, 50 patients who underwent cervical disc arthroplasty from December 2003 to January 2006 were enrolled. There were 39 patients who received 1-level disc arthroplasty, and 11 patients received 2-level disc arthroplasty, with an average age of 50.9 years (range from 29 to 73). The median follow-up was 41.85months (range from 36.00-55.63 months). Patients were followed prospectively with respect to their symptoms,neurologic signs, and radiographic results.Results The median value of Japanese Orthopaedic Association (JOA) score was 14.0 before surgery, and 16.5 at the most recent follow-up (P <0.01). The median value of the recovery rate of the JOA score was 92.2%. The preoperative range of motion (ROM) at the indexed level was (10.40±4.97)°, which has significantly correlated with the most recent follow-up ROM which was (8.56±4.76)° (P <0.05, r=0.33). The ROM at the operative level at the most recent follow-upwas greater than the value at the 3-month follow-up of (7.52±3.37)° (P <0.05). The preoperative functional spinal unit (FSU) angulation was (-0.96±6.52)°, which was not significantly correlated with that of the most recent follow-up value of (-2.65±7.95)° (P <0.01, r=0.53). The preoperative endplate angulation was (2.61±4.85)°, which had no significant correlation with that of the most recent follow-up value of (0.71±6.41)° (p >0.05).Conclusions The clinical and radiographic results of cervical disc arthroplasty are good in mid-term follow-up. The normal range of motion of the operated level and the biomechanics in the cervical spine are well

  6. A FOLLOW UP STUDY OF HYSTERIA1

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    Wig, N.N.; Mangalwedhe, K.; Bedi, Harminder; Murthy, R. Srinivas

    1982-01-01

    SUMMARY The present study undertook to examine the outcome of a group of cases who were diagnosed as hysteria, six or more years ago in a general hospital psychiatric unit and correlate various clinical factors with good or bad outcome. Of the 81 cases selected for the study, 57 (67%) could be located and followed up after a gap of 6-8 years. Majority of the cases (74%) had either no symptoms or symptoms less than before at the time of the follow up. In only 3 cases, there was evidence of an ...

  7. Follow-up study of the treatment outcomes at a psychiatric trauma clinic for refugees

    DEFF Research Database (Denmark)

    Buhmann, Cæcilie; Lykke Mortensen, Erik; Nordentoft, Merete;

    2015-01-01

    PURPOSE: To describe change in mental health after treatment with antidepressants and trauma-focused cognitive behavioral therapy. METHODS: Patients receiving treatment at the Psychiatric Trauma Clinic for Refugees in Copenhagen completed self-ratings of level of functioning, quality of life, and...

  8. Comparative clinical study of the effectiveness of different dental bleaching methods - two year follow-up

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    Rafael Francisco Lia Mondelli

    2012-08-01

    Full Text Available This study evaluated color change, stability, and tooth sensitivity in patients submitted to different bleaching techniques. MATERIAL AND METHODS: In this study, 48 patients were divided into five groups. A half-mouth design was conducted to compare two in-office bleaching techniques (with and without light activation: G1: 35% hydrogen peroxide (HP (Lase Peroxide - DMC Equipments, São Carlos, SP, Brazil + hybrid light (HL (LED/Diode Laser, Whitening Lase II DMC Equipments, São Carlos, SP, Brazil; G2: 35% HP; G3: 38% HP (X-traBoost - Ultradent, South Jordan UT, USA + HL; G4: 38% HP; and G5: 15% carbamide peroxide (CP (Opalescence PF - Ultradent, South Jordan UT, USA. For G1 and G3, HP was applied on the enamel surface for 3 consecutive applications activated by HL. Each application included 3x3' HL activations with 1' between each interval; for G2 and G4, HP was applied 3x15' with 15' between intervals; and for G5, 15% CP was applied for 120'/10 days at home. A spectrophotometer was used to measure color change before the treatment and after 24 h, 1 week, 1, 6, 12, 18 and 24 months. A VAS questionnaire was used to evaluate tooth sensitivity before the treatment, immediately following treatment, 24 h after and finally 1 week after. RESULTS: Statistical analysis did not reveal any significant differences between in-office bleaching with or without HL activation related to effectiveness; nevertheless the time required was less with HL. Statistical differences were observed between the results after 24 h, 1 week and 1, 6, 12, 18 and 24 months (intergroup. Immediately, in-office bleaching increased tooth sensitivity. The groups activated with HL required less application time with gel. CONCLUSION: All techniques and bleaching agents used were effective and demonstrated similar behaviors.

  9. Incidence and Effects of Polypharmacy on Clinical Outcome among Patients Aged 80+: A Five-Year Follow-Up Study.

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    Rong Wang

    Full Text Available Polypharmacy is a problem of growing interest in geriatrics with the increase in drug consumption in recent years, is defined according to the WHO criteria as the, ''concurrent use of five or more different prescription medication". We investigated the clinical characteristics of polypharmacy and identified the effects of polypharmacy on clinical outcome among patients aged 80+ admitted to Chinese PLA general hospital.Older men aged ≥80 years (n = 1562 were included in this study. The included participants attended a structured clinical examination and an interview carried out by a geriatrician and trained nurses. A follow-up survey in 2014 was carried out on survivors in the same way as in 2009. The clinical outcome measured were adverse drug reactions, falls, frailty, disability, cognitive impairment, mortality. The association between polypharmacy and clinical outcome was assessed by logistic regression.The mean (range age of the included participants was 85.2 (80-104 years. Medication exposure was reported by 100% of the population. Mean number of medications reported in this population was 9.56±5.68. The prevalence of polypharmacy (≥6 medications in the present study was 70%. At the time of the follow-up survey, an increase in the number of taken medicines had occurred among half of the survivors. The risk of different outcomes in relation to number of medications rises significantly, the odds ratios were 1.21 (95% confidence interval [CI]1.17-1.28 for adverse drug reactions, 1.18 (95% CI 1.10-1.26 for falls, 1.16 (95% CI 1.09-1.24 for disability, and 1.19 (95% CI 1.12-1.23 for mortality. There was no association between increasing number of medications and cognitive impairment.Our study demonstrates that polypharmacy is very common in the very old patients, and observed that number of medications was a factor associated with difference clinical outcome independently of the age, type of medications prescribed and accompanied

  10. A follow up study on interstitial alveolitis

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    Kamat S

    2004-01-01

    Full Text Available Objective : To study the benefits of steroid therapy in interstitial alveolitis. Method and Materials : One hundred five adult clinic patients were studied with clinical evaluation, chest radiography, CT scan, bronchoscopic lavage, pulmonary function studies and a regular follow up. They were put on daily prednisolone (in 19 on intravenous methyl prednisolone, for several months. Results: Only a few had no cough or dypnoea; 91 cases had atleast gr. III exertional breathlessness; 61(58% had been given steroids earlier and 32(31% were on a prior antitubercular treatment. Only 16% had GERD symptoms. On radiography, interstitial deposits were seen in 102 cases. While 53 cases belonged to idiopathic variety, 41 were sarcoidosis. A majority had poor lung function with a restrictive disability; but 50% showed a significant response (10%+ to bronchodilators. On follow up in 92 cases, 14 died, 8 went in remission; 32 had a fluctuating course. At some stage 66 had showed improvement. Conclusion : A large majority of our interstitial alveolitis cases are very disabled. They show clinical, functional, and radiographic improvement to long term oral prednisolone. In nonresponsive cases, intravenous steroids show an objective response.

  11. Clinical outcome of 215 transmucosal implants with a conical connection: a retrospective study after 5-year follow-up.

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    Lopez, M A; Andreasi Bassi, M; Confalone, L; Gaudio, R M; Lombardo, L; Lauritano, D

    2016-01-01

    The purpose of this retrospective clinical study was to evaluate the survival rate (i.e. SVR – fixtures still in place at the end of the observation period) and success rate (i.e. SCR - bone resorption around implant neck) of an implant system characterized by cylindrical and tapered implants, both types of implant being equipped with a conical connection with an internal octagon (COC), both implant types having a 1.8 mm smooth neck, positioned above the bone crest level. A total of 65 subjects received 215 COCs between January 1996 and October 2011. All COCs were placed and restored by three experienced dental surgeons. The mean follow-up was 84±44 months. The patients involved in the study were both male (30) and female (35), of whom 30 were smokers (less than 20 cigarettes/day) and none was diabetic. The implants differed in terms of diameter and length, and were inserted both in the mandible (97) and in the maxilla (118). Sixty-seven implants were single tooth rehabilitations, and 148 prosthetic bridges. Fourteen had guided bone regeneration (GBR), and 10 were placed in post-extractive sites. Forty of the implants were provided with passing-screw abutments and 175 with full-screw abutments. The data were analyzed using descriptive statistics. None of the implants failed before prosthetic restoration, resulting in an SVR=100% after loading. The radiographic and clinical data revealed well-maintained, hard and soft tissue around the COCs, with an SCR=92.6%. Cox regression analyses did not detect any variables with statistical impact on the clinical outcome. In conclusion, Shiner XT implants are reliable tools for oral rehabilitation. PMID:27469549

  12. The I1307K APC mutation in a high-risk clinic setting: a follow-up study.

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    Regev, M; Barzilai, S-Eisenberg; Figer, A; Zidan, J; Fidder, H H; Friedman, E

    2005-04-01

    While the I1307K APC mutation clearly confers an increased lifetime risk for colorectal cancer, there is a paucity of data on the natural history of colonic neoplasia in symptomatic and asymptomatic mutation carriers. In this study, 51 Jewish I1307K APC mutation carriers were identified in a high-risk familial cancer clinic over a 4-year period, of whom 29 (56.8%) (four males and 25 females) were successfully telephone interviewed for 0.5-5 years (mean 2.4 +/- 1.4) after initial genetic testing. Of these 29 cases, one individual was diagnosed with colon cancer at the age of 45 years, five had adenomatous polyps (mean number of polyps = 1.8), 11 had breast cancer (mean age at diagnosis 49.5 +/- 10.5 years), and 12 were asymptomatic, at the time of the testing. During the follow-up period, new colonic polyps were diagnosed in three mutation carriers, two with previously diagnosed colon cancer and polyps and only one of the asymptomatic mutation carriers, and two additional previously affected patients had new cancer diagnoses: gastric cancer and melanoma. From this descriptive study, it seems that the short-term risk for colonic polyps in I1307K APC mutation is low, primarily affecting patients with previously diagnosed colon tumors. PMID:15733272

  13. Stability of dysfunctional attitudes and early maladaptive schemas: a 9-year follow-up study of clinically depressed subjects.

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    Wang, Catharina E A; Halvorsen, Marianne; Eisemann, Martin; Waterloo, Knut

    2010-12-01

    The Dysfunctional Attitude Scale (DAS) and the Young Schema Questionnaire (YSQ) have been suggested as relatively stable vulnerability markers for depression and entrenched psychological disorders, respectively. One-hundred-and-forty-nine clinically depressed (CDs), previously depressed (PDs) and never-depressed subjects (NDs) completed the DAS, the YSQ and the Beck Depression Inventory in the index study and were followed-up nine years later. Results showed: (1) Elevated scores in CDs and PDs as compared to NDs; (2) Some stability of depressive symptoms; (3) Significant moderate test-retest correlations for DAS scales and YSQ scales Disconnection and Impaired Limits, also after controlling for depression severity; (4) A significant reduction in mean score for DAS total, Approval by Others and YSQ scales Disconnection and Impaired Limits; (5) Significant correlations between DAS and YSQ scales. Our results support a state-trait vulnerability model of depression comprising stable differences in availability of dysfunctional attitudes and early maladaptive schemas, but also fluctuating differences in accessibility of those schemas during the course of depression. The findings point to the significance of the YSQ scales as vulnerability markers for depression in addition to the more established DAS scales. PMID:20452570

  14. Cytokeratin-based CTC counting unrelated to clinical follow up

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    de Carvalho, Fernanda Machado; Rocha, Bruna Maria Malagoli; Aguiar, Caroline Motta; Abdallah, Emne Ali; Campanha, Daniel; Mingues, Natália Breve; de Oliveira, Thiago Bueno; Maciel, Macello Sampaio; Cervantes, Gustavo Marchioro; Dettino, Aldo L.A.; Soares, Fernando Augusto; Paterlini-Bréchot, Patrizia; Fanelli, Marcello Ferretti

    2013-01-01

    Background Circulating tumor cells (CTCs) have been reported to be a relevant prognostic biomarker in metastatic patients. However, their clinical use and impact is still under debate. We have thus comparatively and kinetically assessed two CTC detection methods according to the patient’s clinical follow up. Methods CTC counting and characterization were repeatedly performed during follow up in a patient with metastatic undifferentiated non-small cell lung cancer by using cytokeratin (CK)-dependent immunomagnetic separation (Miltenyi) and CK-independent, size-based isolation [isolation by size of tumor cells (ISET)] (Rarecells). Results Comparison between the two methods showed a parallel increase of CTC detected by ISET and worsening of the clinical status, while CK-dependent CTC numbers were decreasing, misleadingly suggesting a response to treatment. ISET results were in agreement with the clinical follow up showing Circulating tumor microemboli (CTM) and CTC expressing a mesenchymal marker with absence of epithelial markers. Conclusions This case report study shows the interest of a comparative and kinetic analysis of different methods for CTCs detection combined with their evaluation according to the clinical follow up. Our results should open up an area for future research and validation in larger clinical cohorts. PMID:24255771

  15. A feasibility study of functional status and follow-up clinic preferences of patients at high risk of post intensive care syndrome.

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    Farley, K J; Eastwood, G M; Bellomo, R

    2016-05-01

    After prolonged mechanical ventilation patients may experience the 'post intensive care syndrome' (PICS) and may be candidates for post-discharge follow-up clinics. We aimed to ascertain the incidence and severity of PICS symptoms in patients surviving prolonged mechanical ventilation and to describe their views regarding follow-up clinics. In a teaching hospital, we conducted a cohort study of all adult patients discharged alive after ventilation in ICU for ≥7 days during 2013. We administered the EuroQol-5D (EQ-5D) and Hospital Anxiety and Depression Scale (HADS) via telephone interview and asked patients their views about the possible utility of a follow-up clinic. We studied 48 patients. At follow-up (average 19.5 months), seven (15%) patients had died and 14 (29%) did not participate (eight declined; two were non-English speakers; four were non-contactable). Among the 27 responders, 16 (59%) reported at least moderate problems in ≥1 EQ-5D dimension; 10 (37%) in ≥2 dimensions, and 8 (30%) in ≥3 dimensions. Moreover, 10 (37%) patients reported marked psychological symptoms; six (22%) scored borderline or abnormal on the HADS for both anxiety and depression; and four (15%) scored borderline or abnormal for one component. Finally, 21/26 (81%) patients stated that an ICU follow-up clinic would have been beneficial. At long-term follow-up, the majority of survivors of prolonged mechanical ventilation reported impaired quality of life and significant psychological symptoms. Most believed that a follow-up clinic would have been beneficial. PMID:27246943

  16. Diffuse sclerosing variant of papillary carcinoma of the thyroid. Clinical importance, surgical treatment, and follow-up study

    International Nuclear Information System (INIS)

    A diffuse sclerosing variant is not very rare among papillary carcinomas of the thyroid when the patients are female and younger than 30 years of age. The variant is characterized by diffuse involvement of one or both thyroid lobes, with dense sclerosis, patchy lymphocytic infiltration, and abundant psammoma bodies. Controversy still exists concerning its prognosis. We reviewed our experience with 14 patients treated between 1958 and 1988. All patients were young females, their age being from 10 to 28 years with a mean of 19.6. Hashimoto's thyroiditis had been suspected in nine patients before they came to our clinic. Nowadays the diagnosis of this cancer is possible when we have this entity in mind and detect abundant psammoma bodies either by ultrasonography or by soft-tissue roentgenography of the neck. Total thyroidectomy with modified neck dissection was carried out in eight patients, subtotal thyroidectomy with neck dissection in five, and lobectomy with neck dissection in one. All of them are alive and well without distant metastasis at a mean follow-up of 16 years. Because most of the patients with this variant of papillary carcinoma are young women and the prognosis is favorable, a complete resection without causing later recurrence, but also cosmetic and complication-free surgery, should be considered

  17. Effect of antiretroviral therapy on clinical and immunologic disease progression in HIV positive children: One-year follow-up study

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    Ankur Patel

    2012-01-01

    Full Text Available Objective: To study the effect of antiretroviral therapy (ART on clinical, immunologic, and nutritional progression of disease in human immunodeficiency virus (HIV-infected children for 1 year. Materials and Methods: The study included 54 children aged 1.5-15 years who registered at the ART center, Surat, from August 2007 to August 2009. During the study period, the children were followed-up at 6 monthly intervals up to 1 year after starting ART. World Health Organization (WHO clinical staging and CD4 cell count as per national guidelines, and nutritional status were used to measure clinical and immunologic progression of disease up to 1 year. Results: Out of 54 children, mother-to-child transmission was reported in 96.2% children; for 74% of the children, both parents were HIV positive. All the children were classified according to WHO clinical staging into 4 stages and as per CD4 cell count (%, followed up at 6 and 12 months and the benefits with ART reported. At 12 months follow-up, 15% of the study group children had died. Both mean CD4 count and a relative percentage showed significant increase (P < 0.01 in the study group 1 year after ART. Conclusion: The present study reports benefits of ART in terms of clinical and immunologic progression of disease, nutritional status of HIV-infected children after 1 year of ART.

  18. Morbidity follow-up feasibility study

    International Nuclear Information System (INIS)

    The report reviews the available sources of data within Canada for undertaking morbidity follow-up studies to both supplement and complement studies using Canadian mortality data. Such studies would permit earlier detection and more sensitive measures of differences in risk for exposures to radiation and allow timely measures to be taken to minimize any occupational and environmental health risk to radiation workers. The technical feasibility of using these sources was reviewed using the criteria of adequate personal identifying information, automation of data records, file size and the accuracy of the morbidity diagnosis information. At the present time certain of the provincial cancer registry files meet these criteria best. A work plan was prepared suggesting a morbidity pilot study to clarify the role of occupational factors in the incidence of cancer among radiation workers using the Alberta Cancer Registry file and the National Dose Registry (NDR) file of radiation workers. For the longer term a full cohort study using the National Cancer Incidence Reporting System (NCIRS) and the NDR workers as the study population would provide information on all radiation workers on a national basis. A work plan was prepared and some initial format conversion of historical data was undertaken to begin developing the NCIRS into a data base suitable for long-term health studies

  19. Diagnoses behind patients with hard-to-classify tremor and normal DaT-SPECT: A clinical follow up study

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    Manuel Menéndez-González

    2014-04-01

    Full Text Available The [123I]ioflupane - a dopamine transporter radioligand - SPECT (DaT-SPECT has proven to be useful in the differential diagnosis of tremor. Here, we investigate the diagnoses behind patients with hard-to-classify tremor and normal DaT-SPECT. Therefore, 30 patients with tremor and normal DaT-SPECT were followed up for 2 years. In 18 cases we were able to make a diagnosis. The residual 12 patients underwent a second DaT-SPECT, were then followed for additional 12 months and thereafter the diagnosis was reconsidered again. The final diagnoses included cases of essential tremor, dystonic tremor, multisystem atrophy, vascular parkinsonism, progressive supranuclear palsy, corticobasal degeneration, fragile X–associated tremor ataxia syndrome, psychogenic parkinsonism, iatrogenic parkinsonism and Parkinson’s disease. However, for 6 patients the diagnosis remained uncertain. Larger series are needed to better establish the relative frequency of the different conditions behind these cases.

  20. Fractured rheumatoid elbow: treatment with Souter elbow arthroplasty--a clinical and radiologic midterm follow-up study.

    Science.gov (United States)

    Ikävalko, M; Lehto, M U

    2001-01-01

    We report the results in 26 patients who had 32 preoperative fractures treated with Souter elbow arthroplasty. All were rheumatoid patients with a mean disease duration of 29.7 years (range, 10 to 43). Six of the fractures were of the olecranon and 26 of the distal humerus. The time interval between fracture and arthroplasty was 9 months (mean; range, 0 to 48). Fragments were not excised, and osteosynthesis was performed. The follow-up was 2.6 years (mean; range, 0.5 to 8), when 20 of the fractures had united and 12 had not. K-wire fixation, either alone or in combination with cerclage or PDS suture, and bone grafting led to satisfactory results. Union was verified in 14 of 17 cases treated with this technique. There were no severe early complications. Six patients had late complications. In 3 cases, loosening of the humeral component was observed radiologically. One patient had a hematogenous deep infection 4 years after the operation, and 2 patients had avulsion rupture of the triceps tendon. Fracture in the badly destroyed elbow can be more reasonably treated with an arthroplasty than with an attempt of osteosynthesis before arthroplasty. If excision of the fragments is avoided, original, or near original, anatomy of the elbow joint can be better restored and acceptable outcome obtained with elbow arthroplasty. PMID:11408908

  1. Clinical characteristics and immunogenetics of BCGosis/BCGitis in Chinese children: a 6 year follow-up study.

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    Wenjing Ying

    Full Text Available In this study, the clinical and immunogenetical features in a cohort of Chinese patients with BCGosis/BCGitis were investigated. For the patients with abnormal immunological functions, Sanger sequencing was used to identify the involved genes. There were 74 confirmed cases of BCGosis/BCGitis during 2007-2012. Classified by infected tissues and organs, no cases only had local infection, 39 patients had a regional infection, 21 patients had a distant infection and 14 patients had a disseminated infection. Thirty-two patients (43.2% had definitive primary immunodeficiency diseases (PID and chronic granulomatous disease (CGD is the most common PID (n = 23, accounted for 71.9% of all PID patients. For CGD patients, based on the anti-tuberculosis treatment, administration of rhIFN-γ resulted in better control of BCGosis/BCGitis. The results indicate that PIDs are associated with susceptibility to BCG disease. For children with BCGosis/BCGitis, immune function evaluation is necessary, and IFN-γ treatment for BCGosis/BCGitis patients with CGD is effective.

  2. Incidence and Effects of Polypharmacy on Clinical Outcome among Patients Aged 80+: A Five-Year Follow-Up Study

    OpenAIRE

    Rong Wang; Lei Chen; Li Fan; Dewei Gao; Zhiru Liang; Jing He; Weiqin Gong; Linggen Gao

    2015-01-01

    Objectives Polypharmacy is a problem of growing interest in geriatrics with the increase in drug consumption in recent years, is defined according to the WHO criteria as the, ‘‘concurrent use of five or more different prescription medication”. We investigated the clinical characteristics of polypharmacy and identified the effects of polypharmacy on clinical outcome among patients aged 80+ admitted to Chinese PLA general hospital. Methods Older men aged ≥80 years (n = 1562) were included in th...

  3. Immediate or early functional loading on dental osseointegratable implants: a restrospective clinical study with 5-year follow-up

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    Idelmo Rangel Garcia Junior

    2008-01-01

    Full Text Available Objective: After a period of five years, evaluate the use of early load in 24 patients at a private clinic. Methods: One hundred and three fixations and prosthetic rehabilitations were performed in 24 patients, with a mean age of 38 years (minimum of 23 and maximum of 72 years, eleven being women and 13 men, in whom 50 and 53 fixations respectively, were performed. Results: The success obtained among single dentures and splinted implant supported dentures was similar, around 92%. Conclusion: The predictability between the protocol of two separate stages and the protocol of immediate or early functional load is similar; the initial stability of the implant plays a fundamental role in the immediate or early functional load protocol.

  4. Evaluation of mid- and long-term consequences, clinical and social performance in Chernobyl acute radiation syndrome patients in a multi-centre clinical follow-up study

    International Nuclear Information System (INIS)

    Since the Chernobyl accident in 1986 nearly all survivors (n=199) of 237 patients with suspected acute radiation syndrome (ARS) underwent regular follow-up investigations in the scientific centres in Kiev and in Moscow. In a close collaboration with these centres we investigate the health status of this population in a five step approach. An integral part of this approach to patient evaluation and analysis of the mid- and long-term consequences of the Chernobyl accident is a 'Questionnaire for clinical, laboratory and functional follow-up of radiation-exposed persons', developed with these centres. Beyond this project we report as an interim some results of analyses performed by the scientific centers in Kiev and in Moscow about disorders of the cardiovascular system and the digestive tract, formation of cataract, generalized and local skin injuries and/or disorders as well as for a subpopulation (n=89) the Karnofsky performance score and working ability

  5. Design and methodology of the NorthStar Study: NT-proBNP stratified follow-up in outpatient heart failure clinics -- a randomized Danish multicenter study

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Videbaek, Lars;

    2008-01-01

    stable, educated, and medical optimized patients with CHF with N-terminal pro-brain natriuretic peptide (NT-proBNP) levels > or = 1,000 pg/mL benefit from long-term follow-up in an HFC and to assess the efficacy of NT-proBNP monitoring. METHODS: A total of 1,250 clinically stable, medically optimized......, and educated patients with CHF will be enrolled from 18 HFCs in Denmark. The patients will be randomized to treatment in general practice, to a standard follow-up program in the HFC, or to NT-proBNP monitoring in the HFC. The patients will be followed for 30 months (median). RESULTS: Data will be collected...... patients who may benefit from long-term follow-up. Our results may also indicate whether patients with CHF will benefit from adding serial NT-proBNP measurements to usual clinical monitoring....

  6. A Follow-Up Study of Medical Students' Biomedical Understanding and Clinical Reasoning Concerning the Cardiovascular System

    Science.gov (United States)

    Ahopelto, Ilona; Mikkila-Erdmann, Mirjamaija; Olkinuora, Erkki; Kaapa, Pekka

    2011-01-01

    Novice medical students usually hold initial conceptions concerning medical domains, such as the cardiovascular system, which may contradict scientific explanations and thus hinder learning. The purpose of this study was to investigate which kinds of biomedical representations medical students constructed of the central cardiovascular system in…

  7. The prognosis of fixed dystonia: a follow-up study.

    NARCIS (Netherlands)

    Ibrahim, N.M.; Martino, D.; Warrenburg, B.P.C. van de; Quinn, N.P.; Bhatia, K.P.; Brown, R.J.; Trimble, M.; Schrag, A.

    2009-01-01

    BACKGROUND: The syndrome of fixed dystonia includes both CRPS-dystonia and psychogenic dystonia. The underlying mechanisms are unclear, but a high prevalence of neuropsychiatric illness has previously been reported. METHODS: Clinical and neuropsychiatric follow-up study by telephone and self-adminis

  8. No red cell alloimmunization or change of clinical outcome after using fresh frozen cancellous allograft bone for acetabular reconstruction in revision hip arthroplasty: a follow up study

    Directory of Open Access Journals (Sweden)

    Mittag Falk

    2012-09-01

    Full Text Available Abstract Background Possible immunization to blood group or other antigens and subsequent inhibition of remodeling or incorporation after use of untreated human bone allograft was described previously. This study presents the immunological, clinical and radiological results of 30 patients with acetabular revisions using fresh frozen non-irradiated bone allograft. Methods AB0-incompatible (donor-recipient bone transplantation was performed in 22 cases, Rh(D incompatible transplantation in 6 cases. The mean follow up of 23 months included measuring Harris hip score and radiological examination with evaluation of remodeling of the bone graft, implant migration and heterotopic ossification. In addition, all patients were screened for alloimmunization to Rh blood group antigens. Results Compared to the whole study group, there were no differences in clinical or radiological measurements for the groups with AB0- or Rh(D-incompatible bone transplantation. The mean Harris Hip Score was 80.6. X-rays confirmed total remodeling of all allografts with no acetabular loosening. At follow up, blood tests revealed no alloimmunization to Rh blood group donor antigens. Conclusions The use of fresh frozen non-irradiated bone allograft in acetabular revision is a reliable supplement to reconstruction. The risk of alloimmunization to donor-blood group antigens after AB0- or Rh-incompatible allograft transplantation with a negative long-term influence on bone-remodeling or the clinical outcome is negligible.

  9. Flare, persistently active disease, and serologically active clinically quiescent disease in systemic lupus erythematosus: a 2-year follow-up study.

    Directory of Open Access Journals (Sweden)

    Fabrizio Conti

    Full Text Available OBJECTIVE: Several indices have been proposed to assess disease activity in patients with Systemic Lupus Erythematosus (SLE. Recent studies have showed a prevalence of flare between 28-35.3%, persistently active disease (PAD between 46%-52% and serologically active clinically quiescent (SACQ disease ranging from 6 to 15%. Our goal was to evaluate the flare, PAD and SACQ rate incidence in a cohort of SLE patients over a 2-year follow-up. METHODS: We evaluated 394 SLE patients. Flare was defined as an increase in SLEDAI-2K score of ≥4 from the previous visit; PAD was defined as a SLEDAI-2K score of ≥4, on >2 consecutive visits; SACQ was defined as at least a 2-year period without clinical activity and with persistent serologic activity. RESULTS: Among the 95 patients eligible for the analysis in 2009, 7 (7.3% had ≥1 flare episode, whereas 9 (9.4% had PAD. Similarly, among the 118 patients selected for the analysis in 2010, 6 (5% had ≥1 flare episode, whereas 16 (13.5% had PAD. Only 1/45 patient (2.2% showed SACQ during the follow-up. CONCLUSION: We showed a low incidence of flare, PAD and SACQ in Italian SLE patients compared with previous studies which could be partly explained by ethnic differences.

  10. Long-term Clinical Course of Post-infectious Irritable Bowel Syndrome After Shigellosis: A 10-year Follow-up Study

    Science.gov (United States)

    Youn, Young Hoon; Kim, Hyeon Chang; Lim, Hyun Chul; Park, Jae Jun; Kim, Jie-Hyun; Park, Hyojin

    2016-01-01

    Background/Aims A limited number of studies are available regarding the long-term natural history of post-infectious irritable bowel syndrome (PI-IBS). We aimed to investigate the long-term clinical course of PI-IBS. Methods A prospective cohort study was conducted from a 2001 shigellosis outbreak in a Korean hospital with about 2000 employees. A cohort of 124 hospital employees who were infected by Shigella sonnei due to contaminated food in the cafeteria, and 105 sex- and age-matched, non-infected, controls were serially followed for their bowel symptoms by questionnaire surveys for 10 years. Results The Shigella-infected cohort showed significantly higher odds ratio for irritable bowel syndrome (IBS) at 1-year (11.90; 95% CI, 1.49–95.58) and 3-year (3.93; 95% CI, 1.20–12.86) follow-up, compared to their controls. However, corresponding odds ratio for PI-IBS was not significantly increased at 5-year (1.88; 95% CI, 0.64–5.54) and 8-year (1.87; 95% CI, 0.62–5.19) follow-up. At 10-year follow-up survey, the prevalence of IBS was similar for the Shigella-infected cohort and their controls (23.3% versus 19.7%, P = 0.703). Risk factors which were independently associated with PI-IBS among the Shigella-infected cohort included younger age, previous history of functional bowel disorder, and longer duration of diarrhea at baseline. Conclusions Patients who were infected by Shigella sonnei experienced significantly increased risk of IBS until 3 years after shigellosis, and modestly increased risk until 8 years, but showed similar risk of IBS with uninfected controls at 10 years post-infection. PI-IBS is quite a chronic disorder, and follows a long-term natural course. PMID:26908484

  11. The relationship between clinical stage, prognosis and myocardial damage in patients with Duchenne-type muscular dystrophy. Five-year follow-up study

    International Nuclear Information System (INIS)

    The evaluation of myocardial damage by [123I]15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) imaging, which represents free fatty acid metabolism, has not been reported in patients with Duchenne-type muscular dystrophy (DMD). To date, the relationship between clinical stage, prognosis and myocardial damage has not been evaluated by radionuclear cardiac imaging. The main goal of this study was to elucidate the relationship of quantitative indices of myocardial damage obtained by radionuclear cardiac imaging ([201Tl] and [123I]BMIPP) to clinical stage and incidence of severe cardiac events in patients with Duchenne-type muscular dystrophy (DMD). The study population consisted of 28 male patients with DMD. The average age at the beginning of observation was 19.1±7.4 yrs. Nuclear tomographic imaging was performed using [201Tl] and [123I]BMIPP. The mid-ventricular short axial slices were classified into four anatomical regions, and the normalized count data in these areas (TL, BM) were obtained. The endpoint was the occurrence of heart failure during the follow up period. Thirteen cases of heart failure occurred during the 5-year follow-up period, including three cases with cardiac death due to congestive heart failure. Clinical staging correlated directly with TL (p=0.0118) and BM (p=0.0401) in the whole left ventricle. In regional TL analysis, an association was observed only in the septum (p=0.0151), and in the anterior (p=0.0361) region. The only discrepancy between the tracer parameters (TL-BM) in the septum was observed with the radionuclear cardiac values, which exhibited a relationship with cardiac events (p=0.0124). This discordance, TL201Tl] in this area was representative of the clinical stage, and TL-BM correlated well with the prognosis. (author)

  12. Respiratory poliomyelitis: a follow-up study.

    OpenAIRE

    Alcock, A J; Hildes, J. A.; Kaufert, P A; Kaufert, J. M.; Bickford, J.

    1984-01-01

    Data from the medical records of 113 patients living in Manitoba who had contracted respiratory poliomyelitis between 1952 and 1959 were compared with information obtained from interviews with these patients in 1980. The study was designed to determine whether the patients' respiratory function, mobility, ability to perform daily tasks, and employment, residential and marital status had changed between 1 year after the onset of polio and 1980. The patients' dependence on mechanical aids and o...

  13. Diagnostic accuracy of MRI in adults with suspect brachial plexus lesions: A multicentre retrospective study with surgical findings and clinical follow-up as reference standard

    Energy Technology Data Exchange (ETDEWEB)

    Tagliafico, Alberto, E-mail: alberto.tagliafico@unige.it [Institute of Anatomy, Department of Experimental Medicine, University of Genoa, Largo Rosanna Benzi 8, 16132 Genoa (Italy); Succio, Giulia; Serafini, Giovanni [Department of Radiology, Santa Corona Hospital, Pietra Ligure, Italy via XXV Aprile, 38- Pietra Ligure, 17027 Savona (Italy); Martinoli, Carlo [Radiology Department, DISC, Università di Genova, Largo Rosanna Benzi 8, 16138 Genova (Italy)

    2012-10-15

    Objective: To evaluate brachial plexus MRI accuracy with surgical findings and clinical follow-up as reference standard in a large multicentre study. Materials and methods: The research was approved by the Institutional Review Boards, and all patients provided their written informed consent. A multicentre retrospective trial that included three centres was performed between March 2006 and April 2011. A total of 157 patients (men/women: 81/76; age range, 18–84 years) were evaluated: surgical findings and clinical follow-up of at least 12 months were used as the reference standard. MR imaging was performed with different equipment at 1.5 T and 3.0 T. The patient group was divided in five subgroups: mass lesion, traumatic injury, entrapment syndromes, post-treatment evaluation, and other. Sensitivity, specificity with 95% confidence intervals (CIs), positive predictive value (PPV), pre-test-probability (the prevalence), negative predictive value (NPV), pre- and post-test odds (OR), likelihood ratio for positive results (LH+), likelihood ratio for negative results (LH−), accuracy and post-test probability (post-P) were reported on a per-patient basis. Results: The overall sensitivity and specificity with 95% CIs were: 0.810/0.914; (0.697–0.904). Overall PPV, pre-test probability, NPV, LH+, LH−, and accuracy: 0.823, 0.331, 0.905, 9.432, 0.210, 0.878. Conclusions: The overall diagnostic accuracy of brachial plexus MRI calculated on a per-patient base is relatively high. The specificity of brachial plexus MRI in patients suspected of having a space-occupying mass is very high. The sensitivity is also high, but there are false-positive interpretations as well.

  14. Diagnostic accuracy of MRI in adults with suspect brachial plexus lesions: A multicentre retrospective study with surgical findings and clinical follow-up as reference standard

    International Nuclear Information System (INIS)

    Objective: To evaluate brachial plexus MRI accuracy with surgical findings and clinical follow-up as reference standard in a large multicentre study. Materials and methods: The research was approved by the Institutional Review Boards, and all patients provided their written informed consent. A multicentre retrospective trial that included three centres was performed between March 2006 and April 2011. A total of 157 patients (men/women: 81/76; age range, 18–84 years) were evaluated: surgical findings and clinical follow-up of at least 12 months were used as the reference standard. MR imaging was performed with different equipment at 1.5 T and 3.0 T. The patient group was divided in five subgroups: mass lesion, traumatic injury, entrapment syndromes, post-treatment evaluation, and other. Sensitivity, specificity with 95% confidence intervals (CIs), positive predictive value (PPV), pre-test-probability (the prevalence), negative predictive value (NPV), pre- and post-test odds (OR), likelihood ratio for positive results (LH+), likelihood ratio for negative results (LH−), accuracy and post-test probability (post-P) were reported on a per-patient basis. Results: The overall sensitivity and specificity with 95% CIs were: 0.810/0.914; (0.697–0.904). Overall PPV, pre-test probability, NPV, LH+, LH−, and accuracy: 0.823, 0.331, 0.905, 9.432, 0.210, 0.878. Conclusions: The overall diagnostic accuracy of brachial plexus MRI calculated on a per-patient base is relatively high. The specificity of brachial plexus MRI in patients suspected of having a space-occupying mass is very high. The sensitivity is also high, but there are false-positive interpretations as well

  15. A twelve-year follow-up study on a case of early-onset parkinsonism preceding clinical manifestation of Gaucher disease.

    Science.gov (United States)

    Machaczka, Maciej; Arce, Martin Paucar; Rucinska, Malgorzata; Yoshitake, Takashi; Kehr, Jan; Jurczak, Wojciech; Skotnicki, Aleksander B; Månsson, Jan-Erik; Tylki-Szymanska, Anna; Svenningsson, Per

    2012-01-01

    Mutations in the glucocerebrosidase gene (GBA1) cause Gaucher disease (GD) and are the most common genetic risk factor for the development of Parkinson's disease (PD). Here, we present a 12-year follow-up study of a male with GD and PD (diagnosed 24years ago), which PD preceded the clinical manifestation of GD by 12years. The patient is a compound heterozygote for mutations c.115+1G>A and c.1226A>G (IVS2 + 1/N370S) in the GBA1 gene. Imiglucerase had a beneficial effect on GD, but not on PD. Treatment with L-dopa and other PD drugs showed temporary efficacy but 2years later significant wearing-off phenomenon and dyskinesias appeared. Unilateral pallidotomy was performed with transient benefit. Cognitive decline appeared later and developed in to akinetic mutism. A lumbar puncture was performed to characterize the biochemical profile of cerebrospinal fluid (CSF). Analyses of monoamine metabolites levels in the CSF, determined by reverse-phase high-performance liquid chromatography, revealed remarkably low levels of all studied monoamine metabolites (HVA, DOPAC, 5-HIAA, MHPG). These data indicate that PD associated with GBA1 mutations may not only affect dopaminergic neurons, but also noradrenergic and serotonergic neurons. Of note, normal levels of P-tau, total tau and β-amyloid (1-42) were detected on ELISA assay. Thus, the cognitive decline, akinetic mutism and moderate cortical atrophy found on the CT scan were not paralleled by any changes of dementia markers in CSF. This single case study extends the follow-up period and adds novel CSF information; however additional data on other patients with both PD and GD may help put our observations in its ultimate proper context. PMID:23430873

  16. Radiological follow-up of uncemented knee prostheses. Preliminary study

    International Nuclear Information System (INIS)

    The preliminary results of a prospective study of 40 uncemented total knee prostheses (TKP) are presented following a radiological protocol with fluoroscopic control and follow-up of over 2 years. The prosthesis-bone interface and the components alignment were assessed. Several radiological signs were studied to assess this interface with respect to the fixing of the component, but they showed little clinical correlation. Statistical significance (p<0.05, chisquare) was found only in the observation of sclerosis in areas of support for the tibital tray as a reaction of the bone. This radiological follow-up is of interest to determine the evolution of the interface and position of the implant to prevent complications (especially loosening) in patients, particularly those under 60 years old, who represent the group that can most benefit from prosthetic systems with uncemented anchorage because of their life expectation and level of activity. Author

  17. PNH revisited: Clinical profile, laboratory diagnosis and follow-up

    Directory of Open Access Journals (Sweden)

    Gupta P

    2009-01-01

    Full Text Available Background: Paroxysmal nocturnal hemoglobinuria (PNH is characterized by intravascular hemolysis, marrow failure, nocturnal hemoglobinuria and thrombophila. This acquired disease caused by a deficiency of glycosylphosphatidylinositol (GPI anchored proteins on the hematopoietic cells is uncommon in the Indian population. Materials and Methods: Data of patients diagnosed with PNH in the past 1 year were collected. Clinical data (age, gender, various presenting symptoms, treatment information and follow-up data were collected from medical records. Results of relevant diagnostic tests were documented i.e., urine analysis, Ham′s test, sucrose lysis test and sephacryl gel card test (GCT for CD55 and CD59. Results: A total of 5 patients were diagnosed with PNH in the past 1 year. Presenting symptoms were hemolytic anemia (n=4 and bone marrow failure (n=1. A GCT detected CD59 deficiency in all erythrocytes in 4 patients and CD55 deficiency in 2 patients. A weak positive PNH test for CD59 was seen in 1 patient and a weak positive PNH test for CD55 was seen in 3 patients. All patients were negative by sucrose lysis test. Ham′s test was positive in two cases. Patients were treated with prednisolone and/or androgen and 1 patient with aplastic anemia was also given antithymocyte globulin. A total of 4 patients responded with a partial recovery of hematopoiesis and 1 patient showed no recovery. None of the patients received a bone marrow transplant. Conclusion: The study highlights the diagnostic methods and treatment protocols undertaken to evaluate the PNH clone in a developing country where advanced methods like flowcytometry immunophenotyping (FCMI and bone marrow transplants are not routinely available.

  18. Prevalence and progression of visual impairment in patients newly diagnosed with clinical type 2 diabetes: a 6-year follow up study

    Directory of Open Access Journals (Sweden)

    Almind Gitte

    2011-02-01

    Full Text Available Abstract Background Many diabetic patients fear visual loss as the worst consequence of diabetes. In most studies the main eye pathology is assigned as the cause of visual impairment. This study analysed a broad range of possible ocular and non-ocular predictors of visual impairment prospectively in patients newly diagnosed with clinical type 2 diabetes. Methods Data were from a population-based cohort of 1,241 persons newly diagnosed with clinical, often symptomatic type 2 diabetes aged ≥ 40 years. After 6 years, 807 patients were followed up. Standard eye examinations were done by practising ophthalmologists. Results At diabetes diagnosis median age was 65.5 years. Over 6 years, the prevalence of blindness (visual acuity of best seeing eye ≤ 0.1 rose from 0.9% (11/1,241 to 2.4% (19/807 and the prevalence of moderate visual impairment (> 0.1; Conclusions In a comprehensive assessment of predictors of visual impairment, even in a health care system allowing self-referral to free eye examinations, treatable eye pathologies such as DR and cataract emerge together with age as the most notable predictors of continued visual loss after diabetes diagnosis. Our results underline the importance of eliminating barriers to efficient eye care by increasing patients' and primary care practitioners' awareness of the necessity of regular eye examinations and timely surgical treatment.

  19. Relation between clinical depression risk and physical activity and time spent watching television in older women: a 10-year prospective follow-up study.

    Science.gov (United States)

    Lucas, Michel; Mekary, Rania; Pan, An; Mirzaei, Fariba; O'Reilly, Eilis J; Willett, Walter C; Koenen, Karestan; Okereke, Olivia I; Ascherio, Alberto

    2011-11-01

    Although physical activity (PA) has been inversely associated with depressive symptoms, it is not clear whether regular PA and television watching are associated with clinical depression risk. The authors conducted a prospective analysis involving 49,821 US women from the Nurses' Health Study who were free from depressive symptoms at baseline (1996). Information on PA was obtained from validated questionnaires completed in 1992, 1994, 1996, 1998, and 2000; analyses were conducted using the cumulative average of PA (minutes/day) with a 2-year latency period applied. Participants were asked about television-watching habits in 1992. Cox proportional hazards regression models adjusted for multiple risk factors were used to estimate relative risks of clinical depression (self-reported physician-diagnosed depression or use of antidepressants). During 10 years of follow-up (1996-2006), 6,505 incident cases of depression were documented. Higher levels of PA were associated with lower depression risk. The multivariate relative risk comparing the highest level of PA (≥ 90 minutes/day) with the lowest (confidence interval: 0.70, 0.92; P(trend) women who spent 21 hours/week or more watching television with those who spent 0-1 hour/week was 1.13 (95% confidence interval: 1.00, 1.27; P(trend) = 0.01). Analyses simultaneously considering PA and television watching suggested that both contributed independently to depression risk. PMID:21984659

  20. Clinical outcome and follow-up of prenatal hydronephrosis

    Directory of Open Access Journals (Sweden)

    Afshin Safaei Asl

    2012-01-01

    Full Text Available Hydronephrosis is probably the most common congenital abnormality detected prenatally by ultrasonography This study was performed to determine the cause and outcome of prenatal hydronephrosis in our hospital. A total of 45 infants, with 57 prenatally hydronephrotic renal units, were enrolled into this study. For the purpose of this study, the degree of hydronephrosis was defined as mild, moderate or severe. Postnatal ultrasonography was performed as soon as possible in those with bilateral hyronephrosis and 3-7 days after birth in those with unilateral hydronephrosis. Voiding cystourethrogram was performed in 6-8 weeks time. In the absence of vesicoureteral reflux (VUR, Diethylenetriamene penta acetate scan was performed to exclude obstructive uropathy. There were 29 males and 16 females (male:female ratio 1.8:1, and unilateral and bilateral hydronephrosis were seen in 33 (73% and 12 (27% of the cases, res-pectively. Hydronephrosis was caused by ureteropelvic junction obstruction (UPJO in 20 (44.5%, VUR in 10 (22.2%, ureterovesical junction obstruction in four (8.9 %, posteriorurethral valves in four (8.9 %, UPJO with VUR in two (4.4% and non-VUR non-obstructive in one (2.2%. During follow-up, 16 patients (35.5% required operative intervention while seven (15.5% improved spontaneously. Fetal hydronephrosis needs close follow-up during both ante-natal and postnatal periods. In this study, the most common cause for hydronephrosis were UPJO and VUR. Also seen in this study is the noteworthy point that mild fetal hydronephrosis is relatively benign and does not require surgical intervention in most cases and surgery should be performed only if there is renal function compromise. Prenatal consultation with a pediatric nephrologist and urologist is useful in decreasing parental anxiety and facilitating postnatal management.

  1. Can readmission after stroke be prevented? Results of a randomized clinical study: a postdischarge follow-up service for stroke survivors

    DEFF Research Database (Denmark)

    Andersen, H E; Schultz-Larsen, K; Kreiner, S;

    2000-01-01

    BACKGROUND AND PURPOSE: About 50% of stroke survivors are discharged to their homes with lasting disability. Knowledge, however, of the importance of follow-up services that targets these patients is sparse. The purpose of the present study was to evaluate 2 models of follow-up intervention after...... discharge. The study hypothesis was that intervention could reduce readmission rates and institutionalization and prevent functional decline. We report the results regarding readmission. METHODS: This randomized study included 155 stroke patients with persistent impairment and disability who, after the...... physiotherapist in their home (INT2-PI), and 48 received standard aftercare only (controls). Baseline characteristics for the 3 groups were comparable. Six months after discharge, data were obtained on readmission and institutionalization. RESULTS: The readmission rates within 6 months after discharge were...

  2. Clinical outcome study and radiological findings of Zweymuller metal on metal total hip arthroplasty. a follow-up of 6 to 15 years.

    Science.gov (United States)

    Paleochorlidis, Ilias S; Badras, Leonidas S; Skretas, Efstathios F; Georgaklis, Vasilios A; Karachalios, Theofilos S; Malizos, Konstantinos N

    2009-01-01

    We report the clinical and radiological outcome of 99 Zweymuller metal on metal total hip arthroplasties in 84 patients followed up prospectively for a mean period of 9.5 (range, 6-15) years. There were 29 (34.5%) male and 55 (65.5%) female patients with a mean age of 62.85 years (range, 50-70 years) at the time of surgery. All patients had osteoarthritis. One acetabular component and one stem were revised due to aseptic loosening. One femoral stem was revised due to a periprosthetic fracture. HHS score improved from a preoperative mean of 62.56 points (SD 8.87) to a final postoperative follow-up mean of 93.48 (SD 7.7). Cumulative success rate for both implants at 13 years, with aseptic loosening as the end point, was 97.05%, while for both implants at 13 years, with revision for any reason as the end point, it was 91.17%. Satisfactory results were observed with the use of this prosthesis. PMID:20041375

  3. Final results of a long-term, clinical follow-up in fatty liver patients

    DEFF Research Database (Denmark)

    Dam-Larsen, Sanne; Becker, Ulrik; Franzmann, Maria-Benedicte; Larsen, Klaus; Christoffersen, Per; Bendtsen, Flemming

    2009-01-01

    OBJECTIVE: There is increasing focus on non-alcoholic fatty liver disease (NAFLD). The aim of the present study was to conduct a long-term clinical follow-up of patients with biopsy-confirmed fatty liver without inflammation or significant fibrosis (pure fatty liver), to analyse for potential risk...... death. Patients with AFLD died primarily from cirrhosis and other alcohol-related disorders, whereas in patients with NAFLD the main causes of death were cardiovascular disease and cancer. CONCLUSIONS: For patients with pure non-alcoholic fatty liver, survival was good and independent of the....... All admissions, discharge diagnoses and causes of death during follow-up were collected. All surviving patients were invited to a clinical follow-up. RESULTS: The follow-up period was 20.4 and 21.0 years, respectively, for the NAFLD and alcoholic fatty liver disease (AFLD) groups. Two NAFLD patients...

  4. A Sensitivity Analysis of Pathfinder: A Follow-up Study

    OpenAIRE

    Ng, Keung-Chi; Abramson, Bruce

    2013-01-01

    At last year?s Uncertainty in AI Conference, we reported the results of a sensitivity analysis study of Pathfinder. Our findings were quite unexpected-slight variations to Pathfinder?s parameters appeared to lead to substantial degradations in system performance. A careful look at our first analysis, together with the valuable feedback provided by the participants of last year?s conference, led us to conduct a follow-up study. Our follow-up differs from our initial study in two ways: (i) the ...

  5. Intracranial idiopathic hypertension: 1-year follow-up study.

    Science.gov (United States)

    D'Amico, D; Curone, M; Erbetta, A; Farago', G; Bianchi-Marzoli, S; Ciasca, P; Bussone, G; Chiapparini, L

    2014-05-01

    Standard guidelines for ongoing management, as well as definitive data about the long-term course of idiopathic intracranial hypertension (IIH) are not available. The aim of this study was to compare several clinical and instrumental variables as assessed at the time of diagnosis and then after 1 year in a sample of IIH patients. A total of 21 patients were studied. Our results confirmed that headache and TVO are the most frequent symptoms in IIH patients, and that overweight is a very common feature. A trend towards a favorable outcome in patients followed for 1 year and treated by usual medical therapy was found: intracranial pressure was lower at follow-up; improvement of headache and transient visual obscurations, as well as of papilledema, was reported in most patients. On the other hand, neuroradiological findings (such as empty sella, perioptic subarachnoid space distension, narrowing of the transverse sinuses) were substantially stable at follow. These findings may be relevant for future research as far as understanding the role of different clinical and instrumental findings as diagnostic items as well as predictors of outcome in IIH. PMID:24867861

  6. Urodynamic profile in myelopathies: A follow-up study

    Directory of Open Access Journals (Sweden)

    Gupta Anupam

    2009-01-01

    Full Text Available Aims: To study the significance of filling cystometry in assessment and management of neurogenic bladder in myelopathies and correlate neurological recovery and bladder management in the follow up. Study Design: Retrospective analysis of reports of filling cystometry in patients with traumatic and non-traumatic myelopathy. Setting: Neuro-rehabilitation unit of a tertiary care university hospital. Methods: The study was carried out between September 2005 and June 2006 and included all subjects with myelopathy who underwent filling cystometry. ASIA impairment scale was used to assess neurological status during admission as well as in the follow up. Bladder management was advised based on the cystometric findings. Neurological recovery and mode of bladder management were correlated during the follow up after a minimum of 6 months. Results: Fifty-two subjects (38 males, 14 females, mean age 33.26 ± 14.66 years (10-80 underwent filling cystometry. Twenty patients had cervical, 24 had thoracic and 8 had lumbar myelopathy. Cystometric findings were overactive detrusor observed in 43 patients, (21 had detrusor sphincter dyssynergia (DSD, 22 without DSD and areflexic/underactive detrusor in 9. Post-void residual (>15% of voided urine was significant in 27 patients. Twenty-three patients (44% reported for follow up (16 males, 7 females after a mean duration of 9.04 ± 2.44 months (6-15 months. Neurological recovery was seen in 61% cases, while 1 patient showed deterioration. Only 26% patients reported change in bladder management during follow up. Correlation between neurological recovery and bladder management was found to be insignificant ( P > 0.05 using spearman correlation co-efficient. Conclusions: Filling cystometry is valuable for assessment and management of neurogenic bladder after myelopathy. No significant relationship was observed between neurological recovery and neurogenic bladder management in the follow up in the present study.

  7. Percutaneous vertebroplasty compared to conservative treatment in patients with painful acute or subacute osteoporotic vertebral fractures.Three months follow up in a clinical randomised study

    DEFF Research Database (Denmark)

    Rousing, Rikke

    2008-01-01

    Abstract Study design. Clinical randomised study.    Objective. The aim of this study is to compare PVP to conservative treatment of patients with osteoporotic vertebral fractures in a clinical randomised study with respect to pain, physical and mental outcome, and to asses the risk of adjacent f...

  8. Percutaneous vertebroplasty compared to conservative treatment in patients with painful acute or subacute osteoporotic vertebral fractures: three-months follow-up in a clinical randomized study

    DEFF Research Database (Denmark)

    Rousing, Rikke; Andersen, Mikkel O; Jespersen, Stig M;

    2009-01-01

    STUDY DESIGN: Clinical randomized study. OBJECTIVE: The aim of this study is to compare percutaneous vertebroplasty (PVP) to conservative treatment of patients with osteoporotic vertebral fractures in a clinical randomized study with respect to pain, physical and mental outcome, and to asses the...

  9. Nimh Treatment Study of ADHD Follow-Up

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2004-04-01

    Full Text Available The effects of changes in medication use between 14 and 24 months follow-up on effectiveness (symptom ratings and growth (height and weight measures were analyzed, comparing 4 groups of patients, in the Multimodal Treatment Study of ADHD (MTA reported by the MTA Cooperative Group.

  10. Acquisition of Psychomotor Skills in Dentistry: A Follow-Up Study.

    Science.gov (United States)

    Vann, William F., Jr.; And Others

    1984-01-01

    A long-term follow-up study of an experimental method evaluated the lasting effects of that method using preclinical and clinical grades, as well as an assessment of dental students' clinical technical performance. (Author/MLW)

  11. Multicenter follow-up study of ankle fracture surgery

    Institute of Scientific and Technical Information of China (English)

    XU Hai-lin; WANG Gang; WANG Guang-lin; WU Xin-bao; LIU Li-min; LI Xuan; ZHANG Dian-ying; FU Zhong-guo; WANG Tian-bing; ZHANG Pei-xun; JIANG Bao-guo; SHEN Hui-liang

    2012-01-01

    Background Few data on ankle fractures in China from large multicenter epidemiological and clinical studies are available.The aim of this research was to evaluate the epidemiological features and surgical outcomes of ankle fractures by reviewing 235 patients who underwent ankle fracture surgery at five hospitals in China.Methods This study included patients who underwent ankle fracture surgery at five Chinese hospitals from January 2000 to July 2009.Age,gender,mechanism of injury,Arbeitsgemeinschaft für Osteosynthesefragen (AO) fracture type,fracture pattern,length of hospital stay and treatment outcome were recorded.Statistical analyses were conducted using SPSS software.The American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale,visual analogue scale (VAS),and arthritis scale were used to evaluate outcome.Results Of 235 patients with ankle fractures,105 were male with an average age of 37.8 years and 130 were female with an average age of 47.3 years.The average follow-up period was 55.7 months.There were significant differences in the ratios of patients in different age groups between males and females,and in mechanisms of injury among different age groups.There were also significant differences in the length of hospital stay among different fracture types and mechanisms of injury.In healed fractures,the average AOFAS ankle-hindfoot score was 95.5,with an excellence rate of 99.6%,the average VAS score was 0.17,and the average arthritis score was 0.18.Movement of the injured ankle was significantly different to that of the uninjured ankle.There were no significant differences between AO fracture types,fracture patterns or follow-up periods and AOFAS score,but there were some significant differences between these parameters and ankle joint movements,pain VAS score and arthritis score.Conclusions Ankle fractures occur most commonly in middle-aged and young males aged 20-39 years and in elderly females aged 50-69 years.The most common mechanisms of

  12. A Comparative Study of Nurses as Case Manager and Telephone Follow-up on Clinical Outcomes of Patients with Severe Mental Illness

    OpenAIRE

    Malakouti, Seyed Kazem; Nojomi, Marzieh; MIRABZADEH, Arash; Mottaghipour, Yasaman; Zahiroddin, Alireza; Kangrani, Hamed Mohammadi

    2016-01-01

    Background: Providing community-based mental health services is crucial and is an agreed plan between the Iranian Mental Health Office and the Regional Committee for the Eastern Mediterranean (affiliated with WHO). The aim of this study was to determine the effectiveness of home-visit clinical case-management services on the hospitalization rate and other clinical outcomes in patients with severe mental illness. Methods: A total of 182 patients were randomly allocated into three groups, namel...

  13. The Doctorate in Education. Volume IV, Follow-UP Study.

    Science.gov (United States)

    Ludlow, H. Glenn; And Others

    A study was conducted (follow-up to SP 004 600) of the 1,186 recipients of the Ed.D. and Ph.D. degrees in education in the United States in 1958. Questionnaire data was collected to investigate 5-year career development and job satisfaction plus ability and achievement (as measured by high school graduating class rank, intelligence test scores,…

  14. Radiographic follow-up study of Little Leaguer's shoulder

    International Nuclear Information System (INIS)

    Little Leaguer's shoulder is a syndrome involving the proximal humeral epiphyseal plate. Conservative treatment usually resolves the symptoms. However, there are no reports of a radiographic follow-up study of this disease. The purpose of this study was to show the radiographic healing process of Little Leaguer's shoulder. A total of 19 male baseball players diagnosed as having Little Leaguer's shoulder were retrospectively evaluated. The mean age at first presentation was 12.7 years. External rotation anteroposterior radiographs of the shoulder were taken. All patients were treated with rest from throwing, and no throwing was recommended until remodeling was confirmed. Follow-up radiographs were taken at 1-month intervals to assess healing. All patients were observed until healing was confirmed radiographically, after which they returned to baseball. The mean follow-up period was 8.5 months. In addition to radiography, patients were asked whether they had any symptoms and whether they had been able to return to baseball. At the first examination, radiographs showed a wider epiphyseal plate of the throwing side compared with the asymptomatic contralateral shoulder. Healing was observed in all cases. Healing occurred first along the medial side and was then extended laterally. The mean time required for healing was 4.7 months. All patients were able to return to playing baseball at their pre-injury level of play and were asymptomatic when examined at the final follow-up. The healing process of Little Leaguer's shoulder advanced from medial to lateral, and healing was achieved about 5 months after initial examination. (orig.)

  15. A comparative clinical study of the efficacy of subepithelial connective tissue graft and acellular dermal matrix graft in root coverage: 6-month follow-up observation

    Directory of Open Access Journals (Sweden)

    Libby John Thomas

    2013-01-01

    Full Text Available Aims: The purpose of this study was to compare the clinical efficacy of subepithelial connective tissue graft and acellular dermal matrix graft associated with coronally repositioned flap in the treatment of Miller′s class I and II gingival recession, 6 months postoperatively. Settings and Design: Ten patients with bilateral Miller′s class I or class II gingival recession were randomly divided into two groups using a split-mouth study design. Materials and Methods: Group I (10 sites was treated with subepithelial connective tissue graft along with coronally repositioned flap and Group II (10 sites treated with acellular dermal matrix graft along with coronally repositioned flap. Clinical parameters like recession height and width, probing pocket depth, clinical attachment level, and width of keratinized gingiva were evaluated at baseline, 90 th day, and 180 th day for both groups. The percentage of root coverage was calculated based on the comparison of the recession height from 0 to 180 th day in both Groups I and II. Statistical Analysis Used: Intragroup parameters at different time points were measured using the Wilcoxon signed rank test and Mann-Whitney U test was employed to analyze the differences between test and control groups. Results: There was no statistically significant difference in recession height and width, gain in CAL, and increase in the width of keratinized gingiva between the two groups on the 180 th day. Both procedures showed clinically and statistically significant root coverage (Group I 96%, Group II 89.1% on the 180 th day. Conclusions: The results indicate that coverage of denuded root with both subepithelial connective tissue autograft and acellular dermal matrix allograft are very predictable procedures, which were stable for 6 months postoperatively.

  16. Education On Prehospital Pain Management: A Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Scott C. French

    2013-03-01

    Full Text Available Introduction: The most common reason patients seek medical attention is pain. However,there may be significant delays in initiating prehospital pain therapy. In a 2001 qualityimprovement (QI study, we demonstrated improvement in paramedic knowledge,perceptions, and management of pain. This follow-up study examines the impact of thisQI program, repeated educational intervention (EI, and effectiveness of a new painmanagement standard operating procedure.Methods: 176 paramedics from 10 urban and suburban fire departments and two privateambulance services participated in a 3-hour EI. A survey was performed prior to the EI andrepeated one month after the EI. We reviewed emergency medical services (EMS runs withpain complaints prior to the EI and one month after the EI. Follow-up results were comparedto our prior study. We performed data analysis using descriptive statistics and chi-square tests.Results: The authors reviewed 352 surveys and 438 EMS runs with pain complaints. Usingthe same survey questions, even before the EI, 2007 paramedics demonstrated significantimprovement in the knowledge (18.2%; 95% CI 8.9%, 27.9%, perceptions (9.2%; 95% CI6.5%, 11.9%, and management of pain (13.8%; 95% CI 11.3%, 16.2% compared to 2001.Following EI in 2007, there were no significant improvements in the baseline knowledge (0%;95% CI 5.3%, 5.3% but significant improvements in the perceptions of pain principles (6.4%;95% CI 3.9%, 9.0% and the management of pain (14.7%; 95% CI 11.4%, 18.0%.Conclusion: In this follow up study, paramedics’ baseline knowledge, perceptions, andmanagement of pain have all improved from 6 years ago. Following a repeat educationalintervention, paramedics further improved their field management of pain suggestingparamedics will still benefit from both initial and also ongoing continuing education on thetopic of pain management.

  17. Clinical symptoms and performance on the continuous performance test in children with attention deficit hyperactivity disorder between subtypes: a natural follow-up study for 6 months

    Directory of Open Access Journals (Sweden)

    Chiang Yuan-Lin

    2011-04-01

    Full Text Available Abstract Background The aims of this study were to determine the time course of improvements in attention deficit hyperactivity disorder (ADHD clinical symptoms and neurocognitive function in a realistic clinical setting, and the differences in ADHD symptom improvement using different classifications of ADHD subtypes. Methods The Child Behavior Checklist (CBCL was completed by parents of ADHD children at the initial visit. The computerized Continuous Performance Test (CPT, Swanson, Nolan, and Pelham, and Version IV Scale for ADHD (SNAP-IV, and ADHD Rating Scale (ADHD-RS were performed at baseline, one month, three months, and six months later, respectively. Patient care including drug therapy was performed at the discretion of the psychiatrist. The ADHD patients were divided into DSM-IV subtypes (Inattentive, Hyperactive-impulsive and Combined type, and were additionally categorized into aggressive and non-aggressive subtypes by aggression scale in CBCL for comparisons. Results There were 50 ADHD patients with a mean age of 7.84 ± 1.64 years; 15 of them were inattentive type, 11 were hyperactive-impulsive type, and 24 were combined type. In addition, 28 of the ADHD patients were grouped into aggressive and 22 into non-aggressive subtypes. There were significant improvements in clinical symptoms of hyperactivity and inattention, and impulsivity performance in CPT during the 6-month treatment. The clinical hyperactive symptoms were significantly different between ADHD patients sub-grouping both by DSM-IV and aggression. Non-aggressive patients had significantly greater changes in distraction and impulsivity performances in CPT from baseline to month 6 than aggressive patients. Conclusions We found that ADHD symptoms, which included impulsive performances in CPT and clinical inattention and hyperactivity dimensions, had improved significantly over 6 months under pragmatic treatments. The non-aggressive ADHD patients might have a higher potential

  18. Clinical impact of different detection methods for disseminated tumor cells in bone marrow of patients undergoing surgical resection of colorectal liver metastases: a prospective follow-up study

    International Nuclear Information System (INIS)

    Large number of patients with colorectal liver metastasis show recurrent disease after curative surgical resection. Identification of these high-risk patients may guide therapeutic strategies. The aim of this study was to evaluate whether the presence of disseminated tumor cells in bone marrow from patients undergoing surgical resection of colorectal liver metastases can predict clinical outcome. Sixty patients with colorectal liver metastases were planned for a curative resection between 2001 and 2007. All patients underwent bone marrow aspiration before surgery. Detection of tumor cells was performed using immunocytochemical staining for cytokeratin (CK-ICC) combined with automated microscopy or indirectly using reverse transcription-polymerase chain reaction (RT-PCR). Disseminated tumor cells were found in 15 of the 46 patients (33%) using CK-ICC and in 9 of 44 of the patients (20%) using RT-PCR. Patients with negative results for RT-PCR had a significant better disease-free survival after resection of their liver metastases (p = 0.02). This group also showed significant better overall survival (p = 0.002). CK-ICC did not predict a worse clinical outcome. The presence of disseminated tumor cells in bone marrow detected using RT-PCR did predict a worse clinical outcome. The presence of cells detected with CK-ICC did not correlate with poor prognosis

  19. The clinical utility of serum anti-Müllerian hormone in the follow-up of ovarian adult-type granulosa cell tumors--A comparative study with inhibin B.

    Science.gov (United States)

    Färkkilä, Anniina; Koskela, Sanna; Bryk, Saara; Alfthan, Henrik; Bützow, Ralf; Leminen, Arto; Puistola, Ulla; Tapanainen, Juha S; Heikinheimo, Markku; Anttonen, Mikko; Unkila-Kallio, Leila

    2015-10-01

    Ovarian adult-type granulosa cell tumors (AGCTs) require prolonged follow-up, but evidence regarding the optimal follow-up marker is lacking. The objective of our study was to validate the clinical usefulness of serum anti-Müllerian hormone (AMH) and the current marker inhibin B as single and combined markers of AGCTs. We conducted a longitudinal, partially prospective cohort study of 123 premenopausal and postmenopausal AGCT patients with a median follow-up time of 10.5 years (range 0.3-50.0 years). Serum AMH and inhibin B levels were measured from 560 pretreatment and follow-up serum samples by using immunoenzymometric assays. We found that serum AMH and inhibin B levels were significantly elevated in patients with primary or recurrent AGCTs. The levels of both markers positively correlated to tumor size (p < 0.05). AMH and inhibin B performed similarly in receiving operator characteristic analyses; area under the curve (AUC) values were 0.92 [95% confidence interval (CI) 0.88-0.95] for AMH, and 0.94 (95% CI 0.90-0.96) for inhibin B. AMH was highly sensitive (92%) and specific (81%) in detecting a macroscopic AGCT. However, in AUC comparison analyses, the combination of the markers was superior to inhibin B alone. In conclusion, serum AMH is a sensitive and specific marker of AGCT, and either AMH or inhibin B can be monitored during follow-up. However, combining AMH and inhibin B in AGCT patient follow-up improves the detection of recurrent disease. PMID:25808251

  20. Satisfaction with primary care and mental health care among individuals with severe mental illness in a rural area: a seven-year follow-up study of a clinical cohort

    OpenAIRE

    Ruud, Torleif; Aarre, Trond F.; Boeskov, Berit; le Husevåg, Per Stå; Klepp, Rigmor; Kristiansen, Synnøve Alet; Sandvik, Jorunn

    2016-01-01

    Background Most studies of services for people with severe mental illness have been performed in cities. Our 7-year follow-up study aimed to investigate clinical course and satisfaction with services among individuals with severe mental illness who received community mental health services in a rural area. The services were provided by primary care and a community mental health center (CMHC), which worked in close collaboration and emphasized individually tailored case management, relationshi...

  1. Clinical, radiological and functional follow-up after surgical decompression of double aortic arch

    Energy Technology Data Exchange (ETDEWEB)

    Berge, Maartje ten; Laag, Johan van der; Ent, Cornelis K. van der [Department of Respiratory Diseases, Wilhelmina Children' s Hospital, Utrecht (Netherlands); Beek, Frederik J.A. [Department of Radiology, Wilhelmina Children' s Hospital, Lundlaan 6, 3584 EA Utrecht (Netherlands)

    2002-08-01

    Heading AbstractBackground. Double aortic arch (DAA) is a congenital vascular anomaly that causes tracheal and oesophageal compression. It requires surgical intervention in patients with severe symptoms.Objective. To evaluate the clinical, radiological and functional follow-up after surgical relief of the compression.Materials and methods. Ten children (seven boys) with DAA were operated on at a mean age of 1.3 years (range 0.2-7.5). At a mean age of 10.1 years (range 5-18 years), a follow-up study was performed that included clinical, radiological and functional parameters.Results. Seven children reported only mild respiratory symptoms and some trouble with swallowing. Preoperative fluoroscopy with spot images showed the mean tracheal diameter at the level of stenosis to be 37{+-}23% of the maximal diameter. At the time of follow-up, this was 70{+-}13%. The mean of the oesophageal diameter was 39{+-}20% preoperatively and 47{+-}16% postoperatively. Maximal expiratory flow volume (MEFV) curves of seven children showed typical characteristics of intrathoracic upper airway obstruction. Mean peak expiratory flow was significantly reduced (77{+-}10% of predicted, P<0.0001). Bronchial hyper-reactivity, tested by methacholine challenge, was found in two patients.Conclusions. There was marked relief of clinical symptoms after surgical decompression of DAA in all patients. In spite of this, radiological narrowing of trachea and oesophagus persisted and lung function results were abnormal at long-term follow-up. (orig.)

  2. Clinical, radiological and functional follow-up after surgical decompression of double aortic arch

    International Nuclear Information System (INIS)

    Heading AbstractBackground. Double aortic arch (DAA) is a congenital vascular anomaly that causes tracheal and oesophageal compression. It requires surgical intervention in patients with severe symptoms.Objective. To evaluate the clinical, radiological and functional follow-up after surgical relief of the compression.Materials and methods. Ten children (seven boys) with DAA were operated on at a mean age of 1.3 years (range 0.2-7.5). At a mean age of 10.1 years (range 5-18 years), a follow-up study was performed that included clinical, radiological and functional parameters.Results. Seven children reported only mild respiratory symptoms and some trouble with swallowing. Preoperative fluoroscopy with spot images showed the mean tracheal diameter at the level of stenosis to be 37±23% of the maximal diameter. At the time of follow-up, this was 70±13%. The mean of the oesophageal diameter was 39±20% preoperatively and 47±16% postoperatively. Maximal expiratory flow volume (MEFV) curves of seven children showed typical characteristics of intrathoracic upper airway obstruction. Mean peak expiratory flow was significantly reduced (77±10% of predicted, P<0.0001). Bronchial hyper-reactivity, tested by methacholine challenge, was found in two patients.Conclusions. There was marked relief of clinical symptoms after surgical decompression of DAA in all patients. In spite of this, radiological narrowing of trachea and oesophagus persisted and lung function results were abnormal at long-term follow-up. (orig.)

  3. Follow up study of Alzheimer's type dementia with computed tomography

    International Nuclear Information System (INIS)

    In 54 patients who were diagnosed as having Alzheimer's type dementia based on the Diagnostic and Statistical Manual of Mental Disorders, III, cranial computed tomography (CT) scans were obtained before and after their follow-up study ranging from 6 to 24 months (mean 15.4 +- 4.7 months). Cerebrospinal percentage and CT density in various regions of interest were examined. Six patients died during the study. Comparison of the group of the deceased (Group I) with the group of survivors (Group II) revealed: (1) there was no difference in average age and the degree of mental disorder at first presentation; (2) Group I had decreased activities of daily living; and (3) CT density was significantly decreased in the bilateral lateral and frontal lobes in Group I. As for Group II, decreased CT numbers were noticeable during the follow-up period in the frontal lobe, parietal lobe, and caudate nucleus in the group evaluated as aggravated, as compared with the group evaluated as unchanged. (Namekawa, K.)

  4. Clinical effectiveness of pneumococcal vaccination against acute myocardial infarction and stroke in people over 60 years: the CAPAMIS study, one-year follow-up

    Directory of Open Access Journals (Sweden)

    Vila-Corcoles Angel

    2012-03-01

    Full Text Available Abstract Background Conflicting results have been recently reported evaluating the relationship between pneumococcal vaccination and the risk of thrombotic vascular events. This study assessed the clinical effectiveness of the 23-valent polysaccharide pneumococcal vaccine (PPV23 against acute myocardial infarction and ischaemic stroke in older adults. Methods Population-based prospective cohort study conducted from December 1, 2008 until November 30, 2009, including all individuals ≥ 60 years-old assigned to nine Primary Care Centres in Tarragona, Spain (N = 27,204 individuals. Primary outcomes were hospitalisation for acute myocardial infarction and/or ischaemic stroke. All cases were validated by checking clinical records. The association between pneumococcal vaccination and the risk of each outcome was evaluated by Multivariable Cox proportional-hazard models (adjusted by age, sex, influenza vaccine status, presence of comorbidities and cardiovascular risk factors. Results Cohort members were followed for a total of 26,444 person-years, of which 34% were for vaccinated subjects. Overall incidence rates (per 1000 person-years were 4.9 for myocardial infarction and 4.6 for ischaemic stroke. In the multivariable analysis, vaccination was associated with a marginally significant 35% lower risk of stroke (hazard ratio [HR]: 0.65; 95% confidence interval [CI]: 0.42-0.99; p = 0.046. We found no evidence for an association between pneumococcal vaccination and reduced risk of myocardial infarction (HR: 0.83; 95% CI: 0.56-1.22; p = 0.347. Conclusions Our data supports a benefit of PPV23 against ischaemic stroke among the general population over 60 years, suggesting a possible protective role of pneumococcal vaccination against some acute thrombotic events.

  5. Silicon Matrix Calcium Phosphate as a Bone Substitute: Early Clinical and Radiological Results in a Prospective Study With 12-Month Follow-up

    OpenAIRE

    Pimenta, Luiz; Pesántez, Carlos Fernando Arias; Oliveira, Leonardo

    2008-01-01

    Introduction Autograft has been the “gold standard” for orthopedic bone grafting applications, but with some clinical challenges. Here we present the rationale and clinical outcomes supporting the use of a bone substitute material that consists of a mixture of two calcium phosphates (HA and ß-TCP), which are integrated into a silicon xerogel matrix, promoting nanocrystalline apatite layers on the surface of the material following implantation into a physiological environment. Methods Twenty-f...

  6. Parotid gland-recovery after radiotherapy in the head and neck region - 36 months follow-up of a prospective clinical study

    International Nuclear Information System (INIS)

    The aim of the present study was to evaluate the recovery potential of the parotid glands after using either 3D-conformal-radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) by sparing one single parotid gland. Between 06/2002 and 10/2008, 117 patients with head and neck cancer were included in this prospective, non-randomised clinical study. All patients were treated with curative intent. Salivary gland function was assessed by measuring stimulated salivary flow at the beginning, during and at the end of radiotherapy as well as 1, 6, 12, 24, and 36 months after treatment. Measurements were converted to flow rates and normalized relative to rates before treatment. Mean doses (Dmean) were calculated from dose-volume histograms based on computed tomographies of the parotid glands. Patients were grouped according to the Dmean of the spared parotid gland having the lowest radiation exposure: Group I - Dmean < 26 Gy (n = 36), group II - Dmean 26-40 Gy (n = 45), and group III - Dmean > 40 Gy (n = 36). 15/117 (13%) patients received IMRT. By using IMRT as compared to 3D-CRT the Dmean of the spared parotid gland could be significantly reduced (Dmean IMRT vs. 3D-CRT: 21.7 vs. 34.4 Gy, p < 0.001). The relative salivary flow rates (RFSR) as a function of the mean parotid dose after 24 and 36 months was in group I 66% and 74%, in group II 56% and 49%, and in group III 31% and 24%, respectively. Multiple linear regression analyses revealed that the parotid gland dose and the tumor site were the independent determinants 12 and 36 months after the end of RT. Patients of group I and II parotid gland function did recover at 12, 24, and 36 months after the end of RT. If a Dmean < 26 Gy for at least one parotid gland can be achieved then this is sufficient to reach complete recovery of pre-RT salivary flow rates. The radiation volume which depends on tumor site did significantly impact on the Dmean of the parotids, and thus on the saliva flow and recovery of parotid

  7. Clinical characteristics and consequences of hand eczema - an 8-year follow-up study of a population-based twin cohort

    DEFF Research Database (Denmark)

    Lerbaek, Anne; Kyvik, Kirsten Ohm; Ravn, Henrik;

    2008-01-01

    affected. Mean hand eczema severity index score in individuals with clinical symptoms was 12.0. Sick leave was reported by 12.4%; job change by 8.5%. Being in the lowest socio-economic group and atopic dermatitis were risk factors for sick leave [odds ratio (OR) = 5.6; 95% confidence interval (95% CI) 1...

  8. CT Follow-Up and Clinical Outcome in Severe Traumatic Injury Patients

    OpenAIRE

    Belina, Stanko; Kovačić, Sanja

    2011-01-01

    Determining a patient’s prognosis after severe traumatic brain injury remains difficult and complex. The purpose of the present study was following up patients with severe traumatic brain injury by correlating their clinical outcome and sequential computer tomography (CT) findings. We investigated 51 patients who survived the first year following an accident. All patients underwent successive CT examinations within a maximum period of 2 years. The patients’ outcomes depended on th...

  9. The West Point Study: 40 years of follow-up.

    Science.gov (United States)

    Clark, D A; Tolan, G D; Johnson, R; Hickman, J R; Jackson, W G; McGranahan, G M

    1994-05-01

    Completion of cardiovascular evaluations of 387 members marked the end of 40 years of follow-up in the West Point Study. Coronary artery disease (CAD) caused 4 cases of sudden death, 14 cases of myocardial infarction (MI), 13 cases of angina, and 17 cases of silent CAD. Using risk factors (serum cholesterol, estimated HDL-cholesterol, systolic blood pressure, and smoking status) measured before age 28, we derived a multivariate regression formula for predicting which members of the study, had they been pilots, would have been grounded for CAD before age 55. This derivation used data from only those subjects with CAD or with no evidence of CAD. We then used the formula to compute a risk-related score for each member of the study. In the tertile group with the highest risk-related scores, 17% manifested CAD by age 55 and the first event occurred at age 39. In the tertile group of lowest scores, 2% experienced CAD by age 55 and the first event occurred at age 51. We conclude that it is possible to select pilot candidates with the lowest risk for CAD. PMID:8018084

  10. Sleep complaints in adolescent depression: one year naturalistic follow-up study

    OpenAIRE

    Urrila, Anna S; Karlsson, Linnea; Kiviruusu, Olli; Pankakoski, Maiju; Pelkonen, Mirjami; Strandholm, Thea; Marttunen, Mauri; ,

    2014-01-01

    Background Sleep complaints are highly prevalent in adolescents suffering from major depressive disorder (MDD). The aims of this study were to describe the longitudinal course of sleep complaints, and to assess the association between sleep complaints and clinical outcome in a sample of adolescents with MDD during naturalistic follow-up. Methods A sample of adolescent outpatients (n = 166; age 13–19 years, 17.5% boys) diagnosed with MDD was followed-up during one year in naturalistic settings...

  11. Survival, clinical and radiological outcome of the Zweymuller SL/Bicon-Plus total hip arthroplasty : a 15-year follow-up study

    NARCIS (Netherlands)

    Ottink, Karsten; Barnaart, Lex; Westerbeek, Robin; van Kampen, Karin; Bulstra, Sjoerd; van Jonbergen, Hans-Peter

    2015-01-01

    Aim: The primary aim of this study is to analyse the long-term results of the third generation of the " Zweymuller" total hip arthroplasty (THA) comprising the SL-Plus Stem and the Bicon-Plus cup. Methods: We evaluated 208 patients with a SL/Bicon-Plus primary THA (218 hips). Survival analysis was p

  12. Proinsulin and Insulin Sensitivity as Predictors of Type 2 Diabetes Mellitus and Coronary Heart Disease : Clinical Epidemiological Studies with up to 27 Years of Follow-Up

    OpenAIRE

    Zethelius, Björn

    2002-01-01

    Defects in insulin secretion and insulin action are the major abnormalities in the development of Type 2 diabetes. Hyperinsulinemia is a risk marker for Type 2 diabetes and according to some, but not in all studies also for coronary heart disease (CHD). Conventional insulin assays measure immunoreactive insulin including proinsulin-like molecules. Proinsulin and insulin measured by specific methods, insulin sensitivity measured by the euglycemic insulin clamp and early insulin response after...

  13. Infantile eczema: A long-term follow-up study.

    Science.gov (United States)

    Musgrove, K; Morgan, J K

    1976-10-01

    A 15-17 year follow-up study was conducted on ninety-nine patients who had suffered from infantile eczema. The persistance of the eczema and the occurrence of related conditions were noted. The persistence of eczema was shown to be greater in those patients with a positive family history of eczema and in those who had developed asthma or hay-fever. An attempt was made to see if the persistence of eczema was affected by the position of the child in the family, and some factors provoking relapses were noted. The patients were also questioned with regard to their achievements in academic examinations, and to their social, artistic and sporting activities. The results showed a success rate in examinations not significantly higher than average. It was not possible to show if there is a particular type of atopic personality. There was no constant characteristic in social or artistic patterns. The group as a whole were normal at the milestones of early development, i.e. walking, talking and reading, and also normal with regard to weight and height. PMID:974022

  14. Acute/subacute cerebral infarction (ASCI in HIV-negative adults with cryptococcal meningoencephalitis (CM: a MRI-based follow-up study and a clinical comparison to HIV-negative CM adults without ASCI

    Directory of Open Access Journals (Sweden)

    Chang Chiung-Chih

    2011-01-01

    Full Text Available Abstract Background Acute/subacute cerebral infarction (ASCI in HIV-negative cryptococcal meningoencephalitis (CM adults has rarely been examined by a series of MRI-based follow-up study. We studied a series of MRI follow-up study of CM adults and compared the clinical characters of those with ASCI and those without ASCI. Methods The clinical characteristics and a series of brain MRI findings of seven CM adults with ASCI were enrolled for analysis. The clinical characteristics of another 30 HIV-negative CM adults who did not have ASCI were also included for a comparative analysis. Results The seven HIV-negative CM adults with ASCI were four men and three women, aged 46-78 years. Lacunar infarction was the type of ASCI, and 86% (6/7 of the ACSI were multiple infarctions distributed in both the anterior and posterior cerebrovascular territories. The seven CM patients with ASCI were significantly older and had a higher rate of DM and previous stroke than the other 30 CM adults without ASCI. They also had a higher incidence of consciousness disturbance at presentation and had a poor prognosis. Conclusion ASCI was found in 18.9% (7/37 of HIV-negative CM adults. Serial MRI follow-up studies may allow a better delineation of ASCI in this specific group of infectious disease and multiple lacunar infarctions was the most common type. Older in age and presence of DM and previous stroke were the significant underlying conditions. CM patients with ASCI also had a poor therapeutic outcome.

  15. Long-term clinical evaluation of endodontically treated teeth by 15 F CO2 laser microprobe: three years clinical follow-up of 1512 root canals--in-vivo study

    Science.gov (United States)

    Kesler, Gavriel; Koren, Rumelia; Kesler, Anat; Hay, Nissim; Gal, Rivka

    1999-05-01

    The purpose of this study was to determine the efficiency of 15 F CO2 laser microprobe, in cases of periapical lesions, by eliminating the pathological reaction caused by certain species of bacteria, reduction of reinfection and stimulation of osteogenesis in the periapical region. Until now, no suitable delivery fiber existed for CO2 laser endodontic radiation in the apical region where it is most difficult to eliminate the pulp tissue using conventional methods. To overcome this problem, Sharplan laser designed a microprobe that reaches closer to the apex, distributing the energy density to a smaller area of the root canal, thus favorably increasing the thermal effects. The study was conducted on 900 teeth, divided in two groups. 468 were new case, carefully selected according to strict parameters such as: wide periapical translucency over 1mm, supported by digital x-ray, with a lesion of 3mm and more. All root canals were mechanically prepared in the conventional method up to size 35, Physiological saline solution served as finding solution and were treated by 15 F CO2 laser microprobe for 60 pulses repeatedly. The temperature at the surrounding tissue of the root did not exceed 38 degrees C filling of the canal was possible at the same appointment, without antibiotical treatment. 432 of the cases, which were referred to us by other dentists, after an unsuccessful treatment according to the classical therapy, were treated by the same laser therapy. Follow up was performed by clinical examination, and digital x-ray taken, during and after treatment as well as after 3, 6, 9, 12 month. The result demonstrate 98% success rate in both study groups, according to objective criteria for a successful treatment such as: reduction of apical translucency after 2- 6 months, freedom form clinical complains, and no need for periapical surgery.

  16. Long-time follow-up study of localized gastric mucosa-associated lymphoid tissue (MALT) lymphoma and the clinical features of antibiotic-resistant cases of gastric MALT lymphoma

    International Nuclear Information System (INIS)

    To clarify the clinical features of gastric mucosa-associated lymphoid tissue (MALT) lymphoma (GML) with persistent lymphoma after eradication therapy of Helicobacter pylori (H. pylori), and the outcome of long-time follow-up study after treatment against GML, seventy-six patients with localized GML were studied. The median follow-up period was 44.4 months. Thirty-eight of 49 patients (77.6%) with H. pylori-positive GML had been cured of GML by antibiotic therapy alone. On the other hand, none of 13 patients with H. pylori-negative GML had been cured by antibiotic therapy (77.6% vs 0%, p<0.001). ''H. pylori-negative'' is one of the clinical features of antibiotic-resistant cases with GML. There was no significant difference in sex, age, stage, endoscopic finding, depth, and affected region between the two groups of cured and persistent GML with H. pylori infection. Twenty-two of 29 patients (75.6%) with antibiotic-resistant or H. pylori-negative cases of GML had been cured by 30 Gy radiation therapy. Low-dose radiation was thought to be a useful therapeutic procedure as a second line treatment'' of localized GML. (author)

  17. Extended heart failure clinic follow-up in low-risk patients

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Videbaek, Lars; Tuxen, Chr; Keller, Niels; Handberg, Jens; Sejr Knudsen, Anne; Espersen, Geert Tschentscher; Markenvard, John; Egstrup, Kenneth; Ulriksen, Hans; Hildebrandt, Per R.; Korup, Eva; Broberg, Helle; Nielsen, Vivi Lindeborg; Pedersen, Mette Storgaard; Pedersen, Henriette P.; Dam, Anette; Christensen, Tove; Thude, Lilli; Gohr, Thomas; Madsen, Bodil S.; Nielsen, Hanne-Lis; Rosenberg, Jens; Egstrup, Michael; Jensen, Anna-Marie; Hemmingshøj, Jeanett; Bartholdy, Hanne; Groth, Susanne; Leth, Gitte; Jensen, Marianne; Sejrsen, Holger; Skaarstad, Ellen; Larsen, Ingelise; Jensen, Jannie; Borrild, Anne-Mette; Mogelhoj, Birthe; Claussen, Jimi; Jacobsen, Vibeke; Kaiser-Nielsen, Peter; Woelders, Lone; Viem, Nina; Oechsler, Louise; Knoefler, Inge-Lise; Karlsson, Kristina; Egeberg, Helle; Pedersen, Mette R.; Milton, Janne; Anker, Charlotte; Thomassen, Camilla; Koertz, Karin; Petersen, Jane; Hebsgaard, Else; Beksbo, Marianne; Frederiksen, Lene; Skoffer, Hanne; Jespersen, Camilla; Lynggaard, Jette; Brun, Karen-Birgit; Vigstrup, Lone; Kjaer-Andersen, Mogens; Godfredsen, Lone; Fauerskov, Inge; Bidstrup, Pia; Hald-Steffensen, Flemming; Zeuthen, Lise; Petersen, Elin; Gohr, Tove; Munch, Inger; Spencer, Vibeke

    2013-01-01

    BackgroundOutpatient follow-up in specialized heart failure clinics (HFCs) is recommended by current guidelines and implemented in most European countries, but the optimal duration of HFC programmes has not been established. Nor is it known whether all or only high-risk patients, e.g. identified by...... NT-proBNP, might benefit from an extended HFC follow-up.Methods and resultsIn a multi-centre setting, we randomly assigned 921 clinically stable systolic heart failure (HF) outpatients on optimal medical therapy to undergo either an extended follow-up in the HFC (n = 461) or referral back to their......-term follow-up in a specialized HFC in a publicly funded universal access healthcare system. Heart failure patients on optimal medical therapy with mild or moderate symptoms are safely managed by their personal GP.Trial Registration: www.Centerwatch.com: 173491 (NorthStar)....

  18. The Preschool Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS) 6-Year Follow-Up

    Science.gov (United States)

    Riddle, Mark A.; Yershova, Kseniya; Lazzaretto, Deborah; Paykina, Natalya; Yenokyan, Gayane; Greenhill, Laurence; Abikoff, Howard; Vitiello, Benedetto; Wigal, Tim; McCracken, James T.; Kollins, Scott H.; Murray, Desiree W.; Wigal, Sharon; Kastelic, Elizabeth; McGough, James J.; dosReis, Susan; Bauzo-Rosario, Audrey; Stehli, Annamarie; Posner, Kelly

    2013-01-01

    Objective: To describe the clinical course of attention-deficit/hyperactivity disorder (ADHD) symptom severity and diagnosis from ages 3 to 5 up to 9 to 12 years during a 6-year follow-up after the original Preschool ADHD Treatment Study (PATS). Method: A total of 207 participants (75% male) from the original PATS, assessed at baseline (mean age,…

  19. Clinical and radiological long-term follow-up after embolization of pulmonary arteriovenous malformations

    DEFF Research Database (Denmark)

    Andersen, Poul Erik; Kjeldsen, Anette D

    2005-01-01

    The purpose was to evaluate the clinical and radiological long-term results of embolization of pulmonary arteriovenous malformations (PAVMs) and to assess the quality of life after treatment. A clinical follow-up was undertaken after 67 months (mean) in 35 consecutive patients with 106 PAVMs...

  20. Clinical and radiological follow-ups on onlays and overlays from student courses

    International Nuclear Information System (INIS)

    45 patients, whose teeth had been given onlays/overlays in student courses, were followed-up. The following values were measured: plaque index, sulcus bleeding index, clinical depth of the sulcus and the clinical findings for D (decayed) according to the DMF index for the maintained surfaces as well as for the control surfaces; beyond this eye tooth contact in lateral protrusion, lack of contact, approximal contact and approximal spatial orientation were evaluated. Bite wing pictures were taken and evaluated for the comprehension of iatrogenic marginal imperfections, for the control of the dentine in the area of the cervical edge of the filling and for the evaluation of the control surfaces. The maintained approximal surfaces were divided according to the degree of marginal imperfection into four imperfection groups. The data which were collected into a study list were evaluated statistically. (TRV)

  1. Patient beliefs about medicines and quality of life after a clinical medication review and follow-up by a pharmaceutical care plan: A study in elderly polypharmacy patients with a cardiovascular disorder

    NARCIS (Netherlands)

    Geurts, Marlies M.E.; Stewart, Roy E.; Brouwers, Jacobus R.B.J.; de Graeff, Pieter A.; de Gier, Johan J.

    2015-01-01

    Objective: To determine the effect of a clinical medication review, followed up by a pharmaceutical care plan, on the beliefs about medicines and quality of life (QoL) of older patients with polypharmacy and a cardiovascular disorder. Methods: Patients were randomly assigned to an intervention or co

  2. Vertebral Augmentation with Nitinol Endoprosthesis: Clinical Experience in 40 Patients with 1-Year Follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Anselmetti, Giovanni Carlo, E-mail: gc.anselmetti@fastwebnet.it [Villa Maria Hospital, Interventional Radiology Unit (Italy); Manca, Antonio, E-mail: anto.manca@gmail.com [Institute for Cancer Research and Treatment (IRCC), Interventional Radiology Unit (Italy); Marcia, Stefano, E-mail: stemarcia@gmail.com [Institute of Radiology, University of Cagliari (Italy); Chiara, Gabriele, E-mail: gabriele.chiara@ircc.it [Institute for Cancer Research and Treatment (IRCC), Interventional Radiology Unit (Italy); Marini, Stefano, E-mail: stemarini@gmail.com [Institute of Radiology, University of Cagliari (Italy); Baroud, Gamal, E-mail: gamalbaroud@gmail.com [University of Sherbrooke, Departement de Genie Mecanique (Canada); Regge, Daniele, E-mail: daniele.regge@ircc.it [Institute for Cancer Research and Treatment (IRCC), Radiology Unit (Italy); Montemurro, Filippo, E-mail: filippo.montemurro@ircc.it [Institute for Cancer Research and Treatment (IRCC), Internal Medicine Unit (Italy)

    2013-05-08

    PurposeThis study was designed to assess the clinical outcomes of patients treated by vertebral augmentation with nitinol endoprosthesis (VNE) to treat painful vertebral compression fractures.MethodsForty patients with one or more painful osteoporotic VCF, confirmed by MRI and accompanied by back-pain unresponsive to a minimum 2 months of conservative medical treatment, underwent VNE at 42 levels. Preoperative and postoperative pain measured with Visual Analog Scale (VAS), disability measured by Oswestry Disability Index (ODI), and vertebral height restoration (measured with 2-dimensional reconstruction CT) were compared at last follow-up (average follow-up 15 months). Cement extravasation, subsequent fractures, and implant migration were recorded.ResultsLong-term follow-up was obtained in 38 of 40 patients. Both VAS and ODI significantly improved from a median of 8.0 (range 5–10) and 66 % (range 44–88 %) to 0.5 (range 0–8) and 6 % (range 6–66 %), respectively, at 1 year (p < 0.0001). Vertebral height measurements comparing time points increased in a statistically significant manner (ANOVA, p < 0.001). Overall cement extravasation rate was 9.5 %. Discal and venous leakage rates were 7.1 and 0 % respectively. No symptomatic extravasations occurred. Five of 38 (13.1 %) patients experienced new spontaneous, osteoporotic fractures. No device change or migration was observed.ConclusionsVNE is a safe and effective procedure that is able to provide long-lasting pain relief and durable vertebral height gain with a low rate of new fractures and cement leakages.

  3. Vertebral Augmentation with Nitinol Endoprosthesis: Clinical Experience in 40 Patients with 1-Year Follow-up

    International Nuclear Information System (INIS)

    PurposeThis study was designed to assess the clinical outcomes of patients treated by vertebral augmentation with nitinol endoprosthesis (VNE) to treat painful vertebral compression fractures.MethodsForty patients with one or more painful osteoporotic VCF, confirmed by MRI and accompanied by back-pain unresponsive to a minimum 2 months of conservative medical treatment, underwent VNE at 42 levels. Preoperative and postoperative pain measured with Visual Analog Scale (VAS), disability measured by Oswestry Disability Index (ODI), and vertebral height restoration (measured with 2-dimensional reconstruction CT) were compared at last follow-up (average follow-up 15 months). Cement extravasation, subsequent fractures, and implant migration were recorded.ResultsLong-term follow-up was obtained in 38 of 40 patients. Both VAS and ODI significantly improved from a median of 8.0 (range 5–10) and 66 % (range 44–88 %) to 0.5 (range 0–8) and 6 % (range 6–66 %), respectively, at 1 year (p < 0.0001). Vertebral height measurements comparing time points increased in a statistically significant manner (ANOVA, p < 0.001). Overall cement extravasation rate was 9.5 %. Discal and venous leakage rates were 7.1 and 0 % respectively. No symptomatic extravasations occurred. Five of 38 (13.1 %) patients experienced new spontaneous, osteoporotic fractures. No device change or migration was observed.ConclusionsVNE is a safe and effective procedure that is able to provide long-lasting pain relief and durable vertebral height gain with a low rate of new fractures and cement leakages

  4. Ten-year follow-up of anorexia nervosa: clinical course and outcome.

    Science.gov (United States)

    Eckert, E D; Halmi, K A; Marchi, P; Grove, W; Crosby, R

    1995-01-01

    The clinical course and outcome of anorexia nervosa are presented in a 10-year follow-up study of 76 severely ill females with anorexia nervosa who met specific diagnostic criteria and had participated in a well-documented hospital treatment study. Information was obtained on 100% of the subjects. A comprehensive assessment was made in 93% of the living subjects in specific categories of weight, eating and weight control behaviours, menstrual function, anorexic attitudes, and psychological, sexual, social and vocational adjustment. Five subjects had died, which gives a crude mortality rate of 6.6%. Standardized mortality rates demonstrated an almost 13-fold increase in mortality in the anorexia nervosa subjects. Only eighteen (23.7%) were fully recovered. Sixty-four per cent developed binge-eating at some time during their illness, 57% at least weekly. Twenty-nine (41%) were still bulimic at follow-up. The high frequency and chronicity of the bulimic symptoms plus the high rate of weight relapse (42% during the first year after hospital treatment) suggest that intensive intervention is needed to help anorexics restore and maintain their weight within a normal range and to decrease abnormal eating and weight control behaviours. PMID:7792349

  5. Indium-111-monoclonal antimyosin antibody studies after the first year of heart transplantation. Identification of risk groups for developing rejection during long-term follow-up and clinical implications

    International Nuclear Information System (INIS)

    The long-term clinical course and results of biopsies in 21 patients studied with monoclonal antimyosin antibodies more than 12 months after heart transplantation according to the presence and degree of antimyosin-antibody uptake is described. Eighteen men and three women aged 20-52 years (39 +/- 9 years) were studied with antimyosin antibodies 12-40 months (mean, 22 +/- 9 months) after heart transplantation, and followed for a mean of 18 months (10-28 months). The number of biopsies performed during follow-up was 102. Results showed normal antimyosin-antibody studies in nine patients and abnormal studies in 12 patients. Myocyte damage was identified in 18 of the 102 biopsies (17.6%), one in the normal antimyosin-antibody group of patients and 17 in those patients with myocardial antimyosin-antibody uptake. Patients who developed rejection comprised 11% and 67% of each respective group; the mean number of rejection episodes per patient was 0.11 +/- 0.33 and 1.41 +/- 1.41, respectively (p less than 0.01). A trend was noted by which higher heart-to-lung ratios were associated with greater probability of rejection. Conclusively, (1) antimyosin-antibody studies performed after more than 1 year after heart transplantation indicate the presence and level of rejection activity, (2) groups of patients at risk for developing rejection at biopsy during long-term follow-up may be detected by antimyosin-antibody study, and (3) surveillance for rejection and the degree of immunosuppression should be tailored to meet individual patient needs

  6. A follow-up study program for persons irradiated in radiation accidents

    International Nuclear Information System (INIS)

    Clinical and epidemiologic follow-up studies of survivors of radiation accidents are a major part of the program of the Radiation Emergency Assistance Center and Training Site (REAC/TS) in Oak Ridge, Tennessee, where training is provided for physicians and paramedical staff concerned with radiation-accident victims. Guidelines have been developed for clinicians and epidemiologists to do follow-up studies after accidental exposures. The human radiobiological data so obtained are used to improve clinical care and emergency planning in nuclear-energy production. Other aims of these studies are to provide the best prophylactic and anticipatory care for possible late radiation effects, and to continually upgrade radiobiologic risk estimates by epidemiologic investigations. Routine annual clinical follow-up studies are recommended for those survivors who were severely injured, and others who showed clinical or laboratory evidence of the acute radiation syndrome. The extent and protocol for medical examinations will be described. In industrial plants located in the United States where annual physical examinations are routine, medical results obtained about the status of such persons are reported to REAC/TS. Persons involved but not seriously exposed in radiation accidents are contacted annually by phone or letter to ascertain their whereabouts and health status for epidemiologic data collection. Dosimetric guidelines categorizing the follow-up groups will be defined. These are related to total-body exposure levels, extent of local exposures, and residual body and lung burdens of transuranic elements. The follow-up studies are continued for life. The records are deposited in a centralized national radiation-accident registry in REAC/TS where the information is available to clinicians, radiobiologists, and epidemiologists. (author)

  7. Effectiveness of Modified Class IV Atraumatic Restorative Treatment – One Year Clinical Follow-Up

    Directory of Open Access Journals (Sweden)

    Rainer A Jordan

    2016-06-01

    Full Text Available Objectives: To investigate the effectiveness of modified ART class IV restorations in a one-year follow-up interventional study with historical control. Materials and Methods: In 69 adults one modified class IV ART restoration per subject was placed at a public dental ward in Gambia in 2012 by one community oral health worker. Historical controls were 12-months data collected in 2005 in 61 patients with original ART class IV anatomical structure rebuilding restorations. One independent examiner evaluated the restorations according to ART evaluation criteria (secondary outcome parameter. Primary outcome parameter was the annual failure rate. Results: Modified class IV ART performed significantly better compared to historical controls in short-term 12 months follow-up (p<0.001. The annual failure rate in modified class IV ART was 19.2% and was 83.6% in historical controls. Conclusions: One-year performance was close to multiple-surface ART restorations in permanent teeth using high-viscosity glass ionomer cements. Clinical Relevance: Class IV cavities might be treated with modified ART technique in dentally underserved areas.

  8. Development of an Active Follow-up Process in a Stand-alone Medication Therapy Management (MTM) Clinic

    OpenAIRE

    Keri D. Hager, Pharm.D., BCPS

    2013-01-01

    Without following-up with patients, one cannot determine the outcomes of interventions made with patients. To ensure follow-up was occurring in a stand-alone MTM clinic, a process for active follow-up and an easy-to-use way to trigger and document follow-up was developed.

  9. Supported local implementation of clinical guidelines in psychiatry: a two-year follow-up

    Directory of Open Access Journals (Sweden)

    Janszky Imre

    2010-01-01

    Full Text Available Abstract Background The gap between evidence-based guidelines for clinical care and their use in medical settings is well recognized and widespread. Only a few implementation studies of psychiatric guidelines have been carried out, and there is a lack of studies on their long-term effects. The aim of this study was to measure compliance to clinical guidelines for treatment of patients with depression and patients with suicidal behaviours, two years after an actively supported implementation. Methods Six psychiatric clinics in Stockholm, Sweden, participated in an implementation of the guidelines. The guidelines were actively implemented at four of them, and the other two only received the guidelines and served as controls. The implementation activities included local implementation teams, seminars, regular feedback, and academic outreach visits. Compliance to guidelines was measured using quality indicators derived from the guidelines. At baseline, measurements of quality indicators, part of the guidelines, were abstracted from medical records in order to analyze the gap between clinical guidelines and current practice. On the basis of this, a series of seminars was conducted to introduce the guidelines according to local needs. Local multidisciplinary teams were established to monitor the process. Data collection took place after 6, 12, and 24 months and a total of 2,165 patient records were included in the study. Results The documentation of the quality indicators improved from baseline in the four clinics with an active implementation, whereas there were no changes, or a decline, in the two control clinics. The increase was recorded at six months, and persisted over 12 and 24 months. Conclusions Compliance to the guidelines increased after active implementation and was sustained over the two-year follow-up. These results indicate that active local implementation of clinical guidelines involving clinicians can change behaviour and maintain

  10. Clinical and radiological follow-up examinations following fractures of the Collum mandibulae

    International Nuclear Information System (INIS)

    All patients presented a fracture of the collum mandibulae, which had occurred between 1 and 10 years before treatment. The patients were exclusively treated conservatively. 57 of 67 patients did not indicate any subjective pain. 10 patients complained about pain and restricted movability. In only 22 cases no pathologic findings were obtained in the clinical follow-up examinations. In 33 patients the roentgenologic follow-up examination led to pathologic findings. Severe complications as disturbance of growth and formation of ankyloses, occurred only in one single case, due to a fracture of the mandibular joint in childhood. (orig./MG)

  11. Skype clinics after intestinal transplantation - follow-up beyond post codes.

    Science.gov (United States)

    Gerlach, Undine A; Vrakas, Georgios; Holdaway, Lydia; O'Connor, Marion; Macedo, Rubens; Reddy, Srikanth; Friend, Peter J; Giele, Henk; Vaidya, Anil

    2016-07-01

    The follow-up after intestinal transplantation (ITX) is complex and limited to specialized centers. ITX recipients often travel all over the country to be seen in the outpatient clinic of specialized centers which is costly and time-consuming. Videoconferences through Skype have been implemented to eliminate travel time, costs, and to improve patient compliance without jeopardizing safety. Eighteen of 19 patients followed up after ITX or modified multivisceral transplantation (MMVTX) in conventional outpatient clinics in Oxford agreed to attend additional Skype clinics. All patients who were followed up through Skype clinics after ITX/MMVTX received a questionnaire to measure their satisfaction with methods and technical aspects of videoconferencing as well as time/mode of traveling, travel expenses/costs, waiting time in outpatient clinic and patients' satisfaction. Mean travel distance to Oxford was 236 ± 168 miles, mean travel time was 277 ± 175 min, and mean travel cost was 200 ± 56 Great Britain Pounds. A total of 56% had to take time off work and/or find child/family care for the time spent in travel. These patients reported a satisfaction score of 4.38 ± 0.77 of 5 points as opposed to 2.88 ± 0.90 for attending the conventional outpatient clinic. Skype clinics have been proven successful and feasible in highly specialized fields like ITX in eligible patients. PMID:27140671

  12. Long-term follow-up of childhood cancer survivors: clinical decision support and research participation

    OpenAIRE

    Kilsdonk, E.

    2016-01-01

    The aim of the research in this thesis was twofold. Part 1 aimed to provide insights into how the use of a (paper-based) clinical guideline for follow-up care of childhood cancer survivors could be improved (CCS) by communicating the guideline through a computerized clinical decision support system (CDSS). We first investigated factors that could facilitate a successful CDSS implementation through a systematic literature review. Subsequently, we investigated whether the use of an established ...

  13. Postoperative follow-up of pituitary adenomas after trans-sphenoidal resection: MRI and clinical correlation

    International Nuclear Information System (INIS)

    Our purpose was to correlate the morphological changes seen on MRI studies of the sellar region after trans-sphenoidal resection of pituitary adenomas with clinical and hormonal studies. Between January 1993 and March 1994, 16 patients with a pituitary adenoma (9 macroadenomas and 7 microadenomas) were subjected to trans-sphenoidal resection and included in a prospective study. The protocol consisted of MRI, hormonal and visual studies at the following times: immediately postoperative (1st week), 1st month, 4th month and 1st year after surgery. The evolution of the contents of the sella turcica (tumour remnant, packing material and gland tissue), effects on the infundibulum, optic chiasm, cavernous sinus and sphenoid sinus were correlated with the clinical and hormonal studies. Stabilisation of the postsurgical changes occurred by the 4th month. Tumour remnants were noted in the immediate postoperative period in macroadenomas. Compression of the infundibulum was the only reliable indicator of possible involvement. Optic chiasm compression, defined as close contact between the chiasm and the tumour, was the only morphological finding that indicated visual impairment. There was no standard repneumatisation pattern in the sphenoid sinus, since mucosal changes resembling sinusitis were one of the postsurgical changes. We found MRI not to be useful for follow-up of microadenomas. (orig.). With 4 figs., 4 tabs

  14. 3-Year Follow-up of the NIMH MTA Study

    Science.gov (United States)

    Jensen, Peter S.; Arnold, L. Eugene; Swanson, James M.; Vitiello, Benedetto; Abikoff, Howard B.; Greenhill, Laurence L.; Hechtman, Lily; Hinshaw, Stephen P.; Pelham, William E.; Wells, Karen C.; Conners, C. Keith; Elliott, Glen R.; Epstein, Jeffery N.; Hoza, Betsy; March, John S.; Molina, Brooke S. G.; Newcorn, Jeffrey H.; Severe, Joanne B.; Wigal, Timothy; Gibbons, Robert D.; Hur, Kwan

    2007-01-01

    Objective: In the intent-to-treat analysis of the Multimodal Treatment Study of Children With ADHD (MTA), the effects of medication management (MedMgt), behavior therapy (Beh), their combination (Comb), and usual community care (CC) differed at 14 and 24 months due to superiority of treatments that used the MTA medication algorithm (Comb+MedMgt)…

  15. Dropout and Violence Needs Assessment: A Follow-up Study

    Science.gov (United States)

    Miltich, Aimee P.; Hunt, Mary Helen; Meyers, Joel

    2004-01-01

    The current study investigated a needs assessment survey designed to measure perceptions of causes of dropout and school violence and related interventions. The needs assessment was conceptualized as a first step to be taken by schools to facilitate program planning, school-based implementation and acceptability of programs designed to prevent…

  16. Implantable cardioverter defibrillator clinic casualties: inadvertent reprogramming during routine implantable cardioverter defibrillator follow-up.

    Science.gov (United States)

    Ozahowski, T P; Greenberg, M L; Mock, P; Holzberger, P T; Gerling, B; Zalinger, C; Perry, C

    1996-10-01

    On one occasion during a busy ICD follow-up clinic, the preceding patient's parameters for rate, PDF, and delay were inadvertently programmed into the subsequent patient's generator using the CPI Programmer Model 2035. This occurred after capacitor reformation, without pressing the "Program" button. The source of this reprogramming error was failure to clear the programmer memory of the previous patient's data, usually achieved by turning the programmer off between patients (or selecting "New Patient" from the menu). At our next ICD follow-up clinic, we purposely did not turn off the programmer between two sets of patients. On both occasions the above finding was repeated and confirmed. These observations indicate the potential for serious reprogramming errors that can occur simply by not clearing the programmer's memory between clinic patients. PMID:8904549

  17. Clinical Follow-Up for Duchenne Muscular Dystrophy Newborn Screening: A Proposal.

    Science.gov (United States)

    Kwon, Jennifer M; Abdel-Hamid, Hoda Z; Al-Zaidy, Samiah A; Mendell, Jerry R; Kennedy, Annie; Kinnett, Kathi; Cwik, Valerie A; Street, Natalie; Bolen, Julie; Day, John W; Connolly, Anne M

    2016-08-01

    New developments in the rapid diagnosis and treatment of boys with Duchenne muscular dystrophy (DMD) have led to growing enthusiasm for instituting DMD newborn screening (NBS) in the United States. Our group has been interested in developing clinical guidance to be implemented consistently in specialty care clinics charged with the care of presymptomatically identified newborns referred after DMD-NBS. We reviewed the existing literature covering patient-centered clinical follow-up after NBS, educational material from public health and advocacy sites, and federal recommendations on effective NBS follow-up. We discussed the review as a group and added our own experience to develop materials suitable for initial parent and primary care provider education. These materials and a series of templates for subspecialist encounters could be used to provide consistent care across centers and serve as the basis for ongoing quality improvement. Muscle Nerve 54: 186-191, 2016. PMID:27170260

  18. Follow up study of workers manufacturing chrysotile asbestos cement products.

    OpenAIRE

    Gardner, M. J.; Winter, P D; Pannett, B; Powell, C.A.

    1986-01-01

    A cohort study has been carried out of 2167 subjects employed between 1941 and 1983 at an asbestos cement factory in England. The production process incorporated the use of chrysotile asbestos fibre only, except for a small amount of amosite during four months in 1976. Measured airborne fibre concentrations available since 1970 from personal samplers showed mean levels below 1 fibre/ml, although higher levels had probably occurred previously in certain areas of the factory. No excess of lung ...

  19. Inconvenience due to travelers' diarrhea: a prospective follow-up study

    OpenAIRE

    Soonawala Darius; Vlot Jessica A; Visser Leo G

    2011-01-01

    Abstract Background Limited data exist documenting the degree to which travelers are inconvenienced by travelers' diarrhea (TD). We performed a prospective follow-up study at the travel clinic of Leiden University Medical Center in The Netherlands to determine the degree of inconvenience and to determine how experiencing TD affects travelers' perception. Methods Healthy adults who intended to travel to the (sub)tropics for less than two months were invited to take part. Participants filled ou...

  20. Study protocol: follow-up home visits with nutrition: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Beck Anne Marie

    2011-12-01

    Full Text Available Abstract Background Geriatric patients are at high risk of re-admission after discharge. Pre-existing nutritional risk amongst these patients is of primary concern, with former nutritional intervention studies being largely ineffective. None of these studies has included individual dietary counselling by a registered dietician or has considered competing medical conditions in the participants. A former randomised study has shown that comprehensive discharge follow-up in geriatric patients homes by general practitioners and district nurses was effective in reducing the re-admission risk in the intervention group compared to the control group. That study did not include a nutritional intervention. The purpose of this study is to assess the combined benefits of an intervention consisting of discharge follow-up in geriatric patients' home by a general practitioner and a registered dietician. Methods/design This single-blind randomised controlled study, will recruit 160 hospitalised geriatric medical patients (65+ y at nutritional risk. Participants will be randomly allocated to receive in their homes, either 12 weeks individualised nutritional counselling by a registered dietician complemented with follow-up by general practitioners or a 12 weeks follow-up by general practitioners alone. Discussion This trial is the first of its kind to provide individual nutritional intervention combined with follow-up by general practitioner as an intervention to reduce risk of re-admission after discharge among geriatric medical patients. The results will hopefully help to guide the development of more effective rehabilitation programs following hospital admissions, which may ultimately lead to reduced health care costs, and improvement in mobility, independence and quality of life for geriatric patients at nutritional risk. Trial Registration ClinicalTrials.gov 2010 NCT01249716

  1. Asperger Syndrome and Autism: A Comparative Longitudinal Follow-Up Study More than 5 Years after Original Diagnosis

    Science.gov (United States)

    Cederlund, Mats; Hagberg, Bibbi; Billstedt, Eva; Gillberg, I. Carina; Gillberg, Christopher

    2008-01-01

    Prospective follow-up study of 70 males with Asperger syndrome (AS), and 70 males with autism more than 5 years after original diagnosis. Instruments used at follow-up included overall clinical assessment, the Diagnostic Interview for Social and Communication Disorders, Wechsler Intelligence Scales, Vineland Adaptive Behavior Scales, and Global…

  2. Barriers to follow-up for pediatric cataract surgery in Maharashtra, India: How regular follow-up is important for good outcome. The Miraj Pediatric Cataract Study II

    Directory of Open Access Journals (Sweden)

    Parikshit Gogate

    2014-01-01

    Full Text Available Background: Regular follow up and amblyopia treatment are essential for good outcomes after pediatric cataract surgery. Aim: To study the regularity of follow-up after cataract surgery in children and to gauge the causes of poor compliance to follow up. Subjects: 262 children (393 cataracts who underwent cataract surgery in 2004-8. Materials and Methods: The children were identified and examined in their homes and a "barriers to follow-up" questionnaire completed. Demographic data collected, visual acuity estimated, and ocular examination performed. Statistical Analysis: SPSS version 19. Results: Of the 262 children, only 53 (20.6% had been regularly following up with any hospital, 209 (79.4% had not. A total of 150 (57.3% were boys and the average age was 13.23 years (Std Dev 5 yrs. Poor follow up was associated with the older age group ( P 1 line with regular follow-up. Conclusion: Regular follow-up is important and improves vision; eye care practitioners need to take special efforts to ensure better follow-up.

  3. The Prognosis of Primary Percutaneous Coronary Intervention after One Year Clinical Follow Up

    Directory of Open Access Journals (Sweden)

    Yahya Dadjoo

    2013-03-01

    Full Text Available Objectives: The aim of this study was to evaluate the clinical outcomes, one year after primary percutaneous coronary intervention(PCI. Patients and Methods: From September 2009 to March 2012, primary PCI was performed on 70 cases, and the data relating to their catheterization were recorded. Peri-interventional treatment data included PCI with drug-eluting or bare-metal stent or balloon angioplasty alone. Results: The mean age of the patients was 61.34+11.31 years, and 72.9% of them were males. The ratios of patients with diabetes, hypertension and, hyperlipidemia were 61.4%, 71.4%, and 52.9% respectively. In clinical follow-up, total incidence of death was 4.3%, with no death occurring during 30 days. However, 3 patients died after one-year, of which one patient (1.4% had cardiac problem and the other 2 (2.9% died because of non-cardiac reasons. Target vessel revascularization, reinfarction within 30 days, and mechanical complication or stroke were not found in any of the patients. Patients with hypertension (6% and those with LAD ST-elevation myocardial infarction (5% died after one year (P= 0.263 and P= 0.319 respectively. However, no mortality was reported in patients with RCA and LCX ST-elevation myocardial infarction. Of subjects with multivessel disease, 7% died after one-year (P= 0.161, but there was no reported mortality in those with single vessel disease.

  4. Papillary tumor of the pineal region with extended clinical and radiologic follow-up

    OpenAIRE

    Shakir, Hakeem J.; Jingxin Qiu; Dheerendra Prasad; Mechtler, Laszlo L.; Fenstermaker, Robert A.

    2015-01-01

    Background: Papillary tumor of the pineal region (PTPR) is a rare neoplasm with only anecdotal data to guide the treatment. Results of treatment with surgery, radiation therapy, and chemotherapy have been reported to have varying degrees of success. Here we report a patient with a PTPR, who underwent subtotal resection, gamma knife stereotactic radiosurgery, and adjuvant temozolomide chemotherapy. Case Description: During 9 years of clinical and radiographic follow-up, the patient has had...

  5. Reducing lost to follow-up in a large clinical trial of prevention of mother-to-child transmission of HIV: The Breastfeeding, Antiretrovirals and Nutrition (BAN) study experience

    Science.gov (United States)

    Sellers, Christopher J; Lee, Hana; Chasela, Charles; Kayira, Dumbani; Soko, Alice; Mofolo, Innocent; Ellington, Sascha; Hudgens, Michael G; Kourtis, Athena P; King, Caroline C; Jamieson, Denise J; van der Horst, Charles

    2014-01-01

    Background/Aims Retaining patients in prevention of mother-to-child transmission of HIV studies can be challenging in resource limited settings, where high lost to follow-up (LTFU) rates have been reported. In this paper, we describe the effectiveness of methods used to encourage retention in the Breastfeeding, Antiretrovirals, and Nutrition (BAN) study and analyze factors associated with LTFU in the study. Methods The BAN clinical trial was designed to evaluate the efficacy of 3 different mother-to-child HIV transmission prevention strategies. Lower than expected participant retention prompted enhanced efforts to reduce LTFU during the conduct of the trial. Following study completion, we employed regression modeling to determine predictors of perfect attendance and variables associated with being LTFU. Results During the study, intensive tracing efforts were initiated after the first 1686 mother-infant pairs had been enrolled, and 327 pairs were missing. Sixty of these pairs were located and had complete data obtained. Among the 683 participants enrolling after initiation of intensive tracing efforts, the LTFU rate was 3.4%. At study's end, 290 (12.2%) of the 2369 mother-infant pairs were LTFU. Among successfully traced missing pairs, relocation was common and three were deceased. Log-binomial regression modeling revealed higher maternal hemoglobin and older maternal age to be significant predictors of perfect attendance. These factors and the presence of food insecurity were also significantly associated with lower rates of LTFU. Conclusions In this large HIV prevention trial, intensive tracing efforts centered on reaching study participants at their homes succeeded in finding a substantial proportion of LTFU participants, and were very effective in preventing further LTFU during the remainder of the trial. The association between food insecurity and lower rates of LTFU is likely related to the study's provision of nutritional support, including a family maize

  6. Scandinavian Clinical Practice Guidelines on the diagnosis, management and follow-up of anaphylaxis during anaesthesia

    DEFF Research Database (Denmark)

    Kroigaard, M; Garvey, L H; Gillberg, L;

    2007-01-01

    The present approach to the diagnosis, management and follow-up of anaphylaxis during anaesthesia varies in the Scandinavian countries. The main purpose of these Scandinavian Clinical Practice Guidelines is to increase the awareness about anaphylaxis during anaesthesia amongst anaesthesiologists....... It is hoped that increased focus on the subject will lead to prompt diagnosis, rapid and correct treatment, and standardised management of patients with anaphylactic reactions during anaesthesia across Scandinavia. The recommendations are based on the best available evidence in the literature, which...... incremental titration of adrenaline (epinephrine) and fluid therapy as first-line treatment. Recommendations for primary and secondary follow-up are given, bearing in mind that there are variations in geography and resources in the different countries. A list of National Centres from which anaesthesiologists...

  7. A follow-up study of heroin addicts (VEdeTTE2: study design and protocol

    Directory of Open Access Journals (Sweden)

    Lampis Fabio

    2007-03-01

    Full Text Available Abstract Background In Italy, a large cohort study (VEdeTTE1 was conducted between 1998–2001 to evaluate the effectiveness of treatments in reducing mortality and increasing treatment retention among heroin addicts. The follow-up of this cohort (VEdeTTE2 was designed to evaluate the effectiveness of treatments on long-term outcomes, such as rehabilitation and social re-integration. The purpose of this paper is to describe the protocol of the VEdeTTE2 study, and to present the results of the pilot study carried out to assess the feasibility of the study and to improve study procedures. Methods The source population for the VEdeTTE2 study was the VEdeTTE1 cohort, from which a sample of 2,200 patients, traced two or more years after enrolment in the cohort, were asked to participate. An interview investigates drug use; overdose; family and social re-integration. Illegal activity are investigated separately in a questionnaire completed by the patient. Patients are also asked to provide a hair sample to test for heroin and cocaine use. Information on treatments and HIV, HBV and HCV morbidity are obtained from clinical records. A pilot phase was planned and carried out on 60 patients. Results The results of the pilot phase pointed out the validity of the procedures designed to limit attrition: the number of traced subjects was satisfactory (88%. Moreover, the pilot phase was very useful in identifying possible causes of delays and attrition, and flaws in the instruments. Improvements to the procedures and the instruments were subsequently implemented. Sensitivity of the biological test was quite good for heroin (78% but lower for cocaine (42.3%, highlighting the need to obtain a hair sample from all patients. Conclusion In drug addiction research, studies investigating health status and social re-integration of subjects at long-term follow-up are lacking. The VEdeTTE2 study aims to investigate these outcomes at long-term follow-up. Results of the

  8. Male, Mobile, and Moneyed: Loss to Follow-Up vs. Transfer of Care in an Urban African Antiretroviral Treatment Clinic

    OpenAIRE

    Marson, Kara G.; Tapia, Kenneth; Kohler, Pamela; McGrath, Christine J.; John-Stewart, Grace C.; Richardson, Barbra A.; Njoroge, Julia W.; Kiarie, James N.; Sakr, Samah R.; Michael H Chung

    2013-01-01

    Objectives The purpose of this study was to analyze characteristics, reasons for transferring, and reasons for discontinuing care among patients defined as lost to follow-up (LTFU) from an antiretroviral therapy (ART) clinic in Nairobi, Kenya. Design The study used a prospective cohort of patients who participated in a randomized, controlled ART adherence trial between 2006 and 2008. Methods Participants were followed from pre-ART clinic enrollment to 18 months after ART initiation, and were ...

  9. The clinical features and follow-up study of 100 cases of Kawasaki disease%儿童川崎病100例临床特征及随访分析

    Institute of Scientific and Technical Information of China (English)

    刘玉玲; 付四毛; 李小琳; 林汉炼; 陈明; 李性希

    2011-01-01

    Objective To explore the clinical features, etiological factors, treatments and prognosis of 100 cases of Kawasaki disease(KD). Methods Totally 100 patients with KD in our department treated from 2000 to 2005 was included in the study. A retrospective study was carried ont to analyze clinical characteristics, treatment and outcomes of these patients. Results Clinical features: age of onset (2.01 ± 1.35) years, the age of follow-up (8.2 t 1.68) years;male to female ratio was 1.7∶ 1. Tipical KD (88), including recurrence KD (2), incomplete KD (12). Cardiova-scular complications existed in 25 patients,including coronary artery complications(22), pericardial effusion(2), myocarditis( 1 ) ,transient coronary artery ectasia (18) and coronary aneurysm formation (4), (small tumors in 1 case, medium-sized tumor in 2 cases and a huge tumor in 1 case). Non-cardiovascular complications cases included hepatitis or impaired liver function (34), gallbladder hydrops (3), paralytic intestinal obstruction ( 1 ), aseptic meningitis (3) , facial palsy (5), pneumonia (53), urethritis (12) and arthritis (6). Treatment and efficacy: 89 patients within 10 days of the course were given IVIG 2 g/kg; 12 patients without response were given a 2nd IVIG; 2 IVIG non-responsive patients were added the use of glucocorticoid; 11 cases diagnosed as subacute were given IVIG 1 ~ 2 g/(kg-d), 3 cases with coronary aneurysm formation (P < 0.05 ).Those without coronary artery lesions withdrawed the treatment at the course of 6 to 8 weeks; 18 patients with coronary artery dilation were tracked from 6 months to 1 year to discontinuation; 3 cases of small and medium-sized coronary aneurysm withdrawed in the course of 1 to 3 years; 1 case of giant coronary aneurysm was given aspirin for 7 years. Follow-up and prognosis: 56 patients were followed up to ≥ 5 years, up to 10 years. Abnormal follow-up echocardiography occurred in 10 cases (17.8% ).Among them, 1 case of giant coronary artery aneurysms

  10. Diagnostic Work-up and Follow-up in Children with Tall Stature: A Simplified Algorithm for Clinical Practice

    OpenAIRE

    Stalman, Susanne E.; Pons, Anke; Wit, Jan M; Kamp, Gerdine A.; Plötz, Frans B.

    2015-01-01

    Objective: No evidence-based guideline has been published about optimal referral criteria and diagnostic work-up for tall stature in children. The aim of our study was to describe auxological and clinical characteristics of a cohort of children referred for tall stature, to identify potential candidates for adult height reduction, and to use these observations for developing a simple algorithm for diagnostic work-up and follow-up in clinical practice. Methods: Data regarding family and medica...

  11. Tinnitus in elderly patients and prognosis of mild-to-moderate congestive heart failure: a cross-sectional study with a long-term extension of the clinical follow-up

    Directory of Open Access Journals (Sweden)

    Cicero Arrigo FG

    2011-06-01

    Full Text Available Abstract Background The complex mechanism responsible for tinnitus, a symptom highly prevalent in elderly patients, could involve an impaired control of the microcirculation of the inner ear, particularly in patients with poor blood pressure control and impaired left ventricular (LV function. Methods In order to define the relationship between the presence of tinnitus and the severity and clinical prognosis of mild-to-moderate chronic heart failure (CHF in a large population of elderly patients (N = 958, a cross-sectional study was conducted with a long-term extension of the clinical follow-up. Blood pressure, echocardiographic parameters, brain natriuretic peptide (BNP, hospitalization, and mortality for CHF were measured. Multivariate logistic regression analysis was used to assess the association between the presence of tinnitus and some of the prognostic determinants of heart failure. Results The presence of tinnitus was ascertained in 233 patients (24.3%; mean age 74.9 ± 6 years and was associated with reduced systolic and diastolic blood pressure (123.1 ± 16/67.8 ± 9 vs 125.9 ± 15/69.7 ± 9; P = .027/P = .006, reduced LV ejection fraction (LVEF%; 43.6 ± 15 vs 47.9 ± 14%, P = .001, and increased BNP plasma levels (413.1 ± 480 vs 286.2 ± 357, P = .013 in comparison to patients without symptoms. The distribution of CHF functional class was shifted toward a greater severity of the disease in patients with tinnitus. Combined one-year mortality and hospitalization for CHF (events/year was 1.43 ± 0.2 in patients with tinnitus and 0.83 ± 0.1 in patients without tinnitus, with an adjusted hazard ratio (HR of 0.61 (95% confidence interval (CI: 0.37 to 0.93, P Conclusions Our preliminary data indirectly support the hypothesis that tinnitus is associated with a worse CHF control in elderly patients and can have some important clinical implications for the early identification of patients who deserve a more aggressive management of CHF.

  12. Clinical Case Report on Treatment of Generalized Aggressive Periodontitis: 5-Year Follow-up.

    Science.gov (United States)

    Hu, Kai-Fang; Ho, Ya-Ping; Ho, Kun-Yen; Wu, Yi-Min; Wang, Wen-Chen; Chou, Yu-Hsiang

    2015-01-01

    Generalized aggressive periodontitis (GAgP) is a distinct type of periodontal disease associated with considerably more rapid periodontal tissue destruction than chronic periodontitis. This study presents the 5-year follow-up of a patient with GAgP. A 29-year-old man reported experiencing increasing gingival recession. He was treated using cause-related therapy, provisional splints, and flap surgery combined with allograft grafting and was followed up for 5 years. This case study shows that elimination of infectious microorganisms and meticulous long-term maintenance provide an effective treatment modality for aggressive periodontitis cases. This treatment modality can restore the masticatory function and provide the GAgP patient with improved quality of life. PMID:25909527

  13. Transcrestal Sinus Lift Procedure Approaching Atrophic Maxillary Ridge: A 60-Month Clinical and Radiological Follow-Up Evaluation

    Directory of Open Access Journals (Sweden)

    G. Lo Giudice

    2015-01-01

    Full Text Available Aim. The aim of this study was to assess the success and the survival rate of dental implants placed in augmented bone after sinus lifting procedures. Material and Methods. 31 patients were mainly enrolled for a residual upper jaw crest thickness of 3 mm. CBCT scans were performed before and after the augmentation technique and at the follow-up appointments, at 3, 6, 12, 24, and up to 60 months. The follow-up examination included cumulative survival rate of implants, peri-implant marginal bone loss, and the height of sinus floor augmentation. Results. This retrospective study on 31 patients and 45 implants later inserted in a less than 3 mm crest showed excellent survival rates (99.5%, one implant was lost before loading due to an acute infection after 24 days, and two implants did not osteointegrate and were removed after 3 months. The radiological evaluation showed an average bone loss of 0.25 mm (±0.78 mm at the first follow-up appointment (3 months up to 0.30 mm (±1.28 mm after 60-month follow-up. Conclusion. In this study it was reported how even in less than 3 mm thick crest a transcrestal technique can predictably be used with a long-term clinical and radiological outcome, giving patients excellent stability of the grafted material and healthy clinical results.

  14. Prospective image registration for automated scan prescription of follow-up knee images in quantitative studies.

    Science.gov (United States)

    Goldenstein, Janet; Schooler, Joseph; Crane, Jason C; Ozhinsky, Eugene; Pialat, Jean-Baptiste; Carballido-Gamio, Julio; Majumdar, Sharmila

    2011-06-01

    Consistent scan prescription for MRI of the knee is very important for accurate comparison of images in a longitudinal study. However, consistent scan region selection is difficult due to the complexity of the knee joint. We propose a novel method for registering knee images using a mutual information registration algorithm to align images in a baseline and follow-up exam. The output of the registration algorithm, three translations and three Euler angles, is then used to redefine the region to be imaged and acquire an identical oblique imaging volume in the follow-up exam as in the baseline. This algorithm is robust to articulation of the knee and anatomical abnormalities due to disease (e.g., osteophytes). The registration method is performed only on the distal femur and is not affected by the proximal tibia or soft tissues. We have incorporated this approach in a clinical MR system and have demonstrated its utility in automatically obtaining consistent scan regions between baseline and follow-up examinations, thus improving the precision of quantitative evaluation of cartilage. Results show an improvement with prospective registration in the coefficient of variation for cartilage thickness, cartilage volume and T2 relaxation measurements. PMID:21546186

  15. Sex inequality, high transport costs, and exposed clinic location: reasons for loss to follow-up of clients under prevention of mother-to-child HIV transmission in eastern Uganda – a qualitative study

    Directory of Open Access Journals (Sweden)

    Lubega M

    2013-05-01

    Full Text Available Muhamadi Lubega,1–4 Ibrahim A Musenze,3 Gukiina Joshua,2 George Dhafa,2 Rose Badaza,3 Christopher J Bakwesegha,3 Steven J Reynolds41District Health Office, Iganga District Administration, Iganga, Uganda; 2Research Institute, 3School of Graduate Studies and Research, Busoga University, Iganga, Uganda; 4National Institutes of Health/NIAID-ICER American Embassy, Kampala, UgandaBackground: In Iganga, Uganda, 45% of women who tested HIV-positive during antenatal care between 2007 and 2010 were lost to follow-up (LTFU. We explored reasons for LTFU during prevention of mother-to-child transmission (PMTCT from a client perspective in eastern Uganda, where antiretroviral therapy (ART awareness is presumably high.Methods: Seven key informant interviews and 20 in-depth interviews, including both clients who had been retained under PMTCT care and those LTFU during PMTCT were held. Ten focus-group discussions involving a total of 112 participants were also conducted with caretakers/relatives of the PMTCT clients. Content analysis was performed to identify recurrent themes.Results: Our findings indicate that LTFU during PMTCT in eastern Uganda was due to sex inequality, high transport costs to access the services, inadequate posttest counseling, lack of HIV status disclosure, and the isolated/exposed location of the ART clinic, which robs the clients of their privacy.Conclusion: There is a need for approaches that empower women with social capital, knowledge, and skills to influence health-seeking practices. There is also a need to train low-ranking staff and take PMTCT services closer to the clients at the lower-level units to make them affordable and accessible to rural clients. Posttest counseling should be improved to enable PMTCT clients to appreciate the importance of PMTCT services through increasing the number of staff in antenatal care to match the client numbers for improved quality. The counseling should emphasize HIV status disclosure to

  16. The experiences of ICU patients during follow-up sessions : A qualitative study

    OpenAIRE

    Haraldsson, Lena; Christensson, Lennart; Conlon, Lisa; Henricson, Maria

    2015-01-01

    Objective Evidence supports the recommendation for follow-up session(s) for patients after discharge from an intensive care unit (ICU). The aim of these follow-up sessions is to allow patients to express and discuss their experiences and problems following their time in an ICU. To optimise the knowledge gained from the follow-up session experience, it is necessary to describe how patients experience these sessions. The aim of this study was to describe how ICU-patients, experience a follow-up...

  17. Surgical Treatment of Peri-Implantitis: A 17-Year Follow-Up Clinical Case Report

    Directory of Open Access Journals (Sweden)

    Fabrizio Bassi

    2015-01-01

    Full Text Available The purpose of the present case report was to describe the surgical treatment of a peri-implantitis lesion associated with a regenerative approach. A 48-year-old patient came to authors’ attention 36 months after the placement of a dental implant (ITI-Bonefit Straumann, Waldenburg, Switzerland in position 46. A swelling of the peri-implant soft tissues was observed, associated with bleeding on probing and probing depth > 10 mm. A significant peri-implant bone loss was clearly visible on the periapical radiograph. A nonsurgical periodontal supportive therapy was firstly conducted to reduce the inflammation, followed by the surgical treatment of the defect. After mechanical and chemical decontamination with tetracycline solution, a regenerative approach consisting in the application of deproteinized bovine bone mineral (Bio-Oss, Geistlich Pharma AG, Wolhusen, Switzerland and a collagen membrane (Bio-Gide, Geistlich Pharma AG, Wolhusen, Switzerland was performed. An antibiotic therapy was associated with the treatment. The 17-year follow-up showed a physiological probing depth with no clinical signs of peri-implant inflammation and bleeding on probing. No further radiographic bone loss was observed. The treatment described in the present case report seemed to show improved clinical results up to a relevant follow-up period.

  18. Surgical Treatment of Peri-Implantitis: A 17-Year Follow-Up Clinical Case Report.

    Science.gov (United States)

    Bassi, Fabrizio; Poli, Pier Paolo; Rancitelli, Davide; Signorino, Fabrizio; Maiorana, Carlo

    2015-01-01

    The purpose of the present case report was to describe the surgical treatment of a peri-implantitis lesion associated with a regenerative approach. A 48-year-old patient came to authors' attention 36 months after the placement of a dental implant (ITI-Bonefit Straumann, Waldenburg, Switzerland) in position 46. A swelling of the peri-implant soft tissues was observed, associated with bleeding on probing and probing depth > 10 mm. A significant peri-implant bone loss was clearly visible on the periapical radiograph. A nonsurgical periodontal supportive therapy was firstly conducted to reduce the inflammation, followed by the surgical treatment of the defect. After mechanical and chemical decontamination with tetracycline solution, a regenerative approach consisting in the application of deproteinized bovine bone mineral (Bio-Oss, Geistlich Pharma AG, Wolhusen, Switzerland) and a collagen membrane (Bio-Gide, Geistlich Pharma AG, Wolhusen, Switzerland) was performed. An antibiotic therapy was associated with the treatment. The 17-year follow-up showed a physiological probing depth with no clinical signs of peri-implant inflammation and bleeding on probing. No further radiographic bone loss was observed. The treatment described in the present case report seemed to show improved clinical results up to a relevant follow-up period. PMID:26064700

  19. The Mosaic Mitral Valve Bioprosthesis: A Long-Term Clinical and Hemodynamic Follow-Up

    Science.gov (United States)

    Celiento, Michele; Blasi, Stefania; De Martino, Andrea; Pratali, Stefano; Milano, Aldo D.

    2016-01-01

    We reviewed the cases of 100 patients (mean age, 73 ± 10 yr; 64 men) who had mitral valve replacement with a Medtronic Mosaic porcine bioprosthesis from 1995 through 2011. The mean New York Heart Association (NYHA) class was 3 ± 0.7, and 52 patients were in atrial fibrillation. Prosthetic sizes were chiefly 27 mm (50 patients) and 29 mm (40 patients). Follow-up ended in December 2012 and is 97% complete, with a cumulative duration of 611 patient-years (mean duration, 6 ± 4.6 yr; maximum, 17.7 yr). The early mortality rate was 10% (6% in elective patients); late deaths occurred in 31 patients (5 valve-related). Actuarial survival rates at 5, 10, and 15 years were 74% ± 5%, 50% ± 6%, and 37% ± 8%. The mean NYHA class in survivors was 1.4 ± 0.6 (P actuarial freedom at 15 years of 91% ± 5%. No cases of endocarditis were observed. Four patients needed reoperation, 2 for structural failure, and 1 each for perivalvular leakage and valve thrombosis. Actuarial freedom from structural failure and from reoperation, respectively, was 93% ± 5% and 91% ± 5% at 15 years. Echocardiographic follow-up in 24 patients with 27-mm prostheses showed a mean gradient of 5 ± 1.7 mmHg and an effective orifice area of 1.57 ± 0.3 cm2; in 16 patients with 29-mm prostheses, the mean gradient was 4.5 ± 1.9 mmHg, and the effective orifice area, 1.63 ± 0.4 cm2. During nearly 17 years of follow-up, the Mosaic bioprosthesis has shown good overall clinical and hemodynamic performance after mitral valve replacement. PMID:27047280

  20. The Mosaic Mitral Valve Bioprosthesis: A Long-Term Clinical and Hemodynamic Follow-Up.

    Science.gov (United States)

    Celiento, Michele; Blasi, Stefania; De Martino, Andrea; Pratali, Stefano; Milano, Aldo D; Bortolotti, Uberto

    2016-02-01

    We reviewed the cases of 100 patients (mean age, 73 ± 10 yr; 64 men) who had mitral valve replacement with a Medtronic Mosaic porcine bioprosthesis from 1995 through 2011. The mean New York Heart Association (NYHA) class was 3 ± 0.7, and 52 patients were in atrial fibrillation. Prosthetic sizes were chiefly 27 mm (50 patients) and 29 mm (40 patients). Follow-up ended in December 2012 and is 97% complete, with a cumulative duration of 611 patient-years (mean duration, 6 ± 4.6 yr; maximum, 17.7 yr). The early mortality rate was 10% (6% in elective patients); late deaths occurred in 31 patients (5 valve-related). Actuarial survival rates at 5, 10, and 15 years were 74% ± 5%, 50% ± 6%, and 37% ± 8%. The mean NYHA class in survivors was 1.4 ± 0.6 (P <0.0001). Thromboembolic episodes occurred in 4 patients, with an actuarial freedom at 15 years of 91% ± 5%. No cases of endocarditis were observed. Four patients needed reoperation, 2 for structural failure, and 1 each for perivalvular leakage and valve thrombosis. Actuarial freedom from structural failure and from reoperation, respectively, was 93% ± 5% and 91% ± 5% at 15 years. Echocardiographic follow-up in 24 patients with 27-mm prostheses showed a mean gradient of 5 ± 1.7 mmHg and an effective orifice area of 1.57 ± 0.3 cm(2); in 16 patients with 29-mm prostheses, the mean gradient was 4.5 ± 1.9 mmHg, and the effective orifice area, 1.63 ± 0.4 cm(2). During nearly 17 years of follow-up, the Mosaic bioprosthesis has shown good overall clinical and hemodynamic performance after mitral valve replacement. PMID:27047280

  1. The RETHINK Parenting and Anger Management Program: A Follow-Up Validation Study

    Science.gov (United States)

    Fetsch, Robert J.; Yang, Raymond K.; Pettit, Matthew J.

    2008-01-01

    This study is the first follow-up assessment of the RETHINK Parenting and Anger Management Program. Parent participants (N = 168) reduced their anger, violence, and family conflict levels from posttest to follow-up, on average, at 2.5 months on 13 of 15 dependent variables. Current findings are consistent with a small, albeit growing body of…

  2. A follow up study on the efficacy of metadoxine in the treatment of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Gentili Claudio

    2006-12-01

    Full Text Available Abstract Background We carried out a three months follow-up study on the efficacy of metadoxine in a cohort of alcoholics admitted to the Alcohol misuse Long-term Treatment (ALT Unit – University of Pisa (Italy. We analyzed the clinical data, psychometric tests and blood tests of 160 alcoholics on admission and after 3 months of treatment. We compared 58 pts treated with metadoxine (MET with 102 pts who did not receive (NULL any drug as an adjunct to the psycho-educational interventions provided by the ALT Unit. Results At follow-up, the patients in treatment with metadoxine showed a significant improvement in the rate of complete abstinence (44.8% vs. 21.6%; chi square: 8.45, df = 1, p Conclusion Our findings support the use of metadoxine in the management of alcohol dependence. However, randomized clinical trials are necessary to confirm and replicate them. This study raises the importance of identifying new pharmacological compounds effective on the outcome of alcoholism in order to help patients to best adhere to treatment programs and to prevent the development of mental and physical complications due to chronic and heavy use of alcohol.

  3. Inferior clinical outcome of the CD4+ cell count-guided antiretroviral treatment interruption strategy in the SMART study: role of CD4+ Cell counts and HIV RNA levels during follow-up

    DEFF Research Database (Denmark)

    Lundgren, Jens; Babiker, Abdel; El-Sadr, Wafaa;

    2008-01-01

    BACKGROUND AND METHODS: The SMART study compared 2 strategies for using antiretroviral therapy-drug conservation (DC) and viral suppression (VS)-in 5,472 human immunodeficiency virus (HIV)-infected patients with CD4+ cell counts >350 cells/microL. Rates and predictors of opportunistic disease or...... death (OD/death) and the relative risk (RR) in DC versus VS groups according to the latest CD4+ cell count and HIV RNA level are reported. RESULTS: During a mean of 16 months of follow-up, DC patients spent more time with a latest CD4+ cell count <350 cells/microL (for DC vs. VS, 31% vs. 8%) and with a...... latest HIV RNA level >400 copies/mL (71% vs. 28%) and had a higher rate of OD/death (3.4 vs. 1.3/100 person-years) than VS patients. For periods of follow- up with a CD4+ cell count <350 cells/microL, rates of OD/death were increased but similar in the 2 groups (5.7 vs. 4.6/100 person-years), whereas the...

  4. Conservative Treatment Protocol for Keratocystic Odontogenic Tumour: a Follow-up Study of 3 Cases

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    Gülsün Yildirim

    2010-07-01

    Full Text Available Background: The keratocystic odontogenic tumour is classified as a developmental cyst derived from the enamel organ or from the dental lamina. The treatment of keratocystic odontogenic tumour of the jaw remains controversial. The aim of this study was to report the outcome of our conservative treatment protocol for keratocystic odontogenic tumour.Methods: Three patients with different complaints referred to Oral and Maxillofacial Surgery Clinic, Faculty of Dentistry, Selçuk University. Initial biopsy was carried out in all patients and keratocystic odontogenic tumours was diagnosed subsequent to histopathological examination. The patients with keratocystic odontogenic tumours were treated by enucleation followed by open packing. This conservative treatment protocol was selected because of existing young aged patients. The average follow-up duration of the cases was 2 years.Results: Out of 3 cases, 2 lesions were present in mandible and 1 lesion in maxilla. There was no evidence of recurrence during follow-up. All the cases were monitored continuously with panoramic radiographs, computed tomography and clinical evaluations.Conclusions: This conservative treatment protocol for keratocystic odontogenic tumours, based on enucleation followed by open packing would be a possible choice with a view of offering low recurrence rate and low morbidity rate particularly in young patients.

  5. Loss to follow-up in an international, multicentre observational study

    DEFF Research Database (Denmark)

    Mocroft, A; Kirk, O; Aldins, P; Chies, A; Blaxhult, A; Chentsova, N; Vetter, N; Dabis, F; Gatell, J; Lundgren, J D

    2008-01-01

    (incidence rate ratio 2.16; 95% CI 1.84-2.53; P<0.0001). A total of 2743 patients had a period of >1 year with no CD4 cell count or viral load measured during the year; 743 (27.1%) subsequently returned to follow-up. CONCLUSIONS: Some patients thought to be LTFU may have died, and efforts should be made to......OBJECTIVE: The aim of this work was to assess loss to follow-up (LTFU) in EuroSIDA, an international multicentre observational cohort study. METHODS: LTFU was defined as no follow-up visit, CD4 cell count measurement or viral load measurement after 1 January 2006. Poisson regression was used to...... ascertain vital status wherever possible. A significant proportion of patients who have a year with no follow-up visit, CD4 cell count measurement or viral load measurement subsequently return to follow-up....

  6. Breast Cancer and the Environment on Long Island Follow-up Study

    Science.gov (United States)

    A follow-up study on women with breast cancer who participated in the parent population-based case-control study of Long Island women to determine whether environmental and other lifestyle factors influence breast cancer survival.

  7. 无创产前检测的临床应用及随访研究%The clinical application and follow-up study of f non-invasive prenatal testing

    Institute of Scientific and Technical Information of China (English)

    赖允丽; 韦红卫; 陈筠; 易升; 周林; 易赏; 雷亚琴; 郑海洋; 林飞; 邬玲仟

    2016-01-01

    目的:采用大规模平行测序检测胎儿染色体疾病,通过全面随访,为无创产前检测(NIPT )的临床应用提供有效的数据支持及遗传咨询方案。方法唐氏筛查高风险的孕妇接受 NIPT ,结果提示高危者进行核型确诊,低危者进行生育前后随访。结果(1)NIPT提示胎儿异常25例,异常率为1.49%,核型确诊异常12例,均已引产,NIPT 对 T21、T18、XO、XXY、XYY的准确性依次为99.93%、100.00%、99.66%、100.00%、100.00%;在高龄妊娠和双胎妊娠中对 T 21/T 18的准确性达100.00%;产前阳性干预率达100.00%。(2)NIPT提示低风险1651例,完成随访1468例,成功率为88.91%,发现1例9号染色体倒位(母源性)。(3)B超检测染色体异常准确率达98.17%,检出率仅7.69%;唐氏筛查高风险人群的准确率仅为0.88%,假阳性率高达99.12%;NIPT避免了98.71%的孕妇进行介入性产前诊断。结论 NIPT作为现有产前检测技术的重要补充,为寻找最合适的产前筛查模式提供参考。在医疗机构建立健全NIPT随访和服务系统对降低出生缺陷疾病尤为重要。%Objective To provide valid data and useful genetic counseling in the clinical application of non‐invasive prenatal test (NIPT) ,fetal chromosomal disorder were screened by massive parallel sequencing and made a follow‐up study .Methods Preg‐nant women with Down screening in high‐risk were screened by NIPT ;NIPT verified high‐risk individuals were suggested for kary‐otyping ;and we follow up on whoever showed low risk by NIPT before and after their deliveries .Results (1)Totally 1 676 cases of pregnant women were tested by NIPT ,25 cases prompted to be abnormal ,with an abnormal rate of 1 .49% ,karyotype analysis re‐sults in 12 cases of abnormalit ,the accuracies of NIPT for T21 ,T18 ,XO ,XXY ,and XYY were 99 .93% ,100 .00% ,99 .66% , 100 .00

  8. Rehabilitation following total hip arthroplasty evaluation over short follow-up time: Randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Carolina Sant'anna Umpierres, MSc

    2015-03-01

    Full Text Available Hip osteoarthritis (OA is a degenerative disease, and total hip arthroplasty (THA is one of the surgical procedures of choice to improve the OA patient’s quality of life. Without a rehabilitation program, THA patients will develop functional limitations. A randomized double-blind trial was performed between July 2009 and October 2011 to compare over a short follow-up time two groups of patients who underwent THA for OA. The THA protocol (THAP group received verbal instructions and physiotherapy exercise demonstrations, and the THA physiotherapy care protocol (THAPCP group received the same verbal instructions and demonstrations associated with daily exercise practice guided by a physiotherapist. The outcomes that were assessed preoperatively and 15 d postoperatively in 106 patients were muscle strength force, goniometry, Medical Outcomes Study 36-Item Short Form Health Survey, and Merle d’Aubigné and Postel score. Higher muscle strength force scores and degrees in range of motion were found in the THAPCP group. Greater improvements were also observed for the THAPCP group than the THAP group in the Merle d’Aubigné and Postel score. At the end of the follow-up period, the intervention in the THAPCP group improved functional capacity, quality of life, mobility, muscle strength, goniometry, and pain. It appears to be a safe tool for accelerating recovery in THA patients.

  9. Arthroscopic repair of type II SLAP lesions: Clinical and anatomic follow-up

    Directory of Open Access Journals (Sweden)

    John N Trantalis

    2015-01-01

    Full Text Available Aims: The aim was to evaluate the clinical and anatomic outcome of arthroscopic repair of type II SLAP lesions. Materials and Methods: The senior author performed isolated repairs of 25 type II SLAP lesions in 25 patients with a mean age of 40.0 ± 12 years. All tears were repaired using standard arthroscopic suture anchor repair to bone. All patients were reviewed using a standardized clinical examination by a blinded, independent observer, and using several shoulder outcome measures. Patients were evaluated by magnetic resonance imaging arthrogram at a minimum of 1-year postoperatively. Statistical Analysis Used: Two-tailed paired t-test were used to determine significant differences in preoperative and postoperative clinical outcomes scores. In addition, a Fisher′s exact test was used. Results: At a mean follow-up of 54-month, the mean American Shoulder and Elbow Surgeons Shoulder Index (ASES scores improved from 52.1 preoperatively to 86.1 postoperatively (P < 0.0001 and the Simple Shoulder Test (SST scores from 7.7 to 10.6 (P < 0.0002. Twenty-two out of the 25 patients (88% stated that they would have surgery again. Of the 21 patients who had postoperative magnetic resonance imaging arthrographys (MRAs, 9 patients (43% demonstrated dye tracking between the labrum bone interface suggestive of a recurrent tear and 12 patients (57% had a completely intact repair. There was no significant difference in ASES, SST, and patient satisfaction scores in patients with recurrent or intact repairs. Conclusions: Arthroscopic repair of type II SLAP lesions demonstrated improvements in clinical outcomes. However, MRA imaging demonstrated 43% of patients with recurrent tears. MRA results do not necessarily correlate with clinical outcome.

  10. Taking care: practice and philosophy of communication in a critical care follow-up clinic.

    Science.gov (United States)

    Hazzard, Anthony; Harris, Wendy; Howell, David

    2013-06-01

    Human consciousness is inextricable from communication. The conditions of communication in the clinical context are defined by the caring intention and the unequal relationship, which imply special responsibilities on the part of the clinician. The conventional hermeneutic model of communication proposes a close examination of the context of the other, and an objective effort to get close to their consciousness by interpretation of their expressions. The clinician is supposed to lay aside subjective factors but make use of her/his clinical knowledge and skills. At University College Hospital Critical Care follow-up clinic, the communicative task involves history taking; partly by questionnaire and partly by attention to the patient's agenda - assessing needs, providing information and facilitating access to further help. In recent years the provision of Critical Care has become ever more complex, both in terms of the sophisticated medical and nursing techniques it can offer to patients and in the range of conditions it can undertake to treat. This range and complexity is reflected in the variety of problems and consequences that may be encountered at follow-up. Communicative techniques should take account of the emotional vulnerability of patients emerging from severe illness. Attentive listening should identify special anxieties, and care with phraseology aims to avoid further distress. Issues of memory, depression and trauma may be expected, and the interview technique must be flexible enough to offer emotional containment if need be. The consultation should be therapeutic in its conduct but should not embark upon actual psychotherapy or seek to dismantle the patient's defences. Contemporary hermeneutic perspectives emphasise the contextual situatedness of the clinician's consciousness, and propose a model of communication as 'blending of horizons' rather than as objective interpretation. Systems theory contributes to an understanding of the influence on

  11. FOLLOW-UP STUDY OF THREE COGNITIVE POTENTIALS OF DEPRESSION AND ANXIETY DISORDERS

    Institute of Scientific and Technical Information of China (English)

    XIAO Ze-ping; CHEN Xing-shi; ZHANG Ming-dao; LOU Fei-ying; CHEN Jue

    2005-01-01

    Objective To investigate the variations of contingent negative variations (CNV), P300 and mismatch negativity (MMN) in depression and anxiety disorders. Methods CNV, P300 and MMN were recorded from 44 depressive patients using Nicolet Spirit Instrument, and were compared with that of 32 anxiety patients and 28 normal controls(NC). 21 of depressive patients and 18 of anxiety patients were followed up by 2.5 months with the same evoked potentials. Results 1. Compared with NC, all patients in acute episode showed decreased M1 of CNV amplitude, delayed P3 latency and decreased P3 amplitude of P300, and delayed MMN latency and decreased MMN amplitude; 2. The follow-up study of evoked potentials revealed that abnormal P3 of P300 and MMN latencies were significant between depressed patients in remission status and NC group but not P3 of P300 and MMN amplitudes, and M1 of CNV and P3 of P300 amplitudes and P3 of P300 and MMN latencies are not significant between anxiety patients in remission and NC group. Conclusion Delayed P3 of P300 and MMN latencies in depression show state and trait markers, while those variations in anxiety correlate with clinical status of anxiety state.

  12. Relationships in couples treated with sperm donation - a national prospective follow-up study

    OpenAIRE

    Sydsjö, Gunilla; Skoog Svanberg, Agneta; Bladh, Marie; Lampic, Claudia

    2014-01-01

    BACKGROUND: Long-term follow-up on relationship quality in couples who use sperm donation is scarce. Therefore, this study aimed to analyse changes over time in satisfaction with relationship in heterosexual couples who were scheduled for treatment with sperm donation and IVF couples treated with their own gametes and to compare the two groups undergoing different treatment for infertility. METHOD: A prospective follow-up study in which data were collected twice on two groups; couples receivi...

  13. Follicular mucinosis presenting as an acneiform eruption: a follow-up study.

    Science.gov (United States)

    Brau-Javier, Cristina N; Santos-Arroyo, Aileen E; De Sanctis-González, Ivette M; Sánchez, Jorge L

    2013-12-01

    It has been proposed by many authors that follicular mucinosis is directly associated with mycosis fungoides (MF). Follicular mucinosis may be classified into 3 main clinical variants: a benign idiopathic form in children and young adults, which includes an acneiform presentation; an idiopathic form in older patients with a benign course; and a third variant that occurs in adults and is associated with MF. Our goal was to study the relationship between the acneiform variant of follicular mucinosis and MF. Eight patients previously diagnosed with the acneiform variant of follicular mucinosis were identified. Biopsy specimens were reviewed to evaluate the histopathologic attributes that characterize the disease and the infiltrate's immunohistochemistry. Also, patient follow-up was assessed to evaluate the clinical course of the disease. Median age of onset of disease was 29.5 years; 95% of lesions were located in the head and neck region. Biopsy specimens showed a moderate to dense perivascular, perifollicular, and interstitial infiltrate of lymphocytes with mucinous deposits within the follicular epithelium. On immunohistochemistry, the infiltrate showed prominent leukocyte common antigen (LCA) positivity and a CD3-positive and CD4-positive infiltrate with rare CD20-positive cells. None of the study patients showed evidence of MF after a mean follow-up of 3 years. The benign course of disease demonstrated in the study patients suggests that the acneiform variant of follicular mucinosis probably represents a subpopulation of the benign idiopathic form of the disease. However, given that histopathologically this variant cannot be distinguished from the lymphoma-associated variant of follicular mucinosis, longitudinal evaluation is still warranted in these patients. PMID:24257190

  14. Regional radiotherapy versus an axillary lymph node dissection after lumpectomy: a safe alternative for an axillary lymph node dissection in a clinically uninvolved axilla in breast cancer. A case control study with 10 years follow up

    Directory of Open Access Journals (Sweden)

    Elferink Marloes AG

    2007-10-01

    Full Text Available Abstract Background The standard treatment of the axilla in breast cancer used to be an axillary lymph node dissection. An axillary lymph node dissection is known to give substantial risks of morbidity. In recent years the sentinel node biopsy has become common practice. Future randomized study results will determine whether the expected decrease in morbidity can be proven. Methods Before the introduction of the sentinel node biopsy, we conducted a study in which 180 women of 50 years and older with T1/T2 cN0 breast cancer were treated with breast conserving therapy. Instead of an axillary lymph node dissection regional radiotherapy was given in combination with tamoxifen (RT-group. The study group was compared with 341 patients, with the same patient and tumour characteristics, treated with an axillary lymph node dissection (S-group. Results The treatment groups were comparable, except for age. The RT-group was significantly older than the S-group. The median follow up was 7.2 years. The regional relapse rates were low and equal in both treatment groups, 1.1% in RT-group versus 1.5% in S-group at 5 years. The overall survival was similar; the disease free survival was significant better in the RT-group. Conclusion Regional recurrence rates after regional radiotherapy are very low and equal to an axillary lymphnode dissection.

  15. Regional radiotherapy versus an axillary lymph node dissection after lumpectomy: a safe alternative for an axillary lymph node dissection in a clinically uninvolved axilla in breast cancer. A case control study with 10 years follow up

    International Nuclear Information System (INIS)

    The standard treatment of the axilla in breast cancer used to be an axillary lymph node dissection. An axillary lymph node dissection is known to give substantial risks of morbidity. In recent years the sentinel node biopsy has become common practice. Future randomized study results will determine whether the expected decrease in morbidity can be proven. Before the introduction of the sentinel node biopsy, we conducted a study in which 180 women of 50 years and older with T1/T2 cN0 breast cancer were treated with breast conserving therapy. Instead of an axillary lymph node dissection regional radiotherapy was given in combination with tamoxifen (RT-group). The study group was compared with 341 patients, with the same patient and tumour characteristics, treated with an axillary lymph node dissection (S-group). The treatment groups were comparable, except for age. The RT-group was significantly older than the S-group. The median follow up was 7.2 years. The regional relapse rates were low and equal in both treatment groups, 1.1% in RT-group versus 1.5% in S-group at 5 years. The overall survival was similar; the disease free survival was significant better in the RT-group. Regional recurrence rates after regional radiotherapy are very low and equal to an axillary lymphnode dissection

  16. Onset Pattern and Long-Term Prognosis in Schizophrenia: 10-Year Longitudinal Follow-Up Study.

    Directory of Open Access Journals (Sweden)

    Nobuhisa Kanahara

    Full Text Available Although the duration of untreated psychosis (DUP plays an important role in the short-term prognosis of patients with schizophrenia, their long-term prognosis generally is not determined by DUP alone. It is important to explore how other clinical factors in the early stage are related to DUP and consequent disease courses.A total of 664 patients with untreated psychosis were surveyed for this study. At the first examination, we divided them into the severe positive symptoms cases (SC or the less severe cases (NonSC and compared the prognosis among the two groups after a 10-year follow-up. In all, 113 patients in the SC group and 43 patients in the NonSC group were follow-up completers.Whereas DUP was not different between the two groups, patients with nonacute onset in both groups had significantly longer DUP than those in patients with acute onset. For all clinical measures, there was no difference in prognosis between the two groups or among the four groups classified by mode of onset (MoO and initial severity of positive symptoms. However, the degree of improvement of global assessment of functioning (GAF was significantly smaller in the NonSC-nonacute group than in the SC-acute and SC-nonacute groups.These results suggest that neither DUP nor MoO alone necessarily affects the initial severity of positive symptoms. Moreover, it is possible that patients with low impetus of positive symptoms onset within long DUP experience profound pathologic processes. Therefore, the current study results indicated that long DUP and nonacute onset were related to poor long-term prognosis, regardless of initial positive symptoms.

  17. Hepatic radioembolization with yttrium-90 containing glass microspheres: Preliminary results and clinical follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Andrews, J.C.; Walker, S.C.; Ackermann, R.J. [Univ. of Michigan Medical Center, Ann Arborn, MI (United States)] [and others

    1994-10-01

    The treatment of hepatic tumors remains unsatisfactory. These lesions receive most of their blood supply from the hepatic artery, therefore the hepatic artery administration of beta-emitting particulate radiopharmaceuticals is an attractive approach to deliver therapeutic irradiation to the liver and differentially to tumors within the liver. A Phase 1 dose escalation study of the hepatic tolerance to radiation delivered by {sup 90}Y containing glass microspheres was carried out in 24 patients with hepatic malignancy. Doses of {sup 90}Y microspheres to achieve an estimated whole-liver nominal absorbed radiation dose of 5000 cGy (two patients), 7500cGy (six patients), 10,000 cGy (seven patients), 12,500 cGy (six patients), and 15,000 cGy (three patients) were administered via the hepatic artery. The administered nominal absorbed radiation dose (NARD) was estimated based on liver volume determined from CT scans and the assumption of uniform distribution of microspheres throughout the liver. No hematologic, hepatic or pulmonary toxicity was encountered in the dose range examined during a mean follow-up period of up to 53 mo. Reversible gastritis or duodenitis was encountered in four patients without imaging or biopsy evidence for extra-hepatic deposition of microspheres. Response data, based on CT scans obtained 16 wk after treatment, showed progressive disease in eight patients, stable disease in seven patients, minimal response in four patients and partial response in five patients. Subsequent follow-up revealed three long-term survivors at 204, 216 and 228 wk. These preliminary data demonstrates that in the examined dose range, radiation may be safely delivered to liver tumors by means of {sup 90}Y glass microspheres with encouraging response data. 39 refs., 3 figs., 1 tab.

  18. Second-generation autologous chondrocyte transplantation: MRI findings and clinical correlations at a minimum 5-year follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Kon, E. [Biomechanics Laboratory, III Clinic, Rizzoli Orthopaedic Institute, Via Di Barbiano 1/10, 40136 Bologna (Italy); Di Martino, A., E-mail: a.dimartino@biomec.ior.it [Biomechanics Laboratory, III Clinic, Rizzoli Orthopaedic Institute, Via Di Barbiano 1/10, 40136 Bologna (Italy); Filardo, G. [Biomechanics Laboratory, III Clinic, Rizzoli Orthopaedic Institute, Via Di Barbiano 1/10, 40136 Bologna (Italy); Tetta, C.; Busacca, M. [Radiology, Rizzoli Orthopaedic Institute, Bologna (Italy); Iacono, F. [Biomechanics Laboratory, III Clinic, Rizzoli Orthopaedic Institute, Via Di Barbiano 1/10, 40136 Bologna (Italy); Delcogliano, M. [Orthopaedic Departement San Carlo di Nancy Hospital, Rome (Italy); Albisinni, U. [Radiology, Rizzoli Orthopaedic Institute, Bologna (Italy); Marcacci, M. [Biomechanics Laboratory, III Clinic, Rizzoli Orthopaedic Institute, Via Di Barbiano 1/10, 40136 Bologna (Italy)

    2011-09-15

    Objective: To evaluate the clinical outcome of hyaluronan-based arthroscopic autologous chondrocyte transplantation at a minimum of 5 years of follow-up and to correlate it with the MRI evaluation parameters. Methods: Fifty consecutive patients were included in the study and evaluated clinically using the Cartilage Standard Evaluation Form as proposed by ICRS and the Tegner score. Forty lesions underwent MRI evaluation at a minimum 5-year follow-up. For the description and evaluation of the graft, we employed the MOCART-scoring system. Results: A statistically significant improvement in all clinical scores was observed at 2 and over 5 years. The total MOCART score and the signal intensity (3D-GE-FS) of the repair tissue were statistically correlated to the IKDC subjective evaluation. Larger size of the treated cartilage lesions had a negative influence on the degree of defect repair and filling, the integration to the border zone and the subchondral lamina integrity, whereas more intensive sport activity had a positive influence on the signal intensity of the repair tissue, the repair tissue surface, and the clinical outcome. Conclusion: Our findings confirm the durability of the clinical results obtained with Hyalograft C and the usefulness of MRI as a non-invasive method for the evaluation of the repaired tissue and the outcome after second-generation autologous transplantation over time.

  19. [Congenital toxoplasmosis: clinical manifestation, treatment and follow-up] [Article in Italian] • Il neonato con toxoplasmosi congenita: clinica, terapia e follow-up

    Directory of Open Access Journals (Sweden)

    Lina Bollani

    2014-01-01

    Full Text Available Toxoplamosis is a parasitic zoonosis which occurs worldwide, but is prevalent in Europe, South America and Africa. When infection occurs for the first time during pregnancy, mother to child transmission of the parasite can cause congenital toxoplasmosis. Rate of congenital infection ranges from less than 0.1 to approximately 1 per 1,000 live births. The risk of transmission depends on the gestational age at the time of maternal infection. A diagnosis of congenital toxoplasmosis is usually considered in infants who present: hydrocephalus, chorioretinitis, and intracranial calcifications, but this triade is very rare. Approximately 85% of the infants with congenital toxoplasmosis are clinically normal at birth; however, sequelae of infection may become apparent only months or even years later. Chorioretinitis is the main complication of congenital toxoplasmosis, late onset retinal lesions and relapse can appear many years after birth, but the overall ocular prognosis is satisfactory when infection is identified and treated accordingly. Fortunately, serious neonatal forms and severe neurological impairment have become rare, but prompt treatment of children with convulsions, abnormal muscle tone, hydrocephalus, may improve the prognosis and result in almost normal outcome. For infants who have congenital toxoplasmosis, treatment soon after birth for 1 year with pyrimetamine, sulfadiazine and leukoverin led to remarkable resolution of serious, active disease. A long follow-up is necessary to assess the long-term outcome of children and young adults with congenital toxoplasmosis, that is favourable for the majority of cases. Epidemiological surveillance needs to be improved in order to determine the effectiveness of prevention programs.Articoli Selezionati del “3° Convegno Pediatrico del Medio Campidano” · Guspini · 25 Maggio 2013Guest Editor: Roberto Antonucci

  20. Automated percutaneous lumbar discectomy: technique, indications and clinical follow-up in over 1000 patients

    Energy Technology Data Exchange (ETDEWEB)

    Bonaldi, G. [Department of Neuroradiology, Ospedali Riuniti, Bergamo (Italy)

    2003-10-01

    This paper summarises my experience, over 14 years, treating over 1350 patients suffering from lumbar disc pathology, using minimally invasive intradiscal decompressive percutaneous techniques. The vast majority underwent the method introduced by Onik in 1985, referred to as ''automated'' since it involves a mechanical probe, working by a ''suction and cutting'' action for removal of the nucleus pulposus. Postoperative follow-up of at least 6 months was available for 1047 patients aged 15-92 years, who underwent this procedure up to June 2002. Results, based on a patient satisfaction, have been good in 58% of patients at 2 months and in 67.5% at 6 months; they have been particularly favourable in some subgroups such as elderly people (79.5% of excellent or good results), patients previously operated upon (78%) and those with ''discogenic'' low back pain (79%). Complication rates have been extremely low (less than 1%) and all complications cleared up without sequelae. In comparison with other percutaneous disc treatments, Onik's achieves the best compromise between clinical efficacy, comfort for the patient and low invasiveness. (orig.)

  1. Adherence to follow-up CT scans in patients with small pulmonary nodules, a retrospective study

    DEFF Research Database (Denmark)

    Johansson, Sofie Lock; Hansen, Niels-Christian Gerner

    2010-01-01

    Adherence to follow-up CT scans in patients with small pulmonary nodules, a retrospective study The Danish National guidelines have since 2008 suggested serial follow-up CT scans at 3, 6, 12, and 24 months for nodules between 5 and 10 mm and at 12 and 24 months for nodules less than 5 mm in...... in the four year period 2006-2009. In 72 cases, 19 in 2006-2007 and 51 in 2008-2009, one or more small nodules, with diameter ≤ 10 mm, were detected on CT in patients with no known recent malignant disease. For these patients follow-up was suggested, either with CT or PET-CT. One of the 70 patients...... from 2008 was referred to another hospital and we have insufficient data on the follow-up. Another patient – also from 2008 -never came to the suggested first follow-up. Fifty eight patients have completed the first follow-up, while 10 are waiting for the first scheduled control CT. In twelve of the 19...

  2. Follow-up for cervical cancer: a Program in Evidence-Based Care systematic review and clinical practice guideline update

    Science.gov (United States)

    Elit, L.; Kennedy, E.B.; Fyles, A.; Metser, U.

    2016-01-01

    Background In 2009, the Program in Evidence-based Care (pebc) of Cancer Care Ontario published a guideline on the follow-up of cervical cancer. In 2014, the pebc undertook an update of the systematic review and clinical practice guideline for women in this target population. Methods The literature from 2007 to August 2014 was searched using medline and embase [extended to 2000 for studies of human papillomavirus (hpv) dna testing]. Outcomes of interest were measures of survival, diagnostic accuracy, and quality of life. A working group evaluated the need for changes to the earlier guidelines and incorporated comments and feedback from internal and external reviewers. Results One systematic review and six individual studies were included. The working group concluded that the new evidence did not warrant changes to the 2009 recommendations, although hpv dna testing was added as a potentially more sensitive method of detecting recurrence in patients treated with radiotherapy. Comments from internal and external reviewers were incorporated. Recommendations Summary Follow-up care after primary treatment should be conducted and coordinated by a physician experienced in the surveillance of cancer patients. A reasonable follow-up strategy involves visits every 3–4 months within the first 2 years, and every 6–12 months during years 3–5. Visits should include a patient history and complete physical examination, with elicitation of relevant symptoms. Vaginal vault cytology examination should not be performed more frequently than annually. Combined positron-emission tomography and computed tomography, other imaging, and biomarker evaluation are not advocated; hpv dna testing could be useful as a method of detection of recurrence after radiotherapy. General recommendations for follow-up after 5 years are also provided. PMID:27122975

  3. Chronic vagus nerve stimulation in Crohn's disease: a 6-month follow-up pilot study.

    Science.gov (United States)

    Bonaz, B; Sinniger, V; Hoffmann, D; Clarençon, D; Mathieu, N; Dantzer, C; Vercueil, L; Picq, C; Trocmé, C; Faure, P; Cracowski, J-L; Pellissier, S

    2016-06-01

    The vagus nerve (VN) is a link between the brain and the gut. The VN is a mixed nerve with anti-inflammatory properties through the activation of the hypothalamic-pituitary-adrenal axis by its afferents and by activating the cholinergic anti-inflammatory pathway through its efferents. We have previously shown that VN stimulation (VNS) improves colitis in rats and that the vagal tone is blunted in Crohn's disease (CD) patients. We thus performed a pilot study of chronic VNS in patients with active CD. Seven patients under VNS were followed up for 6 months with a primary endpoint to induce clinical remission and a secondary endpoint to induce biological (CRP and/or fecal calprotectin) and endoscopic remission and to restore vagal tone (heart rate variability). Vagus nerve stimulation was feasible and well-tolerated in all patients. Among the seven patients, two were removed from the study at 3 months for clinical worsening and five evolved toward clinical, biological, and endoscopic remission with a restored vagal tone. These results provide the first evidence that VNS is feasible and appears as an effective tool in the treatment of active CD. PMID:26920654

  4. Real-life use of budesonide/formoterol in clinical practice: a 12-month follow-up assessment in a multi-national study of asthma patients established on single-inhaler maintenance and reliever therapy

    OpenAIRE

    Ställberg, Björn; Naya, Ian; Ekelund, Jan; Eckerwall, Göran

    2015-01-01

    Objective: The efficacy and safety of budesonide/formoterol maintenance and reliever therapy (MRT) has been demonstrated in phase III clinical studies, but limited data are available in a real-life setting. We examined the pattern of maintenance and as-needed inhaler use in routine clinical practice among patients with asthma receiving budesonide/formoterol MRT (NCT00505388). Methods: This 12-month European observational study enrolled patients prescribed budesonide/formoterol MRT and grouped...

  5. Three-year follow-up of a randomised clinical trial of intravenous versus oral iron for anaemia in pregnancy

    OpenAIRE

    Alhossain A. Khalafallah; Dennis, Amanda E.; Ogden, Kath; Robertson, Iain; Charlton, Ruth H; Bellette, Jackie M; Shady, Jessica L; Blesingk, Nep; Ball, Madeleine

    2012-01-01

    Background To date, there are no data available concerning the impact of iron therapy on the long-term well-being and health-related quality of life (HRQoL) in pregnancy. Objective To assess the long-term effect of iron therapy on HRQoL in pregnancy. Design This is a follow-up study conducted between January 2010 and January 2011 of an earlier randomised open-label clinical trial of intravenous and oral iron versus oral iron for pregnancy-related iron deficiency anaemia. We used a modified ve...

  6. Advanced hepatocellular carcinoma and sorafenib:Diagnosis, indications, clinical and radiological follow-up

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Advanced stage hepatocellular carcinoma (HCC) is acategory of disease defined by radiological, clinical andhepatic function parameters, comprehending a widerange of patients with different general conditions. Themain therapeutic option is represented by sorafenibtreatment, a multi-kinase inhibitor with anti-proliferativeand anti-angiogenic effect. Trans-arterial Radio Embolizationalso represents a promising new approach tointermediate/advanced HCC. Post-marketing clinicalstudies showed that only a portion of patients actuallybenefits from sorafenib treatment, and an even smallerpercentage of patients treated shows partial/completeresponse on follow-up examinations, up against relevantcosts and an incidence of drug related adverse effects.Although the treatment with sorafenib has shown asignificant increase in mean overall survival in differentstudies, only a part of patients actually shows realbenefits, while the incidence of drug related significantadverse effects and the economic costs are relativelyhigh. Moreover, only a small percentage of patientsalso shows a response in terms of lesion dimensionsreduction. Being able to properly differentiate patientswho are responding to the therapy from non-respondersas early as possible is then still difficult and couldbe a pivotal challenge for the future; in fact it couldspare several patients a therapy often difficult to bear,directing them to other second line treatments (many ofwhich are at the moment still under investigation). Forthis reason, some supplemental criteria to be added tothe standard modified Response Evaluation Criteriain Solid Tumors evaluation are being searched for. Inparticular, finding some parameters (cellular density,perfusion grade and enhancement rate) able to predictthe sensitivity of the lesions to anti-angiogenic agentscould help in stratifying patients in terms of treatmentresponsiveness before the beginning of the therapyitself, or in the first weeks of sorafenib treatment

  7. Medication overuse headache: a critical review of end points in recent follow-up studies

    DEFF Research Database (Denmark)

    Hagen, Knut; Jensen, Rigmor; Bøe, Magne Geir; Stovner, Lars Jacob

    2010-01-01

    No guidelines for performing and presenting the results of studies on patients with medication overuse headache (MOH) exist. The aim of this study was to review long-term outcome measures in follow-up studies published in 2006 or later. We included MOH studies with >6 months duration presenting a...

  8. Postnatal clinical and imaging follow-up of infants with prenatal isolated mild ventriculomegaly: a series of 101 cases

    Energy Technology Data Exchange (ETDEWEB)

    Falip, Celine; Sebag, Guy [Hopital Robert Debre, Department of Paediatric Imaging, Paris (France); Blanc, Nathalie; Maes, Emmanuelle [Hopital Robert Debre, Department of Pediatric Neurology and Metabolic Diseases, Paris (France); Zaccaria, Isabelle [Hopital Robert Debre, AP-HP, Unit of Clinical Epidemiology INSERM, Paris (France); Oury, Jean F. [Hopital Robert Debre, Department of Obstetrics and Gynaecology, Paris (France); Garel, Catherine [Hopital d' Enfants Armand-Trousseau, Department of Radiology, Paris (France)

    2007-10-15

    Postnatal imaging and clinical outcome of fetuses with isolated mild ventriculomegaly (IMV) have never been systematically analysed. To evaluate the postnatal clinical outcomes of a large cohort of fetuses with IMV and to correlate them with pre- and postnatal imaging. We report a prospective study of 101 fetuses with IMV (10-15 mm ventriculomegaly with otherwise normal US, MRI, karyotype and TORCH screening). IMV was divided into minor (10-11.9 mm) and moderate (12-15 mm) ventriculomegaly. Ventriculomegaly was considered uni- or bilateral, stable, progressive, regressive or resolved according to the prenatal US follow-up. Clinical follow-up was performed by a neuropaediatrician. Postnatal imaging included cranial US (n = 71) and MRI (n = 76). The outcome of minor and moderate IMV was excellent in 94% and 85% of infants, respectively. It was not different between uni- and bilateral IMV, and between stable, regressive and resolved IMV, and was independent of gestational age at diagnosis and gender. Fixed neurological abnormalities were observed in nine infants. Postnatal MRI showed white-matter abnormalities in 14 infants, including 6 of the 9 infants with a poor outcome. The prognosis was slightly better in minor IMV than in moderate IMV. Postnatal MRI showed white-matter abnormalities in two-thirds of the infants with a poor outcome. (orig.)

  9. Supported local implementation of clinical guidelines in psychiatry: a two-year follow-up

    OpenAIRE

    Janszky Imre; Brommels Mats; Wistedt Anna; Forsner Tord; de Leon Antonio; Forsell Yvonne

    2010-01-01

    Abstract Background The gap between evidence-based guidelines for clinical care and their use in medical settings is well recognized and widespread. Only a few implementation studies of psychiatric guidelines have been carried out, and there is a lack of studies on their long-term effects. The aim of this study was to measure compliance to clinical guidelines for treatment of patients with depression and patients with suicidal behaviours, two years after an actively supported implementation. ...

  10. Intranasal LH-RH treatment of cryptorchidism. A clinical trial and 5 years follow-up

    DEFF Research Database (Denmark)

    Thorup, Jørgen Mogens; Mauritzen, K; Skakkebaek, N E

    1987-01-01

    The effect of intranasal LH-RH on cryptorchidism was investigated in 45 prepubertal boys with 68 undescended testes. A daily dose of 1.2 mg LH-RH was given for 4 weeks. A total of 16 testes (24%) descended. Follow-up examination 5 years later showed that relapse had occurred in two cases. Fifty-t...

  11. Clinical assessment and echocardiography follow-up results of the children with acute rheumatic fever

    OpenAIRE

    Ahmet Basturk; Kazim Oztarhan; Sultan Kavuncuoglu; Cemal Polat

    2016-01-01

    Acute rheumatic fever (ARF) is an inflammatory collagenous tissue disease which shows its cardinal signs in joints, heart, skin and nervous system while affecting whole connective tissue system more or less. This study was conducted in order to investigate the clinical pattern and severity of ARF, echocardiographic findings and the course of the patients with heart valve involvement by studying the clinical and laboratory aspects of the patients diagnosed with ARF according to updated Jones c...

  12. Profile of a Liver Transplant Follow-Up Clinic in a Nontransplant Canadian Urban Centre

    OpenAIRE

    Bazylewski, R; Rosser, BG; Cohen, A; Kaita, KDE; Minuk, GY

    1997-01-01

    Care of the growing number of liver transplant recipients will increasingly fall on the referring centres. Thus, there is a need to define more clearly the demographic, clinical and laboratory profiles of liver transplant recipients, particularly in the setting of a centre where a liver transplantation program does not exist. The present study documented these features in 37 patients attending an adult ambulatory care clinic in an urban, nonliver transplant centre. Mean ± SD age of the study ...

  13. Sierra Leone's Former Child Soldiers: A Follow-Up Study of Psychosocial Adjustment and Community Reintegration

    Science.gov (United States)

    Betancourt, Theresa Stichick; Borisova, Ivelina Ivanova; Williams, Timothy Philip; Brennan, Robert T.; Whitfield, Theodore H.; de la Soudiere, Marie; Williamson, John; Gilman, Stephen E.

    2010-01-01

    This is the first prospective study to investigate psychosocial adjustment in male and female former child soldiers (ages 10-18; n = 156, 12% female). The study began in Sierra Leone in 2002 and was designed to examine both risk and protective factors in psychosocial adjustment. Over the 2-year period of follow-up, youth who had wounded or killed…

  14. Personnel Needs in School Psychology: A 10-Year Follow-Up Study on Predicted Personnel Shortages

    Science.gov (United States)

    Castillo, Jose M.; Curtis, Michael J.; Tan, Sim Yin

    2014-01-01

    Concerns regarding whether a sufficient supply of school psychologists exists have been evident for decades. Studies have predicted that school psychology would face a critical personnel shortage that would peak in 2010, but continue into the foreseeable future. The current study is a 10-year follow-up investigation based on previously published…

  15. A Follow-Up Study on Word and Non-Word Reading Skills in Down Syndrome

    Science.gov (United States)

    Roch, Maja; Jarrold, Christopher

    2012-01-01

    The current study was designed to trace changes in the relationship between non-word reading and irregular word reading on the one hand, and between phonological awareness and non-word reading on the other, through a follow-up study of a group of individuals with Down syndrome. Twelve individuals with Down syndrome, whose data were originally…

  16. A five-year follow-up study of Swedish adults with gender identity disorder.

    Science.gov (United States)

    Johansson, Annika; Sundbom, Elisabet; Höjerback, Torvald; Bodlund, Owe

    2010-12-01

    This follow-up study evaluated the outcome of sex reassignment as viewed by both clinicians and patients, with an additional focus on the outcome based on sex and subgroups. Of a total of 60 patients approved for sex reassignment, 42 (25 male-to-female [MF] and 17 female-to-male [FM]) transsexuals completed a follow-up assessment after 5 or more years in the process or 2 or more years after completed sex reassignment surgery. Twenty-six (62%) patients had an early onset and 16 (38%) patients had a late onset; 29 (69%) patients had a homosexual sexual orientation and 13 (31%) patients had a non-homosexual sexual orientation (relative to biological sex). At index and follow-up, a semi-structured interview was conducted. At follow-up, 32 patients had completed sex reassignment surgery, five were still in process, and five-following their own decision-had abstained from genital surgery. No one regretted their reassignment. The clinicians rated the global outcome as favorable in 62% of the cases, compared to 95% according to the patients themselves, with no differences between the subgroups. Based on the follow-up interview, more than 90% were stable or improved as regards work situation, partner relations, and sex life, but 5-15% were dissatisfied with the hormonal treatment, results of surgery, total sex reassignment procedure, or their present general health. Most outcome measures were rated positive and substantially equal for MF and FM. Late-onset transsexuals differed from those with early onset in some respects: these were mainly MF (88 vs. 42%), older when applying for sex reassignment (42 vs. 28 years), and non-homosexually oriented (56 vs. 15%). In conclusion, almost all patients were satisfied with the sex reassignment; 86% were assessed by clinicians at follow-up as stable or improved in global functioning. PMID:19816764

  17. Risk factors for onset of asthma: a 12-year prospective follow-up study

    DEFF Research Database (Denmark)

    Porsbjerg, C; von Linstow, Marie-Louise; Ulrik, Charlotte Suppli;

    2006-01-01

    sensitization to aeroallergens were measured. RESULTS: Among the 281 nonasthmatic participants studied, 58 (22%) had AHR to histamine, 33 (12%) had EIB, and 82 (29%) had AHR to histamine and/or EIB. At follow-up, 37.9% of individuals with AHR to histamine and 30% of individuals with EIB had developed current...

  18. CT-follow-up-studies in neurocysticercosis during praziquantel-therapy

    International Nuclear Information System (INIS)

    Praziquanteltherapy has produced a much better prognosis in neurocysticercosis since 1980. The computertomographic findings and follow-up study in 4 patients with neurocysticercosis before and after praziquanteltherapy are described. The special difficulties of differential diagnosis and further diagnostic procedures are discussed in cases in which calcifications are absent and only solitary foci can be found. (orig.)

  19. CT-follow-up-studies in neurocysticercosis during praziquantel-therapy

    Energy Technology Data Exchange (ETDEWEB)

    Schwartz, A.; Aulich, A.; Hammer, B.

    1987-05-01

    Praziquanteltherapy has produced a much better prognosis in neurocysticercosis since 1980. The computertomographic findings and follow-up study in 4 patients with neurocysticercosis before and after praziquanteltherapy are described. The special difficulties of differential diagnosis and further diagnostic procedures are discussed in cases in which calcifications are absent and only solitary foci can be found.

  20. A Follow-Up Study of Graduates of the Perceptual and Behavioural Special Classes.

    Science.gov (United States)

    Gershman, Janis

    Investigated with a follow-up study of successful reintegration into regular classes in the Toronto system was the success of two special programs for elementary level students who were identified as having learning disabilities presumed to be organic, or whose learning disabilities were primarily emotional or behavioral in origin. The initial…

  1. Exploring "Successful" Outcomes of Entrepreneurship Education: A Follow-Up Study

    Science.gov (United States)

    Galloway, Laura; Kapasi, Isla; Whittam, Geoff

    2015-01-01

    During 2005-2006 entrepreneurship students in several UK universities completed a survey about their background and career intentions. This paper reports, eight years on, on a follow-up study with ten of these participants, with the aim of exploring the students' intentions and subsequent actions since graduating. Using a qualitative methodology,…

  2. Rehabilitation after severe brain injury: a follow-up study of a behaviour modification approach.

    OpenAIRE

    Eames, P.; Wood, R.

    1985-01-01

    Twenty four patients with severe brain injury who had disturbed behaviours preventing rehabilitation or care in ordinary settings were treated in a token economy. This long-term follow-up study indicates that post-traumatic behaviour disorders can be lastingly improved, and that lengthy rehabilitation can have surprisingly good effects.

  3. A clinical and radiological evaluation of the relative efficacy of demineralized freeze-dried bone allograft versus anorganic bovine bone xenograft in the treatment of human infrabony periodontal defects: A 6 months follow-up study

    Directory of Open Access Journals (Sweden)

    Vikram Blaggana

    2014-01-01

    Full Text Available Background: The ultimate goal of periodontal therapy entails regeneration of the periodontal tissues lost as a consequence of periodontitis. Predictable correction of vertical osseous defects has however posed as a constant therapeutic challenge. The aim of our present study is to evaluate the relative efficacy of demineralized freeze-dried bone allograft (DFDBA vs anorganic bovine bone xenograft (ABBX in the treatment of human infrabony periodontal defects. Materials and Methods: 15 patients with 30 bilaterally symmetrical defect sites in either of the arches, in the age group of 25-50 years were selected as part of split-mouth study design. Defect-A (right side was grafted with DFDBA while Defect-B (left side was grafted with ABBX. Various clinical and radiographic parameters viz. probing depth(PD, clinical attachment level(CAL and linear bone fill were recorded preoperatively, 12- & 24-weeks postoperatively. Results: Both defect-A & defect-B sites exhibited a highly significant reduction in probing depth, and gain in clinical attachment level and linear bone fill at 12-weeks & at the end of 24-weeks. Comparative evaluation between the study groups revealed a statistically non-significant reduction in probing depth (P<0.1 and mean gain in linear bone fill (P<0.1. However, there was a statistically significant gain in clinical attachment level (P <0.05 in Defect-A (CD=0.356 as compared to Defect-B (CD=0.346. Conclusions: Within the limits of this study, both the materials viz. ABBX and DFDBA are beneficial for the treatment of periodontal infrabony defects. Both the materials were found to be equally effective in all respects except the gain in attachment level, which was found to be more with DFDBA. Long-term studies are suggested to evaluate further the relative efficacy of the two grafts.

  4. 齐拉西酮对女性精神分裂症疗效的随访研究%Clinical Follow-up Study on the Efficacy of Ziprasidone in the Treatment of Female Schizophrenic

    Institute of Scientific and Technical Information of China (English)

    闾金杰; 席杨; 李海玲; 徐冬梅; 刘玲; 冯宝珍

    2012-01-01

    Objective To explore the long-term efficacy of ziprasidone in the treatment of female schizophrenic patients. Methods A total of 100 female patients with schizophrenia were randomly divided into two groups, respectively took ziprasidone or risperidone for 8 weeks, 1 years follow-up study was carried out after the treatment. Using BPRS,TESS scale and life quality evaluation questionnaire (GQOLI - 74) to assessment. Results There were no significant differences before treatment between two groups (After treatment, BPRS, GQOLI-74 scores and treatment compliance compared with before treatment were significantly increased CP 0. 05) ;there were no significant differences in BPRS score between two groups at different time points. 1 years after discharge,the BPRS total points and social functions were better in study group than in control group;the recurrence rate,readmission rates were lower than those of control group. Conclusion Ziprasidone is a safe and effective atypical antipsychotic drug,and can control the psychiatric symptoms;it has little adverse reactions,good treatment compliance,especially for female schizophrenic patients with long-term rehabilitation.%目的 探讨齐拉西酮对女性精神分裂症患者的远期疗效.方法 将100例女性精神分裂症患者随机分为两组,分别予齐拉西酮和利培酮治疗,疗程8周,治疗结束后作1年的随访研究.用简明精神病评定量表(BPRS)、副反应量表(TESS)和生活质量综合评定问卷(GQOLI- 74)进行相关评定.结果 治疗前两组间各项评分均无统计学差异;治疗后两组BPRS、GQOLI-74总分及治疗依从性与治疗前相比均显著提高(P<0.05~0.01);两组有效率分别为94%和92%,无统计学差异(P>0.05);8周内两组间各时点BPRS总分无统计学差异.出院1年后,研究组的BPRS总分及社会功能分均优于对照组;复发率、再住院率均低于对照组.结论 齐拉西酮是一种安全有效的非典型抗精神病

  5. [Accidental ethyl alcohol intoxication in a 30-day-old infant. Clinical findings and neurological follow-up].

    Science.gov (United States)

    Palano, G M; Praticò, A D; Praticò, E R; D'Agata, A; Carpinato, C; Sottile, F; Distefano, G

    2007-06-01

    Fetus damages due to alcohol abuse in pregnancy, fetal alcohol syndrome (FAS), are widely documented in the literature, whereas short and long term clinical signs of acute alcohol intoxication in newborn babies are poorly described. In our study we describe the case of a 30-day-old newborn baby erroneously fed with 70 mL of white wine in place of the water for milk dilution. The baby clinical features were torpor, tremors, slight fever without metabolic anomalies typical of classic acute alcohol intoxication such as hypoglycemia, hypothermia, metabolic acidosis and coma. Periodical follow-up a 2, 3, 6 and 12 months were performed in order to evaluate neuromotor development using Bayley Scales of Infant Development II, for children between 1 and 42 months old. The results showed normal psychomotor development in our patient. PMID:17519873

  6. Course and moderators of emotional eating in anorectic and bulimic patients: a follow-up study.

    Science.gov (United States)

    Fioravanti, Giulia; Castellini, Giovanni; Lo Sauro, Carolina; Ianni, Sirio; Montanelli, Luca; Rotella, Francesco; Faravelli, Carlo; Ricca, Valdo

    2014-04-01

    Emotion dysregulation has been found to be associated with specific eating attitudes and behavior in Eating Disorder (ED) patients. The present study evaluated whether emotional eating profile of ED patients changes over time and the possible effects of a psychotherapeutic intervention on the emotional eating dimension. One hundred and two ED patients (28 with Anorexia Nervosa restricting type [AN-R], 35 with Anorexia Nervosa binge/purging subtype [AN-B/P] and 39 with Bulimia Nervosa [BN]) were evaluated at baseline, at the end of a Cognitive Behavioral Therapy, at 3 and 6 year follow-up. The Structured Clinical Interview for DSM IV Axis I Disorders, the Emotional Eating Scale (EES) and several self-reported questionnaires for eating specific and general psychopathology were applied. A control group of 86 healthy subjects was also studied, in order to compare psychopathological variables at baseline. A significant EES total score reduction was observed among AN-B/P and BN patients, whereas no significant change was found in the AN-R group. Mixed Models analyses showed that a significant effect on EES total score variation was found for cocaine or amphetamine abuse (b = .25; p < .01). Patients who assumed these substances reported no significant EES reduction across time, unlike other patients. The present results suggest that ED patients with a history of cocaine or amphetamine abuse represent a sub-population of patients with lasting dysfunctional mood modulatory mechanisms. PMID:24854803

  7. Effectiveness of a tinnitus management programme: a 2-year follow-up study

    Directory of Open Access Journals (Sweden)

    Sørensen Jan

    2009-06-01

    Full Text Available Abstract Background Tinnitus impairs the possibility of leading a normal life in 0.5–1% of the population. While neither medical nor surgical treatment appears effective, counselling may offer some relief. An intervention combining counselling and hearing devices is offered to clients referred to the Centre for Help Aids and Communication (CHC in southern Denmark. The aims of this exploratory study were to examine i the characteristics of CHC's clients and their tinnitus, ii the effectiveness of the treatment, and iii whether particular client groups benefit more than others. Methods One hundred new clients presenting with tinnitus completed the Tinnitus Handicap Inventory (THI three times – before their first consultation, after one month and after 1–2 years. The scores were tested for significant differences over time using tests for paired data. Logistic regression was used to examine factors associated with a clinically important difference (i.e. THI score improvement of at least 20 points. Results At final follow-up, total THI score was significantly lower than baseline, i.e. 29.8 (CI 25.5–34.2 vs. 37.2 (CI 33.1–37.2, p Conclusion The tinnitus management programme appeared to provide significant benefit to many clients at a relatively low cost. It would be useful to conduct a randomised controlled study comparing the current programme with alternative forms of combination counselling/sound therapy approaches.

  8. Telephone follow-up for cataract surgery: feasibility and patient satisfaction study.

    Science.gov (United States)

    Hoffman, Jeremy J S L; Pelosini, Lucia

    2016-05-01

    Purpose - The purpose of this paper is to investigate the feasibility of telephone follow-up (TFU) after uncomplicated cataract surgery in low-risk patients and patient satisfaction with this alternative clinical pathway. Design/methodology/approach - Prospective, non-randomised cohort study. A ten-point subjective ophthalmic assessment questionnaire and a six-point patient satisfaction questionnaire were administered to patients following routine cataract surgery at two to three weeks post-procedure. All patients were offered a further clinic review if required. Exclusion criteria comprised ophthalmic co-morbidities, hearing/language impairment and high risk of post-operative complications. Patient notes were retrospectively reviewed over the study period to ensure no additional emergency attendances took place. Findings - Over three months, 50 eyes of 50 patients (mean age: 80; age range 60-91; 66 per cent second eye surgery) underwent uncomplicated phacoemulsification surgery received a TFU at 12-24 days (mean: 16 days) post-operatively. Subjective visual acuity was graded as good by 92 per cent of patients; 72 per cent patients reported no pain and 20 per cent reported mild occasional grittiness. Patient satisfaction was graded 8.9 out of 10; 81.6 per cent defined TFU as convenient and 75.5 per cent of patients preferred TFU to routine outpatient review. No additional visits were required. Research limitations/implications - Non-randomised with no control group; small sample size. One patient was unable to be contacted. Practical implications - Post-operative TFU can be suitably targeted to low-risk patients following uncomplicated cataract surgery. This study demonstrated a high patient satisfaction. A larger, randomised study is in progress to assess this further. Originality/value - This is the first study reporting TFU results and patient satisfaction to the usual alternative two-week outpatient review. PMID:27142949

  9. Prevalent pain and pain level among torture survivors: a follow-up study

    DEFF Research Database (Denmark)

    Dorthe Reff, Olsen; Montgomery, Edith; Carlsson, J;

    2006-01-01

    AIM: To estimate change over nine months and over two years, as concerns the prevalence and level of pain in the head, back and feet, among previously tortured refugees settled in Denmark, and to compare associations between torture methods and the prevalence of pain at baseline and at follow......-up. METHODS: Sixty-nine refugees previously exposed to torture in their home country were interviewed at a Danish rehabilitation clinic. Fifty-four accepted to be re-interviewed after nine months, and 47 were interviewed again 14 months later. Interviews focussed on the history of exposure to physical and...... mental torture and on pain in the head, back and feet at baseline and at follow-up. RESULTS: The mean cumulative duration of imprisonment was 1.7 years, and on the average more than 10 years elapsed between torture and examination. The most frequent physical torture method reported was beating (97...

  10. Gestational trophoblastic diseases - clinical guidelines for diagnosis, treatment, follow-up, and counselling

    DEFF Research Database (Denmark)

    Niemann, Isa; Vejerslev, Lars O; Frøding, Ligita; Blaakær, Jan; Maroun, Lisa Leth; Hansen, Estrid Stæhr; Grove, Anni; Lund, Helle; Havsteen, Hanne; Sunde, Lone

    2015-01-01

    forwarded unfixed for genetic analysis (D). Serum hCG is measured on suspicion of hydatidiform mole. At the time of the uterine evacuation, the initial hCG is measured (A). After a hydatidiform mole that is both triploid and partial, serum hCG is measured weekly until there are two consecutive undetectable...... values (< 1 or < 2), after which the patient can be discharged from follow-up (C). After a diploid hydatidiform mole, a complete mole, or a hydatidiform mole without valid ploidy determination, serum hCG is measured weekly until the value is undetectable (< 1 or < 2). If serum hCG is undetectable within...... 56 days after evacuation, the patient can be discharged from follow-up after an additional four monthly measurements. If serum hCG is first normalised after 56 days, the patient is follow-up with monthly serum hCG measurement for six months. Safe contraception should be used during the follow...

  11. Methods used for successful follow-up in a large scale national cohort study in Thailand

    Directory of Open Access Journals (Sweden)

    Chokkanapitak Jaruwan

    2011-05-01

    Full Text Available Abstract Background Ensuring successful follow-up is essential when conducting a prospective cohort study. Most existing literature reviewing methods to ensure a high response rate is based on experience in developed nations. Findings We report our 4-year follow-up success for a national cohort study examining the health transition underway in Thailand. We began the cohort study in 2005 with a baseline postal questionnaire sent to all 200,000 Thais enrolled as distance learning students at Sukhothai Thammathirat Open University and residing all over Thailand; 87,134 or 44% of the students responded. Subsequently we used University and national media to inform cohort members of study progress. Also, we prepared a health book with study results and health advice which was distributed to all cohort members. After 4 years we repeated the survey and achieved a 71% response rate. In this paper we report the methods used to achieve this response The initial follow-up mail-out generated a response rate of about 48% reflecting the extensive preparatory work between baseline and follow-up. After 4 rounds of telephone contact (more than 100,000 phone calls and 4 related mail-out rounds progressively over 16 months an overall response rate was achieved of just over 71% (n = 60,774. The total cost was US$4.06/respondent - 19% for printing, 21% for postage, 14% for tape measures (included in mail-out, 18% for data processing 22% for prizes and 6% for telephone. Conclusions Many of the methods reported as effective for mail questionnaire and cohort response rates held true for Thailand. These included being associated with a university, incentivating cooperation, follow-up contact, providing a second copy of questionnaire where necessary, and assurance of confidentiality. Telephone contact with the cohort and the small prizes given to responders were particularly important in the Thai context as was Thai leadership of the research team.

  12. Follow-up of children exposed to ionising radiation from cardiac catheterisation: the Coccinelle study

    International Nuclear Information System (INIS)

    Cardiac catheterisation has become an essential tool in the diagnosis and treatment of children with a wide variety of congenital and acquired forms of cardiovascular disease. Despite the clear clinical benefit to the patient, radiation exposure from paediatric cardiac catheterisation procedures (CCPs) may be substantial. Given children's greater sensitivity to radiation and the longer life span during which radiation health effects can develop, an epidemiological cohort study, named Coccinelle or 'Ladybird' (French acronym for 'Cohorte sur le risque de cancer apres cardiologie interventionnelle pediatrique'), is carried out in France to evaluate the risks of leukaemia and solid cancers in this population. A total number of 8000 included children are expected. Individual CCP-related doses will be assessed for each child included in the cohort. For each CCP performed, dosimetric parameters (dose-area product, fluoroscopy time and total number of cine frames) are retrieved retrospectively. Organ doses, especially to the lung, the oesophagus and the thyroid, are calculated with PCXMC software. The cohort will be followed up through linkage with French paediatric cancer registries. (authors)

  13. Insulin resistance, adiponectin and adverse outcomes following elective cardiac surgery: a prospective follow-up study

    Directory of Open Access Journals (Sweden)

    Hjortdal Vibeke E

    2010-12-01

    Full Text Available Abstract Background Insulin resistance and adiponectin are markers of cardio-metabolic disease and associated with adverse cardiovascular outcomes. The present study examined whether preoperative insulin resistance or adiponectin were associated with short- and long-term adverse outcomes in non-diabetic patients undergoing elective cardiac surgery. Methods In a prospective study, we assessed insulin resistance and adiponectin levels from preoperative fasting blood samples in 836 patients undergoing cardiac surgery. Population-based medical registries were used for postoperative follow-up. Outcomes included all-cause death, myocardial infarction or percutaneous coronary intervention, stroke, re-exploration, renal failure, and infections. The ability of insulin resistance and adiponectin to predict clinical adverse outcomes was examined using receiver operating characteristics. Results Neither insulin resistance nor adiponectin were statistically significantly associated with 30-day mortality, but adiponectin was associated with an increased 31-365-day mortality (adjusted odds ratio 2.9 [95% confidence interval 1.3-6.4] comparing the upper quartile with the three lower quartiles. Insulin resistance was a poor predictor of adverse outcomes. In contrast, the predictive accuracy of adiponectin (area under curve 0.75 [95% confidence interval 0.65-0.85] was similar to that of the EuroSCORE (area under curve 0.75 [95% confidence interval 0.67-0.83] and a model including adiponectin and the EuroSCORE had an area under curve of 0.78 [95% confidence interval 0.68-0.88] concerning 31-365-day mortality. Conclusions Elevated adiponectin levels, but not insulin resistance, were associated with increased mortality and appear to be a strong predictor of long-term mortality. Additional studies are warranted to further clarify the possible clinical role of adiponectin assessment in cardiac surgery. Trial Registration The Danish Data Protection Agency; reference no

  14. Diffusion-weighted MR imaging of neuro-Behcet's disease: initial and follow-up studies

    International Nuclear Information System (INIS)

    To assess the usefulness of diffusion-weighted MR imaging (DWI) and apparent diffusion coefficient (ADC) in the initial and follow-up studies of patients with neuro-Behcet's disease. Six patients diagnosed with neuro-Behcet's disease were the subjects of this study. Initial and follow-up MR imaging were obtained in all six patients. Initial and follow-up DWI were also obtained is four of the six patients, with only an initial DWI in the other two. The DWI were obtained using multi-shot echo planar imaging, on a 1.5T MR unit, with two gradient steps (b values of 0, 1000 sec/mm2). The ADC value and ADC maps were obtained using commercial software. The locations and signal intensities of the lesions were analyzed on conventional MRI and DWI, respectively. The ADC values of the lesions were calculated on the initial and follow-up DWI, and compared those of lesions in the normal contralateral regions. The initial DWI showed iso-signal intensities in four of the six patients, with high signal intensities in the other two. In five of the six patients, including three of the four that showed isosignal intensities and the two that showed high signal intensities on the initial DWI, the ADC values of the involved lesions were higher than those of the normal contralateral regions. In three of four that showed isosignal intensities, the ADC values of the lesions were decreased and normalized on the follow-up DWI. Obtaining DWI and ADC values in patients with neuro-Behcet's disease may be helpful in the understanding of pathophysiology and differential diagnosis of this disease

  15. Follow-up study on the psychological aspects of chronic pain : quantitative and qualitative correlates of outcomes at one year

    OpenAIRE

    Wong, Ting; 黃婷

    2014-01-01

    Objective: Chronic back pain is highly prevalent in orthopaedic clinics. The aim of the study was to investigate the relationship of psychological factors affecting disability and distress outcomes in chronic low back pain patients. Clinicians shared the impression that chronic pain patients resulted from Injury on Duty (IOD) were particularly difficult to manage. Profiles of IOD patients and non-IOD patients were compared. Methods: The present study is a prospective follow-up study....

  16. Percutaneous laser disc decompression: Clinical experience at SCTIMST and long term follow up

    Directory of Open Access Journals (Sweden)

    Gupta Arun

    2006-01-01

    Full Text Available Background: Low backache (LBA is now increasing in younger population due to misdirected spinal kinetics secondary to improper posture, heavy load lifting and motorbike driving. Hence minimally invasive procedures are increasingly sought after. Among these, PLDD is currently popular and in use. We present our long term follow-up in the use of Nd:YAG laser for PLDD. Aim: To evaluate the efficacy of PLDD in treatment of contained herniation of lumbar discs & long term follow up results. Materials and Methods: Forty patients with contained lumbar disc herniation on MRI and who did not respond to 6 weeks conservative treatment were subjected to PLDD. L4-5 disc was treated in 31, L5-S1 in 12 and L1-2 and L3-4 in one each. Nd:YAG laser at 1064 nm was used for the procedure. Total laser energy of 1500-2000 Joules was delivered at the disc space depending upon the size. Results: There was immediate pain relief in 32/40 (80%. According to MacNab criteria good to fair response was seen in 37/40 (92% and 3 patients (7.5% responded poorly to this treatment. On follow up which ranged from 1 to 7 years, 34/40 (85% had pain relief with no need for further treatment. Complications: Significant pain at local puncture site was experienced by 8 (20%, pain during lasing was experienced by one. One patient developed muscular spasm. Conclusion: Percutaneous laser disc decompression is a safe, relatively noninvasive and effective treatment modality for contained, nonsequestered, herniated lumbar disc disease in carefully selected patients.

  17. Cohabitation and marital status as predictors of mortality - an eight year follow-up study

    DEFF Research Database (Denmark)

    Due, Pernille; Modvig, Jens Simon; Holstein, Bjørn Evald;

    2002-01-01

    In a follow-up study of 1265 women and men aged 50, 60 and 70 years, we analysed how mortality was associated with cohabitation status (living alone/not living alone), living with/without a partner, and marital status respectively. Data originate from a longitudinal questionnaire study of a rando....... We suggest that in future studies of social relations and mortality, cohabitation status is considered to replace marital status as this variable may account for more of the variation in mortality....

  18. A randomized double-blind clinical trial of posterior composite restorations with or without bevel: 1-year follow-up

    Directory of Open Access Journals (Sweden)

    Fábio Herrmann Coelho-De-Souza

    2012-04-01

    Full Text Available OBJECTIVE: This randomized double-blind clinical trial compared the performance of posterior composite restorations with or without bevel, after 1-year follow-up. MATERIAL AND METHODS: Thirteen volunteers requiring at least two posterior composite restorations were selected. Twenty-nine cavities were performed, comprising 14 without bevel (butt joint and 15 with bevel preparation of the enamel cavosurface angle. All cavities were restored with simplified adhesive system (Adper Single Bond and composite resin (Filtek P60. A halogen light curing unit was used through the study. Restorations were polished immediately. Analysis was carried out at baseline, after 6 months and after 1 year by a calibrated evaluator (Kappa, according to the FDI criteria. Data were statistically analyzed by Mann-Whitney test (p <0.05. RESULTS: Beveled and non-beveled cavities performed similarly after 1 year follow-up, regarding to fractures and retention, marginal adaptation, postoperative hypersensitivity, recurrence of caries, surface luster and anatomic form. However, for surface and marginal staining, beveled cavities showed significantly better performance (p<0.05 than butt joint restorations. CONCLUSIONS: It was concluded that the restorations were acceptable after 1 year, but restorations placed in cavities with marginal beveling showed less marginal staining than those placed in non-beveled cavities.

  19. Long-term follow-up study and long-term care of childhood cancer survivors

    Directory of Open Access Journals (Sweden)

    Hyeon Jin Park

    2010-04-01

    Full Text Available The number of long-term survivors is increasing in the western countries due to remarkable improvements in the treatment of childhood cancer. The long-term complications of childhood cancer survivors in these countries were brought to light by the childhood cancer survivor studies. In Korea, the 5-year survival rate of childhood cancer patients is approaching 70%; therefore, it is extremely important to undertake similar long-term follow-up studies and comprehensive long-term care for our population. On the basis of the experiences of childhood cancer survivorship care of the western countries and the current Korean status of childhood cancer survivors, long-term follow-up study and long-term care systems need to be established in Korea in the near future. This system might contribute to the improvement of the quality of life of childhood cancer survivors through effective intervention strategies.

  20. Prediction of 90-day mortality in older patients after discharge from an emergency department: a retrospective follow-up study

    OpenAIRE

    Hofman, Susanna E.; Lucke, Jacinta A.; Heim, Noor; de Gelder, Jelle; Fogteloo, Anne J.; Heringhaus, Christian; de Groot, Bas; Anton J M de Craen; Blauw, Gerard Jan; Mooijaart, Simon P.

    2016-01-01

    Background Older people frequently attend the emergency department (ED) and have a high risk of poor outcome as compared to their younger counterparts. Our aim was to study routinely collected clinical parameters as predictors of 90-day mortality in older patients attending our ED. Methods We conducted a retrospective follow-up study at the Leiden University Medical Center (The Netherlands) among patients aged 70 years or older attending the ED in 2012. Predictors were age, gender, time and w...

  1. Prognosis of Adamantinoma of Long Bones: A Long-Term Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Khodamorad Jamshidi

    2016-05-01

    Full Text Available Background Adamantinoma of long tubular bones is a rare primary malignant bone tumor. According to the literature, different prognosis and recurrence rates have been reported. Objectives The purpose of this case series study was to evaluate the clinical behavior and prognostic features of adamantinoma of long bones. Patients and Methods In this study, 13 histologically proven cases of adamantinoma of long bones which were treated in our hospital during March 1977 to June 2015 were evaluated. The mean follow-up period was 72 ± 44.4 months. The male:female ratio was 10:3, aged between 13 and 63 years at the time of diagnosis (mean = 24.8 ± 13.1 years. There was a period between the onset of disease and definite diagnosis (mean: 17.5 ± 14.7 months. In two cases according to the imaging and clinical symptoms the lesion seemed to be osteofibrous dysplasia, but during the follow-up, the diagnosis was changed to adamantinoma when open biopsy and pathologic assessment were performed. In 10 cases the tumor was located in the tibial diaphysis, in two cases the location was the distal shaft of the femur, and in one case the location was proximal of the humerus. All the cases underwent wide resection and intercalary or osteoarticular allograft reconstruction as the main surgery after primary incisional biopsy. Results In eight cases, at least one local recurrence happened in an average 33.4-month period after the wide resection. In four of these patients rather than one local recurrence was occurred, but in one patient despite pulmonary metastasis the patient underwent pulmonary lobectomy and was alive at the end of the study. Allograft-related complications happened in five cases (two infections, one osteoarthritis of ankle, and two allograft fractures. For five patients ultimately recurrence and complication lead to amputation. Six patients died because of this disease, in all of which pulmonary metastasis occurred. The five-year survival rate in this

  2. Endocrine dysfunction following traumatic brain injury: a 5-year follow-up nationwide-based study

    Science.gov (United States)

    Yang, Wei-Hsun; Chen, Pau-Chung; Wang, Ting-Chung; Kuo, Ting-Yu; Cheng, Chun-Yu; Yang, Yao-Hsu

    2016-01-01

    Post-traumatic endocrine dysfunction is a complication of traumatic brain injury (TBI). However, there is lack of long-term follow-up and large sample size studies. This study included patients suffering from TBI registered in the Health Insurance Database. Endocrine disorders were identified using the ICD codes: 244 (acquired hypothyroidism), 253 (pituitary dysfunction), 255 (disorders of the adrenal glands), 258 (polyglandular dysfunction), and 259 (other endocrine disorders) with at least three outpatient visits within 1 year or one admission diagnosis. Overall, 156,945 insured subjects were included in the final analysis. The 1- and 5-year incidence rates of post-traumatic endocrinopathies were 0.4% and 2%, respectively. The risks of developing a common endocrinopathy (p endocrine dysfunction after TBI increased during the entire 5-year follow-up period. Skull bone fracture and intracranial hemorrhage may be associated with short and long-term post-traumatic pituitary dysfunction, respectively. PMID:27608606

  3. Comparison of magnetic resonance imaging signs and clinical findings in follow-up examinations in children and juveniles with temporomandibular joint involvement in juvenile idiopathic arthritis

    International Nuclear Information System (INIS)

    The aim of this study was to analyze the extent to which pathological findings of temporomandibular joint (TMJ) in magnetic resonance imaging (MRI) follow-up examinations are correlated with clinical symptoms in patients with TMJ involvement in juvenile ideopathic arthritis (JIA) over time. Data from 34 patients with TMJ involvement in JIA was retrospectively examined. Shortly after two clinical examinations, the first MRI and the follow-up MRI were performed. The MRI examinations took place with 1.5 T MRI. In both MRI examinations alterations on the condyle (MRI1: 88 %, MRT2: 91 %) and contrast enhancement (MRT1: 76 %, MRT2 65 %) were found most frequently. TMJ pain (65 %) and lower mouth opening capacity (65 %) were the number one finding in the first clinical examination. A statistically significant correlation was found between the alterations on the condyle and TMJ pain (p = 0.025) and between the alterations on the condyle and lower mouth opening capacity (p = 0.019). By comparing the results of the first MRI with the results of the follow-up MRI, we identified a trend towards a progression of TMJ arthritis, while the clinical follow-up showed an improvement in most patients. We found a discrepancy between the progressive or stable trends of pathological findings in follow-up MRI and the decrease in clinical symptoms over time. Therefore, follow-up examination by MRI shows important information for correct evaluation about the stage of TMJ arthritis and about the need for treatment. Consequently, follow-up examination by MRI is an appropriate addition to clinical examination in the therapeutic concept. (orig.)

  4. Prospective Image Registration for Automated Scan Prescription of Follow-up Knee Images in Quantitative Studies

    OpenAIRE

    Goldenstein, Janet; Schooler, Joseph; Crane, Jason C; Ozhinsky, Eugene; Pialat, Jean-Baptiste; Carballido-Gamio, Julio; Majumdar, Sharmila

    2011-01-01

    Consistent scan prescription for MRI of the knee is very important for accurate comparison of images in a longitudinal study. However, consistent scan region selection is difficult due the complexity of the knee joint. We propose a novel method for registering knee images using a mutual information registration algorithm to align images in a baseline and follow-up exam. The output of the registration algorithm, three translations and three Euler angles, is then used to redefine the region to ...

  5. Antecedents of teenage pregnancy from a 14-year follow-up study using data linkage

    OpenAIRE

    Stanley Fiona J; Lawrence David; Mitrou Francis; Gaudie Jennifer; Silburn Sven R; Zubrick Stephen R

    2010-01-01

    Abstract Background Many western nations continue to have high rates of teenage pregnancies and births, which can result in adverse outcomes for both mother and child. This study identified possible antecedents of teenage pregnancy using linked data from administrative sources to create a 14-year follow-up from a cross-sectional survey. Methods Data were drawn from two sources - the 1993 Western Australian Child Health Survey (WACHS), a population-based representative sample of 2,736 children...

  6. Surgical removal of subfoveal choroidal neovascularization in pathologic myopia: a 12-year follow-up study.

    Science.gov (United States)

    Hera, R; Chiquet, C; Romanet, J P

    2013-12-01

    The purpose of this study was to review the 12-year visual outcomes of patients who underwent surgical removal for subfoveal choroidal neovascularization (CNV) attributable to pathologic myopia. This retrospective study included 14 patients, with a mean age of 45.8 years, high myopia (>6 D) and classic subfoveal CNV. They were treated with pars plana vitrectomy and surgical removal of CNV. All patients were followed up every 3 months for 2 years, with visual acuity (VA), fundus examination, and fluorescein angiography and then every year for 5 years. Ten patients underwent a final visit with VA and fundus examination after a minimum 12-year follow-up. The main outcome measurement was VA and the secondary outcome measurement was the lesion size. After 12 years of follow-up, the mean VA did not significantly change over time, with a mean gain of 0.22 logMAR at 1 year, and 0.18, 0.12 and 0.05 at 2, 5 and 12 years, respectively. The anatomical evolution was characterized by a significant enlargement of the lesion size at 5 years. This study showed that final VA after surgical treatment with 12 years of follow-up was poor, due to the significant CNV scar enlargement over time. These results should prompt a prospective randomized study of other medical treatments, particularly anti-vascular endothelial growth factor therapy. PMID:23539478

  7. Study of 2 years follow-up of referral patients with abnormal Pap smear

    OpenAIRE

    Fariba Behnamfar; Azam Zafarbakhsh; Taj-Alsadat Allameh

    2015-01-01

    Background: Abnormal Pap smear consists of premalignant or malignant cervical lesions. Many of premalignant cervical lesions will never progress to invasive malignancy, or even may regress over the time. Thus, there is always a risk of overtreatment of patients with an abnormal Pap smear. A long-term follow-up of these patients can reveal final events associated with each subtype of abnormal Pap smear, and, therefore, help us to prevent unnecessary interventions. The aim of our study was to p...

  8. Changes in occupational class differences in leisure-time physical activity: a follow-up study

    Directory of Open Access Journals (Sweden)

    Lahelma Eero

    2011-03-01

    Full Text Available Abstract Background Physical activity is known to have health benefits across population groups. However, less is known about changes over time in socioeconomic differences in leisure-time physical activity and the reasons for the changes. We hypothesised that class differences in leisure-time physical activity would widen over time due to declining physical activity among the lower occupational classes. We examined whether occupational class differences in leisure-time physical activity change over time in a cohort of Finnish middle-aged women and men. We also examined whether a set of selected covariates could account for the observed changes. Methods The data were derived from the Helsinki Health Study cohort mail surveys; the respondents were 40-60-year-old employees of the City of Helsinki at baseline in 2000-2002 (n = 8960, response rate 67%. Follow-up questionnaires were sent to the baseline respondents in 2007 (n = 7332, response rate 83%. The outcome measure was leisure-time physical activity, including commuting, converted to metabolic equivalent tasks (MET. Socioeconomic position was measured by occupational class (professionals, semi-professionals, routine non-manual employees and manual workers. The covariates included baseline age, marital status, limiting long-lasting illness, common mental disorders, job strain, physical and mental health functioning, smoking, body mass index, and employment status at follow-up. Firstly the analyses focused on changes over time in age adjusted prevalence of leisure-time physical activity. Secondly, logistic regression analysis was used to adjust for covariates of changes in occupational class differences in leisure-time physical activity. Results At baseline there were no occupational class differences in leisure-time physical activity. Over the follow-up leisure-time physical activity increased among those in the higher classes and decreased among manual workers, suggesting the emergence of

  9. Clinical Experience with Covered Wallstents for Biliary Malignancies: 23-Month Follow-Up

    International Nuclear Information System (INIS)

    Purpose: To evaluate the effectiveness of partially covered metallic Wallstents to prevent tumoral ingrowth in patients with neoplastic obstruction of the biliary tract. Methods: Twenty-one patients with malignant obstructive jaundice have been treated with Wallstents partially covered with a polyurethane polymer. In total, 36 covered stents (8 and 10 mm in diameter, 70 and 90 mm long) were deployed. All the stents were free from covering at both ends. Results: Jaundice was successfully treated in 100% of cases. There were no problems related to the releasing system during stent positioning, no major complications, and no incompatibility reactions to the materials composing the endoprostheses. At 23-month follow-up, 6 patients are still alive and 15 are dead; of these 15 patients, 11 died in the first 6 months and the last 4 died between 6 and 23 months. Seven patients had an obstructed stent; in four of these, cholangioscopy showed the presence of tumoral ingrowth and in one it showed necrotic tissue with biliary pigments and inflammatory cells. No biopsy specimen was obtained in the remaining two patients with stent obstruction. The follow-up, ranging from 7 to 23 months, showed a primary patency of 46.8% and 24.6% and an assisted patency of 66.3% and 59% at 6 months and 23 months, respectively. Conclusions: Covered metallic stents are effective and may produce improved survival in patients with malignant biliary obstruction (27.8% at 23 months). Stent patency, however, is similar to that of uncovered stents. Modifications in the design of the covering membrane may reduce stent obstruction resulting from disruption of the plastic covering

  10. Tele consultation and tele follow up of thyroid cancer patients: A pilot study

    International Nuclear Information System (INIS)

    Full text: Radioiodine therapy is an essential component of thyroid cancer management and these patients require life long follow up at timed interval. Though radioiodine therapy is a well established adjuvant treatment for well differentiated thyroid cancer, still the acceptance by the surgical colleagues and patients is not uniform. In addition, this facility is not available in the eastern part of the country. Therefore, such patients are required to travel more than 1500 K.M. to avail this treatment and subsequent follow up at our Institution. The existing telemedicine facility between SGPGIMS, Lucknow and SCB Medical College, Cuttack provided the opportunity to utilise the system for tele-consultation and tele follow up of thyroid cancer patients. The rationale of this ongoing study is to evaluate the suitability of telemedicine for tele consultation prior to radioiodine therapy and tele follow up following radioiodine therapy of patients with well differentiated thyroid cancer. Thirty patients (10 new cases and 20 follow up cases) were included in this study. New cases were studied on the basis of case history inputs by the operating surgeon and direct patient consultation to find out their suitability for high dose radioiodine therapy. At the same time pre-therapy instructions as well as details of admission were finalised. Follow up of patients (20 in number) were discussed and examined on live along with operating surgeon with respect to compliance of thyroxine suppression therapy, local recurrence and need for further high dose radioiodine therapy. Each time, at least one surgeon and nuclear physician were involved during live evaluation of patients which was done with VSAT, broad band of 256 Kbps band width provided by ISRO, Bangalore, India and case history, radiological and nuclear medicine images were already transmitted prior to live evaluation. All ten new cases were found to be suitable for high dose radioiodine therapy. The appointment dates for

  11. Newly diagnosed incident dizziness of older patients: a follow-up study in primary care

    Directory of Open Access Journals (Sweden)

    Hummers-Pradier Eva

    2011-06-01

    Full Text Available Abstract Background Dizziness is a common complaint of older patients in primary care, yet not much is known about the course of incident dizziness. The aim of the study was to follow-up symptoms, subjective impairments and needs of older patients (≥65 with incident dizziness and to determine predictors of chronic dizziness. Furthermore, we analysed general practitioners' (GPs' initial diagnoses, referrals and revised diagnoses after six months. Methods An observational study was performed in 21 primary care practices in Germany, including a four-week and six-month follow-up. A questionnaire comprising characteristic matters of dizziness and a series of validated instruments was completed by 66 participants during enrolment and follow-up (after 1 month and 6 months. After six months, chart reviews and face-to-face interviews were also performed with the GPs. Results Mean scores of dizziness handicap, depression and quality of life were not or only slightly affected, and did not deteriorate during follow-up; however, 24 patients (34.8% showed a moderate or severe dizziness handicap, and 43 (62.3% showed a certain disability in terms of quality of life at the time of enrolment. In multivariate analysis, n = 44 patients suffering from chronic dizziness (dependent variable, i.e. relapsing or persistent at six months initially had a greater dizziness handicap (OR 1.42, 95%CI 1.05-1.47 than patients with transient dizziness. GPs referred 47.8% of the patients to specialists who detected two additional cases of benign paroxysmal positional vertigo (BPPV. Conclusions New-onset dizziness relapsed or persisted in a considerable number of patients within six months. This was difficult to predict due to the patients' heterogeneous complaints and characteristics. Symptom persistence does not seem to be associated with deterioration of the psychological status in older primary care patients. Management strategies should routinely consider BPPV as

  12. Radiographic follow-up study of Little Leaguer's shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Kanematsu, Yoshiji; Iwase, Takenobu [Tokushima National Hospital, Department of Orthopaedic Surgery, Tokushima (Japan); Matsuura, Tetsuya; Suzue, Naoto; Sairyo, Koichi [University of Tokushima Graduate School, Department of Orthopedics, Institute of Health Bioscience, Tokushima (Japan); Kashiwaguchi, Shinji [Japan Community Health Care Organization, Tokyo Shinjuku Medical Center, Department of Orthopaedic Surgery, Tokyo (Japan); Iwame, Toshiyuki [Tokushima Prefectural Central Hospital, Department of Orthopaedic Surgery, Tokushima (Japan)

    2015-01-15

    Little Leaguer's shoulder is a syndrome involving the proximal humeral epiphyseal plate. Conservative treatment usually resolves the symptoms. However, there are no reports of a radiographic follow-up study of this disease. The purpose of this study was to show the radiographic healing process of Little Leaguer's shoulder. A total of 19 male baseball players diagnosed as having Little Leaguer's shoulder were retrospectively evaluated. The mean age at first presentation was 12.7 years. External rotation anteroposterior radiographs of the shoulder were taken. All patients were treated with rest from throwing, and no throwing was recommended until remodeling was confirmed. Follow-up radiographs were taken at 1-month intervals to assess healing. All patients were observed until healing was confirmed radiographically, after which they returned to baseball. The mean follow-up period was 8.5 months. In addition to radiography, patients were asked whether they had any symptoms and whether they had been able to return to baseball. At the first examination, radiographs showed a wider epiphyseal plate of the throwing side compared with the asymptomatic contralateral shoulder. Healing was observed in all cases. Healing occurred first along the medial side and was then extended laterally. The mean time required for healing was 4.7 months. All patients were able to return to playing baseball at their pre-injury level of play and were asymptomatic when examined at the final follow-up. The healing process of Little Leaguer's shoulder advanced from medial to lateral, and healing was achieved about 5 months after initial examination. (orig.)

  13. Follow-up study of Evolution-drum chipper; Evolution-energiapuuhakkurin kaeyttoeselvitys

    Energy Technology Data Exchange (ETDEWEB)

    Lahti, P. [Kotimaiset Energiat Ky, Kangashaekki (Finland); Vesisenaho, T. [VTT Energy, Jyvaeskylae (Finland). Fuel Production

    1997-12-01

    The aim of this project was to test and further develop a new type of a drum chipper. It was assumed that this Evolution-chipper would be able to produce fuel chips without long splinters and would also be reliable and effective in chipping work at road-side landings. In this project the fuel chip quality and productivity of the chipper were found out. The follow-up study started in October 1995 and ended in the end of 1996. According to the follow-up study the mechanical availability of the chipper was 83 % during a period of one year. Because of the rather low level of fuel chip utilisation in Finland the work sites are located far from each other. Therefore the moving between working sites take as much as 1/5 of the total working hours. The chipper is easy to operate and the differences in the productivity between operators are modest. The chipping productivity varies mainly depending on the raw material. The average productivity was 45,8 m{sup 3} (loose) per gross effective hour during the follow-up period. The internal screening system of the chipper diminishes the amount of long splinters effectively. Other chipping parameters (such as rotating speed) affected the chip quality only a little. (orig.)

  14. Therapeutic community drug treatment success in Peru: a follow-up outcome study

    Directory of Open Access Journals (Sweden)

    Browne Thom

    2008-12-01

    Full Text Available Abstract Background The purpose of this study was to assess the impact of drug abuse treatment in Peru that used the therapeutic community (TC model. Program directors and several staff members from all study treatment facilities received two to eight weeks of in-country training on how to implement the TC treatment model prior to the follow-up study. Methods This outcome study involved 33 TC treatment facilities and 509 former clients in Lima and other cities in five providences across Peru. A retrospective pre-test (RPT follow-up design was employed in which 30-day use of illegal drugs and alcohol to intoxication was measured at baseline retrospectively, at the same time of the six-month follow-up. In-person interview data were collected from directors of 73 percent of the eligible TC organizations in January and February 2003 and from former 58 percent of the eligible TC former clients between October 2003 and October 2004. Drug testing was conducted on a small sample of former clients to increase the accuracy of the self-reported drug use data. Results Medium to large positive treatment effects were found when comparing 30-day illegal drug and alcohol use to intoxication before and six months after receiving treatment. As a supplemental analysis, we assumed the 42 percent of the former clients who were not interviewed at the six month assessment had returned to drugs. These results showed medium treatment effects as well. Hierarchical Generalized Linear Modeling (HGLM results showed higher implementation fidelity, less stigma after leaving treatment, and older clients, singly or in combination are key predictors of treatment success. Conclusion This study found that former clients of drug and alcohol treatment in facilities using the TC model reported substantial positive change in use of illegal drugs and alcohol to intoxication at a six-month follow-up. The unique contribution of this study is that the results also suggest attention should

  15. Clinical assessment and echocardiography follow-up results of the children with acute rheumatic fever

    Directory of Open Access Journals (Sweden)

    Ahmet Basturk

    2016-04-01

    Full Text Available Acute rheumatic fever (ARF is an inflammatory collagenous tissue disease which shows its cardinal signs in joints, heart, skin and nervous system while affecting whole connective tissue system more or less. This study was conducted in order to investigate the clinical pattern and severity of ARF, echocardiographic findings and the course of the patients with heart valve involvement by studying the clinical and laboratory aspects of the patients diagnosed with ARF according to updated Jones criteria. The study included 214 patients diagnosed with ARF for the first time between January 2005 and May 2008. All patients were scanned with doppler echocardiography (ECHO between certain intervals. Severity of carditis was grouped into 3 groups of mild, moderate and severe. The frequency of carditis was 57.9%, arthritis was 73.4%, chorea was 11.7% and erythema marginatum was 0.9% but no subcutaneous nodules. Recovery was observed in 22% of the cases of isolated aortic insufficiency (AI, 50% of the cases with isolated mitral insufficiency (MI and 80% of the cases with mitral and aortic insufficiencies together (MI+AI. Recovery in isolated MI was significantly much more than recovery in isolated AI. However, recovery in AI was significantly much more than in MI in cases of mitral and aortic insufficiencies together. In conclusion, ARF is a cause of acquired and preventable heart disease and it can be reversed through right diagnosis and appropriate treatment. Isolated mitral insufficiency, isolated aortic insufficiency and both mitral and aortic insufficiency are observed during a valvular disease. Remission among valvular diseases are most commonly in those with mitral insufficiency and remissions in both mitral and aortic insufficiency occur most commonly in aortic ones. Regular prophylaxis is the key element for long term prevention of patients with ARF.

  16. Synoviorthesis with colloidal /sup 32/P chromic phosphate for hemophilic arthropathy: clinical follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Rivard, G.E.; Girard, M.; Lamarre, C.; Jutras, M.; Danais, S.; Guay, J.P.; Belanger, R.D.

    1985-11-01

    Thirty-one synoviortheses were performed in 22 joints of 14 hemophilic patients (aged 12 to 28 years) with chronic synovitis and for whom conventional treatments were considered ineffective. Except for patients with inhibitors, conventional treatments included three to six months of adequate prophylactic therapy with the missing coagulation factors, intensive physiotherapy and, when indicated, antiinflammatory agents and orthosis. Colloidal /sup 32/P chromic phosphate was injected intraarticularly in doses of 1.0 mCi for knees and of 0.5 mCi for the other joints. Time of follow-up ranged from two to five years. Frequency and importance of bleeding decreased in all patients. Effect on range of motion was best in knees. In elbows, flexion-extension was improved in four cases, unchanged in five and decreased in one; pronation-supination was decreased in four cases. The results of 13 synoviortheses in four hemophilic patients with high titer factor VIII inhibitors were comparable to those in hemophiliacs with no inhibitors. However, in three of the four patients synoviorthesis had to be repeated after two to four years for recurrence of synovitis. Extraarticular escape of radioactivity was monitored 62 times for 17 synoviortheses in 12 patients; extraarticular counts never exceeded 4% of the intraarticular counts. Chromosome aberrations were found not to be increased after treatment in the seven patients in whom adequate analysis could be done.

  17. Synoviorthesis with colloidal 32P chromic phosphate for hemophilic arthropathy: clinical follow-up

    International Nuclear Information System (INIS)

    Thirty-one synoviortheses were performed in 22 joints of 14 hemophilic patients (aged 12 to 28 years) with chronic synovitis and for whom conventional treatments were considered ineffective. Except for patients with inhibitors, conventional treatments included three to six months of adequate prophylactic therapy with the missing coagulation factors, intensive physiotherapy and, when indicated, antiinflammatory agents and orthosis. Colloidal 32P chromic phosphate was injected intraarticularly in doses of 1.0 mCi for knees and of 0.5 mCi for the other joints. Time of follow-up ranged from two to five years. Frequency and importance of bleeding decreased in all patients. Effect on range of motion was best in knees. In elbows, flexion-extension was improved in four cases, unchanged in five and decreased in one; pronation-supination was decreased in four cases. The results of 13 synoviortheses in four hemophilic patients with high titer factor VIII inhibitors were comparable to those in hemophiliacs with no inhibitors. However, in three of the four patients synoviorthesis had to be repeated after two to four years for recurrence of synovitis. Extraarticular escape of radioactivity was monitored 62 times for 17 synoviortheses in 12 patients; extraarticular counts never exceeded 4% of the intraarticular counts. Chromosome aberrations were found not to be increased after treatment in the seven patients in whom adequate analysis could be done

  18. Longterm clinical and radiological follow-up of living liver donors.

    Science.gov (United States)

    Darwish Murad, Sarwa; Fidler, Jeff L; Poterucha, John J; Sanchez, William; Jowsey, Sheila G; Nagorney, David; Rosen, Charles B; Heimbach, Julie K

    2016-07-01

    Although short-term risks of living donor hepatectomy have been well defined, little is known about the longterm impact. We aimed to perform a systematic follow-up to screen for unanticipated health consequences of liver donation. All donors who were more than 1 year from donation were invited for a systematic evaluation including physical and laboratory assessment, quality of life questionnaire, and magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP). Those unable to return were offered the questionnaire and laboratory assessment at home. Out of our total of 97 donors, 45 returned for a full assessment and 23 completed labs and survey locally (total n = 68; 70%) after a median of 5.5 years (1.5-10.9 years) after donation. The only laboratory abnormality was a significant decrease in platelet count (median 198 ×10(9) /L versus 224 ×10(9) /L before donation; P bowel habits. Seven donors (11%) reported problems obtaining insurance. The vast majority (97%) would have donated again. In conclusion, longterm outcome following liver donation appears satisfactory. None of our donors have developed occult biliary strictures, failure of regeneration, abnormal liver function, or other important health consequences after a median of 5.5 years from surgery. These findings can be used when counseling potential donors in the future. Liver Transplantation 22 934-942 2016 AASLD. PMID:27144969

  19. Tuberculosis screening and follow-up of asylum seekers in Norway: a cohort study

    Directory of Open Access Journals (Sweden)

    Garåsen Helge

    2009-05-01

    Full Text Available Abstract Background About 80% of new tuberculosis cases in Norway occur among immigrants from high incidence countries. On arrival to the country all asylum seekers are screened with Mantoux test and chest x-ray aimed to identify cases of active tuberculosis and, in the case of latent tuberculosis, to offer follow-up or prophylactic treatment. We assessed a national programme for screening, treatment and follow-up of tuberculosis infection and disease in a cohort of asylum seekers. Methods Asylum seekers ≥ 18 years who arrived at the National Reception Centre from January 2005 to June 2006, were included as the total cohort. Those with a Mantoux test ≥ 6 mm or positive x-ray findings were included in a study group for follow-up. Data were collected from public health authorities in the municipality to where the asylum seekers had moved, and from hospital based internists in case they had been referred to specialist care. Individual subjects included in the study group were matched with the Norwegian National Tuberculosis Register which receive reports of everybody diagnosed with active tuberculosis, or who had started treatment for latent tuberculosis. Results The total cohort included 4643 adult asylum seekers and 97.5% had a valid Mantoux test. At least one inclusion criterion was fulfilled by 2237 persons. By end 2007 municipal public health authorities had assessed 758 (34% of them. Altogether 328 persons had been seen by an internist. Of 314 individuals with positive x-rays, 194 (62% had seen an internist, while 86 of 568 with Mantoux ≥ 15, but negative x-rays (16% were also seen by an internist. By December 31st 2006, 23 patients were diagnosed with tuberculosis (prevalence 1028/100 000 and another 11 were treated for latent infection. Conclusion The coverage of screening was satisfactory, but fewer subjects than could have been expected from the national guidelines were followed up in the community and referred to an internist. To

  20. Effectiveness of dementia follow-up care by memory clinics or general practitioners: randomised controlled trial

    OpenAIRE

    2012-01-01

    Objective To examine the effectiveness of post-diagnosis dementia treatment and coordination of care by memory clinics compared with general practitioners. Design Multicentre randomised controlled trial. Setting Nine memory clinics and 159 general practitioners in the Netherlands. Participants 175 patients with a new diagnosis of mild to moderate dementia living in the community and their informal caregivers. Interventions Usual care provided by memory clinic or general practitioner. Main out...

  1. Percutaneous fixation of fractures of the spine: 1-year clinical and radiological follow-up

    Directory of Open Access Journals (Sweden)

    Carlos Fernando Pereira da Silva Herrero

    2014-12-01

    Full Text Available Objective: To evaluate the preliminary results of the surgical treatment through minimally invasive fixation technique in patients with thoracolumbar spinal fractures. Methods: Retrospective study of 17 patients with fractures of thoracolumbar vertebrae who underwent surgery with percutaneous fixation in the period of 2009 to 2011. The clinical evaluation of the results was performed using the SF-36 and Oswestry questionnaires. The radiographic parameters evaluated were: fracture classification according to Magerl's criteria, wedge angle of the fractured vertebrae and bisegmental Cobb angle. These measurements were made in the preoperative, immediate postoperative and 1 year after surgery. Other data such as associated injuries, neurological deficit, post-surgical infection, loosening and breakage of implants were also considered. Results: The data revealed average scores above 80% in all domains of the SF-36 questionnaire while in Oswestry Questionnaire, 79% of patients had minimal or absent physical limitations with a mean score of 12.4±11.89%. The average Cobb angle for preoperative kyphosis was 5.53º±13.80o, 2.18º±13.38o in the early postoperative period and 5.26º±13.95o one year after surgery. The average correction obtained after surgery was 3.35º and the average correction loss was 3.19º. No complications such as post-surgical infection, permanent neurological deficits and implant loosening and breakage were observed. Conclusion: The surgical treatment of fractures of thoracolumbar vertebrae using a minimally invasive technique provides satisfactory clinical and radiographic results with low complication rates.

  2. Oligometastases Treated With Stereotactic Body Radiotherapy: Long-Term Follow-Up of Prospective Study

    International Nuclear Information System (INIS)

    Purpose: To analyze the long-term survival and tumor control outcomes after stereotactic body radiotherapy (SBRT) for metastases limited in number and extent. Methods and Materials: We prospectively analyzed the long-term overall survival (OS) and cancer control outcomes of 121 patients with five or fewer clinically detectable metastases, from any primary site, metastatic to one to three organ sites, and treated with SBRT. Freedom from widespread distant metastasis (FFDM) was defined as metastatic disease not amenable to local therapy (i.e., resection or SBRT). Prognostic variables were assessed using log–rank and Cox regression analyses. Results: For breast cancer patients, the median follow-up was 4.5 years (7.1 years for 16 of 39 patients alive at the last follow-up visit). The 2-year OS, FFDM, and local control (LC) rate was 74%, 52%, and 87%, respectively. The 6-year OS, FFDM, and LC rate was 47%, 36%, and 87%, respectively. From the multivariate analyses, the variables of bone metastases (p = .057) and one vs. more than one metastasis (p = .055) were associated with a fourfold and threefold reduced hazard of death, respectively. None of the 17 bone lesions from breast cancer recurred after SBRT vs. 10 of 68 lesions from other organs that recurred (p = .095). For patients with nonbreast cancers, the median follow-up was 1.7 years (7.3 years for 7 of 82 patients alive at the last follow-up visit). The 2-year OS, FFDM, and LC rate was 39%, 28%, and 74%, respectively. The 6-year OS, FFDM, and LC rate was 9%, 13%, and 65%, respectively. For nonbreast cancers, a greater SBRT target volume was significantly adverse for OS (p = .012) and lesion LC (p < .0001). Patients whose metastatic lesions, before SBRT, demonstrated radiographic progression after systemic therapy experienced significantly worse OS compared with patients with stable or regressing disease. Conclusions: Select patients with limited metastases treated with SBRT are long-term survivors. Future

  3. Australian Aboriginal Birth Cohort study: follow-up processes at 20 years

    Directory of Open Access Journals (Sweden)

    Davison Belinda

    2009-09-01

    Full Text Available Abstract Background In 1987, a prospective study of an Australian Aboriginal Birth Cohort was established focusing on the relationships of fetal and childhood growth with the risk of chronic adult disease. However as the study is being conducted in a highly marginalized population it is also an important resource for cross-sectional descriptive and analytical studies. The aim of this paper is to describe the processes of the third follow up which was conducted 20 years after recruitment at birth. Methods Progressive steps in a multiphase protocol were used for tracing, with modifications for the expected rural or urban location of the participants. Results Of the original 686 cohort participants recruited 68 were untraced and 27 were known to have died. Of the 591 available for examination 122 were not examined; 11 of these were refusals and the remainder were not seen for logistical reasons relating to inclement weather, mobility of participants and single participants living in very remote locations. Conclusion The high retention rate of this follow-up 20 years after birth recruitment is a testament to the development of successful multiphase protocols aimed at overcoming the challenges of tracing a cohort over a widespread remote area and also to the perseverance of the study personnel. We also interpret the high retention rate as a reflection of the good will of the wider Aboriginal community towards this study and that researchers interactions with the community were positive. The continued follow-up of this life course study now seems feasible and there are plans to trace and reexamine the cohort at age 25 years.

  4. Evaluation of the Mandibular Function, after Nonsurgical Treatment of Unilateral Subcondylar Fracture: A 1-Year Follow-Up Study.

    Science.gov (United States)

    K M, Sudheesh; Desai, Rajendra; K Sn, Siva Bharani; S, Subhalakshmi

    2016-09-01

    There are no clearly defined guidelines for when an open or closed treatment is indicated for treatment of mandibular condylar fractures. The aim of the study is to analyze the mandibular function after nonsurgical treatment of unilateral subcondylar fractures, in a prospective study. A prospective study was conducted on 30 patients with unilateral mandibular subcondylar fracture undergoing nonsurgical treatment. Clinical and radiographic examinations were done prior to treatment and at 12-month follow-up. Pain, perceived occlusion, mouth opening, protrusion, and horizontal movements of the mandible were evaluated by clinical examination. Radiologic evaluation was done using Panoramic and Reverse Towne's radiographs. At 12-month follow-up, there was minimal pain in the temporomandibular joint region, there was an improvement in the perceived occlusion, and mouth opening did not reduce. There was insignificant absolute difference between left and right lateral mandibular movements. The amount of increase in the protrusion of mandible was insignificant. On radiographic evaluation, the degree of coronal and sagittal displacement was insignificant at follow-up. Mean ramus height pretreatment and 12 months posttreatment were 0.98 ± 0.50 and 0.87 ± 0.47, respectively. Based on this study, patients had adequate mandibular function and minimal pain after nonsurgical treatment. Unilateral subcondylar fractures of the mandible can be treated nonsurgically in patients with minimal occlusal discrepancies, adequate mouth opening, minimal displacement of condyle, and minimal ramus height shortening. PMID:27516838

  5. Characteristics of Volunteers, Nonvolunteers, and No Shows in a Clinical Follow-Up

    Science.gov (United States)

    Dreger, Ralph Mason; Johnson, William E., Jr.

    1974-01-01

    Attempts to relate "successful" clinic handling of cases to various characteristics, including willingness to participate in research. Found that volunteers were less anxious and had greater sociability and self-esteem than non-volunteers. (Author/PC)

  6. Radiological follow-up of uncemented knee prostheses. Preliminary study. Seguimiento radiologico de protesis de rodilla no cementadas. Estudio preliminar

    Energy Technology Data Exchange (ETDEWEB)

    Martin Hervas, C.; Gomez Barrena, E.; Marquez Moreno, I.; Calle Yuste, F.; Ordoez Parra, J.M.

    1993-10-01

    The preliminary results of a prospective study of 40 uncemented total knee prostheses (TKP) are presented following a radiological protocol with fluoroscopic control and follow-up of over 2 years. The prosthesis-bone interface and the components alignment were assessed. Several radiological signs were studied to assess this interface with respect to the fixing of the component, but they showed little clinical correlation. Statistical significance (p<0.05, chisquare) was found only in the observation of sclerosis in areas of support for the tibital tray as a reaction of the bone. This radiological follow-up is of interest to determine the evolution of the interface and position of the implant to prevent complications (especially loosening) in patients, particularly those under 60 years old, who represent the group that can most benefit from prosthetic systems with uncemented anchorage because of their life expectation and level of activity. Author

  7. Percutaneous endoscopic lumbar discectomy: clinical and quality of life outcomes with a minimum 2 year follow-up

    Directory of Open Access Journals (Sweden)

    Tan Seang B

    2009-06-01

    Full Text Available Abstract Background Percutaneous endoscopic lumbar discectomy is a relatively new technique. Very few studies have reported the clinical outcome of percutaneous endoscopic discectomy in terms of quality of life and return to work. Method 55 patients with percutaneous endoscopic lumbar discectomy done from 2002 to 2006 had their clinical outcomes reviewed in terms of the North American Spine Score (NASS, Medical Outcomes Study Short Form-36 scores (SF-36 and Pain Visual Analogue Scale (VAS and return to work. Results The mean age was 35.6 years, the mean operative time was 55.8 minutes and the mean length of follow-up was 3.4 years. The mean hospital stay for endoscopic discectomy was 17.3 hours. There was significant reduction in the severity of back pain and lower limb symptoms (NASS and VAS, p Conclusion Percutaneous endoscopic lumbar discectomy is associated with improvement in back pain and lower limb symptoms postoperation which translates to improvement in quality of life. It has the advantage that it can be performed on a day case basis with short length of hospitalization and early return to work thus improving quality of life earlier.

  8. Brachytherapy using holmium-166 liquid balloon system for in-stent restenosis: 6 months clinical and angiographic follow-up

    International Nuclear Information System (INIS)

    In western country, 3 systems of brachytherapy using commercial radioactive source has been established. However, brachytherapy using holmium-166 liquid balloon system (HLBS) for the patient with stent restenosis has not been studied enough. 30 patients (male 23, mean age 58.9 7.7) were enrolled. Target dose was 15 Gy at 1 mm distance from the intimal surface. Clinical diagnoses of the study patients included stable angina 10 and unstable angina 20 patients. Target lesion included LAD 19, LCx 5 and RCA 6 arteries. Pre-brachytherapy treatment included cutting balloon angioplasty in 25, rotational atherectomy in 5 patients. Fractionation and stepping was done in 6 patients each. Follow-up angiography was done in 19 patients. Of them, 4 cases developed angiographic restenosis (21%) including 3 cases of total occlusion. 6 month MACE (major adverse cardiac event) occurred in 5 patients including one sudden cardiac death in a patient with 80 year-old, triple-vessel diseased patient. Vascular brachytherapy using HLBS is a safe and effective treatment modality for in-stent restenosis showing acceptable angiographic and clinical result

  9. Race and clinical outcome in breast cancer: a 40-year follow-up

    International Nuclear Information System (INIS)

    Purpose: Survival following breast cancer diagnosis has been reported to be lower in black women compared to white women. Explanations proposed include more advanced presentation and more aggressive biology of the disease. Our objective was to determine whether breast cancer in black women is biologically more aggressive compared to white women. Patients and Methods: One-thousand-two-hundred and seventy-seven (1,277) white, and 481 black women with breast cancer underwent mastectomy between 1927-1987. Median follow-up was 8 years (1-46). Surgery consisted of radical or modified radical mastectomy in 1,421 pt (81%); extended radical in 294 (17%); simple or partial mastectomy in 43 (2%) pts. Thirteen percent of patients received adjuvant chemotherapy and 30% radiation therapy. The disease-free survival (DFS) was analyzed using the Kaplan Meier actuarial method and the log rank test was used to test for difference among the actuarial curves. Estrogen, progesterone receptors (ER, PR), Ki-67, and microvessel density were chosen as molecular markers of prognosis. They were assayed using immunocytochemistry on archival paraffin sections. Fisher nuclear and histologic grading was used. Results: The median age was 54 years (21-91), 54 vs 52 in white compared to black pts. The distribution of tumor sizes was as follows: ≤ 2 cm, 33%; 2.1-4, 39.0% ; >4 cm, 28%. There were no differences in the distribution of the tumor sizes (p = 0.28) between white and black patients. Seven-hundred and seventy-one (44%) were node-negative, 457 (26%) had 1-3, and 530 (30%) ≥ 4 positive nodes. There were no differences in lymph node status between white and black women (p = 0.18). The 20-year actuarial DFS of node-negative patients with ≤ 2 cm, 2.1-4 cm, > 4 cm, and node-positive patients with 1-3, and ≥ 4 nodes is shown in Table 1: Because of the trend towards worse DFS, node-negative white pts, with 2.1-4 cm tumors were further analyzed. Using Cox multivariate analysis the difference

  10. Optical Studies of Space Debris at GEO: Survey and Follow-up with Two Telescopes

    Science.gov (United States)

    Seitzer, P.; Abercomby, K. J.; Rodriquez, H. M.; Barker, E. S.

    2007-01-01

    For 14 nights in March 2007, we used two telescopes at the Cerro Tololo Inter-American Observatory (CTIO) in Chile to study the nature of space debris at Geosynchronous Earth Orbit (GEO). In this project one telescope was dedicated to survey operations, while a second telescope was used for follow-up observations for orbits and colors. The goal was to obtain orbital and photometric information on every faint object found with the survey telescope. Thus we concentrate on objects fainter than R = 15th magnitude.

  11. A four-year follow-up study in fibromyalgia. Relationship to chronic fatigue syndrome

    DEFF Research Database (Denmark)

    Nørregaard, J; Bülow, P M; Prescott, E;

    1993-01-01

    The primary objectives of this study were to examine to what extent fibromyalgia patients later on developed presumpted causative somatic diseases and to examine symptoms and muscle strength some years after the diagnosis of fibromyalgia was established. A secondary objective was to describe the...... overlap between fibromyalgia and chronic fatigue syndrome. Only in two of 91 the muscle pain was found to be caused by another somatic disease during the median 4 year follow-up period. In one of the 83 attending subjects a somatic disease associated with muscle symptoms was established at the follow...

  12. Cessation of smoking after first-ever stroke: a follow-up study

    DEFF Research Database (Denmark)

    Bak, Søren; Sindrup, Søren Hein; Alslev, Torben;

    2002-01-01

    follow-up were included in the present study. Among 198 patients (38.7%) who were current smokers on admission, 43 patients (21.7%) gave up smoking within 6 months of suffering a stroke. Sex, functional status, and sociodemographic characteristics were independently associated with persistent smoking....... CONCLUSIONS: Our results suggest that more efficient antismoking counseling is required to reduce the proportion of persistent smokers after stroke. This counseling should take into account the increased risk of persistent smoking in men, patients with no disability, blue-collar workers, and patients living...

  13. Acute heart failure in the emergency department: a follow-up study.

    Science.gov (United States)

    Fabbri, Andrea; Marchesini, Giulio; Carbone, Giorgio; Cosentini, Roberto; Ferrari, Annamaria; Chiesa, Mauro; Bertini, Alessio; Rea, Federico

    2016-02-01

    Acute heart failure (AHF) is a major public health issue due to high incidence and poor prognosis. Only a few studies are available on the long-term prognosis and on outcome predictors in the unselected population attending the emergency department (ED) for AHF. We carried out a 1-year follow-up analysis of 1234 consecutive patients from selected Italian EDs from January 2011 to June 2012 for an episode of AHF. Their prognosis and outcome-associated factors were tested by Cox proportional hazard model. Patients' mean age was 84, with 66.0% over 80 years and 56.2% females. Comorbidities were present in over 50% of cases, principally a history of acute coronary syndrome, chronic obstructive pulmonary disease, diabetes, chronic kidney disease, valvular heart disease. Death occurred within 6 h in 24 cases (1.9%). At 30-day follow-up, death was registered in 123 cases (10.0%): 110 cases (89.4%) died of cardiovascular events and 13 (10.6%) of non-cardiovascular causes (cancer, gastrointestinal hemorrhages, sepsis, trauma). At 1-year follow-up, all-cause death was recorded in 50.1% (over 3 out of 4 cases for cardiovascular origin). Six variables (older age, diabetes, systolic arterial pressure <110 mm/Hg, high NT pro-BNP, high troponin levels and impaired cognitive status) were selected as outcome predictors, but with limited discriminant capacity (AUC = 0.649; SE 0.015). Recurrence of AHF was registered in 31.0%. The study identifies a cluster of variables associated with 1-year mortality in AHF, but their predictive capacity is low. Old age and the presence of comorbidities, in particular diabetes are likely to play a major role in dictating the prognosis. PMID:26506831

  14. Inconvenience due to travelers' diarrhea: a prospective follow-up study

    Directory of Open Access Journals (Sweden)

    Soonawala Darius

    2011-11-01

    Full Text Available Abstract Background Limited data exist documenting the degree to which travelers are inconvenienced by travelers' diarrhea (TD. We performed a prospective follow-up study at the travel clinic of Leiden University Medical Center in The Netherlands to determine the degree of inconvenience and to determine how experiencing TD affects travelers' perception. Methods Healthy adults who intended to travel to the (subtropics for less than two months were invited to take part. Participants filled out a web-based questionnaire before departure and after returning home. TD was defined as three or more unformed stools during a 24-hour period. Results 390 of 776 Eligible travelers completed both questionnaires. Participants' median age was 31 years and mean travel duration 23 days. Of 160 travelers who contracted TD (incidence proportion 41%, median duration of TD episode 2.5 days the majority (107/160, 67% could conduct their activity program as planned despite having diarrhea. However, 21% (33/160 were forced to alter their program and an additional 13% (20/160 were confined to their accommodation for one or more daylight days; 53 travelers (33% used loperamide and 14 (9% an antibiotic. Eight travelers (5% consulted a physician for the diarrheal illness. When asked about the degree of inconvenience brought on by the diarrheal illness, 39% categorized it as minor or none at all, 34% as moderate and 27% as large or severe. In those who regarded the episode of TD a major inconvenience, severity of symptoms was greater and use of treatment and necessity to alter the activity program were more common. Travelers who contracted travelers' diarrhea considered it less of a problem in retrospect than they had thought it would be before departure. Conclusion Conventional definitions of TD encompass many mild cases of TD (in our study at least a third of all cases for which treatment is unlikely to provide a significant health benefit. By measuring the degree of

  15. Level of suicidal intent predicts overall mortality and suicide after attempted suicide: a 12-year follow-up study

    Directory of Open Access Journals (Sweden)

    Ostamo Aini

    2004-04-01

    Full Text Available Abstract Background The aim of this study was to comprehensively examine clinical risk factors, including suicide intent and hopelessness, for suicide and risk of death from all causes after attempted suicide over a 12-year follow-up period. Methods A systematic sample of 224 patients from consecutive cases of attempted suicide referred to health care in four Finnish cities between 1 January and 31 July 1990 was interviewed. Results After 12 years of follow-up 22% of these patients had died, 8% by committing suicide. The only statistically significant risk factor for eventual suicide was high scores on Beck's Suicidal Intention Scale. Male gender, older age, physical illness or disability and high scores on Beck's Suicidal Intention Scale predicted death overall. Conclusions Following attempted suicide, high intention to kill oneself is a significant risk factor for both death from all causes and suicide.

  16. Musculoskeletal disorders among construction workers: a one-year follow-up study

    Directory of Open Access Journals (Sweden)

    Boschman Julitta S

    2012-10-01

    Full Text Available Abstract Background Work-related musculoskeletal disorders (MSDs are an important cause of functional impairments and disability among construction workers. An improved understanding of MSDs in different construction occupations is likely to be of value for selecting preventive measures. This study aimed to survey the prevalence of symptoms of MSDs, the work-relatedness of the symptoms and the problems experienced during work among two construction occupations: bricklayers and supervisors. Methods We randomly selected 750 bricklayers and 750 supervisors resident in the Netherlands in December 2009. This sample was surveyed by means of a baseline questionnaire and a follow-up questionnaire one year later. The participants were asked about complaints of the musculoskeletal system during the last six months, the perceived work-relatedness of the symptoms, the problems that occurred during work and the occupational tasks that were perceived as causes or aggravating factors of the MSD. Results Baseline response rate was 37%, follow-up response was 80%. The prevalence of MSDs among 267 bricklayers and 232 supervisors was 67% and 57%, respectively. Complaints of the back, knee and shoulder/upper arm were the most prevalent among both occupations. Irrespective of the body region, most of the bricklayers and supervisors reported that their complaints were work-related. Complaints of the back and elbow were the most often reported among the bricklayers during work, whereas lower arm/wrist and upper leg complaints were the most often reported among the supervisors. In both occupations, a majority of the participants perceived several occupational physical tasks and activities as causes or aggravating factors for their MSD. Recurrent complaints at follow-up were reported by both bricklayers (47% of the complaints and supervisors (31% of the complaints. Participants in both occupations report that mainly back and knee complaints result in additional problems

  17. Hypoglossal-facial nerve anastomosis: a clinical and electrophysiological follow-up.

    OpenAIRE

    Iansek, R.; Harrison, M. J.; Andrew, J

    1986-01-01

    Eight patients with acoustic neuroma and five patients with hemifacial spasm, who had undergone hypoglossal-facial nerve anastomosis 1-14 years previously, were reviewed clinically and electrophysiologically with an electrically elicited blink reflex. Functional recovery from the anastomosis, as rigorously judged on a scale of good, fair and poor, was fair to poor. Electrically it was found that the blink reflex was present in eight patients, suggesting facial nerve re-innervation of the faci...

  18. Cytogenomic delineation and clinical follow-up of 10 Brazilian patients with Pallister-Killian syndrome

    OpenAIRE

    Costa, Larissa Sampaio de Athayde; Zandona-Teixeira, Aline C.; Montenegro, Marilia M.; Dias, Alexandre T; Dutra, Roberta L; Honjo, Rachel S; Bertola, Debora R.; Leslie D. Kulikowski; Chong A. Kim

    2015-01-01

    Background Pallister-Killian syndrome (PKS) is a sporadic genetic disorder caused by the presence of a tissue-specific mosaicism for isochromosome 12p - i(12) (p10) and is characterized by facial dysmorphism including coarse facies, upslanting palpebral fissures, bitemporal alopecia, pigmentary skin anomalies, developmental delay, hypotonia and seizures. Although typical clinical features of PKS commonly exist, clinicians often do not raise the possibility of this diagnosis. Results We review...

  19. A clinical and radiological evaluation of the relative efficacy of demineralized freeze-dried bone allograft versus anorganic bovine bone xenograft in the treatment of human infrabony periodontal defects: A 6 months follow-up study

    OpenAIRE

    Vikram Blaggana; Amarjit Singh Gill; Anshu Blaggana

    2014-01-01

    Background: The ultimate goal of periodontal therapy entails regeneration of the periodontal tissues lost as a consequence of periodontitis. Predictable correction of vertical osseous defects has however posed as a constant therapeutic challenge. The aim of our present study is to evaluate the relative efficacy of demineralized freeze-dried bone allograft (DFDBA) vs anorganic bovine bone xenograft (ABBX) in the treatment of human infrabony periodontal defects. Materials and Methods: 15 patien...

  20. Natural evolution of grafted anterior cruciate ligament of the knee: prospective follow-up MR studies

    International Nuclear Information System (INIS)

    To described the MR findings in the periodic changes of the size and signal intensity of reconstructed anterior cruciate ligament (ACL) of the knee and the efficacy of oblique axial imaging in patients who underwent arthroscopic ACL reconstruction using autogenous patellar tendon. The cross-sectional area and signal intensity of grafted ACL increased significantly(p<0.05) after 3 months and at 1 year, respectively. Cross-sectional morphology was smooth and round in 86% of cases, and notched in 14%, and during follow-up MR studies, no periodic changes were seen. Notch-shaped ACL and decreased perigraft signal intensity, as seen on sagittal images, could lead to a misdiagnosis of partial tear: on oblique axial images, ACL and perigraft signal intensity were found to be normal. During the natural evolution of grafted ACL, cross-section area and signal intensity increased significantly after 3 months and at 1 year, respectively: on follow-up MR studies, cross-sectional morphology did not change, however. Oblique axial imaging. (author). 13 refs., 4 figs

  1. Natural evolution of grafted anterior cruciate ligament of the knee: prospective follow-up MR studies

    Energy Technology Data Exchange (ETDEWEB)

    Park, Dong Won; Cho, Jae Hyun; Min, Byung Heum; Suh, Jung Ho [Ajou Univ., Suwon (Korea, Republic of). Coll. of Medicine; Inh, Yon Kwon; Shim, Yong Woon; Suh, Jin Seok [Yonsei Univ., Seoul (Korea, Republic of ). Coll. of Medicine

    1998-01-01

    To described the MR findings in the periodic changes of the size and signal intensity of reconstructed anterior cruciate ligament (ACL) of the knee and the efficacy of oblique axial imaging in patients who underwent arthroscopic ACL reconstruction using autogenous patellar tendon. The cross-sectional area and signal intensity of grafted ACL increased significantly(p<0.05) after 3 months and at 1 year, respectively. Cross-sectional morphology was smooth and round in 86% of cases, and notched in 14%, and during follow-up MR studies, no periodic changes were seen. Notch-shaped ACL and decreased perigraft signal intensity, as seen on sagittal images, could lead to a misdiagnosis of partial tear: on oblique axial images, ACL and perigraft signal intensity were found to be normal. During the natural evolution of grafted ACL, cross-section area and signal intensity increased significantly after 3 months and at 1 year, respectively: on follow-up MR studies, cross-sectional morphology did not change, however. Oblique axial imaging. (author). 13 refs., 4 figs.

  2. A 5-year follow-up study of an atypical case of myotonic dystrophy.

    Science.gov (United States)

    Macniven, J A B; Graham, N L; Davies, R R; Wilson, B A

    2005-12-20

    This study presents 5-year follow-up data on NG, a woman with adult onset myotonic dystrophy and progressive cognitive decline who was first described by Wilson et al. The extent of the cognitive impairment is atypical of symptom-onset in adulthood and of paternal inheritance, both of which apply to this case. Together, the present and earlier studies report the results of regular neuropsychological assessments over a 16-year period. Severe impairment in executive functioning, episodic and semantic memory were apparent early in the history, while visuospatial skills and working memory were only mildly impaired after 16 years of follow-up. There was also a progressive dyslexia, initially characterized by the regularization errors typical of surface dyslexia, but subsequently dominated by visual/phonological reading errors. This pattern of impairment is not typical of myotonic dystrophy but resembles semantic dementia. Whilst the deficits may be attributable wholly to myotonic dystrophy pathology, the co-existence of a form of semantic dementia is also possible. It is noted that the aggregation of tau protein is a neuropathological feature common to both diseases. PMID:16286337

  3. Long-term follow-up study of I-131 therapy for Graves' disease

    International Nuclear Information System (INIS)

    We have studied the follow-up of thyroid function in the patients with late-onset hypothyroidism and euthyroidism after I-131 therapy of hyperthyroidism. Thirty three patients who did not need the thyroid treatment until ten years after I-131 therapy were classified as euthyroid group. And eleven patients who needed the thyroid supplement of thyroid hormone for late-onset hypothyroidism were classified as hypothyroid group. Patients in both groups who required only a single dose of I-131 for successful treatment of hyperthyroidism had similar age, gland size, 24 hour I-131 uptake, pretreatment serum T3 uptake level and T4 concentration, and I-131 treatment dose. Subclinical hypothyroidism occurred in 28.6% of euthyroid group and 66.7% of hypothyroid group four months after I-131 therapy. The levels of T3 were recovered to higher than normal range at 6 months in euthyroid group, while the levels of T3 were kept within the normal range in the seventy percent of hypothyroid group. Patients who were still lower in the level of T3 uptake than normal range at 6 months had a higher incidence of late-onset hypothyroidism. Our observation showed no significant difference in the course of follow-up studies after I-131 therapy between the patients with late-onset hypothyroidism and euthyroidism. (author)

  4. The 2002 results of the second series of follow-up studies on Japanese Thorotrast patients

    International Nuclear Information System (INIS)

    The second series (Aichi series) of Japanese follow-up studies on thorotrast patients started in 1979 based on the results of a nation-wide X-ray survey on the upper abdomen of ex-serviceman who were war-wounded during the Manchurian campaign to world war II (1931-1945). The survey planned by the Ministry of Health and Welfare of Japanese Government was performed between 1975 and 1978 i.e. about 33-47 years after the injection of thorotrast into blood vessels. It aimed to detect the deposited thorotrast in the liver and spleen of war-wounded ex-servicemen. The thorotrast group in the second series consisted of 156 war-wounded ex-servicemen treated by intravascular route with thorotrast. Control patients were selected matching the 5-year-age-classes of thorotrast patients among ex-servicemen who were wounded by almost the same kind of wounds in these wars. The first survey in this second series of our follow-up studies was performed on January 1, 1979. The second and third survey performed in 1995 and 1998, respectively. This fourth 2002 survey was performed 23 years after the first 1979 survey. It revealed that only 8 (5.1%) of 156 thorotrast patients were alive and remaining 148 (94.9%) had died. Of the 915 controls, 264 (28.9%) were still alive and 651 (71.1%) had died. In spite of this second follow-up study began 25 years after the starting of the first follow-up study, the life span of thorotrast patients in the 2002 survey, 23 years after the beginning of this study, revealed significantly shorter period than that of controls [χ 2 test (P <0, 001)]. The main causes of death of thorotrast patients in the 2002 survey were; liver malignancies (73 cases; 46.8%), liver cirrhosis (7 cases; 4.5%), cancer of the extrahepatic bile duct (5 cases; 3.2%), hematopoietic malignancies (6 cases; 3.8%), hemangiosarcoma of the spleen (3 cases; 1.9%) and lung cancer (7 cases; 4.5%). Among the controls, there were 20 cases (2.2%) of hepatic malignancies, 11 cases (1.2%) of

  5. Follow-up factor structure of schizotypy and its clinical associations in a help-seeking sample meeting ultra-high risk for psychosis criteria at baseline

    NARCIS (Netherlands)

    Lin, Ashleigh; Wigman, Johanna T. W.; Nelson, Barnaby; Wood, Stephen J.; Vollebergh, Wilma A. M.; van Os, Jim; Yung, Alison R.

    2013-01-01

    Background: Schizotypy is a multidimensional construct indexing psychometric risk for schizophrenia. This study investigated the factor structure and clinical associations of the Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE) short scales, assessed at follow-up in an originally help

  6. Male, mobile, and moneyed: loss to follow-up vs. transfer of care in an urban African antiretroviral treatment clinic.

    Directory of Open Access Journals (Sweden)

    Kara G Marson

    Full Text Available The purpose of this study was to analyze characteristics, reasons for transferring, and reasons for discontinuing care among patients defined as lost to follow-up (LTFU from an antiretroviral therapy (ART clinic in Nairobi, Kenya.The study used a prospective cohort of patients who participated in a randomized, controlled ART adherence trial between 2006 and 2008.Participants were followed from pre-ART clinic enrollment to 18 months after ART initiation, and were defined as LTFU if they failed to return to clinic 4 weeks after their last scheduled visit. Reasons for loss were captured through phone call or home visit. Characteristics of LTFU who transferred care and LTFU who did not transfer were compared to those who remained in clinic using log-binomial regression to estimate risk ratios.Of 393 enrolled participants, total attrition was 83 (21%, of whom 75 (90% were successfully traced. Thirty-seven (49% were alive at tracing and 22 (59% of these reported having transferred their antiretroviral care. In the final model, transfers were more likely to have salaried employment [Risk Ratio (RR, 2.7; 95% confidence interval (CI, 1.2-6.1; p=0.020] and pay a higher monthly rent (RR, 5.8; 95% CI, 1.3-25.0; p=0.018 compared to those retained in clinic. LTFU who did not transfer care were three times as likely to be men (RR, 3.1; 95% CI, 1.1-8.1; p=0.028 and nearly 4 times as likely to have a primary education or less (RR, 3.8; 95% CI, 1.3-10.6; p=0.013. Overall, the most common reason for LTFU was moving residence, predominantly due to job loss or change in employment.A broad definition of LTFU may include those who have transferred their antiretroviral care and thereby overestimate negative effects on ART continuation. Interventions targeting men and considering mobility due to employment may improve retention in urban African ART clinics.The study's ClinicalTrials.gov identifier is NCT00273780.

  7. Participation as a leader in immersion weight loss treatment: a 1-year follow-up study.

    Science.gov (United States)

    Anderson, L M; Schaumberg, K; Anderson, D A; Kirschenbaum, D S

    2016-02-01

    Non-overweight individuals may follow aggressive weight management approaches alongside overweight/obese friends or family members; thus, research has begun to evaluate subsequent effects among non-overweight populations. A prior study evaluated the short-term effects of an immersion weight loss programme on healthy young adult staff leaders. Results indicated that participation seemed to benefit, not harm, the young adults. The current investigation examined 1-year eating disorder and weight trajectories in this sample. The total sample (N = 244) consisted of staff leaders (44.3%) and demographically similar comparison participants who completed eating disorder and weight assessments across four time points: baseline, end of summer, 6-week follow-up and 1-year follow-up. Forty-seven per cent of the original sample responded to all time points (staff leaders n = 60; comparison n = 55). Over the course of 1 year, risk trajectories did not differ between groups. Staff leaders did not report significant changes in body mass index, suggesting that they maintained healthy weight over the course of 1 year. Participation as an immersion weight loss programme leader appeared to be protective against weight gain, without increasing eating disorder risk, for healthy young adults. This provides further support for using weight management interventions across a wide range of individuals. PMID:26638779

  8. Technical quality of root canal fillings performed in a dental school and the associated retention of root-filled teeth: a clinical follow-up study over a 5-year period.

    LENUS (Irish Health Repository)

    Burke, F M

    2009-07-01

    The aim of this study was to examine the technical quality of root canal fillings performed in a dental school and to investigate the associated effect on the survival\\/retention of root-filled teeth. A review of case notes of patients who had root canal treatment performed in the department of Restorative Dentistry, University Dental School and Hospital, Cork, Ireland was carried out. The technical quality of the root canal filling was described according to its relationship with the radiographic apex on a post-treatment radiograph. Tooth status at review was defined as \\'tooth present\\' or \\'tooth absent\\' based on the presence or absence of the root-filled tooth recorded in the treatment records at a review appointment following placement of the root canal filling. One hundred and forty-eight teeth (129 patients) were considered. Of these, 69.6% (n = 103) were of acceptable technical quality, 23.6% (n = 35) were under-extended, and 6.8% (n = 10) were overextended. An increased number of intra-treatment radiographs to confirm the relationship of the canal preparation to the radiographic apex and operator experience were significant predictors of adequate root canal fillings (P < 0.05). Eighty-three per cent (n = 123) of teeth were present at a review appointment held an average of 40 months following completion of treatment (12-60 months). The technical quality of the root canal filling was the only significant factor in predicting tooth survival (P < 0.05), while the presence of pre-treatment periapical pathology had no significant effect on survival of the root-filled tooth. Determination and maintenance of the working length of the canal system is an important feature in producing good quality root canal fillings, which in turn, is associated with increased likelihood of survival\\/retention of root-filled teeth.

  9. Rationale and design of a prospective study of the efficacy of a remote monitoring system used in implantable cardioverter defibrillator follow-up: the Lumos-T Reduces Routine Office Device Follow-Up Study (TRUST) study.

    Science.gov (United States)

    Varma, Niraj

    2007-12-01

    Increased implantable cardioverter defibrillator (ICD) implant volumes (and product advisories/recalls) pose management challenges. Most device interrogations at 3- to 6-month routine follow-up visits are "nonactionable," that is, require no clinically significant reprogramming, lead revision, or initiation or up-titration of antiarrhythmic medications. Conversely, implanted devices collect important diagnostic data (eg, atrial fibrillation onset, system integrity) that remain concealed between device interrogations. Remote monitoring may resolve some of these challenges, but has not been studied in a large-scale clinical trial. Home Monitoring (HM) uses automatic (without patient intervention) data and electrogram transmissions with rapid (automatically occur between periodic checks for compromised system integrity (battery, lead parameters, high-voltage circuitry) or arrhythmia occurrence (eg, atrial fibrillation, ventricular arrhythmia). All study patients will have a final office visit 15 months after implant. The results of TRUST may confirm the role of remote monitoring as an intensive surveillance mechanism for device management. PMID:18035071

  10. An atypical case of neuro-Whipple: Clinical presentation, magnetic resonance spectroscopy and follow-up.

    Science.gov (United States)

    Pauletti, Caterina; Pujia, Francesco; Accorinti, Massimo; Pauri, Flavia; Tinelli, Emanuele; Bianco, Federico; Morocutti, Cristoforo; Fattapposta, Francesco

    2010-10-15

    We report a case of a 53-year-old man with a 2-year history of progressive gait and balance disturbance, supranuclear ophthalmoparesis, mild dysarthria and dysmetria. EMG revealed a lower limb axonal sensory-motor neuropathy, while MR imaging demonstrated a small focal lesion in the right frontal lobe, mild diffuse hyperintensity of the periventricular white matter and diffuse brain atrophy. Magnetic resonance spectroscopy revealed a mild decrease in N-acetyl-aspartate peak and an increase in the choline peak in the small right frontal lesion and within 6 voxels of interest in normal appearing cerebral tissue. According to the clinical picture the diagnosis of WD was made by the positivity of PCR for T. whipplei DNA on CSF. After treatment the patient showed a mild clinical improvement although MR images and laboratory test remained unchanged. The MRS findings suggest that the pathological process of the disease diffusely involves the brain. Despite the absence of gastrointestinal involvement WD should be suspected in all complex and atypical neurological pictures, even in presence of peripheral involvement, in order to be able to start treatment promptly. PMID:20674936

  11. Self-Reported Low Self-Esteem. Intervention and Follow-Up in a Clinical Setting

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2007-01-01

    Full Text Available At the Research Clinic for Holistic Medicine in Copenhagen, 43 patients who presented with low or very low self-esteem were treated with psychodynamic short-term therapy complemented with bodywork. They received an average of 20 sessions at a cost of 1,600 EURO. The bodywork helped the patients to confront old emotional pain from childhood trauma repressed to the body-mind. Results showed that 60.5% recovered from low selfesteem (95% CI: 44.41–75.02%. Calculated from this, we have NNT = 1.33–2.25. Almost all aspects of life improved at the same time (p < 0.01: physical health, mental health, quality of life, and ability to function in a number of important areas (partner, friends, sexually, and socially. This indicated that we had successfully induced existential healing (Antonovsky salutogenesis. The strategy of improving self-esteem can be the key to a new life for patients presenting with low quality of life, poor health (physical and/omental, and poor ability to function. The patients were strongly motivated and willing to endure strong emotional pain provoked by the therapy. The rate of recovery is comparable to the most successful interventions with psychological and psychiatric treatment. Clinical holistic treatment has many advantages: efficiency, low cost, lack of negative side effects, lasting results, lack of use of psychopharmacological drugs (often with side effects, and an important preventive dimension.

  12. The clinical immunological and long-term follow-up of pediatric patients with common variable immunodeficiency

    Directory of Open Access Journals (Sweden)

    Abdollahzade S

    2011-01-01

    Full Text Available "n 800x600 Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Background: Common Variable Immunodeficiency (CVID is a primary immunodeficiency disease, characterized by hypogammaglobulinemia and heterogeneous clinical manifestations. This study was performed to evaluate the clinical and immunological features of pediatric patients with CVID. "n"nMethods: We reviewed the records of 69 children diagnosed under age of 16 years with CVID (35 males and 34 females."n"nResults: By the year 2008, 15 patients (21% had died. The total follow-up period was 333 patient-years. The mean diagnostic time between onset and diagnosis in our patient group was 4.40 years. The overall rate of consanguineous marriages was 58%. 10 patients had a positive family history of immunodeficiency. At the time of diagnosis, the mean levels of serum immunoglobulin G (IgG, IgM, and IgA levels were 286.86, 39.92, and 18.39 mg/dl, respectively which were below the normal levels for age. All of the patients presented with infectious diseases at the time of onset, the most common of which were pneumonia, diarrhea and sinusitis. Acute and recurrent infections were also found in almost all of the patients, particularly involving respiratory and gastrointestinal systems. The most common infections during follow-up period were pneumonia (31.9%, acute diarrhea (18.8%, acute sinusitis (18.8%, and otitis media (14.5%. Post-diagnosis survival was estimated to be 79% during the first five years. The survival rate was not shown to be influenced by delayed diagnosis, serum levels of IgG and B

  13. Consequences and outcomes of chronic radiation sickness induced by external γ-rays(50 years of clinical follow-up)

    International Nuclear Information System (INIS)

    Health was analyzed for 673 workers of the first Russian nuclear facility. These nuclear workers had CRS induced by external overall exposure to γ -rays in high doses (total, 1.0-9.76 Gy). The study was focused on evaluation of the post-exposure recovery in most radiosensitive systems and organs, consequences and outcomes of chronic radiation sickness (CRS). The complex evaluation of peripheral blood data and results of bone marrow studies revealed a moderately pronounced bone marrow hypoplasia for 2% of cases and partial hypoplasia of granulocytopoiesis for 4.9% of cases (most patients aged over 70). The changes were clinically compensated and did not require any special treatment. Chromosome aberrations in somatic cells are still indicators of radiation past-exposures; their frequency has a correlation with total dose and 239 Pu incorporation. No high incidence of complications such as cerebrovasciular diseases (CVD) was revealed for CRS patients with high doses (total dose exceeded 4.0 Gy, maximum annual dose exceeded 2.0 Gy) and clinical symptoms of the early (up to 45 years) cerebral atherosclerosis (CAS). The retrospective analysis of clinical data for 370 CRS cases registered during 1950-60ss among workers with lower doses indicated that the moderately pronounced symptoms of CRS were formed at dose not less than 1.4 Gy accumulated during the first 1-2 years of work and annual dose, 0.73 Gy. Cardiovascular diseases prevailed followed by malignant neoplasms in the structure of death causes during 50 years of follow-up. Presented results for the cohort of individuals exposed in high doses can be used in health examination of those, who were involved in radiation accidents or exposure incidents

  14. Follow-up study of a pregnant woman 16 years after exposure in the Xinzhou radiation accident

    International Nuclear Information System (INIS)

    To investigate the late effects of radiation on child-bearing women, a follow-up study was performed on a 39-year-old survivor 16 years after a 60Co radiation accident. The woman, Fang, was 19 weeks pregnant at the time of exposure. Physical examinations, a full range of clinical laboratory and imaging tests, as well as cytogenetic analyses were conducted to evaluate Fang's current health conditions. Fang shows the appearance of premature ageing and has a decreased menstrual period. Laboratory studies and imaging tests suggest nodular goitre disease and osteoporosis. Otherwise, no apparent abnormalities were found in the major organs. No malignant tumours were detected by either tumour markers or imaging tests. However, the existence of chromosome aberrations warrants long-term follow-up for tumour incidence in the future. Fang became pregnant 8 years after the accident, but suffered a miscarriage due to the death of the foetus at 6 months into the pregnancy. In conclusion, our findings suggest that the intrauterine death of the foetus might be associated with the previous exposure. There is no evidence of malignant tumours as of the date of the follow-up study. Non-cancerous diseases, i.e. thyroid disease and osteoporosis, which may be related to radiation exposure, are the major manifestations of the long-term effects of the accident. (note)

  15. Clinical Findings, Follow-up and Treatment Results in Patients with Ocular Rosacea

    Directory of Open Access Journals (Sweden)

    İlkay Kılıç Müftüoğlu

    2016-02-01

    Full Text Available Objectives: To report the clinical features, treatment options and complications in patients with ocular rosacea. Materials and Methods: The records of 48 eyes of 24 patients with ocular rosacea were retrospectively reviewed. Patients’ ocular signs and symptoms were scored between 1 and 4 points according to disease severity; tear film break-up time (BUT and Schirmer’s test results were recorded before and after the treatment. Preservative-free artificial tears, topical antibiotic eye drops/ointments, short-term topical corticosteroids, topical 0.05% cyclosporine and oral doxycycline treatment were applied as a standard therapy to all patients. Additional treatments were given as needed. Complications were recorded. Results: Twenty-four patients with a mean age of 48.5±35.4 (32-54 years were followed for a mean 15±9.4 (8-36 months. Ocular findings included meibomitis in 100% of cases, anterior blepharitis in 83% (40 eyes, punctate keratopathy in 67% (32 eyes, chalazia in 50% (24 eyes, corneal neovascularization in 50% (24 eyes and subepithelial infiltrates in 16.6% (8 eyes. Significant improvement of symptoms and clinical findings were achieved in all patients with treatment. The increases in Schirmer’s test and BUT were 3.3±1.5 and 4.5±2.8, respectively (p<0.05. Descemetocele and small corneal perforation occurred in 2 eyes; re-epithelialization was achieved in both eyes with tissue adhesive application (1 eye and additional amniotic membrane transplantation (1 eye. Four eyes of three patients showed significant regression of corneal neovascularization with topical bevacizumab therapy. Conclusion: Ocular rosacea may present with a variety of ophthalmic signs. It is possible to control the ophthalmic disease with appropriate therapeutic modalities including topical corticosteroids, topical cyclosporine and systemic doxycycline.

  16. Cohabitation and marital status as predictors of mortality--an eight year follow-up study

    DEFF Research Database (Denmark)

    Lund, Rikke; Due, Pernille; Modvig, Jens;

    2002-01-01

    .25(0.93-1.69), adjusted for the same covariates. Inclusion of the health behaviour variables--smoking, diet and physical activity--one by one to a model with functional ability, self-rated health and one of the three determinants (cohabitation status, living with/without partner, marital status) showed no effect on the......In a follow-up study of 1265 women and men aged 50, 60 and 70 years, we analysed how mortality was associated with cohabitation status (living alone/not living alone), living with/without a partner, and marital status respectively. Data originate from a longitudinal questionnaire study of a random...... association with mortality. Hereby, we found no evidence of an indirect effect of health behaviours on the association between living arrangements and mortality. In contrast to many previous studies, we found no significant gender and age differences in the association between living arrangement and mortality...

  17. Impact of comorbidity on three month follow-up outcome of children with ADHD in a child guidance clinic: Preliminary report

    OpenAIRE

    Rangan Srinivasaraghavan; Subramanian Mahadevan; Shivanand Kattimani

    2013-01-01

    Context: Attention deficit hyperactivity disorder (ADHD) is one of the common neurodevelopmental disorders. Aims: Study objective is to report impact of comorbidities on short-term outcome in children with ADHD followed in a child guidance clinic. Settings and Design: This was done in a child guidance clinic run jointly by the pediatric and psychiatry department at a tertiary teaching hospital. This is a 3 month prospective follow-up study to assess the outcome in ADHD children. Materials and...

  18. A 10 year follow-up study after Roux-Elmslie-Trillat treatment for cases of patellar instability

    Directory of Open Access Journals (Sweden)

    Wilke Axel

    2011-02-01

    Full Text Available Abstract Background A retrospective study concerning patients presenting with patella instability, treated using a Roux-Elmslie-Trillat reconstruction operation and followed up for 10 years following surgery, is presented. Methods Pre-operative and follow-up radiographic evaluation included the weight-bearing anteroposterior and merchant views. Evaluation was carried out using the Insall-Salvati index, sulcus and congruence angle. The Roux-Elmslie-Trillat reconstruction operation was performed on 18 patients. The clinical evaluation at follow-up was performed using the Knee-Society-Score (KSS and Tegner-Score. Results Subjective results of the operation were classed as excellent or good in 16 of the 18 patients ten years after surgery; persistent instability of the patella was recorded in only one of the 18 patients. The majority of patients returned to the same level of sporting activity after surgery as they had participated in before injury. Conclusions The Roux-Elmslie-Trillat procedure could be recommended in cases presenting with an increased q-angle, trochlea dysplasia or failed soft tissue surgery. In the present study the majority of patients report a return to previous sporting activity ten years after surgery.

  19. Tinnitus Suppression by Intracochlear Electrical Stimulation in Single Sided Deafness – A Prospective Clinical Trial: Follow-Up

    Science.gov (United States)

    Arts, Remo A. G. J.; George, Erwin L. J.; Janssen, Miranda; Griessner, Andreas; Zierhofer, Clemens; Stokroos, Robert J.

    2016-01-01

    Introduction Earlier studies show that a Cochlear Implant (CI), capable of providing intracochlear electrical stimulation independent of environmental sounds, appears to suppress tinnitus at least for minutes. The current main objective is to compare the long-term suppressive effects of looped (i.e. repeated) electrical stimulation (without environmental sound perception) with the standard stimulation pattern of a CI (with environmental sound perception). This could open new possibilities for the development of a “Tinnitus Implant” (TI), an intracochlear pulse generator for the suppression of tinnitus. Materials and Methods Ten patients with single sided deafness suffering from unilateral tinnitus in the deaf ear are fitted with a CI (MED-EL Corporation, Innsbruck, Austria). Stimulation patterns are optimized for each individual patient, after which they are compared using a randomized crossover design, with a follow-up of six months, followed by a 3 month period using the modality of patient’s choice. Results Results show that tinnitus can be suppressed with intracochlear electrical stimulation independent of environmental sounds, even long term. No significant difference in tinnitus suppression was found between the standard clinical CI and the TI. Conclusion It can be concluded that coding of environmental sounds is no requirement for tinnitus suppression with intracochlear electrical stimulation. It is therefore plausible that tinnitus suppression by CI is not solely caused by an attention shift from the tinnitus to environmental sounds. Both the standard clinical CI and the experimental TI are potential treatment options for tinnitus. These findings offer perspectives for a successful clinical application of the TI, possibly even in patients with significant residual hearing. Trial Registration TrialRegister.nl NTR3374 PMID:27111333

  20. Radiological evaluation of percutaneous endoscopic lumbar discectomy: a three-year follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Seung Eun; Lee, Sang Ho; Ahn, Yong; Shin, Song Woo; Jo, Byung June; Park, Jee Young [Wooridul Spine Hospital, Seoul (Korea, Republic of); Kim, Tae Hong [Inje University College of Medicine, Seoul (Korea, Republic of)

    2006-05-15

    We wanted to analyze the radiological changes of the patients who underwent percutaneous endoscopic lumbar discectomy (PELD) for treating soft disc herniation. We retrospectively reviewed 30 patients (32 cases) who were observed for a minimum of 3 years after they underwent PELD. The authors investigated the postoperative radiological changes after PELD and the related clinical outcomes. All the patients received plain X-rays, CT and MRI both preoperatively and at the final follow-up. The radiological parameters were evaluated, including the disc height, the disc signal intensity, the subchondral marrow signal intensity, the sagittal plane instability and the facet joint osteoarthritis. The average amount of removed disc was 1.363 g and a significant correlation was detected between the narrowing of disc height and the amount of removed disc. Although the disc height and the disc height ratio were significantly decreased (-0.97 mm and 86.9%, respectively), the angle of sagittal rotation was well maintained. There were 18 (56.3%) cases of disc signal changes, six cases (18.8%) of subchondral marrow signal changes, and three cases (9.4%) of facet joint osteoarthritis. The success rate was 90.6%. Although disc height narrowing was observed, there was no postoperative instability and the overall clinical outcome was satisfactory. Our results show that PELD is a useful and minimal invasive procedure for the selected patients who are suffering with lumbar disc herniation.

  1. [Study of the follow-up by the general practitioner of the children of separated parents].

    Science.gov (United States)

    Kacenelenbogen, N; Roland, M; Schetgen, M; Dusart, A F

    2006-09-01

    In Belgium, on 10 millions of inhabitants, there are more than 31.000 divorces per year and we estimate that 600.000 children are experiencing separation of their parents. The general practitioner (GP) have inevitably the responsability of the medical follow-up of some of these children. The possible professional implications related to these young patients, concerning the GP have never been the subject of a study so far. Consequently the aim of this research was to reveal what is happening in the daily practice of the family practitioner related with the children of separete parents. There were some hypothesis notably about particular working conditions for the GP in connection with possible consequences for these children and possible necessity of special professional attitudes. A qualitative research in focus group was organized with GPs in order to get an interaction between the participants and to go past the concepts supposed before the study. Therefore between September and December 04, 8 focus groups of 10-18 generalist practitioners were set up in Brussels and Mons. Each meeting was axed around couples separated for less than 3 years and children between 0 and 15 years. Finally, 120 GPs discussed about 242 cases of divorces from their practice. The debates totally typed word by word were analysed with assistance of the software QSR N5. The point of view of the GPs is: 1) A divorce affects the working conditions of the general practitioner, for example the parcelling out of the medical follow-up of the child and the fact " of being used" by the family. 2) The conflict between the parents after the separation increases the difficulties for the GP in his daily practice. 3) The parental's separation influences the choice of professional attitudes of the GP, notably vis-a-vis the conflict (for instance to try or not to try the conflict's management). 4) Mainly in conflict situation, parental divorce is a risk for the child; psychological or behavioural

  2. Anal cancer: ESMO-ESSO-ESTRO clinical practice guidelines for diagnosis, treatment and follow-up.

    Science.gov (United States)

    Glynne-Jones, R; Nilsson, P J; Aschele, C; Goh, V; Peiffert, D; Cervantes, A; Arnold, D

    2014-10-01

    Squamous cell carcinoma of the anus (SCCA) is a rare cancer but its incidence is increasing throughout the world, and is particularly high in the human immunodeficiency virus positive (HIV+) population. A multidisciplinary approach is mandatory (involving radiation therapists, medical oncologists, surgeons, radiologists and pathologists). SCCA usually spreads in a loco-regional manner within and outside the anal canal. Lymph node involvement at diagnosis is observed in 30%-40% of cases while systemic spread is uncommon with distant extrapelvic metastases recorded in 5%-8% at onset, and rates of metastatic progression after primary treatment between 10 and 20%. SCCA is strongly associated with human papilloma virus (HPV, types 16-18) infection. The primary aim of treatment is to achieve cure with loco-regional control and preservation of anal function, with the best possible quality of life. Treatment dramatically differs from adenocarcinomas of the lower rectum. Combinations of 5FU-based chemoradiation and other cytotoxic agents (mitomycin C) have been established as the standard of care, leading to complete tumour regression in 80%-90% of patients with locoregional failures in the region of 15%. There is an accepted role for surgical salvage. Assessment and treatment should be carried out in specialised centres treating a high number of patients as early as possible in the clinical diagnosis. To date, the limited evidence from only 6 randomised trials [1,2,3,4,5,6,7], the rarity of the cancer, and the different behaviour/natural history depending on the predominant site of origin, (the anal margin, anal canal or above the dentate line) provide scanty direction for any individual oncologist. Here we aim to provide guidelines which can assist medical, radiation and surgical oncologists in the practical management of this unusual cancer. PMID:25239441

  3. Anal cancer: ESMO–ESSO–ESTRO clinical practice guidelines for diagnosis, treatment and follow-up

    International Nuclear Information System (INIS)

    Squamous cell carcinoma of the anus (SCCA) is a rare cancer but its incidence is increasing throughout the world, and is particularly high in the human immunodeficiency virus positive (HIV+) population. A multidisciplinary approach is mandatory (involving radiation therapists, medical oncologists, surgeons, radiologists and pathologists). SCCA usually spreads in a loco-regional manner within and outside the anal canal. Lymph node involvement at diagnosis is observed in 30–40% of cases while systemic spread is uncommon with distant extrapelvic metastases recorded in 5–8% at onset, and rates of metastatic progression after primary treatment between 10% and 20%. SCCA is strongly associated with human papilloma virus (HPV, types 16–18) infection. The primary aim of treatment is to achieve cure with loco-regional control and preservation of anal function, with the best possible quality of life. Treatment dramatically differs from adenocarcinomas of the lower rectum. Combinations of 5FU-based chemoradiation and other cytotoxic agents (mitomycin C) have been established as the standard of care, leading to complete tumour regression in 80–90% of patients with locoregional failures in the region of 15%. There is an accepted role for surgical salvage. Assessment and treatment should be carried out in specialised centres treating a high number of patients as early as possible in the clinical diagnosis. To date, the limited evidence from only 6 randomised trials [1,2,3,4,5,6,7], the rarity of the cancer, and the different behaviour/natural history depending on the predominant site of origin, (the anal margin, anal canal or above the dentate line) provide scanty direction for any individual oncologist. Here we aim to provide guidelines which can assist medical, radiation and surgical oncologists in the practical management of this unusual cancer

  4. Cigarette smoking during pregnancy and hyperactive-distractible preschooler's: a follow-up study

    DEFF Research Database (Denmark)

    Markussen Linnet, Karen; Obel, Carsten; Bonde, Else;

    2006-01-01

    AIM: To study the association between intrauterine exposure to tobacco smoke and behavioural disorders in preschool children, primarily symptoms of inattention, hyperactivity and impulsivity but also hostile-aggressive and anxious-fearful symptoms. METHODS: We conducted a follow-up study in 1355...... using the self-administered Preschool Behaviour Questionnaire. The children were categorized into three not mutually exclusive behaviour groups: hyperactive - distractible (13.6%), hostile-aggressive (4.6%), and anxious-fearful (6.4%) children. RESULTS: Compared with children of non-smokers, children...... perinatal factors and parental psychiatric hospitalization did not change the results substantially (OR 1.7; 95% CI 1.1-2.6). We found no statistically significant association between maternal smoking in pregnancy and hostile-aggressive and anxious-fearful behaviour in the offspring. CONCLUSION: Exposure to...

  5. Cytogenetic Follow-up Study of Population Occupationally Exposed to Nonionizing Radiation

    International Nuclear Information System (INIS)

    The aim of this investigation was to analyse the results of a four year follow- up study of chromosome aberrations in a population occupationally exposed to microwave radiation. The study included a group of 30 healthy volunteers - radar technicians occupationally exposed to microwave radiation and a group of 30 healthy controls from the general population. The average duration of employment of the exposed subjects was 16 years. The chromosome aberrations assay was carried out on 48 h culture of lymphocytes. Microwave power density was measured with Raham model 4A (General Microwave Corporation, Farmingdale, NY) at different workplaces. The measurements of electromagnetic field power density distribution at different workplaces show that during an ordinary workday the examinees stay in zones with power density below 5 mW/cm2 with a frequency range of 1250-1350 MHz. The chromosomal type of aberrations in the exposed group during the 4-year follow up study was predominantly higher than in the control group. The total percentage of chromosome aberrations for the exposed group in the first year of the study was 2.36%, in the second 1.43%, in the third 2.88%, and in the fourth year 2.60%, while for the control group was 1.39%. In every year of investigation in exposed group manifested dicentric chromosomes, while in last two years ring chromosome also detected. Mutagenic changes in the somatic cells detected in exposed subjects pointed to the fact that these cellular damages can be related to continuous occupational exposure to microwave radiation. (author)

  6. Risky driving and recorded driving offences: a 24-year follow-up study.

    Science.gov (United States)

    Summala, Heikki; Rajalin, Sirpa; Radun, Igor

    2014-12-01

    Permanent individual differences in driver behavior and accident risk have long been under active debate. Cognitive and personality factors have correlated with risky driving indicators in cross-sectional studies, and prospective cohort studies are now increasingly revealing early antecedents of risky behavior and injury mortality in adult age, with connections to stable personality traits. However, long-term stability in driver behavior or accident involvement has not been documented in a general driver population.This study reports 24-year follow-up data from a study that compared the recorded offenses between 134 drivers stopped by the police because of sustained risky driving and 121 control drivers stopped at the same locations at the same time in 1987 (Rajalin, 1994. Accid. Anal. Prev., 26, 555-562). Data were compiled from national driver records and accident statistics for the same drivers again 24 years later, and their yearly mileage and speed behavior was requested in a mail survey. The results showed that the two groups of drivers sampled on one trip a quarter of a century ago still differ from each other. The offenders still have more entries in their driver record, also when adjusted for age and mileage (OR=1.59, CI=1.03-2.46), they still report in the survey that they drive faster and overtake other cars more often. The results show that individual differences in driver behavior persist for decades, perhaps for life. However, in this on-road sample, the effect seems to be moderated by occupation which also presumably explains the lower mortality among the offenders during this 24-year follow-up. PMID:25171522

  7. Changes in quality of life among Norwegian school children: a six-month follow-up study

    Directory of Open Access Journals (Sweden)

    Larsson Bo

    2009-02-01

    Full Text Available Abstract Background A considerable gap exists in regard to longitudinal research on quality of life (QoL in community populations of children and adolescents. Changes and stability of QoL have been poorly examined, despite the fact that children and adolescents undergo profound developmental changes. The aims of the study were to investigate short-term changes in student QoL with regard to sex and age in a school-based sample. Methods A representative Norwegian sample of 1,821 school children, aged 8–16 years and their parents were tested at baseline and 6 months later, using the Inventory of Life Quality for Children and Adolescents (ILC and the Kinder Lebensqualität Fragebogen (KINDL. Student response rate at baseline was 71.2% and attrition over the follow-up period was 4.6%, and 1,336 parents (70% completed the follow-up. Change scores between baseline and follow-up evaluations were analysed by means of ANCOVA in regard to sex and age effects. Results Students in the 8th grade reported a decrease in QoL over the six-month follow-up period as compared to those in the 6th grade with regard to Family and School domains and total QoL on the KINDL. For emotional well-being a significant linear decrease in QoL across grades 6th to 10th was observed. However, student ratings on the Friends and Self-esteem domains did not change significantly by age. Girls reported a higher decrease in their QoL across all grades over the follow-up period than did boys in respect of Self-esteem on the KINDL, and an age-related decrease in total QoL between 6th and 8th grade on the ILC. Parent reports of changes in child QoL were nonsignificant on most of the domains. Conclusion The observed age and sex-related changes in school children's QoL across the six-month follow-up period should be considered in epidemiological as well as clinical research.

  8. The value of MRI in early Perthes` disease: an MRI study with a 2-year follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Lahdes-Vasama, T. [Department of Orthopaedic Surgery, Helsinki University Central Hospital, Children`s Hospital, Stenbaeckinkatu 11, FIN-00290 Helsinki (Finland); Lamminen, A. [Department of Radiology, Helsinki University Central Hospital, Helsinki (Finland); Merikanto, J. [Department of Orthopaedic Surgery, Helsinki University Central Hospital, Children`s Hospital, Stenbaeckinkatu 11, FIN-00290 Helsinki (Finland); Marttinen, E. [Department of Radiology, Children`s Hospital, Helsinki (Finland)

    1997-06-01

    Eleven hips in nine patients with Perthes` disease were studied by plain radiography at 3-month and MRI at 6-month intervals over a period of 2 years. The aim was to clarify the value of MRI in estimating epiphyseal involvement and in predicting uncoverage of the epiphysis. Signal intensities of the epiphysis and metaphysis were visually evaluated from T1- (T1W) and T2-weighted (T2W) images. The extent of decreased signal intensity (DSI) in the epiphyses was volumetrically calculated from T1W images and then compared with follow-up radiographs. The area of epiphyseal DSI corresponding best with Catterall`s classification was seen by MRI 3-8 months after the first symptoms. MRI images obtained earlier usually showed less involvement than the follow-up radiographs. However, two features predicting extensive epiphyseal necrosis were: (1) DSI on both T1W and T2W images covering over two-thirds of the epiphysis and (2) diffuse bone marrow oedema of the femoral neck and metaphysis. When T1W images showed a reappearance of high signal intensity patches in the lateral quarter of the epiphysis, no clinically significant uncoverage was seen during the follow-up. Extensive epiphyseal necrosis can, therefore, sometimes be predicted by MRI even within the first 3 months, but MRI visualises epiphyseal involvement more clearly 3-8 months after the first symptoms. (orig.). With 3 figs., 2 tabs.

  9. The posterior bone block procedure in posterior shoulder instability: a long-term follow-up study.

    Science.gov (United States)

    Meuffels, D E; Schuit, H; van Biezen, F C; Reijman, M; Verhaar, J A N

    2010-05-01

    We present the long-term outcome, at a median of 18 years (12.8 to 23.5) of open posterior bone block stabilisation for recurrent posterior instability of the shoulder in a heterogenous group of 11 patients previously reported on in 2001 at a median follow-up of six years. We found that five (45%) would not have chosen the operation again, and that four (36%) had further posterior dislocation. Clinical outcome was significantly worse after 18 years than after six years of follow-up (median Rowe score of 60 versus 90 (p = 0.027)). The median Western Ontario Shoulder Index was 60% (37% to 100%) at 18 years' follow-up, which is a moderate score. At the time of surgery four (36%) had glenohumeral radiological osteoarthritis, which was present in all after 18 years. This study showed poor long-term results of the posterior bone block procedure for posterior instability and a high rate of glenohumeral osteoarthritis although three patients with post-traumatic instability were pleased with the result of their operations. PMID:20436001

  10. Quality of care and mortality among patients with stroke - A nationwide follow-up study

    DEFF Research Database (Denmark)

    Ingeman, A.; Pedersen, Lars; Hundborg, Heidi Holmager;

    2008-01-01

    Background: The relationship between process and outcome measures among patients with stroke is unclear. Objectives: To examine the association between quality of care and mortality among patients with stroke in a nationwide population-based follow-up study. Methods: Using data from The Danish...... National Indicator Project, a quality improvement initiative with participation of all Danish hospital departments caring for patients with stroke, we identified 29,573 patients hospitalized with stroke between January 13, 2003 and October 31, 2005. Quality of care was measured in terms of 7 specific...... criteria: early admission to a stroke unit, early initiation of antiplatelet or oral anticoagulant therapy, early examination with computed tomography/magnetic resonance imaging scan, and early assessment by a physiotherapist, an occupational therapist, and of nutritional risk. Data on 30- and 90-day...

  11. Body experience in eating disorders before and after treatment: a follow-up study.

    Science.gov (United States)

    Probst, M; Vandereycken, W; Van Coppenolle, H; Pieters, G

    1999-10-01

    Since body dissatisfaction is an essential part of anorexia/bulimia nervosa, we wanted to assess the patients' body experience before and after intensive treatment. Body experience was studied in 290 eating disorder patients, admitted to a specialised unit, after six months and again after one year using the Body Attitude Test (BAT), the Eating Disorder Inventory (EDI), and the Eating Disorder Evaluation Scale (EDES). The clearly negative body experience of eating disorder patients evolved in a positive way after therapy and this improvement lasted for up to one year after admission. EDI scores and Body Mass Index at the time of admission appeared to be the strongest predictors of the total BAT score at follow-up. Although body dissatisfaction can be quite persistent in eating disorders, intensive treatment can substantially improve the patients' body experience. PMID:10572365

  12. Mortality in parents after death of a child in Denmark: A nationwide follow-up study

    DEFF Research Database (Denmark)

    Li, Jiong; Precht, Dorthe Hansen; Mortensen, Preben Bo;

    2003-01-01

    a child who had died (exposed cohort), and 293745 controls--ie, parents whose children were alive, and whose family structure matched that of the exposed cohort. Natural deaths were defined with ICD8 codes 0000-7969 and ICD10 codes A00-R99, and unnatural deaths with codes 8000-9999 and V01-Y98. We used......BACKGROUND: Little is known about the effect of parental bereavement on physical health. We investigated whether the death of a child increased mortality in parents. METHODS: We undertook a follow-up study based on national registers. From 1980 to 1996, we enrolled 21062 parents in Denmark who had...... Cox's proportional-hazards regression models to assess the mortality rate of parents up to 18 years after bereavement. FINDINGS: We observed an increased overall mortality rate in mothers whose child had died (hazards ratio 1.43, 95% CI 1.24-1.64; p

  13. Risk perception among women receiving genetic counseling: a population-based follow-up study

    DEFF Research Database (Denmark)

    Mikkelsen, Ellen M; Sunde, Lone; Johansen, Christoffer;

    2007-01-01

    BACKGROUND: We aimed to explore the impact of genetic counseling on perceived personal lifetime risk of breast cancer, the accuracy of risk perception, and possible predictors of inaccurate risk perception 1 year following counseling. METHODS: We conducted a population-based prospective follow......-up study of 213 women who received genetic counseling for hereditary breast and ovarian cancer, 319 women who underwent mammography (Reference Group I), and a random sample of 1070 women from the general population (Reference Group II). RESULTS: Women who received genetic counseling decreased their...... counseling, compared to a reduction of 5% (p=0.03) and 2% (p=0.01) in Reference Groups I and II, respectively. Risk communicated only in words, inaccurate risk perception at baseline, and presence of a familial mutation appeared to be predictors of inaccurate risk perception 12 months after counseling...

  14. Exposure therapy for emetophobia: a case study with three-year follow-up.

    Science.gov (United States)

    Maack, Danielle J; Deacon, Brett J; Zhao, Mimi

    2013-06-01

    Emetophobia, also referred to as a specific phobia of vomiting, is a largely under-researched and poorly understood disorder with prevalence estimates of ranging between 1.7 and 3.1% for men and 6 and 7% for women (Hunter & Antony, 2009; Philips, 1985). The current case study, therefore, sought to methodically apply exposure-based behavioral treatment to the treatment of a 26 year-old, Hispanic, female suffering from emetophobia. Although not as powerful as a randomized design, this description may still add to the existing emetophobia literature through the illustration of adaptation of published behavioral treatments for other specific phobias. The case presented was successful in terms of outcome, and includes a three-year follow up wherein treatment gains were measurably maintained. PMID:23973742

  15. Risk factors for onset of asthma: a 12-year prospective follow-up study

    DEFF Research Database (Denmark)

    Porsbjerg, C; von Linstow, Marie-Louise; Ulrik, Charlotte Suppli; Nepper-Christensen, S; Backer, V

    2006-01-01

    .2; 95% CI, 1.1-5.1) predicted the subsequent development of asthma, whereas no risk factors for the development of asthma could be identified in individuals with EIB CONCLUSION: Asymptomatic AHR to histamine and EIB in childhood predict the subsequent development of asthma in adulthood. A genetic...... asymptomatic AHR to histamine and EIB. METHODS: Data from a 12-year follow-up study of a random population sample of individuals aged 7 to 17 years at enrollment were analyzed; only individuals without asthma at enrollment were included in the analysis. AHR to inhaled histamine, EIB, lung function, and...... asthma, compared with only 5% of individuals in whom these test results were negative. In patients with AHR to histamine, parental asthma (odds ratio [OR], 12.6; 95% confidence interval [CI], 1.5-108.5), furred pets ownership (OR, 6.0; 95% CI, 1.2-19.6), and dermatitis and/or rhinitis in childhood (OR, 2...

  16. Importance of a Patient Dosimetry and Clinical Follow-up Program in the Detection of Radiodermatitis After Long Percutaneous Coronary Interventions

    International Nuclear Information System (INIS)

    Complex percutaneous interventions often require high radiation doses likely to produce skin radiation injuries. We assessed the methodology used to select patients with potential skin injuries in cardiac procedures and in need of clinical follow-up. We evaluated peak skin dose and clinical follow-up in a case of radiodermatitis produced during a total occlusion recanalization. This prospective study followed CIRSE and ACC/AHA/SCAI recommendations for patient radiation dose management in interventional procedures carried out in a university hospital with a workload of 4200 interventional cardiac procedures per year. Patient dose reports were automatically transferred to a central database. Patients exceeding trigger levels for air kerma area product (500 Gy cm2) and cumulative skin dose (5 Gy) were counseled and underwent follow-up for early detection of skin injuries, with dermatologic support. The Ethical Committee and the Quality Assurance and Radiation Safety Committee approved the program. During 2010, a total of 13 patients (3.0/1,000 that year) received dose values exceeding trigger levels in the cardiovascular institute. Only one patient, who had undergone two consecutive procedures resulting in 970 Gy cm2 and 13.0 Gy as cumulative skin dose, showed signs of serious radiodermatitis that resolved in 3.7 months. The remaining patients did not manifest skin lesions during follow-up, and whenever patient examination was not feasible as part of the follow-up, neither patients nor families reported any skin injuries. Peak skin dose calculation and close clinical follow-up were feasible and appropriate, with a moderate additional workload for the staff and satisfaction for the patient.

  17. Importance of a Patient Dosimetry and Clinical Follow-up Program in the Detection of Radiodermatitis After Long Percutaneous Coronary Interventions

    Energy Technology Data Exchange (ETDEWEB)

    Vano, Eliseo, E-mail: eliseov@med.ucm.es [Instituto de Investigacion Sanitaria Hospital Clinico San Carlos and Complutense University, Medical Physics Service and Radiology Department (Spain); Escaned, Javier [Hospital Clinico San Carlos, Cardiovascular Institute (Spain); Vano-Galvan, Sergio [Hospital Ramon y Cajal, Dermatology Service (Spain); Fernandez, Jose M. [Instituto de Investigacion Sanitaria Hospital Clinico San Carlos and Complutense University, Medical Physics Service and Radiology Department (Spain); Galvan, Carmen, E-mail: cgalvan@med.ucm.es [Instituto de Investigacion Sanitaria Hospital Clinico San Carlos and Complutense University, Radiotherapy Service and Radiology Department (Spain)

    2013-04-15

    Complex percutaneous interventions often require high radiation doses likely to produce skin radiation injuries. We assessed the methodology used to select patients with potential skin injuries in cardiac procedures and in need of clinical follow-up. We evaluated peak skin dose and clinical follow-up in a case of radiodermatitis produced during a total occlusion recanalization. This prospective study followed CIRSE and ACC/AHA/SCAI recommendations for patient radiation dose management in interventional procedures carried out in a university hospital with a workload of 4200 interventional cardiac procedures per year. Patient dose reports were automatically transferred to a central database. Patients exceeding trigger levels for air kerma area product (500 Gy cm{sup 2}) and cumulative skin dose (5 Gy) were counseled and underwent follow-up for early detection of skin injuries, with dermatologic support. The Ethical Committee and the Quality Assurance and Radiation Safety Committee approved the program. During 2010, a total of 13 patients (3.0/1,000 that year) received dose values exceeding trigger levels in the cardiovascular institute. Only one patient, who had undergone two consecutive procedures resulting in 970 Gy cm{sup 2} and 13.0 Gy as cumulative skin dose, showed signs of serious radiodermatitis that resolved in 3.7 months. The remaining patients did not manifest skin lesions during follow-up, and whenever patient examination was not feasible as part of the follow-up, neither patients nor families reported any skin injuries. Peak skin dose calculation and close clinical follow-up were feasible and appropriate, with a moderate additional workload for the staff and satisfaction for the patient.

  18. Radiation-induced cranial neuropathy in patients with nasopharyngeal carcinoma. A follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Rong, X.; Tang, Y.; Lu, K.; Peng, Y. [Sun Yat-sen Memorial Hospital, Guangzhou (China). Dept. of Neurology; Chen, M. [Sun Yat-sen Univ., Guangzhou (China). Dept. of Nasopharyngeal Carcinoma

    2012-03-15

    The purpose of the current study was to investigate the long-term characteristics of radiation-induced cranial nerve injury in nasopharyngeal carcinoma (NPC) patients. We studied cranial nerve palsy (CNP) in 328 NPC patients who received radiotherapy between 1994 and 2006. Follow-up was 93.6% complete as of December 2009. A total of 72 patients with CNP were recruited for analysis (56 men and 16 women). Patients with evidence of residual or recurrent tumor accompanied by CNP were excluded. The characteristics of CNP and the relationship with the radiation fields as well as re-radiotherapy were evaluated. After a mean follow-up of 11.2 years, 72 patients were found to have developed CNP. The latency of palsy ranged from 0.6-16.0 years. For the 67 patients with first course radiation, the glossopharyngeal and vagus nerves were the most vulnerable combination, occurring in 57 patients (85.1%). Patients with facial-cervical field radiation had a significantly longer latency comparing with that of patients with facial-cervical split fields (p = 0.021). In the first 5 years, 49.3% of patients developed CNP, while 40.3% presented CNP in the second 5-year period. In patients with first course radiation, 61 patients had more than one CNP. With regard to the 5 patients with re-radiation, most of them had multiple upper cranial nerve injuries. Radiation therapy of NPC patients may lead to cranial neuropathy. Patients with facial-cervical radiation fields had a longer latency for the manifestation of CNP compared with those patients who were treated with split fields. In patients with re-radiotherapy, the frequency of upper cranial nerve injury increased greatly.

  19. Radiation-induced cranial neuropathy in patients with nasopharyngeal carcinoma. A follow-up study

    International Nuclear Information System (INIS)

    The purpose of the current study was to investigate the long-term characteristics of radiation-induced cranial nerve injury in nasopharyngeal carcinoma (NPC) patients. We studied cranial nerve palsy (CNP) in 328 NPC patients who received radiotherapy between 1994 and 2006. Follow-up was 93.6% complete as of December 2009. A total of 72 patients with CNP were recruited for analysis (56 men and 16 women). Patients with evidence of residual or recurrent tumor accompanied by CNP were excluded. The characteristics of CNP and the relationship with the radiation fields as well as re-radiotherapy were evaluated. After a mean follow-up of 11.2 years, 72 patients were found to have developed CNP. The latency of palsy ranged from 0.6-16.0 years. For the 67 patients with first course radiation, the glossopharyngeal and vagus nerves were the most vulnerable combination, occurring in 57 patients (85.1%). Patients with facial-cervical field radiation had a significantly longer latency comparing with that of patients with facial-cervical split fields (p = 0.021). In the first 5 years, 49.3% of patients developed CNP, while 40.3% presented CNP in the second 5-year period. In patients with first course radiation, 61 patients had more than one CNP. With regard to the 5 patients with re-radiation, most of them had multiple upper cranial nerve injuries. Radiation therapy of NPC patients may lead to cranial neuropathy. Patients with facial-cervical radiation fields had a longer latency for the manifestation of CNP compared with those patients who were treated with split fields. In patients with re-radiotherapy, the frequency of upper cranial nerve injury increased greatly.

  20. Determinants of aortic stiffness: 16-year follow-up of the Whitehall II study.

    Directory of Open Access Journals (Sweden)

    Nanna B Johansen

    Full Text Available BACKGROUND: Aortic stiffness is a strong predictor of cardiovascular disease endpoints. Cross-sectional studies have shown associations of various cardiovascular risk factors with aortic pulse wave velocity, a measure of aortic stiffness, but the long-term impact of these factors on aortic stiffness is unknown. METHODS: In 3,769 men and women from the Whitehall II cohort, a wide range of traditional and novel cardiovascular risk factors were determined at baseline (1991-1993 and aortic pulse wave velocity was measured at follow-up (2007-2009. The prospective associations between each baseline risk factor and aortic pulse wave velocity at follow-up were assessed through sex stratified linear regression analysis adjusted for relevant confounders. Missing data on baseline determinants were imputed using the Multivariate Imputation by Chained Equations. RESULTS: Among men, the strongest predictors were waist circumference, waist-hip ratio, heart rate and interleukin 1 receptor antagonist, and among women, adiponectin, triglycerides, pulse pressure and waist-hip ratio. The impact of 10 centimeter increase in waist circumference on aortic pulse wave velocity was twice as large for men compared with women (men: 0.40 m/s (95%-CI: 0.24;0.56; women: 0.17 m/s (95%-CI: -0.01;0.35, whereas the opposite was true for the impact of a two-fold increase in adiponectin (men: -0.30 m/s (95%-CI: -0.51;-0.10; women: 0.61 m/s (95%-CI: -0.86;-0.35. CONCLUSION: In this large prospective study, central obesity was a strong predictor of aortic stiffness. Additionally, heart rate in men and adiponectin in women predicted aortic pulse wave velocity suggesting that strategies to prevent aortic stiffening should be focused differently by sex.

  1. Pain following stroke: a population-based follow-up study.

    Directory of Open Access Journals (Sweden)

    Henriette Klit

    Full Text Available BACKGROUND AND PURPOSE: Chronic pain is increasingly recognized as a consequence of stroke. This study aimed to describe the prevalence and pain types of new onset chronic pain ("novel pain" in patients with stroke compared with a randomly selected reference group from the general population and to identify factors associated with pain development in stroke patients. METHODS: In a population-based follow-up design, development of chronic pain after stroke was assessed by a questionnaire sent to consecutive stroke patients, registered in a Danish national stroke database, two years after their stroke. A randomly selected sex- and age-matched reference group from the same catchment area received a similar questionnaire about development of new types of chronic pain in the same time period. A total of 608 stroke patients and 519 reference subjects were included in the study. RESULTS: Development of novel pain was reported by 39.0% of stroke patients and 28.9% of reference subjects (OR 1.57, CI 1.21-2.04, and was associated with low age and depression in a multivariate model. Daily intake of pain medication for novel pain was reported by 15.3% and 9.4% of the stroke and reference population, respectively. Novel headache, shoulder pain, pain from increased muscle stiffness, and other types of novel pain were more common in stroke patients, whereas joint pain was equally common in the two groups. CONCLUSIONS: Development of chronic pain is more common in stroke patients compared with sex- and age-matched reference subjects. Evaluation of post-stroke pain should be part of stroke follow-up.

  2. Short-Term Clinical Result of Cortical Bone Trajectory Technique for the Treatment of Degenerative Lumbar Spondylolisthesis with More than 1-Year Follow-Up

    Science.gov (United States)

    Nishizawa, Kazuya; Nakamura, Akira; Imai, Shinji

    2016-01-01

    Study Design Retrospective follow-up study on the result of surgical treatment for patients with degenerative lumbar spondylolisthesis (DLS) using cortical bone trajectory (CBT) technique. Purpose To evaluate the capability of CBT to manage patients with DLS. Overview of Literature CBT is a recently advocated, novel, less-invasive technique of lumbar pedicle screw, which provides enhanced screw purchase by maximizing the thread contact with higher density bone surface. Despite the frequent use of CBT technique in the lumbar spine surgery, little is known of the capability of this technique to manage patients with DLS. Methods Thirty two consecutive patients (5 males, 27 females) surgically treated with single-level DLS in our institute using CBT were included. All patients were followed up at least 12 months (mean 24 months). Their clinical and radiological features were measured. Results Good leg pain relief was achieved in all patients. The mean postoperative percentage slip demonstrated significant reduction with significant neurological recovery when compared with preoperative percentage slip, and it was maintained until the latest follow-up. Loss of correction of more than 3 mm during the follow-up period was observed in 3 cases. Surgical site infection was observed in one case; however, pull-out of PSs or neurological deterioration was not found. No patient needed additional surgery during the follow-up period. Conclusions These preliminary results confirmed that CBT is useful for the treatment for patients with DLS. This technique allows good reduction of spondylolisthesis and neurological improvement. PMID:27114763

  3. Endovascular Treatment of Pelvic Congestion Syndrome: Visual Analog Scale (VAS) Long-Term Follow-up Clinical Evaluation in 202 Patients

    International Nuclear Information System (INIS)

    PurposeThis study was designed to evaluate the clinical outcome and patients’ satisfaction after a 5 year follow-up period for pelvic congestion syndrome (PCS) coil embolization in patients who suffered from chronic pelvic pain that initially consulted for lower limb venous insufficiency.MethodsA total of 202 patients suffering from chronic pelvic pain were recruited prospectively in a single center (mean age 43.5 years; range 27–57) where they were being treated for lower limb varices. Inclusion criteria were: lower limb varices and chronic pelvic pain (>6 months), >6 mm pelvic venous caliber in ultrasonography, and venous reflux or presence of communicating veins. Both ovarian and hypogastric veins were targeted for embolization. Pain level was assessed before and after embolotherapy and during follow-up using a visual analog scale (VAS). Technical and clinical success and recurrence of leg varices were studied. Patients completed a quality questionnaire. Clinical follow-up was performed at 1, 3, and 6 months and every year for 5 years.ResultsTechnical success was 100 %. Clinical success was achieved in 168 patients (93.85 %), with complete disappearance of symptoms in 60 patients (33.52 %). Pain score (VAS) was 7.34 ± 0.7 preprocedural versus 0.78 ± 1.2 at the end of follow-up (P < 0.0001). Complications were: groin hematoma (n = 6), coil migration (n = 4), and reaction to contrast media (n = 1). Twenty-three cases presented abdominal pain after procedure. In 24 patients (12.5 %), there was recurrence of their leg varices within the follow-up. The mean degree of patients’ satisfaction was 7.4/9.ConclusionsCoil embolization of PCS is an effective and safe procedure, with high clinical success rate and degree of satisfaction

  4. Endovascular Treatment of Pelvic Congestion Syndrome: Visual Analog Scale (VAS) Long-Term Follow-up Clinical Evaluation in 202 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Laborda, Alicia, E-mail: alaborda@unizar.es; Medrano, Joaquin, E-mail: oauieao@gmail.com [University of Zaragoza, Group of Research in Minimally Invasive Techniques Research (GITMI) (Spain); Blas, Ignacio de, E-mail: deblas@unizar.es [University of Zaragoza, Edificio Hospital Veterinario, Department of Animal Pathology (Unit of Infectious Diseases and Epidemiology) (Spain); Urtiaga, Ignacio, E-mail: info@doctorurtiaga.com [Hospital Clinico Universitario ' Lozano Blesa' , Department of Vascular Surgery (Spain); Carnevale, Francisco Cesar, E-mail: fcarnevale@uol.com.br [University of Sao Paulo, Medical School, Interventional Radiology (Brazil); Gregorio, Miguel A. de, E-mail: mgregori@unizar.es [University of Zaragoza, Group of Research in Minimally Invasive Techniques Research (GITMI) (Spain)

    2013-08-01

    PurposeThis study was designed to evaluate the clinical outcome and patients' satisfaction after a 5 year follow-up period for pelvic congestion syndrome (PCS) coil embolization in patients who suffered from chronic pelvic pain that initially consulted for lower limb venous insufficiency.MethodsA total of 202 patients suffering from chronic pelvic pain were recruited prospectively in a single center (mean age 43.5 years; range 27-57) where they were being treated for lower limb varices. Inclusion criteria were: lower limb varices and chronic pelvic pain (>6 months), >6 mm pelvic venous caliber in ultrasonography, and venous reflux or presence of communicating veins. Both ovarian and hypogastric veins were targeted for embolization. Pain level was assessed before and after embolotherapy and during follow-up using a visual analog scale (VAS). Technical and clinical success and recurrence of leg varices were studied. Patients completed a quality questionnaire. Clinical follow-up was performed at 1, 3, and 6 months and every year for 5 years.ResultsTechnical success was 100 %. Clinical success was achieved in 168 patients (93.85 %), with complete disappearance of symptoms in 60 patients (33.52 %). Pain score (VAS) was 7.34 {+-} 0.7 preprocedural versus 0.78 {+-} 1.2 at the end of follow-up (P < 0.0001). Complications were: groin hematoma (n = 6), coil migration (n = 4), and reaction to contrast media (n = 1). Twenty-three cases presented abdominal pain after procedure. In 24 patients (12.5 %), there was recurrence of their leg varices within the follow-up. The mean degree of patients' satisfaction was 7.4/9.ConclusionsCoil embolization of PCS is an effective and safe procedure, with high clinical success rate and degree of satisfaction.

  5. Thin-Section CT Characteristics and Longitudinal CT Follow-up of Chemotherapy Induced Interstitial Pneumonitis: A Retrospective Cohort Study.

    Science.gov (United States)

    Lee, Han Na; Kim, Mi Young; Koo, Hyun Jung; Kim, Sung-Soo; Yoon, Dok Hyun; Lee, Jae Cheol; Song, Jin Woo

    2016-01-01

    To describe the computed tomography (CT) features of chemotherapy-induced interstitial pneumonitis (CIIP) with longitudinal follow-up.The study was approved by the local ethics committee. One hundred consecutive patients with CIIP between May 2005 and March 2015 were retrospectively enrolled. The initial CT was reviewed by 2 independent chest radiologists and categorized into 1 of 4 CT patterns in accordance with the 2013 guidelines for idiopathic interstitial pneumonia: nonspecific interstitial pneumonia (NSIP), organizing pneumonia (OP), hypersensitivity pneumonitis (HP) mimicking desquamative interstitial pneumonitis, and diffuse alveolar damage (DAD). We assessed semiquantitative analysis on a 5% scale to assess the extent of parenchymal abnormalities (emphysema, reticulation, ground-glass opacity, consolidation, honeycombing cyst) and their distribution on initial (n = 100), subsequent (n = 87), and second follow-up CT (n = 48). Interval changes in extent on follow-up CT were compared using paired t test. The clinic-radiologic factors were compared between Group 1 (NSIP and OP patterns) and Group 2 (HP and DAD patterns) using χ and independent t tests.The most common pattern of CIIP on the initial CT was HP (51%), followed by NSIP (23%), OP (20%), and DAD (6%). Diffuse ground-glass opacity was the most common pulmonary abnormality. The predominant distribution was bilateral (99%) and symmetric (82%), with no craniocaudal (60%) or axial (79%) dominance. Subsequent and second follow-up CTs showed decreased extent of total pulmonary abnormalities (P < 0.001, respectively). In comparison with Group 1 CIIP, Group 2 CIIP was more likely to be caused by molecularly targeted drugs (P = 0.030), appeared earlier (P = 0.034), and underwent more complete resolution (P < 0.001). Use of a CT pattern-recognition approach to CIIP is appropriate and practical in interpreting radiological findings. PMID:26765442

  6. Paroxetine in panic disorder: clinical management and long-term follow-up.

    Science.gov (United States)

    Dannon, Pinhas N; Lowengrub, Katherine; Iancu, I; Kotler, Moshe

    2004-03-01

    Panic disorder is one of the most common anxiety disorders and has a lifetime prevalence of 3-5%. Panic attacks can begin at any age, but commonly have their onset in early adulthood between the ages of 20 and 40 years. Naturalistic data has shown that panic disorder has a chronic and relapsing course. Panic disorder is reported to be associated with an increased risk of suicidal behavior and comorbid psychiatric diagnoses such as depression and substance abuse. Currently, recommended treatment modalities for panic disorder include the use of antidepressant pharmacotherapy and/or cognitive behavioral therapy. Paroxetine is unique among the selective serotonin reuptake inhibitors since, in addition to its effect on the CNS serotonergic neurotransmission, it also has mild noradrenergic properties demonstrated to be effective in the treatment of anxiety disorders and depression. Paroxetine treatment has the potential to cause weight gain and sexual dysfunction, primarily anorgasmia and ejaculatory dysfunction for the long term. In the short-term, treatment causes nausea, gastrointestinal disturbances, irritability, headaches and eating and sleeping difficulties. Paroxetine is an example of an selective serotonin reuptake inhibitor agent, which has been well studied in the treatment of panic disorder and is efficacious and well-tolerated. Paroxetine pharmacotherapy has been recommended to be continued for 1 year as specified in the treatment guidelines set by the American Psychiatric Association in the treatment of panic disorder. PMID:15853560

  7. Telephone follow-up by nurse following total knee arthroplasty - protocol for a randomized clinical trial (NCT01771315)

    DEFF Research Database (Denmark)

    Szöts, Kirsten; Konradsen, Hanne; Solgaard, Søren;

    2014-01-01

    to the orthopaedic outpatient clinic during the rehabilitation period. METHOD/DESIGN: The design is a randomized un-blinded parallel group clinical trial conducted at the Department of Orthopaedic Surgery, Gentofte Hospital, the Capital Region of Denmark. In total, 116 patients will be allocated by an external...... of life, general self-efficacy and the number of acute visits to the orthopaedic outpatient clinic. DISCUSSION: The result of this trial is expected to provide new knowledge to support the development of targeted and effective follow-up after total knee arthroplasty in order to improve the patients......´ health-related knowledge and skills of being able to take actively part in their illness and improve their health status. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01771315....

  8. Clinical relevance of positron emission tomography for initial staging and follow-up of malignant melanoma

    International Nuclear Information System (INIS)

    The incidence of melanoma is rapidly increasing (at a rate of 5 percent per year) throughout the world. In Europe, the incidence is approximately 10-12 new cases of invasive melanoma per 100,000 inhabitants. The most important prognostic factor is the stage of disease (Clark Level and vertical tumor depth (TD) according to BRESLOW) at the time of presentation. Ten year survival is 90 percent with a TD of 1.5 mm; 5-year survival is 15-50 percent when there is regional lymph node involvement, and 5 percent when there is disseminated disease. Conventional diagnostic tests for staging include a chest X-ray, lymph node sonography and laboratory tests. Sentinel node biopsy is becoming an increasingly common procedure since melanoma usually metastasizes to regional lymph nodes before dissemination. CT scan of the thorax or abdomen, MRI of the brain and other tests are used only when signs or symptoms warrant. The results of a prospective study which we performed in 100 patients for staging of high risk melanoma (n=48) or for re-staging patients with suspected recurrence demonstrated that FDG whole-body PET is superior to conventional imaging techniques (X-ray, sonography, CT scan) except for the detection of brain metastases. The diagnostic accuracy of PET for the detection of metastases was 92.1% versus 55.7% for conventional imaging (p1.5 mm); and 2) detection of occult metastases in patients with recurrent disease who are being considered for surgery. PET often changes the diagnostic evaluation and therapeutic management of patients with melanoma. PET has also shown to be cost effective in diagnosis and evaluation of patients with melanoma in the USA. (orig.)

  9. Lung function studies in diagnostics and follow-up of pulmonary sarcoidosis

    International Nuclear Information System (INIS)

    In 66 patients the relationship between lung volumes and lung mechanics in pulmonary sarcoidosis was investigated. Lung volumes, static lung mechanics, lung resistance, dynamic lung mechanics and arterial blood gases at rest and during exercise were obtained. Fifteen functionally compromised patients received steroids during one year. They were re-investigated during the treatment and at a follow-up after an average of 7 years. In another 41 patients with newly diagnosed sarcoidosis, the kinetics of the lung clearance of 99mTc-DTPA measured over 180 minutes was explored, and compared to kinetics in healthy smokers. The relationship between lung clearance and lung volumes, lung mechanics, arterial blood gases and disease activity assessed with serum angiotensin-converting enzyme and 67Ga scintigraphy was studied. Reducing lung volumes and compliance, increased resistance and arterial oxygen tension were common. Vital capacity (VC), and changes of VC at follow-up, corresponded to the slope of the static elastic pressure/volume curve, and to the variation of it. Other static lung volumes reflected rather the position of the curve along the volume axis. Reduced VC also reflected obstruction. Forced expiratory volume in one second revealed to equal extent lung stiffness and obstruction. Lung mechanics showed abnormalities not always evident from spirometry.In 50% of the patients lung clearance of 99mTc-DTPA disclosed an abnormally fast mono-exponential clearance or a bi-exponential clearance, which however differed from that in smokers. Lung clearance more readily detected abnormal function than did spirometry. Clearance did nor correlate with other investigations. 67Ga lung activity was higher in patients with a pathologic lung clearance

  10. Incidence of Alzheimer′s disease in India: A 10 years follow-up study

    Directory of Open Access Journals (Sweden)

    P S Mathuranath

    2012-01-01

    Full Text Available Objective: To determine overall and age-specific incidence rates of Alzheimer′s disease (AD in a southern Indian province, Kerala. Materials and Methods: A 10-year (2001-2011 prospective epidemiologic study of community residing subjects aged ≥55 years at enrollment. The catchment area included four urban and semi-urban regions of Trivandrum city in Kerala, India, was selected to provide a range of demographic and socioeconomic representation. Cognitive and functional ability screening were done at baseline and 24-month follow-up assessments. Consensus diagnostic procedures were done using the Diagnostic and Statistical Manual of Mental Disorders, 4 th edition (DSM-IV, and the National Institute of Neurological and Communicative Disorders and Stroke - Alzheimer′s Disease and Related Disorders Association (NINDS-ADRDA criteria for the diagnosis of dementia and AD. Results: Among the 1066 eligible participants who were cognitively normal at baseline, 104 developed dementia (98 with AD over a follow-up period of 8.1 years. The incidence rates per 1000 person-years for AD was 11.67 (95% CI: 10.9-12.4 for those aged ≥55 years and higher for those aged ≥65 years (15.54, 95% CI: 14.6-16.5. In those aged ≥65 years, the world age standardized incidence rate was 21.61 per 100,000, and standardized against the age distribution for the year 2000 U.S. Census, the age-adjusted incidence rate was 9.19 (95% CI: 9.03-9.35 per 1000 person-years. Incidence rate of AD increased significantly and proportionately with increasing age. Conclusion: These are the first AD incidence rates to be reported from southern India. The incidence rates appear to be much higher than that reported from rural north India, comparable with that reported from China, and marginally lower than that reported from the western world.

  11. Percutaneous ethanol ablation of hepatic and renal cyst: therapeutic effect and follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Park, Seog Min; Hahn, Seong Tae; Park, Seog Hee; Jeon, Jung Soo; Moon, Young Hee; Lee, Han Jin; Kim, Ki Tae; Kim, Choon Yul; Shinn, Kyung Sub [Catholic University Medical College, Seoul (Korea, Republic of)

    1994-02-15

    To evaluate the ability of percutaneous ethanol ablation in the treatment of benign cysts of the liver and kidney, and to decide the need and the time of retreatment when the cysts remain on the follow-up ultrasonogram. Twenty benign cysts(8 hepatic and 12 renal cysts) in 18 patients diagnosed or confirmed either by ultrasound, CT or cytology were treated with percutaneous ethanol injection(PEI). After evacuation of cystic fluid, 15-900ml(amount corresponding to 40-50% of the volume of aspirated fluid) of absolute ethanol(99.9%) was injected into the cysts through the aspiration catheter. In large cysts, two or more PEIs were done in one session. Follow-up ultrasonographic studies during the period of 12 months with 1-2 months interval after PEI were performed for evaluation of the therapeutic effect. Nine cysts(45%) disappeared completely within 2 months after initial PEI. Although 11 cysts(55.5%) recurred 2 months after initial PEI, 8 of them disappeared within 6 months and one within 8 months after initial PEI without additional PEI. As a result, 18 of 20 cysts(90%) disappeared within 8 months after initial PEI and most of the recurrent cysts disappeared within 6 months without additional PEI. No major complications were encountered concerning PEI, although transient abdominal pain, elevation of body temperature, and drowsiness were noted in 8 patients. PEI is an effective and safe modality for the treatment of benign hepatic or renal cysts and the apparent recurrence within 6 months after initial PEI might be mostly a transient, reactive or inflammatory fluid collection rather than real recurrence.

  12. Percutaneous ethanol ablation of hepatic and renal cyst: therapeutic effect and follow-up study

    International Nuclear Information System (INIS)

    To evaluate the ability of percutaneous ethanol ablation in the treatment of benign cysts of the liver and kidney, and to decide the need and the time of retreatment when the cysts remain on the follow-up ultrasonogram. Twenty benign cysts(8 hepatic and 12 renal cysts) in 18 patients diagnosed or confirmed either by ultrasound, CT or cytology were treated with percutaneous ethanol injection(PEI). After evacuation of cystic fluid, 15-900ml(amount corresponding to 40-50% of the volume of aspirated fluid) of absolute ethanol(99.9%) was injected into the cysts through the aspiration catheter. In large cysts, two or more PEIs were done in one session. Follow-up ultrasonographic studies during the period of 12 months with 1-2 months interval after PEI were performed for evaluation of the therapeutic effect. Nine cysts(45%) disappeared completely within 2 months after initial PEI. Although 11 cysts(55.5%) recurred 2 months after initial PEI, 8 of them disappeared within 6 months and one within 8 months after initial PEI without additional PEI. As a result, 18 of 20 cysts(90%) disappeared within 8 months after initial PEI and most of the recurrent cysts disappeared within 6 months without additional PEI. No major complications were encountered concerning PEI, although transient abdominal pain, elevation of body temperature, and drowsiness were noted in 8 patients. PEI is an effective and safe modality for the treatment of benign hepatic or renal cysts and the apparent recurrence within 6 months after initial PEI might be mostly a transient, reactive or inflammatory fluid collection rather than real recurrence

  13. A long-term follow-up study of high tibial osteotomy for medial compartment osteoarthrosis

    Institute of Scientific and Technical Information of China (English)

    WU Li-dong 吴立东; Hans J Hahne; Toachim Hassenpflug

    2004-01-01

    Objective: To observe the long-term outcome of high tibial osteotomy (HTO) in treating medial compartment osteoarthrosis of knees. Methods: A retrospective study was carried out on 194 patients (215 knees) treated with HTO for medial compartment osteoarthritis at the Orthopaedic Hospital of Kiel University between 1985 and 1996. Results: One hundred and sixty-one knees (144 patients) were followed up for 1.5-12 years with an average of 7.5 years and their data were reviewed. The proportion of excellent outcome were 97.3%, 93.6% and 78.2% two, five and over five years after HTO, respectively. The revision rate of total knee arthroplasty (TKA) was 11.8% (19 knees retreated with TKA for HTO failure). The survivorship analysis of the 19 knees retreated with TKA showed an expected survival rate of 98.7%, 95.0% and 84.1% 2, 5 and 10 years after HTO, respectively. There were 5.6% complications (12 /161), including five superficial wound infections, one deep infection, five delayed bone healing, and one peroneal nerve palsy. Fifty patients (54 knees) missed follow-up, among them 10 patients (11 knees) died.Conclusions: HTO is an effective method in treating medial compartment osteoarthritis with a varus knee. Appropriate overcorrection of femorotibial alignment is the key for the success of the operation. But as the long-term effect is concerned, there is a trend of deterioration and some of the patients may have a second operation of revision with TKA.

  14. A four-year follow-up study in fibromyalgia. Relationship to chronic fatigue syndrome

    DEFF Research Database (Denmark)

    Nørregaard, J; Bülow, P M; Prescott, E;

    1993-01-01

    overlap between fibromyalgia and chronic fatigue syndrome. Only in two of 91 the muscle pain was found to be caused by another somatic disease during the median 4 year follow-up period. In one of the 83 attending subjects a somatic disease associated with muscle symptoms was established at the follow......-up visit. 60 out of 83 reported increased pain, 8 reported improvement of pain. The 83 subjects showed no significant fall in muscle strength during the follow-up period. The majority reported severe fatigue but only one fifth fulfilled the proposed chronic fatigue syndrome criteria....

  15. What Affects Reintegration of Female Drug Users after Prison Release? Results of a European Follow-Up Study

    Science.gov (United States)

    Zurhold, Heike; Moskalewicz, Jacek; Sanclemente, Cristina; Schmied, Gabriele; Shewan, David; Verthein, Uwe

    2011-01-01

    The main objective of this follow-up study is to explore factors influencing the success or failure of women in reintegrating after their release from prison. Female drug users in five European cities were tracked after being released from prison. Out of 234 female prisoners contacted in prisons, 59 were included in the follow-up study. Structured…

  16. Central pontine myelinolysis in a chronic alcoholic: A clinical and brain magnetic resonance imaging follow-up

    Directory of Open Access Journals (Sweden)

    Dujmović Irena

    2013-01-01

    Full Text Available Introduction. Central pontine myelinolysis (CPM is a noninflammatory, demyelinating lesion usually localised in the basis pontis. Chronic alcoholism is frequently associated with this condition which may have a variable clinical outcome. Until now, brain magnetic resonance imaging (MRI follow-up in alcoholic CPM cases after alcohol withdrawal has been rarely described. Case report. We reported a 30- year-old male with a 12-year history of alcohol abuse, who presented with inability to stand and walk, nausea, vomiting and somnolence. Neurological examination revealed: impared fixation on lateral gaze, dysarthria, mild spastic quadriparesis, truncal and extremity ataxia, sock-like hypesthesia and moderate decrease in vibration sense in legs. Brain MRI showed a trident-shaped non-enhancing pontine lesion highly suggestive of CPM. After an eight-month alcoholfree follow-up period, the patient’s clinical status significantly improved, while the extent of MRI pontine lesion was merely slightly reduced. Conclusion. The presented case demonstrates that CPM in chronic alcoholics may have a benign clinical course after alcohol withdrawal, which is not necessarily associated with the reduction of lesions on brain MRI. [Projekat Ministarstva nauke Republike Srbije, br. 175031

  17. The value of routine follow-up after treatment for head and neck cancer. A national DAHANCA study

    DEFF Research Database (Denmark)

    Pagh, Anja; Vedtofte, Thomas; Lynggaard, Charlotte Duch;

    619 patients attending regular follow-up were enrolled. All patients had received intended curative treatment for head and neck cancer and all were followed according to DAHANCA guidelines. Data were collected by the physician filling in a registration form containing chosen key parameters and......BACKGROUND: The post-treatment follow-up is well-integrated in the oncologic care tradition, based on the risk of developing recurrent disease or new primary tumors in treated patients. Furthermore, follow-up serves as an opportunity to monitor treatment effects and to provide clinical care of side...

  18. Gender differences and determinants of health related quality of life in coronary patients: a follow-up study

    Directory of Open Access Journals (Sweden)

    Arana Roque

    2011-05-01

    Full Text Available Abstract Background The role of gender differences in Health Related Quality Life (HRQL in coronary patients is controversial, so understanding the specific determinants of HRQL in men and women might be of clinical importance. The aim of this study was to know the gender differences in the evolution of HRQL at 3 and 6 months after a coronary event, and to identify the key clinical, demographic and psychological characteristics of each gender associated with these changes. Methods A follow-up study was carried out, and 175 patients (112 men and 63 women with acute myocardial infarction (AMI or unstable angina were studied. The SF-36v1 health questionnaire was used to assess HRQL, and the GHQ-28 (General Health Questionnaire to measure mental health during follow-up. To study the variables related to changes in HRQL, generalized estimating equation (GEE models were performed. Results Follow-up data were available for 55 men and 25 women at 3 months, and for 35 men and 12 women at 6 months. Observations included: a Revascularization was performed later in women. b The frequency of rehospitalization between months 3 and 6 of follow-up was higher in women c Women had lower baseline scores in the SF-36. d Men had progressed favourably in most of the physical dimensions of the SF-36 at 6 months, while at the same time women's scores had only improved for Physical Component Summary, Role Physical and Social Functioning; e the variables determining the decrease in HRQL in men were: worse mental health and angina frequency; and in women: worse mental health, history of the disease, revascularization, and angina frequency. Conclusions There are differences in the evolution of HRQL, between men and women after a coronary attack. Mental health is the determinant most frequently associated with HRQL in both genders. However, other clinical determinants of HRQL differed with gender, emphasizing the importance of individualizing the intervention and the

  19. Association between serotonin transporter gene polymorphism and eating disorders outcome: a 6-year follow-up study.

    Science.gov (United States)

    Castellini, Giovanni; Ricca, Valdo; Lelli, Lorenzo; Bagnoli, Silvia; Lucenteforte, Ersilia; Faravelli, Carlo; Sorbi, Sandro; Nacmias, Benedetta

    2012-07-01

    Eating disorder patients show different long-term outcomes, and trait-related alterations of serotonergic function, which might be related with the serotonin transporter (5-HTT) gene. We studied the relationships between 5-HTTLPR polymorphism, eating specific and general psychopathology and the long-term outcome of anorexia nervosa (AN) and bulimia nervosa (BN) patients. We evaluated the distribution of the functional 5-HTTLPR polymorphism in a series of 201 Italian, Caucasian, eating disorder patients (113 with AN and 88 with BN binge/purging (BP subtype) and in 150 Caucasian unrelated controls. Prior to starting an individual cognitive behavior therapy, a clinical assessment was performed by means of the structured clinical interview for DSM-IV axis I disorders and several self-report questionnaires. This assessment was repeated at the end of treatment, 3 years after the end of treatment and 3 years after the first follow-up. Diagnostic changes between AN and BN were frequent (28.3%), and the presence of depressive disorders was associated with a higher rate of diagnostic crossover during the follow-up period. The S-allele of the 5-HTTLPR genotype increases the risk susceptibility for both depressive comorbidity (OR = 4.23; 95% CI, 1.45-12.37) and diagnostic crossover during the follow-up period in AN patients (OR = 5.04; 95% CI, 1.69-14.98). Logistic regression analyses confirmed these findings, when the interaction between genotype and psychiatric comorbidity as predictors of diagnostic instability in AN patients were taken into account. No significant association was found between 5-HTTLPR genotype and recovery. The S-allele of the 5-HTTLPR genotype increases the risk for depressive disorders comorbidity, and moderates the long-term outcome of anorectic patients. PMID:22488946

  20. Following-up study on radiation-induced retinopathy in nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Objective: To investigate the frequency of ocular complication and the quality of patient's life after radiation therapy in nasopharyngeal carcinoma (NPC). Methods: 254 NPC patients who initially received radiation were followed and analysed. Visual acuity, automational visual field, slit-lamp microscopic findings, pattern visual evoked potential (P-VEP) and fundal findings were determined before, during and after radiation therapy. The severity of retinal impairment was assessed according to the international criteria on late tissue effects. Results: The radiation dose was more than 70 Gy in 241 (94.9%)NPC patients, giving a radiation retinopathy incidence of 8.7% (22) patients after a mean of 46.8±14.4 months. After being diagnosed as radiation retinopathy, 16 patients received combined-modality therapy of the modern medicine and Chinese traditional medicine. The disease condition was controlled in 56%(9) patients but progressed into optic neuropathy in 7 patients, 3 of whom developed radiation encephalopathy in 14 to 20 months after onset of retinopathy. The morbidity of radiation retinopathy was not associated with the patient's age, but was related to the radiation dose. The retinopathy rate was as high as 13.6% in the 75-79 Gy group, which is significantly higher than 5.6% in the 70-74 Gy group (P<0.05). Conclusions: Radiation retinopathy in NPC patients is related to the radiation dose and individual difference in radiosensitivity. Optic nerve and brain damage are already present when clinical manifestations of radiation retinopathy occur. Therefore CT and MRI of the brain should be carried out. The importance of long-term follow-up should be stressed for early diagnosis and treatment of radiation sequelae for the sake of complete return of visual function and good quality of life

  1. MR imaging follow-up studies in patients with aplastic anemia

    International Nuclear Information System (INIS)

    Eight patients with aplastic anemia underwent MR imaging of the pelvis and thoracolumbar spine before and during treatment. Bone marrow patterns on MR images were correlated with stem-cell and peripheral-blood cell counts and Prussian blue stain of bone marrow (to estimate iron overload). Before treatment, two different bone marrow patterns were observed. Three patients had diffuse, homogeneous high signal intensity throughout the bone marrow, indicating fatty replacement of hematopoietic bone marrow. Bone marrow stains were negative for iron overload. Follow-up studies in these three patients showed multiple areas of hypointense foci in the bone marrow at the time when stem cell and blood cell counts returned to normal. The remaining five patients displayed inhomogeneous signal distribution (hypointense foci on T1-weighted images) in the bone marrow on the first and following MR studies. All five patients did not respond to therapy and had multiple transfusions. Bone marrow signal intensities (correlated to a phantom) were similar in patients with recovery of hematopoietic bone marrow and patients with hemochromatosis

  2. Dietary Acid-Base Balance in Adolescent Sprint Athletes: A Follow-up Study

    Directory of Open Access Journals (Sweden)

    Peter Clarys

    2011-02-01

    Full Text Available Sprinters are advised to include additional protein sources in their diet. Basal metabolism and vigorous physical activities generate hydrogen ions that need to be buffered. The present follow-up study estimates the dietary potential renal acid load (PRAL and net endogenous acid production (NEAP in adolescent sprint athletes. Seven-day food diaries and anthropometrics of 60 adolescent sprint athletes (mean age at start 14.7 ± 1.9 years were collected every six months over a three year period. Comparisons were made between athletes with a negative (PRAL(− versus positive PRAL (PRAL(+. For the entire sample, mean PRAL values of up to 6 mEq/day were slightly positive despite a relatively high protein intake of around 1.5 g/kg. The NEAP ranging between 42 and 46 mEq/day remained stable during the study period. Athletes with a PRAL(− (−8 to −10 mEq/day consumed significantly more fruit and fruit juice than athletes with a PRAL(+ (+9 to 14 mEq/day. Athletes with a PRAL(+ did not consume more meat, fish and poultry than athletes with a PRAL(−. Grains and dairy products were only discriminative between the two groups on one measurement occasion. Lowering the PRAL can be obtained by increasing the consumption of potatoes, fruits, vegetables and vegetable soup.

  3. Involvement in bullying and suicidal ideation in middle adolescence: a 2-year follow-up study.

    Science.gov (United States)

    Heikkilä, Hanna-Kaisa; Väänänen, Juha; Helminen, Mika; Fröjd, Sari; Marttunen, Mauri; Kaltiala-Heino, Riittakerttu

    2013-02-01

    The objective of the study was to ascertain whether involvement in bullying increases the risk for subsequent suicidal ideation. A total of 2,070 Finnish girls and boys aged 15 were surveyed in the ninth grade (age 15) in schools, and followed up 2 years later in the Adolescent Mental Health Cohort Study. Involvement in bullying was elicited at age 15 by two questions focusing on being a bully and being a victim of bullying. Suicidal ideation was elicited by one item of the short Beck Depression Inventory at age 17. Baseline depressive symptoms and externalizing symptoms, age and sex were controlled for. Statistical analyses were carried out using cross-tabulations with Chi-square/Fisher's exact test and logistic regression. Suicidal ideation at age 17 was 3-4 times more prevalent among those who had been involved in bullying at age 15 than among those not involved. Suicidal ideation at age 17 was most prevalent among former victims of bullying. Being a victim of bullying at age 15 continued to predict subsequent suicidal ideation when depressive and externalizing symptoms were controlled for. Being a bully at age 15 also persisted as borderline significantly predictive of suicidal ideation when baseline symptoms were controlled for. Findings indicate adolescent victims and perpetrators of bullying alike are at long-term risk for suicidal ideation. PMID:23053774

  4. A NEPA follow-up study of DOE loan guarantee fuel ethanol plants

    International Nuclear Information System (INIS)

    This study was implemented to examine and characterize the actual environmental impacts of three fuel ethanol plants constructed under the US Department of Energy, Office of Alcohol Fuels Loan Guarantee Program, and to compare actual impacts with those predicted about six years ago in environmental assessments (EAs) prepared for these facilities. The objective of the program, established under the Energy Security Act of 1980, was to conserve petroleum resources by promoting the use of fuel ethanol in motor vehicles. The plants were designed to produce fuel-grade ethanol for blending with gasoline and reflect differentfeedstocks, processes, fuel sources, and site locations. Although two of the facilities as constructed differed substantially from those assessed previously, actual environmental impacts generally occurred in the areas predicted by the EAs. Major impacts not anticipated include odor from air emissions, effects of wastewater discharge on operation of a municipal sewage treatment plant, possible classification of treated wastewater from a molasses-based process as a nuisance, and habitat losses from both vegetation removal and unforeseen construction of barge terminals. In all cases, impacts were judged to be not significantn the final outcome, either because plant management (or other involved parties) took corrective action or because the resources affected in these particular cases were not important. Mitigation measures reliedon in the EAs to limit adverse impacts to insignificant levels were implemented and were required by permit condition, law, or regulation. Future follow-up studies would benefit from the availability of ambientmonitoring data to more thoroughly characterize actual impacts

  5. Radioactive iodine therapy and breast cancer. A follow-up study of hyperthyroid women

    International Nuclear Information System (INIS)

    A follow-up study of 1762 hyperthyroid women who were treated at the Massachusetts General Hospital Thyroid Unit between 1946 and 1964 was conducted. The average length of follow-up was 17.2 years. A 1978 mailing address or a death certificate was located for 92% of the women, and 88% of 1058 living patients responded to a mail questionnaire. The standardized mortality ratio (SMR) for all causes of death was 1.3 (95% confidence interval (CI) 1.2-1.4). The standardized mortality ratios for all malignant neoplasms and for breast cancer were 0.9 (95% CI 0.7-1.1) and 1.3 (95% CI 0.8-1.9), respectively. More deaths than expected were observed from endocrine and metabolic diseases (SMR = 1.8, 95% CI 1.2-2.7), circulatory system diseases (SMR = 1.4, 95% CI 1.3-1.6), and respiratory system diseases (SMR = 1.9, 95% CI 1.3-2.6). The standardized incidence ratios (SIR) for all malignant neoplasms and for breast cancer were 0.9 (95% CI 0.8-1.1) and 1.2 (95% CI 0.9-1.5), respectively. A nonsignificant excess breast cancer risk was observed 10 years after the onset of thyroid symptoms and was present at the end of 30 years of observation. A statistically significant excess number of pancreatic cancer cases (SIR = 2.0, 95% CI 1.0-3.7) and a nonsignificant excess of brain cancer cases (SIR = 2.3, 95% CI 0.7-5.3) were observed. Eighty per cent of the women were treated with radioactive iodine. When age at treatment and year of treatment were controlled, women who were ever treated with radioactive iodine had a standardized rate ratio for breast cancer of 1.9 (95% CI 0.9-4.1), compared with those who were never treated with radioactive iodine. Women who developed hypothyroidism as a result of their treatment for hyperthyroidism did not have an increased risk of developing breast cancer (SIR = 1.1, 95% CI 0.8-1.6)

  6. Radioactive iodine therapy and breast cancer. A follow-up study of hyperthyroid women

    Energy Technology Data Exchange (ETDEWEB)

    Goldman, M.B.; Maloof, F.; Monson, R.R.; Aschengrau, A.; Cooper, D.S.; Ridgway, E.C.

    1988-05-01

    A follow-up study of 1762 hyperthyroid women who were treated at the Massachusetts General Hospital Thyroid Unit between 1946 and 1964 was conducted. The average length of follow-up was 17.2 years. A 1978 mailing address or a death certificate was located for 92% of the women, and 88% of 1058 living patients responded to a mail questionnaire. The standardized mortality ratio (SMR) for all causes of death was 1.3 (95% confidence interval (CI) 1.2-1.4). The standardized mortality ratios for all malignant neoplasms and for breast cancer were 0.9 (95% CI 0.7-1.1) and 1.3 (95% CI 0.8-1.9), respectively. More deaths than expected were observed from endocrine and metabolic diseases (SMR = 1.8, 95% CI 1.2-2.7), circulatory system diseases (SMR = 1.4, 95% CI 1.3-1.6), and respiratory system diseases (SMR = 1.9, 95% CI 1.3-2.6). The standardized incidence ratios (SIR) for all malignant neoplasms and for breast cancer were 0.9 (95% CI 0.8-1.1) and 1.2 (95% CI 0.9-1.5), respectively. A nonsignificant excess breast cancer risk was observed 10 years after the onset of thyroid symptoms and was present at the end of 30 years of observation. A statistically significant excess number of pancreatic cancer cases (SIR = 2.0, 95% CI 1.0-3.7) and a nonsignificant excess of brain cancer cases (SIR = 2.3, 95% CI 0.7-5.3) were observed. Eighty per cent of the women were treated with radioactive iodine. When age at treatment and year of treatment were controlled, women who were ever treated with radioactive iodine had a standardized rate ratio for breast cancer of 1.9 (95% CI 0.9-4.1), compared with those who were never treated with radioactive iodine. Women who developed hypothyroidism as a result of their treatment for hyperthyroidism did not have an increased risk of developing breast cancer (SIR = 1.1, 95% CI 0.8-1.6).

  7. Rapid onset of hand ischemia of unknown etiology: clinical evaluation and follow-up of ten patients.

    Science.gov (United States)

    Baur, G M; Porter, J M; Bardana, E J; Wesche, D H; Rösch, J

    1977-08-01

    Ten patients presenting with a history of the acute onset of hand ischemia have undergone detailed clinical, immunologic, and arteriographic evaluation. The disease is characterized by the acute onset of hand ischemia proceeding to fingertip ulceration, in the absence of recognized systemic disease. None of the patients had any evidence of large artery obstruction. Arteriography showed diffuse obstruction of the palmar and digital arteries. No evidence was found in any patient of any systemic disease process associated with small artery obstruction. These patients are suspected of having a previously unreported variant of hypersensitivity angiitis. Patients are left with permanent obstruction of the palmar and digital arteries. Follow-up suggests the disease in non-recurrent and is characterized by progessive clinical improvement associated with the development of collateral circulation. Conservative management of the condition is recommended. PMID:889362

  8. Afterglow Population Studies from Swift Follow-Up Observations of Fermi LAT GRBs

    Science.gov (United States)

    Racusin, Judith L.; Oates, S. R.; McEnery, J.; Vasileiou, V.; Troja, E.; Gehrels, N.

    2010-01-01

    The small population of Fermi LAT detected GRBs discovered over the last year has been providing interesting and unexpected clues into GRB prompt and afterglow emission mechanisms. Over the last 5 years, it has been Swift that has provided the robust data set of UV/optical and X-ray afterglow observations that opened many windows into other components of GRB emission structure. We explore the new ability to utilize both of these observatories to study the same GRBs over 10 orders of magnitude in energy, although not always concurrently. Almost all LAT GRBs that have been followed-up by Swift within 1-day have been clearly detected and carefully observed. We will present the context of the lower-energy afterglows of this special subset of GRBs that has > 100 MeV emission compared to the hundreds in the Swift database that may or may not have been observed by LAT, and theorize upon the relationship between these properties and the origin of the high energy gamma-ray emission.

  9. Lipids and All-Cause Mortality among Older Adults: A 12-Year Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Marcos Aparecido Sarria Cabrera

    2012-01-01

    Full Text Available This is a 12-year follow-up cohort study with 800 people (60–85 years old. The association between lipid disorders and mortality was analysed by Cox proportional hazard adjusted model. All-cause mortality was considered the dependent variable, and lipid disorders as independent variables: total cholesterol (TC >200 and 100 and 130, and triglycerides (TG >50. An initial analysis of all subjects was performed and a second was carried out after having excluded individuals with a body mass index (BMI <20 kg/m2 or mortality in ≤2 years. The mortality showed a positive association with low TC and a negative association with high TC and high LDL-c. After the exclusion of underweight and premature mortality, there was a positive association only with TC <170 mg/dl (HR = 1.36, CI95%: 1.02–1.82. The data did not show a higher risk with high levels of TC, LDL-c, and TG. However, they showed higher mortality among older adults with low TC.

  10. A follow-up study of cognitive impairment due to inferior capsular genu infarction.

    Science.gov (United States)

    Madureira, S; Guerreiro, M; Ferro, J M

    1999-09-01

    Abulia, memory loss, other cognitive deficits, and behavioral changes consistent with dementia can follow an inferior capsular genu infarction, but only little is known about the time course of these disturbances. The present study describes the long-term outcome of cognitive defects in four patients with inferior capsular genu infarction who underwent a neuropsychological examination within 3 and 12 months of onset. Three patients had infarcts in the inferior genu of the left internal capsule and had similar symptoms in the acute phase: disorientation, memory loss, language impairment, and behavioral changes. The patient with right-side infarct showed memory impairment and behavioral changes. Three patients had deficits in one or more cognitive domains on the first assessment, but none was demented. By the second evaluation all subjects had improved. In two patients there were a moderate memory defect persisted and a language disturbance. Improvement in these disturbances during long-time follow-up demonstrates that there are alternative pathways that reestablish the functional connections damaged by the strategically located capsular genu infarct. Inferior capsular genu infarction is not a cause of persisting "strategic infarct dementia." PMID:10525972

  11. [A three years follow-up study on the blood pressures of 6111 children in Chengdu].

    Science.gov (United States)

    Wang, J Y

    1989-04-01

    This paper reports the results of a follow-up study in blood pressures of 6111 children for 3 years in Chengdu city and the villages around. It was showed that the blood pressure for both the city and village children were elevated in overall with age. Among the city children, the rate of BP-rising varied in different periods of childhood and that of girls above 13 was not significant. Among village children, the rate of BP-rising for both male and female comparison to that of urban ones were significant (P less than 0.01). A comparison of BP-rising between these two groups revealed no significant differences. This result might be due to the rapid increase of body weight for the village children. It was demonstrated that heart rate, body weight and body height are the factors affecting blood pressure of which heart rate is something essential and is the test parameter for blood pressure research. PMID:2736619

  12. Hematological follow-up studies on patients with thyroid neoplasms after 131I therapy

    International Nuclear Information System (INIS)

    Based on 391 thyroid neoplasms diagnostic hematological follow-up studies were registered in 34 patients with an overall J-131-dose of more than 500 mCi including the following parameters: 1. Peripheral blood control. 2. Bone marrow aspiration. 3. Cell volume distribution size of leukocytes after preparative enrichment. If in doubt a bone marrow scintigraphy was added. The adjunctive diagnostic procedure was correlated with histological criteria of thyroid carcinoma and J-131 retention after therapeutic application of radioiodine. In particular, a case report is given regarding a patient of 66 years with follicular thyroid carcinoma receiving 990 mCi J-131 during a period of 11 years after having had total thyroidectomy twice. The development of acute leucemia followed by death happened 16 years later. The moment of bone marrow transformation was determined exactly. The value of blood parameters can be calculated as follows: 1. Peripheral blood controls are limited by lack of efficiency. 2. Biopsy of bone marrow can detect hypoplastic alteration being latent in circulating blood for some years, even of J-131 cumulation dose below 500 mCi. 3. The analysis of distribution size of leukocytes represents a functional aspect after radiation induced in injury of bone marrow. (author)

  13. Clinical data from one year follow-up of victims of the radiation accident with 60Co in Bulgaria.

    Science.gov (United States)

    Djounova, J; Guleva, I; Negoicheva, K; Mileva, I; Panova, D; Rupova, I

    2014-09-01

    A severe radiation accident occurred on 14 June 2011 in an industrial irradiation facility for medical equipment sterilization in Bulgaria. Five people were exposed for 5-10 min to a 60Co source containing 137 TBq. The Emergency Department of the National Centre of Radiobiology and Radiation Protection (NCRRP), Bulgaria, put into practice the plans for providing medical care in radiation accidents and the procedures developed for assessment of injury severity, the decision-making algorithm regarding subsequent treatment, and the therapy for persons affected. The activities performed for initial assessment of the severity of injury of irradiated patients were published in 2012. Based on predictive assessments of the severity of radiation damage, it was decided that the victims required hospitalization at a specialized hematology clinic. Percy Hospital in Paris was chosen for this purpose. The aim of this report is to present the results of 1-y follow-up for three of the victims. Sadly, 1 mo after the accident, Patient 4 died from a heart attack. The medical opinion was that this was not a direct outcome of the irradiation. Patient 5 was only followed up for 4 mo (118 d) because medical follow-up is voluntary, and despite repeated calls, the patient did not respond. Medical examinations by a physician as well as hematology and biochemical tests were performed using standard laboratory methods. The obtained results were compared to the victims' personal reference limits obtained from annual health monitoring. After the accident, the recovery to normal content of peripheral blood cells was observed in all victims. Nevertheless, there were observed cases of thrombocytopenia, granulocytopenia, and leucocytopenia at various times after exposure. During the period of observation, morphological changes in red blood cells such as anisomicrocitosis, macrocytes, megalocytes, and polychromatic erythrocytes were demonstrated. During the 1-y observation period, all victims showed

  14. Elbow and wrist/hand symptoms among 6,943 computer operators: a 1-year follow-up study (the NUDATA study)

    DEFF Research Database (Denmark)

    Lassen, C. F.; Mikkelsen, S.; Kryger, Ann Isabel; Brandt, L. P.; Overgaard, E.; Thomsen, J. F.; Vilstrup, Imogen; Andersen, JH

    2004-01-01

    BACKGROUND: The aim of this study was to examine relations between computer work aspects and elbow and wrist/hand pain conditions and disorders. METHODS: In a 1-year follow-up study among 6,943 technical assistants and machine technicians self-reported active mouse and keyboard time, ergonomic...... exposures and associations with elbow and wrist/hand pain were determined. Standardized clinical examinations were performed among symptomatic participants at baseline and at follow-up. RESULTS: For continuous duration of mouse time adjusted linear effects were statistically significant for all investigated......, while keyboard exposure showed a threshold effect with 12-month wrist/hand pain at follow-up. Clinical diagnoses were not associated with exposure. CONCLUSIONS: Detailed examination of self-reported exposures showed that mouse and keyboard time predicted elbow and wrist/hand pain from low exposure...

  15. Stability of childhood anxiety disorder diagnoses: a follow-up naturalistic study in psychiatric care

    OpenAIRE

    Carballo, Juan J.; Baca-Garcia, Enrique; Blanco, Carlos; Perez-Rodriguez, M Mercedes; Jimenez Arriero, Miguel A.; Artes-Rodriguez, Antonio; Rynn, Moira; Shaffer, David; Oquendo, Maria A.

    2009-01-01

    Abstract Few studies have examined the stability of major psychiatric disorders in pediatric psychiatric clinical populations. The objective of this study was to examine the long-term stability of anxiety diagnoses starting with pre-school age children through adolescence evaluated at multiple time points. Prospective cohort study was conducted of all children and adolescents receiving psychiatric care at all pediatric psychiatric clinics belonging to two catchment areas in Madrid,...

  16. Long term functioning in early onset psychosis: Two years prospective follow-up study

    Directory of Open Access Journals (Sweden)

    Taha Ghada RA

    2011-07-01

    Full Text Available Abstract Background There were few studies on the outcome of schizophrenia in developing countries. Whether the outcome is similar to or different from developed world is still a point for research. The main aim of the current study was to know if patients with early onset non affective psychosis can behave and function properly after few years from start of the illness or not. Other aims included investigation of possible predictors and associated factors with remission and outcome. Method The study prospectively investigated a group of 56 patients with onset of psychosis during childhood or adolescence. Diagnosis made according to DSM-IV criteria and included; schizophrenia, psychotic disorder not otherwise specified and acute psychosis. Severity of psychosis was measured by PANSS. Measures of the outcome included; remission criteria of Andreasen et al 2005, the children's global assessment scale and educational level. Results Analysis of data was done for only 37 patients. Thirty patients diagnosed as schizophrenia and 7 with Psychotic disorder not otherwise specified. Mean duration of follow up was 38.4 +/- 16.9 months. At the end of the study, 6 patients (16.2% had one episode, 23(62.1% had multiple episodes and 8 (21.6% continuous course. Nineteen patients (51.4% achieved full remission, and only 11(29.7% achieved their average educational level for their age. Twenty seven percent of the sample had good outcome and 24.3% had poor outcome. Factors associated with non remission and poor outcome included gradual onset, low IQ, poor premorbid adjustment, negative symptoms at onset of the illness and poor adherence to drugs. Moreover, there was tendency of negative symptoms at illness start to predict poor outcome. Conclusion Some patients with early onset non affective psychosis can behave and function properly after few years from the start of the illness. Although remission is a difficult target in childhood psychosis, it is still achievable.

  17. The clinical role of the new tumor marker TPS in the follow up of patients with breast cancer. Final report

    International Nuclear Information System (INIS)

    TPS IRMA is a new assay for quantitative measurement of M3 specific epitope of tissue polypeptide antigen in serum, which occurs especially in conjunction with proliferating tumour cell. The serum TPS concentrations were determined in 34 apparently healthy donors and in 145 patients. Of these patients, 118 had breast cancer and 27 had benign breast diseases. The carcinomas were of different types and included both early (stage I, II) and advanced (stage III, IV) tumours. Clinical stage classification was performed according to TNM system. Blood of neoplastic patients was collected at diagnosis along with serial serum samples during following up in a period of 6-12 months, Serum samples were stored at 30 deg until used. Also, serum levels of two conventional tumour markers CEA (Carcinoembryonic antigen) and CA15-3 were determined for comparison. The distribution of TPS values found in sera from healthy donors ranged between 3 and 60 U/l with a mean of 34±14,57 u/l. We selected a cut-off value for TPS of 63 u/l(X± 2 SD) for healthy controls. Slightly elevated levels of TPS were found in less than 15% of patients with benign breast diseases. High levels of TPS were detected in 85% of patients with breast cancer. The concentration of TPS and the diagnostic sensitivity varied according to stage group. 69% of patients with localised tumours (stage I, II), and 100% of patients with disseminated tumours have shown TPS concentration above the cut-off value. All patients with complete remission have shown TPS values below the cut-off value, in contrast to the progressing group where the values were high. Serial measurements of TPS serum concentration confirmed the fast decrease of TPS where the applied chemotherapy was effective and elevated where the chemotherapy was ineffective. In our study the TPS assay shows a diagnostic sensitivity higher than the CEA and CA15-3 ones. Also, The assay is superior to CEA and CA15-3 ones as TPS reflected earlier the changes of the

  18. EFFECT OF PHYSICAL TRAINING ON LIPID PROFILE IN HEALTHY, YOUNG MALES: A FOLLOW UP STUDY

    Directory of Open Access Journals (Sweden)

    Rathod Shivanand Shriram

    2015-06-01

    Full Text Available Background and objective: Obesity itself is believed to be a morbid condition by many and it is also thought to be a cause of many health problems and chronic diseases like type 2 diabetes mellitus, coronary heart diseases. Regular physical exercise has got many health benefits including its effect on metabolism particularly on lipids. The objective of present study is to assess the effect of exercise training on lipid profile. Materials and Methods: We followed up 40 male students of Physical education aged between 18 to 25 years, for the period of nine months. Those with history of inborn errors of metabolism, those having endocrine disorders, those with diagnosed familial hyperlipidemia are excluded from our study. Their lipid profile parameters were measured in the beginning of exercise training period and then at the interval of every 3 months, with the first reading taken as baseline. Result: when we compared the readings with each other as well as with the baseline reading, we found that the levels of total cholesterol (TC, triglyceride (TG, low density lipoprotein cholesterol (LDL-C and very Low density lipoprotein cholesterol (VLDL-C decreased significantly while high density lipoprotein cholesterol (HDL-C increased as the duration of exercise training period progressed. Significant reduction was also observed in TC/HDL-C ratio as the duration of physical training progressed. Conclusion: Findings of our study suggest that, regular physical exercise has possible effect on improving lipid metabolism as lipid profile improved with increase in duration of exercise training period. Regular physical activity may be associated with decreased risk of chronic diseases like diabetes mellitus type 2, coronary heart disease.

  19. The Nurse-Led Telephone Follow-Up on Medication and Dietary Adherence among Patients after Myocardial Infarction: A Randomized Controlled Clinical Trial

    OpenAIRE

    Seyed Saeed Najafi; Maryam Shaabani; Marzieh Momennassab; Kamran Aghasadeghi

    2016-01-01

    Background: Adherence to dietary and medication regimen plays an important role in successful treatment and reduces the negative complications and severity of the disease. Therefore, the present study aimed to investigate the effect of nurse-led telephone follow-up on the level of adherence to dietary and medication regimen among patients after Myocardial Infarction (MI). Methods: This non-blinded randomized controlled clinical trial was conducted on 100 elderly patients with MI who had re...

  20. The Nurse-Led Telephone Follow-Up on Medication and Dietary Adherence among Patients after Myocardial Infarction: A Randomized Controlled Clinical Trial

    OpenAIRE

    Najafi, Seyed Saeed; Shaabani, Maryam; Momennassab, Marzieh; Aghasadeghi, Kamran

    2016-01-01

    Background: Adherence to dietary and medication regimen plays an important role in successful treatment and reduces the negative complications and severity of the disease. Therefore, the present study aimed to investigate the effect of nurse-led telephone follow-up on the level of adherence to dietary and medication regimen among patients after Myocardial Infarction (MI). Methods: This non-blinded randomized controlled clinical trial was conducted on 100 elderly patients with MI who had refer...

  1. Assessment and evaluation efficacy of a clinical pharmacist-led inpatient warfarin knowledge education program and follow-up at a Chinese tertiary referral teaching hospital

    OpenAIRE

    Guy-Armel Bounda; Cosette Ngarambe; Wei Hong Ge; Feng Yu

    2013-01-01

    Background: Oral anticoagulation therapy with warfarin is used to prevent and to treat venous and arterial thrombosis and embolism. Its narrow therapeutic index should be monitored carefully in order to reach the desired outcomes. Objective: This study aims to evaluate the clinical pharmacist-led in-patient warfarin′s knowledge education program and to assess a follow-up efficacy in a Chinese tertiary referral teaching hospital. Design and Setting: A cross-sectional and observational ...

  2. Irritable bowel syndrome--prognosis and diagnostic safety. A 5-year follow-up study

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Munck, L K; Andersen, J R

    1985-01-01

    The irritable bowel syndrome is the commonest diagnosis in gastroenterological clinics, although diagnostic criteria and investigatory programs vary. To elucidate the diagnostic safety and prognosis of the syndrome, a retrospective study was conducted. One hundred and twelve consecutive patients ...

  3. Oral health follow-up studies in the 1993 Pelotas (Brazil) birth cohort study: methodology and principal results

    OpenAIRE

    Marco A Peres; Barros, Aluísio Jardim; Peres, Karen Glazer; Araújo, Cora Luiza; Ana M. B. Menezes; Hallal, Pedro C; Victora, Cesar G.

    2010-01-01

    The aim of this study was to describe oral health follow-up studies nested in a birth cohort. A population-based birth cohort was launched in 1993 in Pelotas, Rio Grande do Sul State, Brazil. Two oral health follow-up studies were conducted at six (n = 359) and 12 (n = 339) years of age. A high response rate was observed at 12 years of age; 94.4% of the children examined at six years of age were restudied in 2005. The mean DMF-T index at age 12 was 1.2 (SD = 1.6) for the entire sample, rangin...

  4. Is follow up of hematological parameters essential during radiotherapy: retrospective study of 298 case-reports

    International Nuclear Information System (INIS)

    Case-reports of 298 patients treated by radiotherapy were analyzed to determine utility of hematological examinations during radiotherapy. Age and sex had no effect on blood counts usually performed during follow-up investigations. Has to be taken into account, however, is a history of previous chemotherapy and of extensive radiation (at least 20% of functional hemopoietic tissue), differences between normal and pathological full blood count values then being significant. A practical procedure would therefore be an initial full blood count with follow-up examinations of abnormal values and those at the limit of acceptability (platelets 3, WBC 3), as well as follow up of patients treated by previous chemotherapy or wide radiation to the abdominopelvic or thoracic regions. Follow up blood counts in patients receving mammary radiation are necessary only when results are at the limits of normality. An economy of 30,000 FF can be obtained by applying this procedure in a department treating approximately 600 patients per year

  5. Premature thelarche: a follow up study of 40 girls. Natural history and endocrine findings.

    Science.gov (United States)

    Pasquino, A M; Tebaldi, L; Cioschi, L; Cives, C; Finocchi, G; Maciocci, M; Mancuso, G; Boscherini, B

    1985-01-01

    Follow up of 40 girls with premature thelarche showed that where this disorder occurred before age 2 years it usually regressed completely, thus representing a transient and isolated phenomenon. Premature thelarche after age 2 years persisted more frequently, however, and represented the first sign of sexual development, generally leading to simple early puberty. PMID:4091585

  6. Osteoporosis - a risk factor for cardiovascular diseases: A follow-up study

    Directory of Open Access Journals (Sweden)

    Tasić Ivan

    2015-01-01

    Full Text Available Introduction. Cardiovascular (CV diseases and bone fractures due to osteoporosis are the leading causes of death in the elderly. Objective. The aim of this study was to demonstrate a correlation between the overall risk for CV events, and low bone density in postmenopausal women, and its impact on the incidence of serious CV events. Methods. Our prospective study involved 300 postmenopausal women. All the examinees were divided into three groups based on their measured bone density: Group I - 84 examinees with osteoporosis; Group II - 115 examinees with osteopenia; and Group III - 101 examinees with normal bone density. In all examinees the overall ten-year risk for a fatal CV event was calculated using the SCORE system tables. Results. After a 36-month follow-up, CV events occurred in 19 (6.3% examinees. Significant differences in the incidence of CV events were demonstrated between the patients with osteoporosis, osteopenia, and normal bone density (χ2=28.7; p<0.001, as well as between those with a high and low CV risk (χ2=22.6; p<0.001. Multivariate logistic regression analysis showed that smoking (OR: 2.23; 95% CI: 1.02 to 6.19; p=0.035, and increase of overall CV score (OR: 1.36; 95% CI: 1.17 to 1.58; p<0.001 are associated with increased CV event risk, while the increase of T score value is associated with decreased risk of CV event (OR: 0.42; 95% CI: 0.25 to 0.73; p=0.002. Conclusion. Measurement of bone density with a standard assessment of the total CV risk could be useful for selecting women who need intensive prevention and treatment of atherosclerosis.

  7. Co-morbidities among silicotics at Shakarpur: A follow up study

    Directory of Open Access Journals (Sweden)

    Nayanjeet Chaudhury

    2012-01-01

    Full Text Available Context: Studies have revealed high morbidity and mortality among agate stone workers of Shakarpur due to silicosis. Besides the fatal disease, the workers also suffer from debilitating co-morbidities especially tuberculosis and under nutrition. Aims: The present study describes few co-morbidities and their influence in mortality in cases of silicosis that were followed for 30 months at Shakarpur. Settings and Design: Shakarpur, Khambhat of Gujarat. Materials and Methods: Spirometry for lung function, chest X-ray, anthropometry, body fat % measurement, record of tuberculosis status and ILO classification of pneumoconiosis were done among 53 chest symptomatic patients above 15 years of age who were followed for 30 months. Results: Out of 53 participants (35 men, with an average duration of exposure to free silica of 16.8 years, more than half of the male workers were underweight (BMI<18.5 kg/m 2 at enrollment. Thirteen participants died in less than 3 years of follow up. While 11 of them were silicosis positive out of which 10 had tuberculosis. The odds ratio for association between silicosis and tuberculosis was 2.75. A majority (81.1% of the 37 silicosis positive cases showed a mixed pattern in spirometry suggesting co-existence of restrictive and obstructive pathology. On regression analysis, TB and nutritional status were found to have strong influence on mortality. Conclusions: Screening for early diagnosis of silicosis as well as co-morbid conditions and managing them would go a long way in prolonging the lives of the agate stone workers who are prone to die early due to silicosis.

  8. New BPD predicts lung function at school age: Follow-up study and meta-analysis.

    Science.gov (United States)

    Ronkainen, Eveliina; Dunder, Teija; Peltoniemi, Outi; Kaukola, Tuula; Marttila, Riitta; Hallman, Mikko

    2015-11-01

    New treatment practices have improved survival of preterm infants and decreased airway pathology in bronchopulmonary dysplasia (BPD). Our aim was to investigate whether preterm birth, BPD, and the severity of BPD predict lung function in school children that are born in surfactant era. We studied pulmonary function of 88 school-aged children born very preterm (gestational age surfactant treatment. BPD was defined as oxygen dependence for ≥ 28 days and it was severity-graded by oxygen requirement at 36 weeks postmenstrual age (mild, none; moderate, FiO2 = 0.22-0.29; severe, FiO2 ≥ 0.30). Preterm children had lower forced expiratory volume in 1 sec (FEV1 ) 86.4 ± 11.8 versus 94.9 ± 10.1 (mean % predicted ± SD; P < 0.001), and lower diffusion capacity (DLCO) 87.6 ± 13.9 versus 93.7 ± 12.0 (P = 0.005) compared with term controls. BPD group differed in both FEV1 (P = 0.037) and DLCO (P = 0.018) from those without BPD. For meta-analysis, search identified 210 articles. Together with present results, six articles met the inclusion criteria. FEV1 of no BPD, all BPD, and moderate to severe BPD groups differed from that in term controls by -7.4, -10.5, and -17.8%, respectively. According to meta-analysis and follow-up study, the adverse effects of prematurity on pulmonary function are still detectable in school-age. BPD was associated with reductions in both diffusion capacity and spirometry. New interventions are required to document a further decrease in the life-long consequences of prematurity. PMID:25589379

  9. Bone mineral density of the proximal femur after hip resurfacing arthroplasty: 1-year follow-up study

    Directory of Open Access Journals (Sweden)

    Anttila Esa

    2011-05-01

    Full Text Available Abstract Background Hip resurfacing arthroplasty (HRA is considered a bone-preserving procedure and may eliminate proximal femoral stress shielding and osteolysis. However, in addition to implant-related stress-shielding factors, various patient-related factors may also have an effect on bone mineral density (BMD of the proximal femur in patients with HRA. Thus, we studied the effects of stem-neck angle, demographic variables, and physical functioning on the BMD of the proximal femur in a one-year follow-up. Methods Thirty three patients (9 females and 24 males with a mean (SD age of 55 (9 years were included in the study. BMD was measured two days and 3, 6, and 12 months postoperatively and 10 regions of interest (ROI were used. Stem-neck angle was analyzed from anteroposterior radiographs. Results Three months postoperatively, BMD decreased in six out of 10 regions of interest (ROI on the side operated on and in one ROI on the control side (p Conclusions After an early drop, the BMD of the upper femur was restored and even exceeded the preoperative level at one year follow-up. From a clinical standpoint, the changes in BMD in these HRA patients could not be explained by stem-neck angle or patient related factors.

  10. Antecedents of teenage pregnancy from a 14-year follow-up study using data linkage

    Directory of Open Access Journals (Sweden)

    Stanley Fiona J

    2010-02-01

    Full Text Available Abstract Background Many western nations continue to have high rates of teenage pregnancies and births, which can result in adverse outcomes for both mother and child. This study identified possible antecedents of teenage pregnancy using linked data from administrative sources to create a 14-year follow-up from a cross-sectional survey. Methods Data were drawn from two sources - the 1993 Western Australian Child Health Survey (WACHS, a population-based representative sample of 2,736 children aged 4 to 16 years (1,374 girls; and administrative data relating to all their subsequent births and hospital admissions. We used weighted population estimates to examine differences between rates for teenage pregnancy, motherhood and abortion. We used Cox proportional hazards regression to model risk for teenage pregnancy. Results There were 155 girls aged less than 20 years at the time of their first recorded pregnancy. Teenage pregnancy was significantly associated with: family type; highest school year completed by primary carer; combined carer income; whether the primary carer was a smoker; and whether the girl herself displayed aggressive and delinquent behaviours. An age-interaction analysis on the association with aggressive and delinquent behaviours found that while girls with aggressive and delinquent behaviours who were older at the time of the survey were at highest risk of teenage pregnancy, there was elevated risk for future teenage pregnancy across all ages. Conclusions Our findings suggest that interventions to reduce teenage pregnancy rates could be introduced during primary school years, including those that are focused on the prevention and management of aggressive and delinquent behaviour.

  11. Femtosecond lenticule extraction for correction of myopia: a 6 month follow-up study

    Directory of Open Access Journals (Sweden)

    Demirok A

    2013-06-01

    Full Text Available Ahmet Demirok,1 Alper Agca,2 Engin Bilge Ozgurhan,2 Ercument Bozkurt,2 Ugur Celik,2 Ali Demircan,2 Nimet Burcu Guleryuz,2 Kadir Ilker Cankaya,2 Omer Faruk Yilmaz3 1Department of Ophthalmology, Medeniyet University, Istanbul, Turkey; 2Beyoglu Eye Training and Research Hospital, Istanbul, Turkey, 3Private Practice, Istanbul, Turkey Aims: To report our initial experience with femtosecond lenticule extraction (FLEX compared with femtosecond laser-assisted in situ keratomileusis (LASIK. Settings and design: This was a prospective pilot study carried out at the Refractive Surgery Department of the Beyoglu Eye Training and Research Hospital, Istanbul, Turkey. Materials and methods: Surgery was performed on both eyes of 14 consecutive patients with myopia or myopic astigmatism. Patients underwent FLEX in one eye and femtosecond LASIK (FemtoLASIK in the other eye. The primary outcome was based on uncorrected distance visual acuity, corrected distance visual acuity, and spherical equivalent of the subjective manifest refraction, at 1 week, 1 month, and 6 months postsurgery. Statistical analyses were performed using PAWS Statistics 18. Unpaired Student’s t-test was used to compare the groups. Results: During the last follow-up visit (6 months postsurgery, the mean spherical was −0.37 ± 0.60 diopters (D (range −1.00 to 0.50 (P 0.05. No complications occurred during surgery or the postoperative period. Conclusion: FLEX is a safe, effective, and predictable procedure for surgical correction of myopia. Refractive results were stabilized within the first postoperative week, and visual acuities were stabilized within the first month, comparable to FemtoLASIK. Keywords: FLEX, femtosecond laser-assisted in situ keratomileusis

  12. Long-Term follow up after intra-Uterine transfusionS; the LOTUS study

    Directory of Open Access Journals (Sweden)

    Kanhai Humphrey HH

    2010-12-01

    Full Text Available Abstract Background The Leiden University Medical Center (LUMC is the Dutch national referral centre for pregnancies complicated by haemolytic disease of the fetus and newborn (HDFN caused by maternal alloimmunization. Yearly, 20-25 affected fetuses with severe anaemia are transfused with intra-uterine blood transfusions (IUT. Mothers of whom their fetus has undergone IUT for HDFN are considered high responders with regard to red blood cell (RBC antibody formation. Most study groups report high perinatal survival, resulting in a shift in attention towards short- and long-term outcome in surviving children. Methods/Design We set up a large long-term observational follow-up study (LOTUS study, in cooperation with the Sanquin Blood Supply Foundation and the LUMC departments of Obstetrics, Neonatology and ImmunoHematology & Bloodtransfusion. The first part of this study addresses several putative mechanisms associated with blood group alloimmunization in these mothers. The second part of this study determines the incidence of long-term neurodevelopment impairment (NDI and associated risk factors in children treated with IUT. All women and their life offspring who have been treated with IUT for HDFN in the LUMC from 1987-2008 are invited to participate and after consent, blood or saliva samples are taken. RBC and HLA antigen profile and antibodies are determined by serologic or molecular techniques. Microchimerism populations are tested by real time polymerase chain reaction (RT PCR. All children are tested for their neurological, cognitive and psychosocial development using standardised tests and questionnaires. The primary outcome is neurodevelopmental impairment (NDI, a composite outcome defined as any of the following: cerebral palsy, cognitive or psychomotor development Discussion The LOTUS study includes the largest cohort of IUT patients ever studied and is the first to investigate post-IUT long-term effects in both mother and child. The

  13. Encephalopathy associated with autoimmune thyroid disease in patients with Graves' disease: clinical manifestations, follow-up, and outcomes.

    LENUS (Irish Health Repository)

    Tamagno, Gianluca

    2012-02-01

    BACKGROUND: The encephalopathy associated with autoimmune thyroid disease (EAATD) is characterized by neurological\\/psychiatric symptoms, high levels of anti-thyroid antibodies, increased cerebrospinal fluid protein concentration, non-specific electroencephalogram abnormalities, and responsiveness to the corticosteroid treatment in patients with an autoimmune thyroid disease. Almost all EAATD patients are affected by Hashimoto\\'s thyroiditis (HT), although fourteen EAATD patients with Graves\\' disease (GD) have been also reported. METHODS: We have recorded and analyzed the clinical, biological, radiological, and electrophysiological findings and the data on the therapeutic management of all GD patients with EAATD reported so far as well as the clinical outcomes in those followed-up in the long term. RESULTS: Twelve of the fourteen patients with EAATD and GD were women. The majority of GD patients with EAATD presented with mild hyperthyroidism at EAATD onset or shortly before it. Active anti-thyroid autoimmunity was detected in all cases. Most of the patients dramatically responded to corticosteroids. The long term clinical outcome was benign but EAATD can relapse, especially at the time of corticosteroid dose tapering or withdrawal. GD and HT patients with EAATD present with a similar clinical, biological, radiological, and electrophysiological picture and require an unaffected EAATD management. CONCLUSIONS: GD and HT equally represent the possible background condition for the development of EAATD, which should be considered in the differential diagnosis of all patients with encephalopathy of unknown origin and an autoimmune thyroid disease, regardless of the nature of the underlying autoimmune thyroid disease.

  14. Encephalopathy associated with autoimmune thyroid disease in patients with Graves' disease: clinical manifestations, follow-up, and outcomes

    LENUS (Irish Health Repository)

    Tamagno, Gianluca

    2010-04-28

    Abstract Background The encephalopathy associated with autoimmune thyroid disease (EAATD) is characterized by neurological\\/psychiatric symptoms, high levels of anti-thyroid antibodies, increased cerebrospinal fluid protein concentration, non-specific electroencephalogram abnormalities, and responsiveness to the corticosteroid treatment in patients with an autoimmune thyroid disease. Almost all EAATD patients are affected by Hashimoto\\'s thyroiditis (HT), although fourteen EAATD patients with Graves\\' disease (GD) have been also reported. Methods We have recorded and analyzed the clinical, biological, radiological, and electrophysiological findings and the data on the therapeutic management of all GD patients with EAATD reported so far as well as the clinical outcomes in those followed-up in the long term. Results Twelve of the fourteen patients with EAATD and GD were women. The majority of GD patients with EAATD presented with mild hyperthyroidism at EAATD onset or shortly before it. Active anti-thyroid autoimmunity was detected in all cases. Most of the patients dramatically responded to corticosteroids. The long term clinical outcome was benign but EAATD can relapse, especially at the time of corticosteroid dose tapering or withdrawal. GD and HT patients with EAATD present with a similar clinical, biological, radiological, and electrophysiological picture and require an unaffected EAATD management. Conclusions GD and HT equally represent the possible background condition for the development of EAATD, which should be considered in the differential diagnosis of all patients with encephalopathy of unknown origin and an autoimmune thyroid disease, regardless of the nature of the underlying autoimmune thyroid disease.

  15. Encephalopathy associated with autoimmune thyroid disease in patients with Graves' disease: clinical manifestations, follow-up, and outcomes.

    LENUS (Irish Health Repository)

    Tamagno, Gianluca

    2010-01-01

    BACKGROUND: The encephalopathy associated with autoimmune thyroid disease (EAATD) is characterized by neurological\\/psychiatric symptoms, high levels of anti-thyroid antibodies, increased cerebrospinal fluid protein concentration, non-specific electroencephalogram abnormalities, and responsiveness to the corticosteroid treatment in patients with an autoimmune thyroid disease. Almost all EAATD patients are affected by Hashimoto\\'s thyroiditis (HT), although fourteen EAATD patients with Graves\\' disease (GD) have been also reported. METHODS: We have recorded and analyzed the clinical, biological, radiological, and electrophysiological findings and the data on the therapeutic management of all GD patients with EAATD reported so far as well as the clinical outcomes in those followed-up in the long term. RESULTS: Twelve of the fourteen patients with EAATD and GD were women. The majority of GD patients with EAATD presented with mild hyperthyroidism at EAATD onset or shortly before it. Active anti-thyroid autoimmunity was detected in all cases. Most of the patients dramatically responded to corticosteroids. The long term clinical outcome was benign but EAATD can relapse, especially at the time of corticosteroid dose tapering or withdrawal. GD and HT patients with EAATD present with a similar clinical, biological, radiological, and electrophysiological picture and require an unaffected EAATD management. CONCLUSIONS: GD and HT equally represent the possible background condition for the development of EAATD, which should be considered in the differential diagnosis of all patients with encephalopathy of unknown origin and an autoimmune thyroid disease, regardless of the nature of the underlying autoimmune thyroid disease.

  16. Self-experience in the early phases of schizophrenia: 5-year follow-up of the Copenhagen Prodromal Study

    OpenAIRE

    Parnas, Josef; Raballo, Andrea; HANDEST, PETER; Jansson, Lennart; VOLLMER-LARSEN, ANNE; Saebye, Ditte

    2011-01-01

    Despite the avalanche of empirical data on prodromal/”at risk” conditions, the essential aspects of the vulnerability to the schizophrenia spectrum remain largely unaddressed. We report here the results of the Copenhagen Schizophrenia Prodromal Study, a prospective, observational study of first admission patients in putative state of beginning psychosis (N=151) with a follow-up length of 60 months. At follow-up, the rate of conversion to schizophrenia spectrum diagnosis was ...

  17. Association of serum sodium concentration with coronary atherosclerosis in China: follow-up study

    Institute of Scientific and Technical Information of China (English)

    En-zhi JIA; Zhen-xia XU; Zhi-jian YANG; Tie-bing ZHU; Lian-sheng WANG; Bo CHEN; Ke-jiang CAO; Jun HUANG; Wen-zhu MA; Xiang LU

    2009-01-01

    Aim: The aim of this study was to test the hypothesis that lower serum sodium may be associated with increased cardiovascular events and all-cause mortality by means of long-term foUow-up of subjects with coronary atherosclerosis in a prospecfive, hospital-based epidemiological study in China. Methods: A prospective, hospital-based epidemiological design was used. The study population consisted of 1069 consecutive patients who were scheduled to undergo coronary angiography for suspected or known coronary atherosclerosis. The severity of coronary atherosclerosis was defined using Gensini's score system. Age, sex-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for the quartiles of serum sodium concentration were estimated with Cox proportional hazard models, using quartile 1 as the reference. Cox proportional hazard models were also constructed to estimate the hazard ratios and 95% confidence intervals for all-cause mortality and final end-point events by serum sodium quartile and to adjust for potentially confounding variables. Multivariate models were adjusted for the following variables: age, sex, smoking status, alcohol consumption, body mass index, blood pressure, potassium, chloride, total cholesterol triglycerides, fasting blood glucose, urea, creatinine, uric acid, and Gensini's score.Results: During the median 2.86 years (3011.66 person-years) of follow-up, 176 final end-point events were documented.These events included 79 deaths and 97 readmissions for coronary heart disease. There was a statistically significant inverse association of serum sodium with all-cause mortality (P<0.001). After full adjustment comparing the highest serum sodium quartile to the lowest, there was a non-significant inverse association with aU-cause mortality, with an adjusted hazard ratio (95% CI) of 0.67 (0.25-1.80). After adjustment for age and sex, the hazard ratio and 95% CI for final end-point events across increasing quartiles of serum sodium concentration were

  18. Skin cancer in patients with psoriasis treated with coal tar. A 25-year follow-up study

    International Nuclear Information System (INIS)

    For many years, crude coal tar has been used for the treatment of psoriasis. The possible carcinogenic effect of crude coal tar and ultraviolet (UV) radiation (Goeckerman regimen), considered individually or in combination, has been of some concern to physicians. A 25-year follow-up study was completed on 280 patients with psoriasis who were hospitalized and treated with crude coal tar and UV radiation at the Mayo Clinic, Rochester, Minn, during the years 1950 through 1954. The results of this study suggest that the incidence of skin cancer is not appreciably increased above the expected incidence for the general population when patients are treated with coal tar ointments. It seems that the Goeckerman regimen (topical crude coal tar combined with UV radiation) can be used with minimal risk for skin cancer in the treatment of psoriasis

  19. Follow-up Study of Operating Room Technician Graduates. Vol. VIII, No. 9.

    Science.gov (United States)

    Phillips, Shirley C.; Lucas, John A.

    A follow-up survey on the employment of the 55 recent (1973-1976) graduates of the Operating Room Technician (ORT) program at William Rainey Harper College revealed that 51.2% of the 41 respondents had some college work prior to Harper enrollment; 63.5% were currently employed full-time, 14.5% part-time, 17% were voluntarily unemployed, and 5%…

  20. Follow-up services for stroke survivors after hospital discharge--a randomized control study

    DEFF Research Database (Denmark)

    Andersen, Hanne Elkjaer; Eriksen, Karen; Brown, Anne;

    2002-01-01

    ) follow-up home visits by a physician, (2) physiotherapist instruction in the patient's home, or (3) standard aftercare. SUBJECTS: Stroke patients with persisting impairment and disability who, after completing inpatient rehabilitation, were discharged to their homes. OUTCOME MEASURES: Six months after...... were given instructions by a physiotherapist in their home and 48 received standard aftercare only. No statistically significant differences in functional outcome six months after discharge were demonstrated between the three groups. However, all measurements showed a tendency towards higher scores...

  1. Treatment, Services and Follow-up for Victims of Family Violence in Health Clinics in Maputo, Mozambique

    Directory of Open Access Journals (Sweden)

    Jetha, Eunice Abdul Remane

    2011-07-01

    Full Text Available Background: Family violence (FV is a global health problem that not only impacts the victim, but the family unit, local community and society at large.Objective: To quantitatively and qualitatively evaluate the treatment and follow up provided to victims of violence amongst immediate and extended family units who presented to three health centers in Mozambique for care following violence.Methods: We conducted a verbally-administered survey to self-disclosed victims of FV who presented to one of three health units, each at a different level of service, in Mozambique for treatment of their injuries. Data were entered into SPSS (SPSS, version 13.0 and analyzed for frequencies. Qualitative short answer data were transcribed during the interview, coded and analyzed prior to translation by the principal investigator.Results: One thousand two hundred and six assault victims presented for care during the eight-week study period, of which 216 disclosed the relationship of the assailant, including 92 who were victims of FV. Almost all patients (90% waited less than one hour to be seen, with most patients (67% waiting less than 30 minutes. Most patients did not require laboratory or radiographic diagnostics at the primary (70% and secondary (93% health facilities, while 44% of patients received a radiograph at the tertiary care center. Among all three hospitals, only 10% were transferred to a higher level of care, 14% were not given any form of follow up or referral information, while 13% required a specialist evaluation. No victims were referred for psychological follow-up or support. Qualitative data revealed that some patients did not disclose violence as the etiology, because they believed the physician was unable to address or treat the violence-related issues and/or had limited time to discuss.Conclusion: Healthcare services for treating the physical injuries of victims of FV were timely and rarely required advanced levels of medical care, but there

  2. Pramipexole in the treatment of restless legs syndrome: a follow-up study.

    Science.gov (United States)

    Montplaisir, J; Denesle, R; Petit, D

    2000-05-01

    The restless legs syndrome (RLS) is a condition characterized by unpleasant limb sensations occurring at rest and associated with an irresistible urge to move. Several treatments are used to treat RLS including benzodiazepines, opioids, dopaminergic agents, clonidine and anticonvulsant drugs such as carbamazepine and gabapentine. Dopaminergic agents are now considered the treatment of choice for RLS. Levodopa is effective in treating RLS; however, several patients treated with levodopa at bedtime developed morning or late afternoon restlessness. Recently, more attention has been paid to dopamine receptor agonists. Ergoline derivatives, bromocriptine and pergolide were found effective, but require concomitant administration of domperidone, a peripheral dopamine antagonist. In a recent study, we studied the efficacy and innocuity of pramipexole, a new dopamine agonist with a higher affinity for the D3 receptor subtype of the D2 family, in a double-blind, placebo-controlled, randomized trial. Pramipexole had major effects on RLS symptoms without severe side-effects. The present study aimed to assess the long-term efficacy of pramipexole. Seven patients were treated with the drug for a mean follow-up duration of 7.8 months. Treatment was started at a dosage of 0.25 mg, and progressively increased until the optimal therapeutic effect was obtained. Home questionnaires were completed for 7 consecutive days, after one month and after a mean of 7.8 months of treatment with pramipexole, assessing leg restlessness during the daytime, in the evening, at bedtime and during the night. There was no evidence of a decrease in the therapeutic effect of pramipexole in these patients, even 7.8 months after the initiation of treatment. The optimal dosage was 0.25 mg for one patient, 0.5 mg for five patients and 0.75 mg for one patient. While there was a progressive increase in severity of leg restlessness from daytime to nighttime before treatment, a suppression of leg restlessness was

  3. Work, diabetes and obesity: a seven year follow-up study among Danish health care workers.

    Directory of Open Access Journals (Sweden)

    Kjeld Poulsen

    Full Text Available The rise in prevalence of diabetes is alarming and research ascribes most of the increase to lifestyle. However, little knowledge exists about the influence of occupational factors on the risk for developing diabetes. This study estimates the importance of work and lifestyle as risk factors for developing diabetes mellitus among healthcare workers and explores the association of work factors and obesity, which is a risk factor for diabetes.Questionnaire-based prospective cohort study among 7,305 health care workers followed for seven years in the Danish National Diabetes Register. We used bivariate comparisons to give an unadjusted estimate of associations, followed by adjusted survival analysis and logistic regression models to estimate the influences of potential risk factors related to job, health and lifestyle on diabetes and obesity.During seven years of follow up, 3.5% of participants developed diabetes, associated with obesity (HR  =  6.53; 95% CI 4.68-9.10, overweight (HR  =  2.89; CI 2.11-3.96 age 50-69 y (HR  =  2.27; 95% CI 1.57-3.43 and high quality of leadership (HR  =  1.60; CI 1.19-2.16. Obesity at baseline was most common among the youngest employees, and was mainly associated with developing diabetes (OR  =  3.84; CI 2.85-5.17, impaired physical capacity and physical inactivity. In the occupational setting, obesity was associated with shift work, severe musculoskeletal pain, low influence, but also by good management, fewer role conflicts and a positive work-life balance. Looking only at non-smokers, removed the influence of age and pain. However, non-smokers also had higher depression scores and more role conflicts.Confirming obesity as the strongest risk factor for developing diabetes, the present study identified few occupational risk factors. However, obesity, the key risk factor for diabetes, had a more variable relation with work than did diabetes.

  4. Objective outcome evaluation using inertial sensors in subacromial impingement syndrome: a five-year follow-up study

    International Nuclear Information System (INIS)

    Shoulder-related dysfunction is the second most common musculoskeletal disorder and is an increasing burden on health-care systems. Commonly used clinical questionnaires suffer from subjectivity, pain dominance and a ceiling effect. Objective functional measurement has been identified as a relevant issue in clinical rehabilitation. Inertia based motion analysis (IMA) is a new generation of objective outcome assessment tool; it can produce objective movement parameters while being fast, cheap and easy to operate. In this prospective study, an inertial sensor comprising a three-dimensional accelerometer and gyroscope is attached at the humerus to measure shoulder movements during two motion tasks in patients with subacromial impingement syndrome at baseline and at five-year after treatment. One hundred healthy subjects served as healthy reference database and 15 patients were measured pre- and post-treatment. IMA was better able to detect improvement in shoulder movements compared to the clinical questionnaires (Disability of Arm, Shoulder and Hand (DASH) and Simple Shoulder Test (SST); p < 0.05) and was hardly correlated with the clinical questionnaires (Pearson R = 0.39). It may therefore add an objective functional dimension to outcome assessment. The fast assessment (t < 5 min) of a simple motion test makes it suitable for routine clinical follow-up. (paper)

  5. A novel and cost-effective way to follow-up adequacy of pain relief, adverse effects, and compliance with analgesics in a palliative care clinic

    Directory of Open Access Journals (Sweden)

    Radhika Kannan

    2013-01-01

    Full Text Available Introduction: A way to assess compliance with analgesics in an outpatient palliative care clinic is essential since often the patient is too ill or weak to come to hospital for weekly follow-ups. A pilot study was conducted using Short Messaging Service via mobile phone as a follow-up tool. Context: A predominantly outpatient palliative care clinic of a 300 bedded multidisciplinary hospital. Materials and Methods: Sixty patients attending the palliative care clinic were enrolled in the study. Analgesic drugs, co-analgesics, and adjuvants were prescribed on an outpatient basis. If possible, patients were admitted for 1 or 2 days. A simple scoring system was devised and taught to the patients and their attenders. A short message service had to be sent to the author′s mobile number. The period was fixed at 2 weeks by which the patients and attenders were familiar with the drugs and pain relief as well. Drowsiness was a worrisome complaint. The mobile number of the patient was called and attender instructed to skip one or two doses of morphine and reassurance given. If required, attender was asked to bring patient to the hospital or come to the hospital for a different prescription as the situation warranted. Results: Out of 60 patients, 22 were admitted initially for dose titration and all others were outpatients. Three patients were lost to follow-up and one patient died after 7 days. 93% of patients responded promptly. Random survey was done in 10 patients to confirm their SMS response and the results were analyzed. Conclusion: Mobile phones are available with all strata of people. It is easy to train patients to send an SMS.This technology can be used to follow- up palliative care patients and help them comply with their treatment regimen.

  6. Follow up through Endoscopical – Histological Studies and Helicobacter Pylori Infections in Patients Suffering from Gastric Ulcers

    OpenAIRE

    Marcos Félix Osorio Pagola; Antonio Moré Pérez; Libán Álvarez Cáceres; Juan Luis de Pasos Carrazana; Anagalys Ortega Alvelay

    2010-01-01

    Background: Endoscopic follow up of gastric ulcers until healing has a great important due to the possibility of a new proliferation. The commonest chronic infection worldwide is caused by Helicobacter pylori and it is associated to gastro duodenal diseases. Objective: To determine the endoscopic-biopsic follow up and to set the frequency of infection due to Helicobacter pylori in those patients who suffer from gastric ulcers. Methods: observational, descriptive and prospective study car...

  7. Significance of atypia in conventional Papanicolaou smears and liquid-based cytology: a follow-up study

    DEFF Research Database (Denmark)

    Schledermann, D; Ejersbo, D; Hoelund, B

    2004-01-01

    The diagnosis of atypical squamous epithelial cells, borderline nuclear changes, is associated with some controversy, as it encompasses benign, reactive, as well as possible neoplastic conditions. The aim of this study was to evaluate the follow-up diagnoses of cytological atypia in conventional...... significant decrease in atypia rates compared with the conventional Papanicolaou test. In subsequent follow-up the percentage of neoplastic lesions was significantly increased in the ThinPrep Pap Test samples....

  8. Does Maternal HIV Status Affect Infant Growth?: A Hospital Based Follow Up Study

    OpenAIRE

    Sangeeta Trivedi; Prashant Kariya; Vijay Shah; Silky Mody; Prakash Patel; Kanan Desai

    2012-01-01

    Introduction: HIV infection is difficult to diagnose in infants, as most infected babies appear healthy and exhibit no signs and symptoms at birth. The present study was conducted to study the clinical profile & morbidity pattern of infants born to HIV positive mothers, their nutritional status and growth pattern and compare them with HIV non exposed infants. Methodology: This observational longitudinal study was conducted in Dec 2009 – Dec 2010 where all HIV exposed baby born i...

  9. Hand Hygiene Practices in Medical Students: A Follow-Up Study

    OpenAIRE

    Salati, Sajad Ahmad; al Kadi, Azzam

    2014-01-01

    Objective. The study was conducted to study the impact of various measures instituted to improve hand hygiene practices of the medical students after having documented poor hand hygiene awareness and compliance in a study conducted in 2012. Methods. A self-designed questionnaire based on World Health Organization’s concept of “Five Moments for Hand Hygiene” was used to evaluate the awareness of the indications of hand hygiene. Compliance was observed during Objective Structured Clinical Exami...

  10. Gamma-knife radiosurgery in acromegaly: a 4-year follow-up study.

    Science.gov (United States)

    Attanasio, Roberto; Epaminonda, Paolo; Motti, Enrico; Giugni, Enrico; Ventrella, Laura; Cozzi, Renato; Farabola, Mario; Loli, Paola; Beck-Peccoz, Paolo; Arosio, Maura

    2003-07-01

    Stereotactic radiosurgery by gamma-knife (GK) is an attractive therapeutic option after failure of microsurgical removal in patients with pituitary adenoma. In these tumors or remnants of them, it aims to obtain the arrest of cell proliferation and hormone hypersecretion using a single precise high dose of ionizing radiation, sparing surrounding structures. The long-term efficacy and toxicity of GK in acromegaly are only partially known. Thirty acromegalic patients (14 women and 16 men) entered a prospective study of GK treatment. Most were surgical failures, whereas in 3 GK was the primary treatment. Imaging of the adenoma and target coordinates identification were obtained by high resolution magnetic resonance imaging. All patients were treated with multiple isocenters (mean, 8; range, 3-11). The 50% isodose was used in 27 patients (90%). The mean margin dose was 20 Gy (range, 15-35), and the dose to the visual pathways was always less than 8 Gy. After a median follow-up of 46 months (range, 9-96), IGF-I fell from 805 micro g/liter (median; interquartile range, 640-994) to 460 micro g/liter (interquartile range, 217-654; P = 0.0002), and normal age-matched IGF-I levels were reached in 7 patients (23%). Mean GH levels decreased from 10 micro g/liter (interquartile range, 6.4-15) to 2.9 micro g/liter (interquartile range, 2-5.3; P < 0.0001), reaching levels below 2.5 micro g/liter in 11 (37%). The rate of persistently pathological hormonal levels was still 70% at 5 yr by Kaplan-Meier analysis. The median volume was 1.43 ml (range, 0.20-3.7). Tumor shrinkage (at least 25% of basal volume) occurred after 24 months (range, 12-36) in 11 of 19 patients (58% of assessable patients). The rate of shrinkage was 79% at 4 yr. In no case was further growth observed. Only 1 patient complained of side-effects (severe headache and nausea immediately after the procedure, with full recovery in a few days with steroid therapy). Anterior pituitary failures were observed in 2 patients

  11. Reproducibility of radionuclide gastroesophageal reflux studies using quantitative parameters and potential role of quantitative assessment in follow-up

    International Nuclear Information System (INIS)

    Radionuclide gastroesophageal reflux studies have been widely used in the assessment of gastroesophageal reflux disease (GERD) in infants and children. Various qualitative and quantitative parameters have been used for the interpretation of reflux studies but there is little consensus on the use of these parameters in routine gastroesophageal reflux scintigraphic studies. Aim of this study was to evaluate the methodological issues underlying the qualitative and quantitative assessment of gastroesophageal reflux and to determine the potential power of the reflux index calculation in follow-up assessment of the reflux positive patients. Methods: Total 147 patients suffering from recurrent lower respiratory tract infection, asthma and having strong clinical suspicion of GER were recruited in the study. Dynamic scintigraphic study was acquired for 30 minutes after oral administration of 99mTc phytate. Each study was analyzed three times by two nuclear medicine physicians. Clinical symptoms were graded according to predefined criteria and there correlation with severity reflux was done. Time activity curves were generated by drawing ROIs from esophagus. Reflux index was calculated by the standard formula and cut off value of 4% was used for RI calculation. Reflux indices were used for follow-up assessments in reflux positive patients. Kappa statistics and chi square test were used to evaluate the agreement and concordance between qualitative and quantitative parameters. Results: Tlae over all incidence of reflux in total study population was 63.94 %( 94 patients). The kappa value for both qualitative and quantitative parameters showed good agreement for intra and inter-observer reproducibility (kappa value > 0.75). Concordance between visual analysis and time activity curves was not observed. Reflux index and visuat interpretation shows concordance in the interpretation. The severity of clinical symptoms was directly related to the severity of the reflux observed in the

  12. Clinical and Angiographic Characteristics of Myocardial Bridges: a Descriptive Report of 19 Cases and Follow-up Outcomes

    Directory of Open Access Journals (Sweden)

    Maria Raissi Dehkordi

    2007-07-01

    Full Text Available Background: Muscle fibers overlying the intramyocardial segment of an epicardial coronary artery are termed myocardial bridge (MB. The aim of this study was to analyze the mid-term outcome of MB and to examine its possible association with angiographic findings and concomitant cardiac pathologies such as hypertrophic cardiomyopathy (HCM. Methods: From a total of 3218 patients admitted for coronary angiography during 9 consecutive months, 28 (0.9% were diagnosed with MBs with stenoses >=50%. Of these, 19 referred for follow-up with a median duration of 18 months. Results: HCM was present in 5 patients (26.3%, of whom 4 had MB as the sole finding in angiography. Of the 19 patients, 14 had diastolic dysfunction. In follow-up, 2 patients were treated with revascularization strategies due to the concomitant coronary artery disease and in 2, syncope occurred. For two patients, an intra-cardiac device and a permanent pacemaker were implanted. Three patients with MB as the sole finding in angiography were readmitted because of chest pain. Conclusion: Diastolic dysfunction may contribute to the presentation of symptoms of muscle bridging. Also, myocardial bridging as the only finding in coronary angiography is highly associated with hypertrophic cardiomyopathy and may help to detect this group of patients. The mid-term outcome of myocardial bridges is favorable.

  13. Type of Preadmission Antidiabetic Treatment and Outcome among Patients with Ischemic Stroke: A Nationwide Follow-up Study

    DEFF Research Database (Denmark)

    Horsdal, Henriette Thisted; Mehnert, Frank; Rungby, Jørgen; Johnsen, Søren Paaske

    2012-01-01

    BACKGROUND: We examined whether the preadmission use of sulfonylureas is associated with improved clinical outcome compared with other antidiabetic treatments after hospitalization with ischemic stroke. METHODS: We conducted a nationwide population-based follow-up study among all Danish patients...... hospitalized with ischemic stroke between 2003 and 2006 and who were registered in the Danish National Indicator Project. We obtained data on diabetes and type of antidiabetic treatment, patient characteristics, in-hospital quality of care, and mortality and readmissions by linking medical databases. We...... computed mortality rates and rates of readmission recurrent ischemic stroke or myocardial infarction according to type of treatment and used the Cox proportional hazards regression analysis to compute hazard ratios (HRs). RESULTS: We identified 4817 stroke patients with type 2 diabetes mellitus. We found...

  14. Antisaccades as a follow-up tool in major depressive disorder therapies: a pilot study.

    Science.gov (United States)

    Malsert, Jennifer; Guyader, Nathalie; Chauvin, Alan; Polosan, Mircea; Poulet, Emmanuel; Szekely, David; Bougerol, Thierry; Marendaz, Christian

    2012-12-30

    Eight patients with major depression, included in a double-blind study, performed an antisaccade task. Results suggested a link between antisaccade performances and clinical scale scores in patients who respond to therapy. Moreover, error rates may well predict response from day of inclusion, thus serving as a state-marker for mood disorders. PMID:22648007

  15. The Impact of Arbitration Intervention Services on Psychosocial Functioning: A Follow-Up Study

    Science.gov (United States)

    Dembo, Richard; Wareham, Jennifer; Poythress, Norman G.; Cook, Brittany; Schmeidler, James

    2006-01-01

    We report the impact of case management services on drug use and self-reported delinquency for youths involved in a clinical trial of the Juvenile Arbitration program. The project evaluated an innovative intervention service providing 16 weeks of intensive case management services to youths and their families. The present study examines interview…

  16. 18F-Fluorocholine PET/CT as a complementary tool in the follow-up of low-grade glioma: diagnostic accuracy and clinical utility

    International Nuclear Information System (INIS)

    The follow-up of treated low-grade glioma (LGG) requires the evaluation of subtle clinical changes and MRI results. When the result is inconclusive, additional procedures are required to assist decision-making, such as the use of advanced MRI (aMRI) sequences and nuclear medicine scans (SPECT and PET). The aim of this study was to determine whether incorporating 18F-fluorocholine PET/CT in the follow-up protocol for treated LGG improves diagnostic accuracy and clinical utility. This was a prospective case-series study in patients with treated LGG during standard follow-up with indeterminate clinical and/or radiological findings of tumour activity. All patients underwent clinical evaluation, aMRI, 201Tl-SPECT and 18F-fluorocholine PET/CT. Images were interpreted by visual evaluation complemented with semiquantitative analysis. Between January 2012 and December 2013, 18 patients were included in this study. The final diagnosis was established by histology (five surgical specimens, one biopsy specimen) or by consensus of the Neuro-Oncology Group (11 patients) after a follow-up of >6 months (mean 14.9 ± 2.72 months). The global diagnostic accuracies were 90.9 % for aMRI (38.8 % inconclusive), 69.2 % for 201Tl-SPECT (11.1 % inconclusive), and 100 % for 18F-fluorocholine PET/CT. 201Tl-SPECT led correctly to a change in the initial approach in 38.9 % of patients but might have led to error in 27.8 %. The use of 18F-fluorocholine PET/CT alone rather than 201Tl-SPECT led correctly to a change in the approach suggested by routine follow-up in 72.2 % of patients and endorsed the approach in the remaining 27.8 %. Our results support the need to complement structural MRI with aMRI and nuclear medicine procedures in selected patients. 18F-Fluorocholine PET/CT can be useful in the individualized management of patients with treated LGG with uncertain clinical and/or radiological evidence of tumour activity. (orig.)

  17. {sup 18}F-Fluorocholine PET/CT as a complementary tool in the follow-up of low-grade glioma: diagnostic accuracy and clinical utility

    Energy Technology Data Exchange (ETDEWEB)

    Gomez-Rio, Manuel; Rodriguez-Fernandez, Antonio; Llamas-Elvira, Jose M. [Instituto de Investigacion Biosanitaria de Granada, Granada (Spain); University Hospital ' ' Virgen de las Nieves' ' , Department of Nuclear Medicine, Granada (Spain); Testart Dardel, Nathalie [University Hospital ' ' Virgen de las Nieves' ' , Department of Nuclear Medicine, Granada (Spain); Santiago Chinchilla, Alicia [University Hospital ' ' Virgen de las Nieves' ' , Department of Radiology, Granada (Spain); Olivares Granados, Gonzalo [University Hospital ' ' Virgen de las Nieves' ' , Department of Neurosurgery, Granada (Spain); Luque Caro, Raquel [University Hospital ' ' Virgen de las Nieves' ' , Department of Medical Oncology, Granada (Spain); Zurita Herrera, Mercedes [University Hospital ' ' Virgen de las Nieves' ' , Department of Radiotherapy Oncology, Granada (Spain); Chamorro Santos, Clara E. [University Hospital ' ' Virgen de las Nieves' ' , Department of Pathology, Granada (Spain); Lardelli-Claret, Pablo [Instituto de Investigacion Biosanitaria de Granada, Granada (Spain); Centros de Investigacion Biomedica en Red de Epidemiologia y Salud Publica (CIBERESP), Granada (Spain); University of Granada, Department of Preventive Medicine and Public Health, School of Medicine, Granada (Spain)

    2015-05-01

    The follow-up of treated low-grade glioma (LGG) requires the evaluation of subtle clinical changes and MRI results. When the result is inconclusive, additional procedures are required to assist decision-making, such as the use of advanced MRI (aMRI) sequences and nuclear medicine scans (SPECT and PET). The aim of this study was to determine whether incorporating {sup 18}F-fluorocholine PET/CT in the follow-up protocol for treated LGG improves diagnostic accuracy and clinical utility. This was a prospective case-series study in patients with treated LGG during standard follow-up with indeterminate clinical and/or radiological findings of tumour activity. All patients underwent clinical evaluation, aMRI, {sup 201}Tl-SPECT and {sup 18}F-fluorocholine PET/CT. Images were interpreted by visual evaluation complemented with semiquantitative analysis. Between January 2012 and December 2013, 18 patients were included in this study. The final diagnosis was established by histology (five surgical specimens, one biopsy specimen) or by consensus of the Neuro-Oncology Group (11 patients) after a follow-up of >6 months (mean 14.9 ± 2.72 months). The global diagnostic accuracies were 90.9 % for aMRI (38.8 % inconclusive), 69.2 % for {sup 201}Tl-SPECT (11.1 % inconclusive), and 100 % for {sup 18}F-fluorocholine PET/CT. {sup 201}Tl-SPECT led correctly to a change in the initial approach in 38.9 % of patients but might have led to error in 27.8 %. The use of {sup 18}F-fluorocholine PET/CT alone rather than {sup 201}Tl-SPECT led correctly to a change in the approach suggested by routine follow-up in 72.2 % of patients and endorsed the approach in the remaining 27.8 %. Our results support the need to complement structural MRI with aMRI and nuclear medicine procedures in selected patients. {sup 18}F-Fluorocholine PET/CT can be useful in the individualized management of patients with treated LGG with uncertain clinical and/or radiological evidence of tumour activity. (orig.)

  18. Impact of comorbidity on three month follow-up outcome of children with ADHD in a child guidance clinic: Preliminary report

    Directory of Open Access Journals (Sweden)

    Rangan Srinivasaraghavan

    2013-01-01

    Full Text Available Context: Attention deficit hyperactivity disorder (ADHD is one of the common neurodevelopmental disorders. Aims: Study objective is to report impact of comorbidities on short-term outcome in children with ADHD followed in a child guidance clinic. Settings and Design: This was done in a child guidance clinic run jointly by the pediatric and psychiatry department at a tertiary teaching hospital. This is a 3 month prospective follow-up study to assess the outcome in ADHD children. Materials and Methods: Children attending pediatric department with behavioral problems or poor scholastic performance were screened for ADHD and further confirmation of diagnosis was done by semistructured interview of the child and parent. Children functional assessment and ADHD symptom profile was compared at baseline and at follow-up. We screened for and excluded those showing autistic spectrum disorder and having worse than mild mental retardation. Baseline variables were compared between improved and not improved subgroups and impact of these variables on outcome at 3-month follow-up was analyzed. Statistical Analysis: Descriptive statistics. Results: Of the 25 children completing the study, at the end of 3 months, 15 improved (not fulfilling criteria for ADHD and 10 did not improve. Applying Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS for diagnosis of psychiatric comorbidities, six had associated psychiatric comorbidities. This was significantly higher in those who did not improve. Conclusions: Presence of comorbidities at baseline was found to affect outcome at 3 month assessment in this preliminary study. Future studies with larger sample and longer follow-up are needed for finding the predictors of outcome in ADHD children in developing nations.

  19. Recurrent optic neuritis: clues from a long-term follow up study of recurrent and bilateral optic neuritis patients

    Directory of Open Access Journals (Sweden)

    Asli Kurne

    2010-03-01

    Full Text Available Asli Kurne1, Rana Karabudak1, Gul Yalcin-Cakmakli1, Yasemin Gursoy-Ozdemir1, Pinar Aydin3, Ayse Ilksen-Colpak1, Sevda Lule2, Tulay Kansu11Department of Neurology, 2Institute of Neurological Sciences and Psychiatry, Faculty of Medicine, Hacettepe University, Ankara, Turkey; 3Special Eye Clinic, Ankara, TurkeyBackground and aim: Optic neuritis (ON can be recurrent, with unilateral or bilateral presentation. Diagnosis of recurrent cases may be challenging. In this study long-term follow-up of recurrent and/or bilateral ON patients is reported in an effort to guide differential diagnosis and treatment.Methods: The study included 474 optic neuropathy patients. Of these, 70 patients with recurrent unilateral or bilateral, and nonrecurrent bilateral ON were assessed. The characteristics of each ON attack, laboratory and magnetic resonance imaging (MRI findings, associated diseases and response to treatment were noted for each patient. Most of the patients were reevaluated in the outpatient clinic. Seven patients were investigated for neuromyelitis optica (NMO-immunoglobulin G (IgG seropositivity.Results: Forty-seven patients had recurrent unilateral ON and 23 had bilateral ON. Mean follow-up was 7.55 years. Final diagnoses for recurrent unilateral group were multiple sclerosis (MS (n = 29, chronic relapsing inflammatory optic neuritis (CRION (n = 11, NMO (n = 4, or autoimmune thyroid disease (n = 3; and for bilateral ON group, MS (n = 4, vasculitis (n = 13, postinfectious ON (n = 4, and sarcoidosis (n = 2. Three patients were positive for NMO antibodies.Conclusion: Based on the data collected, we conclude when recurrent ON causes moderate to severe visual loss in the absence of cranial MRI findings typical of MS, other diagnoses should be considered, including NMO.Keywords: optic neuritis, recurrent, bilateral, multiple sclerosis, neuromyelitis optica

  20. Initial results and long-term clinical follow-up of an amorphous hydrogenated silicon-carbide-coated stent in daily practice.

    Science.gov (United States)

    Hanekamp, Clara EE; Bonnier, Hans JRM; Michels, Rolf H; Peels, Kathinka H; Heijmen, Eric PCM; Hagen Ev, Eduard van; Koolen, Jacques J

    1998-01-01

    The hemocompatibility and biocompatibility of a stent are determined by the physical and electrochemical properties of the stent surface. The aim of this study was to determine the feasibility, safety and efficacy of implantation of a stent coated with silicon carbide. Baseline characteristics were collected prospectively. The occurrence of cardiac adverse events and the angina score were assessed at clinical follow-up. A total of 193 Tensum stents were implanted in 174 patients. In hospital, one patient experienced stent thrombosis and in 6% of the patients a creatinine kinase elevation to 240 U/l or more occurred. Long-term follow-up was performed in 172 patients, with a mean follow-up of 454 +/- 181 days. Ninety-seven per cent were still alive, 15% had undergone target-vessel revascularization, and 2% had angiographic restenosis and were treated with medication only. Seventy-one per cent of the patients were free of anginal complaints, and 20% had anginal complaints in Canadian Cardiac Society class I or II. The Tensum coronary stent showed to be a safe and efficacious device in this study, with a high primary success rate and favorable long-term clinical followup. PMID:12623396

  1. HIV-exposed infants on follow up at a PMTCT clinic: risk of HIV transmission and its predictors in north-west Ethiopia

    Directory of Open Access Journals (Sweden)

    K Negesse

    2012-11-01

    Full Text Available Background: The HIV pandemic created an enormous challenge to the survival of mankind worldwide. Vertical HIV transmission from mother to child accounts for more than 90% of pediatric AIDS. Prevention of mother-to-child transmission (PMTCT programs are provided for dual benefits, i.e. prevention of HIV transmission from mother to child and enrolment of infected pregnant women and their families into antiretroviral treatment. The availability and use of short-course antiretroviral (ARV prophylaxis, a safe and well-tolerated regimen, can contribute significantly to PMTCT during childbirth. This study assessed risk and predictors of HIV transmission among HIV-exposed infants on follow up at a PMTCT clinic of a referral hospital. Methods: Institution-based retrospective follow-up study was carried out on all records of HIV-exposed infants enrolled between September 2005 and July 2011 at Gondar University Hospital PMTCT clinic. Secondary data were collected using a structured data extraction format prepared in English by a trained nurse working at the PMTCT clinic. Data were then entered in to EPI INFO Version 3.5.1 statistical software and analyzed by SPSS version 16.0. Both bivariate and multivariate analyses were carried out to identify variables that had association with vertical HIV transmission. Results: A total of 509 records were included in the analysis. The median age of infants at enrolment to follow up was 6 weeks (IQR=2 weeks. A total of 51 (10% infants were infected with HIV. Late enrolment to the exposed infant follow-up clinic (AOR=2.89, 95% CI: 1.35, 6.21, rural residence (AOR=5.05, 95% CI: 2.34, 10.9, delivery at home (AOR=2.82, 95% CI: 1.2, 6.64, absence of maternal PMTCT intervention (AOR=5.02, 95% CI: 2.43, 10.4 and mixed infant feeding practices (AOR=4.18, 95% CI: 1.59, 10.99 were significantly and independently associated with maternal-to-child HIV transmission. Conclusion: There is a high risk of MTCT of HIV among exposed

  2. Estimating bias from loss to follow-up in a prospective cohort study of bicycle crash injuries

    Science.gov (United States)

    Tin Tin, Sandar; Woodward, Alistair; Ameratunga, Shanthi

    2014-01-01

    Background Loss to follow-up, if related to exposures, confounders and outcomes of interest, may bias association estimates. We estimated the magnitude and direction of such bias in a prospective cohort study of crash injury among cyclists. Methods The Taupo Bicycle Study involved 2590 adult cyclists recruited from New Zealand's largest cycling event in 2006 and followed over a median period of 4.6 years through linkage to four administrative databases. We resurveyed the participants in 2009 and excluded three participants who died prior to the resurvey. We compared baseline characteristics and crash outcomes of the baseline (2006) and follow-up (those who responded in 2009) cohorts by ratios of relative frequencies and estimated potential bias from loss to follow-up on seven exposure-outcome associations of interest by ratios of HRs. Results Of the 2587 cyclists in the baseline cohort, 1526 (60%) responded to the follow-up survey. The responders were older, more educated and more socioeconomically advantaged. They were more experienced cyclists who often rode in a bunch, off-road or in the dark, but were less likely to engage in other risky cycling behaviours. Additionally, they experienced bicycle crashes more frequently during follow-up. The selection bias ranged between −10% and +9% for selected associations. Conclusions Loss to follow-up was differential by demographic, cycling and behavioural risk characteristics as well as crash outcomes, but did not substantially bias association estimates of primary research interest. PMID:24336816

  3. Endoscopic minimally invasive transforaminal interbody fusion without general anesthesia: initial clinical experience with 1-year follow-up.

    Science.gov (United States)

    Wang, Michael Y; Grossman, Jay

    2016-02-01

    OBJECTIVE One of the principal goals of minimally invasive surgery has been to speed postoperative recovery. In this case series, the authors used an endoscopic technique for interbody fusion combined with percutaneous screw fixation to obviate the need for general anesthesia. METHODS The first 10 consecutive patients treated with a minimum of 1 year's follow-up were included in this series. The patients were all treated using endoscopic access through Kambin's triangle to allow for neural decompression, discectomy, endplate preparation, and interbody fusion. This was followed by percutaneous pedicle screw and connecting rod placement using liposomal bupivacaine for long-acting analgesia. No narcotics or regional anesthetics were used during surgery. RESULTS All patients underwent the procedure successfully without conversion to open surgery. The patients' average age was 62.2 ± 9.0 years (range 52-78 years). All patients had severe disc height collapse, and 60% had a Grade I spondylolisthesis. The mean operative time was 113.5 ± 6.3 minutes (range 105-120 minutes), and blood loss was 65 ± 38 ml (range 30-190 ml). The mean length of hospital stay was 1.4 ± 1.3 nights. There were no intraoperative or postoperative complications. Comparison of preoperative and final clinical metrics demonstrated that the Oswestry Disability Index improved from 42 ± 11.8 to 13.3 ± 15.1; the 36-Item Short Form Health Survey (SF-36) Physical Component Summary improved from 47.6 ± 3.8 to 49.7 ± 5.4; the SF-36 Mental Component Summary decreased from 47 ± 3.9 to 46.7 ± 3.4; and the EQ-5D improved from 10.7 ± 9.5 to 14.2 ± 1.6. There were no cases of nonunion identified radiographically on follow-up imaging. CONCLUSIONS Endoscopic fusion under conscious sedation may represent a feasible alternative to traditional lumbar spine fusion in select patients. Larger clinical series are necessary to validate that clinical improvements are sustained and that arthrodesis rates are

  4. Chronic granulomatous disease with gastric antral narrowing: a study and follow-up by MRI

    International Nuclear Information System (INIS)

    We report the case of a boy with chronic septic granulomatosis (CSG) who presented with a marked gastric antrum narrowing which was evaluated by MRI after oral intake of magnetic contrast particles, and after gadolinium i.v. administration. In particular, a mammillated aspect of the gastric wall in the antral region was seen. Follow-up by MRI clearly showed the gradual resolution of hyperemic wall thickness, after medical management. The antral stenosis resolved after 3 months. Magnetic resonance imaging provides detailed evaluation of gastric wall inflammation in course of CSG. (orig.)

  5. Late juvenile metachromatic leukodystrophy treated with bone marrow transplantation; a 4-year follow-up study.

    Science.gov (United States)

    Navarro, C; Fernández, J M; Domínguez, C; Fachal, C; Alvarez, M

    1996-01-01

    We treated a 28-year-old woman who had metachromatic leukodystrophy with bone marrow transplantation. Leukocyte arylsulfatase A levels increased to the donor's range after successful graft. Motor and sensory nerve conduction values did not change significantly in the 4 years after the transplant, and subcortical white matter lesions, as shown on MRI, remained stable during that period of time. The results, after 4 years of follow-up, indicate that the disease has not progressed and signs and symptoms are stabilized. PMID:8559389

  6. Further follow-up study of workers from an asbestos cement factory.

    OpenAIRE

    Thomas, H F; Benjamin, I T; Elwood, P C; Sweetnam, P.M.

    1982-01-01

    A further follow-up traced 1970 workers employed at an asbestos cement factory for at least six months between 1936 and 1977. At the beginning of this period some crocidolite was used in the factory but by the end of 1936 chrysotile had become the only type of asbestos in use. Only 378 women were employed during the period concerned, and of the 30 who had died, none had a cause of death that is generally associated with exposure to asbestos. The mortality experience of the men was examined se...

  7. Sickness absence in hospital physicians: 2 year follow up study on determinants

    OpenAIRE

    Kivimaki, M.; Sutinen, R; Elovainio, M; Vahtera, J; Rasanen, K.; Toyry, S; Ferrie, J. E.; Firth-Cozens, J

    2001-01-01

    OBJECTIVES—To identify determinants of sickness absence in hospital physicians.
METHODS—The Poisson regression analyses of short (1-3 days) and long (>3 days) recorded spells of sickness absence relating to potential determinants of sickness absence were based on a 2 year follow up period and cohorts of 447 (251 male and 196 female) physicians and 466 controls (female head nurses and ward sisters).
RESULTS—There were no differences in health outcomes, self rated health status, prevalence of c...

  8. Follow-Up Testing

    Science.gov (United States)

    Follow-up Testing Follow-up testing is conducted to ensure that antibody levels are returning to normal, indicating that the intestine is healing on the ... has entered the diet. How often should follow-up testing occur? New celiacs should receive follow-up ...

  9. Retrospective Dosimetry and Clinical Follow-up Programme of Chernobyl Accident Clean-up Workers in Latvia

    International Nuclear Information System (INIS)

    Full text: About 6500 Latvian inhabitants were recruited for clean-up works at Chernobyl Nuclear Power Plant during 1986-1991. Absorbed doses for them are usually unknown, because only less then half of the clean-up workers cohort had officially documented external exposure. Clinical investigations show high morbidity rate of clean-up workers compared with general population. The results of Electronic Spin Resonance (ESR) dose reconstruction (doses absorbed in the tooth enamel) for the clean-up workers were always higher as documented of exposure doses of physical measurements. In many cases more than half of total absorbed dose is due to 90Sr accumulated in teeth. Most of the clean-up workers have poli-symptomatic sicknesses that exhibit tendency to progress, and their morbidity exceeds that observed in general population. ESR dosimetry programs and clinical follow-up improved existing knowledge in the field of radiation medicine. These data will help to develop and apply the proper treatment and rehabilitation procedures for clean-up workers. (author)

  10. Clinical, Radiographic, and Histologic Evaluation of Regional Odontodysplasia: a Case Report with 5-year Follow-up.

    Science.gov (United States)

    Jahanimoghadam, Fatemeh; Pishbin, Lida; Rad, Maryam

    2016-06-01

    Regional odontodysplasia is a developmental anomaly that affects the primary and permanent dentitions. This disorder is generally localized in only one arch and its etiology is still unknown. Clinically, the affected teeth have an abnormal morphology and are typically discolored. Radiographically, these teeth show a ghost-like appearance. This paper reported the results of radiographic, histologic and laboratory findings about the case of a 5-year-old girl presenting this rare anomaly. Her familial history was negative for any genetic anomaly, regional odontodysplasia or other dental anomalies. The patient's general health was good and no congenital or acquired disease was reported. She was kept under follow-up care until she reached the age of 10 years. Panoramic radiograph showed the involvement of permanent teeth on the right maxillary quadrant. The affected edentulous quadrant was rehabilitated with temporary acrylic maxillary partial denture. The presentation of this case would hopefully have valuable information for pediatric dentists to review the clinical and radiographic features of regional odontodysplasia, yet expediting the diagnosis and treatment of patients with this condition. PMID:27284563

  11. Clinical, Radiographic, and Histologic Evaluation of Regional Odontodysplasia: a Case Report with 5-year Follow-up

    Science.gov (United States)

    Jahanimoghadam, Fatemeh; Pishbin, Lida; Rad, Maryam

    2016-01-01

    Regional odontodysplasia is a developmental anomaly that affects the primary and permanent dentitions. This disorder is generally localized in only one arch and its etiology is still unknown. Clinically, the affected teeth have an abnormal morphology and are typically discolored. Radiographically, these teeth show a ghost-like appearance. This paper reported the results of radiographic, histologic and laboratory findings about the case of a 5-year-old girl presenting this rare anomaly. Her familial history was negative for any genetic anomaly, regional odontodysplasia or other dental anomalies. The patient’s general health was good and no congenital or acquired disease was reported. She was kept under follow-up care until she reached the age of 10 years. Panoramic radiograph showed the involvement of permanent teeth on the right maxillary quadrant. The affected edentulous quadrant was rehabilitated with temporary acrylic maxillary partial denture. The presentation of this case would hopefully have valuable information for pediatric dentists to review the clinical and radiographic features of regional odontodysplasia, yet expediting the diagnosis and treatment of patients with this condition. PMID:27284563

  12. Primary Whipple disease of the brain: case report with long-term clinical and MRI follow-up

    Directory of Open Access Journals (Sweden)

    Peregrin J

    2015-09-01

    Full Text Available Jan Peregrin,1 Hana Malikova2,3 1Department of Neurology, 2Department of Radiology, Na Homolce Hospital, 3Second Faculty of Medicine, Institute of Anatomy, Charles University, Prague, Czech Republic Abstract: Whipple disease (WD is a rare systemic disorder caused by the bacteria Tropheryma whipplei. In its classic form, it manifests with gastrointestinal problems including diarrhea, abdominal pain, and weight loss. However, various other systems can be affected, including the central nervous system (CNS. Even more rarely, the CNS is primarily affected without gastrointestinal symptoms and with a negative small bowel biopsy. The incidence of primary CNS WD is unknown. We report the case of a young female with the primary CNS form of WD. In this report, we highlight the main clinical features and diagnostic procedures that lead to the diagnosis and comment on the treatment and clinical response. We stress the importance of neuroimaging and brain biopsy. A unique feature of this case is that the patient has been followed up for 12 years. At the time of diagnosis, no neurological manifestations were detected, although a tumor-like lesion in the right temporal lobe and hypothalamic infiltration were present on magnetic resonance imaging (MRI. The first neurological manifestations developed 2 years later despite recommended antibiotic treatment, with cognitive impairment developing more than 10 years later. According to the MRI findings and clinical course, the disease was active for several years when multiple lesions on MRI appeared despite antibiotic therapy. In the discussion, we compare the present case with similar cases previously reported and we elaborate on the similarities and discrepancies in clinical features, diagnostic procedures, results, and treatment options. Keywords: central nervous system, brain biopsy, antibiotic treatment

  13. Comparison of magnetic resonance imaging signs and clinical findings in follow-up examinations in children and juveniles with temporomandibular joint involvement in juvenile idiopathic arthritis; Vergleich magnetresonanztomografischer und klinischer Befunde von Follow-up-Untersuchungen bei Kindern und Jugendlichen mit rheumatischer Temporomandibulararthritis

    Energy Technology Data Exchange (ETDEWEB)

    Mussler, A.; Schroeder, R.J. [Charite Berlin (Germany). Radiologie; Allozy, B. [Martin-Gropius-Krankenhaus, Eberswalde (Germany). Klinik fuer Kinder- und Jugendpsychiatrie; Landau, H. [Charite Berlin (Germany). Inst. fuer Kieferorthopaedie, Orthodontie und Kinderzahnmedizin; Kallinich, T. [Charite Berlin (Germany). Centrum fuer Frauen-, Kinder- und Jugendmedizin; Trauzeddel, R. [HELIOS Klinikum Berlin-Buch (Germany). Klinik fuer Kinder- und Jugendmedizin

    2010-01-15

    The aim of this study was to analyze the extent to which pathological findings of temporomandibular joint (TMJ) in magnetic resonance imaging (MRI) follow-up examinations are correlated with clinical symptoms in patients with TMJ involvement in juvenile ideopathic arthritis (JIA) over time. Data from 34 patients with TMJ involvement in JIA was retrospectively examined. Shortly after two clinical examinations, the first MRI and the follow-up MRI were performed. The MRI examinations took place with 1.5 T MRI. In both MRI examinations alterations on the condyle (MRI1: 88 %, MRT2: 91 %) and contrast enhancement (MRT1: 76 %, MRT2 65 %) were found most frequently. TMJ pain (65 %) and lower mouth opening capacity (65 %) were the number one finding in the first clinical examination. A statistically significant correlation was found between the alterations on the condyle and TMJ pain (p = 0.025) and between the alterations on the condyle and lower mouth opening capacity (p = 0.019). By comparing the results of the first MRI with the results of the follow-up MRI, we identified a trend towards a progression of TMJ arthritis, while the clinical follow-up showed an improvement in most patients. We found a discrepancy between the progressive or stable trends of pathological findings in follow-up MRI and the decrease in clinical symptoms over time. Therefore, follow-up examination by MRI shows important information for correct evaluation about the stage of TMJ arthritis and about the need for treatment. Consequently, follow-up examination by MRI is an appropriate addition to clinical examination in the therapeutic concept. (orig.)

  14. Gastrin and antral G cells in course of Helicobacter pylori eradication: Six months follow up study

    Institute of Scientific and Technical Information of China (English)

    Aleksandra Sokic-Milutinovic; Vera Todorovic; Tomica Milosavljevic; Marjan Micev; Neda Drndarevic; Olivera Mitrovic

    2005-01-01

    AIM: To assess long-term effects of Helicobacter pylori (H pylori) eradication on antral G cell morphology and function in patients with and without duodenal ulcer (DU).METHODS: Consecutive dyspeptic patients referred to the endoscopy entered the study. Out of 39 H pylori positive patients, 8 had DU (H pylori+DU) and 31 gastritis (H pylori +G). Control groups consisted of 11 uninfected dyspeptic patients (CG1) and 7 healthy volunteers (CG2). Basal plasma gastrin (PGL), antral tissue gastrin concentrations (ATGC), immunohistochemical and electron microscopic characteristics of G cells were determined, prior to and 6 mo after therapy.RESULTS: We demonstrated elevated PGL in infected patients compared to uninfected controls prior to therapy.Elevated PGL were registered in all H pylori+patients (H pylori +DU: 106.78±22.72 pg/mL, H pylori+G: 74.95±15.63,CG1: 68.59±17.97, CG2:39.24±5.59 pg/mL, P<0.01).Successful eradication (e) therapy in H pylori+patients lead to significant decrease in PGL (H pylori+DU: 59.93±9.40and H pylori+Ge: 42.36±10.28 pg/mL, P<0.001). ATGC at the beginning of the study were similar in infected and uninfected patients and eradication therapy lead to significant decrease in ATGC in H pylori+gastritis, but not in DU patients. In the H pylori+DU patients, the mean number of antral G cells was significantly lower in comparison with all other groups (P<0.01), but after successful eradication was close to normal values found in controls. By contrast, G cell number and volume density were significantly decreased (P<0.01) in H pylori+Ge group after successful eradication therapy (294±32 and 0.31±0.02,respectively), in comparison to values before eradication (416±40 and 0.48±0.09). No significant change of the G cell/total endocrine cell ratio was observed during the 6 mo of follow up in any of the groups. A reversible increase in G cell secretory function was seen in all infected individuals, demonstrated by a more prominent secretory

  15. Day Hospital Treatment for Anorexia Nervosa: A 12-Month Follow-up Study.

    Science.gov (United States)

    Abbate-Daga, Giovanni; Marzola, Enrica; De-Bacco, Carlotta; Buzzichelli, Sara; Brustolin, Annalisa; Campisi, Stefania; Amianto, Federico; Migliaretti, Giuseppe; Fassino, Secondo

    2015-09-01

    Day hospitals (DHs) represent a treatment option for anorexia nervosa (AN), a mental disorder that is difficult to treat and has no evidence-based treatments available. We aimed to determine the effectiveness of a DH treatment that was specifically focused on the emotions of severe AN patients. Body mass index and eating psychopathology were the primary outcome measures. Fifty-six adult patients with AN were assessed upon admission, at the end of treatment (EOT) and at a 12-month follow-up evaluation (T18) using Eating Disorders Inventory-2, Beck Depression Inventory, Hamilton Rating Scale for Anxiety and Brief Social Phobia Scale. All participants received a multidisciplinary treatment programme that focused on psychodynamic psychotherapy. Seventy-eight per cent of participants reported positive outcomes at EOT and 68% at T18. Moreover, 82.1% and 65.4% of long-standing patients showed positive outcomes at EOT and T18, respectively. All measures of psychopathology were significantly improved at EOT and were maintained at follow-up. Our DH was effective at treating severe AN patients; however, further investigations of the processes of change are warranted. PMID:25974364

  16. Cherubism: An Unusual Study With Long-Term Follow-Up.

    Science.gov (United States)

    Shokri, Abbas; Khavid, Atefeh

    2016-07-01

    Cherubism is an uncommon hereditary benign fibro-osseous disorder characterized by bilateral enlargement of the mandible and the maxilla that presents with varying degrees of involvement and a tendency toward spontaneous remission.The first visit was in 2002. A 16-year-old female was referred to an orthodontist for correction of her dental crowding. In the radiographic examination that was taken for her treatment the first time in 2002, a jaw bone lesion was discovered accidentally. X-ray panoramic imaging revealed well-defined multilocular radiolucencies involving the posterior body of the mandible and ascending rami with displaced teeth. This lesion had no effect on inferior alveolar canal and maxilla.There was no significant past medical history, and there was no family history suggestive of a similar complaint. On extraoral examination, there was no swelling in both rami of the mandible and face. Histopathological examination of the biopsy specimen showed proliferating fibrous connective tissue interspersed by multinucleated giant cells. It was diagnosed as a case nonfamilial cherubism. An extensive long-term follow-up till 12 years was maintained. In 2014, after 12-years follow-up for this lesion, panoramic imaging examination showed progress of this lesion in mandible and maxilla. PMID:27315317

  17. Nutritional status of young children in Mumbai slums: a follow-up anthropometric study

    Directory of Open Access Journals (Sweden)

    Das Sushmita

    2012-11-01

    Full Text Available Abstract Background Chronic childhood malnutrition remains common in India. As part of an initiative to improve maternal and child health in urban slums, we collected anthropometric data from a sample of children followed up from birth. We described the proportions of underweight, stunting, and wasting in young children, and examined their relationships with age. Methods We used two linked datasets: one based on institutional birth weight records for 17 318 infants, collected prospectively, and one based on follow-up of a subsample of 1941 children under five, collected in early 2010. Results Mean birth weight was 2736 g (SD 530 g, with a low birth weight ( Discussion Our data support the idea that much of growth faltering was explained by faltering in height for age, rather than by wasting. Stunting appeared to be established early and the subsequent decline in height for age was limited. Our findings suggest a focus on a younger age-group than the children over the age of three who are prioritized by existing support systems. Funding The trial during which the birth weight data were collected was funded by the ICICI Foundation for Inclusive Growth (Centre for Child Health and Nutrition, and The Wellcome Trust (081052/Z/06/Z. Subsequent collection, analysis and development of the manuscript was funded by a Wellcome Trust Strategic Award: Population Science of Maternal and Child Survival (085417ma/Z/08/Z. D Osrin is funded by The Wellcome Trust (091561/Z/10/Z.

  18. A follow-up study on extracorporeal fixation of condylar fractures using vertical ramus osteotomy

    OpenAIRE

    Park, Sung Yong; Im, Jae Hyoung; Yoon, Seong Hoe; Lee, Dong Kun

    2014-01-01

    Objectives The aim of this study is to report the results of extracorporeal fixation in patients with mandibular condylar fractures and compare them with the clinical results of conservative treatment. Materials and Methods The medical records of 92 patients (73 male [M] : 19 female [F], age 13-69 years, mean 33.1 years) treated for condylar fractures at the Department of Oral and Maxillofacial Surgery in Sun Dental Hospital (Daejeon, Korea) from 2007 to 2012 were reviewed. Patients were divi...

  19. A prospective clinical evaluation of different single-tooth restoration designs on osseointegrated implants. A 3-year follow-up of Brånemark implants.

    Science.gov (United States)

    Wannfors, K; Smedberg, J I

    1999-12-01

    Since single-tooth implant restorations were introduced 12 years ago (Jemt 1986), there has been continuous development both in the technical design and the aesthetic outcome of the treatment. In order to ensure high quality in single-tooth implant treatments a clinical follow-up study was carried out on patients treated with modifications to the original regimen. In this study 69 consecutive patients were provided with 80 single-tooth implant restorations. The patients were followed for 3 years. There was continuous development of the prosthetic design during the time of the study, allowing us to analyse possible prognostic differences for the different prosthetic treatments. This study confirms earlier reports which describe the single-tooth implant treatment as a safe method with few surgical complications and minimal marginal bone loss. Only 1 implant was lost during the follow-up period and the average marginal bone loss was 0.48 mm over the 3-year follow-up period. Crowns veneered with acrylic and with gold casted directly to the abutments, screwed onto the implants, led to recurring prosthetic complications and gave an appearance of rapid ageing. The first generation of crowns made following the Cera-One design, sometimes produced a gap between the crown and the abutment associated with significant marginal bone loss during the first year. Few surgical or prosthetic complications were noted with cemented all-ceramic constructions, although the number of these crowns in this study was limited. PMID:10740454

  20. Statin Use and the Risk of Kidney Disease With Long-Term Follow-Up (8.4-Year Study).

    Science.gov (United States)

    Acharya, Tushar; Huang, Jian; Tringali, Steven; Frei, Christopher R; Mortensen, Eric M; Mansi, Ishak A

    2016-02-15

    Few studies have examined long-term effects of statin therapy on kidney diseases. The objective of this study was to determine the association of statin use with incidence of acute and chronic kidney diseases after prolonged follow-up. In this retrospective cohort study, we analyzed data from the San Antonio area military health care system from October 2003 through March 2012. Statin users were propensity score matched to nonusers using 82 baseline characteristics including demographics, co-morbidities, medications, and health care utilization. Study outcomes were acute kidney injury, chronic kidney disease (CKD), and nephritis/nephrosis/renal sclerosis. Of the 43,438 subjects included, we propensity score matched 6,342 statin users with 6,342 nonusers. Statin users had greater odds of acute kidney injury (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.14 to 1.48), CKD (OR 1.36, 95% CI 1.22 to 1.52), and nephritis/nephrosis/renal sclerosis (OR 1.35, 95% CI 1.05 to 1.73). In a subset of patients without co-morbidities, the association of statin use with CKD remained significant (OR 1.53, 95% CI 1.27 to 1.85). In a secondary analysis, adjusting for diseases/conditions that developed during follow-up weakened this association. In conclusion, statin use is associated with increased incidence of acute and chronic kidney disease. These findings are cautionary and suggest that long-term effects of statins in real-life patients may differ from shorter term effects in selected clinical trial populations. PMID:26742473

  1. Spinal cord lesions in patients with neuromyelitis optica: a retrospective long-term MRI follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Krampla, Wolfgang; Hruby, Walter [SMZ-Ost Donauspital, Department of Radiology, Vienna (Austria); Aboul-Enein, Fahmy; Jecel, Julia; Kristoferitsch, Wolfgang [SMZ-Ost Donauspital, Department of Neurology, Vienna (Austria); Lang, Wilfried [Hospital of Barmherzige Brueder, Department of Neurology, Vienna (Austria); Fertl, Elisabeth [Krankenanstalt Rudolfstiftung, Department of Neurology, Vienna (Austria)

    2009-10-15

    Neuromyelitis optica (NMO) is characterised by a particular pattern of the optic nerves and the spinal cord. Long-term MRI follow-up studies of spinal NMO lesions are rare, or limited by short observation periods. In nine patients with definite NMO or recurrent longitudinally extensive transverse myelitis (LETM) with NMO-IgG serum antibodies, repeated MRI examinations of the spine were carried out over a period of up to 11 years and evaluated regarding the changes over time in this retrospective study. In eight patients spinal cord lesions were located centrally, involving the grey and white matter. In the first examination after clinical onset changes resembled a stroke of the anterior spinal artery in two patients. Symmetrical signal alterations within the grey matter were observed. In one patient this pattern was transient, but it remained in the other. During the chronic stage, either a variable degree of spinal cord atrophy and high signal alterations, or almost complete remission of the lesions, was observed. Spinal MRI of patients with NMO myelitis can resemble a stroke. MRI of acute NMO stages did not allow a prediction of the clinical outcome. To a variable degree, NMO left behind typical defects which correlated with the clinical outcome. (orig.)

  2. Spinal cord lesions in patients with neuromyelitis optica: a retrospective long-term MRI follow-up study

    International Nuclear Information System (INIS)

    Neuromyelitis optica (NMO) is characterised by a particular pattern of the optic nerves and the spinal cord. Long-term MRI follow-up studies of spinal NMO lesions are rare, or limited by short observation periods. In nine patients with definite NMO or recurrent longitudinally extensive transverse myelitis (LETM) with NMO-IgG serum antibodies, repeated MRI examinations of the spine were carried out over a period of up to 11 years and evaluated regarding the changes over time in this retrospective study. In eight patients spinal cord lesions were located centrally, involving the grey and white matter. In the first examination after clinical onset changes resembled a stroke of the anterior spinal artery in two patients. Symmetrical signal alterations within the grey matter were observed. In one patient this pattern was transient, but it remained in the other. During the chronic stage, either a variable degree of spinal cord atrophy and high signal alterations, or almost complete remission of the lesions, was observed. Spinal MRI of patients with NMO myelitis can resemble a stroke. MRI of acute NMO stages did not allow a prediction of the clinical outcome. To a variable degree, NMO left behind typical defects which correlated with the clinical outcome. (orig.)

  3. GuLF Study: The Gulf Long-Term Follow-Up Study

    Science.gov (United States)

    ... font size, or print this page. The GuLF STUDY Gulf Study Newsletter Learn more about the 33,000 people ... linkage to cancer and mortality records. The GuLF STUDY wants you! If you completed a telephone interview ...

  4. Valvular Abnormalities Detected by Echocardiography in 5-Year Survivors of Childhood Cancer: A Long-Term Follow-Up Study

    International Nuclear Information System (INIS)

    Purpose: To determine the prevalence of valvular abnormalities after radiation therapy involving the heart region and/or treatment with anthracyclines and to identify associated risk factors in a large cohort of 5-year childhood cancer survivors (CCS). Methods and Materials: The study cohort consisted of all 626 eligible 5-year CCS diagnosed with childhood cancer in the Emma Children's Hospital/Academic Medical Center between 1966 and 1996 and treated with radiation therapy involving the heart region and/or anthracyclines. We determined the presence of valvular abnormalities according to echocardiograms. Physical radiation dose was converted into the equivalent dose in 2-Gy fractions (EQD2). Using multivariable logistic regression analyses, we examined the associations between cancer treatment and valvular abnormalities. Results: We identified 225 mainly mild echocardiographic valvular abnormalities in 169 of 545 CCS (31%) with a cardiac assessment (median follow-up time, 14.9 years [range, 5.1-36.8 years]; median attained age 22.0 years [range, 7.0-49.7 years]). Twenty-four CCS (4.4%) had 31 moderate or higher-graded abnormalities. Most common abnormalities were tricuspid valve disorders (n=119; 21.8%) and mitral valve disorders (n=73; 13.4%). The risk of valvular abnormalities was associated with increasing radiation dose (using EQD2) involving the heart region (odds ratio 1.33 per 10 Gy) and the presence of congenital heart disease (odds ratio 3.43). We found no statistically significant evidence that anthracyclines increase the risk. Conclusions: Almost one-third of CCS treated with potentially cardiotoxic therapy had 1 or more asymptomatic, mostly mild valvular abnormalities after a median follow-up of nearly 15 years. The most important risk factors are higher EQD2 to the heart region and congenital heart disease. Studies with longer follow-up are necessary to investigate the clinical course of asymptomatic valvular abnormalities in CCS

  5. Valvular Abnormalities Detected by Echocardiography in 5-Year Survivors of Childhood Cancer: A Long-Term Follow-Up Study

    Energy Technology Data Exchange (ETDEWEB)

    Pal, Helena J. van der, E-mail: h.j.vanderpal@amc.uva.nl [Department of Medical Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Dijk, Irma W. van [Department of Radiation Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Geskus, Ronald B. [Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Kok, Wouter E. [Department of Cardiology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Koolen, Marianne; Sieswerda, Elske [Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Oldenburger, Foppe; Koning, Caro C. [Department of Radiation Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Leeuwen, Flora E. van [Department of Epidemiology, Netherlands Cancer Institute, Amsterdam (Netherlands); Caron, Huib N.; Kremer, Leontien C.; Dalen, Elvira C. van [Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands)

    2015-01-01

    Purpose: To determine the prevalence of valvular abnormalities after radiation therapy involving the heart region and/or treatment with anthracyclines and to identify associated risk factors in a large cohort of 5-year childhood cancer survivors (CCS). Methods and Materials: The study cohort consisted of all 626 eligible 5-year CCS diagnosed with childhood cancer in the Emma Children's Hospital/Academic Medical Center between 1966 and 1996 and treated with radiation therapy involving the heart region and/or anthracyclines. We determined the presence of valvular abnormalities according to echocardiograms. Physical radiation dose was converted into the equivalent dose in 2-Gy fractions (EQD{sub 2}). Using multivariable logistic regression analyses, we examined the associations between cancer treatment and valvular abnormalities. Results: We identified 225 mainly mild echocardiographic valvular abnormalities in 169 of 545 CCS (31%) with a cardiac assessment (median follow-up time, 14.9 years [range, 5.1-36.8 years]; median attained age 22.0 years [range, 7.0-49.7 years]). Twenty-four CCS (4.4%) had 31 moderate or higher-graded abnormalities. Most common abnormalities were tricuspid valve disorders (n=119; 21.8%) and mitral valve disorders (n=73; 13.4%). The risk of valvular abnormalities was associated with increasing radiation dose (using EQD{sub 2}) involving the heart region (odds ratio 1.33 per 10 Gy) and the presence of congenital heart disease (odds ratio 3.43). We found no statistically significant evidence that anthracyclines increase the risk. Conclusions: Almost one-third of CCS treated with potentially cardiotoxic therapy had 1 or more asymptomatic, mostly mild valvular abnormalities after a median follow-up of nearly 15 years. The most important risk factors are higher EQD{sub 2} to the heart region and congenital heart disease. Studies with longer follow-up are necessary to investigate the clinical course of asymptomatic valvular abnormalities

  6. Anemia after gastrectomy for early gastric cancer:Long-term follow-up observational study

    Institute of Scientific and Technical Information of China (English)

    Chul-Hyun Lim; Sang Woo Kim; Won Chul Kim; Jin Soo Kim; Yu Kyung Cho; Jae Myung Park; In Seok Lee

    2012-01-01

    AIM:To identify the incidence and etiology of anemia after gastrectomy in patients with long-term follow-up after gastrectomy for early gastric cancer.METHODS:The medical records of those patients with early gastric adenocarcinoma who underwent curative gastrectomy between January 2006 and October 2007 were reviewed.Patients with anemia in the preoperative workup,cancer recurrence,undergoing systemic chemotherapy,with other medical conditions that can cause anemia,or treated during follow up with red cell transfusions or supplements for anemia were excluded.Anemia was defined by World Health Organization criteria (Hb < 12 g/dL in women and <13 g/dL in men).Iron deficiency was defined as serum ferritin < 20 μg/dL.Vitamin B12 deficiency was defined as serum vitamin B12 < 200 pg/mL.Iron deficiency anemia was defined as anemia with concomitant iron deficiency.Anemia from vitamin B12 deficiency was defined as megaloblastic anemia (mean cell volume >100 fL) with vitamin B12 deficiency.The profile of anemia over 48 mo of follow-up was analyzed.RESULTS:One hundred sixty-one patients with gastrectomy for early gastric cancer were analyzed.The incidence of anemia was 24.5% at 3 mo after surgery and increased up to 37.1% at 48 mo after surgery.The incidence of iron deficiency anemia increased during the follow up and became the major cause of anemia at 48 mo after surgery.Anemia of chronic disease and megaloblastic anemia were uncommon.The incidence of anemia in female patients was significantly higher than in male patients at 12 (40.0% vs 22.0%,P =0.033),24 (45.0% vs 25.0%,P =0.023),36 (55.0%vs 28.0%,P =0.004),and 48 mo (52.0% vs 31.0%,P =0.022) after surgery.Patients with total gastrectomy showed significantly higher incidence of anemia than patients with subtotal gastrectomy at 48 mo after surgery (60.7% vs 31.3%,P =0.008).The incidence of iron deficiency was significantly higher in female patients than in male patients at 6 (35.4% vs

  7. Recidivistic offending and mortality in alcoholic violent offenders: a prospective follow-up study.

    Science.gov (United States)

    Tikkanen, Roope; Holi, Matti; Lindberg, Nina; Tiihonen, Jari; Virkkunen, Matti

    2009-06-30

    Predictive data supporting prevention of violent criminality are scarce. We examined risk factors for recidivism and mortality among non-psychotic alcoholic violent offenders, the majority having antisocial or borderline personality disorders, or both, which is a group that commits the majority of violent offences in Finland. Criminal records and mortality data on 242 male alcoholic violent offenders were analysed after a 7- to 15-year follow-up, and compared between themselves and with those of 1210 age-, sex- and municipality-matched controls. Recidivism and mortality rates were high. The risk of recidivistic violence was increased by antisocial or borderline personality disorder, or both, childhood maltreatment, and a combination of these. A combination of borderline personality disorder and childhood maltreatment was particularly noxious, suggesting an additive risk increase for a poor outcome. Accurate diagnosis and careful childhood interview may help to predict recidivism and premature death. PMID:19467714

  8. Follow-up study of children with cerebral coordination disturbance (CCD, Vojta).

    Science.gov (United States)

    Imamura, S; Sakuma, K; Takahashi, T

    1983-01-01

    713 children (from newborn to 12-month-old) with delayed motor development were carefully examined and classified into normal, very light cerebral coordination disturbance (CCD, Vojta), light CCD, moderate CCD, severe CCD, suspected cerebral palsy (CP) and other diseases at their first visit, and were followed up carefully. Finally, 89.0% of very light CCD, 71.4% of light CCD, 56.0% of moderate CCD and 30.0% of severe CCD developed into normal. 59.5% of moderate CCD and 45.5% of severe CCD among children who were given Vojta's physiotherapy developed into normal. The classification of cases with delayed motor development into very light, light, moderate and severe CCD based on the extent of abnormality in their postural reflexes is useful and well correlated with their prognosis. Treatment by Vojta's method seems to be efficient and helpful for young children with delayed motor development. PMID:6614390

  9. Mindfulness-based program for management of aggression among youth: A follow-up study

    Directory of Open Access Journals (Sweden)

    Manoj Kumar Sharma

    2016-01-01

    Full Text Available Background: Youth have shown indulgence in various high-risk behaviors and violent activities. Yoga-based approaches have been used for the management of psychological problems. The present work explores the role of mindfulness-based program in the management of aggression among youth. Materials and Methods: Sociodemographic information schedule, Buss-Perry Aggression Questionnaire, and World Health Organization quality of life were administered on 50 subjects in the age range of 18-25 years at pre- and post-mindfulness-based program level. Results: It revealed the presence of feeling of well-being and ability to relax themselves; changes in score of anger, hostility, physical, and verbal aggression; and enhancement of quality of life in the physical and environment domains at 1 month follow-up. Conclusions: Mindfulness-based program has shown changes in aggression expression/control and implies integration of it in available program for the management of aggression among youth.

  10. Subjective memory complaints in general practice predicts future dementia: a 4-year follow-up study

    DEFF Research Database (Denmark)

    Waldorff, Frans Boch; Vogel, Asmus Mejling; Siersma, Volkert Dirk;

    2012-01-01

    OBJECTIVE: Many older patients in general practice have subjective memory complaints (SMC); however, not all share this information with their general practitioner (GP). The association between SMC and future cognitive decline or dementia is not clear, especially in a general practice population......-nursing home residents aged 65 years and older consulted their GP in October and November 2002, and, when asked, 177 (24%) reported memory problems, and 50 (6.6%) received a hospital-based dementia diagnosis within the 4-years follow-up. SMC had an adjusted Hazard Ratio (HR) of 2.27 for subsequent dementia...... independent predictor for subsequent hospital-based dementia diagnosis. Thus, the GP could consider inquiring for memory complaints to identify vulnerable older patients....

  11. SLUDGE BATCH 4 FOLLOW-UP QUALIFICATION STUDIES TO EVALUATE HYDROGEN GENERATION

    Energy Technology Data Exchange (ETDEWEB)

    Pareizs, J; David Koopman, D; Dan Lambert, D; Cj Bannochie, C

    2007-08-23

    Follow-up testing was conducted to better understand the excessive hydrogen generation seen in the initial Sludge Batch 4 (SB4) qualification Sludge Receipt and Adjustment Tank/Slurry Mix Evaporator (SRAT/SME) simulation in the Savannah River National Laboratory (SRNL) Shielded Cells. This effort included both radioactive and simulant work. The initial SB4 qualification test produced 0.59 lbs/hr hydrogen in the SRAT, which was just below the DWPF SRAT limit of 0.65 lbs/hr, and the test produced over 0.5 lbs/hr hydrogen in the SME cycle on two separate occasions, which were over the DWPF SME limit of 0.223 lbs/hr.

  12. Study on preimplantation genetic diagnosis and follow-up for Duchenne muscular dystrophy

    Directory of Open Access Journals (Sweden)

    Juan YANG

    2015-07-01

    Full Text Available Objective  To carry out preimplantation genetic diagnosis (PGD for Duchenne muscular dystrophy (DMD carrier, so as to prevent the birth of affected infants with DMD.  Methods  One DMD gene carrier with a deletion of exon 10-30 received fertilization with intracytoplasmic sperm injection (ICSI. DMD gene and haplotype were tested after amplification of genome DNA in multiple displacement amplification (MDA, then healthy embryos were transferred to uterus according to the genetic results. Genetic testing was made in second trimester and after delivery, and also periodic follow-up was made for over 3 years.  Results  The second cycle of PGD was successful, and a total of 14 single blastomeres obtained from 7 embryos were used for genetic analysis. The success rate of MDA was 13/14, and the allele dropout rate was 18.75% (18/96. Three unaffected embryos were transferred, resulting in twin pregnancy. One healthy boy and one healthy girl were born in cesarean section at the pregnant week of 35. Genetic results on DNA from both amniotic fluid at 16 weeks of gestation and peripheral blood after birth were normal. During the 3-year follow-up, both 2 infants were normal in growth and development, motor function and dynamic monitor of serum creatine kinase (CK.  Conclusions  Preimplantation genetic diagnosis can help DMD gene carrier give birth to healthy infants, and these infants have normal development. DOI: 10.3969/j.issn.1672-6731.2015.06.008

  13. Cervical disc herniation. Follow-up studies on morphological changes seen by MRI

    Energy Technology Data Exchange (ETDEWEB)

    Nagata, Kensei; Ohashi, Teruaki; Ishibashi, Kazumasa; Abe, Jun; Morita, Masakazu; Hirohashi, Akiyuki; Satou, Kimiaki; Ishida, Hyota; Inoue, Akio [Kurume Univ., Fukuoka (Japan). School of Medicine

    1996-03-01

    In recent years, many authors have reported that an extruded lumbar intervertebral disc was absorbed through phagocytosis and dehydration. However, absorption of an extruded cervical intervertebral disc has rarely been reported. We have investigated the follow-up MRI of all 24 patients with cervical disc herniation seen between 1991 and 1995. Of these, 8 patients with radiculopathy and 7 with myelopathy had been treated nonoperatively, and a further 9 patients with severe myelopathy had undergone expansive laminoplasty. In follow-up MRI, a reduction in the size of the extruded disc was seen in 5 of the 15 nonoperative patients and in 8 of the 9 operative patients. The 9 operative patients showed a mean recovery rate of 68.4{+-}15.2% (range from 44 to 90%) according to their JOA score. In the nonoperative group, recovery of symptoms was seen in all 5 patients with reduction, and in only 4 of 10 patients with nonreduction. The initial MRI of the 5 patients with reduction was taken between 2 and 7 weeks (mean 4 weeks) after onset, and between 1 month and 14 years (mean 13 months, not including the one at 14 years) after onset in the 10 patients with nonreduction. The initial MRI of the 9 operative patients was taken between 1 month and 6 years (mean 14 months after onset). The pathomechanism for disc reduction was concluded to have been the same as for lumbar disc herniation in the nonoperative patients. However, the pathomechanism in the operative patients was inconclusive and was likely to be different from that in the nonoperative patients. (author).

  14. Cervical disc herniation. Follow-up studies on morphological changes seen by MRI

    International Nuclear Information System (INIS)

    In recent years, many authors have reported that an extruded lumbar intervertebral disc was absorbed through phagocytosis and dehydration. However, absorption of an extruded cervical intervertebral disc has rarely been reported. We have investigated the follow-up MRI of all 24 patients with cervical disc herniation seen between 1991 and 1995. Of these, 8 patients with radiculopathy and 7 with myelopathy had been treated nonoperatively, and a further 9 patients with severe myelopathy had undergone expansive laminoplasty. In follow-up MRI, a reduction in the size of the extruded disc was seen in 5 of the 15 nonoperative patients and in 8 of the 9 operative patients. The 9 operative patients showed a mean recovery rate of 68.4±15.2% (range from 44 to 90%) according to their JOA score. In the nonoperative group, recovery of symptoms was seen in all 5 patients with reduction, and in only 4 of 10 patients with nonreduction. The initial MRI of the 5 patients with reduction was taken between 2 and 7 weeks (mean 4 weeks) after onset, and between 1 month and 14 years (mean 13 months, not including the one at 14 years) after onset in the 10 patients with nonreduction. The initial MRI of the 9 operative patients was taken between 1 month and 6 years (mean 14 months after onset). The pathomechanism for disc reduction was concluded to have been the same as for lumbar disc herniation in the nonoperative patients. However, the pathomechanism in the operative patients was inconclusive and was likely to be different from that in the nonoperative patients. (author)

  15. Associations of Physical Activity and Sedentary Behavior with Academic Skills – A Follow-Up Study among Primary School Children

    Science.gov (United States)

    Haapala, Eero A.; Poikkeus, Anna-Maija; Kukkonen-Harjula, Katriina; Tompuri, Tuomo; Lintu, Niina; Väistö, Juuso; Leppänen, Paavo H. T.; Laaksonen, David E.; Lindi, Virpi; Lakka, Timo A.

    2014-01-01

    Background There are no prospective studies that would have compared the relationships of different types of physical activity (PA) and sedentary behavior (SB) with academic skills among children. We therefore investigated the associations of different types of PA and SB with reading and arithmetic skills in a follow-up study among children. Methods The participants were 186 children (107 boys, 79 girls, 6–8 yr) who were followed-up in Grades 1–3. PA and SB were assessed using a questionnaire in Grade 1. Reading fluency, reading comprehension and arithmetic skills were assessed using standardized tests at the end of Grades 1–3. Results Among all children more recess PA and more time spent in SB related to academic skills were associated with a better reading fluency across Grades 1–3. In boys, higher levels of total PA, physically active school transportation and more time spent in SB related to academic skills were associated with a better reading fluency across the Grades 1–3. Among girls, higher levels of total PA were related to worse arithmetic skills across Grades 1–3. Moreover, total PA was directly associated with reading fluency and arithmetic skills in Grades 1–3 among girls whose parents had a university degree, whereas these relationships were inverse in girls of less educated parents. Conclusions Total PA, physically active school transportation and SB related to academic skills may be beneficial for the development of reading skills in boys, whereas factors that are independent of PA or SB may be more important for academic skills in girls. Trial Registration ClinicalTrials.gov: NCT01803776 PMID:25207813

  16. Associations of physical activity and sedentary behavior with academic skills--a follow-up study among primary school children.

    Directory of Open Access Journals (Sweden)

    Eero A Haapala

    Full Text Available There are no prospective studies that would have compared the relationships of different types of physical activity (PA and sedentary behavior (SB with academic skills among children. We therefore investigated the associations of different types of PA and SB with reading and arithmetic skills in a follow-up study among children.The participants were 186 children (107 boys, 79 girls, 6-8 yr who were followed-up in Grades 1-3. PA and SB were assessed using a questionnaire in Grade 1. Reading fluency, reading comprehension and arithmetic skills were assessed using standardized tests at the end of Grades 1-3.Among all children more recess PA and more time spent in SB related to academic skills were associated with a better reading fluency across Grades 1-3. In boys, higher levels of total PA, physically active school transportation and more time spent in SB related to academic skills were associated with a better reading fluency across the Grades 1-3. Among girls, higher levels of total PA were related to worse arithmetic skills across Grades 1-3. Moreover, total PA was directly associated with reading fluency and arithmetic skills in Grades 1-3 among girls whose parents had a university degree, whereas these relationships were inverse in girls of less educated parents.Total PA, physically active school transportation and SB related to academic skills may be beneficial for the development of reading skills in boys, whereas factors that are independent of PA or SB may be more important for academic skills in girls.ClinicalTrials.gov: NCT01803776.

  17. Clinical practice guideline for the prevention, early detection, diagnosis, management and follow up of type 2 diabetes mellitus in adults.

    Science.gov (United States)

    Aschner, Pablo M; Muñoz, Oscar Mauricio; Girón, Diana; García, Olga Milena; Fernández-Ávila, Daniel Gerardo; Casas, Luz Ángela; Bohórquez, Luisa Fernanda; Arango T, Clara María; Carvajal, Liliana; Ramírez, Doris Amanda; Sarmiento, Juan Guillermo; Colon, Cristian Alejandro; Correa G, Néstor Fabián; Alarcón R, Pilar; Bustamante S, Álvaro Andrés

    2016-01-01

    In Colombia, diabetes mellitus is a public health program for those responsible for creating and implementing strategies for prevention, diagnosis, treatment, and follow-up that are applicable at all care levels, with the objective of establishing early and sustained control of diabetes. A clinical practice guide has been developed following the broad outline of the methodological guide from the Ministry of Health and Social Welfare, with the aim of systematically gathering scientific evidence and formulating recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. The current document presents in summary form the results of this process, including the recommendations and the considerations taken into account in formulating them. In general terms, what is proposed here is a screening process using the Finnish Diabetes Risk Score questionnaire adapted to the Colombian population, which enables early diagnosis of the illness, and an algorithm for determining initial treatment that can be generalized to most patients with diabetes mellitus type 2 and that is simple to apply in a primary care context. In addition, several recommendations have been made to scale up pharmacological treatment in those patients that do not achieve the objectives or fail to maintain them during initial treatment. These recommendations also take into account the evolution of weight and the individualization of glycemic control goals for special populations. Finally, recommendations have been made for opportune detection of micro- and macrovascular complications of diabetes. PMID:27546934

  18. CORONIS - International study of caesarean section surgical techniques: the follow-up study.

    OpenAIRE

    Abalos, E.; Oyarzun, E; Addo, V; Sharma, JB; Matthews, J.; Oyieke, J.; Masood, SN; El Sheikh, MA; Brocklehurst, P; Farrell, B; Gray, S.; Hardy, P.; N. Jamieson; Juszczak, E; Spark, P

    2013-01-01

    BACKGROUND: The CORONIS Trial was a 2×2×2×2×2 non-regular, fractional, factorial trial of five pairs of alternative caesarean section surgical techniques on a range of short-term outcomes, the primary outcome being a composite of maternal death or infectious morbidity. The consequences of different surgical techniques on longer term outcomes have not been well assessed in previous studies. Such outcomes include those related to subsequent pregnancy: mode of delivery; abnormal placentation (e....

  19. Does Maternal HIV Status Affect Infant Growth?: A Hospital Based Follow Up Study

    Directory of Open Access Journals (Sweden)

    Sangeeta Trivedi

    2012-08-01

    Full Text Available Introduction: HIV infection is difficult to diagnose in infants, as most infected babies appear healthy and exhibit no signs and symptoms at birth. The present study was conducted to study the clinical profile & morbidity pattern of infants born to HIV positive mothers, their nutritional status and growth pattern and compare them with HIV non exposed infants. Methodology: This observational longitudinal study was conducted in Dec 2009 – Dec 2010 where all HIV exposed baby born in the hospital (n=44 were compared with suitable sample of HIV non exposed babies (n=140 in context of clinical profile & morbidity pattern. Results: In maternal weight <50 Kg category, mean weight, length and head circumference of HIV exposed infants is significantly lower than HIV non exposed infants. However, pattern of weight gain remain similar in both group. Grade 1 and grade 2 malnutrition was more in HIV exposed group at 3 month & 6 month. HIV exposed baby reported higher episodes of diarrhea (28.57% as compared to non exposed group (15.33% with statistically significant difference (p value<0.05. Conclusion: HIV exposure does not adversely affect growth potential of infants but because of their lower baseline values they seem to lag behind. Moreover maternal HIV status does not lead to severe degree of malnutrition if these babies were not themselves affected with HIV. [Natl J of Med Res 2012; 2(4.000: 512-517

  20. Long-term effects of intermittent IL-2 in HIV infection: extended follow-up of the INSIGHT STALWART Study.

    Directory of Open Access Journals (Sweden)

    Norman Markowitz

    Full Text Available BACKGROUND: The Study of Aldesleukin with and without Antiretroviral Therapy (STALWART was designed to evaluate whether intermittent IL-2 alone or with peri-cycle ART increased CD4+ cell counts (and so delayed initiation of ART in HIV infected individuals having ≥ 300 CD4+ cells/mm(3 compared to untreated controls. When the results of two large clinical trials, ESPRIT and SILCAAT, showed no clinical benefit from IL-2 therapy, IL-2 administration was halted in STALWART. Because IL-2 recipients in STALWART experienced a greater number of opportunistic disease (OD or death and adverse events (AEs, participants were asked to consent to an extended follow-up phase in order to assess persistence of IL-2 effects. METHODOLOGY: Participants in this study were followed for clinical events and AEs every 4 months for 24 months. Unadjusted Cox proportional hazards models were used to summarize death, death or first OD event, and first grade 3 or 4 AE. PRINCIPAL FINDINGS: A total of 267 persons were enrolled in STALWART (176 randomized to the IL-2 arms and 91 to the no therapy arm; 142 individuals in the IL-2 group and 80 controls agreed to enter the extended follow-up study. Initiation of continuous ART was delayed in the IL-2 groups, but once started, resulted in similar CD4+ cell and viral load responses compared to controls. The hazard ratios (95% CI for IL-2 versus control during the extension phase for death or OD, grade 3 or 4 AE, and grade 4 AE were 1.45 (0.38, 5.45, 0.43 (0.24, 1.63 and 0.20 (0.04, 1.03, respectively. The hazard ratios for the AE outcomes were significantly lower during the extension than during the main study. CONCLUSIONS: Adverse events associated with IL-2 cycling did not persist upon discontinuation of IL-2. The use of IL-2 did not impact the subsequent response to initiation of cART.

  1. Effects of medical education on attitudes towards mental illness among medical students: a five-year follow-up study.

    Directory of Open Access Journals (Sweden)

    Mino Y

    2000-06-01

    Full Text Available In order to clarify the effects of medical education on attitudes towards mental illness among medical students, a follow-up study was conducted. All 100 students entering Kochi Medical School in 1988 were subjects. The initial questionnaire survey was conducted in 1988, and followed up in 1993. Response rate was 69% in the initial survey, and 83% in the follow-up study. By the time of the follow-up, all of the students had completed their medical education, including courses in psychiatry and mental health. Results were as follows: At the follow-up study, 1 a significantly higher percentage of students replied that they accepted the mentally ill as co-workers; 2 significantly favorable changes were observed in attitudes towards psychiatric services; 3 optimism about the effectiveness of treatment for mental illness at an early stage and prevention of mental illness had decreased; and 4 no change was observed in attitudes toward human rights of the mentally ill, except in the case of one item stating that the mentally ill should not have children in order to avoid hereditary handicaps, with which a lower percentage agreed. Conclusively, medical education can play an important role in attitudes towards mental illness.

  2. Endovenous laser treatment (EVLT) for the saphenous reflux and varicose veins: a follow-up study

    International Nuclear Information System (INIS)

    The aim of this study is to report our experience about endovenous laser treatment (EVLT) for lower extremity varices in our centre which was followed by ultrasonography during the 6-month period. During a 1-year period, 46 patients who were treated by EVLT with the 940-nm diode laser for venous insufficiency enrolled in the study. The diagnosis of greater saphenous vein (GSV) incompetence with reflux was made by clinical evaluation and duplex Doppler examinations. Clinical outcomes, complications and duplex ultrasound of the GSV were assessed within 1 week, 1 month, 3 months and 6 months, after the endovascular laser treatment. The mean age of our patients was 44 ± 11 years (24–70), and among them, 23 (50%) were male. Improvement in visible varicosity was seen in 39 (84.8%) patients after 6 months (P value=0.011). The baseline mean diameter of GSV was 4.9 ± 1.6 mm and it dropped to 3.5 ± 1.3 after 6 months (P<0.0001). After 6 months, 95.7% of our patients were satisfied and recommended this procedure to others. Endovascular laser ablation seems to be a safe and effective method for the treatment of lower limb varices.

  3. Prospective cohort study of a pharmacological follow-up program of anticoagulated patients admitted to nursing homes

    Directory of Open Access Journals (Sweden)

    Lluís Cuixart Costa

    2013-02-01

    Full Text Available Introduction. Anticoagulant treatment, despite providing a clear benefit to prevent and treat thrombo-embolic disease, is difficult to manage in routine practice. This is due to individual variability of dosing, narrow therapeutic margin, drug interactions, and side effects. An increasing number of patients admitted to nursing homes are under oral anticoagulant therapy because of deep venous thrombosis and, especially, atrial fibrillation. These are patients with a profile that makes prescription of anticoagulant treatment more difficult - elderly, taking multiple concomitant medications and with multiple ailments. Objetive. We hypothesized that the implementation of a primary care pharmacological follow-up program of oral anticoagulant therapy in patients admitted to nursing homes, with the purpose of coordinating the different professionals and care levels, would lead to greater benefit and reduction of side effects. Methods. A one-year descriptive prospective cohort study was conducted of 27 patients admitted to nursing homes who are under anticoagulation therapy followed by the primary care team. We analyzed different variables obtained from computerized medical records, from which indicators on the program were established (coverage and registration as well as outcome indicators (as defined by the British Committee for Standards in Haematology. Results. The profile of patients under anticoagulation and admitted to nursing homes is elderly (84 years, with a predominance of women (70%, atrial fibrillation as most frequent indication (70.4%, hypertension as major cardiovascular risk factor (92% and most of them on multiple drugs (92%. The analysis of the program results showed excellent coverage and registration indicators (100%. Outcome indicators also showed good results, with percentages of optimal international normalized ratio of 78% (exceeding the defined minimum standard and very low rates of complications (3%. Conclusions. The

  4. Evaluation of the combined application of ultrasound imaging techniques for middle cerebral artery stent surveillance and follow-up study.

    Directory of Open Access Journals (Sweden)

    Yu Wang

    Full Text Available OBJECTIVE: In recent years, cerebral artery stenting has become an effective method for the treatment of cerebral artery stenosis. However, methods for assessing efficacy and techniques for follow-up imaging still need to be developed. This study was designed to evaluate the application of transcranial color-coded sonography (TCCS in assessing stenting of middle cerebral artery (MCA stenosis. And, two new imaging techniques (vascular enhancement technology (VET and 3-dimensional (3D imaging were tried out and evaluated. METHOD: We enrolled 43 patients with cerebral artery stenosis for vascular stent implantation. All patients were examined by ultrasonography and confirmed through digital subtraction angiography. The stenosis was imaged and blood flow parameters were analyzed before and after the procedure using TCCS. VET and 3D imaging model were used in part of the patients. Important postoperative hemodynamic changes were noted. RESULTS: 1 Adequate stent image was present in 41 out of 43 patients as detected by postoperative 2-dimensional imaging. Images lacking clarity were obtained in 2 patients. 2 The perioperative and postoperative (one week follow-up instantaneous blood flow velocity at the site of stenosis was significantly decreased (P0.05. 3 VET imaging visualizes the MCA lumen and stent morphology clearly. 3D ultrasound can be used for imaging of the stent shape as well as its inner surface. CONCLUSION: TCCD can be considered a quick and effective clinical detection method to evaluate the intracranial arterial hemodynamics changes before and after stenting treatment for MCA stenosis. New imaging technologies 3D and VET can achieve additional image information.

  5. Recurrent falls in Parkinson's disease after one year of follow-up: A nested case-control study.

    Science.gov (United States)

    Gazibara, Tatjana; Tepavcevic, Darija Kisic; Svetel, Marina; Tomic, Aleksandra; Stankovic, Iva; Kostic, Vladimir S; Pekmezovic, Tatjana

    2016-01-01

    The aims of this study were to compare clinical and fall characteristics of single and recurrent falls among persons with PD and to evaluate factors associated with recurrent falls. A total of 120 consecutive persons with PD, who denied having fallen in the past 6 months, were recruited. Occurrence of falling was registered during one year. Each person was given a "fall diary" with the aim at writing characteristics of the fall and contacted by telephone each month. Over one year of follow-up 42 persons with PD (35.0%) reported falling. Of 42 persons, 19 (45.2%) went on to become single and 23 (54.8%) went on to become recurrent fallers. Indoor falls were more common among single fallers, whilst outdoor falls were more common among recurrent fallers (p=0.017). Slipping and freezing of gait was more common among single fallers (p=0.035 and p=0.024, respectively). Lower extremity weakness was more frequent among recurrent fallers (p=0.023). The most common injury both among single and recurrent fallers was the soft-tissue contusion. The only factor associated with recurrent falling among persons with PD, who did not fall in past 6 months before the start of follow-up, was worse motor performance as measured by the UPDRS III score (odds ratio [OR]=1.06, 95% confidence interval [CI] 1.01-1.11, p=0.022). These results could be used in selection of persons with PD to enroll in fall prevention programs. PMID:26921677

  6. MIME robotic device for upper-limb neurorehabilitation in subacute stroke subjects: A follow-up study.

    Science.gov (United States)

    Lum, Peter S; Burgar, Charles G; Van der Loos, Machiel; Shor, Peggy C; Majmundar, Matra; Yap, Ruth

    2006-01-01

    This study presents results from a randomized controlled clinical trial of the Mirror Image Movement Enabler (MIME) robotic device for shoulder and elbow neurorehabilitation in subacute stroke patients, including data on the use of its bilateral training mode. MIME incorporates a PUMA 560 robot (Staubli Unimation Inc, Duncan, South Carolina) that applies forces to the paretic limb during unilateral and bilateral movements in three dimensions. Robot-assisted treatment (bilateral, unilateral, and combined bilateral and unilateral) was compared with conventional therapy. Similar to a previous study in chronic stroke, combined unilateral and bilateral robotic training had advantages compared with conventional therapy, producing larger improvements on a motor impairment scale and a measure of abnormal synergies. However, gains in all treatment groups were equivalent at the 6-month follow-up. Combined unilateral and bilateral training yielded functional gains that were similar to the gains from equivalent doses of unilateral-only robotic training, although the combined group had more hypertonia and less movement out of synergy at baseline. Robot-assisted treatment gains exceeded those expected from spontaneous recovery. These results are discussed in light of the need for further device development and continued clinical trials. PMID:17123204

  7. New-generation filler based on cross-linked carboxymethylcellulose: study of 350 patients with 3-year follow-up

    Directory of Open Access Journals (Sweden)

    Leonardis M

    2015-01-01

    Full Text Available Mauro Leonardis,1 Andrea Palange2 1Department of Plastic Surgery, Salvator Mundi International Hospital, 2Department of Aesthetic Medicine, Fisiobios Clinic, Rome, Italy Purpose: In recent years there has been a growing interest in nonsurgical procedures for facial rejuvenation. Hyaluronic acid is currently the most widely used dermal filler for the treatment of facial wrinkles. However, new products with interesting features are being introduced into the market. Cross-linked carboxymethylcellulose is one of these and represents a new alternative for the correction of wrinkles and facial defects.Patients and methods: The retrospective, multicenter, open-label study on nasolabial folds reported here was carried out between January 2010 and April 2014 on 350 subjects between 22 and 67 years of age for a 36-month follow-up period in order to consistently and extensively assess the safety and performance of this treatment.Results: The study revealed effective and durable correction of nasolabial wrinkles for periods of 9–12 months. Product reapplication over a 36-month period did not lead to an increase in adverse effects, which always remained rare and of little clinical significance, usually consisting of bruising and redness.Conclusion: Cross-linked carboxymethyl cellulose has been shown to be a safe and effective alternative to the resorbable products currently on the market. Keywords: dermal fillers, nasolabial fold, hyaluronic acids, facial aging, patient satisfaction

  8. Patterns and determinants of receipt of follow-up mammography and/or clinical examination in a cohort of Italian breast cancer survivors.

    Science.gov (United States)

    Giuliani, Orietta; Mancini, Silvia; Puliti, Donella; Caranci, Nicola; Ravaioli, Alessandra; Vattiato, Rosa; Palumbo, Monica; Colamartini, Americo; Biggeri, Annibale; Bucchi, Lauro; Amadori, Dino; Falcini, Fabio

    2016-08-01

    Information regarding the use of mammography by breast cancer survivors is limited. This study aimed at evaluating the compliance to surveillance mammography and/or clinical breast examination and the associated factors among patients living in northern Italy. A cancer registry-based cohort of 1304 patients living in the Health Care District of Forlì was followed up for 10 years. Eighty percent of patients had a mammogram and/or clinical breast examination during the first year after treatment. The proportion decreased to 67 % at 10 years of follow-up. Three demographic characteristics were independently associated with lower odds of having an annual mammogram and/or clinical breast examination: age at diagnosis [odds ratio (OR) 0.51, 95 % confidence interval (CI) 0.41-0.63 for patients aged 65-74 years; and OR 0.14, 95 % CI 0.11-0.18, for patients ≥75 years versus patients aged travel time greater than 30 min (OR 0.44, 95 % CI 0.29-0.68 versus ≤15 min). With respect to clinical and disease characteristics, lower odds were observed for patients treated with mastectomy (OR 0.79, 95 % CI 0.65-0.97), for patients diagnosed with in situ breast cancer (OR 0.68, 95 % CI 0.46-0.99) as well as with stage II + breast cancer (OR 0.77, 95 % CI 0.63-0.94), and for patients with ≥3 Elixhauser comorbidities (OR 0.43, 95 % CI 0.26-0.71). Adherence to follow-up declined over time. Knowledge of associated factors may assist in improving access to care for breast cancer survivors. PMID:27393619

  9. Trends and determinant factors in hypertension control in a population study with 25 years of follow-up

    DEFF Research Database (Denmark)

    Andersen, Ulla O; Jensen, Gorm B

    2010-01-01

    pressure <140/90 mmHg). DESIGN AND METHODS: Copenhagen City Heart Study is a prospective longitudinal epidemiological study with 25 years of follow-up. The study population were treated hypertensive patients. The blood pressure measurement was fully standardized and measurement method was unchanged...

  10. Natural history of large regenerative nodules and dysplastic nodules in liver cirrhosis: 28-year follow-up study

    OpenAIRE

    SATO, Tsunenobu; Kondo, Fukuo; EBARA, Masaaki; Sugiura, Nobuyuki; Okabe, Shinichiro; Sunaga, Masahiko; Yoshikawa, Masaharu; Suzuki, Eiichiro; Ogasawara, Sadayuki; Shinozaki, Yusuke; Ooka, Yoshihiko; Chiba, Tetsuhiro; Kanai, Fumihiko; Kishimoto, Takashi; Nakatani, Yukio

    2015-01-01

    Background and aims Some follow-up studies of large regenerative nodules (LRNs) and dysplastic nodules (DNs) were reported previously. However, the pre-malignant potentiality of LRNs has remained controversial up to now. No LRNs showed malignant transformation in our previous study. We aimed to evaluate the pre-malignant potentiality of LRNs and DNs with a greater number of cases and longer follow-up periods. Methods From 1982 to 2005, 1,500 consecutive nodular lesions up to 2 cm in diameter ...

  11. Risk of suicide after suicide attempt according to coexisting psychiatric disorder: Swedish cohort study with long term follow-up

    OpenAIRE

    Tidemalm, Dag; Långström, Niklas; Lichtenstein, Paul; Runeson, Bo

    2008-01-01

    Objective To investigate the impact of coexistent psychiatric morbidity on risk of suicide after a suicide attempt. Design Cohort study with follow-up for 21-31 years. Setting Swedish national register based study. Participants 39 685 people (53% women) admitted to hospital for attempted suicide during 1973-82. Main outcome measure Completed suicide during 1973-2003. Results A high proportion of suicides in all diagnostic categories took place within the first year of follow-up (14-64% in men...

  12. Cu isotopic signature in blood serum of liver transplant patients: a follow-up study

    Science.gov (United States)

    Lauwens, Sara; Costas-Rodríguez, Marta; van Vlierberghe, Hans; Vanhaecke, Frank

    2016-07-01

    End-stage liver disease (ESLD) is life-threatening and liver transplantation (LTx) is the definitive treatment with good outcomes. Given the essential role of hepatocytes in Cu homeostasis, the potential of the serum Cu isotopic composition for monitoring a patient’s condition post-LTx was evaluated. For this purpose, high-precision Cu isotopic analysis of blood serum of ESLD patients pre- and post-LTx was accomplished via multi-collector ICP-mass spectrometry (MC-ICP-MS). The Cu isotopic composition of the ESLD patients was fractionated in favour of the lighter isotope (by about ‑0.50‰). Post-LTx, a generalized normalization of the Cu isotopic composition was observed for the patients with normal liver function, while it remained light when this condition was not reached. A strong decrease in the δ65Cu value a longer term post-LTx seems to indicate the recurrence of liver failure or cancer. The observed trend in favour of the heavier Cu isotopic composition post-LTx seems to be related with the restored biosynthetic capacity of the liver, the restored hepatic metabolism and/or the restored biliary secretion pathways. Thus, Cu isotopic analysis could be a valuable tool for the follow-up of liver transplant patients and for establishing the potential recurrence of liver failure.

  13. Cu isotopic signature in blood serum of liver transplant patients: a follow-up study

    Science.gov (United States)

    Lauwens, Sara; Costas-Rodríguez, Marta; Van Vlierberghe, Hans; Vanhaecke, Frank

    2016-01-01

    End-stage liver disease (ESLD) is life-threatening and liver transplantation (LTx) is the definitive treatment with good outcomes. Given the essential role of hepatocytes in Cu homeostasis, the potential of the serum Cu isotopic composition for monitoring a patient’s condition post-LTx was evaluated. For this purpose, high-precision Cu isotopic analysis of blood serum of ESLD patients pre- and post-LTx was accomplished via multi-collector ICP-mass spectrometry (MC-ICP-MS). The Cu isotopic composition of the ESLD patients was fractionated in favour of the lighter isotope (by about −0.50‰). Post-LTx, a generalized normalization of the Cu isotopic composition was observed for the patients with normal liver function, while it remained light when this condition was not reached. A strong decrease in the δ65Cu value a longer term post-LTx seems to indicate the recurrence of liver failure or cancer. The observed trend in favour of the heavier Cu isotopic composition post-LTx seems to be related with the restored biosynthetic capacity of the liver, the restored hepatic metabolism and/or the restored biliary secretion pathways. Thus, Cu isotopic analysis could be a valuable tool for the follow-up of liver transplant patients and for establishing the potential recurrence of liver failure. PMID:27468898

  14. Skeletal manifestations of lysinuric protein intolerance. A follow-up study of 29 patients.

    Science.gov (United States)

    Svedström, E; Parto, K; Marttinen, M; Virtama, P; Simell, O

    1993-01-01

    Lysinuric protein intolerance (LPI) is an autosomal recessive disease caused by defective transport of the cationic amino acids lysine, arginine, and ornithine at the cell membrane. About 80 patients with LPI have been described worldwide, almost half of them in Finland. The symptoms appear in early childhood as a failure to thrive, growth retardation, muscular hypotonia, and episodes of stupor after protein-rich meals. Twenty-nine Finnish patients (current median age 24.8 years, range 3.7-47.9 years) over a mean follow-up time of 18.1 years (range 1.2-27.2 years) had 57 fractures after minor trauma, mostly in childhood. Their 440 skeletal radiographs showed severe osteoporosis (13/29), controversially abnormal thickening of cortex of the metacarpals (7/29), or thin cortices of the long bones (5/29), endplate impression of vertebrae (8/29), rickets-like metaphyses (2/29), or early destruction of cartilage (3/29). Skeletal maturation was delayed by 1-5 years in 23 of 24 patients. There was no correlation between fracture incidence, radiological bone structure, and delayed skeletal maturation. PMID:8430340

  15. Genetic counseling follow-up - a retrospective study with a quantitative approach

    Directory of Open Access Journals (Sweden)

    De Pina-Neto João M.

    1999-01-01

    Full Text Available The impact of genetic counseling (GC was evaluated in families, who were interviewed at least two and half years and at most seven years after GC at the Genetics Service of the University Hospital, Faculty of Medicine of Ribeirão Preto, University of São Paulo (HC, FMRP, USP. The 113 families interviewed in this study were asked 48 questions and all children born after GC were studied clinically. We evaluated the families for spontaneous motivation for GC and understanding of GC information, their reproductive decisions, changes in the family after GC and the health status of new children. The majority of families seen at the Hospital das Clínicas de Ribeirão Preto were not spontaneously motivated to undergo GC. They had a low level of understanding about the information they received during GC. Generally families were using contraceptive methods (even when at low genetic risk with a consequent low rate of pregnancies and children born after GC. These families also had a very low rate of child adoption and divorces when compared to other studies.

  16. An immersive “simulation week” enhances clinical performance of incoming surgical interns improved performance persists at 6 months follow-up

    Science.gov (United States)

    Singh, Pritam; Aggarwal, Rajesh; Pucher, Philip H.; Hashimoto, Daniel A.; Beyer-Berjot, Laura; Bharathan, Rasiah; Middleton, Katherine E.; Jones, Joanne; Darzi, Ara

    2015-01-01

    Background The transition from student to intern can be challenging. The “August” or “July effect” describes increased errors and reduced patient safety during this transition. The study objectives were to develop, pilot, and evaluate clinical performance after an immersive simulation course for incoming interns. Methods Graduating students were recruited for a 1-week immersive simulation course. Controls received no simulation training. Primary outcome (at baseline, and 1 and 6 months) was clinical performance on Objective Structured Clinical Examinations (OSCE) of clinical procedures and surgical technical skills. Secondary outcomes were self-reported confidence and clinical procedure logbook data. Results Nineteen students were recruited. Sixteen completed the 6-month follow-up, 10 in the intervention group and 6 in the control group. No differences were demonstrated between interventions and controls at baseline (OSCE [median, 66 vs 78; P = .181], technical skills [48 vs 52.5; P = .381], and confidence [101 vs 96; P = .368]). Interventions outperformed controls at 1 month (OSCE [111 vs 82; P = .001], technical skills [78.5 vs 63; P = .030], and confidence [142 vs 119; P < .001]), and 6 months (OSCE [107 vs 93; P = .007], technical skills [92.5 vs 69; P = .044], and confidence [148 vs 129; P = .022]). No differences were observed in numbers of clinical procedures performed at 1 (P = .958), 4 (P = .093), or 6 months (P = .713). Conclusion The immersive simulation course objectively improved subjects’ clinical skills, technical skills, and confidence. Despite similar clinical experience as controls, the intervention group’s improved performance persisted at 6 months follow-up. This feasible and effective intervention to ease transition from student to intern could reduce errors and enhance patient safety. PMID:25633735

  17. LOng-term follow-up after liVE kidney donation (LOVE) study: A longitudinal comparison study protocol

    OpenAIRE

    Janki, Shiromani; Klop, Karel; Kimenai, F.F.P.; Wetering, Jacqueline; Weimar, Willem; Massey, Emma; Dehghan, Abbas; Rizopoulos, Dimitris; Völzke, Henry; Hofman, Albert; IJzermans, Jan

    2016-01-01

    textabstractBackground: The benefits of live donor kidney transplantation must be balanced against the potential harm to the donor. Well-designed prospective studies are needed to study the long-term consequences of kidney donation. Methods: The "LOng-term follow-up after liVE kidney donation" (LOVE) study is a single center longitudinal cohort study on long-term consequences after living kidney donation. We will study individuals who have donated a kidney from 1981 through 2010 in the Erasmu...

  18. LOng-term follow-up after liVE kidney donation (LOVE) study: a longitudinal comparison study protocol

    OpenAIRE

    Janki, Shiromani; Klop, Karel W. J.; Kimenai, Hendrikus J. A. N.; Wetering, Jacqueline; Weimar, Willem; Massey, Emma K.; Dehghan, Abbas; Rizopoulos, Dimitris; Völzke, Henry; Hofman, Albert; IJzermans, Jan N. M.

    2016-01-01

    Background The benefits of live donor kidney transplantation must be balanced against the potential harm to the donor. Well-designed prospective studies are needed to study the long-term consequences of kidney donation. Methods The “LOng-term follow-up after liVE kidney donation” (LOVE) study is a single center longitudinal cohort study on long-term consequences after living kidney donation. We will study individuals who have donated a kidney from 1981 through 2010 in the Erasmus University M...

  19. LOng-term follow-up after liVE kidney donation (LOVE) study: a longitudinal comparison study protocol

    OpenAIRE

    Janki, Shiromani; Klop, Karel W. J.; Kimenai, Hendrikus J. A. N.; Wetering, Jacqueline; Weimar, Willem; Massey, Emma K.; Dehghan, Abbas; Rizopoulos, Dimitris; Völzke, Henry; Hofman, Albert; IJzermans, Jan N. M.

    2016-01-01

    Background: The benefits of live donor kidney transplantation must be balanced against the potential harm to the donor. Well-designed prospective studies are needed to study the long-term consequences of kidney donation. Methods: The “LOng-term follow-up after liVE kidney donation” (LOVE) study is a single center longitudinal cohort study on long-term consequences after living kidney donation. We will study individuals who have donated a kidney from 1981 through 2010 in the Erasmus University...

  20. Development of Fatigue in Cancer Survivors : A Prospective Follow-Up Study From Diagnosis Into the Year After Treatment

    NARCIS (Netherlands)

    Goedendorp, Martine M.; Gielissen, Marieke F. M.; Verhagen, Constans A. H. H. V. M.; Bleijenberg, Gijs

    2013-01-01

    Context. There is a lack of longitudinal studies investigating fatigue from before cancer treatment to long after successful cancer treatment. Objectives. This prospective follow-up study aimed to determine the prevalence and predictors of persistent fatigue in cancer survivors in the first year aft

  1. Avulsion of puborectalis muscle and other risk factors for cystocele recurrence: a 2-year follow-up study

    NARCIS (Netherlands)

    Weemhoff, M.; Vergeldt, T.F.; Notten, K.; Serroyen, J.; Kampschoer, P.H.; Roumen, F.J.M.E.

    2012-01-01

    INTRODUCTION AND HYPOTHESIS: This study aimed to determine the relationship of recurrent cystocele with avulsion of puborectalis muscle and other risk factors. METHODS: In this prospective observational cohort study, 245 women undergoing anterior colporrhaphy were invited for a 2-year follow-up visi

  2. Five-Year Follow-up Study of Monoclonal Gammopathy of Undetermined Significance in a Korean Elderly Urban Cohort

    OpenAIRE

    Lee, Yun-Gyoo; Bang, Soo-Mee; Lee, Jeong-Ok; Kim, Jin Won; Lee, Keun-Wook; Kim, Jee Hyun; Song, Jung Han; Kim, Tae-Hee; Kim, Ki Woong; Lee, Jong-Seok

    2014-01-01

    Purpose We previously reported the prevalence of monoclonal gammopathy of undetermined significance (MGUS) to be 3.3% among an elderly Korean urban cohort recruited during 2005-2006. Here, we report a 5-year follow-up study of the previously identified MGUS cohort. Materials and Methods The 680 participants from the initial cohort were followed-up for a median of 5 years. Sera were collected between 2010 and 2011. Two-step screening was performed with standard serum electrophoresis followed b...

  3. The Irish DAFNE Study Protocol: A cluster randomised trial of group versus individual follow-up after structured education for Type 1 diabetes

    Directory of Open Access Journals (Sweden)

    Newell John

    2009-09-01

    Full Text Available Abstract Background Structured education programmes for individuals with Type 1 diabetes have become a recognised means of delivering the knowledge and skills necessary for optimal self-management of the condition. The Dose Adjustment for Normal Eating (DAFNE programme has been shown to improve biomedical (HbA1c and rates of severe hypoglycaemia and psychosocial outcomes for up to 12 months following course delivery. The optimal way to support DAFNE graduates and maintain the benefits of the programme has not been established. We aimed to compare 2 different methods of follow-up of DAFNE graduates in a pragmatic clinical trial delivered in busy diabetes clinics on the island of Ireland. Methods Six participating centres were cluster randomised to deliver either group follow-up or a return to traditional one-to-one clinic visits. In the intervention arm group follow-up was delivered at 6 and 12 months post DAFNE training according to a curriculum developed for the study. In the control arm patients were seen individually in diabetes clinics as part of routine care. Study outcomes included HbA1c levels, self-reported rates of severe hypoglycaemia, body weight and measures of diabetes wellbeing and quality of life. These were measured at 6, 12 and 18 months after recruitment. Generalisability (external validity was maximised by recruiting study participants from existing DAFNE waiting lists in each centre, by using broad inclusion criteria (including HbA1c values less than 13 percent with no lower limit and by using existing clinic staff to deliver the training and follow-up. Internal validity and treatment fidelity were maximised by quality assuring the training of all DAFNE educators, by external peer review of the group follow-up sessions and by striving for full attendance at follow-up visits. Assays of HbA1c were undertaken in a central laboratory. Discussion This pragmatic clinical trial evaluating group follow-up after a structured education

  4. The Irish DAFNE study protocol: a cluster randomised trial of group versus individual follow-up after structured education for type 1 diabetes.

    LENUS (Irish Health Repository)

    Dinneen, Seán F

    2009-01-01

    BACKGROUND: Structured education programmes for individuals with Type 1 diabetes have become a recognised means of delivering the knowledge and skills necessary for optimal self-management of the condition. The Dose Adjustment for Normal Eating (DAFNE) programme has been shown to improve biomedical (HbA(1c) and rates of severe hypoglycaemia) and psychosocial outcomes for up to 12 months following course delivery. The optimal way to support DAFNE graduates and maintain the benefits of the programme has not been established. We aimed to compare 2 different methods of follow-up of DAFNE graduates in a pragmatic clinical trial delivered in busy diabetes clinics on the island of Ireland. METHODS: Six participating centres were cluster randomised to deliver either group follow-up or a return to traditional one-to-one clinic visits. In the intervention arm group follow-up was delivered at 6 and 12 months post DAFNE training according to a curriculum developed for the study. In the control arm patients were seen individually in diabetes clinics as part of routine care. Study outcomes included HbA(1c) levels, self-reported rates of severe hypoglycaemia, body weight and measures of diabetes wellbeing and quality of life. These were measured at 6, 12 and 18 months after recruitment. Generalisability (external validity) was maximised by recruiting study participants from existing DAFNE waiting lists in each centre, by using broad inclusion criteria (including HbA(1c) values less than 13 percent with no lower limit) and by using existing clinic staff to deliver the training and follow-up. Internal validity and treatment fidelity were maximised by quality assuring the training of all DAFNE educators, by external peer review of the group follow-up sessions and by striving for full attendance at follow-up visits. Assays of HbA(1c) were undertaken in a central laboratory. DISCUSSION: This pragmatic clinical trial evaluating group follow-up after a structured education programme has

  5. The Impact of Recycled Neonatal Incubators in Nigeria: A 6-Year Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Hippolite Onyejiaka Amadi

    2010-01-01

    Full Text Available Nigeria has a record of high newborn mortality as an estimated 778 babies die daily, accounting for a ratio of 48 deaths per 1000 live births. The aim of this paper was to show how a deteriorating neonatal delivery system in Nigeria may have, in part, been improved by the application of a novel recycled incubator technique (RIT. Retrospective assessment of clinical, technical, and human factors in 15 Nigerian neonatal centres was carried out to investigate how the application of RIT impacted these factors. Pre-RIT and post-RIT neonatal mortalities were compared by studying case files. Effect on neonatal nursing was studied through questionnaires that were completed by 79 nurses from 9 centres across the country. Technical performance was assessed based on 10-indices scores from clinicians and nurses. The results showed an increase in neonatal survival, nursing enthusiasm, and practice confidence. Appropriately recycled incubators are good substitutes to the less affordable modern incubators in boosting neonatal practice outcome in low-income countries.

  6. Uterine Artery Embolisation for Symptomatic Adenomyosis with Polyzene F-Coated Hydrogel Microspheres: Three-Year Clinical Follow-Up Using UFS–QoL Questionnaire

    International Nuclear Information System (INIS)

    PurposeThis study was designed to assess midterm outcome of uterine artery embolisation (UAE) for women with therapy-resistant adenomyosis using polyzene F-coated hydrogel microspheres.MethodsBetween September 2006 and January 2010, 29 consecutive women with adenomyosis (15 in combination with fibroids) were treated with UAE using polyzene F-coated hydrogel microspheres. Junction zone thickness was assessed with MRI at baseline and 3 months. Women filled out the uterine fibroid symptom and quality of life questionnaire at baseline, 3 months and after a mean clinical follow-up of 37 months (median 35, range 29–64 months).ResultsAt baseline, symptom severity score of 29 women was mean 67 (median 72, range 23–100). At 3 months, this score decreased to mean 22 (median 15, range 0–66) and mean 15 (median 17, range 0–34) at final follow-up. At final follow-up of mean 37 months (median 35, range 29–64 months), 22 of 29 (76 %) patients were asymptomatic. Of these 22 women, 3 underwent a second UAE at 6, 7, and 14 months. The remaining seven patients clinically improved but still had symptoms; one underwent a hysterectomy. There was no difference in outcome between women with pure adenomyosis and women with additional fibroids. The junction zone of 4 women with additional therapy was significantly thicker compared with the remaining 25 patients.ConclusionsIn women with therapy resistant adenomyosis, UAE using polyzene F-coated hydrogel microspheres resulted in 3 years preservation of the uterus in 28 of 29 (97 %) with good clinical outcome in the vast majority of patients. Initial thickness of the junction zone is related to additional therapy

  7. Uterine Artery Embolisation for Symptomatic Adenomyosis with Polyzene F-Coated Hydrogel Microspheres: Three-Year Clinical Follow-Up Using UFS–QoL Questionnaire

    Energy Technology Data Exchange (ETDEWEB)

    Nijenhuis, R. J., E-mail: nijenhuis@maastrichtuniversity.nl; Smeets, A. J., E-mail: a.smeets@elisabeth.nl; Morpurgo, M., E-mail: m.morpurgo@elisabeth.nl [St. Elisabeth Ziekenhuis, Department of Radiology (Netherlands); Boekkooi, P. F., E-mail: f.boekkooi@elisabeth.nl; Reuwer, P. J. H. M., E-mail: p.reuwer@elisabeth.nl; Smink, M., E-mail: m.smink@elisabeth.nl [St. Elisabeth Ziekenhuis, Department of Obstetrics and Gynecology (Netherlands); Rooij, W. J. van, E-mail: wjjvanrooij@gmail.com; Lohle, P. N. M., E-mail: radiol@eztilburg.nl, E-mail: paullohle@gmail.com [St. Elisabeth Ziekenhuis, Department of Radiology (Netherlands)

    2015-02-15

    PurposeThis study was designed to assess midterm outcome of uterine artery embolisation (UAE) for women with therapy-resistant adenomyosis using polyzene F-coated hydrogel microspheres.MethodsBetween September 2006 and January 2010, 29 consecutive women with adenomyosis (15 in combination with fibroids) were treated with UAE using polyzene F-coated hydrogel microspheres. Junction zone thickness was assessed with MRI at baseline and 3 months. Women filled out the uterine fibroid symptom and quality of life questionnaire at baseline, 3 months and after a mean clinical follow-up of 37 months (median 35, range 29–64 months).ResultsAt baseline, symptom severity score of 29 women was mean 67 (median 72, range 23–100). At 3 months, this score decreased to mean 22 (median 15, range 0–66) and mean 15 (median 17, range 0–34) at final follow-up. At final follow-up of mean 37 months (median 35, range 29–64 months), 22 of 29 (76 %) patients were asymptomatic. Of these 22 women, 3 underwent a second UAE at 6, 7, and 14 months. The remaining seven patients clinically improved but still had symptoms; one underwent a hysterectomy. There was no difference in outcome between women with pure adenomyosis and women with additional fibroids. The junction zone of 4 women with additional therapy was significantly thicker compared with the remaining 25 patients.ConclusionsIn women with therapy resistant adenomyosis, UAE using polyzene F-coated hydrogel microspheres resulted in 3 years preservation of the uterus in 28 of 29 (97 %) with good clinical outcome in the vast majority of patients. Initial thickness of the junction zone is related to additional therapy.

  8. Neuromotor development and language processing in developmental dyspraxia: a follow-up case study.

    Science.gov (United States)

    Le Normand, M T; Vaivre-Douret, L; Payan, C; Cohen, H

    2000-06-01

    A longitudinal study of a child (MV) with developmental verbal dyspraxia was conducted to determine to what extent language development and motor performance in this clinical diagnosis followed a similar course of maturation. Patient MV was observed for two years from the age of 5 years and 6 months. Initially, this young patient exhibited unintelligible and atypical speech production (multiword utterances without consonants), delay in balance and coordination, and impairments in rhythmic tasks; but she was otherwise developing normally with no intellectual impairment or behavioral disorder. MRI scans showed moderately enlarged ventricles, a thin, incompletely myelinated corpus callosum and intact basal ganglia. Two years later, MV's performance was nearly normal only in comprehension aspects of language. In contrast, production aspects of language and speech and neuromotor development showed very little improvement after two years. These observations first suggest that development of receptive and expressive domains within language may be asynchronous, and that the progression of motor control of language appears to follow a parallel course to neuromotor development. PMID:10855048

  9. An Observational Study with Long-Term Follow-Up of Canine Cognitive Dysfunction

    DEFF Research Database (Denmark)

    Fast, R.; Schutt, T.; Toft, N.;

    2013-01-01

    Background: Canine cognitive dysfunction (CCD) is a neurodegenerative condition affecting geriatric dogs and sharing several characteristics with human Alzheimer's disease (AD). CCD manifests as alterations of behavioral patterns and daily routines. Clinical signs are associated with...... = .99). Conclusions and Clinical Importance: A few key questions addressing sleep-wake cycle, interaction, and signs of confusion and anxiety can be used as a clinical marker of CCD. Special attention should be paid to anxiety in dogs with CCD because it may be especially stressful to both dog and owner...

  10. Electrodiagnostic Studies, “Role in The Diagnosis And Follow-Up in Children With Pompe Disease”

    Directory of Open Access Journals (Sweden)

    Mahmoud MOHAMMADI

    2012-12-01

    Full Text Available How to Cite this Article: Mohammadi M. Electrodiagnostic Studies, “Role in the Diagnosis and Follow-up in Children with Pompe Disease”. Iran J Child Neurol Autumn 2012; 6:4 (suppl. 1:23. Pls see PDF.

  11. Are risk estimates biased in follow-up studies of psychosocial factors with low base-line participation?

    DEFF Research Database (Denmark)

    Kaerlev, Linda; Kolstad, Henrik A; Hansen, Ase Marie;

    2011-01-01

    Low participation in population-based follow-up studies addressing psychosocial risk factors may cause biased estimation of health risk but the issue has seldom been examined. We compared risk estimates for selected health outcomes among respondents and the entire source population....

  12. The Cornella Health Interview Survey Follow-Up (CHIS.FU Study: design, methods, and response rate

    Directory of Open Access Journals (Sweden)

    Perez Gloria

    2003-03-01

    Full Text Available Abstract Background The aim of this report is to describe the main characteristics of the design, including response rates, of the Cornella Health Interview Survey Follow-up Study. Methods The original cohort consisted of 2,500 subjects (1,263 women and 1,237 men interviewed as part of the 1994 Cornella Health Interview Study. A record linkage to update the address and vital status of the cohort members was carried out using, first a deterministic method, and secondly a probabilistic one, based on each subject's first name and surnames. Subsequently, we attempted to locate the cohort members to conduct the phone follow-up interviews. A pilot study was carried out to test the overall feasibility and to modify some procedures before the field work began. Results After record linkage, 2,468 (98.7% subjects were successfully traced. Of these, 91 (3.6% were deceased, 259 (10.3% had moved to other towns, and 50 (2.0% had neither renewed their last municipal census documents nor declared having moved. After using different strategies to track and to retain cohort members, we traced 92% of the CHIS participants. From them, 1,605 subjects answered the follow-up questionnaire. Conclusion The computerized record linkage maximized the success of the follow-up that was carried out 7 years after the baseline interview. The pilot study was useful to increase the efficiency in tracing and interviewing the respondents.

  13. A follow-up study of environmental and biologic determinants of fertility among 430 Danish first-pregnancy planners

    DEFF Research Database (Denmark)

    Bonde, J P; Hjollund, N H; Jensen, T K; Ernst, E; Kolstad, H; Henriksen, T B; Giwercman, A; Skakkebaek, N E; Andersson, A M; Olsen, J

    1998-01-01

    This paper presents design and methods of a follow-up study of fecundability (defined as the probability of conception during one menstrual cycle) in first-pregnancy planners. We recruited 430 couples by postal letter among 52,255 members of four trade unions. Couples without earlier reproductive...

  14. Socioeconomic status and duration and pattern of sickness absence. A 1-year follow-up study of 2331 hospital employees

    DEFF Research Database (Denmark)

    Kristensen, Trine Rønde; Jensen, Signe Marie; Kreiner, Svend;

    2010-01-01

    prospective cohort study of 2331 hospital employees. Baseline information include job title, work unit, perceived general health, work factors and personal factors recorded from hospital administrative files or by questionnaire (response rate 84%). Sickness absence during follow-up was divided into short (1...

  15. Anxiety and depression in patients with head and neck cancer: 6-month follow-up study

    Science.gov (United States)

    Wu, Yi-Shan; Lin, Pao-Yen; Chien, Chih-Yen; Fang, Fu-Min; Chiu, Nien-Mu; Hung, Chi-Fa; Lee, Yu; Chong, Mian-Yoon

    2016-01-01

    Objective We aimed to assess psychiatric morbidities of patients with head and neck cancer (HNC) in a prospective study at pretreatment, and 3 and 6 months after treatment, and to compare their health-related quality of life (HRQL) between those with and without depressive disorders (depression). Materials and methods Patients with newly diagnosed HNC from a tertiary hospital were recruited into the study. They were assessed for psychiatric morbidities using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Their HRQL was simultaneously evaluated using the quality of life questionnaire of the European Organisation for Research and Treatment of Cancer with a specific module for head and neck cancer; and depressed and nondepressed HNC patients were compared by using the generalized mixed-effect model for repeated measurements. Results A total of 106 patients were recruited into this study. High rates of anxiety were found at pretreatment, but steadily declined over time (from 27.3% to 6.4%, and later 3.3%). A skew pattern of depression was observed, with prevalence rates from 8.5% at pretreatment to 24.5% and 14% at 3 and 6 months, respectively, after treatment. We found that loss of sense (P=0.001), loss of speech (P<0.001), low libido (P=0.001), dry mouth (P<0.001), and weight loss (P=0.001) were related to depression over time. The depressed patients had a higher consumption of painkillers (P=0.001) and nutrition supplements (P<0.001). The results showed that depression was predicted by sticky saliva (P<0.001) and trouble with social contact (P<0.001) at 3 months, and trouble with social eating (P<0.001) at 6 months. Conclusion Patients with HNC experienced different changes in anxiety and depression in the first 6 months of treatment. Dysfunction in salivation, problems with eating, and problems with social contacts were major risk factors for depression. PMID:27175080

  16. Anxiety and depression in patients with head and neck cancer: 6-month follow-up study

    Directory of Open Access Journals (Sweden)

    Wu YS

    2016-04-01

    Full Text Available Yi-Shan Wu,1 Pao-Yen Lin,1,2 Chih-Yen Chien,3 Fu-Min Fang,4 Nien-Mu Chiu,1 Chi-Fa Hung,1 Yu Lee,1 Mian-Yoon Chong11Department of Psychiatry, 2Institute for Translational Research in Biomedical Sciences, 3Department of Otolaryngology, 4Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanObjective: We aimed to assess psychiatric morbidities of patients with head and neck cancer (HNC in a prospective study at pretreatment, and 3 and 6 months after treatment, and to compare their health-related quality of life (HRQL between those with and without depressive disorders (depression.Materials and methods: Patients with newly diagnosed HNC from a tertiary hospital were recruited into the study. They were assessed for psychiatric morbidities using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Their HRQL was simultaneously evaluated using the quality of life questionnaire of the European Organisation for Research and Treatment of Cancer with a specific module for head and neck cancer; and depressed and nondepressed HNC patients were compared by using the generalized mixed-effect model for repeated measurements.Results: A total of 106 patients were recruited into this study. High rates of anxiety were found at pretreatment, but steadily declined over time (from 27.3% to 6.4%, and later 3.3%. A skew pattern of depression was observed, with prevalence rates from 8.5% at pretreatment to 24.5% and 14% at 3 and 6 months, respectively, after treatment. We found that loss of sense (P=0.001, loss of speech (P<0.001, low libido (P=0.001, dry mouth (P<0.001, and weight loss (P=0.001 were related to depression over time. The depressed patients had a higher consumption of painkillers (P=0.001 and nutrition supplements (P<0.001. The results showed that depression was predicted by sticky saliva (P<0.001 and trouble with

  17. The Nurse-Led Telephone Follow-Up on Medication and Dietary Adherence among Patients after Myocardial Infarction: A Randomized Controlled Clinical Trial

    Science.gov (United States)

    Najafi, Seyed Saeed; Shaabani, Maryam; Momennassab, Marzieh; Aghasadeghi, Kamran

    2016-01-01

    Background: Adherence to dietary and medication regimen plays an important role in successful treatment and reduces the negative complications and severity of the disease. Therefore, the present study aimed to investigate the effect of nurse-led telephone follow-up on the level of adherence to dietary and medication regimen among patients after Myocardial Infarction (MI). Methods: This non-blinded randomized controlled clinical trial was conducted on 100 elderly patients with MI who had referred to the cardiovascular clinics in Shiraz. Participants were selected and randomly assigned to intervention and control groups using balanced block randomization method. The intervention group received a nurse-led telephone follow-up. The data were collected using a demographic questionnaire, Morisky’s 8-item medication adherence questionnaire, and dietary adherence questionnaire before and three months after the intervention. Data analysis was done by the SPSS statistical software (version 21), using paired t-test for intra-group and Chi-square and t-test for between groups comparisons. Significance level was set at0.05). However, a statistically significant difference was found between the two groups in this regard after the intervention (P<0.05). The mean differences of dietary and medication adherence scores between pre- and post-tests were significantly different between the two groups. Independent t-test showed these differences (P=0.001). Conclusion: The results of the present study confirmed the positive effects of nurse-led telephone follow-up as a method of tele-nursing on improvement of adherence to dietary and medication regimen in the patients with MI. Trial Registration Number: IRCT201409148505N8 PMID:27382586

  18. FOLLOW-UP AFTER SURGICAL TREATMENT OF HEPATIC HYDATID CYSTS: SPECTRUM OF ULTRASOUND AND CONTRAST STUDIES FINDINGS

    Directory of Open Access Journals (Sweden)

    Corina Ursulescu

    2006-01-01

    Full Text Available Purpose: To present the spectrum of imaging findings in the postoperative period and assess the role of ultrasound and contrast studies in postoperative follow-up after surgical treatment for hepatic hydatid cyst (HHC. Material and methods: A retrospective study included 69 patients surgically treated for HHC. The surgical procedures performed were conservative in 59 patients and radical in 10 patients. The imaging follow-up was most frequently made by abdominal ultrasound (69 cases, 1 to 5 examinations/ patient and cavity control with contrast media (46 cases, 1 to 4 examinations/patient. The follow-up was made in early and late postoperative period, up to one year. The following aspects were assessed: cavity evolution (size, content, walls; drains position; biliary fistula; peritoneal or pleural fluid effusion; wound healing; hydatid disease relapse. Results: Cavity evolution was: favourable 52/69; unfavourable - cavity size unchanged/enlarged: 9/69; infected cyst cavity: 8/69. Drains were eccentrically placed, touching the walls in 8/69 cases. Complications detected were: biliary fistula: 14/69; peritoneal effusion: 5/69; acute pancreatitis: 1/69, pleural effusion: 7/69, incision wound infection: 5/69; hydatid disease relapse: 2/69. Conclusions: Ultrasound and contrast studies are necessary to follow-up the patients with operated hepatic hydatid disease, both to certify the normal evolution and to identify the complications

  19. Cognitive-behavioral therapy for anxiety disorders in children and adolescents: a systematic review of follow-up studies

    Directory of Open Access Journals (Sweden)

    Roberta Davis

    2014-12-01

    Full Text Available Objective To conduct a systematic review about the long-term response to cognitive-behavioral therapy (CBT for anxiety disorders (ADs in children and adolescents. Methods The PubMed and ISI Web of Science databases were consulted. Search in the databases was performed in November 2012 and included cohort studies after CBT for ADs in children and adolescents with a follow-up period over 12 months. Results A total of 10 papers met the inclusion criteria. The follow-up period ranged from 12 months to 13 years and the results generally showed maintenance of the short-term benefits with CBT. However, the studies presented limitations, especially regarding methods, such as lack of a control group and losses to follow-up. Conclusion The long-term benefits of CBT were identified, however it would be interesting to conduct other studies with more frequent assessment periods, in order to minimize losses to follow-up, in addition to evaluating children and adolescents in the various stages of their development.

  20. Clinical follow-up of ceramic bridges with auro-galvanoforming primary coping and Ni-Cr pontic for restoration of dentition defects

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiang-hao; SUN Feng

    2009-01-01

    Background Alternatives to the conventional auro-galvanoforming ceramic bridge need to be evaluated in long-term longitudinal studies before being recommended for restoration of dentition defects. This study aimed to evaluate the clinical performance of a ceramic bridge with auro-galvanoforming primary coping and Ni-Cr pontic for restoration of dentition defects.Methods In total, 114 ceramic bridges with auro-galvanoforming (primary coping and Ni-Cr pontic) were placed in 112 patients with dentition defects. Among them, 83 bridges in 82 patients were available for follow-up after 7 years. We evaluated marginal integrity, color match, gingival inflammation, fracture of ceramic bridges, and recurrent caries. Results Marginal integrity of the ceramic bridges was perfect in all patients. Most ceramic bridges maintained their original color. Fracture was found in three bridges; the rest were free of fracture, breakage, and loosening. Recurrent abutment caries were not found. Ceramic bridges with auro-galvanoforming (primary coping and Ni-Cr pontic) produced satisfactory clinical outcomes-equivalent to the conventional porcelain-fused-to-metal restoration. This technique is especially useful for dentition defects of the molar area and is cheaper than restoration with noble metal bridges. Conclusions Ceramic bridges with auro-galvanoforming (primary coping and Ni-Cr pontic) performed well for the restoration of dentition defects during this follow-up period. More studies are warranted to further evaluate this technique as an alternative to the conventional porcelain-fused-to-metal restoration.

  1. Are risk estimates biased in follow-up studies of psychosocial factors with low base-line participation?

    Directory of Open Access Journals (Sweden)

    Andersen Johan

    2011-07-01

    Full Text Available Abstract Background Low participation in population-based follow-up studies addressing psychosocial risk factors may cause biased estimation of health risk but the issue has seldom been examined. We compared risk estimates for selected health outcomes among respondents and the entire source population. Methods In a Danish cohort study of associations between psychosocial characteristics of the work environment and mental health, the source population of public service workers comprised 10,036 employees in 502 work units of which 4,489 participated (participation rate 45%. Data on the psychosocial work environment were obtained for each work unit by calculating the average of the employee self-reports. The average values were assigned all employees and non-respondent at the work unit. Outcome data on sick leave and prescription of antidepressant medication during the follow-up period (1.4.2007-31.12.2008 was obtained by linkage to national registries. Results Respondents differed at baseline from non-respondents by gender, age, employment status, sick leave and hospitalization for affective disorders. However, risk estimates for sick leave and prescription of antidepressant medication, during follow-up, based on the subset of participants, did only differ marginally from risk estimates based upon the entire population. Conclusions We found no indications that low participation at baseline distorts the estimates of associations between the work unit level of psychosocial work environment and mental health outcomes during follow-up. These results may not be valid for other exposures or outcomes.

  2. Disease activity in idiopathic intracranial hypertension: a 3-month follow-up study

    DEFF Research Database (Denmark)

    Skau, Maren; Sander, Birgit; Milea, Dan;

    2011-01-01

    , fast RNFL 3.4 protocol), and Humphrey visual field testing were evaluated at regular intervals. Repeat lumbar puncture was performed at final visit (n = 13). The diagnostic delay was 3 months and initial symptoms were headache (94%), visual blurring (82%) and pulsatile tinnitus (65%). Complete clinical...

  3. The Effect of Follow up (Telenursing on Liver Enzymes in Patients with Nonalcoholic Fatty Liver Disease: A Randomized Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Sorur Javanmardi Fard

    2016-07-01

    Full Text Available Background: Non-alcoholic fatty liver disease (NAFLD is characterized by macro vesicular steatosis in the absence of alcohol. Patients with (NAFLD need extensive education and support in their treatment. Our aim was to investigate the effect of telenursing on liver enzymes (ALT and AST in patients with NAFLD. Methods: Our study is a randomized controlled clinical trial. In this study, 60 patients were enrolled from patients who referred to subspecialty gastrointestinal clinics affiliated to Shiraz University of Medical Sciences. Specialists confirmed their diseases by ultrasound and laboratory test. Simple randomization, based on random number table, was used to randomize the participants into intervention (N=30 and control (N=30 groups. Patients in both groups received dietary advice from a nutritionist and were trained to perform physical activities. Telephone intervention in the intervention group lasted for 12 weeks, in order to see the effect of follow up on the recommended diet and physical activities given by the specialist, while; the control group subjects were only followed up as usual by their physician. Results: The result of an independent t-test showed that the mean difference of liverEnzymesbetween the two groups was statistically significant (P<0.001. The difference of AST and ALT in the intervention and control groups was 18.03 , -1.27 and 40.70, 1.52, respectively. Conclusion: We found out that; telenursing could have a positive effect on reduction of liver enzymes (ALT, AST in patients with NAFLD.

  4. Arthroscopic all-inside meniscal repair - Does the meniscus heal? A clinical and radiological follow-up examination to verify meniscal healing using a 3-T MRI

    Energy Technology Data Exchange (ETDEWEB)

    Hoffelner, Thomas; Resch, Herbert; Mayer, Michael; Tauber, Mark [Department of Traumatology and Sports Injuries, Salzburg (Austria); Forstner, Rosemarie [University Hospital of Salzburg, Department of Radiology, Salzburg (Austria); Minnich, Bernd [University of Salzburg, Department of Organismic Biology, Salzburg (Austria)

    2011-02-15

    The purpose of this study was to correlate clinical and radiological results using a 3-T MRI to verify meniscal healing after arthroscopic all-inside meniscus repair. We selected 27 patients (14 men and 13 women) with an average age of 31 {+-} 9 years and retrospective clinical examinations and radiological assessments using a 3-T MRI after all-inside arthroscopic meniscal repair were conducted. Repair of the medial meniscus was performed in 19 patients and of the lateral meniscus in eight. In 17 patients (63%), we performed concomitant anterior cruciate ligament reconstruction. The mean follow-up period was 4.5 {+-} 1.7 years. The Lysholm score and Tegner activity index were used for clinical evaluation. Four grades were used to classify the radiological signal alterations within the meniscus: central globular (grade 1); linear horizontal or band-like (grade 2); intrameniscal alterations and linear signal alterations communicating with the articular surface (grade 3); and complex tears (grade 4). At follow-up, the average Lysholm score was 76 {+-} 15 points, with ten of the patients placed in group 6 based on the Tegner activity index. MRI examinations revealed no signal alteration in three patients, grade 1 in 0, grade 2 in five, grade 3 in 13, and grade 4 in six. The MRI findings correlated positively with the clinical scores in 21 patients (78%). Correlation of clinical and radiological examination was performed using 3-T MRI. In spite of satisfactory clinical outcomes at follow-up, a radiological signal alteration may still be visible on MRI, which was believed to be scar tissue, but could not be proven definitively. Imaging with a 3-Tesla MRI after meniscal suture surgery provides good but no definitive reliability on meniscus healing and therefore gives no advantage compared to 1.5-T MRI, with good clinical outcome using an all-inside arthroscopic meniscal repair. 3T-MRI can not substitute diagnostic arthroscopy in patients with persistent complaints after

  5. Arthroscopic all-inside meniscal repair - Does the meniscus heal? A clinical and radiological follow-up examination to verify meniscal healing using a 3-T MRI

    International Nuclear Information System (INIS)

    The purpose of this study was to correlate clinical and radiological results using a 3-T MRI to verify meniscal healing after arthroscopic all-inside meniscus repair. We selected 27 patients (14 men and 13 women) with an average age of 31 ± 9 years and retrospective clinical examinations and radiological assessments using a 3-T MRI after all-inside arthroscopic meniscal repair were conducted. Repair of the medial meniscus was performed in 19 patients and of the lateral meniscus in eight. In 17 patients (63%), we performed concomitant anterior cruciate ligament reconstruction. The mean follow-up period was 4.5 ± 1.7 years. The Lysholm score and Tegner activity index were used for clinical evaluation. Four grades were used to classify the radiological signal alterations within the meniscus: central globular (grade 1); linear horizontal or band-like (grade 2); intrameniscal alterations and linear signal alterations communicating with the articular surface (grade 3); and complex tears (grade 4). At follow-up, the average Lysholm score was 76 ± 15 points, with ten of the patients placed in group 6 based on the Tegner activity index. MRI examinations revealed no signal alteration in three patients, grade 1 in 0, grade 2 in five, grade 3 in 13, and grade 4 in six. The MRI findings correlated positively with the clinical scores in 21 patients (78%). Correlation of clinical and radiological examination was performed using 3-T MRI. In spite of satisfactory clinical outcomes at follow-up, a radiological signal alteration may still be visible on MRI, which was believed to be scar tissue, but could not be proven definitively. Imaging with a 3-Tesla MRI after meniscal suture surgery provides good but no definitive reliability on meniscus healing and therefore gives no advantage compared to 1.5-T MRI, with good clinical outcome using an all-inside arthroscopic meniscal repair. 3T-MRI can not substitute diagnostic arthroscopy in patients with persistent complaints after

  6. [Use of pulmonary function tests and biomarkers studies to diagnose and follow-up interstitial lung disease in systemic sclerosis].

    Science.gov (United States)

    Hua-Huy, T; Rivière, S; Tiev, K P; Dinh-Xuan, A T

    2014-12-01

    Interstitial lung disease (ILD) is becoming one of the main causes of death of patients with systemic sclerosis (SSc). The prevalence of ILD associated with SSc (SSc-ILD) varies from 33% to 100% according to diagnostic methods. Clinical features such as dyspnea on exertion, dry cough, and chest pains are not specific and usually late-appearing, implying more specific tests in the diagnostic, prognosis, and follow-up of ILD in patients with SSc. High resolution thoracic CT scanner (HRCT) is more sensitive than chest X-ray in the detection of SSc-ILD. Pulmonary function tests (PFT) are non-invasive and periodically used to assess the impacts of SSc on respiratory function. Diagnostic values of bronchoalveolar lavage and histological examination on lung biopsy are controversial. However, these techniques are essential for studying cellular and molecular mechanisms underlying the pathophysiology of SSc-ILD. Several biomarkers such as surfactant-A (SP-A), -D (SP-D), mucin-like high molecular weight glycoprotein (KL-6), and chemokine CCL-18 have been implicated in SSc-PID. Serum levels of these proteins are correlated with the severity of SSc-ILD, as assessed by HRCT and/or PFT. Finally, alveolar concentration of exhaled nitric oxide can be used to screen SSc patients with high risk of deterioration of respiratory function, in whom immunosuppressant treatment could be useful in preventing the evolution to irreversible lung fibrosis. PMID:25457218

  7. What physical performance measures predict incident cognitive decline among intact older adults? A 4.4year follow up study.

    Science.gov (United States)

    Veronese, Nicola; Stubbs, Brendon; Trevisan, Caterina; Bolzetta, Francesco; De Rui, Marina; Solmi, Marco; Sartori, Leonardo; Musacchio, Estella; Zambon, Sabina; Perissinotto, Egle; Crepaldi, Gaetano; Manzato, Enzo; Sergi, Giuseppe

    2016-08-01

    Reductions in physical performance, cognitive impairment (CI) and decline (CD), are common in older age, but few prospective cohort studies have considered the relationship between these domains. In this study we investigated whether reduced physical performance and low handgrip/lower limbs strength, could predict a higher incidence of CI/CD during a 4-year follow-up among a cohort of elderly individuals. From 3099 older community-dwelling individuals initially enrolled in the Progetto Veneto Anziani (PRO.V.A.) study, 1249 participants without CI at the baseline were included (mean age 72.2years, 59.5% females). Physical performance measures included the Short Physical Performance Battery (SPPB), 4m gait speed, chair stands time, leg extension and flexion, handgrip strength, and 6-Minute Walking Test (6MWT), categorized in gender-specific tertiles. CI was defined as a Mini-Mental State Examination (MMSE) score below 24; CD a decline of 3 or more points in the MMSE without CI. At baseline, participants developing CI during follow-up scored significantly worse across all physical performance measures compared to those that retained normal cognitive status. After adjusting for potential confounders, a significant trend for MMSE changes was noted for all physical performance tests, except for the SPPB and chair stands time. Multinomial logistic regression revealed that slow gait speed at baseline significantly predicted CD at follow up. Poor SPPB performance and slower gait speed predicted the onset of CI at the follow-up. In conclusion, slow walking speed appears to be the best independent predictor of poor cognitive status over a 4.4-year follow-up, while other items of SPPB were also significantly associated with CI. PMID:27235850

  8. The Impact of Recycled Neonatal Incubators in Nigeria: A 6-Year Follow-Up Study

    OpenAIRE

    Hippolite Onyejiaka Amadi; Jonathan C. Azubuike; Etawo, Uriah S.; Offiong, Uduak R.; Chinyere Ezeaka; Eyinade Olateju; Adimora, Gilbert N; Akin Osibogun; Ngozi Ibeziako; Edna O. Iroha; Dutse, Abdulhameed I.; Chukwu, Christian O.; Okpere, Eugene E.; Kawuwa, Mohammed B.; El-Nafaty, Aliyu U.

    2011-01-01

    Nigeria has a record of high newborn mortality as an estimated 778 babies die daily, accounting for a ratio of 48 deaths per 1000 live births. The aim of this paper was to show how a deteriorating neonatal delivery system in Nigeria may have, in part, been improved by the application of a novel recycled incubator technique (RIT). Retrospective assessment of clinical, technical, and human factors in 15 Nigerian neonatal centres was carried out to investigate how the application of RIT impacted...

  9. The Bacterial Overgrowth Syndrome is Uncommon in Pernicious Anaemia: Results of a Follow-up Study

    OpenAIRE

    Stockbrügger, R. W.; Armbrecht, U.; Rode, J. W.; Teall, A J; Oberholzer, V. G.; Croker, J R; Cotton, P B

    2011-01-01

    It is still uncertain whether upper gastrointestinal bacterial overgrowth in patients with permanent achlorhydria causes malassimilation in more than just the occasional case. In an attempt to clarify this, 19 patients with pernicious anaemia who had undergone a thorough investigation 6.6 y (mean) previously, were reinvestigated with clinical history, upper GI endoscopy including multiple duodenal biopsies, microbial cultures of gastric juice and duodenal mucosa, a xylose absorption test, and...

  10. Clinical Follow-up on Sagittal Fracture at the Temporal Root of the Zygomatic Arch: Does It Need Open Reduction?

    Directory of Open Access Journals (Sweden)

    Ji Seon Cheon

    2013-09-01

    Full Text Available Background The zygoma is a major portion of the midfacial contour. When deformity occursin this area, a reduction should be conducted to correct it. If a sagittal fracture at the temporalroot of the zygomatic arch occurs, this also requires reduction, but it is difficult to approachdue to its anatomical location, and the possibility of fixation is also limited. Thus, the authorsattempted the reduction of sagittal fracture by two- or three-point fixation and the Gilliesapproach without direct manipulation. The preoperative and postoperative results of thepatients were evaluated. Follow-up was performed to establish a treatment guideline.Methods A retrospective study was done with 40 patients who had sagittal fractures at thetemporal root of the zygomatic arch from March 2009 to June 2012. Only two- or three-pointfixation was performed for the accompanying zygomatic-orbital-maxillary fracture. The Gilliesapproach was used for complex fractures of the zygomatic arch, while the temporal root ofthe zygomatic arch was only observed without reduction. Preoperative and postoperativecomputed tomography and X-ray scans were performed to examine the results.Results The result of the paired t-test on preoperative and postoperative bone gap differences,the depression level, and the degree of temporal protrusion showed a marked decrease in themean difference at a 95% confidence interval. The results were acceptable.Conclusions In the treatment of sagittal fractures at the temporal root of the zygomatic arch,it is acceptable to use indirect reduction and non-fixation methods. This leads to a satisfactoryaesthetic and functional outcome.

  11. Follow up through Endoscopical – Histological Studies and Helicobacter Pylori Infections in Patients Suffering from Gastric Ulcers

    Directory of Open Access Journals (Sweden)

    Marcos Félix Osorio Pagola

    2010-02-01

    Full Text Available Background: Endoscopic follow up of gastric ulcers until healing has a great important due to the possibility of a new proliferation. The commonest chronic infection worldwide is caused by Helicobacter pylori and it is associated to gastro duodenal diseases. Objective: To determine the endoscopic-biopsic follow up and to set the frequency of infection due to Helicobacter pylori in those patients who suffer from gastric ulcers. Methods: observational, descriptive and prospective study carried out at the University Hospital “Arnaldo Milián Castro”. It included 96 gastric ulcer sufferers diagnosed endoscopically and who fulfilled with the selection criteria. Endoscopy and biopsy of the gastric mucosa was done for the histological study of the gastric ulcers and for the diagnosis of infection due to Helicobacter pylori through hematoxiline-eosine and giemsa stains respectively. Results: 89 patients (92,7 % healed their ulcers in the first three months of follow up and 5 patients underwent a histological diagnosis of malignant ulcers (5,2 %. Surgery was done on the two patients whose ulcers did not heal. (2,1 %. 67,7 % had been infected with the bacteria. There was a greater frequency of patients infected with Helicobacter pylori, either with benign or malignant ulcus (93,8 % y 6,2 % respectively. Conclusions: the follow up of benign ulcers was good , almost all of them healed in a three-month follow up. 5 patients suffered from malignant ulcers, being 2 of them diagnosed in their second endoscopy. More than half of the patients were infected with Helicobacter pylori.

  12. Diffusion-weighted MR imaging of neuro-Behcet's disease: initial and follow-up studies

    Energy Technology Data Exchange (ETDEWEB)

    Heo, Suk Hee; Seo, Jeong Jin; Kim, Heung Joong; Chang, Nam Gyu; Shin, Sang Soo; Jeong, Yong Yeon; Jeong Gwang Woo; Kang, Heoung Keun [Chonnam National University, Gwangju (Korea, Republic of)

    2005-09-15

    To assess the usefulness of diffusion-weighted MR imaging (DWI) and apparent diffusion coefficient (ADC) in the initial and follow-up studies of patients with neuro-Behcet's disease. Six patients diagnosed with neuro-Behcet's disease were the subjects of this study. Initial and follow-up MR imaging were obtained in all six patients. Initial and follow-up DWI were also obtained is four of the six patients, with only an initial DWI in the other two. The DWI were obtained using multi-shot echo planar imaging, on a 1.5T MR unit, with two gradient steps (b values of 0, 1000 sec/mm{sup 2}). The ADC value and ADC maps were obtained using commercial software. The locations and signal intensities of the lesions were analyzed on conventional MRI and DWI, respectively. The ADC values of the lesions were calculated on the initial and follow-up DWI, and compared those of lesions in the normal contralateral regions. The initial DWI showed iso-signal intensities in four of the six patients, with high signal intensities in the other two. In five of the six patients, including three of the four that showed isosignal intensities and the two that showed high signal intensities on the initial DWI, the ADC values of the involved lesions were higher than those of the normal contralateral regions. In three of four that showed isosignal intensities, the ADC values of the lesions were decreased and normalized on the follow-up DWI. Obtaining DWI and ADC values in patients with neuro-Behcet's disease may be helpful in the understanding of pathophysiology and differential diagnosis of this disease.

  13. Criterion validity of a competency-based assessment center in medical education – a 4-year follow-up study

    Directory of Open Access Journals (Sweden)

    Thomas Rotthoff

    2014-09-01

    Full Text Available Introduction: Core competencies have progressively gained importance in medical education. In other contexts, especially personnel selection and development, assessment centers (ACs are used to assess competencies, but there is only a limited number of studies on competency-based ACs in medical education. To the best of our knowledge, the present study provides the first data on the criterion-related validity of a competency-based AC in medical education. Methods: We developed an AC tailored to measure core competencies relevant to medical education (social-ethical, communicative, self, and teaching and tested its validity in n=30 first-year medical students using 3- to 4-year follow-up measures such as (a objective structured clinical examinations (OSCE on basic clinical skills (n=26, (b OSCE on communication skills (n=21, and (c peer feedback (n=18. The AC contained three elements: interview, group discussion, and role play. Additionally, a self-report questionnaire was provided as a basis for the interview. Results: Baseline AC average score and teaching competency correlated moderately with the communication OSCE average score (r=0.41, p=0.03, and r=0.38, p=0.04, respectively. Social-ethical competency in the AC showed a very strong convergent association with the communication OSCE average score (r=0.60, p0.05. Conclusion: The results showed that competency-based ACs can be used at a very early stage of medical training to successfully predict future performance in core competencies.

  14. Somatic comorbidity in anorexia nervosa: First results of a 21-year follow-up study on female inpatients

    Directory of Open Access Journals (Sweden)

    Erdur Laurence

    2012-02-01

    Full Text Available Abstract Background Anorexia nervosa is a severe psychosomatic disease with somatic complications in the long-term course and a high mortality rate. Somatic comorbidities independent of anorexia nervosa have rarely been studied, but pose a challenge to clinical practitioners. We investigated somatic comorbidities in an inpatient cohort and compared somatically ill anorexic patients and patients without a somatic comorbidity. In order to evaluate the impact of somatic comorbidity for the long-term course of anorexia nervosa, we monitored survival in a long-term follow-up. Method One hundred and sixty-nine female inpatients with anorexia nervosa were treated at the Charité University Medical Centre, Campus Benjamin Franklin, Berlin, between 1979 and 2011. We conducted retrospective analyses using patient's medical and psychological records. Information on survival and mortality were required through the local registration office and was available for one hundred patients. The mean follow-up interval for this subgroup was m = 20.9 years (sd = 4.7, min = 13.3, max = 31.6, range = 18.3. We conducted survival analysis using cox regression and included somatic comorbidity in a multivariate model. Results N = 41 patients (24.3% showed a somatic comorbidity, n = 13 patients (7.7% showed somatic comorbidities related to anorexia nervosa and n = 26 patients (15.4% showed somatic comorbidities independent of anorexia nervosa, n = 2 patients showed somatic complications related to other psychiatric disorders. Patients with a somatic comorbidity were significantly older (m = 29.5, sd = 10.3 vs m = 25.0, sd = 8.7; p = .006, showed a later anorexia nervosa onset (m = 24.8, sd = 9.9 vs. m = 18.6, sd = 5.1; p Conclusion Somatic comorbidity seems to be an important factor for anorexia nervosa outcome and should be included in multivariate analyses on the long-term course of anorexia nervosa as an independent variable. Further investigations are needed in order to

  15. Zirconia Implants in Esthetic Areas: 4-Year Follow-Up Evaluation Study

    Science.gov (United States)

    Borgonovo, Andrea Enrico; Censi, Rachele; Vavassori, Virna; Arnaboldi, Oscar; Maiorana, Carlo

    2015-01-01

    Objectives. The aim is to evaluate the survival and success rates, as well as the marginal bone loss (MBL) and periodontal indexes of zirconia implants positioned in the esthetic jaw areas. Materials and Method. 13 patients were selected and 20 one-piece zirconia implants were used for the rehabilitation of single tooth or partially edentulous ridge in the esthetic jaw areas. Six months after surgery and then once a year, a clinical-radiographic evaluation was performed in order to estimate peri-implant tissue health and marginal bone loss. Results. The survival and success rates were 100%. The average marginal bone loss from baseline to 48 months after surgery was +2.1 mm. Four years after surgery, the median and the mode for visible Plaque Index and Bleeding On Probing resulted 1 whereas Probing Pocket Depth amounted to 3 mm (SD = ±0.49 mm). Conclusion. One-piece zirconia dental implants are characterized by high biocompatibility, low plaque adhesion, and absence of microgap that can be related to the clinical success of these implants even in the esthetic areas. PMID:26124836

  16. Zirconia Implants in Esthetic Areas: 4-Year Follow-Up Evaluation Study

    Directory of Open Access Journals (Sweden)

    Andrea Enrico Borgonovo

    2015-01-01

    Full Text Available Objectives. The aim is to evaluate the survival and success rates, as well as the marginal bone loss (MBL and periodontal indexes of zirconia implants positioned in the esthetic jaw areas. Materials and Method. 13 patients were selected and 20 one-piece zirconia implants were used for the rehabilitation of single tooth or partially edentulous ridge in the esthetic jaw areas. Six months after surgery and then once a year, a clinical-radiographic evaluation was performed in order to estimate peri-implant tissue health and marginal bone loss. Results. The survival and success rates were 100%. The average marginal bone loss from baseline to 48 months after surgery was +2.1 mm. Four years after surgery, the median and the mode for visible Plaque Index and Bleeding On Probing resulted 1 whereas Probing Pocket Depth amounted to 3 mm (SD = ±0.49 mm. Conclusion. One-piece zirconia dental implants are characterized by high biocompatibility, low plaque adhesion, and absence of microgap that can be related to the clinical success of these implants even in the esthetic areas.

  17. Oral health follow-up studies in the 1993 Pelotas (Brazil) birth cohort study: methodology and principal results

    Science.gov (United States)

    Peres, Marco A.; Barros, Aluísio Jardim; Peres, Karen Glazer; Araújo, Cora Luiza; Menezes, Ana M. B.; Hallal, Pedro C.; Victora, Cesar G.

    2013-01-01

    The aim of this study was to describe oral health follow-up studies nested in a birth cohort. A population-based birth cohort was launched in 1993 in Pelotas, Rio Grande do Sul State, Brazil. Two oral health follow-up studies were conducted at six (n = 359) and 12 (n = 339) years of age. A high response rate was observed at 12 years of age; 94.4% of the children examined at six years of age were restudied in 2005. The mean DMF-T index at age 12 was 1.2 (SD = 1.6) for the entire sample, ranging from 0.6 (SD = 1.1) for children that were caries-free at age six, 1.3 (SD = 1.5) for those with 1-3 carious teeth at six years, and 1.8 (SD = 1.8) for those with 4-19 carious teeth at six years (p < 0.01). The number of individuals with severe malocclusions at 12 years was proportional to the number of malocclusions at six years. Oral health problems in early adolescence were more prevalent in individuals with dental problems at six years of age. PMID:20963297

  18. Treatment, Services and Follow-up for Victims of Family Violence in Health Clinics in Maputo, Mozambique

    OpenAIRE

    Jetha, Eunice Abdul Remane; Lynch, Catherine A.; Houry, Debra; Rodrigues, Maria Alexandra; Keyes, Christine E.; Chilundo, Baltazar; Wright, David W.; Sasser, Scott M.

    2011-01-01

    Background: Family violence (FV) is a global health problem that not only impacts the victim, but the family unit, local community and society at large. Objective: To quantitatively and qualitatively evaluate the treatment and follow up provided to victims of violence amongst immediate and extended family units who presented to three health centers in Mozambique for care following violence. Methods: We conducted a verbally-administered survey to self-disclosed victims of FV ...

  19. An open label follow-up study on amisulpride in the add-on treatment of bipolar I patients

    Directory of Open Access Journals (Sweden)

    Hardoy Maria

    2006-08-01

    Full Text Available Abstract Background Atypical antipsychotics are widely used in the treatment of bipolar disorders. Amisulpride is an atypical antipsychotic that has been proven to be effective in treatment of schizophrenia, major depressive disorder and, more recently, acute mania. At the moment, however, no study has assessed the effectiveness of this compound in maintenance therapy of bipolar disorders. The purpose of this study was to assess the long-term effectiveness of amisulpride in combination with standard treatments in patients with bipolar I disorder who have shown inadequate responses to ongoing standard therapies. Methods The study enrolled fourteen bipolar I outpatients, not responding to ongoing standard therapy. Three patients discontinued treatment but 11 were followed-up for 11.7 ± 8.2 months before (range 3–24 months and 5.2 ± 2.7 months after the introduction of amisulpride (range 3–9 months. Relapse rates before and during treatment with amisulpride were calculated in accordance to an increase of 1 or more in Clinical Global Impressions Scale-Bipolar Version (CGI-BP score that was accompanied by a change in therapy or to an exacerbation of the symptoms that required hospitalization. Results A statistically significant decrease in overall relapse rate was observed during the period of amisulpride therapy compared with months previous to the introduction of amisulpride. The relative risk of relapse in the absence of amisulpride therapy was 3.1 (χ2 = 4.2, P Discussion and conclusion This open-label study suggests that long-term therapy with amisulpride may benefit patients by improving global symptoms of bipolar disorder and reducing the rate of manic/mixed relapses. Large, randomized, double-blind, placebo-controlled studies are needed to explore the benefits of adding long-term amisulpride to standard therapies for bipolar disorder.

  20. The course and outcome of alcohol use disorders in men in Goa: A population- based follow-up study

    OpenAIRE

    Nadkarni, Abhijit; Bhat, Bhargav; Ebrahim, Shah; Patel, Vikram

    2013-01-01

    Background: Research on the natural history and long-term outcomes of alcohol use disorders (AUD) is important to guide health policy. However, attrition is a major challenge in longitudinal studies and can affect validity of findings. Materials and Methods: A 4-year follow-up study was conducted on a randomly selected subgroup of a sample of men in rural and urban communities in Goa to assess attrition, preliminary estimates of AUD outcomes, and chronic disease risk factors. Results: Overall...

  1. Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden

    OpenAIRE

    Dhejne, Cecilia; Lichtenstein, Paul; Boman, Marcus; Johansson, Anna L. V.; Långström, Niklas; Landén, Mikael

    2011-01-01

    Context The treatment for transsexualism is sex reassignment, including hormonal treatment and surgery aimed at making the person's body as congruent with the opposite sex as possible. There is a dearth of long term, follow-up studies after sex reassignment. Objective To estimate mortality, morbidity, and criminal rate after surgical sex reassignment of transsexual persons. Design A population-based matched cohort study. Setting Sweden, 1973-2003. Participants All 324 sex-reassigned persons (...

  2. Unplanned pregnancy after ultrasound-guided percutaneous microwave ablation of uterine fibroids: A follow-up study

    OpenAIRE

    Zhang Bing-song; Zhang Jing; Han Zhi-yu; Xu Chang-tao; Xu Rui-fang; Li Xiu-mei; Liu Hui

    2016-01-01

    A follow-up study was performed with 169 women of childbearing age who underwent ultrasound-guided percutaneous microwave ablation (UPMWA) therapy for symptomatic uterine fibroids in the Chinese PLA General Hospital from June 2007 to December 2014. This study aimed to observe the incidence of unplanned pregnancies in these women after UPMWA treatment in order to evaluate its effect on natural conception. Ten unplanned pregnancies in nine women were occurred. Of the nine patients, six did not ...

  3. Avulsion of puborectalis muscle and other risk factors for cystocele recurrence: a 2-year follow-up study

    OpenAIRE

    Weemhoff, Mirjam; Vergeldt, Tineke F. M.; Notten, Kim; Serroyen, Jan; Kampschoer, Paul H. N. M.; Roumen, Frans J. M. E.

    2011-01-01

    Introduction and hypothesis This study aimed to determine the relationship of recurrent cystocele with avulsion of puborectalis muscle and other risk factors. Methods In this prospective observational cohort study, 245 women undergoing anterior colporrhaphy were invited for a 2-year follow-up visit consisting of a questionnaire, physical examination, and translabial 3D ultrasonography. Women with and without recurrent cystocele were compared to identify recurrence risk factors. Results Of the...

  4. A 5-year follow-up study of Alfredson's heel-drop exercise programme in chronic midportion Achilles tendinopathy

    OpenAIRE

    2011-01-01

    Background Eccentric exercises have the most evidence in conservative treatment of midportion Achilles tendinopathy. Although short-term studies show significant improvement, little is known of the long-term (>3 years) results. Aim To evaluate the 5-year outcome of patients with chronic midportion Achilles tendinopathy treated with the classical Alfredson's heel-drop exercise programme. Study design Part of a 5-year follow-up of a previously conducted randomised controlled trial. Methods 58 p...

  5. A 5-year follow-up study of Alfredson's heel-drop exercise programme in chronic midportion Achilles tendinopathy

    OpenAIRE

    Plas, J.F.A.N.; Jonge, Suzan; Vos, Robert-Jan; Van der Heide, H.J.L.; Verhaar, Jan; Weir, Adam; Tol, Johannes

    2012-01-01

    textabstractBackground: Eccentric exercises have the most evidence in conservative treatment of midportion Achilles tendinopathy. Although short-term studies show significant improvement, little is known of the long-term (>3 years) results. Aim: To evaluate the 5-year outcome of patients with chronic midportion Achilles tendinopathy treated with the classical Alfredson's heel-drop exercise programme. Study design: Part of a 5-year follow-up of a previously conducted randomised controlled tria...

  6. Normal course of events amongst Swedish soccer players: an 8-year follow-up study.

    OpenAIRE

    Ekstrand, J; Roos, H.; Tropp, H

    1990-01-01

    In this study 180 male soccer players entered into a prospective study of injuries in 1980. They were examined again in 1988. The aim of the present study was to evaluate the course of events during their active period. The study was carried out using a questionnaire. The importance of major injuries was evaluated. Hospital records were scrutinized and 179 of 180 (99 per cent) were included in the evaluation.

  7. A Follow-up Study on U.S.-Trained Iranian Faculty Members: Satisfactions and Dissatisfactions

    Science.gov (United States)

    Arasteh, Hamidreza

    2009-01-01

    Iran was one of the major contributors to the international student population in the United States. For some years, the number of Iranian students studied in America mounted such that there were more Iranians studying at colleges and universities in the United States than from any other foreign country. This study examined the satisfaction of…

  8. [A 3-year follow-up study of the incidence of campylobacteriosis in a pediatric population].

    Science.gov (United States)

    Hofstetr, A; Dvoráková, A; Nikodýmová, I; Sláma, J

    1990-11-01

    The authors investigated the incidence of campylobacteriosis in the population of five paediatric health communities of the Jihlava policlinic (5831 children) for a period of three years. A total of 2408 specimens faeces from 1501 subjects were examined. Campylobacter jejuni was detected in 151 subjects (10.1%), Salmonella sp. in 47 (3.1%), Shigella sp. in 18 (1.2%), Yersinia enterocolitica in 12 (0.8%) and enteropathogenic Escherichia coli in five subjects (0.3%). The total incidence of campylobacteriosis in the investigated group was 863 cases per 100,000 subjects per year. The incidence of campylobacteriosis was seasonal with a maximum during the summer months. To elucidate the source of infection and way of transmission 323 smears from animals, animal products and from the environment were made. Seventy were positive. Campylobacterosis is transmitted to man most frequently by ingestion of primarily or secondarily contamined food, by contact with animals and even interhuman transmission cannot be ruled out. The most frequent clinical symptoms of campylobacteriosis were diarrhoea, fever, abdominal pain and vomiting. Seventeen children were hospitalized. For treatment most frequently Endiaron was used and dietotherapy. Campylobacteriosis affects significantly more frequently children of gipsy origin. PMID:2092913

  9. A follow-up study of hypertensive patients after operative treatment of unilateral renovascular or renal disease

    DEFF Research Database (Denmark)

    McNair, A; Nielsen, M D; Gammelgaard, P A;

    1979-01-01

    than two years. As a group, the patients had severe hypertension with extensive target organ damage and widespread atherosclerosis. A fairly rigorous selection process was applied, and an unsatisfactory response to medical management was considered a point of major importance. In the majority of cases......A study of 44 hypertensive patients with unilateral renovascular or renal parenchymal disease is presented. All patients underwent corrective surgery. Out of the 44 operated patients, five did not participate in the follow-up examination. The remaining 39 patients constitute the study population....... The effects of surgery on the hypertensive state could be evaluated in 35 patients, whereas four died less than two months after the operation. Follow-up studies were carried out at 8-60 months after the operation. The average period of observation was 32 months; 24 patients were observed for more...

  10. Turned Implants in Vertical Augmented Bone: A Retrospective Study with 13 to 21 Years Follow-Up.

    Science.gov (United States)

    Simion, Massimo; Ferrantino, Luca; Idotta, Eleonora; Zarone, Fernando

    2016-01-01

    The aim of this retrospective clinical trial was to evaluate the performance of 91 turned implants placed in vertically augmented ridges in 33 patients by means of guided bone regeneration techniques after a mean follow-up of 15 years. A total of 88 implants were in function (97% survival rate), whereas 9 showed peri-implantitis (9.9%). A mean radiographic bone loss of 1.02 mm between the baseline evaluation (1 year after loading) and the final visit (13 to 21 years later) was recorded. In conclusion, turned implants placed in vertically augmented bone seem to remain stable after many years of function. PMID:27100800

  11. Clinical trial methodology and clinical cohorts: the importance of complete follow-up in trials evaluating the virological efficacy of anti-HIV medicines

    DEFF Research Database (Denmark)

    Kirk, Ole; Lundgren, Jens Dilling

    2004-01-01

    PURPOSE OF REVIEW: It has been common practice in randomized trials of HIV medicines to classify switches away from the original therapy as failures in analyses of virological effect, in line with an HIV-RNA measurement above a given level of quantification. This approach precludes the ability to...... identify the possible effects of a given therapy on those of a subsequent therapy. This review explores whether there have been changes in the reporting of randomized trials since the importance of continuous follow-up throughout the study period was initially raised 2 years ago. RECENT FINDINGS: Follow......-up is still likely to be discontinued at a premature switch from study medication in a large number of the randomized trials published in 2002-2003. However, some studies, all initiated by investigators, did follow patients throughout the study period. In three of the studies, the proportions of...

  12. Doses from nuclear medicine examinations: A 25-year follow-up study

    International Nuclear Information System (INIS)

    New radiopharmaceuticals have been introduced in nuclear medicine examinations, and on the other hand, the amount of many routine nuclear medicine procedures have been replaced with clinical methods utilising non-ionisating radiation (ultrasonography, MRI). To clarify the situation in Finland, a country wide survey on the use of radiopharmaceuticals in diagnostics and therapy was made in 1975, 1982, 1989, 1994, 1997 and will be made in 2000. A questionnaire was sent to all hospitals and institutes using unsealed sources in both diagnostic and therapeutic nuclear medicine procedures. For each procedure, the pharmaceutical used, the number of procedures and the typical administered activities were recorded. The collective effective doses from nuclear medicine examinations were calculated according to the ICRP formulae similarly for each survey. In Finland, in each of these years, more than 50,000 procedures in more than 30 different laboratories were performed. Significant changes in collective doses were observed: for example, the collective dose from I-131 was 350 manSv in 1975, and 20 manSv in 1997. In 1975, 68% (n=23967) of collective dose originated from I-131, whereas in 1997 the percentage of I-131 in collective dose was 10 % (n=1118). In 1994 and 1997, the use of the three radionuclides (Tc-99m, I-131 and Tl-201) accounted for 96% and 95% of the collective effective dose. Our results indicate that the collective effective dose from nuclear medicine examinations has decreased in last 25 years. National surveys form the basis when setting reference levels for typical nuclear medicine examinations. By introducing reference levels based on national practice it is possible to even decrease the collective effective dose. (author)

  13. Gender differences in outcomes of acute mania : a 12-month follow-up study

    NARCIS (Netherlands)

    Miquel, Laia; Usall, Judith; Reed, Catherine; Bertsch, Jordan; Vieta, Eduard; Gonzalez-Pinto, Ana; Angst, Jules; Nolen, Willem; van Rossum, Inge; Maria Haro, Josep

    2011-01-01

    This study aimed to assess short-term (12 weeks) and long-term (12 months) gender differences in the outcomes of patients experiencing an episode of mania in the course of bipolar disorder. European Mania in Bipolar Longitudinal Evaluation of Medication was a 2-year, prospective, observational study

  14. Soft Skills for Information Technology Professionals in Recruitment Advertisements: A Follow-up Study

    Science.gov (United States)

    McMahon, Cynthia J. Moore

    2013-01-01

    The purpose of this research is to determine if the use of soft skills requirements in job posting advertisements for information technology professional positions has increased since the dissertation study by G. K. Tannnahill in 2007, titled "Study of Soft Skills for IT Workers in Recruitment Advertising," to support prior research…

  15. Adjustment to University and Academic Performance: Brief Report of a Follow-Up Study

    Science.gov (United States)

    Petersen, Il-haam; Louw, Johann; Dumont, Kitty; Malope, Nomxolisi

    2010-01-01

    This study presents data that extend an earlier analysis of predictors of academic performance from one to three years. None of the adjustment and other psychosocial variables (help-seeking, academic motivation, self-esteem, perceived stress and perceived academic overload) could predict success at university at the end of three years of study.…

  16. A nationwide follow-up study of children of women with type 1 diabetes mellitus

    NARCIS (Netherlands)

    Rijpert, M.

    2010-01-01

    Previous studies have shown that children of women with type 1 diabetes are at risk for cardiometabolic diseases later in life, such as obesity, hypertension and type 2 diabetes. However, most of these studies have been performed in children of mixed cohorts of women with type 1, type 2 and/or gesta

  17. Sexual function in multiple sclerosis. A 5-year follow-up study

    DEFF Research Database (Denmark)

    Stenager, E; Stenager, E N; Jensen, K

    1996-01-01

    Sexual dysfunction is known to occur in multiple sclerosis (MS). The purpose of the study is to describe the change in sexual function and symptoms in a longitudinal study. Forty-nine patients (27 females, 22 males) with definite MS were interviewed and examined with 5 years interval. The number of...

  18. Health Care Use by Patients with Somatoform Disorders A Register-Based Follow-Up Study*

    DEFF Research Database (Denmark)

    Andersen, Nadia Lyhne Trærup; Eplov, Lene Falgaard; Andersen, Jon Trærup;

    2012-01-01

    OBJECTIVE: Studies have shown a greater use of medical than mental health services in patients with somatoform disorders. However, not many studies are based on structured interviews and include the entire somatoform spectrum of diagnoses. We conducted a register-based case-control study to...... background population. Data from the Danish National Registers were used to assess health care use in both primary and secondary care. RESULTS: Somatoform patients incurred 2.11 (2.09-2.12) times the primary care visits of controls. They had 3.12 (3.08-3.16) times as many somatic bed-days than controls and 3...

  19. A nationwide follow-up study of children of women with type 1 diabetes mellitus

    OpenAIRE

    Rijpert, M.

    2010-01-01

    Previous studies have shown that children of women with type 1 diabetes are at risk for cardiometabolic diseases later in life, such as obesity, hypertension and type 2 diabetes. However, most of these studies have been performed in children of mixed cohorts of women with type 1, type 2 and/or gestational diabetes, or in children who were born >20 years ago when glycemic control was not as good as in current times. It has been concluded from a previous nationwide study on pregnancy outcome in...

  20. Self-experience in the early phases of schizophrenia: 5-year follow-up of the Copenhagen Prodromal Study

    DEFF Research Database (Denmark)

    Parnas, Josef; Raballo, Andrea; Handest, Peter;

    2011-01-01

    admission patients in putative state of beginning psychosis (N=151) with a follow-up length of 60 months. At follow-up, the rate of conversion to schizophrenia spectrum diagnosis was 37%, whereas the conversion rate from schizotypal disorder to schizophrenia was 25%. High levels of perplexity and self......Despite the avalanche of empirical data on prodromal/"at risk" conditions, the essential aspects of the vulnerability to the schizophrenia spectrum remain largely unaddressed. We report here the results of the Copenhagen Schizophrenia Prodromal Study, a prospective, observational study of first......-disorders baseline scores yielded the best prediction of the subsequent development of schizophrenia spectrum disorders. Escalating transitions within the spectrum (i.e., from schizotypal disorder to schizophrenia) were not associated to any candidate psychopathological predictor....

  1. Health effects of selected microbiological control agents. A 3-year follow-up study

    DEFF Research Database (Denmark)

    Baelum, Jesper; Larsen, Preben; Doekes, Gert;

    2012-01-01

    Introduction and objectives: Microbiological control agents (MBCA) are widely used in greenhouses, replacing chemical pesticides. The presented study aims to describe health effects of exposure to three types commonly used: Bacillus thuringiensis, Verticillium lecanii, and Trichoderma harzenianum...

  2. Treatment Compliance of Adolescents after Attempted Suicide: A 2-Year Follow-Up Study

    Science.gov (United States)

    Burns, Craig D.; Cortell, Ranon; Wagner, Barry M.

    2008-01-01

    The study investigates compliance with mental health treatments among suicidal adolescents. Results show that child psychopathology and parental attitudes toward treatment plays an important part in increasing compliance with mental health treatment for adolescent suicide attempters.

  3. Longitudinal pulmonary functional loss in cotton textile workers: A 5-year follow-up study

    OpenAIRE

    Kahraman, Hasan; Sucakli, Mustafa Haki; Kilic, Talat; Celik, Mustafa; Koksal, Nurhan; Ekerbicer, Hasan Cetin

    2013-01-01

    Background Occupational exposure to cotton dust causes several diseases affecting the lungs, but only limited information is available on effects of long-term exposure. In this study, we aimed to evaluate longitudinal changes in selected parameters of pulmonary function in textile workers. Material/Methods This prospective cohort study began with 196 textile workers in 2006 and was completed in 2011 with 49 workers. We used standardized tests for pulmonary function on participants on the firs...

  4. Development of mental health problems – a follow-up study of unaccompanied refugee minors.

    OpenAIRE

    2014-01-01

    Background: Studies have shown that unaccompanied refugee children have elevated symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, and externalizing problems. Few studies have examined change in this group’s mental health symptoms after resettlement in a new country, particularly for those who arrive to a host country when being under the age of 15. Method: The sample included 75 unaccompanied refugee children (mean age 16.5 years, SD =1.6; 83% boys) who settled in No...

  5. Insulin resistance, adiponectin and adverse outcomes following elective cardiac surgery: a prospective follow-up study

    OpenAIRE

    Hjortdal Vibeke E; Christensen Thomas D; Andersen Niels H; Gjedsted Jakob; Hansen Troels K; Mikkelsen Martin M; Johnsen Søren P

    2010-01-01

    Abstract Background Insulin resistance and adiponectin are markers of cardio-metabolic disease and associated with adverse cardiovascular outcomes. The present study examined whether preoperative insulin resistance or adiponectin were associated with short- and long-term adverse outcomes in non-diabetic patients undergoing elective cardiac surgery. Methods In a prospective study, we assessed insulin resistance and adiponectin levels from preoperative fasting blood samples in 836 patients unde...

  6. Can contrast effects regulate emotions? A follow-up study of vital loss decisions.

    Science.gov (United States)

    Li, Qi; Qi, Yue; Liu, Xianyun; Luo, Jing

    2012-01-01

    Although many studies focus on the how contrast effects can impact cognitive evaluations, the question of whether emotions are regulated by such contrast effects is still the subject of considerable debate, especially in the study of loss-related decisions. To address this gap in the literature, we designed three decision making loss conditions: (i) both losses are trivial (TT), (ii) one loss is trivial and the other loss is vital (TV), or (iii) one loss is trivial and the other loss is routine (TR). In study 1, which compared the difference between the negative emotion ratings in TT and TV, we found that negative emotions were affected by the contrast effects. In study 2, which compared the difference between the importance of trivial options in TT and TV, we found that the contrast effects differentially changed the importance of trivial options in the two conditions, which in turn down-regulated negative emotions. In study 3, the impact of decision difficulty was controlled by predetermining the items to be lost. In this study, we found that, when comparing the differences between the negative emotions of losing trivial options in TV and TR, the contrast effects still modulated the loss-related emotions. We concluded that the contrast effects could down-regulate emotions. To our knowledge, this is the first demonstration that contrast effects can alleviate negative affect in loss-related decision making. This study will enrich and extend the literature on emotion regulation theory, and it will provide a new cost-effective mitigation strategy for regulating negative emotions. PMID:22905170

  7. Can contrast effects regulate emotions? A follow-up study of vital loss decisions.

    Directory of Open Access Journals (Sweden)

    Qi Li

    Full Text Available Although many studies focus on the how contrast effects can impact cognitive evaluations, the question of whether emotions are regulated by such contrast effects is still the subject of considerable debate, especially in the study of loss-related decisions. To address this gap in the literature, we designed three decision making loss conditions: (i both losses are trivial (TT, (ii one loss is trivial and the other loss is vital (TV, or (iii one loss is trivial and the other loss is routine (TR. In study 1, which compared the difference between the negative emotion ratings in TT and TV, we found that negative emotions were affected by the contrast effects. In study 2, which compared the difference between the importance of trivial options in TT and TV, we found that the contrast effects differentially changed the importance of trivial options in the two conditions, which in turn down-regulated negative emotions. In study 3, the impact of decision difficulty was controlled by predetermining the items to be lost. In this study, we found that, when comparing the differences between the negative emotions of losing trivial options in TV and TR, the contrast effects still modulated the loss-related emotions. We concluded that the contrast effects could down-regulate emotions. To our knowledge, this is the first demonstration that contrast effects can alleviate negative affect in loss-related decision making. This study will enrich and extend the literature on emotion regulation theory, and it will provide a new cost-effective mitigation strategy for regulating negative emotions.

  8. Needs for care among patients with schizophrenia in six European countries: a one-year follow-up study

    Directory of Open Access Journals (Sweden)

    Roelandt Jean-Luc

    2006-09-01

    Full Text Available Abstract Background This article compares needs for care among patients with schizophrenia across six European countries and examines how this relates to the diversity of psychiatric systems in Europe. Methods A one-year prospective cohort study was set up. Inclusion criteria for patients were: a clinical lifetime diagnosis of schizophrenia according to ICD-10 (F20 diagnostic criteria for research, age between 18 and 65 years and at least one contact with mental health services in 1993. The patients were assessed for their clinical diagnosis and symptoms using the SCAN interview (Schedules for Clinical Assessment in Neuropsychiatry and the interventions proposed to them were recorded through the systematic use of the NFCAS (Needs For Care Assessment Schedule. Results 438 patients were included and 391 were followed up. The mean age was 38 years, the mean age at onset was 22 years, and 59% were out-patients, 24% in day care and 15% hospitalized. The populations in the different centres were significantly different for almost all the variables: sociodemographic, clinical and social, and the problems identified remained relatively stable over the year. Comparisons highlighted cultural differences concerning the interventions that were proposed. Centres in Italy, Spain and Portugal proposed many interventions even though they were relatively deprived in terms of resources, and the tendency seems to be the reverse for the Northern European countries. On average, one in four patients suffered from needs that were not adequately met by the mental health service in their region. These needs (on average 6 per patient varied from psychotic symptoms to managing their own affairs. The number of interventions was not correlated to the need status. The availability of community-based treatment, rehabilitation and residential care seems to predict smaller proportions of patients with unmet needs. Conclusion There appeared to be a systematic relationship

  9. Negative predictive value of multiparametric MRI for prostate cancer detection: Outcome of 5-year follow-up in men with negative findings on initial MRI studies

    International Nuclear Information System (INIS)

    Highlights: • We assess the negative predictive value of multiparametric MRI for prostate cancer. • Patients with positive prostate biopsy findings were defined as false-negative. • Patients with negative initial prostate biopsy findings were followed up for 5 years. • The negative predictive value was 89.6% for significant prostate cancer. • MRI is a useful tool to rule out significant prostate cancer before biopsy. - Abstract: Objective: To assess the clinical negative predictive value (NPV) of multiparametric MRI (mp-MRI) for prostate cancer in a 5-year follow-up. Materials and methods: One hundred ninety-three men suspected of harboring prostate cancer with negative MRI findings were included. Patients with positive transrectal ultrasound (TRUS)-guided biopsy findings were defined as false-negative. Patients with negative initial TRUS-guided biopsy findings were followed up and only patients with negative findings by digital rectal examination, MRI, and repeat biopsy and no increase in PSA at 5-year follow-up were defined as “clinically negative”. The clinical NPV of mp-MRI was calculated. For quantitative analysis, mean signal intensity on T2-weighted images and the mean apparent diffusion coefficient value on ADC maps of the initial MRI studies were compared between peripheral-zone (PZ) cancer and the normal PZ based on pathologic maps of patients who had undergone radical prostatectomy. Results: The clinical NPV of mp-MRI was 89.6% for significant prostate cancer. Small cancers, prostatitis, and benign prostatic hypertrophy masking prostate cancer returned false-negative results. Quantitative analysis showed that there was no significant difference between PZ cancer and the normal PZ. Conclusion: The mp-MRI revealed a high clinical NPV and is a useful tool to rule out clinically significant prostate cancer before biopsy

  10. Negative predictive value of multiparametric MRI for prostate cancer detection: Outcome of 5-year follow-up in men with negative findings on initial MRI studies

    Energy Technology Data Exchange (ETDEWEB)

    Itatani, R., E-mail: banguliao@gmail.com [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556 (Japan); Department of Radiology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto 862-0965 (Japan); Namimoto, T. [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556 (Japan); Atsuji, S.; Katahira, K.; Morishita, S. [Department of Radiology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto 862-0965 (Japan); Kitani, K.; Hamada, Y. [Department of Urology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto 862-0965 (Japan); Kitaoka, M. [Department of Pathology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto 862-0965 (Japan); Nakaura, T. [Department of Diagnostic Radiology, Amakusa Medical Center, Kameba 854-1, Amakusa, Kumamoto 863-0046 (Japan); Yamashita, Y. [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556 (Japan)

    2014-10-15

    Highlights: • We assess the negative predictive value of multiparametric MRI for prostate cancer. • Patients with positive prostate biopsy findings were defined as false-negative. • Patients with negative initial prostate biopsy findings were followed up for 5 years. • The negative predictive value was 89.6% for significant prostate cancer. • MRI is a useful tool to rule out significant prostate cancer before biopsy. - Abstract: Objective: To assess the clinical negative predictive value (NPV) of multiparametric MRI (mp-MRI) for prostate cancer in a 5-year follow-up. Materials and methods: One hundred ninety-three men suspected of harboring prostate cancer with negative MRI findings were included. Patients with positive transrectal ultrasound (TRUS)-guided biopsy findings were defined as false-negative. Patients with negative initial TRUS-guided biopsy findings were followed up and only patients with negative findings by digital rectal examination, MRI, and repeat biopsy and no increase in PSA at 5-year follow-up were defined as “clinically negative”. The clinical NPV of mp-MRI was calculated. For quantitative analysis, mean signal intensity on T2-weighted images and the mean apparent diffusion coefficient value on ADC maps of the initial MRI studies were compared between peripheral-zone (PZ) cancer and the normal PZ based on pathologic maps of patients who had undergone radical prostatectomy. Results: The clinical NPV of mp-MRI was 89.6% for significant prostate cancer. Small cancers, prostatitis, and benign prostatic hypertrophy masking prostate cancer returned false-negative results. Quantitative analysis showed that there was no significant difference between PZ cancer and the normal PZ. Conclusion: The mp-MRI revealed a high clinical NPV and is a useful tool to rule out clinically significant prostate cancer before biopsy.

  11. Use of design methods, team leaders' goal orientation, and team effectiveness : a follow-up study in software development projects

    OpenAIRE

    Sonnentag, Sabine; Frese, Michael; Brodbeck, Felix C.; Heinbokel, Torsten

    1997-01-01

    This article reports an empirical study on effectiveness of software development teams. Itwaspredicted thatboth the extent to whieh design methods are used and teamleaders' goal orientation is related to team effectiveness. Follow-up data (6-12 months after first assessment) were available from 25 German and Swiss software development projeets. Hierarchical regression analysis showed that use of design methods and team leaders' goal orientation predicted team effideney and changeability of th...

  12. A Follow-up Study of Academic Functioning and Social Adjustment in Children with Attention Deficit Hyperactivity Disorder

    OpenAIRE

    Jasmin Garg; Priti Arun

    2013-01-01

    Background : Attention deficit hyperactivity disorder (ADHD) persists in a majority of adolescents. It has been reported that ADHD patients have poor social functioning and risk for developing co-morbid psychiatric illnesses. Aims: To determine the retention of diagnosis of ADHD and to assess social adjustment, academic functioning and co-morbidities at follow-up. Design: Retrospective cohort study. Materials and Methods: ADHD patients of 5-14 years of age who came to the out-patient departme...

  13. Actinic Skin Damage and Mortality - the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study

    OpenAIRE

    He, Wei; Zhu, Fei; Ma, Xiaoguang; Zhao, Xinyu; Min ZHENG; Chen, Zhao; Heymsfield, Steven B.; Zhu, Shankuan

    2011-01-01

    Background Exposure to sunlight may decrease the risk of several diseases through the synthesis of vitamin D, whereas solar radiation is the main cause of some skin and eye diseases. However, to the best of our knowledge, the association of sun-induced skin damage with mortality remains unknown. Methodology/Principal Findings Subjects were 8472 white participants aged 25–74 years in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Cardiovascular diseas...

  14. Patients with Wegener's granulomatosis : A long-term follow-up study

    NARCIS (Netherlands)

    de Leeuw, K.; van der Graaf, A. M.; Bijzet, J.; Stegeman, C. A.; Smit, A. J.; Kallenberg, C. G.; Bijl, M.

    2010-01-01

    Introduction. Atherosclerosis is accelerated in Wegener's granulomatosis (WG) patients. This study was aimed to assess which factors can predict progression of atherosclerosis in WG. Methods. 23 WG patients (14 men; age 47 +/- 9 years, mean +/- SD) and 21 controls (12 men; age 47 +/- 10 years) were

  15. Motor Development in Children at Risk of Autism: A Follow-Up Study of Infant Siblings

    Science.gov (United States)

    Leonard, Hayley C.; Bedford, Rachael; Charman, Tony; Elsabbagh, Mayada; Johnson, Mark H.; Hill, Elisabeth L.

    2014-01-01

    Recently, evidence of poor or atypical motor skills in autism spectrum disorder has led some to argue that motor impairment is a core feature of the condition. The current study uses a longitudinal prospective design to assess the development of motor skills of 20 children at increased risk of developing autism spectrum disorder, who were…

  16. Cognitive Deficits Associated with Acquired Amusia after Stroke: A Neuropsychological Follow-Up Study

    Science.gov (United States)

    Sarkamo, Teppo; Tervaniemi, Mari; Soinila, Seppo; Autti, Taina; Silvennoinen, Heli M.; Laine, Matti; Hietanen, Marja

    2009-01-01

    Recent evidence on amusia suggests that our ability to perceive music might be based on the same neural resources that underlie other higher cognitive functions, such as speech perception and spatial processing. We studied the neural correlates of acquired amusia by performing extensive neuropsychological assessments on 53 stroke patients with a…

  17. International standard problem (ISP) no. 41 follow up exercise: Containment iodine computer code exercise: parametric studies

    International Nuclear Information System (INIS)

    This report describes the results of the second phase of International Standard Problem (ISP) 41, an iodine behaviour code comparison exercise. The first phase of the study, which was based on a simple Radioiodine Test Facility (RTF) experiment, demonstrated that all of the iodine behaviour codes had the capability to reproduce iodine behaviour for a narrow range of conditions (single temperature, no organic impurities, controlled pH steps). The current phase, a parametric study, was designed to evaluate the sensitivity of iodine behaviour codes to boundary conditions such as pH, dose rate, temperature and initial I- concentration. The codes used in this exercise were IODE(IPSN), IODE(NRIR), IMPAIR(GRS), INSPECT(AEAT), IMOD(AECL) and LIRIC(AECL). The parametric study described in this report identified several areas of discrepancy between the various codes. In general, the codes agree regarding qualitative trends, but their predictions regarding the actual amount of volatile iodine varied considerably. The largest source of the discrepancies between code predictions appears to be their different approaches to modelling the formation and destruction of organic iodides. A recommendation arising from this exercise is that an additional code comparison exercise be performed on organic iodide formation, against data obtained front intermediate-scale studies (two RTF (AECL, Canada) and two CAIMAN facility, (IPSN, France) experiments have been chosen). This comparison will allow each of the code users to realistically evaluate and improve the organic iodide behaviour sub-models within their codes. (author)

  18. Very Mild to Severe Dementia and Mortality: A 14-Year Follow-up-The Odense Study

    DEFF Research Database (Denmark)

    Kragh-Sørensen, Per; Lolk, Annette; Martinussen, Torben;

    2010-01-01

    BACKGROUND/AIMS: To examine the mortality of very mildly to severely demented persons compared to nondemented persons. METHODS: Participants in a randomly drawn population-based cohort study on dementia were followed for 14 years from 1992 to 2006. Participants were examined at baseline (3,065 no...

  19. Surgical management of neuroma pain : A prospective follow-up study

    NARCIS (Netherlands)

    Stokvis, Annemieke; van der Avoort, Dirk-Jan J. C.; van Neck, Johan W.; Hovius, Steven E. R.; Coert, J. Henk

    2010-01-01

    Painful neuromas can cause severe loss of function and have great impact on the daily life of patients. Surgical management remains challenging; despite improving techniques, success rates are low. To accurately study the success of surgical neuroma treatment and factors predictive of outcome, a pro

  20. Emotional Psychopathology and Increased Adiposity: Follow-Up Study in Adolescents

    Science.gov (United States)

    Aparicio, Estefania; Canals, Josefa; Voltas, Nuria; Hernandez-Martinez, Carmen; Arija, Victoria

    2013-01-01

    Based on data from a three-year longitudinal study, we assess the effect, according to gender, of emotional psychopathology in preadolescence on anthropometric and body composition parameters in adolescence (N = 229). Psychopathology was assessed using the "Screen for Childhood Anxiety and Related Emotional Disorders, the Children's Depression…

  1. Hormonal contraception and risk of venous thromboembolism: national follow-up study

    DEFF Research Database (Denmark)

    2009-01-01

    -49 with no history of cardiovascular or malignant disease. MAIN OUTCOME MEASURES: Adjusted rate ratios for all first time deep venous thrombosis, portal thrombosis, thrombosis of caval vein, thrombosis of renal vein, unspecified deep vein thrombosis, and pulmonary embolism during the study period. RESULTS...

  2. International standard problem (ISP) no. 41 follow up exercise: Containment iodine computer code exercise: parametric studies

    Energy Technology Data Exchange (ETDEWEB)

    Ball, J.; Glowa, G.; Wren, J. [Atomic Energy of Canada Limited, Chalk River, Ontario (Canada); Ewig, F. [GRS Koln (Germany); Dickenson, S. [AEAT, (United Kingdom); Billarand, Y.; Cantrel, L. [IPSN (France); Rydl, A. [NRIR (Czech Republic); Royen, J. [OECD/NEA (France)

    2001-11-01

    This report describes the results of the second phase of International Standard Problem (ISP) 41, an iodine behaviour code comparison exercise. The first phase of the study, which was based on a simple Radioiodine Test Facility (RTF) experiment, demonstrated that all of the iodine behaviour codes had the capability to reproduce iodine behaviour for a narrow range of conditions (single temperature, no organic impurities, controlled pH steps). The current phase, a parametric study, was designed to evaluate the sensitivity of iodine behaviour codes to boundary conditions such as pH, dose rate, temperature and initial I{sup -} concentration. The codes used in this exercise were IODE(IPSN), IODE(NRIR), IMPAIR(GRS), INSPECT(AEAT), IMOD(AECL) and LIRIC(AECL). The parametric study described in this report identified several areas of discrepancy between the various codes. In general, the codes agree regarding qualitative trends, but their predictions regarding the actual amount of volatile iodine varied considerably. The largest source of the discrepancies between code predictions appears to be their different approaches to modelling the formation and destruction of organic iodides. A recommendation arising from this exercise is that an additional code comparison exercise be performed on organic iodide formation, against data obtained front intermediate-scale studies (two RTF (AECL, Canada) and two CAIMAN facility, (IPSN, France) experiments have been chosen). This comparison will allow each of the code users to realistically evaluate and improve the organic iodide behaviour sub-models within their codes. (author)

  3. One-year follow-up after successful ECT: A naturalistic study in depressed inpatients

    NARCIS (Netherlands)

    T.K. Birkenhäger (Tom); J.-W. Renes (Jan-Willem); E.M. Pluijms (Esther)

    2004-01-01

    textabstractBackground: The aim of this study is to examine both long-term efficacy of electroconvulsive therapy (ECT) and the predictive value of adequate pre-ECT pharmacotherapy and the presence of delusions in relation to post-ECT relapse in patients who suffered from DSM-III-R major depression.

  4. Solitary functioning kidney in children--a follow-up study

    NARCIS (Netherlands)

    Kolvek, Gabriel; Podracka, Ludmila; Rosenberger, Jaroslav; Stewart, Roy E.; van Dijk, Jitse P.; Reijneveld, Sijmen A.

    2014-01-01

    BACKGROUND/AIMS: This study aims to assess the cumulative incidence of elevated albuminuria, hypertension and decreased estimated glomerular filtration rate (eGFR) to identify possible renal injury in children with SFK. METHODS: Forty-two children with SFK (23 boys; 27 congenital) were included in a

  5. Thyroid Nodules in an 11-Year DanThyr Follow-Up Study

    DEFF Research Database (Denmark)

    Krejbjerg, Anne; Bjergved, Lena; Pedersen, Inge Bulow;

    2014-01-01

    (Copenhagen, mild iodine deficiency [ID]; Aalborg, moderate ID). Design and Setting: We conducted a longitudinal population-based study (DanThyr) where participants were examined before (1997) and after (2008) the Danish mandatory IF of salt (2000). Participants: We examined 2465 adults, and ultrasonography...

  6. Smoking cessation, lung function, and weight gain : a follow-up study

    NARCIS (Netherlands)

    Chinn, S; Jarvis, D; Melotti, R; Luczynska, C; Ackermann-Liebrich, U; Anto, JM; Cerveri, [No Value; de Marco, R; Gislason, T; Heinrich, J; Janson, C; Kunzli, N; Leynaert, B; Neukirch, F; Schouten, J; Sunyer, J; Svanes, C; Vermeire, P; Wjst, M; Burney, P

    2005-01-01

    Background Only one population-based study in one country has reported effects of smoking cessation and weight change on lung function, and none has reported the net effect. We estimated the net benefit of smoking cessation, and the independent effects of smoking and weight change on change in venti

  7. Long-term follow-up study of moderate chronic obstructive pulmonary disease in elderly patients

    Institute of Scientific and Technical Information of China (English)

    向平超

    2006-01-01

    Objective To investigate the prognosis of moderate chronic obstructive pulmonary disease (COPD) in the elderly patients, and to evaluate the factors for long term survival. Methods From May 1993,a prospective cohort study was carried out,in which 191 elderly patients with moderate COPD were recruited in Shougang communities, Shijingshan District, Beijing. The general health

  8. Aerobic fitness after JDM--a long-term follow-up study

    DEFF Research Database (Denmark)

    Mathiesen, Pernille Raasthøj; Ørngreen, Mette Cathrine; Vissing, John;

    2013-01-01

    Objectives. It has previously been shown that patients with active JDM have decreased aerobic fitness; however, it is not known whether these patients regain their physical fitness after recovery. The objective of this study was to investigate the long-term outcome of aerobic fitness in patients...

  9. Long-term follow-up study of dilation with temporary cardia stent in different diameters for achalasia

    International Nuclear Information System (INIS)

    Objective: To determine the curative effect of dilation for achalasia with temporary cardia stent in different diameters based on a long-term follow-up. Methods: Th study cohort was comprised of 135 patients of achalasia. Among them differentiated by stent diameters as followings: 30 patients were treated under fluoroscopy with dilation of temporary cardia stent in 20 mm diameter (group A), 30 patients with dilation of temporary cardia stent in 25 mm diameter (group B), and 75 patients with dilation of temporary cardia stent in 30 mm diameter (group C). 135 cardia stents were temporarily placed in the 135 patients and withdrawn after 3-5 days via gastroscopy. All the stents were inserted and withdrawn successfully. the follow-up in all groups lasted 6-128 months. Results: Six (20.0%) out of 30 patients, 6(20.0%) out of 30 patients, 5(22.7%) out of 22 patients, 6 (37.5%) out of 16 patients, 5 out of 9 patients, 3 out of 3 patients in group A exhibited dysphagia relapse during 6 months, 1 year, 3 years, 5 years, 8 years, and 10 years follow-up, respectively. Four (13.3%) out of 30 patients, 4(13.3%) out of 30 patients, 3(13.0%) out of 23 patients, 4(22.2%) out of 18 patients, 5(45.4%) out of 11 patients, and 3 out of 4 patients in group B exhibited dysphagia relapse during 6 months, 1 year, 3 years, 5 years, 8 years, and 10 years follow-up, respectively. No (0.0%) out of 75 patients, 1(1.5%) out of 66 patients, 4(8.3%) out of 48 patients, 6(18.2%) out of 33 patients, 6(33.3%) out of 18 patients, 2 out of 5 patients in group C exhibited dysphagia relapse during 6 months, 1 year, 3 years, 5 years, 8 years, and 10 years follow-up, respectively. Conclusion: Dilation with temporary cardia metal stent in 30 mm diameter is the best dilation for achalasia in long-term follow-up. (authors)

  10. Predicting chronic posttraumatic stress disorder in bereaved relatives: a 6-month follow-up study.

    Science.gov (United States)

    Kristensen, Tina E; Elklit, Ask; Karstoft, Karen-Inge; Palic, Sabina

    2014-06-01

    The objectives of the present study were to examine the prevalence of posttraumatic stress disorder (PTSD) and to identify predicative risk factors for PTSD in bereaved people after a terminal illness. Fifty-four persons (mean age 60 years) participated in the study. Demographic, peritraumatic, and psychosocial factors were assessed in order to identify variables that affected PTSD severity. Six months after the loss, 21.6 % of the subjects had PTSD, an 8.6 % decrease from PTSD measured one month after the loss. Intake of medicine after the loss, place of death, not having a close intimate, negative affectivity, and the A2 criterion predicted 65 % of PTSD severity. A considerable number of the bereaved were still at great risk for developing PTSD six months after loss. PMID:23687214

  11. Effect of Breastfeeding Duration on Cognitive Development in Infants: 3-Year Follow-up Study.

    Science.gov (United States)

    Lee, Hyungmin; Park, Hyewon; Ha, Eunhee; Hong, Yun-Chul; Ha, Mina; Park, Hyesook; Kim, Bung-Nyun; Lee, Boeun; Lee, Soo-Jeong; Lee, Kyung Yeon; Kim, Ja Hyeong; Jeong, Kyoung Sook; Kim, Yangho

    2016-04-01

    We investigated the association between breastfeeding and cognitive development in infants during their first 3 years. The present study was a part of the Mothers' and Children's Environmental Health (MOCEH) study, which was a multi-center birth cohort project in Korea that began in 2006. A total of 697 infants were tested at age 12, 24, and 36 months using the Korean version of the Bayley Scales of Infant Development II (K-BSID-II). The use and duration of breastfeeding and formula feeding were measured. The relationship between breastfeeding and the mental development index (MDI) score was analyzed by multiple linear regression analysis. The results indicated a positive correlation between breastfeeding duration and MDI score. After adjusting for covariates, infants who were breastfed for ≥ 9 months had significantly better cognitive development than those who had not been breastfed. These results suggest that the longer duration of breastfeeding improves cognitive development in infants. PMID:27051242

  12. Deliberate Self-Harm (DSH): a follow-up study of Irish children.

    LENUS (Irish Health Repository)

    Cassidy, C

    2012-02-01

    This study aimed to look at rates of repetition in children presenting with Deliberate Self-Harm (DSH) to a paediatric A&E department. Children presenting with DSH to a paediatric A&E between 2000 and 2005 were invited to participate in the study. Telephone interviews collected information on demographic details and mental health functioning, including repetition of DSH. Data was obtained from 39 parents and 10 children (31 girls and 8 boys, mean age 15) 1 in 5 females (20%) had made a repeat attempt of DSH and 1 in 10 (10%) had repeated more than once. No males repeated self-harm. On going parental concern rather than clinician risk assessment at index episode predicted subsequent DSH. Given the poor predictive value of clinician risk assessment, all attempts of DSH must be taken seriously, especially those associated with ongoing parental concern.

  13. Deliberate Self-Harm (DSH): a follow-up study of Irish children.

    LENUS (Irish Health Repository)

    Cassidy, C

    2009-04-01

    This study aimed to look at rates of repetition in children presenting with Deliberate Self-Harm (DSH) to a paediatric A&E department. Children presenting with DSH to a paediatric A&E between 2000 and 2005 were invited to participate in the study. Telephone interviews collected information on demographic details and mental health functioning, including repetition of DSH. Data was obtained from 39 parents and 10 children (31 girls and 8 boys, mean age 15) 1 in 5 females (20%) had made a repeat attempt of DSH and 1 in 10 (10%) had repeated more than once. No males repeated self-harm. On going parental concern rather than clinician risk assessment at index episode predicted subsequent DSH. Given the poor predictive value of clinician risk assessment, all attempts of DSH must be taken seriously, especially those associated with ongoing parental concern.

  14. Nitrate in drinking water and colorectal cancer - a nationwide population-based follow-up study

    DEFF Research Database (Denmark)

    Schullehner, Jörg; Hansen, Birgitte; Pedersen, Carsten Bøcker;

    Importance of work and objectives Studies have suggested that nitrate in drinking water increased the risk of colorectal cancer. However, often exposure estimations and study size were insufficient to yield unequivocal results. We addressed these challenges by conducting a detailed exposure...... assessment of the entire Danish population. Methodologies GIS methods were used to assign nitrate concentrations at the waterworks to the 2,779 water supply areas and 55,752 private wells. Annual nitrate concentrations were assigned to each resident of Denmark from 1978-2012, based on their exact address in...... the Civil Registration System. For each person the individual adult exposure (age 20-35) was calculated. Information on colon and rectal cancer diagnoses was obtained from the national Cancer Registry. Cox proportional hazard models using age as time scale were fit to assess the risk within exposure...

  15. Risk factors for criminal recidivism - a prospective follow-up study in prisoners with substance abuse

    OpenAIRE

    Håkansson, Anders C; Berglund, Mats

    2012-01-01

    Background: Substance use in general has been shown to predict criminal recidivism. The present study aimed to examine potential predictors of criminal recidivism, including substance-specific substance use patterns, in prisoners with substance use. Methods: A cohort of prisoners with substance use problems (N = 4,152) were assessed with the Addiction Severity Index (ASI) in the Swedish criminal justice system. Clients were followed for an average of 2.7 years. Criminal recidivism was defined...

  16. Risk factors for schizophrenia. Follow-up data from the Northern Finland 1966 Birth Cohort Study

    OpenAIRE

    Isohanni, Matti; Miettunen, Jouko; Mäki, Pirjo; Murray, Graham K; Ridler, Khanum; LAURONEN, ERIKA; Moilanen, Kristiina; Alaräisänen, Antti; Haapea, Marianne; Isohanni, Irene; Ivleva, Elena; TAMMINGA, CAROL; McGrath, John; Koponen, Hannu

    2006-01-01

    This paper updates single risk factors identified by the Northern Finland 1966 Birth Cohort Study up to the end of year 2001 or age 34. Impaired performance (e.g., delayed motor or intellectual development) or adverse exposures (e.g., pregnancy and birth complications, central nervous system diseases) are associated with an increased risk for schizophrenia. However, upper social class girls and clever schoolboys also have an increased risk to develop schizophrenia, contraste...

  17. ADULT STATUS OF CHILDREN WITH CONTRASTING EARLY LIFE EXPERIENCES, A FOLLOW-UP STUDY.

    Science.gov (United States)

    SKEELS, HAROLD M.

    TO STUDY EFFECTS OF EARLY INTERVENTION ON CHILDREN, AN EXPERIMENTAL GROUP OF 13 SUBJECTS (AGED 7 TO 30 MONTHS, IQ 35 TO 89) WAS TRANSFERRED FROM AN ORPHANAGE TO THE INTENSE STIMULATION OF A MOTHER SURROGATE AT AN INSTITUTION FOR THE MENTALLY HANDICAPPED. A CONTRAST GROUP OF 12 SUBJECTS (AGED 11.9 TO 21.8 MONTHS, IQ 50 TO 103) REMAINED AT THE…

  18. Do communication training programs improve students’ communication skills? - a follow-up study

    OpenAIRE

    Simmenroth-Nayda Anne; Weiss Cora; Fischer Thomas; Himmel Wolfgang

    2012-01-01

    Background Although it is taken for granted that history-taking and communication skills are learnable, this learning process should be confirmed by rigorous studies, such as randomized pre- and post-comparisons. The purpose of this paper is to analyse whether a communication course measurably improves the communicative competence of third-year medical students at a German medical school and whether technical or emotional aspects of communication changed differently. Method A sample of 32 ran...

  19. Neighbourhood Environment and Stroke: A Follow-Up Study in Sweden

    OpenAIRE

    Tsuyoshi Hamano; Naomi Kawakami; Xinjun Li; Kristina Sundquist

    2013-01-01

    BACKGROUND: In recent years, research on the association between physical environments and cardiovascular disease outcomes has gained momentum with growing attention being paid to Geographic Information Systems (GIS). This nationwide study is the first to examine the effect of neighbourhood physical environments on individual-level stroke, using GIS-based measures of neighbourhood availability of potentially health-damaging (fast food restaurants and pubs/bars) and health-promoting (physical ...

  20. Prospective follow up study of maternal and foetal outcome in abruption placenta

    OpenAIRE

    Poovathi M.; Raji

    2016-01-01

    Background: Abruptio placentae (AP) which is a major cause of maternal morbidity, mortality and perinatal mortality. Abruptio placentae are one of the leading causes of perinatal deaths. Abruptio placentae increase the neonatal morbidity and mortality. It is one of the recognized causes of low birth weight. The purpose of this study was to examine the risk factors for abruptio placentae together with the maternal and fetal outcome in a tertiary care government medical college hospital. Me...