WorldWideScience

Sample records for icu follow-up services

  1. Impact of follow-up consultations for ICU survivors on post-ICU syndrome

    DEFF Research Database (Denmark)

    Jensen, J. F.; Thomsen, Thordis; Overgaard, D

    2015-01-01

    /unpublished trials. Randomized controlled trials investigating post-ICU consultations in adults with outcomes such as quality of life (QOL), anxiety, depression, posttraumatic stress disorder (PTSD), physical ability, cognitive function, and return to work were included. Two reviewers extracted data and assessed...... ratio 0.49, 95 % CI 0.26-0.95). There was no effect on other outcomes. CONCLUSIONS: The evidence indicates that follow-up consultations might reduce symptoms of PTSD at 3-6 months after ICU discharge in ICU survivors, but without affecting QOL and other outcomes investigated. This review highlights...

  2. Post-ICU symptoms, consequences, and follow-up

    DEFF Research Database (Denmark)

    Svenningsen, Helle; Langhorn, Leanne; Ågård, Anne Sophie

    2015-01-01

    and rehabilitation in general hospital wards, rehabilitation facilities and at home. A prolonged stay in an ICU is associated with stressful memories that have long-term physical, mental and social consequences for health-related quality of life. We therefore conducted a data search to identify the programmes...

  3. Review of retention strategies in longitudinal studies and application to follow-up of ICU survivors.

    Science.gov (United States)

    Tansey, Catherine M; Matté, Andrea L; Needham, Dale; Herridge, Margaret S

    2007-12-01

    To review the literature on retention strategies in follow-up studies and their relevance to critical care and to comment on the Toronto experience with the acute respiratory distress syndrome (ARDS) and severe acute respiratory syndrome (SARS) follow-up studies. Literature review and two cohort studies in a tertiary care hospital in Toronto, Canada. ARDS and SARS patients. Review articles from the social sciences and medicine are summarized and our own experience with two longitudinal studies is drawn upon to elucidate strategies that can be successfully used to attenuate participant drop-out from longitudinal studies. Three key areas for retention of subjects are identified from the literature: (a) respect for patients: respect for their ideas and their time commitment to the research project; (b) tracking: collect information on many patient contacts at the initiation of the study and outline tracking procedures for subjects lost to follow-up; and (c) study personnel: interpersonal skills must be reinforced, flexible working hours mandated, and support offered. Our 5-year ARDS and 1-year SARS study retention rates were 86% and 91%, respectively, using these methods. Strategies to reduce patient attrition are time consuming but necessary to preserve internal and external validity. When the follow-up system is working effectively, researchers can acquire the necessary data to advance knowledge in their field and patients are satisfied that they have an important role to play in the research project.

  4. Two-Year Follow-Up After Percutaneous Dilatational Tracheostomy in a Surgical ICU.

    Science.gov (United States)

    Voelker, Maria Theresa; Wiechmann, Marcus; Dietz, Andreas; Laudi, Sven; Bercker, Sven

    2017-07-01

    The modalities of tracheostomy for critically ill patients are still controversially discussed. Although the use of percutaneous dilatational tracheostomy (PDT) is generally accepted to be a safe procedure, it is still not considered to be suitable for patients requiring a permanent tracheostomy. This was an observational cohort study investigating long-term outcome parameters of PDT. All patients having received a PDT at the interdisciplinary ICU at the University of Leipzig between October 2008 and August 2009 that survived to discharge were asked for consent to participate ( n = 103). Baseline data, admitting diagnosis, reasons for tracheostomy, and timing for tracheostomy were recorded. Subjects and medical providers were asked for neurological outcome, adverse events, and personal discomfort related to the tracheostomy. The study period was 2 y from the time of tracheostomy. Seventy-one subjects were finally included in the survey. Data of 8 subjects (11%) were incomplete. Reasons for tracheostomy were the need for long-term ventilation (42%), weaning (31%), and neurological deficits (27%). No severe adverse events were registered. Sixty-five percent of all subjects could finally be decannulated. Two subjects remained with their initial tracheostomy, and in 5 subjects (7%) tracheostomy was modified to a surgical tracheostomy. Thirty-seven percent of subjects died during the 2 y. Twenty-five of the surviving subjects (35%) had only minor or moderate neurological and psychological deficits. Complaints were mostly connected to swallowing and breathing. Decannulations after PDT are easily done. Complications after PDT requiring a transformation to a surgical tracheostomy are rare. Elective surgical conversions are not necessary. Copyright © 2017 by Daedalus Enterprises.

  5. 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

    OBJECTIVE: To evaluate whether follow-up services for stroke survivors could improve functional outcome and reduce readmission rate. In this paper results of functional outcome are reported. DESIGN: Randomized controlled trial allocating patients to one of three different types of aftercare: (1......) 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...... discharge, functional outcome was assessed with Functional Quality of Movement, Barthel Index, Frenchay Activity Index and Index of Extended Activites of Daily Living. RESULTS: One-hundred and fifty-five stroke patients were included in the study. Fifty-four received follow-up home visits by a physician, 53...

  6. Cost analysis for the implementation of a medication review with follow-up service in Spain.

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    Noain, Aranzazu; Garcia-Cardenas, Victoria; Gastelurrutia, Miguel Angel; Malet-Larrea, Amaia; Martinez-Martinez, Fernando; Sabater-Hernandez, Daniel; Benrimoj, Shalom I

    2017-08-01

    Background Medication review with follow-up (MRF) is a professional pharmacy service proven to be cost-effective. Its broader implementation is limited, mainly due to the lack of evidence-based implementation programs that include economic and financial analysis. Objective To analyse the costs and estimate the price of providing and implementing MRF. Setting Community pharmacy in Spain. Method Elderly patients using poly-pharmacy received a community pharmacist-led MRF for 6 months. The cost analysis was based on the time-driven activity based costing model and included the provider costs, initial investment costs and maintenance expenses. The service price was estimated using the labour costs, costs associated with service provision, potential number of patients receiving the service and mark-up. Main outcome measures Costs and potential price of MRF. Results A mean time of 404.4 (SD 232.2) was spent on service provision and was extrapolated to annual costs. Service provider cost per patient ranged from €196 (SD 90.5) to €310 (SD 164.4). The mean initial investment per pharmacy was €4594 and the mean annual maintenance costs €3,068. Largest items contributing to cost were initial staff training, continuing education and renting of the patient counselling area. The potential service price ranged from €237 to €628 per patient a year. Conclusion Time spent by the service provider accounted for 75-95% of the final cost, followed by initial investment costs and maintenance costs. Remuneration for professional pharmacy services provision must cover service costs and appropriate profit, allowing for their long-term sustainability.

  7. Health Centre Staff Are Satisfied with Librarian-Mediated Search Services, Especially When Librarians Follow Up

    Directory of Open Access Journals (Sweden)

    Peace Ossom Williamson

    2018-03-01

    Full Text Available A Review of: McKeown, S., Konrad, S.-L., McTavish, J., & Boyce, E. (2017. Evaluation of hospital staff’s perceived quality of librarian-mediated literature searching services. Journal of the Medical Library Association, 105(2, 120-131. http://dx.doi.org/10.5195/jmla.2017.201 Abstract Objective – To determine the effects of the professional designation and communication method on clinical, educational, and research activities and related users’ reported satisfaction with and perceived quality of a librarian-mediated literature searching service. Design – Online survey. Setting – A large teaching hospital in Ontario, Canada. Subjects – 237 health sciences centre staff who were requesting librarian-mediated literature searching over a one-year period. Methods – From February 1, 2014 to January 31, 2015, one-third of the health centre staff members requesting searching services, representing a systematic sample of the user group, were invited to participate in the survey. The survey centred on questioning participants on a critical incident, which, according to the critical incident technique, is an actual event upon which recollections are made, rather than hypothetical situations. In the case of this study, the critical incident was the service they received upon requesting literature searching by a librarian who was blinded concerning the originator of the request. With a 71% response rate, the researchers received 137 responses to the survey by health sciences staff. Participants were asked how many literature searches they had requested in the previous year, the reason they requested the service, how they submitted the request, and whether the librarian followed up for further clarification of their need. They also reported on the relevance of the results and their method of delivery, along with their perceptions of the overall quality of the service. Main Results – The results came from 137 completed surveys, for a 71% response

  8. Infection control and quality assurance of health services provided in ICU: development of an ICU website.

    Science.gov (United States)

    Diomidous, Marianna; Ponirou, Paraskevi; Mpizopoulou, Zoi; Tzalera, Vaia; Mechili, Aggelos

    2013-01-01

    The aim of this study is to examine the infections control methods in ICU as well as the issue of quality in health services provided, as they constitute an important quality assurance indicator. Moreover, nowadays the causes of Nosocomial infections are known and so do the measures for their control. There is a need however for an information resource that will promote specialized and general guidelines. The measures include the appropriate use of gloves, cleaning and disinfection of the ICU environment and hand washing which is the most important of all. Therefore an effort was made to develop an easy to navigate webpage with practical and comprehensible clinical guidelines. Additionally, it gives to all visitors the opportunity for further information research with the use of the included links. For the development of the web side existing clinical guide lines were scrutinizes as well as studies that concern the effectiveness of the measures mentioned and for the identification of quality assurance criteria.

  9. Time Trend of the People lost follow up on Antiretroviral Therapy (ART Services in Nepal: A Epidemiological Modelling

    Directory of Open Access Journals (Sweden)

    Brijesh Sathian

    2014-06-01

    Full Text Available Background: The real state about the spread of the HIV epidemic in Nepal is not clear since the details available are on the basis of repeated integrated biological and behavioral surveillance. Objective To study the trends of People lost follow up on ART in future. Material and methods: A retrospective study was carried out on the data collected from the Health ministry records of Nepal, between 2006 and 2012. Descriptive statistics and statistical modelling were used for the analysis and forecasting of data. Results: Including the constant term from the equation, the quadratic model was the best fit, for the forecasting of People lost follow up on ART. Using quadratic equation, it is estimated that 4331 reported number of People lost follow up on ART will be there in Nepal by the year 2020. Conclusion: The People lost follow up on ART in Nepal are having an increasing trend. Estimates of the total number of People lost follow up on ART attributable to the major routes of infection make an important contribution to public health policy. They can be used for the planning of healthcare services and for contributing to estimates of the future numbers with People lost follow up on ART used for planning health promotion programmes.

  10. 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…

  11. Health assessments for Indigenous Australians at Orange Aboriginal Medical Service: health problems identified and subsequent follow up.

    Science.gov (United States)

    Dutton, Tegan; Stevens, Wendy; Newman, Jamie

    2016-01-01

    This study aimed to document the types, management and follow up of health issues identified by all Aboriginal Health Assessments (AHA) performed at Orange Aboriginal Medical Service from 1 January 2011 to 31 December 2012. This was done with a retrospective audit of clinical records. In total, 1169 AHAs were performed: 41% child, 53% adult and 6% older person AHAs. Newly identified health issues were documented in 85% (984). Being overweight (41%; 476) and smoking (26%; 301) were the common risk factors identified. As a result of the AHA, most children who were not up-to-date with their vaccinations received catch-up immunisations; 11% (36) of adult women (n=314) received a Pap smear, although Pap smear status was unknown or not up-to-date for 61% (192); 27% (311) of cases were prescribed new medication; and 1239 referrals were made but only 40% were attended. At 6 months following the AHA, 26% (240) of cases with newly identified health issues were completely managed and followed up, whereas 25% (226) received no follow up. The AHAs are useful for identifying new health issues; however, follow up of the identified health issues should be improved. If AHAs are to improve health outcomes, appropriate management and follow up of the identified health issues are essential.

  12. Reducing pharmacy wait time to promote customer service: a follow-up study.

    Science.gov (United States)

    Slowiak, Julie M; Huitema, Bradley E

    2015-01-01

    The present study had 3 objectives: (1) to evaluate the effects of 2 different interventions (feedback regarding customer satisfaction with wait time and combined feedback and goal setting) on wait time in a hospital outpatient pharmacy; (2) to assess the extent to which the previously applied interventions maintained their effects; and (3) to evaluate the differences between the effects of the original study and those of the present follow-up study. Participants were 10 employees (4 pharmacists and 6 technicians) of an outpatient pharmacy. Wait times and customer satisfaction ratings were collected for "waiting customers." An ABCB within-subjects design was used to assess the effects of the interventions on both wait time and customer satisfaction, where A was the baseline (no feedback and no goal setting); B was the customer satisfaction feedback; and C was the customer satisfaction feedback, the wait time feedback, and the goal setting for wait time reduction. Wait time decreased after baseline when the combined intervention was introduced, and wait time increased with the reintroduction of satisfaction feedback (alone). The results of the replication study confirm the pattern of the results of the original study and demonstrate high sensitivity of levels of customer satisfaction with wait time. The most impressive result of the replication is the nearly 2-year maintenance of lower wait time between the end of the original study and the beginning (baseline) of the replication.

  13. A prospective examination of service use by abused and neglected children followed up into adulthood.

    Science.gov (United States)

    Yanos, Philip T; Czaja, Sally J; Widom, Cathy Spatz

    2010-08-01

    This study sought to determine whether abused and neglected children are more likely than those without childhood maltreatment to use health and social services as adults and whether psychiatric status mediates or moderates the relationship. A prospective cohort design was used. Individuals with documented cases of physical and sexual abuse and neglect (ages 0-10) and nonvictimized children matched on age, sex, and race-ethnicity were interviewed in adulthood (mean age 41 years). Past-year service use (general medical, mental health, substance abuse, and social) was assessed during 2003-2004 interviews (maltreated group, N=458; control group, N=349). Psychiatric status (posttraumatic stress disorder [PTSD], drug abuse, and major depressive disorder) was assessed during 1989-1995 (mean age 29) by structured interview. Individuals with histories of childhood abuse and neglect were significantly more likely than their control group counterparts to use mental health services (odds ratio [OR]=1.60, 95% confidence interval [CI]=1.04-2.45) and social services (OR=2.95, CI=2.19-3.97) in adulthood. Psychiatric status in young adulthood (PTSD and major depressive disorder) partially mediated the relationship between childhood maltreatment and use of mental health services, whereas major depression and drug abuse moderated the relationship between maltreatment and use of any services and general medical services. In adulthood, individuals with documented histories of childhood abuse and neglect are more likely than persons without such histories to use some types of services, and psychiatric status mediates and moderates these relationships. Findings have implications for the provision of services to persons with childhood abuse and neglect.

  14. 20 CFR 664.450 - What are follow-up services for youth?

    Science.gov (United States)

    2010-04-01

    ...) The leadership development and supportive service activities listed in §§ 664.420 and 664.440; (2) Regular contact with a youth participant's employer, including assistance in addressing work-related...

  15. Results of a quantitative survey to explore both perceptions of the purposes of follow-up and preferences for methods of follow-up delivery among service users, primary care practitioners and specialist clinicians after cancer treatment.

    Science.gov (United States)

    Frew, G; Smith, A; Zutshi, B; Young, N; Aggarwal, A; Jones, P; Kockelbergh, R; Richards, M; Maher, E J

    2010-12-01

    To ascertain perceptions of reasons for follow-up after cancer treatment among service users (patients and carers), primary care practitioners and specialist clinicians (doctors and specialist nurses) and to identify levels of preference for different models of follow-up and the effect of an individual's experience on preferred models. A national survey designed to meet the needs of each key respondent group was carried out after a structured literature review, an extensive consultation process and a pilot scheme. Respondents were asked to assess their degree of preference for 10 pre-selected indications for follow-up. Eight models of follow-up were also identified and respondents were asked to state their experience and preference for each type. The questionnaire was distributed nationally via the 34 cancer networks in England and was available both online and in hard copy (postal). The uptake for the electronic format was in the main by primary care practitioners and specialist clinicians. Service users preferred the paper (postal) format. The survey was also publicised through the primary care and patient partnership forums at a Cancer Network Development event. In total, 2928 responses were received, comprising service users (21% of the sample), primary care practitioners (32%) and specialist clinicians (47%). Eighty-six per cent of responses were received from the 10 strategic health authorities in England, with the remaining 14% from Scotland, Wales and The Isle of Man. The responses from Scotland, Wales and the Isle of Man generally occurred where they interfaced with English cancer networks or had been engaged through word of mouth by colleagues. Among all respondents the main aims of cancer follow-up were considered to be: (1) to monitor for early complications after treatment; (2) to detect recurrences early; (3) to detect late effects of treatment. The most commonly experienced method of follow-up among all respondent groups was outpatient review with a

  16. Rehabilitation Engineering Service Evaluation: A Follow-Up Survey of Device Effectiveness and Patient Acceptance.

    Science.gov (United States)

    Caudrey, David J.; Seeger, Barry R.

    1983-01-01

    A study was undertaken to determine the extent to which a rehabilitation engineering service met the needs and expectations of 100 patients (or parents of child patients). The patients were interviewed an average of 16 weeks after a new piece of equipment was supplied. (Author)

  17. Marketing and Distribution: A Team Plan for In-Service Follow-Up

    Science.gov (United States)

    Mason, Ralph E.

    1976-01-01

    Distributive education (DE) teacher education universities in Indiana completed a consortium testing an exemplary plan to use in followup service activities with first- and second-year distributive education teachers. How the plan was developed and ways in which it was successful are discussed. (HD)

  18. Evaluation Services from Needs Assessment to Follow-up: A Case Study.

    Science.gov (United States)

    Broadbooks, Wendy J.

    This paper describes the nature and scope of evaluation services provided within the training division of Arthur Andersen & Company, and highlights some of the evaluation results. The cycle of assessment began with a needs assessment study at the curriculum level. Curriculum planning was undertaken for first-year trainees in the Tax Division.…

  19. Improving the Blood Pressure Control With the ProActive Attitude of Hypertensive Patients Seeking Follow-up Services

    Science.gov (United States)

    Tang, Shangfeng; Bishwajit, Ghose; Ji, Lu; Feng, Da; Fang, Haiqing; Fu, Hang; Shao, Tian; Shao, Piaopiao; Liu, Chunyan; Feng, Zhanchun; Luba, Tegene R.

    2016-01-01

    Abstract Proactive attitude of hypertensive patients seeking follow-up services (FUS) lies at the core of self-efficacy. However, few evidence have shown the activeness of seeking FUS in the context of blood pressure control among hypertensive patients. Improvements in follow-up visits may not just by services itself cause better control of blood pressure among hypertensive patients, rather due to the patient's pro-active attitude of the patient in seeking FUS. A cross-sectional study was carried out in selected rural regions of China to explore the association between blood pressure control and sociodemographic and economic variables and activeness of hypertensive patients in seeking FUS. The primary clinical outcome for this study was blood pressure control (systolic blood pressure seekers were 3.17 times greater than those of passive seekers (odds ratio [OR] = 3.17, 95% confidence interval [CI] = 2.56–3.93, P passively. Proactive attitude of seeking follow-up services can improve blood pressure control among hypertensive patients. PMID:27057859

  20. Workplace health promotion and utilization of health services: follow-up data findings.

    Science.gov (United States)

    Deitz, Diane; Cook, Royer; Hersch, Rebekah

    2005-01-01

    This article reports findings from a workplace substance abuse prevention program designed to investigate best practices. The study sought to assess the effects of the worksite wellness program and employee assistance program (EAP) on healthcare utilization and costs, identify predictors of outpatient costs and visits, and assess the effect of the intervention on health attitudes, behaviors, and behavioral health-related costs and visits. Results indicated that visits to the EAP increased as did overall healthcare visits, that utilization of healthcare services and costs were higher in the population receiving substance abuse prevention intervention, and that employees in the substance abuse prevention intervention reported lower heavy drinking and binge drinking. Data suggest that substance abuse prevention may result in higher healthcare costs and utilization in the short term, but a reduction in health risk behaviors such as heavy drinking may result in lower healthcare costs and utilization in the long term.

  1. Parental mental health after the accidental death of a son during military service: 23-year follow-up study.

    Science.gov (United States)

    Kristensen, Pål; Heir, Trond; Herlofsen, Pål H; Langsrud, Øyvind; Weisæth, Lars

    2012-01-01

    We prospectively studied parental mental health after suddenly losing a son in a military training accident. Parents (N = 32) were interviewed at 1, 2 and 23 years after the death of their son. The General Health Questionnaire and Expanded Texas Inventory of Grief were self-reported at 1, 2, 5, and 23 years; the Inventory of Complicated Grief was self-reported at 23 years. We observed a high prevalence of psychiatric disorders at 1- and 2-year follow-ups (57% and 45%, respectively), particularly major depression (43% and 31%, respectively). Only one mental disorder was diagnosed at the 23-year follow-up. Grief and psychological distress were highest at 1- and 2-year follow-ups. Spouses exhibited a high concordance of psychological distress. Mothers reported more intense grief reactions than did fathers. The loss of a son during military service may have a substantial impact on parental mental health particularly during the first 2 years after death. Spouses' grief can be interrelated and may contribute to their psychological distress.

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

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    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

  3. A long term follow-up study from India assessing the risk of diabetes mellitus in service population.

    Science.gov (United States)

    Kumar, K V S Hari; Patnaik, S K

    The data about the incidence of diabetes is scarce from developing countries. We studied the incidence of type 1 (T1DM) and type 2 DM (T2DM) in a cohort of young military personnel followed for a long duration. The data for this descriptive epidemiologic study was derived from the electronic medical records (EMR) of the male service personnel enrolled between 1990 and 2015. All subjects were recruited before 18 years of age in good health and the onset of DM was derived from the EMR. We calculated the incidence rates as per person years using appropriate statistical methods. Our study population includes 51,217 participants (median age 33 years, range 17-54) with a mean follow up of 12.5 years, giving a cumulative follow up duration of 613,925 person-years (py). A total of 251 patients developed T2DM and 15 patients developed T1DM during the study period. The incidence rate of T2DM was 0.41 per 1000 py and that of T1DM was 2.44 per 100,000 py. Our cohort had low incidence rates of diabetes when compared with other studies from India and abroad. Active military service with good life style measures may offer protection from the DM. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  4. CONTRACT FOLLOW UP TRAINING

    CERN Multimedia

    Technical Training; Tel. 74460

    2001-01-01

    SPL is organizing Training Sessions on the Contract Follow Up application. CFU is a Web based tool, developped and supported by the Administrative Information Services. It allows the creation of Divisional Requests and the follow up of their processing, from the Market Survey to the Invitation to Tender or Price Enquiry, approval by the Finance Committee, up to the actual signature of a Contract, acccording to the CERN Purchasing procedures. It includes a document management component. It also provides link with other AIS applications such as BHT and EDH. The course is primarily intended for DPOs, Contract Technical responsibles in the division and their assistants, but is beneficial to anybody involved in the follow up of such Purchasing Procedures. This course is free of charge, but application is necessary. The details of the course may be found at http://training.web.cern.ch/Training/ENSTEC/P2001/Bureautique/cfu4_f.htm General information of CFU may be found at http://ais.cern.ch/apps/cfu/ The dates of t...

  5. Assessing nonresponse bias at follow-up in a large prospective cohort of relatively young and mobile military service members

    Directory of Open Access Journals (Sweden)

    Hooper Tomoko

    2010-10-01

    Full Text Available Abstract Background Nonresponse bias in a longitudinal study could affect the magnitude and direction of measures of association. We identified sociodemographic, behavioral, military, and health-related predictors of response to the first follow-up questionnaire in a large military cohort and assessed the extent to which nonresponse biased measures of association. Methods Data are from the baseline and first follow-up survey of the Millennium Cohort Study. Seventy-six thousand, seven hundred and seventy-five eligible individuals completed the baseline survey and were presumed alive at the time of follow-up; of these, 54,960 (71.6% completed the first follow-up survey. Logistic regression models were used to calculate inverse probability weights using propensity scores. Results Characteristics associated with a greater probability of response included female gender, older age, higher education level, officer rank, active-duty status, and a self-reported history of military exposures. Ever smokers, those with a history of chronic alcohol consumption or a major depressive disorder, and those separated from the military at follow-up had a lower probability of response. Nonresponse to the follow-up questionnaire did not result in appreciable bias; bias was greatest in subgroups with small numbers. Conclusions These findings suggest that prospective analyses from this cohort are not substantially biased by non-response at the first follow-up assessment.

  6. Follow-up after arthroplasty of the hip and knee : are we over-servicing or under-caring?

    Science.gov (United States)

    Lovelock, T M; Broughton, N S

    2018-01-01

    The number of arthroplasties of the hip and knee is predicted to increase rapidly during the next 20 years. Accompanying this is the dilemma of how to follow-up these patients appropriately. Current guidelines recommend long-term follow-up to identify patients with aseptic loosening, which can occur more than a decade postoperatively. The current guidelines and practices of orthopaedic surgeons vary widely. Existing models take up much clinical time and are expensive. Pilot studies using 'virtual' clinics and advanced-practice physiotherapists have shown promise in decreasing the time and costs for orthopaedic surgeons and patients. This review discusses current practices and future trends in the follow-up of patients who have an arthroplasty. Cite this article: Bone Joint J 2018;100-B:6-10. ©2018 The British Editorial Society of Bone & Joint Surgery.

  7. 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

    the completion of inpatient rehabilitation, were discharged to their homes. The patients were randomized to 1 of 2 follow-up interventions provided in addition to standard care or to standard aftercare. Fifty-four received follow-up home visits by a physician (INT1-HVP), 53 were provided instructions......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...... by a 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...

  8. [Situation and reasons for missed follow-up services among newly reported HIV/AIDS cases transmitted by homosexual behavior in China, 2008-2015].

    Science.gov (United States)

    Xu, J; Han, J; Tang, H L; Li, J; Zang, C P; Mao, Y R

    2018-04-10

    Objective: To determine the prevalence and relative factors on those who missed the follow-up service among newly reported HIV/AIDS cases that were infected by homosexual behavior. Methods: Data were extracted from both HIV/AIDS case-reporting and follow-up cards on HIV/AIDS in the Comprehensive Response Information Management System, between December 2008 and December 2015. Data was analyzed, using the generalized estimating equations (GEE) to explore the relative factors of influence. Results: Among the newly reported HIV infection among MSM, the proportion of those who missed the follow-up services was 5.06% (6 037/119 358), and decreased dramatically, from 37.57% (1 261/3 356) to 0.84% (267/31 935) (trend χ (2)=103.43, P discovered MSM HIV cases declined dramatically. Among the MSM HIV cases, those having the following characteristics as: younger than 50-year old, with less school education, with unspecified occupation or unemployment, working in commercial service, being student, having history of incarceration, recruited from special investigation, and floating population were prone to miss the follow-up program, suggesting that the follow-up service should be targeting on these patients.

  9. Consumer satisfaction with the Child and Adolescent Mental Health Service and its association with treatment outcome: a 3-4-year follow-up study.

    Science.gov (United States)

    Solberg, Cathrine; Larsson, Bo; Jozefiak, Thomas

    2015-04-01

    Consumer satisfaction studies with the Child and Adolescent Mental Health Service (CAMHS) have mainly assessed evaluations in a short-term follow-up perspective. Adolescent reports with CAMHS have not been included nationally. The purposes of this study were to explore adolescent and parental satisfaction with the CAMHS in a 3-4-year follow-up perspective, and to examine the relationships between reported consumer satisfaction and clinical parameters such as reason for adolescent referral, emotional/behavioral symptoms and treatment outcome. Of 190 adolescent-parent pairs in a sample of CAMHS outpatients, 120 completed a Consumer Satisfaction Questionnaire. Parents assessed adolescent emotional/behavior problems both at baseline and at follow-up by completing the Child Behavior Checklist (CBCL). Correlations were examined between adolescent and parental evaluations. The relationships between service satisfaction and symptom load at baseline and follow-up and treatment outcome at follow-up were explored. Overall, adolescents and parents were satisfied with the services received from the CAMHS. The correlations between adolescent and parent consumer satisfaction ratings were low to moderate. Consumer satisfaction was significantly and negatively correlated with symptom load on the CBCL Total Problems scores at baseline, but not at follow-up. There was no difference in satisfaction levels between those who improved after treatment and those who did not. Given the differences in informant ratings of consumer satisfaction, it is important to include both adolescent and parental perceptions in evaluations of CAMHS services and treatment outcomes. Consumer satisfaction should serve as a supplement to established standardized outcome measures.

  10. The contribution of the psychosocial work environment to sickness absence in human service workers : Results of a 3-year follow-up study

    NARCIS (Netherlands)

    Rugulies, Reiner; Christensen, Karl B.; Borritz, Marianne; Villadsen, Ebbe; Bultmann, Ute; Kristensen, Tage S.

    2007-01-01

    We investigated to what extent psychosocial. work characteristics predict sickness absence in a cohort of 890 human service professionals (84% women), followed-up for 3 years. We measured 16 different psychosocial work characteristics at baseline and analysed their associations with number of

  11. Treatment and Follow Up

    Science.gov (United States)

    ... Close Celiac Disease Understanding Celiac Disease What is Celiac Disease? Symptoms Screening and Diagnosis Treatment and Follow-Up Dermatitis ... you find the right healthcare practitioner to discuss symptoms, diagnose, and ... Our nationwide Healthcare Practitioner Directory lists primary care ...

  12. A mobile phone-based, community health worker program for referral, follow-up, and service outreach in rural Zambia: outcomes and overview.

    Science.gov (United States)

    Schuttner, Linnaea; Sindano, Ntazana; Theis, Mathew; Zue, Cory; Joseph, Jessica; Chilengi, Roma; Chi, Benjamin H; Stringer, Jeffrey S A; Chintu, Namwinga

    2014-08-01

    Mobile health (m-health) utilizes widespread access to mobile phone technologies to expand health services. Community health workers (CHWs) provide first-level contact with health facilities; combining CHW efforts with m-health may be an avenue for improving primary care services. As part of a primary care improvement project, a pilot CHW program was developed using a mobile phone-based application for outreach, referral, and follow-up between the clinic and community in rural Zambia. The program was implemented at six primary care sites. Computers were installed at clinics for data entry, and data were transmitted to central servers. In the field, using a mobile phone to send data and receive follow-up requests, CHWs conducted household health surveillance visits, referred individuals to clinic, and followed up clinic patients. From January to April 2011, 24 CHWs surveyed 6,197 households with 33,304 inhabitants. Of 15,539 clinic visits, 1,173 (8%) had a follow-up visit indicated and transmitted via a mobile phone to designated CHWs. CHWs performed one or more follow-ups on 74% (n=871) of active requests and obtained outcomes on 63% (n=741). From all community visits combined, CHWs referred 840 individuals to a clinic. CHWs completed all planned aspects of surveillance and outreach, demonstrating feasibility. Components of this pilot project may aid clinical care in rural settings and have potential for epidemiologic and health system applications. Thus, m-health has the potential to improve service outreach, guide activities, and facilitate data collection in Zambia.

  13. Determinants of Mortality and Loss to Follow-Up among Adults Enrolled in HIV Care Services in Rwanda

    Science.gov (United States)

    Wang, Chunhui; Lahuerta, Maria; Nuwagaba-Biribonwoha, Harriet; Tayebwa, Edwin; Ingabire, Eugenie; Ingabire, Pacifique; Sahabo, Ruben; Twyman, Peter; Abrams, Elaine J.

    2014-01-01

    Background Antiretroviral therapy (ART) improves morbidity and mortality in patients with HIV, however high rates of loss to follow-up (LTF) and mortality have been documented in HIV care and treatment programs. Methods We analyzed routinely-collected data on HIV-infected patients ≥15 years enrolled at 41 healthcare facilities in Rwanda from 2005 to 2010. LTF was defined as not attending clinic in the last 12 months for pre-ART patients and 6 months for ART patients. For the pre-ART period, sub-distribution hazards models were constructed to estimate LTF and death to account for competing risks. Kaplan-Meier (KM) and Cox proportional hazards models were used for patients on ART. Results 31,033 ART-naïve adults were included, 64% were female and 75% were WHO stage I or II at enrollment. 17,569 (56%) patients initiated ART. Pre-ART competing risk estimates of LTF at 2 years was 11.2% (95%CI, 10.9–11.6%) and 2.9% for death (95%CI 2.7–3.1%). Among pre-ART patients, male gender was associated with higher LTF (adjusted sub-hazard ratio (aSHR) 1.3, 95%CI 1.1–1.5) and death (aSHR 1.7, 95%CI 1.4–2.1). Low CD4 count (CD4Rwanda but greater efforts are needed to retain patients in care prior to ART initiation, particularly among those who are healthy at enrollment. PMID:24454931

  14. Capitation of public mental health services in Colorado: a five-year follow-up of system-level effects.

    Science.gov (United States)

    Bloom, Joan R; Wang, Huihui; Kang, Soo Hyang; Wallace, Neal T; Hyun, Jenny K; Hu, Teh-wei

    2011-02-01

    Capitated Medicaid mental health programs have reduced costs over the short term by lowering the utilization of high-cost inpatient services. This study examined the five-year effects of capitated financing in community mental health centers (CMHCs) by comparing not-for-profit with for-profit programs. Data were from the Medicaid billing system in Colorado for the precapitation year (1994) and a shadow billing system for the postcapitation years (1995-1999). In a panel design, a random-effect approach estimated the impact of two financing systems on service utilization and cost while adjusting for all the covariates. Consistent with predictions, in both the for-profit and the not-for-profit CMHCs, relative to the precapitation year, there were significant reductions in each postcapitation year in high-cost treatments (inpatient treatment) for all but one comparison (not-for-profit CMHCs in 1999). Also consistent with predictions, the for-profit programs realized significant reductions in cost per user for both outpatient services and total services. In the not-for-profit programs, there were no significant changes in cost per user for total services; a significant reduction in cost per user for outpatient services was found only in the first two years, 1995 and 1996). The evidence suggests that different strategies were used by the not-for-profit and for-profit programs to control expenditures and utilization and that the for-profit programs were more successful in reducing cost per user.

  15. Determinants of mortality and loss to follow-up among adults enrolled in HIV care services in Rwanda.

    Directory of Open Access Journals (Sweden)

    Veronicah Mugisha

    Full Text Available Antiretroviral therapy (ART improves morbidity and mortality in patients with HIV, however high rates of loss to follow-up (LTF and mortality have been documented in HIV care and treatment programs.We analyzed routinely-collected data on HIV-infected patients ≥ 15 years enrolled at 41 healthcare facilities in Rwanda from 2005 to 2010. LTF was defined as not attending clinic in the last 12 months for pre-ART patients and 6 months for ART patients. For the pre-ART period, sub-distribution hazards models were constructed to estimate LTF and death to account for competing risks. Kaplan-Meier (KM and Cox proportional hazards models were used for patients on ART.31,033 ART-naïve adults were included, 64% were female and 75% were WHO stage I or II at enrollment. 17,569 (56% patients initiated ART. Pre-ART competing risk estimates of LTF at 2 years was 11.2% (95%CI, 10.9-11.6% and 2.9% for death (95%CI 2.7-3.1%. Among pre-ART patients, male gender was associated with higher LTF (adjusted sub-hazard ratio (aSHR 1.3, 95%CI 1.1-1.5 and death (aSHR 1.7, 95%CI 1.4-2.1. Low CD4 count (CD4<100 vs. ≥ 350 aSHR 0.2, 95%CI 0.1-0.3 and higher WHO stage (WHO stage IV vs. stage I aSHR 0.4, 95%CI 0.2-0.6 were protective against pre-ART LTF. KM estimates for LTF and death in ART patients at 2 years were 4.4% (95%CI 4.4-4.5% and 6.3% (95%CI 6.2-6.4%. In patients on ART, male gender was associated with LTF (adjusted hazard ratio (AHR 1.4, 95%CI 1.2-1.7 and death (AHR1.3, 95%CI 1.2-1.5. Mortality was higher for ART patients ≥ 40 years and in those with lower CD4 count at ART initiation.Low rates of LTF and death were founds among pre-ART and ART patients in Rwanda but greater efforts are needed to retain patients in care prior to ART initiation, particularly among those who are healthy at enrollment.

  16. Trends in service time of pacemakers in the Netherlands: A long-term nationwide follow-up study

    NARCIS (Netherlands)

    L.M. de Vries (Laura); M.J.G. Leening (Maarten); W.A. Dijk (Arnold); C.A.M. Hooijschuur (C. A M); B.H.Ch. Stricker (Bruno); N.M. van Hemel (Norbert)

    2017-01-01

    textabstractAims After decades of experience and strongly improved technology, service time of pacemaker generators is expected to increase. To test this hypothesis, we conducted a retrospective review of a large cohort of patients with a pacemaker. Methods We reviewed data collected between 1984

  17. ASN takes position in the in-service follow-up programs of primary and secondary loops of EdF's nuclear power plants

    International Nuclear Information System (INIS)

    2002-01-01

    This decision from the French authority of nuclear safety (ASN) aims at fixing the conditions to be respected by Electricite de France (EdF) during its in-service follow-up programs for the monitoring and preventive maintenance of the primary and secondary cooling loops of EdF's PWR reactors. The components and the particular points to be controlled are listed in appendixes. (J.S.)

  18. Follow-Up Testing

    Science.gov (United States)

    ... second should occur after 1 year on the gluten-free diet. After that, a celiac should receive follow-up ... test result is straightforward—a celiac on the gluten-free diet should have a negative test. The numerical value ...

  19. The REAnimation Low Immune Status Markers (REALISM) project: a protocol for broad characterisation and follow-up of injury-induced immunosuppression in intensive care unit (ICU) critically ill patients.

    Science.gov (United States)

    Rol, Mary-Luz; Venet, Fabienne; Rimmele, Thomas; Moucadel, Virginie; Cortez, Pierre; Quemeneur, Laurence; Gardiner, David; Griffiths, Andrew; Pachot, Alexandre; Textoris, Julien; Monneret, Guillaume

    2017-06-21

    The host response to septic shock is dynamic and complex. A sepsis-induced immunosuppression phase has recently been acknowledged and linked to bad outcomes and increased healthcare costs. Moreover, a marked suppression of the immune response has also been partially described in patients hospitalized in intensive care unit (ICU) for severe trauma or burns. It has been hypothesized that immune monitoring could enable identification of patients who might most benefit from novel, adjunctive immune-stimulating therapies. However, there is currently neither a clear definition for such injury-induced immunosuppression nor a stratification biomarker compatible with clinical constraints. We set up a prospective, longitudinal single-centre clinical study to determine the incidence, severity and persistency of innate and adaptive immune alterations in ICU patients. We optimized a workflow to describe and follow the immunoinflammatory status of 550 patients (septic shock, severe trauma/burn and major surgery) during the first 2 months after their initial injury. On each time point, two immune functional tests will be performed to determine whole-blood TNF-α production in response to ex vivo lipopolysaccharide stimulation and the T lymphocyte proliferation in response to phytohaemagglutinin. In addition, a complete immunophenotyping using flow cytometry including monocyte HLA-DR expression and lymphocyte subsets will be obtained. New markers (ie, levels of expression of host mRNA and viral reactivation) will be also evaluated. Reference intervals will be determined from a cohort of 150 age-matched healthy volunteers. This clinical study will provide, for the first time, data describing the immune status of severe ICU patients over time. Ethical approval has been obtained from the institutional review board (no 69HCL15_0379) and the French National Security agency for drugs and health-related products. Results will be disseminated through presentations at scientific meetings

  20. Antenatal care service quality increases the odds of utilizing institutional delivery in Bahir Dar city administration, North Western Ethiopia: A prospective follow up study.

    Science.gov (United States)

    Ejigu Tafere, Tadese; Afework, Mesganaw Fanthahun; Yalew, Alemayehu Worku

    2018-01-01

    In Ethiopia, more than 62% of pregnant women attend antenatal care at least once, yet only about one in four women give birth at health facility. This gap has fueled the need to investigate on the quality of ANC services at public health facilities and its link with the use of institutional delivery. To assess the linkage between ANC quality and the use of institutional delivery among pregnant women attending ANC at public health facilities of BDR City Administration. A facility based prospective follow up study was conducted. and nine hundred seventy pregnant women with gestational age ≤ 16 weeks who came for their first ANC visit were enrolled.Women were followed from their first ANC visit until delivery. Longitudinal data was collected during consultation with ANC providers using structured observation checklist. ANC service was considered as acceptable quality if women received ≥75th percentile of the essential ANC services. Generalized Estimating Equation (GEE) was carried out to control cluster effect among women who received ANC in the same facility. Among 823 pregnant women who completed follow up, only about one third (27.6%) received acceptable quality of ANC services. In one health facility syphilis test was not done at all for the last two years. The odds of giving birth at health institution among pregnant women who received acceptable ANC quality service was about 3.38 times higher than among pregnant women who received unacceptable ANC quality service (AOR = 3.38, 95% CI: 1.67, 6.83). In this study the quality of ANC service provision in public health facilities was compromised/low. Provision of quality ANC service had a great role in promoting institutional delivery. Therefore the local authorities at each level of health sector or the nongovernmental organizations working to improve maternal health need to provide training on focused antenatal care protocol for ANC providers.

  1. About the contribution of occupational health's services for risk factors evaluation, medical and dosimetric follow-up in the workers monitoring exposed to ionising radiations in France

    International Nuclear Information System (INIS)

    Bailloeuil, C.; Gonin, M.; Gerondal, M.

    2006-01-01

    Full text of publication follows: French national regulation (31/03/2003) indicates principles of a global approach about the medical and dosimetric follow-up in the workers monitoring. Legislator insists on risks and expositions trace ability along all professional career and after. The aim of this French specific system is to institute medical clinic aspects in accordance with dosimetry and professional risks. The occupational practitioners are approved practitioners who have followed a specific training. The organisation guarantees that a worker will be followed by one specific practitioner in order to reinforce the quality and the traceability of follow up. Medical supervision is done at taking on and at least once a year. It means to identify and take care of risks and expositions at work stations. If necessary, biological measurements and recommendations about collective and individual protection equipments complete the estimation of risks. On the subject of emergency, first aid is delivered on sites by occupational health personnel, either for classic medical problem or for radiological accident. Furthermore, occupational health personnel assist outside emergency services with whom we have specific conventions. External dosimetric follow-up is done with radiation protection qualified expert of the company. The internal contamination supervision and internal dose evaluation are done by the occupational health services. Measurements either whole body counts or radio-toxicologic analysis are submitted to technical quality process. Beyond the respect of regulatory dose limits, the aim of the dosimetric follow-up is the contribution to the preparation of work places with strong dosimetric focus. Informations at workers are dispensed about every risks and every kinds of risks: ionising radiation health effects, ionising radiation and pregnancy, high exposition, chemical risks, work at heat, asbestos. All data are conserved 50 years after the exposure These data

  2. Increased ICU resource needs for an academic emergency general surgery service*.

    Science.gov (United States)

    Lissauer, Matthew E; Galvagno, Samuel M; Rock, Peter; Narayan, Mayur; Shah, Paulesh; Spencer, Heather; Hong, Caron; Diaz, Jose J

    2014-04-01

    ICU needs of nontrauma emergency general surgery patients are poorly described. This study was designed to compare ICU utilization of emergency general surgery patients admitted to an acute care emergency surgery service with other general surgery patients. Our hypothesis is that tertiary care emergency general surgery patients utilize more ICU resources than other general surgical patients. Retrospective database review. Academic, tertiary care, nontrauma surgical ICU. All patients admitted to the surgical ICU over age 18 between March 2004 and June 2012. None. Six thousand ninety-eight patients were evaluated: 1,053 acute care emergency surgery, 1,964 general surgery, 1,491 transplant surgery, 995 facial surgery/otolaryngology, and 595 neurosurgery. Acute care emergency surgery patients had statistically significantly longer ICU lengths of stay than other groups: acute care emergency surgery (13.5 ± 17.4 d) versus general surgery (8.7 ± 12.9), transplant (7.8 ± 11.6), oral-maxillofacial surgery (5.5 ± 4.2), and neurosurgery (4.47 ± 9.8) (all psurgery patients: acute care emergency surgery 73.4% versus general surgery 64.9%, transplant 63.3%, oral-maxillofacial surgery 58.4%, and neurosurgery 53.1% (all p surgery patients: acute care emergency surgery 10.8% versus general surgery 4.3%, transplant 6.6%, oral-maxillofacial surgery 0%, and neurosurgery 0.5% (all p surgery patients were more likely interhospital transfers for tertiary care services than general surgery or transplant (24.5% vs 15.5% and 8.3% respectively, p surgery (13.7% vs 6.7% and 3.5%, all p surgery and general surgery, whereas transplant had fewer. Emergency general surgery patients have increased ICU needs in terms of length of stay, ventilator usage, and continuous renal replacement therapy usage compared with other services, perhaps due to the higher percentage of transfers and emergent surgery required. These patients represent a distinct population. Understanding their resource needs

  3. Health Problems during Compulsory Military Service Predict Disability Retirement: A Register-Based Study on Secular Trends during 40 Years of Follow-Up.

    Science.gov (United States)

    Frilander, Heikki; Lallukka, Tea; Viikari-Juntura, Eira; Heliövaara, Markku; Solovieva, Svetlana

    2016-01-01

    Disability retirement causes a significant burden on the society and affects the well-being of individuals. Early health problems as determinants of disability retirement have received little attention. The objective was to study, whether interrupting compulsory military service is an early indicator of disability retirement among Finnish men and whether seeking medical advice during military service increases the risk of all-cause disability retirement and disability retirement due to mental disorders and musculoskeletal diseases. We also looked at secular trends in these associations. We examined a nationally representative sample of 2069 men, who had entered military service during 1967-1996. We linked military service health records with cause-specific register data on disability retirement from 1968 to 2008. Secular trends were explored in three service time strata. We used the Cox regression model to estimate proportional hazard ratios and their 95% confidence intervals. During the follow-up time altogether 140 (6.8%) men retired due to disability, mental disorders being the most common cause. The men who interrupted service had a remarkably higher cumulative incidence of disability retirement (18.9%). The associations between seeking medical advice during military service and all-cause disability retirement were similar across the three service time cohorts (overall hazard ratio 1.40 per one standard deviation of the number of visits; 95% confidence interval 1.26-1.56). Visits due to mental problems predicted disability retirement due to mental disorders in the men who served between 1987 and 1996 and a tendency for a similar cause-specific association was seen for musculoskeletal diseases in the men who served in 1967-1976. In conclusion, health problems-in particular mental problems-during late adolescence are strong determinants of disability retirement. Call-up examinations and military service provide access to the entire age cohort of men, where

  4. [Priorization of facilitators for the implementation of medication review with follow-up service in Spanish community pharmacies through exploratory factor analysis].

    Science.gov (United States)

    Gil, Modesta Inmaculada; Benrimoj, Shalom Isaac; Martínez-Martínez, Fernando; Cardero, Manuel; Gastelurrutia, Miguel Ángel

    2013-01-01

    to prioritize previously identified in Spain facilitators for the implementation of new Pharmaceutical Services that allow designing strategies for the implementation of Medication Review with follow-up (MRFup) service. Exploratory factor analysis (EFA). A draft of a questionnaire was performed based on a previous literature review and following the RAND/UCLA methodology. An expert panel worked with it and generated a definitive questionnaire which, after piloting, was used with a representative sample of pharmacists, owners or staff members, who were working in community pharmacy, using computer-assisted telephone interviewing (CATI) methodology. To understand underlying constructs in the questionnaire an EFA was performed. Different approaches were tested such as principal components factor analysis and principal axis factoring method. The best interpretability was achieved using the Factorization of Principal axis method with Direct Oblimin rotation, which explained the 40.0% of total variance. This produced four factors defined as: «Incentives», «External campaigns», «Expert in MRFup» and «Professionalism of the pharmacist». It can be stated that for implementation and sustainability of MRFup Service it is necessary being paid; also it must be explained to health professional and society in general. Practice of MRFup service demands pharmacists receiving a more clinical education and assuming more responsibilities as health professionals. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  5. Pregnant women's preference and factors associated with institutional delivery service utilization in Debra Markos Town, North West Ethiopia: a community based follow up study.

    Science.gov (United States)

    Bayu, Hinsermu; Adefris, Mulatu; Amano, Abdella; Abuhay, Mulunesh

    2015-02-05

    Majority of deaths from obstetric complications are preventable. But every pregnant woman face risks which may not always be detected through the risk assessment approach during antenatal care (ANC). Therefore, the presence of a skilled birth attendant in every delivery is the most critical intervention in reducing maternal mortality and morbidity. In Ethiopia the proportion of births attended by skilled personnel, is very low, even for women who have access to the services. A community-based follow up study was conducted from January 17, 2012 to July 30, 2012, among 2(nd) and 3(rd) trimester's pregnant women in Debre-Markos town, east Gojam Zone, Amhara Region, North West Ethiopia. Simple random sampling technique was used to get a total sample size of 422 participants. A total of 393 pregnant women were included in the study. The study revealed that 292(74.3%) of the pregnant women planned to deliver in a health institution. Of these 292 pregnant women 234 (80.14%) actually delivered in a health facility. Age range from 15-19 year (AOR = 4.83, 95% CI = 1.562-12.641), college and above education of the pregnant women (AOR = 12.508, 95% CI = 1.082-14.557), ANC visit during the current pregnancy (AOR = 1.975, 95% CI = 1.021-3.392),perceived susceptibility and severity of pregnancy and delivery complication (AOR = 3.208, 95% CI = 1.262-8.155) and intention (preference) of pregnant women for place of delivery (AOR = 7.032, 95% CI = 3.045-10.234) are predictors of institutional delivery service utilization. Preference for institutional delivery is low in the study area. Sociodemographic factors, perception about delivery complication, ANC follow up and their intentions for institutional delivery are among important predictors of institutional delivery.

  6. [Breastfeeding and the anthropometric profile of children with sickle cell anemia receiving follow-up in a newborn screening reference service].

    Science.gov (United States)

    Nogueira, Zeni Drubi; Boa-Sorte, Ney; Leite, Maria Efigênia de Queiroz; Kiya, Márcia Miyuki; Amorim, Tatiana; Fonseca, Silvana Fahel da

    2015-01-01

    To study breastfeeding history (BF) and the anthropometric status of children with Sickle Cell Disease (SCD). A cross-sectional study of 357 children with SS and SC hemoglobinopathies aged between 2 and 6 years old receiving regular follow-up at a Newborn Screening Reference Service (NSRS) between November 2007 and January 2009. The outcome was anthropometric status and the exposures were: BF pattern, type of hemoglobinopathy and child's age and sex. The average (SD) age was 3.7 (1.1) years, 52.9% were boys and 53.5% had SS hemoglobinopathy. The prevalence of exclusive breastfeeding (EBR) up to six months of age was 31.5%, the median EBR times (p25-p75) was 90.0 (24.0-180.0) days and the median weaning ages (p25-p75) was 360.0 (90.0-20.0) days respectively. Normal W/H children experienced EBR for an average duration almost four times longer than malnourished children (p=0.01), and were weaned later (p<0.05). Height deficit was found in 5.0% of children, while all the children with severe short stature had SS hemoglobinopathy and were over 4 years of age. EBR time and weaning age were greater than found in the literature, which is a possible effect of the multidisciplinary follow-up. Duration of EBR and later weaning were associated with improved anthropometric indicators. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  7. Follow-up study of female delinquent adolescents in a detention centre: effectiveness of psychiatric intervention as a mental health service.

    Science.gov (United States)

    Ariga, Michio; Uehara, Toru; Takeuchi, Kazuo; Ishige, Yoko; Nakano, Reiko; Mikuni, Masahiko

    2010-01-01

    of previous studies suggest that many female offenders have co-morbid psychiatric disorders, which require mental health services. However, few longitudinal studies examined subjects during incarceration or detention. This study compares depressive symptoms, abnormal eating behaviour and impulsivity before release from a detention centre and after incarceration, thereby indicating the effectiveness of psychiatric intervention in a Japanese detention centre. Of 64 young women, 36 were followed up. Self-report measures were used to assess depression, eating behaviour and impulsivity after incarceration and one month before release. s: Of the 36 participants, nine were diagnosed using the MINI-kids as needing mental health services. Those who received psychiatric intervention were diagnosed as having major depression and/or post-traumatic stress disorder. Significant main effects of intervention and effects of time were shown in the DSD. The EAT-26 score demonstrated the significance of the effects of time and interaction. In the BIS-11 scores, neither intervention nor time showed significant effects. Results of this study showed that the time course and psychiatric intervention contributed to recovery of depression and therapeutic intervention. The time course might reduce eating problems. Psychiatric intervention might be necessary for female juvenile detainees, which presents an important issue for future studies.

  8. Homeless people's access to primary care physiotherapy services: an exploratory, mixed-method investigation using a follow-up qualitative extension to core quantitative research.

    Science.gov (United States)

    Dawes, Jo; Deaton, Stuart; Greenwood, Nan

    2017-06-30

    The purpose of this study was to appraise referrals of homeless patients to physiotherapy services and explore perceptions of barriers to access. This exploratory mixed-method study used a follow-up qualitative extension to core quantitative research design. Over 9 months, quantitative data were gathered from the healthcare records of homeless patients referred to physiotherapy by a general practitioner (GP) practice, including the number of referrals and demographic data of all homeless patients referred. Corresponding physiotherapy records of those people referred to physiotherapy were searched for the outcome of their care. Qualitative semi-structured telephone interviews, based on the quantitative findings, were carried out with staff involved with patient care from the referring GP practice and were used to expand insight into the quantitative findings. Two primary care sites provided data for this study: a GP practice dedicated exclusively to homeless people and the physiotherapy department receiving their referrals. Quantitative data from the healthcare records of 34 homeless patient referrals to physiotherapy were collected and analysed. In addition, five staff involved in patient care were interviewed. 34 referrals of homeless people were made to physiotherapy in a 9-month period. It was possible to match 25 of these to records from the physiotherapy department. Nine (36%) patients did not attend their first appointment; seven (28%) attended an initial appointment, but did not attend a subsequent appointment and were discharged from the service; five (20%) completed treatment and four patients (16%) had ongoing treatment. Semi-structured interviews revealed potential barriers preventing homeless people from accessing physiotherapy services, the complex factors being faced by those making referrals and possible ways to improve physiotherapy access. Homeless people with musculoskeletal problems may fail to access physiotherapy treatment, but opportunities

  9. What Contributes to the Regularity of Patients with Hypertension or Diabetes Seeking Health Services? A Pilot Follow-Up, Observational Study in Two Sites in Hubei Province, China

    Directory of Open Access Journals (Sweden)

    Da Feng

    2016-12-01

    Full Text Available Regular maintenance of non-communicable chronic diseases can constrain disease progression in diabetic and hypertensive patients. To identify the individual and social factors that are associated with positive health-seeking behaviors and regular maintenance of chronic diseases, we have conducted a follow up study in 2015 on diabetic and hypertensive patients in Hubei Province. We used binary logistic regression models to determine specific factors associated with diabetic and hypertensive patients that sought healthcare services for their conditions in accordance with current Chinese Centers for Disease Prevention and Control (CDC guidelines. Our findings show that 42.16% of 510 people living with chronic conditions (PLCDs sought health services in line with existing guidelines. Findings also show a higher probability (8.418 times for PLCDs seeking healthcare services at higher-tiered hospitals (secondary and tertiary hospitals than for PLCDs seeking care at primary hospitals (odds ratio (OR = 8.418, 95% confidence interval (CI = 4.82, 14.27, p < 0.001. These analyses underscore the importance of having patient advocates who can provide support, where necessary, and encourage positive health-seeking behavior. The study also shows a negative impact on regular maintenance for PLCDs in households with high financial constraints. In contrast, the study shows positive impacts for increased household income, age, and residency in rural locations. In sum, this study underscores the importance of primary hospitals as key points of care and critical players in care coordination for PLCDs. The study provides more evidence for Chinese policymakers seeking to contain costs and improve population health. The findings also underscore the need for community-based interventions, specifically interventions that link local primary hospitals, friends/family members, and PLCDs.

  10. Eight-year incidence of psychiatric disorders and service use from adolescence to early adulthood: longitudinal follow-up of the Mexican Adolescent Mental Health Survey.

    Science.gov (United States)

    Benjet, Corina; Borges, Guilherme; Méndez, Enrique; Albor, Yesica; Casanova, Leticia; Orozco, Ricardo; Curiel, Teresa; Fleiz, Clara; Medina-Mora, María Elena

    2016-02-01

    Half of mental disorders have their first onset before adulthood when the presence of a disorder may be particularly disruptive to developmental milestones. Retrospective prevalence estimates have been shown to underestimate the burden of mental illness and scarce data are available on the incidence of disorders throughout the adolescent period, especially in developing countries. Thus, the objective was to determine the incidence of mental disorders in an 8-year period from adolescence to young adulthood, onset of service use and their predictors in a Mexican cohort. 1071 respondents from a representative two-wave panel sample participated in the Mexican Adolescent Mental Health Survey in 2005 and in the follow-up survey in 2013. Disorders were evaluated with the World Mental Health Composite International Diagnostic Interview. 37.9% experienced the onset of a psychiatric disorder and 28.4% sought services for the first time. Substance use disorders had the greatest incidence, followed by mood and behavior disorders, anxiety disorders and lastly eating disorders. Sex, age, school dropout, childhood adversities and prior mental disorders predicted the onset of new disorders. Being female, having more educated parents and most classes of disorder predicted first time service use. These findings contribute to a paradigm shift in conceptions of mental disorder similar to how we think of common physical afflictions as near universal experiences across the life course, but less frequent at any given moment. Adolescents are particularly vulnerable. Therefore, public health policy should focus on early universal promotion of positive mental health and structural determinants of mental health.

  11. Long-Term Effectiveness of Two Educational Methods on Knowledge, Attitude, and Practice Toward Palliative Care Consultation Services Among Nursing Staff: A Longitudinal Follow-Up Study.

    Science.gov (United States)

    Pan, Hsueh-Hsing; Wu, Li-Fen; Hung, Yu-Chun; Chu, Chi-Ming; Wang, Kwua-Yun

    2018-05-01

    This experimental study investigated long-term effectiveness of two educational methods on knowledge, attitude, and practice (KAP) about palliative care consultation services (PCCS) among nurses, recruited from a medical center located in Northern Taiwan in 2015, using a stratified cluster sampling method, with 88 participants in multimedia (experimental) and 92 in traditional paper education (control) group. Data were collected using KAP-PCCS questionnaire before education, immediately after, and 3rd and 6th month after education. Results showed that both K-PCCSI and P-PCCSI significantly increased immediately after, and at the 3rd month after education for the experimental group; the K-PCCSI remained significantly higher for the experimental group at the 6th month. The highest increase in scores for both K-PCCSI and P-PCCSI was observed at the 3rd month. There was no significant change in A-PCCS in both groups after follow-up periods, when compared before education. Therefore, using multimedia every 3 months to continue strengthening their knowledge may increase the referrals of terminal patients to PCCS.

  12. Mental health service use by patients with dysthymic disorder: treatment use and dropout in a 7 1/2-year naturalistic follow-up study.

    Science.gov (United States)

    McFarland, Brian R; Klein, Daniel N

    2005-01-01

    Little is known about long-term treatment use among patients with dysthymia. This paper describes patterns of treatment use by 85 outpatients with dysthymic disorder and a comparison group of 36 outpatients with nonchronic (episodic) major depression in a naturalistic follow-up. Patients with dysthymia had higher rates of treatment use across 7 1/2 years compared with patients with episodic major depression. Baseline variables that predicted which patients with dysthymia dropped out of treatment before recovering from dysthymic disorder included age, ethnicity, Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition Axis II pathology as obtained from informant reports, higher self-reported autonomy, and receiving psychotherapy alone as compared to receiving a combination of psychotherapy and medication. Dysthymic disorder places a significant burden on the mental health services system, yet many outpatients with dysthymia may be receiving inadequate treatment. Younger patients, ethnic minority patients, and patients with personality disorders may be at increased risk of dropping out from treatment for depression. Combination treatments may increase treatment retention.

  13. Electronic Whiteboards and Intensive Care Unit follow up

    DEFF Research Database (Denmark)

    Østergaard, Kija Lin; Brandrup, Morten

    -ended dry-erase whiteboard (make-up-your-own-sentences). In conclusion the primary feature in the two subjects is to optimize communication/collaboration and information between ICU and general wards in the transition. To make it a long term solution the content of such a support would need involvement...... of the end-users in the design process (Participatory Design). Hence these two findings, this review is setting the stage for further research on how electronic whiteboards can support the initial follow up when patients are transferred from an ICU to a general ward.......This paper is reviewing the existing literature on Intensive Care Unit (ICU) Outreach, in-hospital follow up 24 hours after the transition to a general ward from an ICU. It also touches upon the use of Electronic Whiteboards in a hospital setting and how the electronic whiteboards might support...

  14. From screening to postpartum follow-up – the determinants and barriers for gestational diabetes mellitus (GDM) services, a systematic review

    Science.gov (United States)

    2014-01-01

    Background Gestational diabetes mellitus (GDM) – a transitory form of diabetes first recognised during pregnancy complicates between diabetes in mother and offspring, timely detection, optimum treatment, and preventive postpartum care and follow-up is necessary. However the area remains grossly under-prioritised. Methods To investigate determinants and barriers to GDM care from initial screening and diagnosis to prenatal treatment and postpartum follow-up, a PubMed database search to identify quantitative and qualitative studies on the subject was done in September 2012. Fifty-eight relevant studies were reviewed. Results Adherence to prevailing GDM screening guidelines and compliance to screening tests seems sub-optimal at best and arbitrary at worst, with no clear or consistent correlation to health care provider, health system or client characteristics. Studies indicate that most women express commitment and motivation for behaviour change to protect the health of their unborn baby, but compliance to recommended treatment and advice is fraught with challenges, and precious little is known about health system or societal factors that hinder compliance and what can be done to improve it. A number of barriers related to health care provider/system and client characteristics have been identified by qualitative studies. Immediately following a GDM pregnancy many women, when properly informed, desire and intend to maintain healthy lifestyles to prevent future diabetes, but find the effort challenging. Adherence to recommended postpartum screening and continued lifestyle modifications seems even lower. Here too, health care provider, health system and client related determinants and barriers were identified. Studies reveal that sense of self-efficacy and social support are key determinants. Conclusions The paper identifies and discusses determinants and barriers for GDM care, fully recognising that these are highly dependent on the context. PMID:24450389

  15. 15-Year Follow-Up

    OpenAIRE

    Karjula, Salla; Morin-Papunen, Laure; Auvinen, Juha; Ruokonen, Aimo; Puukka, Katri; Franks, Stephen; Jarvelin, Marjo-Riitta; Tapanainen, Juha S.; Jokelainen, Jari; Miettunen, Jouko; Piltonen, Terhi T.

    2017-01-01

    Context: Polycystic ovary syndrome (PCOS) is associated with increased psychological distress, obesity and hyperandrogenism being suggested as key promoters. Objectives: To investigate the prevalence of anxiety/depression and their coexistence in women with PCOS/PCOS-related symptoms at ages 31 and 46. The roles of obesity, hyperandrogenism, and awareness of PCOS on psychological distress were also assessed. Design: Population-based follow-up. Setting: Northern Finland Birth Cohort 1966 with ...

  16. Critical Care Follow-up Clinics: A Scoping Review of Interventions and Outcomes.

    Science.gov (United States)

    Lasiter, Sue; Oles, Sylwia K; Mundell, James; London, Susan; Khan, Babar

    2016-01-01

    The purpose of this scoping review is to identify evidence describing benefits of interventions provided in intensive care unit (ICU) survivor follow-up clinics. Advances in ICU treatments have increased the number of survivors who require specialized care for ICU-related sequelae. Intensive care unit survivor follow-up clinics exist, yet little is known about the nature and impact of interventions provided in such clinics. A scoping review of publications about in-person post-ICU follow-up care was undertaken. Ten databases were searched yielding 111 relevant unique publication titles and abstracts. Sample heterogeneity supported using a scoping review method. After excluding nonrelated publications, 33 reports were fully reviewed. Twenty international publications were included that described ICU follow-up clinic interventions and/or outcomes. Authors discussed very diverse interventions in 15 publications, and 9 reported some level of intervention effectiveness. Evidence was strongest that supported the use of prospective diaries as an intervention to prevent or improve psychological symptoms, whereas evidence to support implementation of other interventions was weak. Although ICU follow-up clinics exist, evidence for interventions and effectiveness of treatments in these clinics remains underexplored. Intensive care unit survivor follow-up clinics provide a venue for further interdisciplinary intervention research that could lead to better health outcomes for ICU survivors.

  17. Incentive regulation regarding the service quality of electricity and natural gas network operators in 2015. Follow-up Report, January 2017

    International Nuclear Information System (INIS)

    2017-01-01

    The tariffs set by the French Energy Regulation Commission (CRE) for natural gas distribution system operators (DSOs), natural gas transmission system operators (TSOs) as well as for the electricity distribution system operator (Enedis, former ERDF) include an incentive regulation regarding the quality of service. The CRE has defined indicators to monitor the performance of operators in several fields considered relevant to assess the quality of service. Some of these indicators, considered to have specific importance in ensuring that the market operates properly, are subject to a system of financial incentives: bonuses or penalties are given to operators depending on the attainment of objectives set by the CRE. Other indicators, which do not carry financial incentives, complete the mechanism and ensure a broader surveillance of the operators' service quality. A financial incentive may be applied to these indicators at a later date if the CRE deems it necessary. The analyses of the service quality monitoring indicators presented in this report cover the period from January 1 to December 31, 2015. A review of the service quality of DSOs, TSOs and Enedis is made according to these indicators. An annex contains all individual quality reports of Enedis, DSOs and TSOs

  18. Association of Structured Virtual Visits for Hypertension Follow-Up in Primary Care with Blood Pressure Control and Use of Clinical Services.

    Science.gov (United States)

    Levine, David Michael; Dixon, Ronald F; Linder, Jeffrey A

    2018-04-23

    Optimal management of hypertension requires frequent monitoring and follow-up. Novel, pragmatic interventions have the potential to engage patients, maintain blood pressure control, and enhance access to busy primary care practices. "Virtual visits" are structured asynchronous online interactions between a patient and a clinician to extend medical care beyond the initial office visit. To compare blood pressure control and healthcare utilization between patients who received virtual visits compared to usual hypertension care. Propensity score-matched, retrospective cohort study with adjustment by difference-in-differences. Primary care patients with hypertension. Patient participation in at least one virtual visit for hypertension. Usual care patients did not use a virtual visit but were seen in-person for hypertension. Adjusted difference in mean systolic blood pressure, primary care office visits, specialist office visits, emergency department visits, and inpatient admissions in the 180 days before and 180 days after the in-person visit. Of the 1051 virtual visit patients and 24,848 usual care patients, we propensity score-matched 893 patients from each group. Both groups were approximately 61 years old, 44% female, 85% White, had about five chronic conditions, and about 20% had a mean pre-visit systolic blood pressure of 140-160 mmHg. Compared to usual care, virtual visit patients had an adjusted 0.8 (95% CI, 0.3 to 1.2) fewer primary care office visits. There was no significant adjusted difference in systolic blood pressure control (0.6 mmHg [95% CI, - 2.0 to 3.1]), specialist visits (0.0 more visits [95% CI, - 0.3 to 0.3]), emergency department visits (0.0 more visits [95% CI, 0.0 to 0.01]), or inpatient admissions (0.0 more admissions [95% CI, 0.0 to 0.1]). Among patients with reasonably well-controlled hypertension, virtual visit participation was associated with equivalent blood pressure control and reduced in-office primary care utilization.

  19. A Pragmatic Randomised, Controlled Trial of Intensive Care follow up programmes in improving Longer-term outcomes from critical illness. The PRACTICAL study

    Directory of Open Access Journals (Sweden)

    Ramsey Craig

    2007-07-01

    Full Text Available Abstract Background A number of intensive care (ICU patients experience significant problems with physical, psychological, and social functioning for some time after discharge from ICU. These problems have implications not just for patients, but impose a continuing financial burden for the National Health Service. To support recovery, a number of hospitals across the UK have developed Intensive Care follow-up clinics. However, there is a lack of evidence base to support these, and this study aims to test the hypothesis that intensive care follow up programmes are effective and cost-effective at improving physical and psychological quality of life in the year after intensive care discharge. Methods/Design This is a multi-centre, pragmatic, randomised controlled trial. Patients (n = 270 will be recruited prior to hospital discharge from three intensive care units in the UK, and randomised to one of two groups. The control group will receive standard in-hospital follow-up and the intervention group will participate in an ICU follow-up programme with clinic appointments 2–3 and 9 months after ICU discharge. The primary outcome measure is Health-related Quality of Life (HRQoL 12 months after ICU discharge as measured by the Short Form-36. Secondary measures include: HRQoL at six months; Quality-adjusted life years using EQ-5D; posttraumatic psychopathology as measured by Davidson Trauma Scale; and anxiety and depression using the Hospital Anxiety and Depression Scale at both six and twelve months after ICU discharge. Contacts with health services in the twelve months after ICU discharge will be measured as part of the economic analysis. Discussion The provision of intensive care follow-up clinics within the UK has developed in an ad hoc manner, is inconsistent in both the number of hospitals offering such a service or in the type of service offered. This study provides the opportunity to evaluate such services both in terms of patient benefit and

  20. Follow-up after intensive care treatment

    DEFF Research Database (Denmark)

    Kjer, C K W; Estrup, S; Poulsen, L M

    2017-01-01

    common early ICU-aftercare items were as follows: respiratory care (82%), tracheostomy care (59%) and nutritional care (59%). For late ICU-aftercare, the most common eligibility criterion was LOS (41%). Guidelines (71%), but not checklist at patient contact (35%), were more common. Most frequent late ICU...

  1. A prospective 8-year follow-up of posterior resin composite restorations in permanent teeth of children and adolescents in Public Dental Health Service: reasons for replacement

    DEFF Research Database (Denmark)

    Pallesen, Ulla; van Dijken, Jan W.V.; Halken, Jette

    2014-01-01

    in general practice showed a good durability with annual failure rates of 2 %. The main reason for failure was secondary caries followed by post-operative sensitivity and resin composite fracture. A high proportion of replaced/repaired RC restorations were caused by primary caries in a non-filled surface......Objectives: the aim of the study was to investigate reasons for replacement and repair of posterior resin composite (RC) restorations placed in permanent teeth of children and adolescents attending Public Dental Health Service in Denmark. Material and method: all posterior RC placed consecutively...... by 115 dentists over a period of 4 years were evaluated at baseline and up to 8 years later. The endpoint of each restoration was defined when repair or replacement was performed. The influence of patient, dentist and material factors on reasons for repair or replacement was investigated. Results...

  2. An 8 year follow-up of a specialist supported employment service for high-ability adults with autism or Asperger syndrome.

    Science.gov (United States)

    Howlin, Patricia; Alcock, Jennifer; Burkin, Catherine

    2005-12-01

    Few supported employment programmes have been specifically designed for people with autism, especially those who are more able. This study examines the outcome of a supported employment service (NAS Prospects) for adults with autism or Asperger syndrome (IQ 60+) over an 8 year period. Approximately 68 percent of clients found employment. Of the 192 jobs, the majority were permanent contracts and most involved administrative, technical or computing work. Assessment of current clients indicates that IQ, language skills and educational attainments are high. However, work has also been found for those of lower abilities. Individuals supported by Prospects show a rise in salaries, contribute more tax and claim fewer benefits. Satisfaction with the scheme is high among clients, employers and support workers. Although the programme continues to incur a financial deficit, this has decreased. Moreover, there are many non-financial benefits, which are difficult to quantify. The importance of specialist employment support of this kind is discussed.

  3. Public telesurveillance service for frail elderly living at home, outcomes and cost evolution: a quasi experimental design with two follow-ups

    Directory of Open Access Journals (Sweden)

    Deaudelin Isabelle

    2006-07-01

    Full Text Available Abstract Background Telesurveillance is a technologically based modality that allows the surveillance of patients in the natural setting, mainly home. It is based on communication technologies to relay information between a patient and a central call center where services are coordinated. Different types of telesurveillance systems have been implemented, some being staffed with non-health professionals and others with health professional, mainly nurses. Up to now, only telesurveillance services staffed with non-health professionals have been shown to be effective and efficient. The objective of this study was to document outcomes and cost evolution of a nurse-staffed telesurveillance system for frail elderly living at home. Methods A quasi experimental design over a nine-month period was done. Patients (n = 38 and caregivers (n = 38 were selected by health professionals from two local community health centers. To be eligible, elders had to be over 65, live at home with a permanent physical, slight cognitive or motor disability or both and have a close relative (the caregiver willing to participate to the study. These disabilities had to hinder the accomplishment of daily life activities deemed essential to continue living at home safely. Three data sources were used: patient files, telesurveillance center's quarterly reports and personal questionnaires (Modified Mini-Mental State, Functional Autonomy Measurement System, Life Event Checklist, SF-12, Life-H, Quebec User Evaluation of Satisfaction with Assistive Technology, Caregiver Burden. The telesurveillance technology permitted, among various functionalities, bi-directional communication (speaker-receiver between the patient and the response center. Results A total of 957 calls for 38 registered clients over a 6-month period was recorded. Only 48 (5.0% of the calls were health-related. No change was reported in the elders' quality of life and daily activity abilities. Satisfaction was very

  4. Effects of mobile phone WeChat services improve adherence to corticosteroid nasal spray treatment for chronic rhinosinusitis after functional endoscopic sinus surgery: a 3-month follow-up study.

    Science.gov (United States)

    Feng, Shaoyan; Liang, Zibin; Zhang, Rongkai; Liao, Wei; Chen, Yuan; Fan, Yunping; Li, Huabin

    2017-03-01

    The objective of the study is to investigate the impact of receiving daily WeChat services on one's cell phone on adherence to corticosteroid nasal spray treatment in chronic rhinosinusitis (CRS) patients after functional endoscopic sinus surgery (FESS). This study was a two-arm, randomized, follow-up investigation. Patients with chronic rhinosinusitis with/without nasal polyps following bilateral FESS were randomised to receive, or to not receive, daily WeChat service on their cell phone to take corticosteroid nasal spray treatment. A prescription of budesonide aqueous nasal spray 128 µg bid was given to all the subjects. Then they returned to the clinic after 30, 60, 90 days. The primary study outcome was adherence to nasal spray treatment, whereas secondary outcomes were change in endoscopic findings and SinoNasal Outcome Test-20 (SNOT-20). On the whole, there was a significant inter-group difference in the change of adherence rate (F = 90.88, p = 0.000). The WeChat group had much higher adherence rate than the control group during the follow-up. In terms of postoperative endoscopic scores and SNOT-20, except granulation score, no significant differences were observed between the two randomization groups. WeChat services are already after a short period of observation associated with improved adherence to corticosteroid nasal spray treatment in CRS patients after FESS.

  5. Post-Discharge Follow-Up Visits and Hospital Utilization

    Data.gov (United States)

    U.S. Department of Health & Human Services — Analysis reported in Post-Discharge Follow-Up Visits and Hospital Utilization by Medicare Patients, 2007-2010, published in Volume 4, Issue 2 of Medicare and...

  6. Tele-ICU "myth busters".

    Science.gov (United States)

    Venditti, Angelo; Ronk, Chanda; Kopenhaver, Tracey; Fetterman, Susan

    2012-01-01

    Tele-intensive care unit (ICU) technology has been proven to bridge the gap between available resources and quality care for many health care systems across the country. Tele-ICUs allow the standardization of care and provide a second set of eyes traditionally not available in the ICU. A growing body of literature supports the use of tele-ICUs based on improved outcomes and reduction in errors. To date, the literature has not effectively outlined the limitations of this technology related to response to changes in patient care, interventions, and interaction with the care team. This information can potentially have a profound impact on service expectations. Some misconceptions about tele-ICU technology include the following: tele-ICU is "watching" 24 hours a day, 7 days a week; tele-ICU is a telemetry unit; tele-ICU is a stand-alone crisis intervention tool; tele-ICU decreases staffing at the bedside; tele-ICU clinical roles are clearly defined and understood; and tele-ICUs are not cost-effective to operate. This article outlines the purpose of tele-ICU technology, reviews outcomes, and "busts" myths about tele-ICU technology.

  7. Supervised team management, with or without structured psychotherapy, in heavy users of a mental health service with borderline personality disorder: a two-year follow-up preliminary randomized study.

    Science.gov (United States)

    Amianto, Federico; Ferrero, Andrea; Pierò, Andrea; Cairo, Elisabetta; Rocca, Giuseppe; Simonelli, Barbara; Fassina, Simona; Abbate-Daga, Giovanni; Fassino, Secondo

    2011-11-21

    Individuals affected by severe Borderline Personality Disorder (BPD) are often heavy users of Mental Health Services (MHS). Short-term treatments currently used in BPD therapy are useful to target disruptive behaviors but they are less effective in reducing heavy MHS use. Therefore, alternative short-term treatments, less complex than long-term psychodynamic psychotherapies but specifically oriented to BPD core problems, need to be developed to reduce MHS overuse. This study aimed to evaluate the efficacy of adding Sequential Brief Adlerian Psychodynamic Psychotherapy (SB-APP) to Supervised Team Management (STM) in BPD treatment compared to STM alone in a naturalistic group of heavy MHS users with BPD. Effectiveness was evaluated 6 times along a two-year follow-up. Thirty-five outpatients who met inclusion criteria were randomly assigned to two treatment groups (STM = 17; SB-APP = 18) and then compared. Clinical Global Impression (CGI) and CGI-modified (CGI-M) for BPD, Global Assessment of Functioning (GAF), State-Trait Anger Expression Inventory (STAXI), and Symptom Checklist-90 Revised (SCL-90-R) were administered at T1, T3, T6, T12, T18 and T24. At T12 the Working Alliance Inventory-Short Form (WAI-S) was also completed. At the one-year follow-up, SB-APP group did not receive any additional individual psychological support. MHS team was specifically trained in BPD treatment and had regular supervisions. All patients improved on CGI, GAF, and STAXI scores after 6 and 12 months, independently of treatment received. SB-APP group showed better outcome on impulsivity, suicide attempts, chronic feelings of emptiness, and disturbed relationships. We found a good stabilization at the one year follow-up, even after the interruption of brief psychotherapy in the SB-APP group. Although STM for BPD applied to heavy MHS users was effective in reducing symptoms and improving their global functioning, adding a time-limited and focused psychotherapy was found to achieve a

  8. Supervised team management, with or without structured psychotherapy, in heavy users of a mental health service with borderline personality disorder: a two-year follow-up preliminary randomized study

    Directory of Open Access Journals (Sweden)

    Amianto Federico

    2011-11-01

    Full Text Available Abstract Background Individuals affected by severe Borderline Personality Disorder (BPD are often heavy users of Mental Health Services (MHS. Short-term treatments currently used in BPD therapy are useful to target disruptive behaviors but they are less effective in reducing heavy MHS use. Therefore, alternative short-term treatments, less complex than long-term psychodynamic psychotherapies but specifically oriented to BPD core problems, need to be developed to reduce MHS overuse. This study aimed to evaluate the efficacy of adding Sequential Brief Adlerian Psychodynamic Psychotherapy (SB-APP to Supervised Team Management (STM in BPD treatment compared to STM alone in a naturalistic group of heavy MHS users with BPD. Effectiveness was evaluated 6 times along a two-year follow-up. Methods Thirty-five outpatients who met inclusion criteria were randomly assigned to two treatment groups (STM = 17; SB-APP = 18 and then compared. Clinical Global Impression (CGI and CGI-modified (CGI-M for BPD, Global Assessment of Functioning (GAF, State-Trait Anger Expression Inventory (STAXI, and Symptom Checklist-90 Revised (SCL-90-R were administered at T1, T3, T6, T12, T18 and T24. At T12 the Working Alliance Inventory-Short Form (WAI-S was also completed. At the one-year follow-up, SB-APP group did not receive any additional individual psychological support. MHS team was specifically trained in BPD treatment and had regular supervisions. Results All patients improved on CGI, GAF, and STAXI scores after 6 and 12 months, independently of treatment received. SB-APP group showed better outcome on impulsivity, suicide attempts, chronic feelings of emptiness, and disturbed relationships. We found a good stabilization at the one year follow-up, even after the interruption of brief psychotherapy in the SB-APP group. Conclusions Although STM for BPD applied to heavy MHS users was effective in reducing symptoms and improving their global functioning, adding a time

  9. Impacto de un servicio de seguimiento farmacoterapéutico implementado a pacientes con diabetes mellitus tipo 2 Impact of a pharmaceutical follow-up service implemented in type 2 diabetes mellitus patients

    Directory of Open Access Journals (Sweden)

    Yaily Lazo Roblejo

    2011-06-01

    Full Text Available Se evaluó el impacto de un servicio de seguimiento farmacoterapéutico implementado a 30 pacientes con diabetes mellitus tipo 2, dispensarizados en la Farmacia Principal Municipal Santiago de Cuba, según la metodología Dáder, en el período comprendido desde enero del 2009 hasta enero de 2010. El índice de impacto de la estabilidad clínica de los pacientes resultó moderado, mientras que en las intervenciones farmacéuticas aceptadas y el nivel de satisfacción de los pacientes, los índices de impacto obtenidos fueron elevados, por lo que el impacto global del servicio de seguimiento farmacoterapéutico implementado para la atención de estos fue considerado alto.The impact of a pharmacotherapy follow-up service was assessed in 30 patients dispensarized in municipal main drugstore of Santiago de Cuba according to Dáder's methodology from January, 2009 to January, 2010. The level of the clinical stability impact of patients was qualified as moderate, whereas in the accepted pharmaceutical interventions and at level of patient's satisfaction, the rates of impact achieved were high thus; the global above mentioned service repercussion was also qualified as high.

  10. Towards sustainability assessment follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Morrison-Saunders, Angus, E-mail: a.morrison-saunders@murdoch.edu.au [Murdoch University (Australia); North-West University (South Africa); Pope, Jenny, E-mail: jenny@integral-sustainability.net [North-West University (South Africa); Integral Sustainability (Australia); Curtin University (Australia); Bond, Alan, E-mail: alan.bond@uea.ac.uk [North-West University (South Africa); University of East Anglia (United Kingdom); Retief, Francois, E-mail: francois.retief@nwu.ac.za [North-West University (South Africa)

    2014-02-15

    This paper conceptualises what sustainability assessment follow-up might entail for three models of sustainability assessment: EIA-driven integrated assessment, objectives-led integrated assessment and the contribution to sustainability model. The first two are characterised by proponent monitoring and evaluation of individual impacts and indicators while the latter takes a holistic view based around focused sustainability criteria relevant to the context. The implications of three sustainability challenges on follow-up are also examined: contested time horizons and value changes, trade-offs, and interdisciplinarity. We conclude that in order to meet these challenges some form of adaptive follow-up is necessary and that the contribution to sustainability approach is the best approach. -- Highlights: • We explore sustainability follow-up for three different sustainability models. • Long-time frames require adaptive follow-up and are a key follow-up challenge. • Other key challenges include interdisciplinarity, and trade-offs. • Sustainability follow-up should be a direction of travel and not an outcome. • Only the follow-up for contribution to sustainability model addresses sustainability challenges sufficiently.

  11. Follow-up utterances in QA dialogue

    NARCIS (Netherlands)

    van Schooten, B.W.; op den Akker, Hendrikus J.A.

    2006-01-01

    The processing of user follow-up utterances by a QA system is a topic which is still in its infant stages, but enjoys growing interest in the QA community. In this paper, we discuss the broader issues related to handling follow-up utterances in a real-life "information kiosk" setting. With help of a

  12. Towards sustainability assessment follow-up

    International Nuclear Information System (INIS)

    Morrison-Saunders, Angus; Pope, Jenny; Bond, Alan; Retief, Francois

    2014-01-01

    This paper conceptualises what sustainability assessment follow-up might entail for three models of sustainability assessment: EIA-driven integrated assessment, objectives-led integrated assessment and the contribution to sustainability model. The first two are characterised by proponent monitoring and evaluation of individual impacts and indicators while the latter takes a holistic view based around focused sustainability criteria relevant to the context. The implications of three sustainability challenges on follow-up are also examined: contested time horizons and value changes, trade-offs, and interdisciplinarity. We conclude that in order to meet these challenges some form of adaptive follow-up is necessary and that the contribution to sustainability approach is the best approach. -- Highlights: • We explore sustainability follow-up for three different sustainability models. • Long-time frames require adaptive follow-up and are a key follow-up challenge. • Other key challenges include interdisciplinarity, and trade-offs. • Sustainability follow-up should be a direction of travel and not an outcome. • Only the follow-up for contribution to sustainability model addresses sustainability challenges sufficiently

  13. Follow-up in Childhood Functional Constipation

    DEFF Research Database (Denmark)

    Modin, Line; Walsted, Anne-Mette; Rittig, Charlotte Siggaard

    2016-01-01

    OBJECTIVES: Guidelines recommend close follow-up during treatment of childhood functional constipation. Only sparse evidence exists on how follow-up is best implemented. Our aim was to evaluate if follow-up by phone or self-management through web-based information improved treatment outcomes....... METHODS: In this randomized, controlled trial, conducted in secondary care, 235 children, aged 2-16 years, who fulfilled the Rome III criteria of childhood constipation, were assigned to one of three follow-up regimens: (I) control group (no scheduled contact), (II) phone group (2 scheduled phone contacts......: Improved self-management behavior caused by access to self-motivated web-based information induced faster short-term recovery during treatment of functional constipation. Patient empowerment rather than health care promoted follow-up might be a step towards more effective treatment for childhood...

  14. Audit Follow-up Tracking System (AFTS)

    Data.gov (United States)

    Office of Personnel Management — The Audit Follow-up Tracking System (AFTS) is used to track, monitor, and report on audits and open recommendations of the U.S. Office of Personnel Management (OPM)...

  15. The design and implementation of a study to investigate the effectiveness of community vs hospital eye service follow-up for patients with neovascular age-related macular degeneration with quiescent disease.

    Science.gov (United States)

    Taylor, J; Scott, L J; Rogers, C A; Muldrew, A; O'Reilly, D; Wordsworth, S; Mills, N; Hogg, R; Violato, M; Harding, S P; Peto, T; Townsend, D; Chakravarthy, U; Reeves, B C

    2016-01-01

    IntroductionStandard treatment for neovascular age-related macular degeneration (nAMD) is intravitreal injections of anti-VEGF drugs. Following multiple injections, nAMD lesions often become quiescent but there is a high risk of reactivation, and regular review by hospital ophthalmologists is the norm. The present trial examines the feasibility of community optometrists making lesion reactivation decisions.MethodsThe Effectiveness of Community vs Hospital Eye Service (ECHoES) trial is a virtual trial; lesion reactivation decisions were made about vignettes that comprised clinical data, colour fundus photographs, and optical coherence tomograms displayed on a web-based platform. Participants were either hospital ophthalmologists or community optometrists. All participants were provided with webinar training on the disease, its management, and assessment of the retinal imaging outputs. In a balanced design, 96 participants each assessed 42 vignettes; a total of 288 vignettes were assessed seven times by each professional group.The primary outcome is a participant's judgement of lesion reactivation compared with a reference standard. Secondary outcomes are the frequency of sight threatening errors; judgements about specific lesion components; participant-rated confidence in their decisions about the primary outcome; cost effectiveness of follow-up by optometrists rather than ophthalmologists.DiscussionThis trial addresses an important question for the NHS, namely whether, with appropriate training, community optometrists can make retreatment decisions for patients with nAMD to the same standard as hospital ophthalmologists. The trial employed a novel approach as participation was entirely through a web-based application; the trial required very few resources compared with those that would have been needed for a conventional randomised controlled clinical trial.

  16. Rectal neoplasms. Postoperative follow-up

    International Nuclear Information System (INIS)

    Galano Urgelles, Rolando; Rodriguez Fernandez, Zenen; Casaus Prieto, Arbelio

    1997-01-01

    A study of 31 patients operated on for rectal neoplasms between September, 1989 and September, 1995 in SantiAug de Cuba was performed. Patients Webre followed-up during this period for the purpose of the study. There was a frank predominance of males and ages between 45 and 64, of the stage II and the groups BI and BII according to Dukes' classification. Most patients received 5-fluoracil, without tumor relapses. The current survival rate of the series was 76 % at the end of the investigation. It is recommended that all patients operated on for this segment be followed-up after the operation; to continue with cytostatic treatment using 5-fluoracil, and to emphasize the importance of the use of tumor markers during the follow-up, in addition to transrectal ultrasound, as well as to make an early diagnosis through mass screening methods

  17. Follow-up after rectal cancer

    DEFF Research Database (Denmark)

    Hovdenak Jakobsen, Ida; Juul, Therese; Bernstein, Inge

    2017-01-01

    BACKGROUND: The main treatment for non-metastatic rectal cancer (RC) is surgical resection. Late adverse effects that are highly prevalent and negatively impact patients' symptom burden and quality of life are: bowel-, urological and sexual dysfunctions; psychological distress; fear of recurrence....... As a consequence, the randomized controlled trial Follow-up after Rectal Cancer (FURCA) has been launched, testing the effect of a new patient-led, follow-up program. The aim of this paper is to describe the methodology used in the FURCA study and to report results from the development of the patient-led, follow......, or a control group following the current follow-up program with routine medicals. The primary outcomes are symptom burden and quality of life, measured by the Functional Assessment of Cancer Therapy - Colorectal (FACT-C) questionnaire. Other outcome and demographic data are collected as patient...

  18. Handbook of Exemplary Practices in Placement and Follow-Up.

    Science.gov (United States)

    Mehallis, Mantha Vlahos

    This handbook for teachers, counselors, and administrators presents exemplary practices in the use of job placement and follow-up services based on results of a survey of Florida school districts and community colleges. A description of survey methodology and the survey questionnaire, as well as a statewide profile of Florida exemplary practices…

  19. The Kepler follow-up observation program

    DEFF Research Database (Denmark)

    Gautier...[], T.N.; Batalha, N.M.; Borucki, W. J.

    2010-01-01

    The Kepler Mission was launched on March 6, 2009 to perform a photometric survey of more than 100,000 dwarf stars to search for terrestrial-size planets with the transit technique. Follow-up observations of planetary candidates identified by detection of transit-like events are needed both...

  20. Management of kyphoscoliosis patients with respiratory failure in the intensive care unit and during long term follow up

    Directory of Open Access Journals (Sweden)

    Adıgüzel Nalan

    2012-09-01

    Full Text Available Abstract Background We aimed to evaluate the ICU management and long-term outcomes of kyphoscoliosis patients with respiratory failure. Methods A retrospective observational cohort study was performed in a respiratory ICU and outpatient clinic from 2002–2011. We enrolled all kyphoscoliosis patients admitted to the ICU and followed-up at regular intervals after discharge. Reasons for acute respiratory failure (ARF, ICU data, mortality, length of ICU stay and outpatient clinic data, non-invasive ventilation (NIV device settings, and compliance were recorded. NIV failure in the ICU and the long term effect of NIV on pulmonary performance were analyzed. Results Sixty-two consecutive ICU kyphoscoliosis patients with ARF were enrolled in the study. NIV was initially applied to 55 patients, 11 (20% patients were intubated, and the majority had sepsis and septic shock (p  Conclusions We strongly discourage the use of NIV in the case of septic shock in ICU kyphoscoliosis patients with ARF. Pulmonary performance improved with NIV during long term follow up.

  1. Follow-up of colorectal cancer patients: quality of life and attitudes towards follow-up

    NARCIS (Netherlands)

    Stiggelbout, A. M.; de Haes, J. C.; Vree, R.; van de Velde, C. J.; Bruijninckx, C. M.; van Groningen, K.; Kievit, J.

    1997-01-01

    The aims of our study were to assess the effect of follow-up on the quality of life of colorectal cancer patients and to assess the attitudes of patients towards follow-up as a function of patient characteristics. Patients who had been treated with curative intent were selected from four types of

  2. Spectroscopic follow up of Kepler planet candidates

    DEFF Research Database (Denmark)

    Latham..[], D. W.; Cochran, W. D.; Marcy, G.W.

    2010-01-01

    Spectroscopic follow-up observations play a crucial role in the confirmation and characterization of transiting planet candidates identified by Kepler. The most challenging part of this work is the determination of radial velocities with a precision approaching 1 m/s in order to derive masses from...... spectroscopic orbits. The most precious resource for this work is HIRES on Keck I, to be joined by HARPS-North on the William Herschel Telescope when that new spectrometer comes on line in two years. Because a large fraction of the planet candidates are in fact stellar systems involving eclipsing stars...... and not planets, our strategy is to start with reconnaissance spectroscopy using smaller telescopes, to sort out and reject as many of the false positives as possible before going to Keck. During the first Kepler observing season in 2009, more than 100 nights of telescope time were allocated for this work, using...

  3. Short- and long-term follow-up of intensive care unit patients after sedation with isoflurane and midazolam--a pilot study.

    Science.gov (United States)

    Sackey, Peter V; Martling, Claes-Roland; Carlswärd, Christine; Sundin, Orjan; Radell, Peter J

    2008-03-01

    To compare memories from the intensive care unit (ICU) and short- and long-term psychological morbidity in patients after sedation with intravenous midazolam or inhaled isoflurane. Prospective long-term follow-up after randomized controlled trial. General ICU at Karolinska University Hospital, Solna, Stockholm. Forty patients in need of sedation during ventilator treatment. Patients were randomized to receive isoflurane or midazolam for goal-directed sedation until extubation or for a maximum of 96 hrs. For short-term follow-up, doctors', nurses', and physiotherapists' notes from the 4 days following exposure to the study drugs were reviewed for words indicating adequate or pathologic cognitive and psychological recovery. For long-term follow-up, all 6-month survivors received questionnaires including the ICU Memory Tool (ICU-MT), Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale (IES), and Well-Being Index. Additionally, several screening questions for previous posttraumatic stress symptoms were included. In the short term follow-up, no significant differences were found between groups. In the long-term follow-up, a trend toward fewer hallucinations/delusions after isoflurane sedation than after midazolam (two of ten isoflurane patients vs. five of seven midazolam patients) was found (p = .06). None of the five solely isoflurane-sedated patients reported hallucinations/delusions from the ICU. There was no difference in groups in long-term psychological morbidity as measured with HADS and IES. Memories of negative feelings in the ICU (ICU-MT) were associated with high HADS and IES scores (Fisher's exact test, p = .02 and p = .01, respectively). Sedation of ICU patients with isoflurane may result in fewer delusional memories or hallucinations from the ICU compared with more commonly used intravenous sedation. Memories of negative feelings from the ICU were associated with symptoms of depression or anxiety or symptoms indicating posttraumatic stress

  4. Systematic co-operation between employer, occupational health service and social insurance office: a 6-year follow-up of vocational rehabilitation for people on sick-leave, including economic benefits.

    Science.gov (United States)

    Kärrholm, Jenny; Ekholm, Karolina; Ekholm, Jan; Bergroth, Alf; Ekholm, Kristina Schüldt

    2008-08-01

    To evaluate the effects of systematic co-operation among municipal employees on the number of sick-leave days per month and the type of benefit granted by the Social Insurance Office. A further aim was to evaluate the economic consequences for society. A 6-year follow-up study with a matched-pairs design. Days on sick-leave were calculated for each subject one year before the intervention started and yearly for the following 6-year period. Statistical mixed-model analysis was used. The economic benefit of the intervention was estimated as the increased production stemming from fewer days on sick-leave. Sixty-four employees on long-term sick-leave were individually matched with controls from another Social Insurance Office in a county with a socioeconomic structure similar to that of the study group. The study group had 5.7 fewer days on sick-leave per month and person over the 6-year period (p=0.003). The estimated average economic benefit of the intervention was euro36,600 per person over the 6-year period. In conclusion, those who received systematic co-operation in vocational rehabilitation had fewer days on sick-leave than their "treatment-as-usual" peers. This effect persisted over 6 years, generating substantial net economic gains for society.

  5. Morbidity follow-up feasibility study

    International Nuclear Information System (INIS)

    Carpenter, M.

    1988-02-01

    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

  6. Therapeutic abortion follow-up study.

    Science.gov (United States)

    Margolis, A J; Davison, L A; Hanson, K H; Loos, S A; Mikkelsen, C M

    1971-05-15

    To determine the long-range psychological effects of therapeutic abortion, 50 women (aged from 13-44 years), who were granted abortions between 1967 and 1968 Because of possible impairment of mental and/or physical health, were analyzed by use of demographic questionnaires, psychological tests, and interviews. Testing revealed that 44 women had psychiatric problems at time of abortion. 43 patients were followed for 3-6 months. The follow-up interviews revealed that 29 patients reacted positively after abortion, 10 reported no significant change and 4 reacted negatively. 37 would definitely repeat the abortion. Women under 21 years of age felt substantially more ambivalent and guilty than older patients. A study of 36 paired pre- and post-abortion profiles showed that 15 initially abnormal tests had become normal. There was a significant increase in contraceptive use among the patients after the abortion, but 4 again became pregnant and 8 were apparently without consistent contraception. It is concluded that the abortions were therapeutic, but physicians are encouraged to be aware of psychological problems in abortion cases. Strong psychological and contraceptive counselling should be exercised.

  7. Colon neoplasms. Postoperative follow-up

    International Nuclear Information System (INIS)

    Galano Urgelles, Rolando; Rodriguez Fernandez, Zenen; Casaus Prieto, Arbelio

    1997-01-01

    A longitudinal and prospective study of 69 patients operated on for colon cancer was carried out during 6 years. Patients Webre folloWebd-up for the purpose of the study. The analysis evidenced that the most frequent age group ranged betWeben 65 and 74 years and that there was a predominance of females, as Webll as of stages II and III b and groups BI and BII according to Dukes' classification. Certain relapses resulting in re operations Webre detected. 5-fluoracil was used as a therapeutic agent, while the highest survival rate was attained in patients presenting with tumors in 0, I, II, and III a stages from groups A, BI, and CI of Dukes, or in those who complied with the cytostatic treatment. Survival outcomes Webre higher than the ones reported. Recommendations include to encourage mass screening in those risk groups at primary care level in order to detect early the entity, and thus improve the surgical outcomes and the results of postoperative follow-up

  8. Follow-up radiological surveillance, Marshall Islands

    International Nuclear Information System (INIS)

    Greenhouse, N.A.

    1978-01-01

    The political approvals have been given for the return of Bikini and Enewetak Atolls to their original inhabitants. These two regions, which comprised the Pacific Nuclear Testing Areas from 1946 to 1958, are now being repopulated by their original inhabitants and their families. Recent assessments of internal and external exposure pathways at Bikini and Enewetak have indicated that doses and dose commitments in excess of current radiation protection guidelines are possible or even likely for persons living in these areas. Rongelap and Utirik Atolls, which were downwind of the 1954 Bravo event, also received significant fallout; potential radiological problems exist in these areas as well. In view of this prospect, follow-up environmental monitoring and personnel monitoring programs are being established to maintain our cognizance of radiological conditions, and to make corrective action where necessary. The unexpected finding of detectable amounts (above background) of plutonium in the urine of individuals at Bikini and Rongelap Atolls also raises the possibility of radiological problems in the long term from environmentally-derived plutonium via pathways which are not completely understood. This finding adds further impetus to the surveillance programs for an area where real radiological concerns for the general public are already known to exist. The continuing environmental and personnel monitoring programs which this paper describes are a necessary part of the BNL radiological safety program in the Marshall Islands, which is designed to do the following: (1) elucidate the internal exposure pathways; (2) define the external radiation environment; (3) assess the doses and dose commitments from radioactivity in the environment; (4) provide the feedback necessary to improve existing predictive modelling of radiological trends; and (5) suggest actions which will minimize doses via the more significant pathways. (author)

  9. A follow-up meeting post death is appreciated by family members of deceased patients.

    Science.gov (United States)

    Kock, M; Berntsson, C; Bengtsson, A

    2014-08-01

    A practice with a follow-up meeting post death (FUMPD) with physician and staff for family members of patients who died in the intensive care unit (ICU) was started as a quality project to improve the support of families in post-ICU bereavement. A quality improvement control was conducted after 4 years. The quality improvement control was made retrospectively as an anonymous non-coded questionnaire. Part A related to the FUMPD. Part B inquired if we could contact the family member again for a research project to evaluate family support post-ICU bereavement. The questionnaires were sent to 84 family members of 56 deceased patients. Part A: 46 out of 84 family members answered and had attended a FUMPD. Ninety-one percent of the family members thought that we should continue to offer FUMPD. Seventy-eight percent were satisfied with their meeting. Eighty percent felt that they understood the cause of death. The majority wanted the meeting to take place within 6 weeks of death. Ninety-one percent rated the physician as important to be present at the meeting. The social worker was rated more important to attend the meeting than the assistant nurse. Ninety-one percent wanted to discuss the cause of death.Part B: 54 out of 84 family members answered. Twenty out of 54 did not want us to contact them again. A routine with a Follow-Up Meeting Post Death with the ICU team for the families of the patients who die in the ICU is appreciated. The presence of the physician is important. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  10. A Nationwide Census of ICU Capacity and Admissions in Mongolia.

    Directory of Open Access Journals (Sweden)

    Naranpurev Mendsaikhan

    Full Text Available In Mongolia, a Central Asian lower-middle income country, intensive care medicine is an under-resourced and-developed medical specialty. The burden of critical illness and capacity of intensive care unit (ICU services in the country is unknown. In this nationwide census, we collected data on adult and pediatric/neonatal ICU capacities and the number of ICU admissions in 2014. All hospitals registered to run an ICU service in Mongolia were surveyed. Data on the availability of an adult and/or pediatric/neonatal ICU service, the number of available ICU beds, the number of available functional mechanical ventilators, the number of patients admitted to the ICU, and the number of patients admitted to the study hospital were collected. In total, 70 ICUs with 349 ICU beds were counted in Mongolia (11.7 ICU beds/100,000 inhabitants; 1.7 ICU beds/100 hospital beds. Of these, 241 (69% were adult and 108 (31% pediatric/neonatal ICU beds. Functional mechanical ventilators were available for approximately half of the ICU beds (5.1 mechanical ventilators/100,000 inhabitants. While all provincial hospitals ran a pediatric/neonatal ICU, only dedicated pediatric hospitals in Ulaanbaatar did so. The number of adult and pediatric/neonatal ICU admissions varied between provinces. The number of adult ICU beds and adult ICU admissions per 100,000 inhabitants correlated (r = 0.5; p = 0.02, while the number of pediatric/neonatal ICU beds and pediatric/neonatal ICU admissions per 100,000 inhabitants did not (r = 0.25; p = 0.26. In conclusion, with 11.7 ICU beds per 100,000 inhabitants the ICU capacity in Mongolia is higher than in other low- and lower-middle-income countries. Substantial heterogeneities in the standardized ICU capacity and ICU admissions exist between Mongolian provinces. Functional mechanical ventilators are available for only half of the ICU beds. Pediatric/neonatal ICU beds make up one third of the national ICU capacity and appear to meet or even

  11. [Endoscopic follow-up of translaryngeal Fantoni tracheostomy].

    Science.gov (United States)

    Succo, G; Crosetti, E; Mattalia, P; Voltolina, M; Bramardi, F; Di Lisi, D; Riva, F; Sartoris, A

    2002-08-01

    Dilatational tracheotomy techniques are widely used in the long-term management of the respiratory tract in patients in intensive care units (ICU). The translaryngeal tracheotomy technique (TLT) was first described by Fantoni in 1993 and rapidly asserted itself, especially in Europe. This technique basically differs from the other percutaneous techniques in that it involves a progressive, retrograde, dilatation of the trachea in a single session conducted from inside the trachea, working outward, simultaneously exerting a counter-pressure on the pre-tracheal soft tissues with the fingers. The present study involves an endoscopy follow-up of 130 patients who had undergone TLT at the Intensive Care Unit of our Hospital between November 2000 and May 2001. The pre-operative oro-tracheal intubation time varied from 1 to 42 days. All patients filled out a brief questionnaire containing validated questions on their general health and quality of life with particular attention focused on respiratory conditions. Then, after receiving informed consent, the patients underwent laryngo-tracheoscopy with local anesthetic using a flexible tracheobronchoscope. All tests were recorded and viewed later by two operators in order to identify and divide the patients according to the level of execution of the tracheotomy and the presence of sequelae. The results obtained have shown that, like other percutaneous tracheotomy techniques, TLT provides some benefits including the fact that procedure can be performed at the bedside in a short time, with few post-operative complications, simpler nursing and fewer sequelae in time. Analysis of data concerning time of tracheostomy execution, tracheal level of stomia and nursing times has revealed three factors that determine severe sequelae: delay in tracheostomy execution, high level of execution with cricoid involvement and onset of problems during first tracheal cannula change.

  12. Biological age as a health index for mortality and major age-related disease incidence in Koreans: National Health Insurance Service – Health screening 11-year follow-up study

    Directory of Open Access Journals (Sweden)

    Kang YG

    2018-03-01

    Full Text Available Young Gon Kang,1 Eunkyung Suh,2 Jae-woo Lee,3 Dong Wook Kim,4 Kyung Hee Cho,5 Chul-Young Bae1 1Department of R&D, MediAge Research Center, Seongnam, Republic of South Korea; 2Department of Family Medicine, College of Medicine, CHA University, Chaum, Seoul, Republic of South Korea; 3Department of Family Medicine, College of Medicine, Chungbuk National University, Cheongju, Republic of South Korea; 4Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang, Republic of South Korea; 5Department of Family Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of South KoreaPurpose: A comprehensive health index is needed to measure an individual’s overall health and aging status and predict the risk of death and age-related disease incidence, and evaluate the effect of a health management program. The purpose of this study is to demonstrate the validity of estimated biological age (BA in relation to all-cause mortality and age-related disease incidence based on National Sample Cohort database.Patients and methods: This study was based on National Sample Cohort database of the National Health Insurance Service – Eligibility database and the National Health Insurance Service – Medical and Health Examination database of the year 2002 through 2013. BA model was developed based on the National Health Insurance Service – National Sample Cohort (NHIS – NSC database and Cox proportional hazard analysis was done for mortality and major age-related disease incidence.Results: For every 1 year increase of the calculated BA and chronological age difference, the hazard ratio for mortality significantly increased by 1.6% (1.5% in men and 2.0% in women and also for hypertension, diabetes mellitus, heart disease, stroke, and cancer incidence by 2.5%, 4.2%, 1.3%, 1.6%, and 0.4%, respectively (p<0.001.Conclusion: Estimated BA by the developed BA model based on NHIS – NSC database is expected to be

  13. The increased effectiveness of HIV preventive intervention among men who have sex with men and of follow-up care for people living with HIV after 'task-shifting' to community-based organizations: a 'cash on service delivery' model in China.

    Science.gov (United States)

    Yan, Hongjing; Zhang, Min; Zhao, Jinkou; Huan, Xiping; Ding, Jianping; Wu, Susu; Wang, Chenchen; Xu, Yuanyuan; Liu, Li; Xu, Fei; Yang, Haitao

    2014-01-01

    A large number of men who have sex with men (MSM) and people living with HIV/AIDS (PLHA) are underserved despite increased service availability from government facilities while many community based organizations (CBOs) are not involved. We aimed to assess the feasibility and effectiveness of the task shifting from government facilities to CBOs in China. HIV preventive intervention for MSM and follow-up care for PLHA were shifted from government facilities to CBOs. Based on 'cash on service delivery' model, 10 USD per MSM tested for HIV with results notified, 82 USD per newly HIV cases diagnosed, and 50 USD per PLHA received a defined package of follow-up care services, were paid to the CBOs. Cash payments were made biannually based on the verified results in the national web-based HIV/AIDS information system. After task shifting, CBOs gradually assumed preventive intervention for MSM and follow-up care for PLHA from 2008 to 2012. HIV testing coverage among MSM increased from 4.1% in 2008 to 22.7% in 2012. The baseline median CD4 counts of newly diagnosed HIV positive MSM increased from 309 to 397 cells/µL. HIV tests among MSM by CBOs accounted for less than 1% of the total HIV tests in Nanjing but the share of HIV cases detected by CBOs was 12.4% in 2008 and 43.6% in 2012. Unit cost per HIV case detected by CBOs was 47 times lower than that by government facilities. The coverage of CD4 tests and antiretroviral therapy increased from 71.1% and 78.6% in 2008 to 86.0% and 90.1% in 2012, respectively. It is feasible to shift essential HIV services from government facilities to CBOs, and to verify independently service results to adopt 'cash on service delivery' model. Services provided by CBOs are cost-effective, as compared with that by government facilities.

  14. The increased effectiveness of HIV preventive intervention among men who have sex with men and of follow-up care for people living with HIV after 'task-shifting' to community-based organizations: a 'cash on service delivery' model in China.

    Directory of Open Access Journals (Sweden)

    Hongjing Yan

    Full Text Available A large number of men who have sex with men (MSM and people living with HIV/AIDS (PLHA are underserved despite increased service availability from government facilities while many community based organizations (CBOs are not involved. We aimed to assess the feasibility and effectiveness of the task shifting from government facilities to CBOs in China.HIV preventive intervention for MSM and follow-up care for PLHA were shifted from government facilities to CBOs. Based on 'cash on service delivery' model, 10 USD per MSM tested for HIV with results notified, 82 USD per newly HIV cases diagnosed, and 50 USD per PLHA received a defined package of follow-up care services, were paid to the CBOs. Cash payments were made biannually based on the verified results in the national web-based HIV/AIDS information system.After task shifting, CBOs gradually assumed preventive intervention for MSM and follow-up care for PLHA from 2008 to 2012. HIV testing coverage among MSM increased from 4.1% in 2008 to 22.7% in 2012. The baseline median CD4 counts of newly diagnosed HIV positive MSM increased from 309 to 397 cells/µL. HIV tests among MSM by CBOs accounted for less than 1% of the total HIV tests in Nanjing but the share of HIV cases detected by CBOs was 12.4% in 2008 and 43.6% in 2012. Unit cost per HIV case detected by CBOs was 47 times lower than that by government facilities. The coverage of CD4 tests and antiretroviral therapy increased from 71.1% and 78.6% in 2008 to 86.0% and 90.1% in 2012, respectively.It is feasible to shift essential HIV services from government facilities to CBOs, and to verify independently service results to adopt 'cash on service delivery' model. Services provided by CBOs are cost-effective, as compared with that by government facilities.

  15. Effectiveness of palliative home-care services in reducing hospital admissions and determinants of hospitalization for terminally ill patients followed up by a palliative home-care team: a retrospective cohort study.

    Science.gov (United States)

    Riolfi, Mirko; Buja, Alessandra; Zanardo, Chiara; Marangon, Chiara Francesca; Manno, Pietro; Baldo, Vincenzo

    2014-05-01

    It has been demonstrated that most patients in the terminal stages of cancer would benefit from palliative home-care services. The aim of this study was to assess the effectiveness of appropriate palliative home-care services in reducing hospital admissions, and to identify factors predicting the likelihood of patients treated at home being hospitalized. Retrospective cohort study. We enrolled all 402 patients listed by the Local Health Authority No. 5, Veneto Region (North-East Italy), as dying of cancer in 2011. Of the cohort considered, 39.9% patients had been taken into care by a palliative home-care team. Irrespective of age, gender, and type of tumor, patients taken into care by the palliative home-care team were more likely to die at home, less likely to be hospitalized, and spent fewer days in hospital in the last 2 months of their life. Among the patients taken into care by the palliative home-care team, those with hematological cancers and hepatocellular carcinoma were more likely to be hospitalized, and certain symptoms (such as dyspnea and delirium) were predictive of hospitalization. Our study confirms the effectiveness of palliative home care in enabling patients to spend the final period of their lives at home. The services of a palliative home-care team reduced the consumption of hospital resources. This study also provided evidence of some types of cancer (e.g. hematological cancers and hepatocellular carcinoma) being more likely to require hospitalization, suggesting the need to reconsider the pathways of care for these diseases.

  16. Biological age as a health index for mortality and major age-related disease incidence in Koreans: National Health Insurance Service – Health screening 11-year follow-up study

    OpenAIRE

    Kang,Young Gon; Suh,Eunkyung; Lee,Jae-woo; Kim,Dong Wook; Cho,Kyung Hee; Bae,Chul-Young

    2018-01-01

    Young Gon Kang,1 Eunkyung Suh,2 Jae-woo Lee,3 Dong Wook Kim,4 Kyung Hee Cho,5 Chul-Young Bae1 1Department of R&D, MediAge Research Center, Seongnam, Republic of South Korea; 2Department of Family Medicine, College of Medicine, CHA University, Chaum, Seoul, Republic of South Korea; 3Department of Family Medicine, College of Medicine, Chungbuk National University, Cheongju, Republic of South Korea; 4Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital...

  17. Family members' satisfaction with care and decision-making in intensive care units and post-stay follow-up needs-a cross-sectional survey study.

    Science.gov (United States)

    Frivold, Gro; Slettebø, Åshild; Heyland, Daren K; Dale, Bjørg

    2018-01-01

    The aim of this study was to explore family members' satisfaction with care and decision-making during the intensive care units stay and their follow-up needs after the patient's discharge or death. A cross-sectional survey study was conducted. Family members of patients recently treated in an ICU were participating. The questionnaire contented of background variables, the instrument Family Satisfaction in ICU (FS-ICU 24) and questions about follow-up needs. Descriptive and non-parametric statistics and a multiple linear regression were used in the analysis. A total of 123 (47%) relatives returned the questionnaire. Satisfaction with care was higher scored than satisfaction with decision-making. Follow- up needs after the ICU stay was reported by 19 (17%) of the participants. Gender and length of the ICU stay were shown as factors identified to predict follow-up needs.

  18. Hearing screening follow-up return rate in a very low birth weight ...

    African Journals Online (AJOL)

    These may involve parental education and counselling, as well as involvement of nursing staff and medical professionals in implementation of EHDI programmes. It may be possible to improve followup by aligning follow-up screening with the day of neonatal follow-up clinics in provincial hospitals where such services are ...

  19. Meeting increased demand for total knee replacement and follow-up: determining optimal follow-up.

    Science.gov (United States)

    Meding, J B; Ritter, M A; Davis, K E; Farris, A

    2013-11-01

    The strain on clinic and surgeon resources resulting from a rise in demand for total knee replacement (TKR) requires reconsideration of when and how often patients need to be seen for follow-up. Surgeons will otherwise require increased paramedical staff or need to limit the number of TKRs they undertake. We reviewed the outcome data of 16 414 primary TKRs undertaken at our centre to determine the time to re-operation for any reason and for specific failure mechanisms. Peak risk years for failure were determined by comparing the conditional probability of failure, the number of failures divided by the total number of TKRs cases, for each year. The median times to failure for the most common failure mechanisms were 4.9 years (interquartile range (IQR) 1.7 to 10.7) for femoral and tibial loosening, 1.9 years (IQR 0.8 to 3.9) for infection, 3.1 years (IQR 1.6 to 5.5) for tibial collapse and 5.6 years (IQR 3.4 to 9.3) for instability. The median time to failure for all revisions was 3.3 years (IQR 1.2 to 8.5), with an overall revision rate of 1.7% (n = 282). Results from our patient population suggest that patients be seen for follow-up at six months, one year, three years, eight years, 12 years, and every five years thereafter. Patients with higher pain in the early post-operative period or high body mass index (≥ 41 kg/m(2)) should be monitored more closely.

  20. ESRD QIP - Pain Assessment and Follow-up - Payment Year 2018

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset includes facility details, measure score, and the state and national average measure scores for the pain assessment and follow up reporting measure...

  1. ESRD QIP - Clinical Depression Screening and Follow-up - Payment Year 2018

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset includes facility details, measure score, and the state and national average measure scores for the clinical depression screening and follow up...

  2. The Increased Effectiveness of HIV Preventive Intervention among Men Who Have Sex with Men and of Follow-Up Care for People Living with HIV after ‘Task-Shifting’ to Community-Based Organizations: A ‘Cash on Service Delivery’ Model in China

    Science.gov (United States)

    Yan, Hongjing; Zhang, Min; Zhao, Jinkou; Huan, Xiping; Ding, Jianping; Wu, Susu; Wang, Chenchen; Xu, Yuanyuan; Liu, Li; Xu, Fei; Yang, Haitao

    2014-01-01

    Background A large number of men who have sex with men (MSM) and people living with HIV/AIDS (PLHA) are underserved despite increased service availability from government facilities while many community based organizations (CBOs) are not involved. We aimed to assess the feasibility and effectiveness of the task shifting from government facilities to CBOs in China. Methods HIV preventive intervention for MSM and follow-up care for PLHA were shifted from government facilities to CBOs. Based on ‘cash on service delivery’ model, 10 USD per MSM tested for HIV with results notified, 82 USD per newly HIV cases diagnosed, and 50 USD per PLHA received a defined package of follow-up care services, were paid to the CBOs. Cash payments were made biannually based on the verified results in the national web-based HIV/AIDS information system. Findings After task shifting, CBOs gradually assumed preventive intervention for MSM and follow-up care for PLHA from 2008 to 2012. HIV testing coverage among MSM increased from 4.1% in 2008 to 22.7% in 2012. The baseline median CD4 counts of newly diagnosed HIV positive MSM increased from 309 to 397 cells/µL. HIV tests among MSM by CBOs accounted for less than 1% of the total HIV tests in Nanjing but the share of HIV cases detected by CBOs was 12.4% in 2008 and 43.6% in 2012. Unit cost per HIV case detected by CBOs was 47 times lower than that by government facilities. The coverage of CD4 tests and antiretroviral therapy increased from 71.1% and 78.6% in 2008 to 86.0% and 90.1% in 2012, respectively. Conclusion It is feasible to shift essential HIV services from government facilities to CBOs, and to verify independently service results to adopt ‘cash on service delivery’ model. Services provided by CBOs are cost-effective, as compared with that by government facilities. PMID:25050797

  3. The value of gynecologic cancer follow-up

    DEFF Research Database (Denmark)

    Lajer, Henrik; Jensen, Mette B.; Kilsmark, Jannie

    2010-01-01

    that follow-up affects the women's quality of life. CONCLUSIONS:: The main purpose of follow-up after treatment of cancer is improved survival. Our review of the literature showed no evidence of a positive effect on survival in women followed up after primary treatment of endometrial or ovarian cancer......INTRODUCTION:: To explore the extent of evidence-based data and cost-utility of follow-up after primary treatment of endometrial and ovarian cancer, addressing perspectives of technology, organization, economics, and patients. METHODS:: Systematic literature searches according......:: None of the identified studies supported a survival benefit from hospital-based follow-up after completion of primary treatment of endometrial or ovarian cancer. The methods for follow-up were of low technology (gynecologic examination with or without ultrasound examination). Other technologies had...

  4. 29 CFR 99.315 - Audit findings follow-up.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Audit findings follow-up. 99.315 Section 99.315 Labor Office... § 99.315 Audit findings follow-up. (a) General. The auditee is responsible for follow-up and corrective... include the reference numbers the auditor assigns to audit findings under § 99.510(c). Since the summary...

  5. Structured nursing follow-up: does it help in diabetes care?

    Science.gov (United States)

    Shani, Michal; Nakar, Sasson; Lustman, Alex; Lahad, Amnon; Vinker, Shlomo

    2014-01-01

    In 1995 Clalit Health Services introduced a structured follow-up schedule, by primary care nurses, of diabetic patients. This was supplementary care, given in addition to the family physician's follow-up care. This article aims to describe the performance of diabetes follow-up and diabetes control in patients with additional structured nursing follow-up care, compared to those patients followed only by their family physician. We randomly selected 2,024 type 2 diabetic subjects aged 40-76 years. For each calendar year, from 2005-2007, patients who were "under physician follow-up only" were compared to those who received additional structured nursing follow-up care. Complete diabetes follow-up parameters including: HbA1c, LDL cholesterol, microalbumin, blood pressure measurements and fundus examination. The average age of study participants was 60.7 years, 52% were females and 38% were from low socioeconomic status (SES). In 2005, 39.5% of the diabetic patients received structured nursing follow-up, and the comparable figures for 2006 and 2007 were 42.1% 49.6%, respectively. The intervention subjects tended to be older, from lower SES, suffered from more chronic diseases and visited their family physician more frequently than the control patients. Patients in the study group were more likely to perform a complete diabetes follow-up plan: 52.8% vs. 21.5% (2005; p nursing follow-up care were more likely to perform complete diabetes follow-up protocol. Our results reinforce the importance of teamwork in diabetic care. Further study is required to identify strategies for channeling the use of the limited resources to the patients who stand to benefit the most.

  6. Follow-up methods for retrospective cohort studies in New Zealand.

    Science.gov (United States)

    Fawcett, Jackie; Garrett, Nick; Bates, Michael N

    2002-01-01

    To define a general methodology for maximising the success of follow-up processes for retrospective cohort studies in New Zealand, and to illustrate an approach to developing country-specific follow-up methodologies. We recently conducted a cohort study of mortality and cancer incidence in New Zealand professional fire fighters. A number of methods were used to trace vital status, including matching with records of the New Zealand Health Information Service (NZHIS), pension records of Work and Income New Zealand (WINZ), and electronic electoral rolls. Non-electronic methods included use of paper electoral rolls and the records of the Registrar of Births Deaths and Marriages. 95% of the theoretical person-years of follow-up of the cohort were traced using these methods. In terms of numbers of cohort members traced to end of follow-up, the most useful tracing methods were fire fighter employment records, the NZHIS, WINZ, and the electronic electoral rolls. The follow-up process used for the cohort study was highly successful. On the basis of this experience, we propose a generic, but flexible, model for follow-up of retrospective cohort studies in New Zealand. Similar models could be constructed for other countries. Successful follow-up of cohort studies is possible in New Zealand using established methods. This should encourage the use of cohort studies for the investigation of epidemiological issues. Similar models for follow-up processes could be constructed for other countries.

  7. National screening program vs. standardized neurodevelopmental follow-up

    NARCIS (Netherlands)

    Maschke, Cornelia; Ellenrieder, Birte; Hecher, Kurt; Bartmann, Peter

    Background: Long-term follow-up is urgently needed to decide on the consequences of new therapies. Objective: This study assesses the use of a national child development screening program for a follow-up examination of a defined patient group. Patients and methods: Neurodevelopmental outcome of 139

  8. Carcinoembryonic Antigen (CEA) in colorectal cancer follow-up

    NARCIS (Netherlands)

    Verberne, Charlotte

    2016-01-01

    Colorectal cancer follow-up aims to detect recurrent disease as soon as possible, since earlier detection of recurrent disease is associated with greater chances for cure. A part of follow-up is the measurement of Carcinoembryonic Antigen (CEA) in the blood of the patient. This tumor marker is

  9. ICU Director Data

    Science.gov (United States)

    Ogbu, Ogbonna C.; Coopersmith, Craig M.

    2015-01-01

    Improving value within critical care remains a priority because it represents a significant portion of health-care spending, faces high rates of adverse events, and inconsistently delivers evidence-based practices. ICU directors are increasingly required to understand all aspects of the value provided by their units to inform local improvement efforts and relate effectively to external parties. A clear understanding of the overall process of measuring quality and value as well as the strengths, limitations, and potential application of individual metrics is critical to supporting this charge. In this review, we provide a conceptual framework for understanding value metrics, describe an approach to developing a value measurement program, and summarize common metrics to characterize ICU value. We first summarize how ICU value can be represented as a function of outcomes and costs. We expand this equation and relate it to both the classic structure-process-outcome framework for quality assessment and the Institute of Medicine’s six aims of health care. We then describe how ICU leaders can develop their own value measurement process by identifying target areas, selecting appropriate measures, acquiring the necessary data, analyzing the data, and disseminating the findings. Within this measurement process, we summarize common metrics that can be used to characterize ICU value. As health care, in general, and critical care, in particular, changes and data become more available, it is increasingly important for ICU leaders to understand how to effectively acquire, evaluate, and apply data to improve the value of care provided to patients. PMID:25846533

  10. Follow-up measles campaign in the Dominican Republic.

    Science.gov (United States)

    1998-12-01

    The Dominican Republic conducted a national follow-up measles vaccination campaign 6 weeks after sustaining heavy damage from Hurricane Georges, on November 6-12, targeting 830,517 children aged 9 months to 5 years in 29 provinces and the capital city. This campaign was the first mass vaccination effort in the country, following the beginning of the decentralized delivery of health services. Priority was given to vaccinating against diphtheria, whooping cough, and tetanus, especially in refugee camps. More than 500,000 vaccines were given to different age groups, with almost 100,000 of those immunized under 5 years old. Children aged 9 months to 5 years were targeted for immunization regardless of their vaccination status. At the same time, children aged 2 months through 2 years were immunized against poliomyelitis. Vaccination activities were continued until the entire target population was reached and no important side effects have thus far been reported. The government of Mexico donated 300,000 doses of measles vaccine, while other vaccines for the campaign were acquired through the PAHO Revolving Fund for Vaccine Procurement. The decentralized implementation of this campaign allowed the population to actively participate and the resulting high vaccination coverage rates.

  11. The follow-up time issue on small roundabouts

    Directory of Open Access Journals (Sweden)

    Janusz WOCH

    2008-01-01

    Full Text Available The follow-up time was investigated. The aim of this analysis was to create a formula that allows the follow-up time calculated using the most important external parameters. The studies were based on empirical data collected at small roundabouts localized on Upper Silesia. The follow-up time is the average time gap between two cars of the minor stream being queued and entered the same major stream gap one behind the other. Follow-up times were measured directly by observing traffic flow. Resulting follow-up times were analyzed to determine their dependence on parameters such as intersection layout, roundabouts diameter and left visibility. These parameters were tested using the conventional calculation method (regression analysis. The dependence of follow-up time was then integrated into the own capacity estimation method for small roundabouts localized on urban areas. One of the biggest advantages this dependence is that capacity and traffic flow on small roundabouts can be determined reliably and appropriately for actual situations. The new follow-up time values for all range of external diameters of small roundabout 26 (22 – 40 m have been presented in this article.

  12. Inadequate follow-up after tracheostomy and intensive care

    DEFF Research Database (Denmark)

    Mondrup, Frederik; Skjelsager, Karen; Madsen, Kristian Rørbæk

    2012-01-01

    When patients are transferred from intensive care units (ICUs) to general wards with a tracheostomy in situ, there is a risk of suboptimal care and increased morbidity. The aim of this study was to elucidate the management of patients with a tracheostomy in situ at discharge from the ICU...

  13. The Danish Cerebral Palsy Follow-up Program

    DEFF Research Database (Denmark)

    Rasmussen, Helle Mätzke; Nordbye-Nielsen, Kirsten; Møller-Madsen, Bjarne

    2016-01-01

    AIM OF DATABASE: The Danish Cerebral Palsy Follow-up Program is a combined follow-up program and national clinical quality database that aims to monitor and improve the quality of health care for children with cerebral palsy (CP). STUDY POPULATION: The database includes children with CP aged 0...... indicators in three of five regions in Denmark comprising 432 children with CP, corresponding to a coverage of 82% of the expected population. CONCLUSION: The Danish Cerebral Palsy Follow-up Program is currently under development as a national clinical quality database in Denmark. The database holds...

  14. Suporte informacional como elemento para orientação de pais de pré-termo: um guia para o serviço de acompanhamento do desenvolvimento no primeiro ano de vida Information support as an element for advising parents of preterm infants: a guide for development follow-up services during the first year of life

    Directory of Open Access Journals (Sweden)

    CMS Martinez

    2007-02-01

    Full Text Available INTRODUÇÃO: A literatura aponta o alto risco de distúrbios biológicos e psicossociais aos quais o bebê pré-termo está susceptível, necessitando de atenção diferenciada daquela dada ao bebê a termo. OBJETIVO: Elaborar um guia de orientação e acompanhamento do desenvolvimento no primeiro ano de vida para pais que freqüentam um serviço de acompanhamento do desenvolvimento de bebês. MÉTODO: Os critérios para inclusão dos participantes foram: ser pais de bebê pré-termo de zero a seis meses de idade corrigida que não apresentavam doença neurológica e não necessitaram de intervenção fisioterápica. O presente estudo, de caráter qualitativo, empregou, na etapa de coleta de dados, a observação direta e a entrevista, efetivadas com as mães e profissionais deste serviço de acompanhamento do desenvolvimento de bebês. A elaboração do Guia baseou-se nas análises das observações dos atendimentos no serviço, na freqüência das respostas das entrevistas com profissionais e mães sobre necessidades e dúvidas no manuseio e cuidado com o bebê e a associação com a literatura. RESULTADOS: Obteve-se um guia contendo informações sobre o desenvolvimento do bebê, distribuído nos quatro primeiros trimestres de vida, e o alerta sobre a importância de calcular a idade corrigida para o acompanhamento adequado dos marcos do desenvolvimento. CONCLUSÃO: A utilização deste guia pode ser feita por diferentes profissionais da saúde e por aqueles que desenvolvem atividades educativas para pais.INTRODUCTION: The literature shows that preterm infants are at high risk of biological and psychological disorders and consequently require a higher level of care than is provided for full-term infants. OBJECTIVE: To draw up a guide advising on development follow-up during the first year of life, for parents who attend a child development follow-up service. METHOD: The inclusion criteria were that participants should be parents of preterm

  15. Follow-up Medical Care After Cancer Treatment

    Science.gov (United States)

    ... Data Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... Questions to Ask About Cancer Research Follow-Up Medical Care Once you’re done with cancer treatment, ...

  16. Creating the Action Model for High Risk Infant Follow Up Program in Iran.

    Science.gov (United States)

    Heidarzadeh, Mohammad; Jodiery, Behzad; Mirnia, Kayvan; Akrami, Forouzan; Hosseini, Mohammad Bagher; Heidarabadi, Seifollah; HabibeLahi, Abbas

    2013-11-01

    Intervention in early childhood development as one of the social determinants of health, is important for reducing social gap and inequity. In spite of increasingly developing intensive neonatal care wards and decreasing neonatal mortality rate, there is no follow up program in Iran. This study was carreid out to design high risk infants follow up care program with the practical aim of creating an model action for whole country, in 2012. This qualitative study has been done by the Neonatal Department of the Deputy of Public Health in cooperation with Pediatrics Health Research Center of Tabriz University of Medical Sciences, Iran. After study of international documents, consensus agreement about adapted program for Iran has been accomplished by focus group discussion and attended Delphi agreement technique. After compiling primary draft included evidence based guidelines and executive plan, 14 sessions including expert panels were hold to finalize the program. After finalizing the program, high risk infants follow up care service package has been designed in 3 chapters: Evidence based clinical guidelines; eighteen main clinical guidelines and thirteen subsidiaries clinical guidelines, executive plan; 6 general, 6 following up and 5 backup processes. Education program including general and especial courses for care givers and follow up team, and family education processes. We designed and finalized high risk infants follow up care service package. It seems to open a way to extend it to whole country.

  17. Factors Associated With Follow-Up Attendance Among Rape Victims Seen in Acute Medical Care.

    Science.gov (United States)

    Darnell, Doyanne; Peterson, Roselyn; Berliner, Lucy; Stewart, Terri; Russo, Joan; Whiteside, Lauren; Zatzick, Douglas

    2015-01-01

    Rape is associated with posttraumatic stress disorder (PTSD) and related comorbidities. Most victims do not obtain treatment for these conditions. Acute care medical settings are well positioned to link patients to services; however, difficulty engaging victims and low attendance at provided follow-up appointments is well documented. Identifying factors associated with follow-up can inform engagement and linkage strategies. Administrative, patient self-report, and provider observational data from Harborview Medical Center were combined for the analysis. Using logistic regression, we examined factors associated with follow-up health service utilization after seeking services for rape in the emergency department. Of the 521 diverse female (n = 476) and male (n = 45) rape victims, 28% attended the recommended medical/counseling follow-up appointment. In the final (adjusted) logistic regression model, having a developmental or other disability (OR = 0.40, 95% CI = 0.21-0.77), having a current mental illness (OR = 0.25, 95% CI = 0.13-0.49), and being assaulted in public (OR = 0.50, 95% CI = 0.28-0.87) were uniquely associated with reduced odds of attending the follow-up. Having a prior mental health condition (OR = 3.02, 95% CI = 1.86-4.91), a completed Sexual Assault Nurse Examiner's (SANE) examination (OR = 2.97, 95% CI = 1.84-4.81), and social support available to help cope with the assault (OR = 3.54, 95% CI = 1.76-7.11) were associated with an increased odds of attending the follow-up. Findings point to relevant characteristics ascertained at the acute care medical visit for rape that may be used to identify victims less likely to obtain posttraumatic medical and mental health services. Efforts to improve service linkage for these patients is warranted and may require alternative service delivery models that engage rape survivors and support posttraumatic recovery.

  18. Internet of things and bariatric surgery follow-up: Comparative study of standard and IoT follow-up.

    Science.gov (United States)

    Vilallonga, Ramon; Lecube, Albert; Fort, José Manuel; Boleko, Maria Angeles; Hidalgo, Marta; Armengol, Manel

    2013-09-01

    Follow-up of obese patient is difficult. There is no literature related to patient follow-up that incorporates the concept of Internet of Things (IoT), use of WiFi, Internet, or portable devices for this purpose. This prospective observational study commenced in June 2011. Patients were prospectively offered to participate in the IoT study group, in which they received a WiFi scale (Withing®, Paris) that provides instant WiFi data to the patient and surgeon. Other patients were admitted to the standard follow-up group at the outpatient clinic. A total of 33 patients were included in our study (ten in the IoT group). Twelve patients did not have WiFi at home, ten lacked of computer knowledge, and seven preferred standard for follow-up. All patients underwent different surgical procedures. There were no complications. Excess weight loss (EWL) was similar in both groups. More than 90% of patients were satisfied. In the IoT group, patients considered it valuable in saving time, and considered seeing their evolution graphics extremely motivating. IoT technology can monitor medical parameters remotely and collect data. A WiFi scale can facilitate preoperative and follow-up. Standard follow-up in a classical outpatient clinic setting with the surgeon was preferred globally.

  19. Estimating ICU bed capacity using discrete event simulation.

    Science.gov (United States)

    Zhu, Zhecheng; Hen, Bee Hoon; Teow, Kiok Liang

    2012-01-01

    The intensive care unit (ICU) in a hospital caters for critically ill patients. The number of the ICU beds has a direct impact on many aspects of hospital performance. Lack of the ICU beds may cause ambulance diversion and surgery cancellation, while an excess of ICU beds may cause a waste of resources. This paper aims to develop a discrete event simulation (DES) model to help the healthcare service providers determine the proper ICU bed capacity which strikes the balance between service level and cost effectiveness. The DES model is developed to reflect the complex patient flow of the ICU system. Actual operational data, including emergency arrivals, elective arrivals and length of stay, are directly fed into the DES model to capture the variations in the system. The DES model is validated by open box test and black box test. The validated model is used to test two what-if scenarios which the healthcare service providers are interested in: the proper number of the ICU beds in service to meet the target rejection rate and the extra ICU beds in service needed to meet the demand growth. A 12-month period of actual operational data was collected from an ICU department with 13 ICU beds in service. Comparison between the simulation results and the actual situation shows that the DES model accurately captures the variations in the system, and the DES model is flexible to simulate various what-if scenarios. DES helps the healthcare service providers describe the current situation, and simulate the what-if scenarios for future planning.

  20. Nonimaging aspects of follow-up in breast cancer reconstruction.

    Science.gov (United States)

    Wood, W C

    1991-09-01

    Follow-up of patients with breast cancer is directed to the early detection of recurrent or metastatic disease and the detection of new primary breast cancer. The survival benefit of early detection is limited to some patients with local failure or new primary tumors. That imaging is not used in follow-up of patients who have had breast cancer reconstruction is related to possible interference with this putative benefit by the reconstructive procedure. Such follow-up is accomplished by the patient's own surveillance, clinical examination, and laboratory testing supplemented by imaging studies. Clinical follow-up trials of women who have undergone breast reconstructive surgery show no evidence that locally recurrent breast carcinoma is masked when compared with follow-up of women who did not undergo reconstructive procedures. Reshaping of the contralateral breast to match the reconstructed breast introduces the possibility of interference with palpation as well as mammographic distortion in some women. This is an uncommon practical problem except when complicated by fat necrosis.

  1. Follow-up care of children suffered from burns

    Directory of Open Access Journals (Sweden)

    Konstantin Aleksandrovich Afonichev

    2015-03-01

    Full Text Available Outcomes of III-VI AB degree burns in children,regardless of the nature of treatment in the acute andrecovery period, are the development of scar contractures and deformities of the joints. However, thecorrect organization of follow-up care and rehabilitation treatment can significantly reduce the severity and facilitates the full recovery of the affected segment. Based on the analysis of their own material, the author defines the early stage of rehabilitation in these patients before full maturation of scar tissue or before the formation of functionally significant joint contractures, and later period, when there are indications for surgical rehabilitation. In the early period, follow-up care is recommended in 1 month after discharge and then on a quarterly basis, and with the appearance of deformities - at least once in 2 months. At the2nd stage of rehabilitation, older children and children of secondary school age are subject to follow-up care at least 1 time per year of primary school age - atleast once in 6 months, preschool children - every3 months. The proposed assessment of scar tissuehelps to determine the terms of follow-up care. Usingthis scheme of follow-up care and appropriate treatment allowed the author to obtain excellent and goodresults in 87-90 % of cases at the stages of rehabilitaion.

  2. Peritoneal inclusion cysts: Changes on follow-up ultrasonography

    International Nuclear Information System (INIS)

    Kim, Jung Sik; Lee, Jin Hee; Lee, Hee Jung; Lee, Sung Moon; Woo, Seong Ku

    2003-01-01

    To evaluate the volume change of peritoneal inclusion cysts on the follow-up ultrasonography (US). From March 1995 to May 1999, thirty seven women with ultrasonographically diagnosed peritoneal inclusion cysts were included in this study. Six patients underwent surgery for several reasons. Follow-up ultrasonography was performed 70-456 days (mean=191 days) after initial US examination in 12 of the remaining 31 patient with no further treatment. US was performed with a 3.5 or 4 MHz transabdominal probe in all 18 patients who underwent either surgery or follow-up US, and additional tranvaginal US examination using a 5-7 MHz probe in 15 of 18 patients. The volume change of the cysts was recorded for each US examination. Three cysts (25%) (volume=170 cm 3 , 61 cm 3 , and 38 cm 3 , respectively) were completely resolved on the follow-up US while the other nine cysts showed a decreased volume in seven patients (58%) and increased volume in two patients (17%). Spontaneous regression of peritoneal inclusion cysts is more common than it is believed to be, and ultrasonography may be a useful follow-up examination for peritoneal inclusion cysts.

  3. Course of disease and follow-up in breast cancer

    International Nuclear Information System (INIS)

    Ebner, F.; Hackl, H.; Hoermann, M.; Schneider, G.

    1986-01-01

    Besides individual care, regular follow-up studies in breast cancer patients have different aims, relative to different tumor stages at presentation. In early stages emphasis has to be laid on detection of loco-regional recurrences, which will not reduce overall survival if diagnosed and treated early. In addition, treatment effects and changes in the activity of disease are evaluated. Radiographic studies for detection of distant metastases are justified if followed by proper treatment. Early diagnosis of cancer of the opposite breast and of such cancers that are associated with breast cancer (colon, ovaries, endometrium) is imperative. The aim of a regular follow-up in more advanced tumor stages is to monitor the extent of disease and to prevent complications (e.g. fractures, spinal cord compression). In familial breast cancer first degree relatives should be included in the follow-up plan. The patient's psychosocial needs, even if not verbalized, should not be neglected. (Author)

  4. Follow up of Graves' Opthalmopathy after radioiodine therapy

    International Nuclear Information System (INIS)

    Miah, M.S.R.; Paul, A. K.; Rahman, H.A.

    2002-01-01

    Graves' ophthalmopathy may first appear or worsen during or after treatment for hyperthyroidism. We followed up 158 Graves' hyperthyroid patients treated with radioiodine of which 49 had Grave's' ophthalmopathy during presentation in Nuclear Medicine Centre, Khulna during the period from 1995 to 2000. The aim of our study is to see the effect of radioiodine in Graves' ophthalmopathy. All the patients received radioiodine at fixed dose regime ranged from 7 mCi to 12 mCi. The duration of follow up was at least 12 months Graves' ophthalmopathy patients, 4 (4/49 i.e., 8.2%) showed exaggeration of ophthalmopathy and the rest (45/49 i.e., 91.8%) remained unchanged. None of ophthalmopathy developed among any of Graves' hyperthyroid or disappeared after radioiodine treatment during follow up period. From the study we concluded that eye changes in Graves' hyperthyroidism remain unchanged or exaggerated after radioiodine therapy and needs ophthalmologist care.(author)

  5. Esophageal atresia: long-term interdisciplinary follow-up

    Directory of Open Access Journals (Sweden)

    Lidia B. Giúdici

    2016-07-01

    Full Text Available Background: We provide protocolized interdisciplinary follow-up to babies born with Esophageal Atresia (EA. There are few reports in Argentina about follow-up of EA patients.Objective: To describe outcomes in follow-up of EA patients at 1, 3 and 6 years old and to compare outcomes at age 1 with those at age 6.Methods: Prospective, longitudinal, analytic study of the cohort of babies born with EA, admitted to the follow-up program from 11/01/03 to 10/31/14. Follow-up includes: growth (weight > 10th centile, WHO, neurology-psychomotor development, audiology, vision, genetic, mental health, surgical reintervention, phonostomatology, language, pulmonology, re-hospitalization for clinical causes, lost to follow-up. Outcomes were described at age 1, 3 and 6. We included all EA patients who had reached age 1 at the start of this study.Results: 27 babies were admitted; 30% had long-gap EA; 18% presented VACTERL association; 23 children met inclusion criteria. Genetics  was assessed in 18 newborns (78%; a chromosomal map was performed in 11 babies; 3 had an abnormal karyotype. Mental health: 5/14 of the assessed children showed problems. Phonostomatology: 11 newborns checked (6 required treatment, 4 recovered at age 1. Pulmonologist evaluated 18 babies (7 with recurrent wheezing, 6 with moderate tracheomalacia. Gastroenterology and endoscopy: 80% presented gastroesophageal reflux (GER grade 3-4, and 50% showed a pathologic pHmetry. Lost to follow-up: age 1, 2 (8%; age 3, 3 (17%; age 6, 3 (23%. Normal outcomes observed are the following. Age 1 – growth: 81%; neurologic-psychomotor developmental index (NPDI: 76%; audiology: 95%; vision: 85%; language: 62%; re-hospitalization for clinical causes: 38%; surgical reinterventions: 47%. Age 3 – growth: 78%; NPDI: 50%; audiology: 93%; vision: 93%; language: 43%; re-hospitalization: 35%; surgical reinterventions: 14%. Age 6 – growth: 50%; NPDI: 30%; audiology: 90%; vision: 40%; language: 50%; re

  6. Exercise-Induced Ventricular Fibrillation: Seven Years Follow-Up

    Directory of Open Access Journals (Sweden)

    Gökmen Gemici

    2011-11-01

    Full Text Available We present a 7-year follow-up of a 55-year-old male who experienced ventricular fibrillation during the recovery period of exercise testing and refused implantation of an ICD. Normal left ventricular systolic function was found on echocardiographic examination, and coronary angiography revealed only a side branch disease with a vessel diameter of less than 2 millimeters. The patient was discharged on metoprolol and ASA in addition to his previous treatment with lisinopril and simvastatin. Outpatient cardiac evaluation by repeated 24-hour ECG monitorizations (Holter revealed normal findings. On follow up visits every six months for the past seven years, the patient was found to be asymptomatic.

  7. Group anxiety management: effectiveness, perceived helpfulness and follow-up.

    Science.gov (United States)

    Cadbury, S; Childs-Clark, A; Sandhu, S

    1990-05-01

    An evaluation was conducted on out-patient cognitive-behavioural anxiety management groups. Twenty-nine clients assessed before and after the group and at three-month follow-up showed significant improvement on self-report measures. A further follow-up on 21 clients, conducted by an independent assessor at an average of 11 months, showed greater improvement with time. Clients also rated how helpful they had found non-specific therapeutic factors, and specific anxiety management techniques. 'Universality' was the most helpful non-specific factor, and 'the explanation of anxiety' was the most helpful technique.

  8. Barrett's esophagus. Diagnosis, follow-up and treatment

    DEFF Research Database (Denmark)

    Bremholm, Lasse; Funch-Jensen, Peter; Eriksen, Jan

    2012-01-01

    gastroesophageal junction. The extent of the endoscopic findings is described by the Prague classification. The metaplasia is histologically confirmed by the presence of intestinal metaplasia. The diagnosis of BE can only be made by a combined macroscopic and microscopic examination. The histological description...... and it is not recommended outside controlled studies. Treatment of high grade dysplasia and carcinoma in situ is handled in departments treating esophageal cancer. Follow-up with endoscopy and biopsy can be offered. Follow-up endoscopy with biopsy can only be recommended after thorough information to the patients...

  9. Danish offshore wind. Key environmental issues - a follow-up

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-02-15

    This follow-up to the Danish environmental monitoring programme on large-scale offshore wind power builds on the result of the former programme of 2006 and focuses on updated knowledge on harbour porpoises, water birds and fish communities, and on the cumulative effects of wind farms. The scientific quality of the projects in this follow-up has been assessed by experts from the International Advisory Panel of Experts on Marine Ecology (IAPEME), who have commented on the results in an independent evaluation which is reproduced in this publication. (LN)

  10. A Follow-up Study of Returning Students--A Concentration on Women.

    Science.gov (United States)

    Plotsky, Frances; Ohm, Susan

    The office of Services for Returning Students (SRS) at the University of Texas (U.T.) at Austin conducted a follow-up study of men and women students who had visited the office from February 1969 to the end of 1971. The study ascertained the average interval between periods of formal education, the fulfillment of educational goals, and the use of…

  11. Advances in diagnosis and follow-up in kidney cancer

    NARCIS (Netherlands)

    Rioja, Jorge; de La Rosette, Jean J. M. C. H.; Wijkstra, Hessel; Laguna, M. Pilar

    2008-01-01

    PURPOSE OF REVIEW: To review the most recent data on preoperative diagnostic methods in kidney cancer and in follow-up and monitoring after ablation therapy. RECENT FINDINGS: Although the role of the percutaneous biopsy in the diagnostics of renal masses has been limited, new data suggest a high

  12. 38 CFR 41.315 - Audit findings follow-up.

    Science.gov (United States)

    2010-07-01

    ... include audit findings from multiple years, it shall include the fiscal year in which the finding... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Audit findings follow-up... (CONTINUED) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditees § 41.315 Audit...

  13. Follow-up of conservatively treated sleep apnoea patients

    African Journals Online (AJOL)

    Health of School Children: Treatment of /ntestinal. Helminths and Schistosomiasis (WHO/GDS/IPI/GTD 92.1). Geneva: WHO, 1992. Accepted 17 June 1994. Follow-up of conservatively treated sleep apnoea patients. P. R. Bartel, J. Verster, P. J. Becker. Polysomnograms have been recorded at our laboratory since 1985 for ...

  14. 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.

  15. Factors Associated with Adherence to Follow-up Colposcopy

    Science.gov (United States)

    Fish, Laura J.; Moorman, Patricia G.; Wordlaw-Stintson, Lashawn; Vidal, Adriana; Smith, Jennifer S.; Hoyo, Cathrine

    2013-01-01

    Background: Understanding the gaps in knowledge about human papilloma virus (HPV) infection, transmission, and health consequences and factors associated with the knowledge gap is an essential first step for the development of interventions to improve adherence to follow-up among women with abnormal Pap smears. Purpose: To examine the relationship…

  16. Immunological follow-up of hydatid cyst cases

    Directory of Open Access Journals (Sweden)

    Bulut Vedat

    2001-01-01

    Full Text Available Hydatid disease is caused by Echinococcus granulosus. In this study, we aimed to investigate the benefit of monitoring cases with hydatid cyst by means of immune components in patients in a long-term follow-up after surgery. Eighty-four preoperative and postoperative serum samples from 14 cases undergoing surgery for hydatid disease were evaluated in terms of immune parameters, such as total and specific IgE, IgG, IgM, IgA and complement. Total and specific IgE were determined by ELISA. Specific IgG levels were measured by indirect hemaglutination.Total IgG, IgM, IgA and complement (C3 and C4 were detected by nephelometry. Imaging studies were also carried out during the follow-up. In none of the patients hydatid cysts were detected during the follow-up. Total IgE levels in the sera of the patients decreased to normal six months after surgery. Although specific IgE against echinococcal antigens decreased one year after operation, levels were still significantly high. There were no changes in the levels of anti-Echinococcus IgG and total IgG in follow-up period. Additionally, other parameters, such as IgA, IgM, C3 and C4, were not affected.

  17. Refractive surgery for accommodative esotropia: 5-year follow-up.

    Science.gov (United States)

    Magli, Adriano; Forte, Raimondo; Gallo, Flavio; Carelli, Roberta

    2014-02-01

    To assess the long-term effectiveness and safety of refractive surgery with LASIK or photorefractive keratectomy (PRK) for treating accommodative esotropia in adults. All patients with accommodative esotropia treated with LASIK or PRK until December 2007 and with a minimum follow-up of 5 years were retrospectively included. LASIK was performed on 44 eyes of 22 patients (12 women, 10 men; mean age: 22.7 ± 2.9 years). Mean postoperative follow-up was 62.1 ± 3.2 months. PRK was performed on 16 eyes of 8 patients (4 women, 4 men; mean age: 23.7 ± 1.7 years). Mean postoperative follow-up was 61.3 ± 2.8 months. At the 5-year follow-up, the mean cycloplegic refraction was more hyperopic in the PRK group (0.3 ± 0.8 vs 0.06 ± 0.3 diopters, P = .01). Correction of esotropia to esophoria or orthotropia was present in 21 patients (95.4%) treated with LASIK and in all patients treated with PRK. Both LASIK and PRK were effective in the long-term reduction of accommodative esotropia. Copyright 2014, SLACK Incorporated.

  18. Women's experiences of a follow up childbearing journey with ...

    African Journals Online (AJOL)

    The purpose of this study was to describe and analyse the lived experiences of the follow up journey of a pregnant woman by listening to the voices of women as they reflect on their journey. A qualitative, descriptive and contextual design was used to examine into each woman's experience of her world from pregnancy to ...

  19. [Follow-up and treatment outcome of early anorexia nervosa].

    Science.gov (United States)

    Schulze, U; Neudörfl, A; Krill, A; Warnke, A; Remschmidt, H; Herpertz-Dahlmann, B

    1997-03-01

    In a two-center follow-up study on the early-onset form of anorexia nervosa, we reexamined 43 (74%) of 58 former patients who had developed anorexia nervosa at the age of 13 years or younger. In addition to make a standardized assessment of the eating disorder at follow-up we assessed psychiatric comorbidity with a structured interview based on the criteria of DSM-III-R and ICD-10. After an average follow-up period of 6.8 years, 8 (18%) of our former patients had an eating disorder not otherwise specified (EDNOS) and 4 (9%) still suffered from anorexia nervosa. 5 (11%) of the subjects had developed bulimia nervosa. In 3 cases (7%) we found both syndromes. 12 (28%) of our former patients had an additional psychiatric disorder. The results of our study indicate that the quality of outcome in patients with an early-onset form of anorexia nervosa does not differ from that in individuals with a later manifestation of the eating disorder. Factors of prognostic relevance were the existence of an eating disorder during the first year of life and the duration of the follow-up period.

  20. Eight to ten years follow-up after carotid endarterectomy

    DEFF Research Database (Denmark)

    Knudsen Rathenborg, Lisbet; Sillesen, H; Schroeder, T

    1990-01-01

    Follow-up information was obtained on 185 patients who consecutively underwent carotid endarterectomy eight to ten years previously. Doppler ultrasound examination was performed in 59 patients who were still alive and living within 100 miles of the hospital. Using lifetable analysis, the annual r...

  1. Challenges of loss to follow-up in tuberculosis research

    DEFF Research Database (Denmark)

    Nissen, Thomas N; Rose, Michala V; Kimaro, Godfather

    2012-01-01

    In studies evaluating methods for diagnosing tuberculosis (TB), follow-up to verify the presence or absence of active TB is crucial and high dropout rates may significantly affect the validity of the results. In a study assessing the diagnostic performance of the QuantiFERON®-TB Gold In-Tube test...

  2. Nurse-Initiated Telephone Follow Up after Ureteroscopic Stone Surgery.

    Science.gov (United States)

    Tackitt, Helen M; Eaton, Samuel H; Lentz, Aaron C

    2016-01-01

    This article presents findings of a quality improvement (QI) project using the DMAIC (define, measure, analyze, improve, and control) model designed to decrease the rate of emergency department (ED) visits and nurse advice line calls after ureteroscopic stone surgery. Results indicated that nurse-initiated follow- up phone calls can decrease ED visits.

  3. A Follow-Up Study of the Deaf.

    Science.gov (United States)

    Reich, P. A.; Reich, C. M.

    Followed up through interviews and questionnaires were 278 former students, average age 28 years, of two residential schools and one day school for the deaf in Ontario. Data was collected on the degree of hearing loss, use of a hearing aid, educational and occupational history, social integration, methods of communication, and attitudes toward…

  4. Loss to Follow-Up: Issues and Recommendations

    Science.gov (United States)

    Hoffman, Jeff; Munoz, Karen F.; Bradham, Tamala S.; Nelson, Lauri

    2011-01-01

    State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that examined 12 areas within state EHDI programs. Related to how EHDI programs address loss to follow-up, 47 coordinators responded with 277 items, and themes were identified in each…

  5. MRI of penile fracture: diagnosis and therapeutic follow-up

    International Nuclear Information System (INIS)

    Uder, Michael; Gohl, Dietrich; Takahashi, Masahide; Kramann, Bernhard; Schneider, Guenther

    2002-01-01

    A rupture of corpus cavernosum (CC) is a rare injury of the erect penis. The present study describes the role of MRI for diagnosis and follow-up of this injury. Four patients with clinically suspected acute penile fractures underwent MRI. Imaging findings were confirmed at surgery. In three patients, follow-up MRI was also available at 1, 6 and 16 weeks after surgical repair. In all patients pre-contrast T1-weighted images (T1WI) clearly disclosed ruptures of CC, which depicted as discontinuity of low signal intensity of the tunica albuginea (TA). Concomitant subcutaneous haematoma were well visualised both on T1-weighted (T1WI) and T2-weighted images, whereas haematoma in CC were optimally demonstrated on contrast-enhanced T1WI. On follow-up MRI all fractures presented similar healing process. Shortly after the repair, the tunical suture showed an increase in signal intensity on pre-contrast T1WI and was strongly enhanced with the administration of contrast material. Then the tear site gradually recovered low signal intensity on all spin-echo sequences by 4 months after surgery. These serial findings may suggest the formation of vascularised granulation tissue during cicatrisation. Magnetic resonance imaging is of great value for the diagnosis and follow-up in patients with penile fracture. (orig.)

  6. A formula for continued improvement: Audit follow-up

    International Nuclear Information System (INIS)

    Maday, J.H. Jr.

    1989-10-01

    In his book Management Audits, Allan J. Sayle states, ''QA standards stipulate that corrective action, required as a result of performing an audit, be followed up and closed out. There would, indeed, be little point in performing audits, requiring corrective action, or having a QA system at all if the auditee knows that the auditor will never verify that the corrective action has been efficaciously implemented.'' The QA auditor has an obligation to include follow-up in the overall audit planning. All too often the auditor will go to great lengths to plan and perform an audit only to have a recurring finding in the next audit. The proposed corrective action was only promissory and was not designed to stop the problem from recurring or to identify its root cause. Auditors do a disservice to the overall QA program and particularly to the customer when they fail to follow up and verify that an audit corrective action has been effectively implemented. In this paper, the techniques used by the quality assurance auditors at the Pacific Northwest Laboratory (PNL) will be presented. Although PNL is a research and development laboratory, the techniques outlined in this paper could be applied to any industry conducting quality assurance audits. Most important, they provide a formula for continued improvement by assuring that audit follow-up is timely, meaningful, and permanent

  7. Analytical framework and tool kit for SEA follow-up

    International Nuclear Information System (INIS)

    Nilsson, Mans; Wiklund, Hans; Finnveden, Goeran; Jonsson, Daniel K.; Lundberg, Kristina; Tyskeng, Sara; Wallgren, Oskar

    2009-01-01

    Most Strategic Environmental Assessment (SEA) research and applications have so far neglected the ex post stages of the process, also called SEA follow-up. Tool kits and methodological frameworks for engaging effectively with SEA follow-up have been conspicuously missing. In particular, little has so far been learned from the much more mature evaluation literature although many aspects are similar. This paper provides an analytical framework and tool kit for SEA follow-up. It is based on insights and tools developed within programme evaluation and environmental systems analysis. It is also grounded in empirical studies into real planning and programming practices at the regional level, but should have relevance for SEA processes at all levels. The purpose of the framework is to promote a learning-oriented and integrated use of SEA follow-up in strategic decision making. It helps to identify appropriate tools and their use in the process, and to systematise the use of available data and knowledge across the planning organization and process. It distinguishes three stages in follow-up: scoping, analysis and learning, identifies the key functions and demonstrates the informational linkages to the strategic decision-making process. The associated tool kit includes specific analytical and deliberative tools. Many of these are applicable also ex ante, but are then used in a predictive mode rather than on the basis of real data. The analytical element of the framework is organized on the basis of programme theory and 'DPSIR' tools. The paper discusses three issues in the application of the framework: understanding the integration of organizations and knowledge; understanding planners' questions and analytical requirements; and understanding interests, incentives and reluctance to evaluate

  8. Follow-up of Antihypertensive Therapy Improves Blood Pressure Control: Results of HYT (HYperTension survey) Follow-up.

    Science.gov (United States)

    Fici, F; Seravalle, G; Koylan, N; Nalbantgil, I; Cagla, N; Korkut, Y; Quarti-Trevano, F; Makel, W; Grassi, G

    2017-09-01

    Although improved during the past few years, blood pressure control remains sub optimal. The impact of follow-up assessment on blood pressure control was evaluated in a group of patients of the HYT (HYperTension survey), treated with a combination of different dihydropyridine calcium-channel blockers (CCBs regimen) and inhibitors of renin-angiotensin-aldosterone system (RAAS) and with uncontrolled blood pressure. This was obtained assessing (a) the rate of blood pressure control at 3 and 6 months of follow-up in the whole group of patients, (b) the rate of blood pressure control and the average blood pressure values in subjects treated with different DHP-CCBs regimen. From the 4993 patients with uncontrolled blood pressure, (BP ≥ 140/90 or ≥140/85 in patients with diabetes), 3729 (mean age 61.2 ± 11.5 years), maintained CCBs regimen combined wih RAAS blockers and were evaluated at 3 and 6 months follow-up. At each visit BP (semiautomatic device, Omron-M6, 3 measurements), heart rate, adverse events and treatment persistence were collected. At 1st and 2nd follow-up the rate of controlled BP was 63.5 and 72.8% respectively (p blood pressure control; (b) there is no significant difference in the antihypertensive effect between different CCBs regimen; (c) lipophilic CCBs induce less ankle edema.

  9. What Happens Next? Follow-Up From the Children's Toddler School Program.

    Science.gov (United States)

    Akshoomoff, Natacha; Stahmer, Aubyn C; Corsello, Christina; Mahrer, Nicole E

    2010-10-01

    This study was a follow-up of a group of 29 children diagnosed with autism spectrum disorders at age 2 who attended an inclusive toddler program until age 3. Children ranged in age from 4 to 12 years at the time of the parent survey and follow-up testing. The majority of children were placed in a special education (noninclusive) preschool class, but among the children who were in elementary school at the time of follow-up, 63% were in general education classroom placement. Diagnoses of autism spectrum disorders remained stable, socialization skills remained a weakness, and child-related parental stress remained high despite average cognitive and language skills in the majority of children. Social skill development and support remained a service need.

  10. CT follow-up of conservatively treated lumbar disc herniation

    International Nuclear Information System (INIS)

    Schumacher, M.; Fischer, R.; Thoden, U.

    1990-01-01

    A CT study was carried out on 43 patients with low back pain and sciatica who were treated conservatively. They were followed up for over 20 months (mean) clinically and monitored by CT before and after treatment. Initially, 38 of them had herniation and 5 had protrusion of the disc. At the time of follow-up only 24 of the initial 40 patients still had neurological deficits. In 76.7% of the patients CT showed an improvement (clear regression in 15 patients, moderate decrease in 18 patients). A favourable tendency towards regression was observed in disc herniation at the L5-S1 level and in cases showing sequestration. The prognosis was unfavourable in herniations at higher levels than L5-S1 and in lateral herniation reaching the intervertebral foramen. (orig.) [de

  11. [Laparoscopic management of ureteroileal stenosis: Long term follow up.

    Science.gov (United States)

    Emiliani, Esteban; Gavrilov, Pavel; Mayordomo, Olga; Salvador, Josep; Palou, Joan; Rosales, Antonio; Villavicencio, Humberto

    2017-05-01

    To describe the laparoscopic approach for uretero-ileal anastomosis strictures and to analyse our long term series. A retrospective review was performed evaluating our series of patients with benign ureteroileal anastomosis strictures treated laparoscopically from 2011 to 2017. Demographics and perioperative data were obtained and analyzed. Complications were described with the Clavien-Dindo classification. The surgical technique was described and a literature review was performed. Eleven procedures were performed in ten patients. Mean blood loss was 180 ml. All the operations were performed laparoscopically without conversion. Mean hospital stay was 10 days (4-23). Early complications were Clavien-Dindo I y II: Two cases of limited anastomosis leakage, one lymphorrea, one paralitic ileum and one accidental descent of the ureteral catheter. Mean follow-up was 56 months (12-179) No late complications have been described. Based on our series with 5 year follow up, the laparoscopic approach for uretero-ileal anastomosis strictures is feasible and safe.

  12. Role of cytology in screening, staging and follow-up

    International Nuclear Information System (INIS)

    Fischnaller, M.

    1986-01-01

    Cytology has become an integral component in the battery of diagnostic tools for a rational diagnosis of tumors. When all materials obtainable with sophisticated methods are utilized, almost every pulmonary lesion can be defined micromorphologically. In urgent cases instant staining techniques will permit a 'stat diagnosis'. The characterization of a tumor cell by cytology with accurate typing and grading offers preliminary information for subsequent staging efforts. Bronchial cancer may be both of the single-cell and of the mixed-cell type with the more aggressive cell elements determining the metastasising potential and prognosis. Sampling for cytology is devoid of risks and does not make any special demands on the patients; it can safely be repeated for follow-up studies; it helps to detect tumor regrowths or secondaries at an early stage during postoperative follow-up programs and to monitor treatment-related cellular changes. (Author)

  13. Treatment of craniopharyngioma estimated by follow-up CT

    Energy Technology Data Exchange (ETDEWEB)

    Kubota, T.; Ito, H.; Aizumi, S.; Yamamoto, S.; (Kanazawa Univ. (Japan). School of Medicine)

    1981-12-01

    Follow-up CT scans were taken from 12 cases of craniopharyngiomas after various treatment. Preoperative CT findings of craniopharyngiomas could be classified into three types. Type 1 was a non-enhanced or a thinly ring-like enhanced large cystic mass. Type 2 was a thickly enhanced large cystic mass with small solid mass. Type 3 was a large solid mass. Postoperative follow-up CT findings were as follows: Type 1 had a favorable postoperative course because the tumor tissues of the thin cystic wall seemed to collapse only with the procedure of cystic fluid aspiration. Recurrence frequently took place in patients of Type 2 and 3 if the tumor couldn't be radically removed or radiotherapy was not given after partial resection. Radiotherapy was most effective in these cases.

  14. Treatment of craniopharyngioma estimated by follow-up CT

    International Nuclear Information System (INIS)

    Kubota, Toshihiko; Ito, Haruhide; Aizumi, Shinichi; Yamamoto, Shinjiro

    1981-01-01

    Follow-up CT scans were taken from 12 cases of craniopharyngiomas after various treatment. Preoperative CT findings of craniopharyngiomas could be classified into three types. Type 1 was a non-enhanced or a thinly ring-like enhanced large cystic mass. Type 2 was a thickly enhanced large cystic mass with small solid mass. Type 3 was a large solid mass. Postoperative follow-up CT findings were as follows: Type 1 had a favorable postoperative course because the tumor tissues of the thin cystic wall seemed to collapse only with the procedure of cystic fluid aspiration. Recurrence frequently took place in patients of Type 2 and 3 if the tumor couldn't be radically removed or radiotherapy was not given after partial resection. Radiotherapy was most effective in these cases. (author)

  15. [Follow-up of newborns with hypoxic-ischaemic encephalopathy].

    Science.gov (United States)

    Martínez-Biarge, M; Blanco, D; García-Alix, A; Salas, S

    2014-07-01

    Hypothermia treatment for newborn infants with hypoxic-ischemic encephalopathy reduces the number of neonates who die or have permanent neurological deficits. Although this therapy is now standard of care, neonatal hypoxic-ischaemic encephalopathy still has a significant impact on the child's neurodevelopment and quality of life. Infants with hypoxic-ischaemic encephalopathy should be enrolled in multidisciplinary follow-up programs in order to detect impairments, to initiate early intervention, and to provide counselling and support for families. This article describes the main neurodevelopmental outcomes after term neonatal hypoxic-ischaemic encephalopathy. We offer recommendations for follow-up based on the infant's clinical condition and other prognostic indicators, mainly neonatal neuroimaging. Other aspects, such as palliative care and medico-legal issues, are also briefly discussed. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  16. From themes to hypotheses: following up with quantitative methods.

    Science.gov (United States)

    Morgan, David L

    2015-06-01

    One important category of mixed-methods research designs consists of quantitative studies that follow up on qualitative research. In this case, the themes that serve as the results from the qualitative methods generate hypotheses for testing through the quantitative methods. That process requires operationalization to translate the concepts from the qualitative themes into quantitative variables. This article illustrates these procedures with examples that range from simple operationalization to the evaluation of complex models. It concludes with an argument for not only following up qualitative work with quantitative studies but also the reverse, and doing so by going beyond integrating methods within single projects to include broader mutual attention from qualitative and quantitative researchers who work in the same field. © The Author(s) 2015.

  17. [Normocalcemic primary hyperparathyroidism: recommendations for management and follow-up].

    Science.gov (United States)

    Martínez Díaz-Guerra, Guillermo; Jódar Gimeno, Esteban; Reyes García, Rebeca; Gómez Sáez, José Manuel; Muñoz-Torres, Manuel

    2013-10-01

    To provide practical recommendations for evaluation and follow-up of patients with normocalcemic primary hyperparathyroidism. Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. A systematic search was made in MEDLINE (PubMed), using the terms normocalcemic primary hyperparathyroidism and primary hyperparathyroidism, for articles in English published before 22 November 2012. Literature was reviewed by 2 members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology, and after development of recommendations, the manuscript was reviewed by all other members of the Group, and their suggestions were incorporated. The document provides practical recommendations for evaluation and follow-up of patients with normocalcemic primary hyperparathyroidism. There is however little evidence available about different aspects of this disease, mainly progression rate and clinical impact. More data are therefore needed before definite recommendations may be made. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

  18. Pneumatic dilatation in achalasia cardia results and follow-up.

    Directory of Open Access Journals (Sweden)

    Supe A

    1990-10-01

    Full Text Available Pneumatic dilatation is one of the more recent methods in the management of achalasia cardia. Fifty dilatations were done in 42 patients with achalasia cardia over 5 years. There was a significant decrease in the maximum diameter of the oesophagus and a significant increase in diameter in the narrowed lower oesophageal segment in all the patients. Of the patients studied, 95.23% were relieved of their symptoms after only one to two sessions. There were no immediate complications. Out of the 38 patients on long term follow up, 8 (21.05% had recurrence of symptoms. On repeat dilatations, 4 (50% of them had good response. Late complication like reflux oesophagitis was observed in only 1 patient over a median follow up period of 22 months. It was thus concluded that pneumatic dilatation is a safe, simple and effective procedure in managing patients with achalasia cardia.

  19. Hyperfunctioning thyroid cancer: a five-year follow-up.

    Science.gov (United States)

    Azevedo, Monalisa Ferreira; Casulari, Luiz Augusto

    2010-02-01

    Differentiated thyroid cancer rarely occurs in association with hyperfunctioning nodules. We describe a case of a 47-year-old woman who developed symptoms of hyperthyroidism associated with a palpable thyroid nodule. Thyroid scintigraphy showed an autonomous nodule, and fine-needle aspiration biopsy was suggestive of papillary carcinoma. Laboratorial findings were consistent with the diagnosis of hyperthyroidism. The patient underwent thyroidectomy and a papillary carcinoma of 3.0 x 3.0 x 2.0 cm, follicular variant, was described by histological examination. The surrounding thyroid tissue was normal. Postoperatively, the patient received 100 mCi of (131)I, and whole body scans detected only residual uptake. No evidence of metastasis was detected during five years of follow-up. Hot thyroid nodules rarely harbor malignancies, and this case illustrated that, when a carcinoma occurs the prognosis seems to be very good with no evidence of metastatic dissemination during a long-term follow-up.

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

    International Nuclear Information System (INIS)

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

    1993-01-01

    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

  1. Feasibility of an EIS Follow-up Program

    International Nuclear Information System (INIS)

    Nelson, I.C.; Jaquish, R.E.; Watson, D.G.

    1982-12-01

    The proposed level of an EIS Follow-up Program is believed to be feasible and that it can and should be implemented. Guidance to authors should result in fewer, but more important, commitments for mitigating adverse environmental impacts. Selecting the significant commitments from Records of Decisions published since July 1, 1979 for tracking to satisfaction should result in conformance with regulations, orders, and the intent of the NEPA

  2. Follow-up of prenatally diagnosed unilateral hydronephrosis

    DEFF Research Database (Denmark)

    Thorup, Jørgen Mogens; Lenz, K; Rabol, A

    1996-01-01

    Based on previous experience with prenatally diagnosed unilateral hydronephrosis, we found that the primary indications for surgical intervention should be symptoms or functional impairment of the hydronephrotic kidney. Nonoperative management of neonates without symptoms and with normal function...... of the affected kidney was proposed. However, the strategy of treatment after prenatally diagnosed hydronephrosis is still controversial. We studied 28 consecutive children with suspected unilateral pelviureteral junction obstruction and a normal contralateral kidney. The overall follow-up period varied between 2...

  3. Ute Unit: Study Guide and Follow Up Activities.

    Science.gov (United States)

    North Conejos School District, Capulin, CO.

    The study guide and follow-up activities were designed primarily to give students a feeling of Ute life in the San Luis Valley in Colorado. The unit begins with six Southern Ute stories about the wolf and coyote, the race between the skunk and the coyote, the frog and the eagle, why the frog croaks, the bear (Que Ye Qat), and the two Indian…

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

    International Nuclear Information System (INIS)

    Kanematsu, Yoshiji; Iwase, Takenobu; Matsuura, Tetsuya; Suzue, Naoto; Sairyo, Koichi; Kashiwaguchi, Shinji; Iwame, Toshiyuki

    2015-01-01

    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.)

  5. Bobath or motor relearning programme? A follow-up one and four years post stroke.

    Science.gov (United States)

    Langhammer, Birgitta; Stanghelle, Johan K

    2003-11-01

    The purpose of this follow-up one and four years post stroke was to find out whether the initial physiotherapy approach had had any long-term effects on mortality, motor function, postural control, activities of daily living, life quality, follow-up from community services and living conditions. A randomized controlled trial of first time ever stroke patients. Group 1 (n = 33) and group 2 (n = 28) had initial physiotherapy according to the Motor Relearning Programme and Bobath, respectively. The Motor Assessment Scale (MAS), the Sødring Motor Evaluation Scale (SMES), the Barthel ADL Index, the Nottingham Health Profile (NHP) and Berg Balance Scale were used. The following parameters were also registered: incidence of new strokes, other diseases, use of assistive devices, the patient's accommodation and use of services from the community. The mortality rates were similar in the two groups. In both groups the motor function, postural control and ADL had decreased rapidly, leaving many of the patients dependent and with a high risk of falling. Life quality had increased compared to the acute stage, but was still low in comparison with healthy persons. Patients in both groups lived at home, but were dependent on help from relatives and community services. Physiotherapy as follow-up service was seldom used. The initial physiotherapy approach did not seem to have a major influence on the patients' ability to cope in the long-term. This follow-up at one and four years post stroke showed no major influence of two different initial physiotherapy regimens on long-term function. The study confirmed a rapid deterioration of ADL and motor function and an increased dependence on relatives. The study reveals a gap between the intense treatment in the acute phase and little or no follow-up of physiotherapy treatment or other rehabilitation activities later.

  6. Follow-up of permanent hearing impairment in childhood.

    Science.gov (United States)

    Della Volpe, A; De Lucia, A; Pastore, V; Bracci Laudiero, L; Buonissimo, I; Ricci, G

    2016-02-01

    Programmes for early childhood childhood hearing impairment identification allows to quickly start the appropriate hearing aid fitting and rehabilitation process; nevertheless, a large number of patients do not join the treatment program. The goal of this article is to present the results of a strategic review of the strengths, weaknesses, opportunities and threats connected with the audiologic/prosthetic/language follow-up process of children with bilateral permanent hearing impairment. Involving small children, the follow-up includes the involvement of specialised professionals of a multidisciplinary team and a complex and prolonged multi-faced management. Within the framework of the Italian Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children", the purpose of this analysis was to propose recommendations that can harmonise criteria for outcome evaluation and provide guidance on the most appropriate assessment methods to be used in the follow-up course of children with permanent hearing impairment. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  7. Neonatal follow-up program: Where do we stand?

    Science.gov (United States)

    2012-01-01

    Neonatal follow-up program (NFP) is becoming the corner stone of standard, high quality care provided to newborns at risk of future neuorodevelopmental delay. Most of the recognized neonatal intensive care units in the developed countries are adopting NFP as part of their mandatory care for the best long term outcome of high risk infants, especially very low birth weight (VLBW) infants. Unfortunately, in the developing and in underdeveloped countries, such early detection and intervention programs are rarely existing, mainly because of the lack of awareness of and exposure to such programs in spite of the increasing numbers of surviving sick newborns due to advancement in neonatal care in these countries. This is a review article to explore the Neonatal follow-up programs looking at historical development, benefts and aims, and standard requirements for successful program development that can be adopted in our countries. In conclusion, proper Neonatal follow-up programs are needed to improve neonatal outcome. Therefore all professionals working in the feld of neonatal care in developing countries should cooperate to create such programs for early detection and hence early intervention for any adverse long term outcome in high-risk newborn infants PMID:27493326

  8. Complications and Follow-up after Unprotected Carotid Artery Stenting

    International Nuclear Information System (INIS)

    Hauth, Elke A.M.; Drescher, Robert; Jansen, Christian; Gissler, H. Martin; Schwarz, Michael; Forsting, Michael; Jaeger, Horst J.; Mathias, Klaus D.

    2006-01-01

    Purpose. This prospective study was undertaken to determine the success rate, complications, and outcome of carotid artery stenting (CAS) without the use of cerebral protection devices. Methods. During 12 months, 94 high-grade stenoses of the carotid artery in 91 consecutive patients were treated. Sixty-six (70%) of the stenoses were symptomatic and 28 (30%) were asymptomatic. Results. In all 94 carotid stenoses CAS was successfully performed. During the procedure and within the 30 days afterwards, there were 2 deaths and 3 major strokes in the 66 symptomatic patients, resulting in a combined death and stroke rate of 5 of 66 (7%). Only one of these complications, a major stroke, occurred during the procedure. In the 6-month follow-up, one additional major stroke occurred in a originally symptomatic patient resulting in a combined death and stroke rate of 6 of 66 (10%) for symptomatic patients at 6 months. No major complications occurred in asymptomatic patients during the procedure or in the 6-month follow-up period. At 6 months angiographic follow-up the restenosis rate with a degree of >50% was 3 of 49 (6%) and the rate with a degree of ≥70% was 1 of 49 (2%). Conclusions. Cerebral embolization during CAS is not the only cause of the stroke and death rate associated with the procedure. The use of cerebral protection devices during the procedure may therefore not prevent all major complications following CAS

  9. Mortality in acromegaly: a 20-year follow-up study.

    Science.gov (United States)

    Ritvonen, Elina; Löyttyniemi, Eliisa; Jaatinen, Pia; Ebeling, Tapani; Moilanen, Leena; Nuutila, Pirjo; Kauppinen-Mäkelin, Ritva; Schalin-Jäntti, Camilla

    2016-06-01

    It is unclear whether mortality still is increased in acromegaly and whether there are gender-related differences. We dynamically assessed outcome during long-term follow-up in our nationwide cohort. We studied standardized mortality ratios (SMRs) relative to the general population and causes of death in acromegaly (n=333) compared with age- and gender-matched controls (n=4995). During 20 (0-33) years follow-up, 113 (34%) patients (n=333, 52% women) and 1334 (27%) controls (n=4995) died (P=0.004). SMR (1.9, 95% CI: 1.53-2.34, Pacromegaly. Overall distribution of causes of death (Pacromegaly, but not in controls, causes of deaths shifted from 44% cardiovascular and 28% cancer deaths during the first decade, to 23% cardiovascular and 35% cancer deaths during the next two decades. In acromegaly, cancer deaths were mostly attributed to pancreatic adenocarcinoma (n=5), breast (n=4), lung (n=3) and colon (n=3) carcinoma. In acromegaly, men were younger than women at diagnosis (median 44.5 vs 50 years, Pacromegaly, men are younger at diagnosis and death than women. Compared with controls, mortality is increased during 20 years of follow-up, especially in women. Causes of deaths shift from predominantly cardiovascular to cancer deaths. © 2016 Society for Endocrinology.

  10. [Guidelines for the follow up of patients with bronchopulmonary dysplasia].

    Science.gov (United States)

    Pérez Tarazona, S; Rueda Esteban, S; Alfonso Diego, J; Barrio Gómez de Agüero, M I; Callejón Callejón, A; Cortell Aznar, I; de la Serna Blázquez, O; Domingo Miró, X; García García, M L; García Hernández, G; Luna Paredes, C; Mesa Medina, O; Moreno Galdó, A; Moreno Requena, L; Pérez Pérez, G; Salcedo Posadas, A; Sánchez Solís de Querol, M; Torrent Vernetta, A; Valdesoiro Navarrete, L; Vilella Sabaté, M

    2016-01-01

    Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth, and remains a major problem in pediatric pulmonology units. The decision of discharging from the Neonatal Unit should be based on a thorough assessment of the condition of the patient and compliance with certain requirements, including respiratory and nutritional stability, and caregiver education on disease management. For proper control of the disease, a schedule of visits and complementary tests should be established prior to discharge, and guidelines for prevention of exacerbations and appropriate treatment should be applied. In this paper, the Working Group in Perinatal Respiratory Diseases of the Spanish Society of Pediatric Pulmonology proposes a protocol to serve as a reference for the follow up of patients with BPD among different centers and health care settings. Key factors to consider when planning discharge from the Neonatal Unit and during follow up are reviewed. Recommendations on treatment and prevention of complications are then discussed. The final section of this guide aims to provide a specific schedule for follow-up and diagnostic interventions to be performed in patients with BPD. Copyright © 2015 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  11. Follow-Up Photometry of Kelt Transiting Planet Candidates

    Science.gov (United States)

    Stephens, Denise C.; Joner, Michael D.; Hintz, Eric G.; Martin, Trevor; Spencer, Alex; Kelt Follow-Up Network (FUN) Team

    2017-10-01

    We have three telescopes at BYU that we use to follow-up possible transiting planet canidates for the KELT team. These telescopes were used to collect data on Kelt-16b and Kelt-9b, which is the hottest known exoplanet. More recently we used the newest of these telescopes, a robotic 8-inch telescope on the roof of our building, to confirm the most recent Kelt planet that will be published soon. This research has been ideal for the teaching and training of undergraduate students in the art of photometric observing and data reduction. In this presentation I will highlight how we are using our membership in the Kelt team to further the educational objective of our undergraduate astronomy program, while contributing meaningful science to the ever growing field of exoplanet discovery. I will also highlight a few of the more interesting Kelt planets and the minimum telescope requirements for detecting these planets. I will then discuss the sensitivities required to follow-up future TESS candidates, which may be of interest to others interested in joining the TESS follow-up teams.

  12. Appraising the value of independent EIA follow-up verifiers

    Energy Technology Data Exchange (ETDEWEB)

    Wessels, Jan-Albert, E-mail: janalbert.wessels@nwu.ac.za [School of Geo and Spatial Sciences, Department of Geography and Environmental Management, North-West University, C/O Hoffman and Borcherd Street, Potchefstroom, 2520 (South Africa); Retief, Francois, E-mail: francois.retief@nwu.ac.za [School of Geo and Spatial Sciences, Department of Geography and Environmental Management, North-West University, C/O Hoffman and Borcherd Street, Potchefstroom, 2520 (South Africa); Morrison-Saunders, Angus, E-mail: A.Morrison-Saunders@murdoch.edu.au [School of Geo and Spatial Sciences, Department of Geography and Environmental Management, North-West University, C/O Hoffman and Borcherd Street, Potchefstroom, 2520 (South Africa); Environmental Assessment, School of Environmental Science, Murdoch University, Australia. (Australia)

    2015-01-15

    Independent Environmental Impact Assessment (EIA) follow-up verifiers such as monitoring agencies, checkers, supervisors and control officers are active on various construction sites across the world. There are, however, differing views on the value that these verifiers add and very limited learning in EIA has been drawn from independent verifiers. This paper aims to appraise how and to what extent independent EIA follow-up verifiers add value in major construction projects in the developing country context of South Africa. A framework for appraising the role of independent verifiers was established and four South African case studies were examined through a mixture of site visits, project document analysis, and interviews. Appraisal results were documented in the performance areas of: planning, doing, checking, acting, public participating and integration with other programs. The results indicate that independent verifiers add most value to major construction projects when involved with screening EIA requirements of new projects, allocation of financial and human resources, checking legal compliance, influencing implementation, reporting conformance results, community and stakeholder engagement, integration with self-responsibility programs such as environmental management systems (EMS), and controlling records. It was apparent that verifiers could be more creatively utilized in pre-construction preparation, providing feedback of knowledge into assessment of new projects, giving input to the planning and design phase of projects, and performance evaluation. The study confirms the benefits of proponent and regulator follow-up, specifically in having independent verifiers that disclose information, facilitate discussion among stakeholders, are adaptable and proactive, aid in the integration of EIA with other programs, and instill trust in EIA enforcement by conformance evaluation. Overall, the study provides insight on how to harness the learning opportunities

  13. Appraising the value of independent EIA follow-up verifiers

    International Nuclear Information System (INIS)

    Wessels, Jan-Albert; Retief, Francois; Morrison-Saunders, Angus

    2015-01-01

    Independent Environmental Impact Assessment (EIA) follow-up verifiers such as monitoring agencies, checkers, supervisors and control officers are active on various construction sites across the world. There are, however, differing views on the value that these verifiers add and very limited learning in EIA has been drawn from independent verifiers. This paper aims to appraise how and to what extent independent EIA follow-up verifiers add value in major construction projects in the developing country context of South Africa. A framework for appraising the role of independent verifiers was established and four South African case studies were examined through a mixture of site visits, project document analysis, and interviews. Appraisal results were documented in the performance areas of: planning, doing, checking, acting, public participating and integration with other programs. The results indicate that independent verifiers add most value to major construction projects when involved with screening EIA requirements of new projects, allocation of financial and human resources, checking legal compliance, influencing implementation, reporting conformance results, community and stakeholder engagement, integration with self-responsibility programs such as environmental management systems (EMS), and controlling records. It was apparent that verifiers could be more creatively utilized in pre-construction preparation, providing feedback of knowledge into assessment of new projects, giving input to the planning and design phase of projects, and performance evaluation. The study confirms the benefits of proponent and regulator follow-up, specifically in having independent verifiers that disclose information, facilitate discussion among stakeholders, are adaptable and proactive, aid in the integration of EIA with other programs, and instill trust in EIA enforcement by conformance evaluation. Overall, the study provides insight on how to harness the learning opportunities

  14. ICU Telemedicine Program Financial Outcomes.

    Science.gov (United States)

    Lilly, Craig M; Motzkus, Christine; Rincon, Teresa; Cody, Shawn E; Landry, Karen; Irwin, Richard S

    2017-02-01

    ICU telemedicine improves access to high-quality critical care, has substantial costs, and can change financial outcomes. Detailed information about financial outcomes and their trends over time following ICU telemedicine implementation and after the addition of logistic center function has not been published to our knowledge. Primary data were collected for consecutive adult patients of a single academic medical center. We compared clinical and financial outcomes across three groups that differed regarding telemedicine support: a group without ICU telemedicine support (pre-ICU intervention group), a group with ICU telemedicine support (ICU telemedicine group), and an ICU telemedicine group with added logistic center functions and support for quality-care standardization (logistic center group). The primary outcome was annual direct contribution margin defined as aggregated annual case revenue minus annual case direct costs (including operating costs of ICU telemedicine and its related programs). All monetary values were adjusted to 2015 US dollars using Producer Price Index for Health-Care Facilities. Annual case volume increased from 4,752 (pre-ICU telemedicine) to 5,735 (ICU telemedicine) and 6,581 (logistic center). The annual direct contribution margin improved from $7,921,584 (pre-ICU telemedicine) to $37,668,512 (ICU telemedicine) to $60,586,397 (logistic center) due to increased case volume, higher case revenue relative to direct costs, and shorter length of stay. The ability of properly modified ICU telemedicine programs to increase case volume and access to high-quality critical care with improved annual direct contribution margins suggests that there is a financial argument to encourage the wider adoption of ICU telemedicine. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  15. Social functioning and the course of early-onset schizophrenia: five-year follow-up of a psychosocial intervention

    NARCIS (Netherlands)

    Lenior, M. E.; Dingemans, P. M.; Linszen, D. H.; de Haan, L.; Schene, A. H.

    2001-01-01

    BACKGROUND: Schizophrenia implies severe social impairments. Since the treatment of patients with schizophrenia shifted from long-term hospital admissions to community services, research on social functioning has become increasingly important. AIMS: Follow-up assessment of social functioning in

  16. Information, support, and follow-up offered to women who experienced severe maternal morbidity.

    Science.gov (United States)

    Furniss, Mary; Conroy, Molly; Filoche, Sara; MacDonald, E Jane; Geller, Stacie E; Lawton, Beverley

    2018-06-01

    To determine what information, support, and follow-up were offered to women who had experienced severe maternal morbidity (SMM). The present retrospective case review included patients who experienced SMM (admission to intensive care during pregnancy or up to 42 days postpartum) who had previously been reviewed for potential preventability as part of a nationwide New Zealand study performed between January 1 and December 31, 2014. Data were audited to ascertain documented evidence of an event debrief or explanation; referral to social support and/or mental health services; a detailed discharge letter; and a follow-up appointment with a specialist. Of 257 patients who experienced SMM, 23 (8.9%) were offered all four components of care, 99 (38.5%) an event debrief, 102 (39.7%) a referral to social support and/or mental health services, 148 (57.6%) a detailed discharge letter, and 131 (51.0%) a follow-up appointment. Many women who had experienced SMM did not receive explanatory information about their illness, an offer of psychosocial support, or a follow-up appointment prior to discharge from hospital. It is incumbent on clinicians and the maternity care system to improve these aspects of care for all women experiencing a potentially life-changing SMM event to minimize the risk and burden of long-term mental illness. © 2018 International Federation of Gynecology and Obstetrics.

  17. Nefropatia por IgA em portadores de espondiloartrites acompanhados no Serviço de Reumatologia do Hospital das Clínicas da UFMG IgA nephropathy in patients with spondyloarthritis followed-up at the Rheumatology Service of Hospital das Clínicas/UFMG

    Directory of Open Access Journals (Sweden)

    Daniela Castelo Azevedo

    2011-10-01

    Full Text Available OBJETIVO: Determinar a frequência das glomerulonefrites nos pacientes espondiloartríticos acompanhados em Serviço de Reumatologia Brasileiro e avaliar variáveis clínicas correlacionadas. PACIENTES E MÉTODOS: Os pacientes foram avaliados quanto às características sociodemográfi cas, tipo de espondiloartrite, tempo e atividade da doença, uso de anti-infl amatórios não esteroides, presença do HLA-B27, níveis de creatinina e ureia séricas, presença de comorbidades e presença de hematúria e/ou proteinúria. Os pacientes com hematúria foram submetidos à pesquisa de dismorfi smo eritrocitário, e aqueles com proteinúria submeteram-se à quantifi cação da proteína na urina de 24 horas. Biópsia renal foi indicada para aqueles com hematúria de origem glomerular e/ou proteinúria maior que 3,5 g. RESULTADOS: Foram avaliados 76 pacientes. A alteração mais frequente no exame de urina de rotina foi a hematúria microscópica (44,7%, geralmente intermitente e em amostra isolada de urina durante o seguimento do paciente. Em oito (10,5% dos pacientes a hematúria sugeriu origem glomerular. A biópsia renal foi realizada em cinco deles, e mostrou nefropatia por IgA em quatro (5,3% e doença da membrana fi na em um paciente. CONCLUSÕES: Notou-se alta frequência de alterações no exame de urina desse subgrupo de pacientes, assim como alta prevalência de nefropatia por IgA. Apesar de mais estudos sobre o assunto serem necessários para melhor esclarecimento desses resultados, a realização periódica de exames de urina deveria ser recomendável.OBJECTIVE: To determine the frequency of glomerulonephritis in patients with spondyloarthritis followed-up at a Brazilian Rheumatology Service, and to evaluate the clinical variables associated. PATIENTS AND METHODS: Patients were assessed for sociodemographic characteristics, type of spondyloarthritis, time since diagnosis and disease activity, non-steroidal anti-infl ammatory drug use, HLA

  18. Can JWST Follow Up on Gravitational-Wave Detections?

    Science.gov (United States)

    Kohler, Susanna

    2016-02-01

    Bitten by the gravitational-wave bug? While we await Thursdays press conference, heres some food for thought: if LIGO were able to detect gravitational waves from compact-object mergers, how could we follow up on the detections? A new study investigates whether the upcoming James Webb Space Telescope (JWST) will be able to observe electromagnetic signatures of some compact-object mergers.Hunting for MergersStudying compact-object mergers (mergers of black holes and neutron stars) can help us understand a wealth of subjects, like high-energy physics, how matter behaves at nuclear densities, how stars evolve, and how heavy elements in the universe were created.The Laser Interferometer Gravitational-Wave Observatory (LIGO) is searching for the signature ripples in spacetime identifying these mergers, but gravitational waves are squirrelly: LIGO will only be able to localize wave sources to tens of square degrees. If we want to find out more about any mergers LIGO discovers in gravitational waves, well need a follow-up search for electromagnetic counterparts with other observatories.The Kilonova KeyOne possible electromagnetic counterpart is kilonovae, explosions that can be produced during a merger of a binary neutron star or a neutron starblack hole system. If the neutron star is disrupted during the merger, some of the hot mass is flung outward and shines brightly by radioactive decay.Kilonovae are especially promising as electromagnetic counterparts to gravitational waves for three reasons:They emit isotropically, so the number of observable mergers isnt limited by relativistic beaming.They shine for a week, giving follow-up observatories time to search for them.The source location can beeasily recovered.The only problem? We dont currently have any sensitive survey instruments in the near-infrared band (where kilonova emission peaks) that can provide coverage over tens of square degrees. Luckily, we will soon have just the thing: JWST, launching in 2018!JWSTs

  19. Sleep During Menopausal Transition: A 6-Year Follow-Up.

    Science.gov (United States)

    Lampio, Laura; Polo-Kantola, Päivi; Himanen, Sari-Leena; Kurki, Samu; Huupponen, Eero; Engblom, Janne; Heinonen, Olli J; Polo, Olli; Saaresranta, Tarja

    2017-07-01

    Menopausal transition is associated with increased dissatisfaction with sleep, but the effects on sleep architecture are conflicting. This prospective 6-year follow-up study was designed to evaluate the changes in sleep stages and sleep continuity that occur in women during menopausal transition. Sixty women (mean age 46.0 years, SD 0.9) participated. All women were premenopausal at baseline, and at the 6-year follow-up, women were in different stages of menopausal transition. Polysomnography was used to study sleep architecture at baseline and follow-up. The effects of aging and menopause (assessed as change in serum follicle-stimulating hormone [S-FSH]) on sleep architecture were evaluated using linear regression models. After controlling for body mass index, vasomotor, and depressive symptoms, aging of 6 years resulted in shorter total sleep time (B -37.4, 95% confidence interval [CI] -71.5 to (-3.3)), lower sleep efficiency (B -6.5, 95%CI -12.7 to (-0.2)), as well as in increased transitions from slow-wave sleep (SWS) to wakefulness (B 1.0, 95%CI 0.1 to 1.9), wake after sleep onset (B 37.7, 95%CI 12.5 to 63.0), awakenings per hour (B 1.8, 95%CI 0.8 to 2.8), and arousal index (B 2.3, 95%CI 0.1 to 4.4). Higher S-FSH concentration in menopausal transition was associated with increased SWS (B 0.09, 95%CI 0.01 to 0.16) after controlling for confounding factors. A significant deterioration in sleep continuity occurs when women age from 46 to 52 years, but change from premenopausal to menopausal state restores some SWS. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  20. Automated detection of follow-up appointments using text mining of discharge records.

    Science.gov (United States)

    Ruud, Kari L; Johnson, Matthew G; Liesinger, Juliette T; Grafft, Carrie A; Naessens, James M

    2010-06-01

    To determine whether text mining can accurately detect specific follow-up appointment criteria in free-text hospital discharge records. Cross-sectional study. Mayo Clinic Rochester hospitals. Inpatients discharged from general medicine services in 2006 (n = 6481). Textual hospital dismissal summaries were manually reviewed to determine whether the records contained specific follow-up appointment arrangement elements: date, time and either physician or location for an appointment. The data set was evaluated for the same criteria using SAS Text Miner software. The two assessments were compared to determine the accuracy of text mining for detecting records containing follow-up appointment arrangements. Agreement of text-mined appointment findings with gold standard (manual abstraction) including sensitivity, specificity, positive predictive and negative predictive values (PPV and NPV). About 55.2% (3576) of discharge records contained all criteria for follow-up appointment arrangements according to the manual review, 3.2% (113) of which were missed through text mining. Text mining incorrectly identified 3.7% (107) follow-up appointments that were not considered valid through manual review. Therefore, the text mining analysis concurred with the manual review in 96.6% of the appointment findings. Overall sensitivity and specificity were 96.8 and 96.3%, respectively; and PPV and NPV were 97.0 and 96.1%, respectively. of individual appointment criteria resulted in accuracy rates of 93.5% for date, 97.4% for time, 97.5% for physician and 82.9% for location. Text mining of unstructured hospital dismissal summaries can accurately detect documentation of follow-up appointment arrangement elements, thus saving considerable resources for performance assessment and quality-related research.

  1. Neuroradiolological diagnosis and follow-up of brain tumors

    International Nuclear Information System (INIS)

    Kummer, R. von

    1997-01-01

    Primary tumors of the brain and cerebral metastases cause considerable morbidity and mortality. To assess the chance for cure and to develop a valid concept of treatment, the exact assessment of the tumor's location, of the tumor's borders and malignancy is essential. Today, neuroradiological examination mainly with magnetic resonance imaging (MRI) allows an almost histological diagnosis and description of the tumor's extent. MRI is as well useful for studying the patient's short- and long-term follow-up clinical course. This is illustrated by 3 case histories. (orig.)

  2. Primary cemented total hip arthroplasty: 10 years follow-up

    Directory of Open Access Journals (Sweden)

    Nath Rajendra

    2010-01-01

    Full Text Available Background: Primary cemented total hip arthroplasty is a procedure for non-traumatic and traumatic affections of the hip. Long term follow-up is required to assess the longevity of the implant and establish the procedure. Indo-Asian literature on long term result of total hip arthroplasty is sparse. We present a 10-year follow-up of our patients of primary cemented total hip arthroplasty. Materials and Methods: We operated 31 hips in 30 patients with primary cemented total hip arthroplasty. We followed the cases for a minimum period of 10 years with a mean follow-up period of 12.7 years. The mean age of the patients was 60.7 years (range 37-82 yrs male to female ratio was 2:1. The clinical diagnoses included - avascular necrosis of femoral head (n=15, sero positive rheumatoid arthritis (n=5, seronegative spondylo-arthropathy (n=4, neglected femoral neck fractures (n=3, healed tubercular arthritis (n=2 and post traumatic osteoarthritis of hip (n=2. The prostheses used were cemented Charnley′s total hip (n=12 and cemented modular prosthesis (n=19. The results were assessed according to Harris hip score and radiographs taken at yearly intervals. Results: The mean follow-up is 12.7 yrs (range 11-16 yrs Results in all operated patients showed marked improvement in Harris hip score from preoperative mean 29.2 to 79.9 at 10 years or more followup. However, the non-inflammatory group showed more sustained long term improvement as compared to the inflammatory group, as revealed by the Harris hip score. Mean blood loss was 450ml (±3.7 ml, mean transfusion rate was 1.2 units (±.3. The complications were hypotension (n=7, shortening> 1.5 cm (n=9, superficial infection (n=2 and malposition of prosthesis (n=1. Conclusion: The needs of Indian Asian patients, vary from what is discussed in literature. The pain tolerance is greater than western population and financial constraints are high. Thus revision surgery among Indian-Asian patients is less compared

  3. GRBs optical follow-up observation at Lunin observatory, Taiwan

    Energy Technology Data Exchange (ETDEWEB)

    Huang, K.Y.; Ip, W.H. [Chung-Li Univ., Taiwan (China). Institute of astronomy; Urata, Y. [RIKEN, Saitama (Japan); Tokyo Institute of Technology, Tokyo (Japan). Department of Physics; Tamagawa, T.; Onda, K. [RIKEN, Saitama (Japan); Makishima, K. [RIKEN, Saitama (Japan); Tokyo Univ., Tokyo (Japan). Department of Physics

    2005-07-15

    The Lulin GRB program, using the Lulin One-meter Telescope (LOT) in Taiwan started in July 2003. Its scientific aims are to discover optical counterparts of XRFs and short and long GRBs, then to quickly observe them in multiple bands. Thirteen follow-up observations were provided by LOT between July 2003 and Feb. 2005. One host galaxy was found at GRB 031203. Two optical afterglows were detected for GRB 040924 and GRB 041006. In addition, the optical observations of GRB 031203 and a discussion of the non-detection of the optical afterglow of GRB 031203 are also reported in this article.

  4. GRBs optical follow-up observation at Lunin observatory, Taiwan

    International Nuclear Information System (INIS)

    Huang, K.Y.; Ip, W.H.; Makishima, K.; Tokyo Univ., Tokyo

    2005-01-01

    The Lulin GRB program, using the Lulin One-meter Telescope (LOT) in Taiwan started in July 2003. Its scientific aims are to discover optical counterparts of XRFs and short and long GRBs, then to quickly observe them in multiple bands. Thirteen follow-up observations were provided by LOT between July 2003 and Feb. 2005. One host galaxy was found at GRB 031203. Two optical afterglows were detected for GRB 040924 and GRB 041006. In addition, the optical observations of GRB 031203 and a discussion of the non-detection of the optical afterglow of GRB 031203 are also reported in this article

  5. Postoperative follow-up studies in biliary atresia using radioisotope

    Energy Technology Data Exchange (ETDEWEB)

    Kanto, Kei; Ishida, Haruo; Hayashi, Akira; Kamagata, Shoichiro; Sanbonmatsu, Toru; Matsufuji, Hiroshi; Ishii, Katsumi

    1988-09-01

    With increasing numbers of long survival patients in biliary atresia, associated diseases such as liver cirrhosis and portal hypertension seem to be more important in their course. We use liver scintigraphy, hepatobiliary scintigraphy and transrectal portal scintigraphy as the follow-up study. Three studies generally correlate the present state of the patients, but there seems to be dissociation in the group of cirrhosis without icterus which are encountered most often in biliary atresia. That can be seen in hepatobiliary scintigraphy especially. So we emphasis that to choose several isotope studies are essential in determination of the postoperative state in biliary atresia.

  6. Follow-up study of memory deficits after ECT.

    Science.gov (United States)

    Shellenberger, W; Miller, M J; Small, I F; Milstein, V; Stout, J R

    1982-06-01

    Twenty-four patients received ECT induced by either alternating sine wave or brief pulsed-square wave stimulus and were evaluated at follow-up for clinical functioning and subjective memory loss. The hypothesis of less memory loss in the group receiving a weaker stimulus (pulsed-square wave) was not supported. The two treatment groups and a group of controls showed no significant differences on the memory test. On measures of clinical functioning the sine wave group scored better on every measure than the square wave group, although not significantly better.

  7. A follow-up of transients. Stage 1

    International Nuclear Information System (INIS)

    Enekull, Aa.; Wallner, B.

    1981-09-01

    A follow-up of the transients of temperature and pressure in the primary pressurized system of a nuclear power plant has been completed for the Barsebaeck-1 reactor. The investigation consists of the following steps:- the collation of transients - drawing up load data based on transients-analyses of stress - recommendations for future programs. It was found that the lifetime of the system will exceed 40 years excluding some of the pipes for feed water. The appendices give a detailed description of the transients.(G.B.)

  8. Shillapoo Wildlife Area 2007 Follow-up HEP Report.

    Energy Technology Data Exchange (ETDEWEB)

    Ashley, Paul R.

    2008-03-01

    In April and May 2007 the Regional HEP Team (RHT) conducted a follow-up HEP analysis on the Egger (612 acres) and Herzog (210 acres) parcels located at the north end of the Shillapoo Wildlife Area. The Egger and Herzog parcels have been managed with Bonneville Power Administration funds since acquired in 1998 and 2001 respectively. Slightly more than 936 habitat units (936.47) or 1.14 HUs per acre was generated as an outcome of the 2007 follow-up HEP surveys. Results included 1.65 black-capped chickadee HUs, 280.57 great blue heron HUs, 581.45 Canada goose HUs, 40 mallard HUs, and 32.80 mink HUs. Introduction A follow-up Habitat Evaluation Procedures (HEP) (USFWS 1980) analysis was conducted by the Columbia Basin Fish and Wildlife Authority's (CBFWA) Regional HEP Team (RHT) during April and May 2007 to document changes in habitat quality and to determine the number of habitat units (HUs) to credit Bonneville Power Administration (BPA) for providing operation and maintenance (O&M) funds since WDFW acquired the parcels. The 2007 follow-up HEP evaluation was limited to Shillapoo Wildlife Area (SWA) parcels purchased with Bonneville Power Administration funds. D. Budd (pers. comm.) reported WDFW purchased the 612 acre Egger Farms parcel on November 2, 1998 for $1,737,0001 and the 210 acre Herzog acquisition on June 21, 2001 for $500,000 with Memorandum of Agreement funds (BPA and WDFW 1996) as partial fulfillment of BPA's wildlife mitigation obligation for construction of Bonneville and John Day Dams (Rasmussen and Wright 1989). Anticipating the eventual acquisition of the Egger and Herzog properties, WDFW conducted HEP surveys on these lands in 1994 to determine the potential number of habitat units to be credited to BPA. As a result, HEP surveys and habitat unit calculations were completed as much as seven years prior to acquiring the sites. The term 'Shillapoo Wildlife Area' will be used to describe only the Herzog and Egger parcels in this

  9. Follow-up of young road accident victims.

    Science.gov (United States)

    Gillies, Marjorie L; Barton, Joanne; Di Gallo, Alain

    2003-10-01

    The aim of this study was to follow-up a group of children and young people previously examined for psychological sequelae following road traffic accidents. The group was assessed 18-month postaccident to assess the severity of continuing symptoms and examine any emergence of delayed onset of posttraumatic stress reactions. Participants (N = 31) completed the Revised Impact of Event Scale and the Child Posttraumatic Stress Reaction Index. Parents completed the Child Behavior Check-List and participated in a semistructured interview. Symptoms of PTSD were noted in a quarter of participants as was delayed onset of symptoms. The role of avoidance in symptom reporting and continuing disorder is discussed.

  10. Automated medical follow-up and delayed industrial risks

    International Nuclear Information System (INIS)

    Smith, M.E.

    In response to increasing demand for human data to identify social, environmental, and occupational influences upon health, Statistics Canada has been organizing existing files of vital and health records to facilitate such studies on a national scale. In particular, the development of a Canadian Mortality Data Base file, the initiation of the National Cancer Incidence system, and the development of new computer techniques have helped reduce the cost and increase the scale and efficiency of automated medical follow-up to produce statistics of sickness or death attributable to environmental factors. Specific occupational studies now in progress serve to illustrate the methods, practical difficulties, potential size, and products from such investigations

  11. Destructive spondyloarthropathy and radiographic follow-up in hemodialysis patients

    International Nuclear Information System (INIS)

    Orzincolo, C.; Cardona, P.; Bedani, P.L.; Gilli, P.; Scutellari, P.N.; Trotta, F.

    1990-01-01

    Nine patients undergoing regular dialytic treatment for more than 60 months showed clinical and radiologic features of a noninfective and destructive spondyloarthropathy. Typically, radiographs and CT scans revealed narrowing of intervertebral spaces, with destruction or sclerosis of the subchondral bone of the vertebral plate. A radiographic follow-up of the cervical spine was performed in seven patients after a period of 12 months and showed that the bone destruction in DSA is very rapid and progressive. The lower biocompatibility of the cuprophan membranes of dialyzers is probably the factor most responsible for hyperproduction of β 2 -m and subsequently osteoarticular deposition of a new type of amyloidosis. (orig./DG)

  12. Simplified method evaluation for piping elastic follow-up

    International Nuclear Information System (INIS)

    Severud, L.K.

    1983-05-01

    A proposed simplified method for evaluating elastic follow-up effects in high temperature pipelines is presented. The method was evaluated by comparing the simplified analysis results with those obtained from detailed inelastic solutions. Nine different pipelines typical of a nuclear breeder reactor power plant were analyzed; the simplified method is attractive because it appears to give fairly accurate and conservative results. It is easy to apply and inexpensive since it employs iterative elastic solutions for the pipeline coupled with the readily available isochronous stress-strain data provided in the ASME Code

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

    International Nuclear Information System (INIS)

    Hirata, Nobuhide

    1987-01-01

    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.)

  14. Rothmund-Thomson Syndrome: A 13-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Guillermo Antonio Guerrero-González

    2014-07-01

    Full Text Available Rothmund-Thomson syndrome (RTS is a rare autosomal recessive disorder presenting with poikiloderma and other clinical features, affecting the bones and eyes and, in type II RTS, presenting an increased risk for malignancy. With about 300 cases reported so far, we present a 13-year follow-up including clinical images, X-rays and genetic analysis. A 13-month-old female started with a facial rash with blisters on her cheeks and limbs at the age of 3 months along with congenital hypoplastic thumbs, frontal bossing and fine hair, eyebrows and eyelashes. The patient was lost to follow-up and returned 12 years later with palmoplantar hyperkeratotic lesions, short stature, disseminated poikiloderma and sparse scalp hair, with absence of eyelashes and eyebrows. Radiographic analysis showed radial ray defect, absence of the thumb and three wrist carpal bones, and reduced bone density. Gene sequencing for the RECQL4 helicase gene revealed a mutation on each allele. RTS is a rare disease, and in this patient we observed the evolution of her skin lesions and other clinical features, which were important for the classification of type II RTS. The next years will provide even more information on this rare disease.

  15. [Follow-up of children conceived by assisted reproductive technologies].

    Science.gov (United States)

    Bouillon, C; Fauque, P

    2013-05-01

    Since the birth of the first baby conceived by in vitro fertilization (IVF) 30 years ago (Louise Brown in 1978), there has been a rapid and constant increase in the number of couples using assisted reproductive technologies (ART). Around four million of children have been born from couples experiencing fertility problems, through the use of ART, comprising roughly 2-3 % of all births in Europe and U.S. That highlights that these modes of fertilization are now well assumed by our societies. However, several questions on health of these children remain to be elucidated. As evoked in this review, even if methodological limitations exist, numerous studies have reported increased risks of birth defects, like prematurity, foetal hypotrophy, neonatal complications, congenital malformations and epigenetic diseases among ART-conceived children as compared to naturally conceived children. Nowadays, it is difficult to determine if these increased risks found in ART infants are a consequence of the ART procedures or are inherent to the infertility problems per se. However, absolute risks remain moderate and reassuring as well as the data on follow-up into infancy and early childhood. Nevertheless, because the effects may occur at the adulthood, there is a need for long-term follow-up of children born after ART. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  16. Follow-up of pulmonary perfusion recovery after embolism

    International Nuclear Information System (INIS)

    Palla, A.; Donnamaria, V.; Petruzzelli, S.; Giuntini, C.

    1986-01-01

    Blood flow recovery in a group of 69 patients with pulmonary embolism was followed by serial lung scans over a six month period. Each patient underwent perfusion lung scan at diagnosis then 7, 30 and 180 days later; i.v. heparin was systematically administered for one week after diagnosis, followed by oral warfarin for six months. Blood flow impairment was evaluated by assessing the total number of unperfused lung segments (ULS), as calculated on both lateral views at each scan. The number of ULS was significantly reduced at each interval (P<0.001), ranging from 8.4±3.3 at diagnosis to 3.6±2.7 six months later; most of the recovery (79%) occurred within the first month. No patient had complete restoration of pulmonary blood flow during the whole follow-up period. No difference was found between the number of ULS in right lung versus that in left lung at each interval. Recovery of blood flow was heavily affected by coexisting cardiac or pulmonary disease. In fact, those patients with underlying cardiopulmonary disease (49.2% of the total) showed significantly smaller perfusion improvement after six months (P<0.001). Eight patients (6 with and 2 without cardiopulmonary disease) had clinical and scintigraphic evidence of recurrent embolism during the follow-up period

  17. Gastric and Duodenal Stents: Follow-Up and Complications

    International Nuclear Information System (INIS)

    Pinto Pabon, Isabel Teresa; Paul Diaz, Laura; Ruiz de Adana, Juan Carlos; Lopez Herrero, Julio

    2001-01-01

    Purpose: To assess the efficacy of self-expanding metallic stents in treating inoperable gastric and duodenal stenoses during follow-up and to evaluate the complications encountered.Methods: A total of 31 patients suffering from gastroduodenal obstruction (29 malignant, 2 benign) were treated with a self-expanding metallic stent (Wallstent). In 24 cases insertion was by the peroral route, in seven cases via gastrostomy.Results: All the strictures were successfully negotiated under fluoroscopic guidance without having to resort to endoscopy. A total of 27 patients (87%) were able to resume a regular diet, a soft diet, or a liquid diet orally. Complications included one case of stent malpositioning, one case of leakage of ascitic fluid through the gastrostomy orifice, one case of perforation and fistula to the biliary tree, and two cases of hematemesis. In two patients (6%) additional stents were implanted to improve patency. In all patients follow-up was maintained until death. Recurrence of symptoms immediately before death occurred in seven cases (23%). Mean survival time of patients was 13.3 weeks (SE ± 4.6).Conclusions: The deployment of gastroduodenal stents resulted in good palliation of inoperable gastric and duodenal stenoses. Certain technical aspects, e.g., adaptation of stents to bowel morphology, is critical to proper stent function and avoidance of complications

  18. CT follow-up after radiation therapy for pituitary adenomas

    International Nuclear Information System (INIS)

    Rush, S.C.; Newall, J.

    1988-01-01

    Between 1973 and 1985, 105 patients received radiation therapy as all or part of their treatment for pituitary tumor at the New York University Medical Center. Of these, 48 patients underwent computed tomography (CT) at a minimum of 2 years following treatment, with detailed reports available for analysis of tumor regression. There were 28 men with a median age of 46 years (range, 18-71 years) and 20 women with a median age of 53 years (range, 28-80 years). Tumors were classified as secretory in 23 patients, nonsecretory in 21, and undetermined in four. Sixteen patients were treated with radiation therapy alone, 23 patients with surgery and radiation therapy, and the other with bromocriptine and radiation therapy, with or without surgery. With a median follow-up of 5 years (range, 2-14 years), 16 patients developed an empty sella, 25 patients had residual sellar mass, and seven patients had persistent extrasellar components or no change in their intrasellar mass. Among patients who did not have hypopituitarism at the inception of radiation therapy, five of 13 with empty sellas and 12 of 22 with residual mass subsequently required therapy. The authors conclude that residual mass is commonly found in long-term follow-up after radiation therapy, that isolated imaging studies revealing such findings after treatment in no way herald a diagnosis of recurrence, and that hypopituitarism following pituitary radiation therapy does not correlate with the ablation or persistence of tissue within the sella

  19. Follow-up of breast cancer by bone scintigraphy

    International Nuclear Information System (INIS)

    Garcia N, E.; Castro, F.; Miranda, R.; Leon, L.; Bustamante, G.; Escobar, M.

    2004-01-01

    Full text: Breast cancer is one of the most common cancers in women. It is the second most widespread cancer in Mexican women. Among the several methods for diagnosis and follow up of the disease, tumor markers like CA-53 have high sensitivity and specificity. Bone scan is a useful method in the detection of bone metastases. In comparison to other diagnostic modalities, bone scan is more sensitive and less expensive for detection of early bone abnormalities and hence to select an appropriate treatment for better prognosis. In our country, in about 70% of cases diagnosis of breast cancer is made when the disease is in an advanced state - states III and IV. The aim of this study was to evaluate the follow up of breast cancer by bone scans and to correlate these findings with the stage of the disease and other diagnostic modalities. The work was carried out at Mexican General Hospital. A total of 350 patients with breast tumor were included; bone scans were performed in all patients at the time of clinical diagnosis and at every 6 months for a period of 1 to 5 years using an Elscint APEX SP6 HR gamma camera coupled with ultra high resolution collimator. Scan was performed 2-3 hours after intravenous administration of 555-925 MBq of Tc-99m methyl diphosphonate. Tumor classification was made according to TNM criteria. Serum levels of alkaline phosphates, carcino-embrionic antigen (CEA) and Ca 53 were also measured on the same day. Fifty-one patients confirmed to have a diagnosis of benign breast were excluded from the study group. Of the remaining 299 patients, 89 (39%) were between 41 years to 50 years, 69 between 51 to 60 years. The clinical stage most commonly observed was stage III (n=164, 54%) followed by stage II (25%). In 59.5% of patients, scintigraphy showed bone metastasis. Four patients with bone metastases showed regression and 42 (14%) with negative scans became positive on follow up bone scans. Ninety-three patients were free of bone metastases during all

  20. Evaluating telephone follow-up of a mail survey of community pharmacies.

    Science.gov (United States)

    Westrick, Salisa C; Mount, Jeanine K

    2007-06-01

    Mail and telephone are commonly used modes of survey with pharmacists. Research conducted using general population surveys consistently describes mail surveys as being less expensive but yielding lower response rates than telephone surveys. However, findings obtained from the general population may not be generalizable to pharmacist surveys. This study evaluates the effectiveness of telephone follow-up of mail survey nonrespondents by comparing the 2 survey modes on response rates, cooperation rates, cost per sample unit, and cost per usable response and evaluating potential nonresponse bias in the context of immunization activities. A census mail survey of 1,143 Washington State community pharmacies and a follow-up telephone survey of 262 randomly selected mail survey nonrespondents were compared. Both surveys included the same 15 yes/no-type questions to ask respondents about their pharmacy's involvement in immunization activities. The mail survey yielded a response rate 1 of 26.7% and a cooperation rate 1 of 26.7%, compared with 83.6% and 87.8%, respectively, for the follow-up telephone survey. With respect to cost per sample unit, the mail survey was the least expensive option ($1.20). However, when comparing cost per usable response, the mail survey was the most expensive ($4.37), and the follow-up telephone survey without an advance notification was the least expensive ($1.99). Furthermore, results suggest the presence of nonresponse bias: compared with pharmacies participating in the follow-up telephone survey, pharmacies participating in the mail survey were more likely to be involved in in-house immunization services but less likely to be involved in outsourced services. The telephone survey achieved higher outcome rates with reduced cost per usable response. A telephone survey is a viable mode that holds promise in pharmacy practice research. Maximizing response rates and assessing potential nonresponse bias should be a standard practice among pharmacy

  1. The US Department of Defense Millennium Cohort Study: career span and beyond longitudinal follow-up.

    Science.gov (United States)

    Smith, Tyler C

    2009-10-01

    To describe current and future career-span health research in the US Department of Defense Millennium Cohort Study. Collaborating with all military service branches and the Department of Veterans Affairs, the Millennium Cohort Study launched in 2001, before September 11 and the start of deployments in Afghanistan and Iraq, to conduct coordinated strategic research to determine any effects of military occupational and deployment-related exposures, on long-term health. More than 150,000 consenting members represent demographic, occupational, military, and health characteristics of the US military. More than 70% of the first two panels have submitted follow-up questionnaires and >50% have deployed since 2001. Prospective cohort data have identified subgroups of military populations at higher risk or more resilient to decrements in mental and physical health. Continued career span and beyond follow-up will answer long-term health questions related to military service.

  2. Association between subjective memory complaints and health care utilisation: a three-year follow up

    DEFF Research Database (Denmark)

    Waldorff, Frans Boch; Siersma, Volkert; Waldemar, Gunhild

    2009-01-01

    their general practitioner and reporting subjective memory complaints (SMC). METHODS: This study was conducted as a prospective cohort survey in general practice with three-year follow-up. Selected health care utilisation or costs relative to SMC adjusted for potential confounders were analyzed in a two......BACKGROUND: Subjective memory complaints (SMC) are common among elderly patients and little is know about the association between SMC and health care utilisation. Thus, the aim of this study was to investigate health care utilisation during a three-year follow-up among elderly patients consulting......-part model where the incidence of use of a selected health care service were analyzed separately from the quantity of use for those that use the service. The former analyzed in a Poisson regression approach, the latter in a generalized linear regression model. RESULTS: A total 758 non-nursing home residents...

  3. Therapeutic follow-up in hospitalization: social inclusion, recovery of citizenship and respect for individuality

    Directory of Open Access Journals (Sweden)

    Regina Célia Fiorati

    2008-01-01

    Full Text Available This study was carried out in a psychiatric crisis hospitalization unit, with the aim of drawing up a proposal for implementing therapeutic follow-up as part of the therapeutic program at this unit. The concept of therapeutic follow-up was envisaged as an important resource to be included in psychosocial rehabilitation projects, with the following goals: linking users with extra-hospital services, avoiding re-hospitalization and achieving inclusion in social networks. The study consisted of an exploratory-descriptive case study with a qualitative approach to data. Participant observation and a field diary were the techniques used for gathering and recording data. The difficulties experienced were correlated with the spheres of social networks, family, institutional relationships and society. The results included heeding the patient's and the family's suffering and including users in social networks, extra-hospital services and community organizations.

  4. Long term follow up of medical therapy of thyroid cancer

    International Nuclear Information System (INIS)

    Jaffiol, C.; Daures, J.P.; Nsakala, N.; Guerenova, J.; Baldet, L.; Pujol, P.; Vannereau, D.; Bringer, J.

    1995-01-01

    106 patients, 114 W, 27 M, were thyroidectomized for differentiated thyroid cancer (follicular 29.3% - papillary 54.3%) with different stages of gravity (N O: 48.2% - N 1: 32.8% - N 2: 19%). Neck dissection was used in cases of involved nodes. One or several doses of 131 I were given to 126 subjects, 106 patients were treated with L thyroxine (LT4) (mean daily dose: 2.5 μg/kg BW). 23 patients presenting intolerance to LT4 with non suppressed TSH for 13 of them were treated by an association of tiratricol (TRIAC) + LT4. The follow up included a yearly check up involving clinical examination, plasma thyroglobulin (Tg) and thyroid stimulating hormone (TSH) assessment, neck ultrasonography and X ray of the chest. Therapy was stopped for 4 weeks in cases with Tg above its detectable value and a total body scan performed with Tg and TSH controls. The mean duration of follow up was 94.5 ± 67.7 months and extended to more than 5 years for 61% of the patients. We observed 22 relapses of the tumor with 4 deaths. Age less then 45 years, appears as the best factor of prognosis. 2 groups of patients were compared to evaluate the incidence of TSH suppression on the relapse free survival (group 1 n = 30 with a TSH ≤ 0.10 mU/1 and group 2 n = 15 with a TSH always > 1 mU/1 during the follow up). The relapse free survival was shorter in group 2 (p 0.01). Association of TRIAC with LT4 leads to a reduction of the daily dose of LT4 (m 25μg/day) with a significant improvement of TSH suppression and clinical tolerance. In conclusion, TSH suppression improves the prognosis in thyroidectomized patients for differentiated carcinoma. Association of TRIAC with LT4 seems able to approve TSH suppression and therapeutic tolerance. (authors). 40 refs., 5 tabs

  5. Vaginismus Treatment: Clinical Trials Follow Up 241 Patients.

    Science.gov (United States)

    Pacik, Peter T; Geletta, Simon

    2017-06-01

    Vaginismus is mostly unknown among clinicians and women. Vaginismus causes women to have fear, anxiety, and pain with penetration attempts. To present a large cohort of patients based on prior published studies approved by an institutional review board and the Food and Drug Administration using a comprehensive multimodal vaginismus treatment program to treat the physical and psychologic manifestations of women with vaginismus and to record successes, failures, and untoward effects of this treatment approach. Assessment of vaginismus included a comprehensive pretreatment questionnaire, the Female Sexual Function Index (FSFI), and consultation. All patients signed a detailed informed consent. Treatment consisted of a multimodal approach including intravaginal injections of onabotulinumtoxinA (Botox) and bupivacaine, progressive dilation under conscious sedation, indwelling dilator, follow-up and support with office visits, phone calls, e-mails, dilation logs, and FSFI reports. Logs noting dilation progression, pain and anxiety scores, time to achieve intercourse, setbacks, and untoward effects. Post-treatment FSFI scores were compared with preprocedure scores. One hundred seventy-one patients (71%) reported having pain-free intercourse at a mean of 5.1 weeks (median = 2.5). Six patients (2.5%) were unable to achieve intercourse within a 1-year period after treatment and 64 patients (26.6%) were lost to follow-up. The change in the overall FSFI score measured at baseline, 3 months, 6 months, and 1 year was statistically significant at the 0.05 level. Three patients developed mild temporary stress incontinence, two patients developed a short period of temporary blurred vision, and one patient developed temporary excessive vaginal dryness. All adverse events resolved by approximately 4 months. One patient required retreatment followed by successful coitus. A multimodal program that treated the physical and psychologic aspects of vaginismus enabled women to achieve

  6. Mammographic follow-up after conservation therapy for breast cancer

    International Nuclear Information System (INIS)

    Gu Yajia; Xiao Qin; Zheng Xiaojing; Wu Jiong; Chen Jiayi; Gu Rongfeng; Feng Xiaoyuan

    2006-01-01

    Objective: To recognize the mammographic changes after conservation therapy for breast carcinoma. Methods: A total of 139 follow-up mammographic examinations in 85 cases were studied during the period between 1999 and 2004. Mammography was performed at intervals of 6 months for the first 2 years, then annually. Attention was paid to mammographic change patterns of conservation therapy for breast carcinoma, including breast edema, skin thickening, architectural disturbance, asymmetric density, architectural distortion retraction, and calcifications. SPSS version 11.0 for windows was used to perform all statistical tests. Kruskal-Wallis H test was used for calculating the overall statistical differences between difference periods. Categorical data were expressed as percentages and analyzed by using the X 2 test. The age of the patients ranged from 25 to 63 years (mediate, 44 years old). The time of follow-up observation ranged from 1 week to 72 months. Results: Two cases were normal on mammograms. High proportion of abnormal mammography was seen in the period of 12 month (40.3%, 56/139) and 24 month (21.6%, 30/139), respectively. Various findings appeared in various periods and the difference was statistically significant(X 2 =30.998, v=6, P=0.001). Mild edema appeared in the first 3 years. Moderately severe or marked breast edema may be present between 6 months to 12 months, then slowly resolved. The appearance and disappearance of skin thickening were similar to the process of breast edema. The changes of architectural disturbance did not correlate with time (X 2 =8.634, P>0.05), but on sequential mammograms for same patient, the extent of architectural disturbance relieved over time (17/19). Asymmetric density was found in only 5 patients, and disappeared in later period of follow-up in 3. Architectural distortion retraction got more and more obvious with time, and kept stable after certain period of time. Calcifications were shown in 2 patients, including 1

  7. Role of imaging in glaucoma diagnosis and follow-up

    Directory of Open Access Journals (Sweden)

    Vizzeri Gianmarco

    2011-12-01

    Full Text Available The purpose of the review is to provide an update on the role of imaging devices in the diagnosis and follow-up of glaucoma with an emphasis on techniques for detecting glaucomatous progression and the newer spectral domain optical coherence tomography instruments. Imaging instruments provide objective quantitative measures of the optic disc and the retinal nerve fiber layer and are increasingly utilized in clinical practice. This review will summarize the recent enhancements in confocal scanning laser ophthalmoscopy, scanning laser polarimetry, and optical coherence tomography with an emphasis on how to utilize these techniques to manage glaucoma patients and highlight the strengths and limitations of each technology. In addition, this review will briefly describe the sophisticated data analysis strategies that are now available to detect glaucomatous change overtime.

  8. Patients’ Vulnerability in Follow-up After Colorectal Cancer

    DEFF Research Database (Denmark)

    Thomsen, Thora Grothe; Hølge-Hazelton, Bibi

    2017-01-01

    and reorganizing follow-up after cancer treatment. OBJECTIVE:: The aim of this study was to identify the perspectives of fast-track colorectal cancer surgery patients on challenges experienced in the transition from being a hospitalized patient with cancer to being a cancer survivor. METHODS:: The current article......BACKGROUND:: In the transition between being a hospitalized patient with cancer and resuming “normal” life, many patients experience physical, mental, and social challenges. Scientifically, as well as politically, it is therefore recommended to undertake research with a focus on rethinking...... hospital after a few days; however, shortly after returning home, most of them became mentally overwhelmed by the feeling of vulnerability that was closely related to the feeling of being handed over the responsibility for a newly cancer-operated body and a fragile life situation. Four issues...

  9. Scintigraphic follow-up of fracture healing in animals

    International Nuclear Information System (INIS)

    Klug, W.; Franke, W.G.; Schulze, M.

    1983-01-01

    Secondary bone fracture heating was analysed by scintigraphic follow-up studies in rabbits using sup(99m)Tc-HEDP. 24 hours after fracture the activity ratio between the fractured and the non-fractured lower limb was 2,2. The maximal count density in the fracture region is found during the 14th and 28th day after fracture. Concomitantly there is a significant increase of bone marrow vessels and content of copper, magnesium, sodium and water in the callus. Although roentgenographic controls and static investigations with respect to consolidation reveal a complete heating already 126 days after fracture, the complete scintigraphic normalisation of the lower limb fracture of the rabbit is found not earlier than at the 203rd day after fracture. (orig.) [de

  10. Scintigraphic follow-up of fracture healing in animals

    Energy Technology Data Exchange (ETDEWEB)

    Klug, W.; Franke, W.G.; Schulze, M.

    1983-08-01

    Secondary bone fracture healing was analysed by scintigraphic follow-up studies in rabbits using sup(99m)Tc-HEDP. 24 hours after fracture the activity ratio between the fractured and the non-fractured lower limb was 2,2. The maximal count density in the fracture region is found during the 14th and 28th day after fracture. Concomitantly there is a significant increase of bone marrow vessels and content of copper, magnesium, sodium and water in the callus. Although roentgenographic controls and static investigations with respect to consolidation reveal a complete healing already 126 days after fracture, the complete scintigraphic normalisation of the lower limb fracture of the rabbit is found not earlier than at the 203rd day after fracture.

  11. Epidemiological follow-up study of Japanese Thorotrast cases

    International Nuclear Information System (INIS)

    Mori, T.; Maruyama, T.; Kato, Y.; Takahashi, S.

    1979-01-01

    The authors conducted a follow-up study on 243 Thorotrast-administered war-wounded ex-servicemen in 1975, after a lapse of 30 to 38 years from Thorotrast injections, and found 18 cases of malignant hepatic tumor, 15 cases of other malignant tumors, 2 cases of blood diseases, and 9 cases of liver cirrhosis in 224 cases who had been given Thorotrast intravascularly. The incidence of hepatic and other malignant tumors, blood diseases, and liver cirrhosis was significantly higher than in the controls. The total number of deaths in the Thorotrast-administered cases was also significantly higher than in the controls. In the remaining 19 cases who had been given Thorotrast by a route other than intravascularly, no fatal case related to Thorotrast administration was discovered. In the living cases, however, one sarcoma was observed to have developed at the site of the Thorotrast injection

  12. [Neuromuscular disease: respiratory clinical assessment and follow-up].

    Science.gov (United States)

    Martínez Carrasco, C; Villa Asensi, J R; Luna Paredes, M C; Osona Rodríguez de Torres, F B; Peña Zarza, J A; Larramona Carrera, H; Costa Colomer, J

    2014-10-01

    Patients with neuromuscular disease are an important group at risk of frequently suffering acute or chronic respiratory failure, which is their main cause of death. They require follow-up by a pediatric respiratory medicine specialist from birth or diagnosis in order to confirm the diagnosis and treat any respiratory complications within a multidisciplinary context. The ventilatory support and the cough assistance have improved the quality of life and long-term survival for many of these patients. In this paper, the authors review the pathophysiology, respiratory function evaluation, sleep disorders, and the most frequent respiratory complications in neuromuscular diseases. The various treatments used, from a respiratory medicine point of view, will be analyzed in a next paper. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  13. A follow-up of 72 cases referred for abortion.

    Science.gov (United States)

    Gillis, A

    1975-01-01

    Whilst the medical indications for therapeutic abortion and the legal limitations set vary enormously from one country to another there is in general an undoubted trend towards giving the pregnant woman herself a greater say in the decision. During the first year of the operation of the Abortion Act, 1967, in England some 72 pregnant women were referred to the author and his colleagues for a recommendation on abortion. A psychiatric examination and follow-up over a period of one year was made both in those cases where abortion was performed as well as in those cases who were refused therapeutic abortion. In this communication a comparison is made between the reactions and outcome in the two groups. A provisional conclusion is reached that no significant psychiatric disturbance could be attributed to the performance of the operation or on the other hand to refusal of the woman's request.

  14. Vertebral sarcoidosis: long-term follow-up with MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lefere, M. [University Hospitals Gasthuisberg, Department of Radiology, Leuven (Belgium); Larbi, A.; Malghem, J.; Vande Berg, B.; Dallaudiere, B. [University Hospitals St Luc, Department of Radiology, Brussels (Belgium)

    2014-08-15

    Vertebral involvement in sarcoidosis is rare and its clinical and imaging features are non-specific. Indeed, because the lesions are hard to differentiate from metastatic disease based on imaging alone, a histological confirmation is advised. Fatty replacement is a well-known finding indicating stabilization and healing in both benign and malignant conditions. It can be used as an indicator of a favorable disease course and response to treatment. We report the case of a 43-year-old woman with multifocal vertebral sarcoidosis lesions and long-term follow-up showing progressive and gradual fatty involution on magnetic resonance imaging (MRI) during 4 years of steroid treatment with a final favorable outcome. (orig.)

  15. Hydrotherapy after total knee arthroplasty. A follow-up study.

    Science.gov (United States)

    Giaquinto, S; Ciotola, E; Dall'Armi, V; Margutti, F

    2010-01-01

    The study evaluated the subjective functional outcome following total knee arthroplasty (TKA) in participants who underwent hydrotherapy (HT) six months after discharge from a rehabilitation unit. A total of 70 subjects, 12 of which were lost at follow-up, were randomly assigned to either a conventional gym treatment (N=30) or HT (N=28). A prospective design was performed. Participants were interviewed with Western-Ontario McMasters Universities Osteoarthritis Index (WOMAC) at admission, at discharge and six months later. Kruskal-Wallis and Wilcoxon tests were applied for statistical analysis. Both groups improved. The WOMAC subscales, namely pain, stiffness and function, were all positively affected. Statistical analysis indicates that scores on all subscales were significantly lower for the HT group. The benefits gained by the time of discharge were still found after six months. HT is recommended after TKA in a geriatric population. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  16. Magnetic resonance imaging in follow-up assessment of sciatica.

    Science.gov (United States)

    el Barzouhi, Abdelilah; Vleggeert-Lankamp, Carmen L A M; Lycklama à Nijeholt, Geert J; Van der Kallen, Bas F; van den Hout, Wilbert B; Jacobs, Wilco C H; Koes, Bart W; Peul, Wilco C

    2013-03-14

    Magnetic resonance imaging (MRI) is frequently performed during follow-up in patients with known lumbar-disk herniation and persistent symptoms of sciatica. The association between findings on MRI and clinical outcome is controversial. We studied 283 patients in a randomized trial comparing surgery and prolonged conservative care for sciatica and lumbar-disk herniation. Patients underwent MRI at baseline and after 1 year. We used a 4-point scale to assess disk herniation on MRI, ranging from 1 for "definitely present" to 4 for "definitely absent." A favorable clinical outcome was defined as complete or nearly complete disappearance of symptoms at 1 year. We compared proportions of patients with a favorable outcome among those with a definite absence of disk herniation and those with a definite, probable, or possible presence of disk herniation at 1 year. The area under the receiver-operating-characteristic (ROC) curve was used to assess the prognostic accuracy of the 4-point scores regarding a favorable or unfavorable outcome, with 1 indicating perfect discriminatory value and 0.5 or less indicating no discriminatory value. At 1 year, 84% of the patients reported having a favorable outcome. Disk herniation was visible in 35% with a favorable outcome and in 33% with an unfavorable outcome (P=0.70). A favorable outcome was reported in 85% of patients with disk herniation and 83% without disk herniation (P=0.70). MRI assessment of disk herniation did not distinguish between patients with a favorable outcome and those with an unfavorable outcome (area under ROC curve, 0.48). MRI performed at 1-year follow-up in patients who had been treated for sciatica and lumbar-disk herniation did not distinguish between those with a favorable outcome and those with an unfavorable outcome. (Funded by the Netherlands Organization for Health Research and Development and the Hoelen Foundation; Controlled Clinical Trials number, ISRCTN26872154.).

  17. SUBMILLIMETER FOLLOW-UP OF WISE-SELECTED HYPERLUMINOUS GALAXIES

    International Nuclear Information System (INIS)

    Wu Jingwen; Eisenhardt, Peter R. M.; Stern, Daniel; Assef, Roberto; Tsai, Chao-Wei; Cutri, Roc; Griffith, Roger; Jarrett, Thomas; Sayers, Jack; Bridge, Carrie; Benford, Dominic; Blain, Andrew; Petty, Sara; Lake, Sean; Bussmann, Shane; Comerford, Julia M.; Evans, Neal J. II; Lonsdale, Carol; Rho, Jeonghee; Stanford, S. Adam

    2012-01-01

    We have used the Caltech Submillimeter Observatory (CSO) to follow-up a sample of Wide-field Infrared Survey Explorer (WISE) selected, hyperluminous galaxies, the so-called W1W2-dropout galaxies. This is a rare (∼1000 all-sky) population of galaxies at high redshift (peaks at z = 2-3), which are faint or undetected by WISE at 3.4 and 4.6 μm, yet are clearly detected at 12 and 22 μm. The optical spectra of most of these galaxies show significant active galactic nucleus activity. We observed 14 high-redshift (z > 1.7) W1W2-dropout galaxies with SHARC-II at 350-850 μm, with nine detections, and observed 18 with Bolocam at 1.1 mm, with five detections. Warm Spitzer follow-up of 25 targets at 3.6 and 4.5 μm, as well as optical spectra of 12 targets, are also presented in the paper. Combining WISE data with observations from warm Spitzer and CSO, we constructed their mid-IR to millimeter spectral energy distributions (SEDs). These SEDs have a consistent shape, showing significantly higher mid-IR to submillimeter ratios than other galaxy templates, suggesting a hotter dust temperature. We estimate their dust temperatures to be 60-120 K using a single-temperature model. Their infrared luminosities are well over 10 13 L ☉ . These SEDs are not well fitted with existing galaxy templates, suggesting they are a new population with very high luminosity and hot dust. They are likely among the most luminous galaxies in the universe. We argue that they are extreme cases of luminous, hot dust-obscured galaxies (DOGs), possibly representing a short evolutionary phase during galaxy merging and evolution. A better understanding of their long-wavelength properties needs ALMA as well as Herschel data.

  18. Submillimeter Follow-up of Wise-Selected Hyperluminous Galaxies

    Science.gov (United States)

    Wu, Jingwen; Tsai, Chao-Wei; Sayers, Jack; Benford, Dominic; Bridge, Carrie; Blain, Andrew; Eisenhardt, Peter R. M.; Stern, Daniel; Petty, Sara; Assef, Roberto; hide

    2013-01-01

    We have used the Caltech Submillimeter Observatory (CSO) to follow-up a sample of Wide-field Infrared Survey Explorer (WISE) selected, hyperluminous galaxies, the so-called W1W2-dropout galaxies. This is a rare (approximately 1000 all-sky) population of galaxies at high redshift (peaks at zeta = 2-3), which are faint or undetected by WISE at 3.4 and 4.6 micrometers, yet are clearly detected at 12 and 22 micrometers. The optical spectra of most of these galaxies show significant active galactic nucleus activity. We observed 14 high-redshift (zeta greater than 1.7) W1W2-dropout galaxies with SHARC-II at 350-850 micrometers, with nine detections, and observed 18 with Bolocam at 1.1 mm, with five detections. Warm Spitzer follow-up of 25 targets at 3.6 and 4.5 micrometers, as well as optical spectra of 12 targets, are also presented in the paper. Combining WISE data with observations from warm Spitzer and CSO, we constructed their mid-IR to millimeter spectral energy distributions (SEDs). These SEDs have a consistent shape, showing significantly higher mid-IR to submillimeter ratios than other galaxy templates, suggesting a hotter dust temperature.We estimate their dust temperatures to be 60-120 K using a single-temperature model. Their infrared luminosities are well over 10(exp 13) solar luminosity. These SEDs are not well fitted with existing galaxy templates, suggesting they are a new population with very high luminosity and hot dust. They are likely among the most luminous galaxies in the universe.We argue that they are extreme cases of luminous, hot dust-obscured galaxies (DOGs), possibly representing a short evolutionary phase during galaxy merging and evolution. A better understanding of their long-wavelength properties needs ALMA as well as Herschel data.

  19. SUBMILLIMETER FOLLOW-UP OF WISE-SELECTED HYPERLUMINOUS GALAXIES

    Energy Technology Data Exchange (ETDEWEB)

    Wu Jingwen; Eisenhardt, Peter R. M.; Stern, Daniel; Assef, Roberto [Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, CA 91109 (United States); Tsai, Chao-Wei; Cutri, Roc; Griffith, Roger; Jarrett, Thomas [Infrared Processing and Analysis Center, California Institute of Technology, Pasadena, CA 91125 (United States); Sayers, Jack; Bridge, Carrie [Division of Physics, Math and Astronomy, California Institute of Technology, Pasadena, CA 91125 (United States); Benford, Dominic [NASA Goddard Space Flight Center, Greenbelt, MD 20771 (United States); Blain, Andrew [Department of Physics and Astronomy, University of Leicester, LE1 7RH Leicester (United Kingdom); Petty, Sara; Lake, Sean [Department of Physics and Astronomy, University of California Los Angeles, Los Angeles, CA 90095 (United States); Bussmann, Shane [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, MS78, Cambridge, MA 02138 (United States); Comerford, Julia M.; Evans, Neal J. II [Department of Astronomy, University of Texas, Austin, TX 78731 (United States); Lonsdale, Carol [National Radio Astronomy Observatory, 520 Edgemont Road, Charlottesville, VA 22903 (United States); Rho, Jeonghee [SETI Institute, 189 BERNARDO Avenue, Mountain View, CA 94043 (United States); Stanford, S. Adam, E-mail: jingwen.wu@jpl.nasa.gov [Department of Physics, University of California Davis, One Shields Avenue, Davis, CA 95616 (United States); and others

    2012-09-01

    We have used the Caltech Submillimeter Observatory (CSO) to follow-up a sample of Wide-field Infrared Survey Explorer (WISE) selected, hyperluminous galaxies, the so-called W1W2-dropout galaxies. This is a rare ({approx}1000 all-sky) population of galaxies at high redshift (peaks at z = 2-3), which are faint or undetected by WISE at 3.4 and 4.6 {mu}m, yet are clearly detected at 12 and 22 {mu}m. The optical spectra of most of these galaxies show significant active galactic nucleus activity. We observed 14 high-redshift (z > 1.7) W1W2-dropout galaxies with SHARC-II at 350-850 {mu}m, with nine detections, and observed 18 with Bolocam at 1.1 mm, with five detections. Warm Spitzer follow-up of 25 targets at 3.6 and 4.5 {mu}m, as well as optical spectra of 12 targets, are also presented in the paper. Combining WISE data with observations from warm Spitzer and CSO, we constructed their mid-IR to millimeter spectral energy distributions (SEDs). These SEDs have a consistent shape, showing significantly higher mid-IR to submillimeter ratios than other galaxy templates, suggesting a hotter dust temperature. We estimate their dust temperatures to be 60-120 K using a single-temperature model. Their infrared luminosities are well over 10{sup 13} L{sub Sun }. These SEDs are not well fitted with existing galaxy templates, suggesting they are a new population with very high luminosity and hot dust. They are likely among the most luminous galaxies in the universe. We argue that they are extreme cases of luminous, hot dust-obscured galaxies (DOGs), possibly representing a short evolutionary phase during galaxy merging and evolution. A better understanding of their long-wavelength properties needs ALMA as well as Herschel data.

  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. Follow up study and interested cases in subdural hematoma

    International Nuclear Information System (INIS)

    Kano, Mitsumasa; Goh, Jyunto; Koomura, Eiji; Nakao, Kazutami

    1983-01-01

    1. Out of 67 patients ranging from 16 to 82 years old, 20 were followed up by CT scan after operation. 2. Five patients presented hematoma on the both sides after operation, though they had suffered from the lesion of one side before operation. In four patients, hematoma was observed on the both sides before and after operation. Neither preoperative involved side changed nor hematoma appeared on the opposite side after operation in 11 patients. Follow-up examinations lasted up almost three months. 3. The maximum width of the subdural space was divided by the maximum intracranial width. These two factors were measured on horizontal CT scan. The calculated value was expressed in percentage and then, the result was regarded as Subdural Space (SDS) Index. Dividing a difference between the largest SDS Index (before operation) and the smallest by the number of days between the two points gave us a reduction rate of SDS Index. As a result, a reduction rate of 0.4 or less was obtained in all the patients less than 65 years old. There were three patients within the range from 0.7 to 1.0 of the rate. 76-year-old patients showed 2.6 and 5.7. Except the 76-old patients, mean duration of 35.5 days was calculated in Group I and SDS Index was 0, while Group II showed mean duration of 52.4 days, resulting in SDS Index of 0. 4. Specific progresses are shown below: 1) Hemorrhage of the caudate nucleus after operation 2) Subdural effusion of the both sides 3) Appearance of abscess 4) Subtentrial hemorrhage after operation 5) Postoperative epidural hematoma 6) Traumatic intracerebral hemorrhage, resulting in chronic subdural hematoma six months afterward (author)

  2. Early Identification Referral and Follow-up (EIRF) Individual Form

    Data.gov (United States)

    U.S. Department of Health & Human Services — The EIRF dataset contains information about each individual youth who was identified and referred for mental or non-mental health related services as part of a...

  3. The efficacy of psychoeducation on recurrent depression: A randomised trial with a two-year follow-up

    DEFF Research Database (Denmark)

    Aagaard, Jørgen; Foldager, Leslie; Makki, Ahmad

    2017-01-01

    and decline in Beck’s Depression Inventory (BDI). Methods: Eighty patients were randomized, either to the psychoeducative programme (consisting of eight sessions, each of 2 hours duration) and 2-year outpatient follow-up (42 cases), or only to 2-year outpatient follow-up (38 controls). The patients were...... monitored during 2 years after randomization. Data were collected from interviews including BDI, drug treatment and social measurements, and register data concerning use of psychiatric services. Results: At 2-year follow-up, a significant reduction in the consumption of psychiatric inpatient services...... and in BDI was found; however, it was uniform for case and control patients. Drop-out/non-compliance was significantly more frequent among patients randomized to the control group. Furthermore, during follow-up the case group got a significant stronger attachment to the Labour market than the control group...

  4. Acute Physiologic Stress and Subsequent Anxiety Among Family Members of ICU Patients.

    Science.gov (United States)

    Beesley, Sarah J; Hopkins, Ramona O; Holt-Lunstad, Julianne; Wilson, Emily L; Butler, Jorie; Kuttler, Kathryn G; Orme, James; Brown, Samuel M; Hirshberg, Eliotte L

    2018-02-01

    The ICU is a complex and stressful environment and is associated with significant psychologic morbidity for patients and their families. We sought to determine whether salivary cortisol, a physiologic measure of acute stress, was associated with subsequent psychologic distress among family members of ICU patients. This is a prospective, observational study of family members of adult ICU patients. Adult medical and surgical ICU in a tertiary care center. Family members of ICU patients. Participants provided five salivary cortisol samples over 24 hours at the time of the patient ICU admission. The primary measure of cortisol was the area under the curve from ground; the secondary measure was the cortisol awakening response. Outcomes were obtained during a 3-month follow-up telephone call. The primary outcome was anxiety, measured by the Hospital Anxiety and Depression Scale-Anxiety. Secondary outcomes included depression and posttraumatic stress disorder. Among 100 participants, 92 completed follow-up. Twenty-nine participants (32%) reported symptoms of anxiety at 3 months, 15 participants (16%) reported depression symptoms, and 14 participants (15%) reported posttraumatic stress symptoms. In our primary analysis, cortisol level as measured by area under the curve from ground was not significantly associated with anxiety (odds ratio, 0.94; p = 0.70). In our secondary analysis, however, cortisol awakening response was significantly associated with anxiety (odds ratio, 1.08; p = 0.02). Roughly one third of family members experience anxiety after an ICU admission for their loved one, and many family members also experience depression and posttraumatic stress. Cortisol awakening response is associated with anxiety in family members of ICU patients 3 months following the ICU admission. Physiologic measurements of stress among ICU family members may help identify individuals at particular risk of adverse psychologic outcomes.

  5. Progression of Myopic Maculopathy during 18-Year Follow-up.

    Science.gov (United States)

    Fang, Yuxin; Yokoi, Tae; Nagaoka, Natsuko; Shinohara, Kosei; Onishi, Yuka; Ishida, Tomoka; Yoshida, Takeshi; Xu, Xian; Jonas, Jost B; Ohno-Matsui, Kyoko

    2018-06-01

    To examine the progression pattern of myopic maculopathy. Retrospective, observational case series. Highly myopic patients who had been followed up for 10 years or more. Using fundus photographs, myopic features were differentiated according to Meta-analysis of Pathologic Myopia (META-PM) Study Group recommendations. Progression pattern of maculopathy. The study included 810 eyes of 432 patients (mean age, 42.3±16.8 years; mean axial length, 28.8±1.9 mm; mean follow-up, 18.7±7.1 years). The progression rate of myopic maculopathy was 47.0 per 1000 eye-years. Within the pathologic myopia (PM) group (n = 521 eyes), progression of myopic maculopathy was associated with female gender (odds ratio [OR], 2.21; P = 0.001), older age (OR, 1.03; P = 0.002), longer axial length (OR, 1.20; P = 0.007), greater axial elongation (OR, 1.45; P = 0.005), and development of parapapillary atrophy (PPA; OR, 3.14; P < 0.001). Diffuse atrophy, found in 217 eyes without choroidal neovascularization (CNV) or lacquer cracks (LCs) at baseline, progressed in 111 (51%) eyes, leading to macular diffuse atrophy (n = 64; 64/111 or 58%), patchy atrophy (n = 59; 53%), myopic CNV (n = 18; 16%), LCs (n = 9; 5%), and patchy-related macular atrophy (n = 3; 3%). Patchy atrophy, detected in 63 eyes without CNV or LCs at baseline, showed progression in 60 eyes (95%), leading to enlargement of original patchy atrophy (n = 59; 59/60 or 98%), new patchy atrophy (n = 29; 48%), CNV-related macular atrophy (n = 13; 22%), and patchy-related macular atrophy (n = 5; 8%). Of 66 eyes with LCs, 43 eyes (65%) showed progression with development of new patchy atrophy (n = 38; 38/43 or 88%) and new LCs (n = 7; 16%). Reduction in best-corrected visual acuity (BCVA) was associated mainly (all P < 0.001) with the development of CNV or CNV-related macular atrophy and enlargement of macular atrophy. The most frequent progression patterns were an extension of peripapillary diffuse atrophy to macular diffuse

  6. Diagnosis, surgical treatment and follow-up of thyroid cancers

    International Nuclear Information System (INIS)

    Pacini, F.; Pinchera, A.; Vorontsova, T.; Demidchik, E.P.; Delange, F.; Reiners, C.; Schlumberger, M.

    1996-01-01

    This paper reports the activities and the results of the research carried out by the Centers participating to the JSP4 project, within the framework of the EU program on the consequences of the Chernobyl disaster. The project was aimed to develop and to control the application of basic principles for the diagnosis, treatment and follow-up of thyroid carcinoma, with special attention to the peculiar requirement of children and adolescents. To this purpose, training in Western European Centers was offered to a number of scientists from Belarus, Ukraine and Russia. Several official meetings were organized to share views and to discuss the progress of the project. A basic protocol for the diagnosis, treatment and follow-up of thyroid carcinoma has been developed and approved by all participating Centers. Hopefully, it will be applied to the new cases and to those already under monitoring. A large part of the protocol is dedicated to the post-surgical treatment with thyroid hormones for the suppression of TSH and with calcitriol for the management of surgical hypoparathyroidism. A detailed protocol to asses iodine deficiency and, eventually, to introduce a program of iodine supplementation has been proposed. The collection of control cases of childhood thyroid carcinoma in non-radiation exposed European countries has been initiated in Italy, France and Germany. This data will be used as control for the post-Chernobyl childhood thyroid carcinomas. Here is reported a preliminary comparison of the clinical and epidemiological features of almost all (n=368) radiation-exposed Belarus children who developed thyroid carcinoma (age at diagnosis < 16 years), with respect to 90 children of the same age group, who, in the past 20 years, have received treatment for thyroid carcinoma in two centers in Italy (Pisa and Rome). Finally, by molecular biology, genetic mutations of the RET proto-oncogene have been found in several samples of thyroid carcinomas provided by the Belarus

  7. Operative correction and follow-up of craniofacial duplication.

    Science.gov (United States)

    Kotrikova, Bibiana; Hassfeld, Stefan; Steiner, Hans H; Hähnel, Stefan; Krempien, Robert; Mühling, Joachim

    2007-03-01

    Anterior craniofacial duplication (diprosopus) is an extremely rare form of conjoined twins. The children share a single trunk with normal extremities and varying degrees of facial malformation. Duplication of specific structures, such as the nose (diprosopus dirrhinus), eyes (diprosopus tetraophthalmus), and ears, is possible. The authors present a case of partial facial duplication (diprosopus dirrhinus) in a male infant. The clinical and radiographic findings and the surgical correction and follow-up are described. In a single surgical session, the authors were able to achieve not only a functionally but also an aesthetically acceptable result. In the postoperative course, the child showed nearly normal growth and satisfactory psychosocial and motor development. However, 40 months postoperatively, we noticed a tendency of the orbitae to diverge (i.e., toward hypertelorism). The surgical management of complex craniofacial malformations such as diprosopus needs a precise morphologic analysis of the patient's deformity followed by a clear treatment plan. A staged reconstructive approach is carried out to coincide with facial growth patterns and brain and eye function. If the interorbital distance in our patient increases progressively, a second operation for reduction of the interorbital distance may be necessary.

  8. [Assessment and follow up of diabetic patients in hemodialysis].

    Science.gov (United States)

    Sanhueza, María Eugenia; Cotera, Alejandro; Elgueta, Leticia; López S, Gloria; Loncon, Patricia; Macan, Fernando; Pérez, Francisco; Cavada, Gabriel; Alvo, Miriam

    2008-03-01

    Despite a better management of the variables that influence the development of diabetic nephropathy there is a progressive increase in the prevalence of terminal renal failure among diabetics, whose cause is not clear. To study in a group of patients in hemodialysis, the quality of diabetes control previous to the entry to dialysis, their physical condition and their evolution. Diabetic patients with at least three months of hemodialysis answered a questionnaire about diabetes control quality previous to dialysis and had physical and laboratory assessment. They were followed for at least four years thereafter. Fifty seven patients aged 62+/-11 years were studied. Eighty four percent had some degree of disability. Eighty seven percent had high blood pressure and 73% had to enter dialysis as an emergency. Mean glycosilated hemoglobin was 7.7% and 58% had a dialysis dose with a Kt/Vofless than 1.2. Fifty eight percent died during follow up. No relationship between mortality and age, blood pressure, glycosilated hemoglobin of Kt/V, was observed. There is an inadequate management of blood glucose and blood pressure of diabetic patients before entry to dialysis. They are referred inverted exclamation markate to the nephrologist, the dialysis dose is insufficient and they have a high mortality.

  9. SDSS-III MARVELS Planet Candidate RV Follow-up

    Science.gov (United States)

    Ge, Jian; Thomas, Neil; Ma, Bo; Li, Rui; SIthajan, Sirinrat

    2014-02-01

    Planetary systems, discovered by the radial velocity (RV) surveys, reveal strong correlations between the planet frequency and stellar properties, such as metallicity and mass, and a greater diversity in planets than found in the solar system. However, due to the sample sizes of extant surveys (~100 to a few hundreds of stars) and their heterogeneity, many key questions remained to be addressed: Do metal poor stars obey the same trends for planet occurrence as metal rich stars? What is the distribution of giant planets around intermediate- mass stars and binaries? Is the ``planet desert'' within 0.6 AU in the planet orbital distribution of intermediate-mass stars real? The MARVELS survey has produced the largest homogeneous RV measurements of 3300 V=7.6-12 FGK stars. The latest data pipeline effort at UF has been able to remove long term systematic errors suffered in the earlier data pipeline. 18 high confident giant planet candidates have been identified among newly processed data. We propose to follow up these giant planet candidates with the KPNO EXPERT instrument to confirm the detection and also characterize their orbits. The confirmed planets will be used to measure occurrence rates, distributions and multiplicity of giants planets around F,G,K stars with a broad range of mass (~0.6-2.5 M_⊙) and metallicity ([Fe/H]~-1.5-0.5). The well defined MARVELS survey cadence allows robust determinations of completeness limits for rigorously testing giant planet formation theories and constraining models.

  10. Bilateral sacrospinous fixation without hysterectomy: 18-month follow-up

    Science.gov (United States)

    Şentürk, Mehmet Baki; Güraslan, Hakan; Çakmak, Yusuf; Ekin, Murat

    2015-01-01

    Objective The aim of this study was to evaluate the results of bilateral sacrospinous fixation (SSF), which was performed with surgical mesh interposition and bilateral vaginal repair. Material and Methods Twenty-two patients underwent SSF between 2010 and 2012, and the results were evaluated retrospectively. The results at preoperative and postoperative 6th, 12th, and 18th months of the pelvic organ prolapse quantification system (POP-Q) and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 (PISQ-12) were compared using Friedman and Wilcoxon Signed Ranks tests. Values of p<0.05 and <0.01 were considered statistically significant. Results According to the POP-Q, significant healing was observed on all vaginal vault points (p=0.001), and no prolapse was observed until the 18-month follow-up stage. There were also prominent patients who felt satisfactory with respect to their sexual life according to PISQ-12 (p=0.001). Conclusion This technique appears to provide an adequate clinical resolution, and it may be the primary surgical option for women with pelvic organ prolapse. PMID:26097393

  11. Long term follow up in hemodialysis patients with parathyroidectomy

    International Nuclear Information System (INIS)

    Alvarez, A.; Petraglia, A.; Caorsi, H.; Mazzuchi, N.; Olaizola, I.; Acuna, G.; Fajardo, L.; Ambrosoni, P.; Morelli, R.

    1998-01-01

    A retrospective study was performed in 41 patients, in chronic hemodialysis with severe hyperparathyroidism (HPT), who underwent surgery during time period from 1985 to 1997. 22 females, 19 males, aged 50 and 14 years, with PTHI 1345 and 604 pg/ml were followed up 32 and 22 months. Three surgical methods we evaluated: group I) total para thyroidectomy(PTX) with Implants(n=24); group II) subtotal PTX(n=14) and group III) total PTX(n=3). It considered recurrence of HPT when PTH levels were higher than upper range of normal, after 6 months post surgery. persistence was defined when there was no standardization of PTH levels. In group I, 9 patients had normal parathyroid function, 7 had persistent hypoparathyroidism and had hyperparathyroidism (7 recurrences). Group II patients had parathyroid over function in 5 cases (4 persistence s), 5 were normal and 4 hypoparathyroidism. All patients of the third group had hypoparathyroidism. Long term normalization of parathyroid gland activity was achieved in one third of troduccion patients (34,1%) whereas 34,1% permanent hypoparathyroidism and 31,8% hyperparathyroidism. It found no differences in recurrence and histological subtype of parathyroid gland in the different groups. In conclusion, similar long term clinical results were obtained with the different groups. The surgical ideal treatment is controversial. We think that in the long run, the evolution of parathyroid status is mostly influenced by the persistence of uremic state rather than the type of surgery performed [es

  12. Congenital cytomegalovirus infection: treatment, sequelae and follow-up.

    Science.gov (United States)

    Lombardi, Giuseppina; Garofoli, Francesca; Stronati, Mauro

    2010-10-01

    Cytomegalovirus (CMV) is the most common cause of congenital infection affecting about 1% of all the live births worldwide. Its prevalence in the developed world seems to be slightly lower, ranging between 0.6 and 0.7%. Symptoms can be detected at birth in 10-15% of the congenitally infected of which 50-90% will develop sequelae, the most frequent being sensorineural hearing loss (SNHL), visual defect, psychomotor impairment, mental retardation, cerebral palsy and seizures. Eighty-five to 90% of the infected newborns are asymptomatic but 10-15% of them are equally at risk for sensorineural sequelae, like 20-30% of all the infected children. Therefore it is important a time prolonged and closer follow-up of infected children that we propose should be until 6 years of age. This should lead to an early intervention, better management and eventually even control the long-term sequelae. Infants born with symptomatic congenital infection have a worse prognosis than those with no evidence of clinical disease, and ganciclovir (GCV) intravenous 6 mg/kg every 12 h for 6 weeks is the most used therapy for symptomatic newborns. Valganciclovir (V-GCV) syrup is a pro-drug of GCV and presents high oral bioavailability. To date, it is possible to administer this drug at home, and the tolerability profile may allow for wider indications and longer treatments.

  13. Patients’ follow-up using biomechanical analysis of rehabilitation exercises

    Directory of Open Access Journals (Sweden)

    Bruno Bonnechère

    2017-03-01

    Full Text Available Thanks to the evolution of game controllers video games are becoming more and more popular in physical rehabilitation. The integration of serious games in rehabilitation has been tested for various pathologies. Parallel to this clinical research, a lot of studies have been done in order to validate the use of these game controllers for simple biomechanical evaluation. Currently, it is thus possible to record the motions performed by the patients during serious gaming exercises for later analysis. Therefore, data collected during the exercises could be used for monitoring the evolution of the patients during long term rehabilitation. Before using the parameters extracted from the games to assess patients’ evolution two important aspects must be verified: the reproducibility of measurement and a possible effect of learning of the task to be performed. Ten healthy adults played 9 sessions of specific games developed for rehabilitation over a 3-weeks period. Nineteen healthy children played 2 sessions to study the influence of age. Different parameters were extracted from the games: time, range of motion, reaching area. Results of this study indicates that it is possible to follow the evolution of the patients during the rehabilitation process. The majority of the learning effect occurred during the very first session. Therefore, in order to allow proper regular monitoring, the results of this first session should not be included in the follow-up of the patient.

  14. Bradykinesia in Huntington's disease. A prospective, follow-up study.

    Science.gov (United States)

    García Ruiz, Pedro J; Hernández, Jaime; Cantarero, Susana; Bartolomé, Manuel; Sánchez Bernardos, Vicenta; García de Yébenez, Justo

    2002-04-01

    Bradykinesia is a frequent finding in Huntington's disease (HD), but some aspects are presently unknown; including the natural evolution of bradykinesia over time and the correlation between bradykinesia and functional capacity. We studied the motor performance of 20 genetically confirmed patients with HD (age: 40+/-10.8 years; age at onset 33.6+/-11 years; total functional capacity (TFC): 9.57+/-3; UHDRS total motor scale: 31.4+/-13, triplet length (CAG)n: 46.7+/-4 triplets). These patients were studied in baseline conditions and after 18.7+/-6 months of follow-up. In addition, HD patients were compared with 20 age-matched normal controls. Motor study included the four CAPIT timed tests commonly used for Parkinson's disease: pronation-supination (PS), finger dexterity (FD), movement between two points (MTP) and walking test (WT). HD patients were significantly slower than controls in all motor tasks. A significant deterioration occurred over time in three of the four motor tasks (especially FD and WT). A significant correlation between timed tests and TFC score was found (for MTP, r: -0.845; p < 0,0001). In addition a significant correlation between timed tests and the UHDRDS total motor scale was also found (for MTP, r: 0.864; p < 0.0001). In conclusion, simple timed motor tests can detect a deterioration of motor activity over time in HD. Timed tests might be useful to follow the natural evolution of HD and to assess the efficacy of new therapies.

  15. Measles vaccine: a 27-year follow-up.

    LENUS (Irish Health Repository)

    Ramsay, M E

    1994-04-01

    In 1964, the Medical Research Council undertook a trial of measles vaccine in over 36,000 United Kingdom children; 9577 of whom received live vaccine, 10,625 received inactivated followed by live vaccines, and 16,328 acted as unvaccinated controls. Participants in this study have been followed to determine the long term protection from measles vaccine and follow-up data were available on 4194, 4638 and 274 respectively. During the 5-year period 1986-90, the protective efficacy of live measles vaccine has remained high at 87%, but the 95% confidence interval was wide (-43 to 99%) due to the small numbers of cases. Between 1976 and 1990, however, the overall efficacy of the live vaccine was 92% (95% confidence interval 86 to 95%) and there was no evidence of a decline in efficacy (P = 0.13) over the 15-year period. This study suggests that the protection from live measles vaccine persists for up to 27 years after vaccination, and that no change in the current United Kingdom measles immunization policy should be made on the grounds of waning immunity.

  16. Follow-up Sonography after Sonoguided Renal Biopsy

    International Nuclear Information System (INIS)

    Kim, Hyung Soo; Park, Cheol Min; Cha, In Ho

    1996-01-01

    To assess ultrasonographic findings and clinical significance after renal biopsy. 174 cases of post-biopsy sonography were studied retrospectively. We classified post-biopsy hematoma on the basis of their size as small (thickness less than 1 cm, length less than 3cm), medium (thickness less than 1cm, length greater than 3 cm), large (thickness greater than 1 cm, length greater than 3 cm). We also compared bleeding parameters (prothrombin time, partial thromboplastin time) and renal function in both cases which had hematoma or not. Total 33 hematomas were found (19%). Small hematoma was observed in 14 cases, medium hematoma in 16 cases, large hematoma in 3 cases. Severe complications requiring prompt therapy occurred in 1 case(0.6%). In 6 cases hematocrit fell by more than 4%, all of these hematomas were observed on US. Severe complications after sonoguided renal biopsy were rare. There was poor correlation between prebiopsybleeding parameter, renal function and post-biopsy hematomas. And sonography is considered as adequate method for follow up of post-biopsy hematoma

  17. Follow-up study on energy entrepreneurs; Laempoeyrittaejaet seurannassa

    Energy Technology Data Exchange (ETDEWEB)

    Solmio, H

    1995-11-01

    Energy supplying (i.e. wood and peat fuels) is a new form of entrepreneurship in which one or more entrepreneurs attend to the supply of energy to local buildings. At present there are about ten localities where this is practised. TTS Institute is engaged in a follow-up study of a chipfired heating system with energy entrepreneurs supplying the chipped wood. The study is part of the nationwide Bioenergy research programme. The targets of the study, three in number during the 1993-94 heating season, are rural schools located in southern and eastern Finland. The primary fuel used to heat these premises is chipped wood made from small-diameter timber with light fuel oil as the supplementary fuel. The entrepreneurs supplying the chip fuel are local farmers, and they both delivered the fuel and attended to the actual heating. The time consumed in transporting the chipped wood to the heating plant and to attend to the actual heating was 0,1-1,1 h/MWh with the work associated with heating representing 0,2-0,5 h/MWh. The productivity of fuelwood harvesting in the study sites was 0,4-0,8 m{sup 3}/h and the productivity of chipping was 3,8-7,5 loose m{sup 3}/h. TTS Institute expanded the study in 1994 to also include a few premises larger in their energy requirement than those mentioned in the above

  18. Spectroscopic follow-up of the Hercules-Aquila Cloud

    Science.gov (United States)

    Simion, Iulia T.; Belokurov, Vasily; Koposov, Sergey E.; Sheffield, Allyson; Johnston, Kathryn V.

    2018-05-01

    We designed a follow-up program to find the spectroscopic properties of the Hercules-Aquila Cloud (HAC) and test scenarios for its formation. We measured the radial velocities (RVs) of 45 RR Lyrae in the southern portion of the HAC using the facilities at the MDM observatory, producing the first large sample of velocities in the HAC. We found a double-peaked distribution in RVs, skewed slightly to negative velocities. We compared both the morphology of HAC projected on to the plane of the sky and the distribution of velocities in this structure outlined by RR Lyrae and other tracer populations at different distances to N-body simulations. We found that the behaviour is characteristic of an old, well-mixed accretion event with small apo-galactic radius. We cannot yet rule out other formation mechanisms for the HAC. However, if our interpretation is correct, HAC represents just a small portion of a much larger debris structure spread throughout the inner Galaxy whose distinct kinematic structure should be apparent in RV studies along many lines of sight.

  19. Thyroid carcinoma: A follow-up study of 11 years

    International Nuclear Information System (INIS)

    Ritzl, F.; Siebers, G.; Neumann, C.; Ritzl, E.K.

    1987-01-01

    During a follow-up of 11 years of thyroid carcinoma 136 patients were repeatedly examined. 43% papillary, 43% follicular, 11% anaplastic and 2% medullary carcinomas was found. The incidence of these types of carcinoma differed considerably; the frequency peak of papillary carcinomas was reached in 45-year-old humans, that of the follicular carcinomas in people aged 60, that of the anaplastic carcinomas in 70-year-old humans. 84% of the patients was female. Classification in pTNM-system: 8% in pT1, 27% in pT2, 12% in pT3 and 49% in pT4. Local and distant metastases were found at a low rate equally in pT1, pT2 and pT3; 26% of patients in pT4 had local metastases and 18% had distant ones in addition. There were 6 patients with metastases of a differentiated adenocarcinoma accumulating no 131-iodine and with no thyroglobulin in serum. 29% of patients had after thyroidectomy an unilateral paresis of the nervus recurrens and 4% a bilateral one. 26% of patients had a permanent hypoparathyroidism after thyroidectomy. (orig.)

  20. Thyroid carcinoma: A follow-up study of 11 years

    Energy Technology Data Exchange (ETDEWEB)

    Ritzl, F.; Siebers, G.; Neumann, C.; Ritzl, E.K.

    1987-09-01

    During a follow-up of 11 years of thyroid carcinoma 136 patients were repeatedly examined. 43% papillary, 43% follicular, 11% anaplastic and 2% medullary carcinomas was found. The incidence of these types of carcinoma differed considerably; the frequency peak of papillary carcinomas was reached in 45-year-old humans, that of the follicular carcinomas in people aged 60, that of the anaplastic carcinomas in 70-year-old humans. 84% of the patients was female. Classification in pTNM-system: 8% in pT1, 27% in pT2, 12% in pT3 and 49% in pT4. Local and distant metastases were found at a low rate equally in pT1, pT2 and pT3; 26% of patients in pT4 had local metastases and 18% had distant ones in addition. There were 6 patients with metastases of a differentiated adenocarcinoma accumulating no 131-iodine and with no thyroglobulin in serum. 29% of patients had after thyroidectomy an unilateral paresis of the nervus recurrens and 4% a bilateral one. 26% of patients had a permanent hypoparathyroidism after thyroidectomy.

  1. WFIRST Microlensing Exoplanet Characterization with HST Follow up

    Science.gov (United States)

    Bhattacharya, Aparna; David Bennett, Jay Anderson, J.P. Beaulieu.

    2018-01-01

    More than 50 planets are discovered with the different ground based telescopes available for microlensing. But the analysis of ground based data fails to provide a complete solution. To fulfill that gap, space based telescopes, like Hubble space telescope and Spitzer are used. My research work focuses on extracting the planet mass, host star mass, their separation and their distance in physical units from HST Follow-up observations. I will present the challenges faced in developing this method.This is the primary method to be used for NASA's top priority project (according to 2010 decadal survey) Wide Field InfraRed Survey Telescope (WFIRST) Exoplanet microlensing space observatory, to be launched in 2025. The unique ability of microlensing is that with WFIRST it can detect sub-earth- mass planets beyond the reach of Kepler at separation 1 AU to infinity. This will provide us the necessary statistics to study the formation and evolution of planetary systems. This will also provide us with necessary initial conditions to model the formation of planets and the habitable zones around M dwarf stars.

  2. Two Siblings Followed Up for Hereditary Multiple Exostoses

    Directory of Open Access Journals (Sweden)

    Meltem Erol

    2014-06-01

    Full Text Available Hereditary multiple exostoses is an autosomal dominant disease with abnormal bone formation especially at the long bones. Osteochondromas, which occur in the course of the disease, can cause growth disturbances in affected children. Due to pressure effects of osteochondromas, compression of vessels, nerves and tendons, restriction of joint motion, and neurologic compromise as well as painful local symptoms can be seen. Here, we aimed to present two siblings who had generalized pain and swelling in different parts of the body. We detected multiple osteochondromas in different parts of their bodies, especially at the long bones. Our patients had painful local symptoms. There was no growth retardation, but the presence of many osteochondromas led us to contemplate that it was serious form of the disease. Their father had lesser number of osteochondromas. In this paper, we aimed to emphasize the necessity of close follow-up for the risk of malignant transformation of osteochondromas. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 116-9

  3. Follow-up of obstructive sleep apnea in children.

    Science.gov (United States)

    Barros, Emília Leite de; Pradella-Hallinan, Marcia; Moreira, Gustavo Antonio; Stefanini, Daniele de Oliveira Soares; Tufik, Sergio; Fujita, Reginaldo Raimundo

    2014-01-01

    the evolution of snoring and OSAS in children is not well established since few studies of patients without surgical treatment have been published. to evaluate the evolution of sleep disordered breathing in children who had not been submitted to upper airway surgery. twenty-six children with snoring who had not undergone upper airway surgery were evaluated prospectively. Patients were evaluated by full physical examination and nocturnal polysomnography, after which they were divided into 2 groups: apnea (16 children) and snoring (10 children). After 6 months following the initial evaluation, patients were submitted to a new nocturnal polysomnography, and all data were compared to those of the first examination. the groups did not show any differences regarding age, weight, height and airway physical examination. After 6 months of follow-up, the apnea index did not change, but the respiratory disturbance index increased in the snoring group and the number of hypopneas decreased in the group apnea. there was an increase in the percentage of N1 sleep stage and the respiratory disturbance index in the patients with primary snore. The AHI did not show significant alteration in both groups, but the number of hypopneas decreased in patients with SAOS. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  4. Follow-up of obstructive sleep apnea in children

    Directory of Open Access Journals (Sweden)

    Emília Leite de Barros

    2014-07-01

    Full Text Available INTRODUCTION: the evolution of snoring and OSAS in children is not well established since few studies of patients without surgical treatment have been published. OBJECTIVE: to evaluate the evolution of sleep disordered breathing in children who had not been submitted to upper airway surgery. METHOD: twenty-six children with snoring who had not undergone upper airway surgery were evaluated prospectively. Patients were evaluated by full physical examination and nocturnal polysomnography, after which they were divided into 2 groups: apnea (16 children and snoring (10 children. After 6 months following the initial evaluation, patients were submitted to a new nocturnal polysomnography, and all data were compared to those of the first examination. RESULTS: the groups did not show any differences regarding age, weight, height and airway physical examination. After 6 months of follow-up, the apnea index did not change, but the respiratory disturbance index increased in the snoring group and the number of hypopneas decreased in the group apnea. CONCLUSION: there was an increase in the percentage of N1 sleep stage and the respiratory disturbance index in the patients with primary snore. The AHI did not show significant alteration in both groups, but the number of hypopneas decreased in patients with SAOS.

  5. Thoracic aortic coarctation: MR evaluation and follow-up

    International Nuclear Information System (INIS)

    Papavero, R.; Kastler, B.; Clair, C.; Livolsi, A.; Papavero, R.; Site, O.; Kastler, B.; Clair, C.; Litzler, J.F.; Delabrousse, E.; Scheneider, P.; Bernard, Y.

    2001-01-01

    Purpose: Report our experience in the evaluation and follow-up of thoracic aortic coarctation with MRI and describe its role to estimate trans-stenotic flow. Material and methods: 43 MR examinations were performed in 30 patients (age range 15 days to 73 years) referred to our institution in the last 7 years. Results: MRI visualized the ascending, horizontal and descending portions of the aorta and the supra-aortic vessels in 42/43 patients. MRI clearly identified preoperatively an aortic coarctation in 11/12 cases confirmed by surgery. Postoperatively MRI depicted 4 restenosis and one aneurysm. In 5 patients MRI demonstrated pseudo-coarctation. A significant correlation was established between the maximal trans-stenotic pressure gradient when measured by Doppler US or angiography and the size of the signal void measured on cine-MR images (r=0.72; p<0.01). Conclusion: MRI is a reliable non invasive investigation method for the diagnosis and semi-quantitative evaluation of aortic coarctation particularly when colour Doppler US is not satisfactory. (authors)

  6. Engaging patients via mobile phone technology to assist follow-up after hospitalization in Quito, Ecuador.

    Science.gov (United States)

    Maslowsky, Julie; Valsangkar, Bina; Chung, Jennifer; Rasanathan, Jennifer; Cruz, Freddy Trujillo; Ochoa, Marco; Chiriboga, Monica; Astudillo, Fernando; Heisler, Michele; Merajver, Sofia

    2012-05-01

    Disease management following hospital discharge is difficult in most low-resourced areas, posing a major obstacle to health equity. Although mobile phones are a ubiquitous and promising technology to facilitate healthcare access, few studies have tested the acceptability and feasibility of patients themselves using the devices for assisting linkages to healthcare services. We hypothesized that patients would use mobile phones to help manage postdischarge problems, if given a communication protocol. We developed a mobile phone-based program and investigated its acceptability and feasibility as a method of delivering posthospitalization care. A consecutive cohort of adult patients in a public hospital in Quito, Ecuador was enrolled over a 1-month period. A hospital-based nurse relayed patients' discharge instructions to a community-based nurse. Patients corresponded with this nurse via text messaging and phone calls according to a protocol to initiate and participate in follow-up. Eighty-nine percent of eligible patients participated. Ninety-seven percent of participants completed at least one contact with the nurse; 81% initiated contact themselves. Nurses completed 262 contacts with 32 patients, clarifying discharge instructions, providing preventive education, and facilitating clinic appointments. By this method, 87% of patients were successfully linked to follow-up appointments. High levels of patient participation and successful delivery of follow-up services indicate the mobile phone program's acceptability and feasibility for facilitating posthospitalization follow-up. Patients actively used mobile phones to interact with nurses, enabling the provision of posthospitalization medical advice and facilitate community-based care via mobile phone.

  7. Electrochemical sensors in breast cancer diagnostics and follow-up

    Directory of Open Access Journals (Sweden)

    Raquel Marques

    2015-12-01

    electrodes (SPCEs were used as the transducers. These SPCEs (working volume: ~40 μL are widely employed in the construction of electrochemical (biosensors because of several reasons: simplicity and low cost, versatility of design, small dimensions and possibility of incorporation in portable systems, as well as adequate electroanalytical characteristics. These SPCEs were modified with gold nanoparticles (nAu through the electrochemical deposition of ionic gold from a solution. The developed sensors were applied to the analysis of the selected biomarkers in spiked human serum samples.Besides these immunosensors, a molecularly imprinted polymer (MIP sensor was developed for the analysis of HER2-ECD. In this case a gold electrode was used as the transducer. The MIP was formed by surface imprinting and electrochemical impedance spectroscopy and voltammetry were used for detection purposes.Results: For the immunoassays the following parameters were optimized: capture and detection antibody concentration, surface blocking, reaction mixtures and incubation times. The best limits of detection obtained were below the established cut-off values (25 U/mL and 15 ng/mL for CA15-3 and HER2-ECD, respectively. For the MIP sensor the most adequate polymer was chosen and the electropolymerization, template removal, and incubation conditions were optimized. The lowest HER2-ECD concentration that was analyzed was 50 µg/mL.Conclusion: The obtained results indicate that the developed sensors could be promising tools in breast cancer diagnostics and follow-up. However, further studies should be conducted using patients' samples and the results of these assays should be validated with the established analysis procedures for these cancer biomarkers.-----------------------------------------Cite this article as:  Marques R, Pacheco J, Rama EC, Viswanathan S, Nouws H, Delerue-Matos C. Electrochemical sensors in breast cancer diagnostics and follow-up. Int J Cancer Ther Oncol 2015; 3(4:34012.[This

  8. Clinical 3-year follow-up of uterine fibroid embolization

    International Nuclear Information System (INIS)

    Radeleff, B.A.; Satzl, S.; Eiers, M.; Fechtner, K.; Hakim, A.; Kauffmann, G.W.; Richter, G.M.; Rimbach, S.

    2007-01-01

    Purpose: The purpose of this study was to evaluate the clinical long-term success of uterine artery embolization (UAE) in patients with symptomatic fibroids using spherical particles (Embosphere). Materials and Methods: 34 consecutive patients treated with UAE were initially enrolled in the study which had the following study goals (1) 1-year follow-up MRI evaluation of the fibroid behavior and (2) clinical long-term success due to standardized assessment of the main fibroid-related symptoms (hypermenorrhoea, dysmenorrhoea and dysuria) of the patients' individual overall health status and their therapy satisfaction at 1-year, 2- year and 3-year intervals after UAE. Results: Technical success was achieved in all procedures. Four patients had to be excluded from the long-term evaluation schedule: one because of a hysterectomy due to bleeding after 6 weeks, 3 patients were not available for the designated minimum follow-up interval. The preinterventional severe hypermenorrhoea (n = 27) with a score of 4.4 ± 0.7 (5 = extreme menstrual bleeding) decreased after one year to 2.1 ± 0.5 (p = 0.0001), after two years to 1.7 ± 0.5 (p = 0.0042) and after three years to 1.3 ± 0.6 (p = 0.0001). The preinterventional dysmenorrhoea (n = 15) with a score of 3.1 ± 1.5 (3 = distinctly increased dysmenorrhoea) decreased after one year to 1.1 ± 0.3 (p = 0.0001), after two years to 1.2 ± 0.2 and after three years to 1.2 ± 0.4 (p = 0.148). The pretreatment dysuria (n = 12) with a preinterventional score of 3.1 ± 1.5 (3 = distinctly increased dysuria) decreased after one year to 1.1 ± 0.3 (p 0.0069) and remained after two years at 1.1 ± 0.2 and after three years at 1.2 ± 0.4 (p = 0.905). The initial overall health status was 54.7 ± 20.1 (maximal value 100). After one year it rose to 90.5 ± 15.4 (p = 0.0001), was 91.8 ± 5.6 after two years and was 91.3 ± 8.5 (p = 0.8578) after three years. The satisfaction with the therapy was 2.9 ± 0.2 after one year, 2.6 ± 0.3 after two

  9. Postpartum follow-up: can psychosocial support reduce newborn readmissions?

    Science.gov (United States)

    Barilla, Dora; Marshak, Helen Hopp; Anderson, S Eric; Hopp, Joyce W

    2010-01-01

    To determine whether there was a relationship between postpartum psychosocial support from healthcare providers and the rate of normal newborn readmissions (NNRs), and whether there was a cost benefit to justify an intervention. Data were abstracted for all normal newborn births from 1999 to 2006 (N = 14,786) at a community hospital in southern California at three different time periods: (1) at baseline prior to any intervention (1999-2000), (2) the 4 years during the comprehensive psychosocial support intervention (2001-2004), and (3) the 2 years during a limited psychosocial support intervention (2004-2006). A cost-benefit analysis was performed to analyze whether the financial benefits from the intervention matched or exceeded the costs for NNRs. There was a significantly lower readmission rate of 1.0% (p = < .001) during the comprehensive intervention time period compared to baseline (2.3%) or to the limited intervention time period (2.3%). Although there was no significant difference in the average cost per newborn readmitted across the three study time periods, during the comprehensive intervention time period the average costs of a NNR were significantly lower ($4,180, p = .041) for the intervention group compared to those who received no intervention ($5,338). There was a cost benefit of 513,540 dollars due to fewer readmissions during the comprehensive time period, but it did not exceed the cost of the intervention. Providing comprehensive follow-up for new mothers in the postpartum period can reduce NNRs, thus lowering the average newborn readmission costs for those who receive psychosocial support. Followup for new mothers should be an accepted norm rather than the exception in postpartum care, but NNRs should not be considered the sole outcome in such programs.

  10. Parenchymal neurocysticercosis: follow-up and staging by MRI

    International Nuclear Information System (INIS)

    Dumas, J.L.; Visy, J.M.; Belin, C.; Gaston, A.; Goldlust, D.; Dumas, M.

    1997-01-01

    We describe the evolution of parenchymal cerebral cysticerci on MRI, to assess signs of early cyst degeneration. We studied 15 lesions in four treated and one untreated patient. MRI was performed before therapy and repeated in the 1st month after each course of anticysticercus drugs, every 4 months during the 1st year and then annually; the follow-up period was 8-48 months. Lesions were classified according to changes in four features: cyst content and capsule signal, gadolinium enhancement and oedema signal. We were able to recognise each of the pathological phases; five MRI stages were identified. Stage 1 showed oedema and/or nodular gadolinium enhancement in the tissue invasion phase; stage 2 was cerebrospinal fluid-like signal within a cyst in the vesicular phase; stage 3 showed a thick capsule with an impure liquid content signal and surrounding oedema, in the cystic phase; stage 4 showed the disappearance of the cyst fluid content signal in the degenerative phase; stage 5 showed a calcified lesion in the residual phase. Stage 1 lesions disappeared after therapy; the other progressed from one stage to another. Stage 4 indicated the end of viability of the parasite and determined the point after which treatment was useless. On T2-weighted images changes in the cyst content differed according to the history of the lesion; nodular low intensity followed the natural degeneration of the parasite and a mixed fluid signal with punctate low signal seemed to represent the specific result of therapy. MRI staging can help in the evaluation of indications for treatment and facilitate clinical therapeutic trials. (orig.). With 4 figs., 1 tab

  11. 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.

  12. Tracking the follow-up of work in progress papers.

    Science.gov (United States)

    Mubin, Omar; Arsalan, Mudassar; Al Mahmud, Abdullah

    2018-01-01

    Academic conferences offer numerous submission tracks to support the inclusion of a variety of researchers and topics. Work in progress papers are one such submission type where authors present preliminary results in a poster session. They have recently gained popularity in the area of Human Computer Interaction (HCI) as a relatively easier pathway to attending the conference due to their higher acceptance rate as compared to the main tracks. However, it is not clear if these work in progress papers are further extended or transitioned into more complete and thorough full papers or are simply one-off pieces of research. In order to answer this we explore self-citation patterns of four work in progress editions in two popular HCI conferences (CHI2010, CHI2011, HRI2010 and HRI2011). Our results show that almost 50% of the work in progress papers do not have any self-citations and approximately only half of the self-citations can be considered as true extensions of the original work in progress paper. Specific conferences dominate as the preferred venue where extensions of these work in progress papers are published. Furthermore, the rate of self-citations peaks in the immediate year after publication and gradually tails off. By tracing author publication records, we also delve into possible reasons of work in progress papers not being cited in follow up publications. In conclusion, we speculate on the main trends observed and what they may mean looking ahead for the work in progress track of premier HCI conferences.

  13. Parenchymal neurocysticercosis: follow-up and staging by MRI

    Energy Technology Data Exchange (ETDEWEB)

    Dumas, J.L. [Dept. of Radiology, Hopital Avicenne, Bobigny (France)]|[Inst. of Tropical Neurology, Faculty of Medicine, Limoges (France); Visy, J.M. [Dept. of Neurology, Hopital Lariboisiere, Paris (France); Belin, C. [Dept. of Neurology, Hopital Avicenne, Bobigny (France); Gaston, A. [Dept. of Neuroradiology, Hopital Henri-Mondor, Creteil (France); Goldlust, D. [Dept. of Radiology, Hopital Avicenne, Bobigny (France); Dumas, M. [Inst. of Tropical Neurology, Faculty of Medicine, Limoges (France)

    1997-01-01

    We describe the evolution of parenchymal cerebral cysticerci on MRI, to assess signs of early cyst degeneration. We studied 15 lesions in four treated and one untreated patient. MRI was performed before therapy and repeated in the 1st month after each course of anticysticercus drugs, every 4 months during the 1st year and then annually; the follow-up period was 8-48 months. Lesions were classified according to changes in four features: cyst content and capsule signal, gadolinium enhancement and oedema signal. We were able to recognise each of the pathological phases; five MRI stages were identified. Stage 1 showed oedema and/or nodular gadolinium enhancement in the tissue invasion phase; stage 2 was cerebrospinal fluid-like signal within a cyst in the vesicular phase; stage 3 showed a thick capsule with an impure liquid content signal and surrounding oedema, in the cystic phase; stage 4 showed the disappearance of the cyst fluid content signal in the degenerative phase; stage 5 showed a calcified lesion in the residual phase. Stage 1 lesions disappeared after therapy; the other progressed from one stage to another. Stage 4 indicated the end of viability of the parasite and determined the point after which treatment was useless. On T2-weighted images changes in the cyst content differed according to the history of the lesion; nodular low intensity followed the natural degeneration of the parasite and a mixed fluid signal with punctate low signal seemed to represent the specific result of therapy. MRI staging can help in the evaluation of indications for treatment and facilitate clinical therapeutic trials. (orig.). With 4 figs., 1 tab.

  14. Nutritional rehabilitation after ICU - does it happen: a qualitative interview and observational study.

    Science.gov (United States)

    Merriweather, Judith; Smith, Pam; Walsh, Timothy

    2014-03-01

    To compare and contrast current nutritional rehabilitation practices against recommendations from National Institute for Health and Excellence guideline Rehabilitation after critical illness (NICE) (2009, http://www.nice.org.uk/cg83). Recovery from critical illness has gained increasing prominence over the last decade but there is remarkably little research relating to nutritional rehabilitation. The study is a qualitative study based on patient interviews and observations of ward practice. Seventeen patients were recruited into the study at discharge from the intensive care unit (ICU) of a large teaching hospital in central Scotland in 2011. Semi-structured interviews were conducted on transfer to the ward and weekly thereafter. Fourteen of these patients were followed up at three months post-ICU discharge, and a semi-structured interview was carried out. Observations of ward practice were carried out twice weekly for the duration of the ward stay. Current nutritional practice for post-intensive care patients did not reflect the recommendations from the NICE guideline. A number of organisational issues were identified as influencing nutritional care. These issues were categorised as ward culture, service-centred delivery of care and disjointed discharge planning. Their influence on nutritional care was compounded by the complex problems associated with critical illness. The NICE guideline provides few nutrition-specific recommendations for rehabilitation; however, current practice does not reflect the nutritional recommendations that are detailed in the rehabilitation care pathway. Nutritional care of post-ICU patients is problematic and strategies to overcome these issues need to be addressed in order to improve nutritional intake. © 2013 John Wiley & Sons Ltd.

  15. Relationship between TISS and ICU cost.

    Science.gov (United States)

    Dickie, H; Vedio, A; Dundas, R; Treacher, D F; Leach, R M

    1998-10-01

    To determine whether the therapeutic intervention scoring system (TISS) reliably reflects the cost of the overall intensive care unit (ICU) population, subgroups of that population and individual ICU patients. Prospective analysis of individual patient costs and comparison with TISS. Adult, 12 bedded general medical and surgical ICU in a university teaching hospital. Two hundred fifty-seven consecutive patients including 52 coronary care (CCU), 99 cardiac surgery (CS) and 106 general ICU (GIC) cases admitted to the ICU during a 12-week period in 1994. A total of 916 TISS-scored patient days were analysed A variable cost (VC) that included consumables and service usage (nursing, physiotherapy, radiology and pathology staff costs) for individual patients was measured daily. Nursing costs were calculated in proportion to a daily nursing dependency score. A fixed cost (FC) was calculated for each patient to include medical, technical and clerical salary costs, capital equipment depreciation, equipment and central hospital costs. The correlation between cost and TISS was analysed using regression analysis. For the whole group (n = 257) the average daily FC was pound sterling 255 and daily VC was pound sterling 541 (SEM 10); range pound sterling 23-pound sterling 2,806. In the patient subgroups average daily cost (FC + VC) for CCU was pound sterling 476 (SEM 17.5), for CS pound sterling 766 (SEM 13.8) and for GIC pound sterling 873 (SEM 13.6). In the group as a whole, a strong correlation was demonstrated between VC and the TISS for each patient day (r = 0.87, p < 0.001) and this improved further when the total TISS score was compared with the total VC of the entire patient episode (r = 0.93, p < 0.001). This correlation was maintained in CCU, CS and GIC patient cohorts with only a small median difference between actual and predicted cost (2.2 % for GIC patients). However, in the individual patient, the range of error was up to +/- 65 % of the true variable cost. For the

  16. Health and re-employment in a two year follow up of long term unemployed.

    Science.gov (United States)

    Claussen, B; Bjørndal, A; Hjort, P F

    1993-02-01

    The aim was to examine re-employment and changes in health during a two year follow up of a representative sample of long term unemployed. This was a cross sectional study and a two year follow up. Health was measured by psychometric testing, Hopkins symptom checklist, General health questionnaire, and medical examination. Health related selection to continuous unemployment and recovery by re-employment was estimated by logistic regression with covariances deduced from the labour market theories of human capital and segmented labour market. Four municipalities in Greenland, southern Norway. Participants were a random sample of 17 to 63 year old people registered as unemployed for more than 12 weeks. In the cross sectional study, the prevalence of depression, anxiety, and somatic illness was from four to 10 times higher than in a control group of employed people. In the follow up study, there was considerable health related selection to re-employment. A psychiatric diagnosis was associated with a 70% reduction in chances of obtaining a job. Normal performance on psychometric testing showed a two to three times increased chance of re-employment. Recovery of health following re-employment was less than expected from previous studies. Health related selection to long term unemployment seems to explain a substantial part of the excess mental morbidity among unemployed people. An increased proportion of the long term unemployed will be vocationally handicapped as years pass, putting a heavy burden on social services.

  17. Electronic Follow-Up of Developing World Cleft Patients: A Digital Dream?

    Science.gov (United States)

    Walker, Tom W M; Chadha, Ambika; Rodgers, William; Mills, Caroline; Ayliffe, Peter

    2017-10-01

    To identify potential access to telemedicine follow-up of children with clefts operated on a humanitarian mission. A cross-sectional study of parents of children presenting to a humanitarian cleft lip and palate mission in a Provincial Hospital in the Philippines. A purpose designed questionnaire was used to assess access to electronic and digital resources that could be used to aid follow-up. Forty-five (N = 45) parents of children having primary cleft lip and or palate surgery participated. There were no interventions. Access to the Internet was through Parent Perceived Affordability of Internet Access and Parent Owned Devices. Thirty-one (N = 31) respondents were female. There was 93% mobile phone ownership. The mean distance traveled to the clinic was 187 km. Majority (56%) were fluent in English. Thirty-one percent accessed the Internet daily. Sixteen percent reported use of e-mail. Fifty-one percent accessed the Internet on a mobile device, and short message service use was the most affordable means of communication. Due to perceived unaffordability and low levels of access to devices with cameras and the Internet, as well as issues with privacy, we cannot recommend relying on electronic follow-up of patients in the developing world.

  18. Mortality risk in the french cohort of uranium miners: extended follow-up 1946-1999

    International Nuclear Information System (INIS)

    Blandine Vacquier; Dominique Laurier; Sylvaine Caer; Benoit Quesne

    2006-01-01

    Since the 1970's, exposure to radon and to its radioactive decay products has been studied in relation to lung cancer risk among cohorts of miners [1-3]. These studies concluded that cumulative exposure to radon was associated with an increased risk of death from lung cancer. In 1988, the International Agency for Research on Cancer (IARC) classified radon as a known pulmonary human carcinogen [4]. The French cohort of uranium miners has been established in order to assess the mortality risk of miners exposed to low levels of radon and its decay products as well as to other occupational hazards. The primary aim of the cohort study is the quantification of the relationship between cumulated radon exposure and risk of lung cancer death. The study has been conducted by the Institut de Radioprotection et de Surete Nucleaire (IRSN) since 1982, in collaboration with the Occupational Medical Service of COGEMA. The French Data Protection Authority (CNIL) gave approval for this study. Previous analyses have demonstrated an excess of lung cancer death associated with radon exposure. These results regarding lung cancer have been presented in several publications and congress [5-11]. In 2004, the follow-up of this cohort was extended from 31 December 1994 through 31 December 1999. The extension of the follow-up increases the statistical power of the cohort. The present article describes the extended cohort and the analysis of mortality based on the follow-up of the cohort to end of 1999. (authors)

  19. Psychopathology from adolescence into young adulthood: an 8-year follow-up study.

    Science.gov (United States)

    Ferdinand, R F; Verhulst, F C

    1995-11-01

    This study investigated the stability of behavioral and emotional problems from adolescence into young adulthood. Subjects from the general population (N = 459), aged 13-16 years, were evaluated initially with the Child Behavior Checklist (completed by parents) and 8 years later with the Young Adult Self-Report. The scoring format and factor structure of the two assessment instruments are similar; syndromes constructed from the two instruments are based on parents', teachers', and self-report information derived from large clinical samples. Signs of maladjustment also were assessed at follow-up through interviews. Of the individuals with total problem scores in the deviant range on the Child Behavior Checklist, 27.3% had total problem scores in the deviant range on the Young Adult Self-Report at follow-up. The probability of having a total problem score in the deviant range at follow-up was raised 7.4-fold by having deviant-range scores on the Child Behavior Checklist somatic complaints and anxious/depressed syndromes (simultaneously) at the initial assessment. Referral to mental health services was predicted by deviant-range scores on the anxious/depressed syndrome, while suicide attempts were predicted by deviance on the withdrawn syndrome. Adolescent problems tended to persist into young adulthood to a moderate degree. High rates of withdrawal from social contacts, anxiety or depression, somatic complaints without known medical origin, social problems, attention problems, delinquent behavior, and aggressive behavior during adolescence were risk factors for specific types of psychopathology and maladjustment at 8-year follow-up. The presence of psychopathology in adolescence should not be regarded as normative.

  20. Psychiatric Assessment and Follow-up of Young People after ...

    African Journals Online (AJOL)

    hanumantp

    to talk about their psychological distress. ... impact of this group of young people who presented to Kings ... and social assessment of young people following a serious physical assault as ... pediatric liaison Child and Adolescent Mental Health Service (CAMHS). ... highlights various factors that may be at work leading to the.

  1. Health related quality of life in trauma patients. Data from a one-year follow up study compared with the general population

    Directory of Open Access Journals (Sweden)

    Skogstad Laila

    2011-04-01

    Full Text Available Abstract Background Trauma patients have impaired health-related quality of life (HRQOL after trauma. The aim of the study was to assess HRQOL during the first year after trauma and hospital stay in trauma patients admitted to an intensive-care unit (ICU for >24 hours compared with non-ICU trauma patients and the general population, and to identify predictors of HRQOL. Methods A prospective one-year follow-up study of 242 trauma patients received by the trauma team of a trauma referral centre in Norway was performed. HRQOL was measured using the Medical Outcomes Study Short Form 36 (SF-36 at 3 and 12 months. Results The mean age of the cohort was 42.3 years (95% CI, 40.4-44.3 years. The median Injury Severity Score (ISS was 10, interquartile range 16. The HRQOL improved significantly from the 3 to the 12 months follow up in the trauma patients. However their scores were significantly lower for most subscales of SF-36 compared to the general population. Significant differences between ICU and non-ICU patients at 12 months were observed only for physical functioning and role physical subscales. Optimism was an independent predictor of good HRQOL at 12 months, in all dimensions (beta, 0.95-2.45. A higher depression score at baseline predicted lower HRQOL in four of eight dimensions (beta -1.1 to -1.70. In addition, better physical functioning was predicted by lower age (beta, -0.20, and having head injury (reference as the most severe injury vs. spine or extremity injuries (beta, -9.49 and -10.85, and better mental health by higher age (beta, 0.21 and being employed or studying before the trauma (beta, 12.27. In addition to optimism good general health was predicted by lower score for post-traumatic stress (PTS symptoms at baseline (beta, -0.27 and lower ISS score (beta -10.59. Conclusions The HRQOL improved significantly from the 3 to the 12 months follow up in our sample. However their scores were significantly lower for most subscales of SF-36

  2. Focussed probes ultrasonic follow-up of actual flaw growth during fatigue testing

    International Nuclear Information System (INIS)

    Cinotti, C.; Dufresne, J.; Prot, A.C.; Touffait, A.M.; Saglio, R.

    1979-01-01

    A programme was undertaken to follow-up the growth of actual flaws purposely introduced during the welding process of five test specimens. The aim of this programme is to measure the actual size of the cracks which develop from the known defects during the fatigue testing. The sizing method is based on the use of focussed probes, which allow good accuracy and repeatability, as well as good sensitivity. Examples are given of the first results: sizing before testing, then step by step during the fatigue testing and also under compression. This last point is very important in view of the ultrasonic testing during periodic in-service inspection

  3. Virtual rapid response: the next evolution of tele-ICU.

    Science.gov (United States)

    Hawkins, Carrie L

    2012-01-01

    The first of its kind in the Veterans Affairs (VA) system, the Denver VA Medical Center's tele-intensive care unit (ICU) program is unique because it is entirely nurse driven. A nontraditional tele-ICU model, the program was tailored to meet the needs of rural veterans by using critical care nursing expertise in Denver, Colorado. An experienced CCRN-certified nurse manages the system 24 hours a day, 7 days a week, from Eastern Colorado Health Care System. The virtual ICU provides rapid response interventions through virtual technology. This tele-ICU technology allows for a "virtual handshake" by nursing staff at the start of the shift and a report on potential patient issues. Clinical relationships have been strengthened between all 5 VA facilities in the Rocky Mountain Region, increasing the likelihood of early consultation at the onset of clinical decline of a patient. In addition, the tele-ICU nurse is available for immediate nursing consultation and support, coordinates point-to-point virtual consultation between physicians at the rural sites and specialists in Denver, and assists in expediting critical care transfers. The primary objectives for the tele-ICU program include improving quality and access of care to critical care services in rural sites, reducing community fee basis costs and frequency of transfers, and increasing collaboration and collegiality among nursing and medical staff in all Region 19's medical centers.

  4. Comparing the effects of education using telephone follow-up and smartphone-based social networking follow-up on self-management behaviors among patients with hypertension.

    Science.gov (United States)

    Najafi Ghezeljeh, Tahereh; Sharifian, Sanaz; Nasr Isfahani, Mehdi; Haghani, Hamid

    2018-03-05

    Little is known about the benefits of social networks in the management of patients. The aim of this study was to compare the effects of self-management (SM) education using telephone follow-up and mobile phone-based social networking on SM behaviors among patients with hypertension. This randomized clinical trial was conducted with 100 patients. They were randomly allocated to four groups: (i) control, (ii) SM training without follow-up, (iii) telephone follow-up and (iv) smartphone-based social networking follow-up. The hypertension SM behavior questionnaire was used for data collection before and six weeks after the study. Those patients who underwent SM education training (with and without follow-up) had statistically significant differences from those in the control group in terms of SM behaviors (p social networking follow-up influenced SM behaviors among patients with hypertension.

  5. Travelers' health problems and behavior: prospective study with post-travel follow-up.

    Science.gov (United States)

    Vilkman, Katri; Pakkanen, Sari H; Lääveri, Tinja; Siikamäki, Heli; Kantele, Anu

    2016-07-13

    after travel. As the symptoms mostly remained mild, health care services were seldom needed. Typical traveler profiles were identified, thereby providing a tool for pre-travel advice. The finding that one third reported new-onset illness during follow-up attests to the importance of advising clients on potential post-travel health problems already during pre-travel visits.

  6. Quality of follow-up after hospitalization for mental illness among patients from racial-ethnic minority groups.

    Science.gov (United States)

    Carson, Nicholas J; Vesper, Andrew; Chen, Chih-Nan; Lê Cook, Benjamin

    2014-07-01

    Outpatient follow-up after hospitalization for mental health reasons is an important indicator of quality of health systems. Differences among racial-ethnic minority groups in the quality of service use during this period are understudied. This study assessed the quality of outpatient treatment episodes following inpatient psychiatric treatment among blacks, whites, and Latinos in the United States. The Medical Expenditure Panel Survey (2004-2010) was used to identify adults with any inpatient psychiatric treatment (N=339). Logistic regression models were used to estimate predictors of any outpatient follow-up or the beginning of adequate outpatient follow-up within seven or 30 days following discharge. Predicted disparities were calculated after adjustment for clinical need variables but not for socioeconomic characteristics, consistent with the Institute of Medicine definition of health care disparities as differences that are unrelated to clinical appropriateness, need, or patient preference. Rates of follow-up were generally low, particularly rates of adequate treatment (<26%). Outpatient treatment prior to inpatient care was a strong predictor of all measures of follow-up. After adjustment for need and socioeconomic status, the analyses showed that blacks were less likely than whites to receive any treatment or begin adequate follow-up within 30 days of discharge. Poor integration of follow-up treatment in the continuum of psychiatric care leaves many individuals, particularly blacks, with poor-quality treatment. Culturally appropriate interventions that link individuals in inpatient settings to outpatient follow-up are needed to reduce racial-ethnic disparities in outpatient mental health treatment following acute treatment.

  7. 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.

  8. Six-year follow-up with Empress veneers.

    Science.gov (United States)

    Fradeani, M

    1998-06-01

    This study reports on 6 years experience with IPS Empress laminate veneers. A total of 83 anterior veneers were positioned in 21 patients from January 1991 to December 1996 in the author's private practice. Final evaluation was carried out in May and June 1997. Color match, marginal discoloration, recurrent caries, contour, and marginal integrity were evaluated using the modified U.S. Public Health Service criteria at baseline and subsequent recall appointments. On the basis of the criteria used, a large percentage of veneers were rated Alfa. Only one failure was recorded, resulting in a success rate of 98.8%. A thorough description of clinical procedures and laboratory techniques through which anterior teeth can be successfully treated with ceramic veneers is supplied. A clinical case is presented to demonstrate the satisfactory esthetic results obtained using this very conservative restorative technique.

  9. Surviving ICU: Stories of recovery.

    Science.gov (United States)

    Ewens, Beverley A; Hendricks, Joyce M; Sundin, Deborah

    2018-02-28

    The aim of this study was to investigate stories of recovery through the lens of intensive care unit (ICU) survivors. Survival from ICUs is increasing, as are associated physical and psychological complications. Despite the significant impact on survivors, there is inadequate support provision in Australia and world-wide for this population. An interpretive biographical approach of intensive care survivors' experiences of recovery. Data were collected during 2014-2015 from diaries, face to face interviews, memos and field notes. Six participants diarized for 3 months commencing 2 months after hospital discharge. At 5 months, participants were interviewed about the content of their diaries and symbols and signifiers in them to create a shared meaning. Analysis of diaries and interviews were undertaken using two frameworks to identify themes throughout participants' stories and provides a unique portrait of recovery through their individual lens. Participants considered their lives had irreparably changed and yet felt unsupported by a healthcare system that had "saved" them. This view through their lens identified turmoil, which existed between their surface and inner worlds as they struggled to conform to what recovery "should be". The novel biographical methods provided a safe and creative way to reveal survivors' inner thoughts and feelings. Participants' considered creating their stories supported their recovery process and in particular enabled them to reflect on their progress. Findings from this study may lead to increased awareness among health care providers about problems survivors face and improved support services more broadly, based on frameworks appropriate for this population. © 2018 John Wiley & Sons Ltd.

  10. Magnitude and causes of loss to follow-up among patients with viral hepatitis at a tertiary care hospital in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Hanan H. Balkhy

    2017-07-01

    Full Text Available Background: Non-adherence with recommended follow-up visits is a major barrier for completing treatment of viral hepatitis and is consequently associated with unfavorable outcomes of health services. Objectives: To estimate the magnitude and identify perceived reasons and patient characteristics associated with loss to follow-up in a tertiary care setting. Methods: A two-step cross-sectional study design was used, including a chart review (2011 followed by phone survey (2012. Loss to follow-up was recorded among those who were diagnosed with hepatitis B (HBV or C (HCV during 2009–2010 but never returned for recommended/scheduled follow-up appointment(s. Results: A total of 328 patients (202 HBV and 126 HCV were included in the current analysis. The average age was 49.6 ± 17.9 years, and 57% were males. Out of 328, 131 (40% were not advised to do follow-up, and 98 (30% were not doing follow-up. Perceived reasons for loss to follow-up were as follows: unaware that a follow-up appointment was scheduled (69%, never informed of need for follow-up by healthcare provider (15%, personal belief that follow-up was not necessary (9%, logistical reasons (3% and other reasons (5%. Loss to follow-up was higher among those who had been diagnosed with HBV, referred by non-liver-related specialty, never advised to follow-up, unaware of their diagnosis, incorrectly identified their type of hepatitis, lacking hepatitis complications, having full medical coverage, pregnant, and those with low knowledge or negative attitude towards hepatitis. Conclusions: Loss to follow-up is a significant problem among patients with hepatitis in a tertiary care center, with several patient and system failures being implicated. Keywords: Viral hepatitis, Loss to follow-up, Tertiary care, Management, Saudi Arabia

  11. Experiences of ICU survivors in a low middle income country- a multicenter study.

    Science.gov (United States)

    Pieris, Lalitha; Sigera, Ponsuge Chathurani; De Silva, Ambepitiyawaduge Pubudu; Munasinghe, Sithum; Rashan, Aasiyah; Athapattu, Priyantha Lakmini; Jayasinghe, Kosala Saroj Amarasiri; Samarasinghe, Kerstein; Beane, Abi; Dondorp, Arjen M; Haniffa, Rashan

    2018-03-21

    Stressful patient experiences during the intensive care unit (ICU) stay is associated with reduced satisfaction in High Income Countries (HICs) but has not been explored in Lower and Middle Income Countries (LMICs). This study describes the recalled experiences, stress and satisfaction as perceived by survivors of ICUs in a LMIC. This follow-up study was carried out in 32 state ICUs in Sri Lanka between July and December 2015.ICU survivors' experiences, stress factors encountered and level of satisfaction were collected 30 days after ICU discharge by a telephone questionnaire adapted from Granja and Wright. Of 1665 eligible ICU survivors, 23.3% died after ICU discharge, 49.1% were uncontactable and 438 (26.3%) patients were included in the study. Whilst 78.1% (n = 349) of patients remembered their admission to the hospital, only 42.3% (n = 189) could recall their admission to the ICU. The most frequently reported stressful experiences were: being bedridden (34.2%), pain (34.0%), general discomfort (31.7%), daily needle punctures (32.9%), family worries (33.6%), fear of dying and uncertainty in the future (25.8%). The majority of patients (376, 84.12%) found the atmosphere of the ICU to be friendly and calm. Overall, the patients found the level of health care received in the ICU to be "very satisfactory" (93.8%, n = 411) with none of the survivors stating they were either "dissatisfied" or "very dissatisfied". In common with HIC, survivors were very satisfied with their ICU care. In contrast to HIC settings, specific ICU experiences were frequently not recalled, but those remembered were reported as relatively stress-free. Stressful experiences, in common with HIC, were most frequently related to uncertainty about the future, dependency, family, and economic concerns.

  12. Can follow-up controls improve the confidence of MR of the breast? A retrospective analysis of follow-up MR images of the breast

    International Nuclear Information System (INIS)

    Betsch, A.; Arndt, E.; Stern, W.; Claussen, C.D.; Mueller-Schimpfle, M.; Wallwiener, D.

    2001-01-01

    Purpose: To assess the change in diagnostic confidence between first and follow-up dynamic MR examination of the breast (MRM). Methods: The reports of a total of 175 MRM in 77 patients (mean age 50 years; 36-76) with 98 follow-up MRM were analyzed. All examinations were performed as a dynamic study (Gd-DTPA, 0.16 mmol/kg; 6-7 repetitive studies). The change in diagnostic confidence was retrospectively classified as follows: Controlled lesion vanished during follow-up (category I); diagnostic confidence increases during follow-up (II), more likely benign (IIa), more suspicious (IIb); no difference in diagnostic confidence (III). Long-term follow-up over an average of four years was obtained for 57 patients with category IIa/III findings. Results: In 98 follow-up examinations, only two lesions vanished (2%). In 77/98 cases a category IIa lesion was diagnosed, in 11 cases a category IIb lesion. In 8 cases (8%) there was no change in diagnostic confidence during follow-up. Lesions in category IIb underwent biopsy in 10/11 cases, in one case long-term follow-up proved a completely regredient inflammatory change. In 8/11 suspicious findings (IIb) a malignant tumor was detected. The mean time interval between first and follow-up MRM was 8 months for I-IIb lesions, and 4 months for category III lesions. In the longterm follow-up two patients with a category II a lesion developed a carcinoma in a different breast area after four and five years. Conclusion: MRM follow up increases the diagnostic confidence if the time interval is adequate (>4 months). A persistently or increasingly suspicious finding warrants biopsy. (orig.) [de

  13. The impact of substance use disorders on the course of schizophrenia - a 15 year follow-up study

    DEFF Research Database (Denmark)

    Schmidt, Lasse M.; Hesse, Morten; Lykke, Jørn

    2011-01-01

    also significantly more at risk of dying during follow-up than were patients with schizophrenia only. Conclusions The findings suggest that the long-term course of schizophrenia is considerably more severe in patients who have a dual diagnosis compared to patients with schizophrenia only Substance use......; Substance use disorders; Alcohol; Cannabis; Longitudinal; Course of illness; Health services utilization...

  14. Storytelling in the Early Bereavement Period to Reduce Emotional Distress Among Surrogates Involved in a Decision to Limit Life Support in the ICU: A Pilot Feasibility Trial.

    Science.gov (United States)

    Barnato, Amber E; Schenker, Yael; Tiver, Greer; Dew, Mary Amanda; Arnold, Robert M; Nunez, Eduardo R; Reynolds, Charles F

    2017-01-01

    Surrogate decision makers involved in decisions to limit life support for an incapacitated patient in the ICU have high rates of adverse emotional health outcomes distinct from normal processes of grief and bereavement. Narrative self-disclosure (storytelling) reduces emotional distress after other traumatic experiences. We sought to assess the feasibility, acceptability, and tolerability of storytelling among bereaved surrogates involved in a decision to limit life support in the ICU. Pilot single-blind trial. Five ICUs across three hospitals within a single health system between June 2013 and November 2014. Bereaved surrogates of ICU patients. Storytelling and control conditions involved printed bereavement materials and follow-up assessments. Storytelling involved a single 1- to 2-hour home or telephone visit by a trained interventionist who elicited the surrogate's story. The primary outcomes were feasibility (rates of enrollment, intervention receipt, 3- and 6-mo follow-up), acceptability (closed and open-ended end-of-study feedback at 6 mo), and tolerability (acute mental health services referral). Of 53 eligible surrogates, 32 (60%) consented to treatment allocation. Surrogates' mean age was 55.5 (SD, 11.8), and they were making decisions for their parent (47%), spouse (28%), sibling (13%), child (3%), or other relation (8%). We allocated 14 to control and 18 to storytelling, 17 of 18 (94%) received storytelling, 14 of 14 (100%) and 13 of 14 (94%) control subjects and 16 of 18 (89%) and 17 of 18 (94%) storytelling subjects completed their 3- and 6-month telephone assessments. At 6 months, nine of 13 control participants (69%) and 16 of 17 storytelling subjects (94%) reported feeling "better" or "much better," and none felt "much worse." One control subject (8%) and one storytelling subject (6%) said that the study was burdensome, and one control subject (8%) wished they had not participated. No subjects required acute mental health services referral. A

  15. Schizophrenia and quality of life: a one-year follow-up in four EU countries.

    LENUS (Irish Health Repository)

    2006-01-01

    BACKGROUND: This article systematically monitors the quality of life (QOL) of patients with schizophrenia from seven different sites across four European countries: France, Ireland, Portugal and Spain. METHODS: A one-year prospective cohort study was carried out. 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. Data concerning QOL were recorded in seven sites from four countries: France, Portugal, Ireland and Spain, and were obtained using the Baker and Intagliata scale. At baseline, 339 patients answered the QOL questionnaire. At one-year follow-up, Spain could not participate, so only 263 patients were contacted and 219 agreed to take part. QOL was compared across centres by areas and according to a global index. QOL was correlated with presence of clinical and social problems, needs for care and interventions provided during the one-year follow-up. RESULTS: We did not find any link between gender and QOL. There were some significant differences between centres concerning many items. What is more, these differences were relative: in Lisbon where the lowest level of satisfaction was recorded, people were satisfied with food but highly dissatisfied with finances, whereas in St Etienne, where the highest level of satisfaction was recorded, people were less satisfied with food when they were more satisfied with finances. The evolution in one year among those respondents who took part in the follow-up (excluding the subjects from Granada) showed different patterns depending on the items. CONCLUSION: The four countries have different resources and patients live in rather different conditions. However, the main differences as far as their QOL is concerned very much depend on extra-psychiatric variables, principally marital status and income.

  16. Getting the most from the sleeve: the importance of post-operative follow-up.

    Science.gov (United States)

    Keren, Dean; Matter, Ibrahim; Rainis, Tova; Lavy, Alexandra

    2011-12-01

    Bariatric approach to obesity provides substantial weight loss and comorbidity resolution. Our unique service includes pre- and postoperative visits to the Health and Nutrition Clinic headed by a specialist in gastroenterology and nutrition. We compared patients attending regular clinic routine with those who were lost to follow-up with regard to anthropometry, comorbidity, quality of life, and food tolerance and determined who benefited most from the operation. A retrospective review was performed on patients 30 months after undergoing sleeve gastrectomy. Body mass index was used to report weight loss. Bariatric Analysis and Reporting Outcome System (BAROS) and Food Tolerance Score were (FTS) completed by all patients at the 30-month follow-up visit and compared between two groups (group I-30 months of active postoperative follow-up; group II-without). A total of 119 patients participated in the study. For groups I and II, the mean percentage of excess BMI loss at 30 months was 82.08 ± 9.83 and 74.88 ± 8.75, respectively, with better comorbidity improvement in group I. BAROS scores were 7.62 ± 0.72 and 6.92 ± 0.92. FTS was 24.30 ± 2.09 and 22.55 ± 2.27, respectively. From our experience, getting the most from the sleeve is attributed to two main factors: surgery and nutrition. Surgery results in optimal restriction and improved satiety, whereas nutrition relies on a professional medical team providing constant, ongoing patient support throughout all the bariatric process stages. These teams of surgeons and gastroenterologists specializing in nutrition, working side by side, each in their area of specialty, are the main pillars leading to the success of the sleeve.

  17. Primary care follow-up of radical prostatectomy patients: A regional New Zealand experience

    Directory of Open Access Journals (Sweden)

    Omid Yassaie

    2016-12-01

    Conclusion: Our study identified that follow-up by GPs after RP is insufficient. Accordingly, there is a requirement for formal educational programs if primary care is to take a greater role in follow-up of these patients.

  18. Smartphone Application WeChat for Clinical Follow-up of Discharged Patients with Head and Neck Tumors: A Randomized Controlled Trial.

    Science.gov (United States)

    Lyu, Ke-Xing; Zhao, Jing; Wang, Bin; Xiong, Guan-Xia; Yang, Wei-Qiang; Liu, Qi-Hong; Zhu, Xiao-Lin; Sun, Wei; Jiang, Ai-Yun; Wen, Wei-Ping; Lei, Wen-Bin

    2016-12-05

    Nowadays, social media tools such as short message service, Twitter, video, and web-based systems are more and more used in clinical follow-up, making clinical follow-up much more time- and cost-effective than ever before. However, as the most popular social media in China, little is known about the utility of smartphone WeChat application in follow-up. In this study, we aimed to investigate the feasibility and superiority of WeChat application in clinical follow-up. A total of 108 patients diagnosed with head and neck tumor were randomized to WeChat follow-up (WFU) group or telephone follow-up (TFU) group for 6-month follow-up. The follow-ups were delivered by WeChat or telephone at 2 weeks, 1, 2, 3, and 6 months to the patients after being discharged. The study measurements were time consumption for follow-up delivery, total economic cost, lost-to-follow-up rate, and overall satisfaction for the follow-up method. Time consumption in WFU group for each patient (23.36 ± 6.16 min) was significantly shorter than that in TFU group (42.89 ± 7.15 min) (P smartphone WeChat application was found to be a viable option for follow-up in discharged patients with head and neck tumors. WFU was time-effective, cost-effective, and convenient in communication. This doctor-led follow-up model has the potential to establish a good physician-patient relationship by enhancing dynamic communications and providing individual health instructions. Chinese Clinical Trial Registry, ChiCTR-IOR-15007498; http://www.chictr.org.cn/ showproj.aspx?proj=12613.

  19. Five-year follow-up of an acute psychiatric admission cohort in Auckland, New Zealand.

    Science.gov (United States)

    Wheeler, Amanda; Moyle, Stuart; Jansen, Carol; Robinson, Elizabeth; Vanderpyl, Jane

    2011-06-10

    This paper describes a follow-up of acute psychiatric hospital contact in Auckland, New Zealand for an admission cohort in the 5-years past an index admission (published in the NZMJ in 2005). A 5-year follow-up study of hospital psychiatric service utilisation by 924 patients admitted (index admission) in Auckland during 2000. Hospital admissions within New Zealand for this population were extracted from electronic records. Relevant demographic information (gender, age and ethnicity) and clinical data (primary diagnosis at index admission and admission history) were included for each person. Descriptive analysis of inpatient data and negative binomial regression models were conducted. Of 924 patients, 38.5% had no readmissions anywhere in New Zealand in the 5-years following index discharge. 41.0% were readmitted within 12 months and 61.4% were readmitted within 5 years of index discharge. Only 5.6% experienced an admission every year for the 5-years post index admission. Readmission was least likely for those with index discharge diagnosis of depression. A history of admissions prior to index admission and Maori ethnicity were characteristics associated with higher numbers of readmission. Those who were younger, or a diagnosis of schizophrenia/schizoaffective disorder or previous admissions tended to have longer total length of stay over the 5-years. More than a third of patients had no further hospital contact and the two factors associated with readmission were a history of previous admissions and Maori ethnicity. Reliable community-based data needs to be a priority to enable exploration of community service utilisation and impact of service alternatives to hospital for acute care.

  20. Chronic Heart Failure Follow-up Management Based on Agent Technology.

    Science.gov (United States)

    Mohammadzadeh, Niloofar; Safdari, Reza

    2015-10-01

    Monitoring heart failure patients through continues assessment of sign and symptoms by information technology tools lead to large reduction in re-hospitalization. Agent technology is one of the strongest artificial intelligence areas; therefore, it can be expected to facilitate, accelerate, and improve health services especially in home care and telemedicine. The aim of this article is to provide an agent-based model for chronic heart failure (CHF) follow-up management. This research was performed in 2013-2014 to determine appropriate scenarios and the data required to monitor and follow-up CHF patients, and then an agent-based model was designed. Agents in the proposed model perform the following tasks: medical data access, communication with other agents of the framework and intelligent data analysis, including medical data processing, reasoning, negotiation for decision-making, and learning capabilities. The proposed multi-agent system has ability to learn and thus improve itself. Implementation of this model with more and various interval times at a broader level could achieve better results. The proposed multi-agent system is no substitute for cardiologists, but it could assist them in decision-making.

  1. Social inclusion: An effort to end loss-to-treatment follow-up in tuberculosis.

    Science.gov (United States)

    Balakrishnan, S; Manikantan, J; Sreenivas, A; Jayasankar, S; Sunilkumar, M; Rakesh, P S; Karthickeyan, D S A; Mohandas, C R

    2015-10-01

    Pathanamthitta district is implementing Revised National Tuberculosis Control Program as a pilot district since 1993. The district programme was reporting approximately 5% of their diagnosed smear positive patients as never put on treatment (Initial lost to follow up - ILFU) and 5% of the new smear positive [NSP] Pulmonary TB patients as lost to follow up [LFU] during treatment. Attempts based on reengineering of DOTS were not largely successful in bringing down these proportions. A treatment support group [TSG] is a non-statutory body of socially responsible citizens and volunteers to provide social support to each needy TB patient safeguarding his dignity and confidentiality by ensuring access to information, free and quality services and social welfare programs, empowering the patient for making decision to complete treatment successfully. It is a complete fulfilment of social inclusion standards enumerated by Standards for TB Care in India. Pathanamthitta district started implementing this strategy since 2013. After intervention, proportion of LFU among NSPTB cases dropped markedly and no LFU were reported among the latest treatment cohorts. Proportion of ILFU keeps similar trend and none were reported among the latest diagnostic cohorts. Social support for TB care is feasible under routine program conditions. Addition of standards for social inclusion in STCI is meaningful. Its meaning is translated well by a society empowered with literacy and political sense. Copyright © 2015 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

  2. Use of the Whatsapp application in health follow-up of people with HIV: a thematic analysis

    Directory of Open Access Journals (Sweden)

    Ivana Cristina Vieira de Lima

    2018-04-01

    Full Text Available Abstract Objective: To investigate the statements of people living with HIV during a health follow-up through the WhatsApp® application. Methods: A descriptive study, using a qualitative approach, was conducted with 26 people accompanied by two specialized care services for HIV/AIDS in Fortaleza, Ceará. Data were collected from September 2016 to February 2017, with participants' statements given during the online follow-up and submitted to thematic content analysis. Results: The following categories emerged: difficulties with treatment, antiretroviral dose delayed or missed, side effects, association between antiretroviral drugs and alcohol, use of dietary supplements and medicines, emotional changes, life habits, social rights, physical symptoms, and coping with and committing to with treatment. Conclusion: Follow-up over WhatsApp® improved access to health professionals, by providing an open and immediate communication channel.

  3. Patients highly value routine follow-up of skin cancer and cutaneous melanoma

    DEFF Research Database (Denmark)

    Themstrup, Lotte; Jemec, Gregor E; Lock-Andersen, Jørgen

    2013-01-01

    INTRODUCTION: Skin cancer follow-up is a substantial burden to outpatient clinics. Few studies have investigated patients' views on skin cancer follow-up and cutaneous melanoma. The objective was to investigate patients' perceived benefits and the impact of follow-up. MATERIAL AND METHODS...

  4. The impact of phone calls on follow-up rates in an online depression prevention study

    Directory of Open Access Journals (Sweden)

    R.F. Muñoz

    2017-06-01

    Conclusions: Adding phone call contacts to email reminders and monetary incentives did increase follow-up rates. However, the rate of response to follow-up was low and the number of phone calls required to achieve one completed follow-up raises concerns about the utility of adding phone calls. We also discuss difficulties with using financial incentives and their implications.

  5. Value of routine timed barium esophagram follow-up in achalasia after myotomy.

    Science.gov (United States)

    Kachala, Stefan S; Rice, Thomas W; Baker, Mark E; Rajeswaran, Jeevanantham; Thota, Prashanthi N; Murthy, Sudish C; Blackstone, Eugene H; Zanoni, Andrea; Raja, Siva

    2018-03-08

    The value of routine timed barium esophagram (TBE) in longitudinal follow-up of achalasia after Heller myotomy is unknown. We prospectively prescribed a yearly follow-up TBE. Purposes were to characterize esophageal emptying over time after myotomy, identify preoperative TBE measures associated with follow-up TBE, and characterize follow-up TBE over time in relationship to reintervention. From March 1995 to April 2013, 635 patients underwent Heller myotomy for achalasia; 559 had at least 1 follow-up TBE. Temporal trends of 1335 follow-up TBEs in all nonreintervention and reintervention patients were assessed. Multivariable longitudinal analysis identified preoperative TBE measures associated with follow-up TBE. On average, TBE height and width at 1 and 5 minutes decreased approximately 50% and 60%, respectively, at first postoperative follow-up, and remained stable or slightly decreased for up to 5 years. Wider TBE width at 5 minutes was associated with greater follow-up TBE height and width at 1 minute. Of 118 patients undergoing reintervention, 64 (57%) had only 1 reintervention, with follow-up TBE returning to that of nonreintervention patients. Patients whose follow-up TBE remained abnormal underwent a further reintervention, some normalizing on subsequent TBE, and some not. Follow-up TBE is valuable postmyotomy, particularly if there is substantial esophageal dilatation preoperatively. Follow-up TBE reassures patients with stable or decreasing TBE measures, permitting decreased follow-up intensity. Reintervention should not be considered a myotomy failure, because a successful, single, nonsurgical reintervention often results in long-term successful palliation. More than 1 reintervention requires intensification of TBE follow-up, facilitating treatment planning. Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  6. Loss to Follow-Up Among HIV-Exposed Children in an HIV Clinic in Beira, Mozambique

    Directory of Open Access Journals (Sweden)

    Ana Judith Blanco

    2015-07-01

    Full Text Available Loss to follow-up contributes to the low coverage of HIV care interventions among HIV-exposed infants in Beira, Mozambique. This qualitative study explores the perceptions of HIV-infected women and their health care providers regarding the main obstacles preventing women from attending follow-up visits for HIV care, and factors influencing women’s decisions about newborn care. Fifty-two in-depth interviews and two focus group discussions were conducted; transcripts were coded and analyzed using ATLAS.ti. Interviewees perceived three major barriers to follow-up: food insecurity, difficulties navigating the health system, and women’s familial roles and responsibilities. Our findings unveil the complex context in which HIV-infected women and their children live, and suggest that the structure and function of the HIV care system should be reviewed. Economic empowerment of women is crucial to achieving better compliance with medical care. Integration of mother and child services and more efficient and culturally sensitive medical services may improve follow-up.

  7. Use of Mobile Phone Technology to Improve follow-up at a Community Mental Health Clinic: A Randomized Control Trial.

    Science.gov (United States)

    Singh, Gaurav; Manjunatha, Narayana; Rao, Sabina; Shashidhara, H N; Moirangthem, Sydney; Madegowda, Rajendra K; Binukumar, B; Varghese, Mathew

    2017-01-01

    Mobile phone technology is being used worldwide to improve follow-ups in health care. Aim of the study is to evaluate whether the use of mobile technology will improve or not the follow-up of Indian patients from a community mental health center. Patients or caregivers having mobile phones and consenting for study were enrolled, and sociodemographic and clinical details of patients were taken. Participants were randomized into two groups (short message service [SMS] vs. non-SMS group). At first intervention level, a SMS was sent to SMS group (not in non-SMS group) 1 day before their appointment. At second-level intervention (voice call level), patients from both groups who missed their first appointment were given a voice call requesting them to come for follow-up, and the reasons for first missed appointments (MA) were also elicited. The effect of these two intervention levels (first SMS for SMS group and next voice calls for both groups) on follow-up was evaluated. A total of 214 patients were enrolled in the study. At first SMS intervention level of SMS group ( n = 106), 62.26% of participants reached appointment-on-time (RA), while in the non-SMS/as usual group ( n = 108), 45.37% of patients RA. The difference of these groups is statistically significant. At second-level intervention (voice call), 66 of 88 (another 15 were unable to contact) were came for follow-up consultation within 2 days of MA. Distance and diagnosis of alcohol dependence were significantly associated with MA. Social reasons were most common reasons for first MA. The use of mobile phone technology in an outpatient community psychiatric clinic improved follow-up significantly.

  8. The current status of bereavement follow-up in hospice and palliative care in Japan.

    Science.gov (United States)

    Matsushima, T; Akabayashi, A; Nishitateno, K

    2002-03-01

    In order to explore the implementation of bereavement care in hospice/palliative care settings in Japan, a self-administered questionnaire was sent to all 54 government-approved hospice/palliative care units (PCUs) in May of 1999 (recovery rate 93%). Results showed that bereavement follow-up is performed in 37 institutes (74%) and memorial cards and services are most frequently provided. Memorial cards are provided mainly by nurses, and memorial services involve many health care professionals as well as volunteers. Religious workers tended to be involved in memorial services and social group meetings. Individually oriented interventions such as telephone contacts, personal visits and personal counselling were reportedly used less often. The need for individual-oriented programmes was recognized, and many institutes were considering the expansion of their programmes to include them. However, the difficulties of implementing such care at hospice/PCUs were also raised. Two socio-cultural factors possibly affecting bereavement care in Japan, namely, the roles of family and religious (Buddhist) ceremonies were discussed. It was pointed out that the spirit of bereavement care may be embodied in existing religious ceremonies. We conclude that it is necessary to develop bereavement care programmes based on common, basic hospice care tenets while making full use of existing local resources and taking into account regional values.

  9. Follow-up skeletal surveys for nonaccidental trauma: can a more limited survey be performed?

    Energy Technology Data Exchange (ETDEWEB)

    Harlan, Susan R. [University of Utah School of Medicine, Department of Radiology, Salt Lake City, UT (United States); Nixon, G.W.; Prince, Jeffrey S. [Primary Children' s Medical Center, Department of Medical Imaging, Salt Lake City, UT (United States); Campbell, Kristine A.; Hansen, Karen [University of Utah School of Medicine, Department of Pediatrics, Salt Lake City, UT (United States)

    2009-09-15

    Studies have demonstrated the value of the follow-up skeletal survey in identifying additional fractures, clarifying indeterminate findings, and improving dating of skeletal injuries in victims of physical abuse. To determine whether a more limited follow-up survey could yield the same radiologic data as a full follow-up survey. The study cohort comprised 101 children who had follow-up surveys that met our inclusion criteria. Consensus readings of both original and follow-up surveys were performed by two pediatric radiologists. These results were compared to determine additional findings from the follow-up surveys. Limited skeletal survey protocols were evaluated to determine whether they would detect the same fractures seen with a complete osseous survey. In the 101 children 244 fractures were identified on the initial osseous survey. Follow-up surveys demonstrated new information in 38 children (37.6%). A 15-view limited follow-up survey identified all additional information seen on the complete follow-up survey. Our data demonstrate that a 15-view limited follow-up skeletal survey could be performed without missing clinically significant new fractures and still allow proper identification of confirmed fractures or normal findings. A limited survey would decrease radiation dose in children. (orig.)

  10. Follow-up skeletal surveys for nonaccidental trauma: can a more limited survey be performed?

    International Nuclear Information System (INIS)

    Harlan, Susan R.; Nixon, G.W.; Prince, Jeffrey S.; Campbell, Kristine A.; Hansen, Karen

    2009-01-01

    Studies have demonstrated the value of the follow-up skeletal survey in identifying additional fractures, clarifying indeterminate findings, and improving dating of skeletal injuries in victims of physical abuse. To determine whether a more limited follow-up survey could yield the same radiologic data as a full follow-up survey. The study cohort comprised 101 children who had follow-up surveys that met our inclusion criteria. Consensus readings of both original and follow-up surveys were performed by two pediatric radiologists. These results were compared to determine additional findings from the follow-up surveys. Limited skeletal survey protocols were evaluated to determine whether they would detect the same fractures seen with a complete osseous survey. In the 101 children 244 fractures were identified on the initial osseous survey. Follow-up surveys demonstrated new information in 38 children (37.6%). A 15-view limited follow-up survey identified all additional information seen on the complete follow-up survey. Our data demonstrate that a 15-view limited follow-up skeletal survey could be performed without missing clinically significant new fractures and still allow proper identification of confirmed fractures or normal findings. A limited survey would decrease radiation dose in children. (orig.)

  11. Effects of EAP follow-up on prevention of relapse among substance abuse clients.

    Science.gov (United States)

    Foote, A; Erfurt, J C

    1991-05-01

    Clients entering an employee assistance program (EAP) of a large manufacturing plant in 1985 who were assessed as having an alcohol or drug abuse problem (N = 325) were randomized into an experimental "special follow-up" group and a control "regular care" group. The regular care group received follow-up only as needed (following the usual practice of the EAP), while a follow-up counselor was hired to make routine contacts with the special follow-up group. Study intake continued through 1985, and follow-up continued through the end of 1986. Data collected on study subjects included EAP participation data, absenteeism, number of hospitalizations, health care claims paid and disability claims paid. The major study hypothesis was that EAP clients randomly allocated to special follow-up would show better results than regular care clients (i.e., would have fewer relapses, better job attendance and lower health benefit utilization during the follow-up year). The follow-up intervention was incompletely implemented due to a variety of organizational problems. Differences between the two groups on the six outcome measures were not statistically significant, although clients in the special follow-up group did show better results than clients in the regular care group on the three measures related to substance abuse. Differences on these three measures were marginally significant in regression analyses after controlling for the effects of number of follow-up visits, age, race and chronicity.

  12. The experience of emotional wellbeing for patients with physical injury: A qualitative follow-up study.

    Science.gov (United States)

    Wiseman, Taneal; Foster, Kim; Curtis, Kate

    2016-09-01

    Traumatic physical injury is abrupt, painful, debilitating, costly and life-altering. The experience of emotional wellbeing following traumatic physical injury has not been well investigated, and the role of health services and how services can support the emotional recovery of injured patients has not been well understood. This has impacted on care provision and contributed to a lack of evidence-informed guidance for clinicians to support patients' emotional wellbeing. To explore the patient experience of emotional wellbeing following injury and to understand how injured patients manage their emotional wellbeing. The study comprises the follow-up qualitative phase of a mixed-methods explanatory sequential study. Semi-structured interviews were conducted with a purposive sample of 14 participants admitted to hospital following physical injury. Participants were purposely selected where they had reported high levels of depression, anxiety and stress on the DASS-21 at 3 and 6-months after injury. The qualitative data were analysed using thematic analysis. Three main themes were identified: experiencing the many impacts of injury; facing the emotional journey following injury; and being supported and managing the impacts of injury. Key findings were the extreme negative emotional responses experienced many months after the injury; a strong physical link between the emotional and physical aspects of health; participant reluctance to seek emotional support; a lack of emotional support provision by the health service and a subsequent need for individual and group support in order to develop resilience in the injured person. Finally, male participants who reported extreme emotional responses after injury, including suicidality, were less likely to seek help for their symptoms. Injured patients can experience substantial negative emotional responses following injury. The lack of support provided by health services to injured patients identified highlights the importance of

  13. Survival of sealants in molars affected by molar-incisor hypomineralization: 18-month follow-up

    Directory of Open Access Journals (Sweden)

    Camila Maria Bullio FRAGELLI

    2017-04-01

    Full Text Available Abstract The objective of this study was to evaluate the clinical survival of sealants applied in first permanent molars (FPMs affected by molar-incisor hypomineralization (MIH, at 18 months of follow-up. Forty-one first permanent molars were selected from 21 children, 6–8 years of age. MIH was classified by one calibrated examiner (kappa = 0.80 according to EAPD criteria. The inclusion criteria were fully erupted FPMs with MIH or sound FPMs (without MIH for which sealant treatment was indicated. The FPMs were assigned to two groups: CG (control group and HG (MIH group. Both groups were treated with sealant (FluroShield. Clinical follow-up was performed from baseline to 18 months to assess anatomical form, marginal adaptation, retention and presence of caries, according to criteria set by the United States Public Health Service-Modified, and was conducted by a blinded examiner (kappa = 0.80. The actuarial method was used to evaluate the survival of the sealants. The survival rates for the groups were compared using Fisher’s exact test (α = 5%. The cumulative survival rates were 81% at 1 month, 68.8% at 6 months, 68.8% at 12 months, and 62.6% at 18 months for CG, and 88% at 1 month, 84% at 6 months, 76% at 12 months, and 72% at 18 months for HG. No significant difference was found between the groups. The sealants in molars affected by MIH presented a survival rate similar to the sealants in the control, suggesting that sealants may be an adequate approach for preventing carious lesions in MIH-affected molars.

  14. A Decade of GRB Follow-Up by BOOTES in Spain (2003–2013

    Directory of Open Access Journals (Sweden)

    Martin Jelínek

    2016-01-01

    Full Text Available This article covers ten years of GRB follow-ups by the Spanish BOOTES stations: 71 follow-ups providing 23 detections. Follow-ups by BOOTES-1B from 2005 to 2008 were given in a previous article and are here reviewed and updated, and additional detection data points are included as the former article merely stated their existence. The all-sky cameras CASSANDRA have not yet detected any GRB optical afterglows, but limits are reported where available.

  15. Follow up Evaluation of Air Force Blood Donors Screening Positive for Chagas Disease

    Science.gov (United States)

    2017-10-05

    59 MDW/SGVU SUBJECT: Professional Presentation Approval 31 JULY2017 Your paper, entitled Follow-up Evaluation of Air Force Blood Donors Screening...PUBLISHED OR PRESENTED: Follow-up Evaluation of Air Force Blood Donors Screening Positive for Chagas Disease 7. FUNDING RECEIVED FOR THIS STUDY? 0...PREVIOUS EDITIONS ARE OBSOLETE 50. DATE Page 3 of 3 Pages Follow-up Evaluation of Air Force Blood Donors Screening Positive for Chagas Disease

  16. Predictors of outpatient mental health clinic follow-up after hospitalization among Medicaid-enrolled young adults.

    Science.gov (United States)

    Marino, Leslie; Wissow, Lawrence S; Davis, Maryann; Abrams, Michael T; Dixon, Lisa B; Slade, Eric P

    2016-12-01

    To assess demographic and clinical predictors of outpatient mental health clinic follow-up after inpatient psychiatric hospitalization among Medicaid-enrolled young adults. Using logistic regression and administrative claims data from the Maryland public mental health system and Maryland Medicaid for young adults ages 18-26 who were enrolled in Medicaid (N = 1127), the likelihood of outpatient mental health follow-up within 30 days after inpatient psychiatric hospitalization was estimated . Only 51% of the young adults had any outpatient mental health follow-up visits within 30 days of discharge. Being black and having a co-occurring substance use disorder diagnosis were associated with a lower probability of having a follow-up visit (OR = 0.60, P young adults hospitalized for serious psychiatric conditions, half did not connect with an outpatient mental healthcare provider following their discharge. Outpatient transition supports may be especially needed for young adults who were not receiving outpatient services prior to being admitted for psychiatric inpatient care, as well as for young adults with substance use disorders and African Americans. © 2015 Wiley Publishing Asia Pty Ltd.

  17. 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.

  18. Establishment of an inferior vena cava filter database and interventional radiology led follow-up - retrieval rates and patients lost to follow-up.

    Science.gov (United States)

    Klinken, Sven; Humphries, Charlotte; Ferguson, John

    2017-10-01

    To evaluate the rates of inferior vena cava (IVC) filter retrieval and the number of patient's lost to follow-up, before and after the establishment of an IVC filter database and interventional radiology (inserting physician) led follow-up. On the 1st of June 2012, an electronic interventional radiology database was established at our Institution. In addition, the interventional radiology team took responsibility for follow-up of IVC filters. Data were prospectively collected from the database for all patients who had an IVC filter inserted between the 1st June 2012 and the 31st May 2014. Data on patients who had an IVC filter inserted between the 1st of June 2009 to the 31st of May 2012 were retrospectively reviewed. Patient demographics, insertion indications, filter types, retrieval status, documented retrieval decisions, time in situ, trackable events and complications were obtained in the pre-database (n = 136) and post-database (n = 118) cohorts. Attempted IVC filter retrieval rates were improved from 52.9% to 72.9% (P = 0.001) following the establishment of the database. The number of patients with no documented decision (lost to follow-up) regarding their IVC filter reduced from 31 of 136 (23%) to 0 of 118 patients (P = database group (113 as compared to 137 days, P = 0.129). Following the establishment of an IVC filter database and interventional radiology led follow-up, we demonstrate a significant improvement in the attempted retrieval rates of IVC filters and the number of patient's lost to follow-up. © 2017 The Royal Australian and New Zealand College of Radiologists.

  19. The positive effect of posterolateral lumbar spinal fusion is preserved at long-term follow-up: a RCT with 11-13 year follow-up

    DEFF Research Database (Denmark)

    Andersen, Thomas; Videbaek, Tina S; Hansen, Ebbe S

    2008-01-01

    outcome parameter. RESULTS: Follow-up was 83% of the original study population (107 patients). Average follow-up time was 12 years (range 11-13 years). DPQ-scores were significantly lower than preoperatively in both groups (P ... had retired due to low back pain had poorer outcome than patients retired for other reasons, best outcome was seen in patients still at work (P = 0.01 or less in all questionnaires, except SF-36 MCS P = 0.08). DISCUSSION: Improvement in functional outcome is preserved for 10 or more years after...

  20. Experts Complete IAEA Follow-up Review of Spanish Nuclear Regulatory Authority

    International Nuclear Information System (INIS)

    2011-01-01

    Full text: Nuclear safety experts today concluded an eight-day mission to review Spain's nuclear regulator, the Nuclear Safety Council (CSN). At the request of the Spanish Government, the International Atomic Energy Agency assembled a peer-review team of five high-level regulatory experts from four nations and two IAEA staff members to conduct a follow-up assessment of an Integrated Regulatory Review Service (IRRS) mission conducted in 2008. This follow-up IRRS mission examined CSN's progress in acting upon the recommendations and suggestions made during the 2008 IRRS mission and reviewed the areas of significant regulatory changes since that review. Both reviews covered safety and security regulatory aspects of all facilities and activities in Spain. The first mission reviewed Spain's regulatory framework against IAEA Safety Standards and fostered the exchange of information and experience on safety regulation. The mission also included a peer review of the security activities within the regulatory framework. IRRS team leader Luis Reyes, Senior Executive of the US Nuclear Regulatory Commission, said today, 'In 2008, the mission found particular strengths in CSN's policy, its regulatory framework and its regulatory activities. We made a number of suggestions and recommendations for further improvement of the regulatory framework. CSN should be commended for the significant amount of efforts in addressing all the findings identified in 2008 mission.' The review team found that CSN has made significant progress toward improving its regulatory activities. Most of the findings identified in the 2008 report have been effectively addressed and therefore can be considered closed. Additional findings are being addressed in accordance with a comprehensive and systematic action plan, in particular efforts to revise the CSN Statute. Complementing the CSN strengths identified during the 2008 mission, the 2011 IRRS team noted the following strengths: Improvements in regulatory

  1. Motivators and barriers to uptake of post-operative voluntary medical male circumcision follow-up in Yala division, Siaya County, Kenya.

    Science.gov (United States)

    Abunah, Bonface; Onkoba, Rueben; Nyagero, Josephat; Muhula, Samuel; Omondi, Edward; Guyah, Bernard; Omondi, Gregory Barnabas

    2016-01-01

    Follow-up visits are recommended to all voluntary medical male circumcision clients (VMMC), however, adherence is variable. High lost-to-follow-up cases limit knowledge about clinical status of clients and adverse events. This study sought to establish Motivators and Barriers to the Uptake of VMMC post-operative follow-up services in Siaya County, Kenya. 277 clients from five VMMC sites in Yala were recruited immediately post-operation to participate in a telephone interview between the 21st and 31st day post-surgery during which a semi-structured questionnaire was administered. Descriptive and inferential statistics was used to analyse quantitative information using SPSS while responses from open ended questions were grouped into themes, sieved out, coded and analyzed. 137(49.5%) of the 277 participants utilized the follow-up services. Health education (31.4%) and emergency reviews/adverse events (24.1%) were the main motivation for returning for follow-up while occupational and other engagements (29.7%) and presumption of healing (24.6%) were the main barriers. Type of facility attended (p=0.0173), satisfaction with the discharge process (p=0.0150) and residency in Yala (p<0.001) were statistically significant to the respondents' return for follow-up. 85(62.0%) of the participants returned on the 7th day, 9(6.6%) returned after 7 days, and 43(31.4%) returned before 7 days. VMMC health education should include and emphasize the benefits of follow-up care to the clients and the providers should address the barriers to accessing follow-up services. Our results will inform the programme on areas identified to improve care for VMMC clients and reduce subsequent lost-to-follow-up cases.

  2. Experts Complete IAEA Follow-up Review of Australia's Nuclear Regulatory Authority

    International Nuclear Information System (INIS)

    2011-01-01

    Full text: Nuclear and radiation safety experts today concluded an eight-day mission to review the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA), the country's nuclear regulator. At the request of the Australian Government, the International Atomic Energy Agency (IAEA) assembled a peer-review team of five regulatory experts from as many nations and three IAEA staff members to conduct a follow-up assessment of an Integrated Regulatory Review Service (IRRS) mission conducted in 2007. This follow-up IRRS mission examined ARPANSA's progress in acting upon the recommendations and suggestions made during the 2007 IRRS mission and reviewed the areas of significant regulatory changes since that review. Both reviews covered safety regulatory aspects of all facilities and activities regulated by ARPANSA. IRRS team leader Kaare Ulbak, Chief Advisor of Denmark's National Institute of Radiation Protection, said: ''ARPANSA should be commended for the significant amount of efforts in addressing all the findings identified in the 2007 mission and for inviting this follow-up review.'' The review team found that ARPANSA has made significant progress toward improving its regulatory activities, as most of the findings identified in the 2007 report have been effectively addressed and therefore can be considered closed. Complementing the ARPANSA strengths identified during the 2007 mission, the 2011 IRRS team noted the following strengths: Response to the Tepco Fukushima Dai-ichi accident; High level of in-house technical expertise in radiation safety; Recognition of the need and willingness to re-organize ARPANSA; Timely development of the national sealed source register in good coordination with other relevant organizations; and Creation of the Australian clinical dosimetry service and the national dose reference levels database. The 2011 IRRS team also made recommendations and suggestions to further strengthen ARPANSA's regulatory system, including: Making full

  3. Follow-up care of young childhood cancer survivors: attendance and parental involvement.

    Science.gov (United States)

    Vetsch, Janine; Rueegg, Corina S; Mader, Luzius; Bergstraesser, Eva; Rischewski, Johannes; Kuehni, Claudia E; Michel, Gisela

    2016-07-01

    Despite recommendations, only a proportion of long-term childhood cancer survivors attend follow-up care. We aimed to (1) describe the follow-up attendance of young survivors aged 11-17 years; (2) describe the parental involvement in follow-up, and (3) investigate predictors of follow-up attendance and parental involvement. As part of the Swiss Childhood Cancer Survivor Study, a follow-up questionnaire was sent to parents of childhood cancer survivors aged 11-17 years. We assessed follow-up attendance of the child, parents' involvement in follow-up, illness perception (Brief IPQ), and sociodemographic data. Clinical data was available from the Swiss Childhood Cancer Registry. Of 309 eligible parents, 189 responded (67 %; mean time since diagnosis 11.3 years, range 6.8-17.2) and 75 % (n = 141) reported that their child still attended follow-up. Of these, 83 % (n = 117) reported ≥1 visit per year and 17 % (n = 23) reported parents (92 %) reported being involved in follow-up (n = 130). In multivariable and Cox regression analyses, longer time since diagnosis (p = 0.025) and lower perceived treatment control (assessed by IPQ4: how much parents thought follow-up can help with late effects; p = 0.009) were associated with non-attendance. Parents' overall information needs was significantly associated with parental involvement in the multivariable model (p = 0.041). Educating survivors and their parents on the importance and effectiveness of follow-up care might increase attendance in the longer term.

  4. Profile and pattern of follow-ups of psychiatry outpatients at Christian Medical College, Ludhiana

    Directory of Open Access Journals (Sweden)

    Mamta Singla

    2015-01-01

    Full Text Available Context: As psychiatric illness requires long-term treatment, some patients are lost to follow-up. Aims: The present study aimed to find the follow-up pattern of psychiatric patients attending psychiatry outpatient department (OPD and to determine the correlation of follow-up with socio-demographic profile and diagnosis, if any. Settings and Design: This study was a retrospective data analysis study carried out at the OPD of Psychiatry, Christian Medical College and Hospital, Ludhiana. Subjects and Methods: New cases attending the OPD from April 2010 to March 2011 were included in this study. The data were scrutinized 1 year after the initial assessment. Socio-demographic data, diagnosis and follow-up information were obtained from the files. The collected data were statistically analyzed. Statistical Analysis Used: Chi-square and P value. Results: 53.1% of the patients dropped out after first visit, 29.4% patients had 1-3 follow-up, 14.9% had 4-10 follow-ups and only 2.6% had more than 10 follow-ups. Correlation between follow-up and various socio-demographic variables such as age, gender, place of living or distance from hospital, occupation, religion and marital status was not statistically significant. It was, however, seen that cognitive disorders, conversion disorder, mental retardation, and patients in which diagnosis was deferred, had more dropout rate after first visit. Conclusions: In our study 53.1% of the patients did not attend follow-up at all and only 2.6% had more than 10 follow ups. Correlation between follow-up and various socio-demographic variables was not statistically significant. Patients in which diagnosis was deferred had more drop out rate than patients who had a diagnosis and the difference was statistically significant.

  5. Palliative Care Needs Assessment in the Neuro-ICU: Effect on Family.

    Science.gov (United States)

    Creutzfeldt, Claire J; Hanna, Marina G; Cheever, C Sherry; Lele, Abhijit V; Spiekerman, Charles; Engelberg, Ruth A; Curtis, J Randall

    2017-10-01

    Examine the association of a daily palliative care needs checklist on outcomes for family members of patients discharged from the neurosciences intensive care unit (neuro-ICU). We conducted a prospective, longitudinal cohort study in a single, thirty-bed neuro-ICU in a regional comprehensive stroke and level 1 trauma center. One of two neuro-ICU services that admit patients to the same ICU on alternating days used a palliative care needs checklist during morning work rounds. Between March and October, 2015, surveys were mailed to family members of patients discharged from the neuro-ICU. Nearly half of surveys (n = 91, 48.1%) were returned at a median of 4.7 months. At the time of survey completion, mean Modified rankin scale score (mRS) of neuro-ICU patients was 3.1 (SD 2). Overall ratings of quality of care were relatively high (82.2 on a 0-100 scale) with 32% of family members meeting screening criteria for depressive syndrome. The primary outcome measuring family satisfaction, consisting of eight items from the Family Satisfaction in the ICU questionnaire, did not differ significantly between families of patients from either ICU service nor did family ratings of depression (PHQ-8) and post-traumatic stress (PCL-17). Among families of patients discharged from the neuro-ICU, the daily use of a palliative care needs checklist had no measurable effect on family satisfaction scores or long-term psychological outcomes. Further research is needed to identify optimal interventions to meet the palliative care needs specific to family members of patients treated in the neuro-ICU.

  6. Design and impact of bundled payment for detox and follow-up care.

    Science.gov (United States)

    Quinn, Amity E; Hodgkin, Dominic; Perloff, Jennifer N; Stewart, Maureen T; Brolin, Mary; Lane, Nancy; Horgan, Constance M

    2017-11-01

    Recent payment reforms promote movement from fee-for-service to alternative payment models that shift financial risk from payers to providers, incentivizing providers to manage patients' utilization. Bundled payment, an episode-based fixed payment that includes the prices of a group of services that would typically treat an episode of care, is expanding in the United States. Bundled payment has been recommended as a way to pay for comprehensive SUD treatment and has the potential to improve treatment engagement after detox, which could reduce detox readmissions, improve health outcomes, and reduce medical care costs. However, if moving to bundled payment creates large losses for some providers, it may not be sustainable. The objective of this study was to design the first bundled payment for detox and follow-up care and to estimate its impact on provider revenues. Massachusetts Medicaid beneficiaries' behavioral health, medical, and pharmacy claims from July 2010-April 2013 were used to build and test a detox bundled payment for continuously enrolled adults (N=5521). A risk adjustment model was developed using general linear modeling to predict beneficiaries' episode costs. The projected payments to each provider from the risk adjustment analysis were compared to the observed baseline costs to determine the potential impact of a detox bundled payment reform on organizational revenues. This was modeled in two ways: first assuming no change in behavior and then assuming a supply-side cost sharing behavioral response of a 10% reduction in detox readmissions and an increase of one individual counseling and one group counseling session. The mean total 90-day detox episode cost was $3743. Nearly 70% of the total mean cost consists of the index detox, psychiatric inpatient care, and short-term residential care. Risk mitigation, including risk adjustment, substantially reduced the variation of the mean episode cost. There are opportunities for organizations to gain revenue

  7. Cardiac abnormalities in a follow-up study on carriers of Duchenne and Becker muscular dystrophy

    NARCIS (Netherlands)

    van Westrum, S. M. Schade; Hoogerwaard, E. M.; Dekker, L.; Standaar, T. S.; Bakker, E.; Ippel, P. F.; Oosterwijk, J. C.; Majoor-Krakauer, D. F.; van Essen, A. J.; Leschot, N. J.; Wilde, A. A. M.; de Haan, R. J.; de Visser, M.; van der Kooi, A. J.

    Objectives: Cardiac involvement has been reported in carriers of dystrophin mutations giving rise to Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD). The progress of these abnormalities during long-term follow-up is unknown. We describe the long-term follow-up of dilated

  8. Cardiac abnormalities in a follow-up study on carriers of Duchenne and Becker muscular dystrophy

    NARCIS (Netherlands)

    Schade van Westrum, S. M.; Hoogerwaard, E. M.; Dekker, L.; Standaar, T. S.; Bakker, E.; Ippel, P. F.; Oosterwijk, J. C.; Majoor-Krakauer, D. F.; van Essen, A. J.; Leschot, N. J.; Wilde, A. A. M.; de Haan, R. J.; de Visser, M.; van der Kooi, A. J.

    2011-01-01

    Objectives: Cardiac involvement has been reported in carriers of dystrophin mutations giving rise to Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD). The progress of these abnormalities during long-term follow-up is unknown. We describe the long-term follow-up of dilated

  9. Colorectal cancer incidence in path_MLH1 carriers subjected to different follow-up protocols

    DEFF Research Database (Denmark)

    Seppälä, Toni; Pylvänäinen, Kirsi; Evans, Dafydd Gareth

    2017-01-01

    We have previously reported a high incidence of colorectal cancer (CRC) in carriers of pathogenic MLH1 variants (path_MLH1) despite follow-up with colonoscopy including polypectomy.......We have previously reported a high incidence of colorectal cancer (CRC) in carriers of pathogenic MLH1 variants (path_MLH1) despite follow-up with colonoscopy including polypectomy....

  10. Socializing Intellectual Talk: A Case Study of Instructor Follow-Up Statements in Classroom Discourse

    Science.gov (United States)

    Parsons, Caroline S.

    2017-01-01

    By analyzing the audio recording and transcription of classroom discourse, this case study focused on the ways in which the instructor used follow-up statements to socialize students into intellectual talk. Four relevant categories of follow-up statements emerged: (a) revoicing, (b) contextualization, (c) parallel elaboration, and (d) assistive…

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

    DEFF Research Database (Denmark)

    Mocroft, A; Kirk, O; Aldins, P

    2008-01-01

    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...

  12. Anxiety and depression after prostate cancer diagnosis and treatment: 5-year follow-up

    NARCIS (Netherlands)

    Korfage, I. J.; Essink-Bot, M.-L.; Janssens, A. C. J. W.; Schröder, F. H.; de Koning, H. J.

    2006-01-01

    To document anxiety and depression from pretreatment till 5-year follow-up in 299 men with localized prostate cancer. To assess, if baseline scores were predictive for anxiety and depression at 1-year follow-up. Respondents completed four assessments (pretreatment, at 6 and 12 months, and at 5-year

  13. Breast cancer follow-up: from the perspective of health professionals and patients

    NARCIS (Netherlands)

    Kwast, A.B.G.; Drossaert, Constance H.C.; Siesling, Sabine

    2013-01-01

    Increased breast cancer incidence and better survival have raised the number of patients requiring follow-up care. Despite guidelines, there is controversy about appropriate breast cancer follow-up. Therefore, semi-structured interviews were conducted in two hospitals with 23 patients and 18 health

  14. Patient's needs and preferences in routine follow-up after treatment for breast cancer

    NARCIS (Netherlands)

    de Bock, GH; Bonnema, J; Zwaan, RE; de Velde, CJH; Kievit, J; Stiggelbout, AM

    2004-01-01

    The purpose of the study was to analyse the needs of women who participated in a routine follow-up programme after treatment for primary breast cancer. A cross-sectional survey was conducted using a postal questionnaire among women without any sign of relapse during the routine follow-up period. The

  15. Methodological guide for the follow-up and elaboration of performance assessments of a methanization plant

    International Nuclear Information System (INIS)

    Bastide, Guillaume

    2014-06-01

    This guide aims at giving indications required for a good implementation of an exploitation follow-up of a methanization plant. More precisely, it aims at foreseeing equipment necessary to the follow-up of installation construction, at preparing the operator to the follow-up and command of his installation, at elaborating operation assessments and performance interpretations, at proposing solutions and/or improvements. The described follow-up process can be applied to all the process stages (from receipt to by-product valorization), and addresses technical as well as economic aspects. Thus, four types of assessments are made: technical, energetic, environmental, and social-economic. This guide comprises five parts: a presentation of follow-up objectives (information to be looked for, benefits and drawbacks, follow-up level to be implemented), the follow-up methodology, follow-up assessments (what they are and how to elaborate them), practical sheets (practical presentation of techniques, typical Excel spreadsheets), and a glossary which explains the main technical terms

  16. Towards increasing the utility of follow-up in Canadian EIA

    International Nuclear Information System (INIS)

    Noble, Bram; Storey, Keith

    2005-01-01

    The importance of follow-up in the EIA process is clearly recognized in the Canadian Environmental Assessment Act (Act) in which, where it is considered appropriate, the responsible authority for a project will design a follow-up program and ensure its implementation. The Act is also explicit in recommending that the results of follow-up programs be used to improve the quality of environmental assessments (EAs). The purpose of this paper is to examine whether the specific requirements for follow-up under the Act in fact provide the best opportunity for such quality improvements. The definition of follow-up under the Act requires the verification of the accuracy of the environmental assessment and determination of the effectiveness of measures taken to mitigate the adverse environmental effects of a project. We argue that the Act, generally, and the requirements for follow-up specifically, adopts a negative perspective towards project effects by focusing on the mitigation of adverse effects and discourages the follow-up of important social or economic effects which are independent of project-related changes to the biophysical environment. Secondly, we argue that verification of accuracy places an unwarranted emphasis on 'what was expected' rather than on 'what was wanted' in terms of environmental outcomes. Using examples from Canadian experience, we illustrate the limitations of the current approach to follow-up and suggest that greater utility would be achieved by focusing on whether the environmental objectives of the project in question have been achieved

  17. Follow-up, treatment, and reinfection rates among asymptomatic Chlamydia trachomatis cases in general practice

    NARCIS (Netherlands)

    Van Valkengoed, Irene G.M.; Morré, Servaas A.; Van Den Brule, Adriaan J.C.; Meijer, Chris J.L.M.; Bouter, Lex M.; Van Eijk, Jacques Th M.; Boeke, A. Joan P.

    2002-01-01

    Background: Adequate treatment and follow-up of patients is essential to the success of a screening programme for Chlamydia trachomatis. There has been a lack of data on follow-up, confirmation of infections, and reinfection rates among asymptomatic patients in general practice. Aim: To study the

  18. Follow-up, treatment, and reinfection rates among asymptomatic Chlamydia trachomatis cases in general practice

    NARCIS (Netherlands)

    Van Valkengoed, Irene G.M.; Morré, Servaas A.; Van Den Brule, Adriaan J.C.; Meijer, Chris J.L.M.; Bouter, Lex M.; Van Eijk, Jacques Th M.; Boeke, A. Joan P.

    2002-01-01

    BACKGROUND: Adequate treatment and follow-up of patients is essential to the success of a screening programme for Chlamydia trachomatis. There has been a lack of data on follow-up, confirmation of infections, and reinfection rates among asymptomatic patients in general practice. AIM: 7b study the

  19. Follow-up, treatment, and reinfection rates among asymptomatic chlamydia trachomatis cases in general practice

    NARCIS (Netherlands)

    van Valkengoed, Irene G. M.; Morré, Servaas A.; van den Brule, Adriaan J. C.; Meijer, Chris J. L. M.; Bouter, Lex M.; van Eijk, Jacques Th M.; Boeke, A. Joan P.

    2002-01-01

    BACKGROUND: Adequate treatment and follow-up of patients is essential to the success of a screening programme for Chlamydia trachomatis. There has been a lack of data on follow-up, confirmation of infections, and reinfection rates among asymptomatic patients in general practice. AIM: 7b study the

  20. Initial non-participation and loss to follow-up in a Danish youth cohort

    DEFF Research Database (Denmark)

    Winding, Trine Nøhr; Andersen, Johan H; Labriola, Merete

    2014-01-01

    BACKGROUND: Initial non-participation and loss to follow-up in the Danish youth cohort Vestliv could introduce selection bias of the measured risk estimates. OBJECTIVE: To investigate the impact of initial non-participation and loss to follow-up on the validity of descriptive measures and selected...

  1. Oral squamous cell carcinoma and a clinically negative neck : the value of follow-up

    NARCIS (Netherlands)

    Wensing, Bart M; Merkx, Matthias A W; Krabbe, Paul F M; Marres, Henri A M; Van den Hoogen, Frank J A

    2011-01-01

    BACKGROUND: In squamous cell carcinoma of the oral cavity (SCCOC), regular follow-up comprises 5 years of prescheduled visits, irrespective of tumor stage/classification and/or treatment. We analyzed our standard treatment and follow-up protocol in patients with a preoperative clinically negative

  2. 48 CFR 2427.305-2 - Follow-up by contractor.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Follow-up by contractor....305-2 Follow-up by contractor. (b) Contractor reports. Contractors shall complete and submit to the... Contracting Officer shall send the form to those contractors whose contract work may have required the...

  3. Long-Term Follow-up After Embolization of Pulmonary Arteriovenous Malformations with Detachable Silicone Balloons

    DEFF Research Database (Denmark)

    Andersen, Poul Erik; Kjeldsen, Anette D

    2008-01-01

    ) with pulmonary angiography. Fifty-four percent of the balloons were deflated at latest radiographic chest film follow-up, but at pulmonary angiographic follow-up all embolized malformations were without flow irrespective of whether or not the balloons were visible. Detachable silicone balloons are not available...

  4. Risk of Future Suicide Attempts in Adolescent Psychiatric Inpatients at 18-Month Follow-Up.

    Science.gov (United States)

    Brinkman-Sull, David C.; Overholser, James C.; Silverman, Eden

    2000-01-01

    Investigates potential predictors of suicidal behavior in adolescent psychiatric patients (N=60) during an 18-month follow-up period. Follow-up suicidality was most strongly predicted by high intake levels of hopelessness, and an increase in or persistent problems with depression. Proposes a model in which the impact of family functioning on…

  5. Infantile Amnesia across the Years: A 2-Year Follow-Up of Children's Earliest Memories

    Science.gov (United States)

    Peterson, Carole; Warren, Kelly L.; Short, Megan M.

    2011-01-01

    Although infantile amnesia has been investigated for many years in adults, only recently has it been investigated in children. This study was a 2-year follow-up and extension of an earlier study. Children (4-13 years old) were asked initially and 2 years later for their earliest 3 memories. At follow-up, their age at the time of these memories…

  6. Follow-up of treated coeliac patients: Sugar absorption test and intestinal biopsies compared

    NARCIS (Netherlands)

    Uil, J. J.; van Elburg, R. M.; van Overbeek, F. M.; Meyer, J. W.; Mulder, C. J.; Heymans, H. S.

    1996-01-01

    Objective: To determine whether the sugar absorption test (SAT) during follow-up of patients with coeliac disease on a gluten-free diet (GFD) correlates with improvement of the villous architecture of the small intestine. Methods: The SAT was performed in coeliacs at diagnosis and during follow-up

  7. Nurse-Led Telephone Follow-up: Improving Options for Women With Endometrial Cancer

    NARCIS (Netherlands)

    Smits, A.; Lopes, A.; Das, N.; Bekkers, R.L.M.; Kent, E.; McCullough, Z.; Galaal, K.

    2015-01-01

    BACKGROUND: Nurse-led follow-up (NLFU) has been identified as a suitable means of follow-up care in cancer patients, and its acceptability has already been demonstrated in other areas of cancer care. OBJECTIVES: The objectives of this study were to evaluate the effect of NLFU on quality of life and

  8. Effective follow-up consultations : the importance of patient-centered communication and shared decision making

    NARCIS (Netherlands)

    Brand, Paul L. P.; Stiggelbout, Anne M.

    2013-01-01

    Paediatricians spend a considerable proportion of their time performing follow-up visits for children with chronic conditions, but they rarely receive specific training on how best to perform such consultations. The traditional method of running a follow-up consultation is based on the doctor's

  9. International clinical guideline for the management of classical galactosemia: diagnosis, treatment, and follow-up

    NARCIS (Netherlands)

    Welling, Lindsey; Bernstein, Laurie E.; Berry, Gerard T.; Burlina, Alberto B.; Eyskens, François; Gautschi, Matthias; Grünewald, Stephanie; Gubbels, Cynthia S.; Knerr, Ina; Labrune, Philippe; van der Lee, Johanna H.; MacDonald, Anita; Murphy, Elaine; Portnoi, Pat A.; Õunap, Katrin; Potter, Nancy L.; Rubio-Gozalbo, M. Estela; Spencer, Jessica B.; Timmers, Inge; Treacy, Eileen P.; van Calcar, Sandra C.; Waisbren, Susan E.; Bosch, Annet M.

    2017-01-01

    Classical galactosemia (CG) is an inborn error of galactose metabolism. Evidence-based guidelines for the treatment and follow-up of CG are currently lacking, and treatment and follow-up have been demonstrated to vary worldwide. To provide patients around the world the same state-of-the-art in care,

  10. An ontology-based approach to patient follow-up assessment for continuous and personalized chronic disease management.

    Science.gov (United States)

    Zhang, Yi-Fan; Gou, Ling; Zhou, Tian-Shu; Lin, De-Nan; Zheng, Jing; Li, Ye; Li, Jing-Song

    2017-08-01

    Chronic diseases are complex and persistent clinical conditions that require close collaboration among patients and health care providers in the implementation of long-term and integrated care programs. However, current solutions focus partially on intensive interventions at hospitals rather than on continuous and personalized chronic disease management. This study aims to fill this gap by providing computerized clinical decision support during follow-up assessments of chronically ill patients at home. We proposed an ontology-based framework to integrate patient data, medical domain knowledge, and patient assessment criteria for chronic disease patient follow-up assessments. A clinical decision support system was developed to implement this framework for automatic selection and adaptation of standard assessment protocols to suit patient personal conditions. We evaluated our method in the case study of type 2 diabetic patient follow-up assessments. The proposed framework was instantiated using real data from 115,477 follow-up assessment records of 36,162 type 2 diabetic patients. Standard evaluation criteria were automatically selected and adapted to the particularities of each patient. Assessment results were generated as a general typing of patient overall condition and detailed scoring for each criterion, providing important indicators to the case manager about possible inappropriate judgments, in addition to raising patient awareness of their disease control outcomes. Using historical data as the gold standard, our system achieved a rate of accuracy of 99.93% and completeness of 95.00%. This study contributes to improving the accessibility, efficiency and quality of current patient follow-up services. It also provides a generic approach to knowledge sharing and reuse for patient-centered chronic disease management. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Follow-up care for breast cancer survivors: improving patient outcomes

    Directory of Open Access Journals (Sweden)

    Chopra I

    2014-08-01

    Full Text Available Ishveen Chopra,1 Avijeet Chopra2 1Department of Pharmacy Administration, Duquesne University, Pittsburgh, PA, USA; 2Department of Molecular and Cell Biology, University of Connecticut, Storrs, CT, USA Background: Appropriate follow-up care is important for improving health outcomes in breast cancer survivors (BCSs and requires determination of the optimum intensity of clinical examination and surveillance, assessment of models of follow-up care such as primary care-based follow-up, an understanding of the goals of follow-up care, and unique psychosocial aspects of care for these patients. The objective of this systematic review was to identify studies focusing on follow-up care in BCSs from the patient's and physician's perspective or from patterns of care and to integrate primary empirical evidence on the different aspects of follow-up care from these studies. Methods: A comprehensive literature review and evaluation was conducted for all relevant publications in English from January 1, 1990 to December 31, 2013 using electronic databases. Studies were included in the final review if they focused on BCS’s preferences and perceptions, physician's perceptions, patterns of care, and effectiveness of follow-up care. Results: A total of 47 studies assessing the different aspects of follow-up care were included in the review, with a majority of studies (n=13 evaluating the pattern of follow-up care in BCSs, followed by studies focusing on BCS's perceptions (n=9 and preferences (n=9. Most of the studies reported variations in recommended frequency, duration, and intensity of follow-up care as well as frequency of mammogram screening. In addition, variations were noted in patient preferences for type of health care provider (specialist versus non-specialist. Further, BCSs perceived a lack of psychosocial support and information for management of side effects. Conclusion: The studies reviewed, conducted in a range of settings, reflect variations in

  12. Exploration of Postoperative Follow-up Strategies for Early Staged NSCLC Patients on the Basis of Follow-up Result of 416 Stage I NSCLC Patients after Lobectomy

    Directory of Open Access Journals (Sweden)

    Liang DAI

    2018-03-01

    Full Text Available Background and objective Currently, there is no consensus on the follow-up strategy (follow-up time interval and content of non-small cell lung cancer (NSCLC in the world, and the relevant clinical evidence is also very limited. In this study, we aimed to summarize the recurrence/metastasis sites and timings of stage I NSCLC patients based on their follow-up data, aiming to provide a basis of follow-up time interval and content for this group of patients. Methods We retrospectively analyzed the 416 stage I NSCLC patients that underwent continuous anatomic lobectomy between Jan. 2000 to Oct. 2013 in our prospective lung cancer database. According to the recurrence/metastasis sites and timings, the long term follow-up time interval and content were explored. Results The 5-yr disease free survival (DFS and overall survival (OS in the whole group were 82.4% and 85.4%, respectively. There were 76 cases (18.3% had recurrence/metastasis during follow-up, among which the most frequent site was pulmonary metastasis (21 cases, 5.0%, followed by brain metastasis (20 cases, 4.8%, bone metastasis (12 cases, 2.9%, and mediastinal lymph node metastasis (12 cases, 2.9%. Among the factors that could influence recurrence/metastasis, patients with pT2a suffered from a higher recurrence/metastasis rate compared to patients with pT1 (P=0.006, with 5-yr DFS being 73.8% and 87.3%, respectively (P=0.002, and the 5-yr OS being 77.7% and 90.3%, respectively (P=0.011. Conclusion The commonest recurrence/metastasis sites of stage I NSCLC after anatomic lobectomy are lung, brain and mediastinal lymph nodes, the risk of recurrence/metastasis within 2 years were equal to that between 3 years and 5 years. The follow-up frequencies and content within 2 years could be adjusted according to T stages.

  13. Recurrence after surgery due to cervical cancer - An evaluation of the follow-up program

    DEFF Research Database (Denmark)

    Fuglsang, Katrine; Petersen, Lone Kjeld; Blaakær, Jan

    Objective During the last 20 years the follow-up program after surgical treatment for cervical cancer has remained unchanged. Surprisingly, little is communicated in relation to the follow-up program even though it has a huge impact on the life of the women and their relatives for five years....... The focus for this study is to evaluate the follow-up program in fulfilling the purpose for early diagnosis of recurrence while reminding and concerning women, who we consider healthy after surgery, 10 times during five years. Already politicians are focusing on the subject due to the socioeconomic...... consequences, but there is a need for a foundation prior to an adjustment of the follow-up program. Methods Design: retrospective study of a cohort of women attending follow-up program after surgery due to cervical cancer. Material: From the patient register at the Department of Gynaecology and Obstetrics...

  14. Increasing Follow-up Outcomes of At-Risk Alcohol Patients Using Motivational Interviewing.

    Science.gov (United States)

    Wagner, Andrew J; Garbers, Rachael; Lang, Ann; Borgert, Andrew J; Fisher, Mason

    2016-01-01

    Our trauma division implemented a screening, brief intervention, and referral to treatment (SBIRT) program in 2009 and has maintained more than 92% screening rate for all inpatient admissions since inception. Brief interventions are proven to be more likely to effect and reinforce change if a follow-up contact is made with patients. This led to discussion regarding whether identified patients were more likely to follow up with our SBIRT wellness specialist using motivational interviewing or with our partners, exercise physiology, who use traditional interviewing techniques. We retrospectively reviewed more than 3,000 inpatient admissions in which screening for at-risk alcohol use were positive. Fifty-one percent of identified patients were referred for wellness specialist consultation with a follow-up rate of 52% compared with a follow-up rate of only 21% in the exercise physiology group. Motivational interviewing is more effective in encouraging at-risk alcohol users to participate in follow-up care.

  15. EA follow-up in the Ghanaian mining sector: Challenges and opportunities

    International Nuclear Information System (INIS)

    Appiah-Opoku, Seth; Bryan, Hobson C.

    2013-01-01

    Environmental assessment (EA) follow-up provides a means for monitoring and evaluating the implementation of environmental impact studies. It is integral to the success or failure of a project or program. In spite of its importance, very little attention is given to the need for follow-up programs in most jurisdictions in Africa. Using a case study in the Ghanaian mining sector, this paper explores the challenges and opportunities within the country's EA process for an effective follow-up program. The paper is based on informal interviews, content analysis of relevant publications, official EA documents, and internet searches. The authors suggest a standard EA follow-up program to be formalized as an integral part of Ghana's environmental assessment policy. They also propose a follow-up process that harnesses existing opportunities within the country's EA system. This approach can be replicated in other African countries

  16. [Health management system in outpatient follow-up of kidney transplantation patients].

    Science.gov (United States)

    Zhang, Hong; Xie, Jinliang; Yao, Hui; Liu, Ling; Tan, Jianwen; Geng, Chunmi

    2014-07-01

    To develop a health management system for outpatient follow-up of kidney transplant patients. Access 2010 database software was used to establish the health management system for kidney transplantation patients in Windows XP operating system. Database management and post-operation follow-up of the kidney transplantation patients were realized through 6 function modules including data input, data query, data printing, questionnaire survey, data export, and follow-up management. The system worked stably and reliably, and the data input was easy and fast. The query, the counting and printing were convenient. Health management system for patients after kidney transplantation not only reduces the work pressure of the follow-up staff, but also improves the efficiency of outpatient follow-up.

  17. The Research Agenda in ICU Telemedicine

    Science.gov (United States)

    Hill, Nicholas S.; Lilly, Craig M.; Angus, Derek C.; Jacobi, Judith; Rubenfeld, Gordon D.; Rothschild, Jeffrey M.; Sales, Anne E.; Scales, Damon C.; Mathers, James A. L.

    2011-01-01

    ICU telemedicine uses audiovisual conferencing technology to provide critical care from a remote location. Research is needed to best define the optimal use of ICU telemedicine, but efforts are hindered by methodological challenges and the lack of an organized delivery approach. We convened an interdisciplinary working group to develop a research agenda in ICU telemedicine, addressing both methodological and knowledge gaps in the field. To best inform clinical decision-making and health policy, future research should be organized around a conceptual framework that enables consistent descriptions of both the study setting and the telemedicine intervention. The framework should include standardized methods for assessing the preimplementation ICU environment and describing the telemedicine program. This framework will facilitate comparisons across studies and improve generalizability by permitting context-specific interpretation. Research based on this framework should consider the multidisciplinary nature of ICU care and describe the specific program goals. Key topic areas to be addressed include the effect of ICU telemedicine on the structure, process, and outcome of critical care delivery. Ideally, future research should attempt to address causation instead of simply associations and elucidate the mechanism of action in order to determine exactly how ICU telemedicine achieves its effects. ICU telemedicine has significant potential to improve critical care delivery, but high-quality research is needed to best inform its use. We propose an agenda to advance the science of ICU telemedicine and generate research with the greatest potential to improve patient care. PMID:21729894

  18. Nut consumption and incidence of metabolic syndrome after 6-year follow-up: the SUN (Seguimiento Universidad de Navarra, University of Navarra Follow-up) cohort.

    Science.gov (United States)

    Fernández-Montero, Alejandro; Bes-Rastrollo, Maira; Beunza, Juan J; Barrio-Lopez, Maria Teresa; de la Fuente-Arrillaga, Carmen; Moreno-Galarraga, Laura; Martínez-González, Miguel Angel

    2013-11-01

    To assess the long-term relationship between tree nut consumption and the risk of developing metabolic syndrome (MetS). Nut consumption was collected using a validated 136-item FFQ. The MetS was defined according to the International Diabetes Federation and American Heart Association/National Heart, Lung, and Blood Institute harmonizing definition. The association between nut consumption and MetS was assessed with logistic regression models adjusting for potential confounders. We compared the incidence of MetS between extreme categories of nut intake (> or = 2 servings/week v. never/almost never) after 6 years of follow-up. The SUN Project (Seguimiento Universidad de Navarra, University of Navarra Follow-up) is a prospective cohort study, formed of Spanish university graduates. Information is gathered by mailed questionnaires collected biennially. Nut consumption and MetS information was collected by self-reported data. Participants (n 9887) initially free of MetS or diabetes and followed up for a minimum of 6 years were included. We observed 567 new cases of MetS during follow-up. Participants who consumed nuts > or = 2 servings/week presented a 32% lower risk of developing MetS than those who never/almost never consumed (adjusted OR = 0.68, 95% CI 0.50, 0.92). The inverse association was stronger among participants who were health professionals. Nut consumption was significantly associated with lower risk of developing MetS after a 6-year follow-up period in a cohort of Spanish graduates.

  19. Factors associated with intentions to adhere to colorectal cancer screening follow-up exams

    Directory of Open Access Journals (Sweden)

    Ishibashi Teruo

    2006-11-01

    Full Text Available Abstract Background To increase adherence rate to recommendations for follow-up after abnormal colorectal cancer (CRC screening results, factors that inhibit and facilitate follow-up must be identified. The purpose of this study was to identify the factors associated with intention to adhere to CRC screening follow-up exams. Methods During a 4-week period in October 2003, this survey was conducted with 426 subjects participating in a community-based CRC screening program in Nagano, Japan. Study measures included intention to adhere to recommendation for clinical follow-up in the event of an abnormal fecal occult blood test (FOBT result, perceived susceptibility and severity of CRC, perceived benefits and barriers related to undergoing follow-up examination, social support, knowledge of CRC risk factors, health status, previous CRC screening, personality and social demographic characteristics. Univariate and multivariate logistic regression analyses on intention to adhere to recommendations for follow-up were performed. Results Among the 288 individuals analyzed, approximately 74.7% indicated that they would definitely adhere to recommendations for follow-up. After controlling for age, gender, marital status, education, economic status, trait anxiety, bowel symptoms, family history of CRC, and previous screening FOBT, analyses revealed that lower levels of perceived barriers, higher levers of perceived benefits and knowledge of CRC risk factors were significantly associated with high intention respectively. Conclusion The results of this study suggest that future interventions should focus on reducing modifiable barriers by clarifying misperceptions about follow-up, promoting the acceptance of complete diagnostic evaluations, addressing psychological distress, and making follow-up testing more convenient and accessible. Moreover, educating the public regarding the risk factors of CRC and increasing understanding of the benefits of follow-up is

  20. Utility of MRI in the follow-up of pyogenic spinal infection in children

    International Nuclear Information System (INIS)

    Wang, Qiuyan; Babyn, Paul; Branson, Helen; Davila, Jorge; Mueller, Edrise L.; Tran, Dat

    2010-01-01

    MRI is used at an increasing rate in evaluation of pediatric spinal infections both at the time of diagnosis and in follow-up. However, the impact of MRI in follow-up has been rarely evaluated to date. To evaluate serial follow-up spinal MRI changes compared to clinical outcome and assess their impact on clinical management. All pediatric (<18 years) patients with pyogenic spinal infection over a 9-year period with at least one follow-up after treatment were included. Atypical infections were excluded. We examined 35 whole-spine and 16 localized spinal scans from 17 patients (2 months to 16 years, 9F:8 M) who had 51 follow-ups done 2 weeks to 4.75 years after baseline. Seven children (41%) younger than 3 years underwent 33 follow-ups (65%); most required GA or sedation. Short-term follow-up scans demonstrated epidural and/or paraspinal soft-tissue changes correlating with clinical status and laboratory findings in all cases. However, MRI showed that bone and/or disc abnormalities continued and progressed in some cases despite clinical improvement. Long-term follow-up scans showed bone, disc and soft-tissue changes 1-3 years after baseline, despite children being symptom free. Extension of antibiotics occurred in 47% of children partly based on follow-up MRI. Epidural and paraspinal soft-tissue changes correlated with children's clinical symptoms. Progression of bone and disc changes can manifest despite adequate clinical response. Long-term or serial routine follow-ups were not necessary. Management should be made based on clinical response. (orig.)

  1. Mobile phone text messaging and Telephone follow-up in type 2 diabetic patients for 3 months: a comparative study

    Directory of Open Access Journals (Sweden)

    Zolfaghari Mirta

    2012-08-01

    Full Text Available Abstract Background To investigate and to compare the effectiveness of a nurse short message service (SMS by cellular phone and telephone follow-up by nurse on Glycosylated hemoglobin (HbA1c levels in people with type 2 diabetes. Methods Semi experimental study consisted of 77 patients with type 2 diabetes that randomly assigned to two groups: telephone follow-up (n = 39 and short message service (n = 38. Telephone interventions were applied by researcher for 3 months. SMS group that received message daily for 12 weeks. Data gathering instrument include data sheet to record HbA1c and questionnaire that consisted of demographic characteristics. Data gathering was performed at two points: initial the study and after 12 weeks. Data analyzed using descriptive and inferential statistics methods with SPSS version 11.5. Results Demographic variables were compared and all of them were homogenous. Results of this study showed that both interventions had significant mean changes in HbA1c; for the telephone group (p = 0.001, with a mean change of −0.93% and for the SMS group (p = 0.001, with a mean change of −1.01%. Conclusion Finding of this research showed that intervention using SMS via cellular phone and nurse-led-telephone follow up improved HbA1c for three months in type 2 diabetic patients and it can consider as alternative methods for diabetes control.

  2. Communication skills in ICU and adult hospitalisation unit nursing staff.

    Science.gov (United States)

    Ayuso-Murillo, D; Colomer-Sánchez, A; Herrera-Peco, I

    In this study researchers are trying to analyse the personality factors related to social skills in nurses who work in: Intensive Care Units, ICU, and Hospitalisation units. Both groups are from the Madrid Health Service (SERMAS). The present investigation has been developed as a descriptive transversal study, where personality factors in ICU nurses (n=29) and those from Hospitalisation units (n=40) were compared. The 16PF-5 questionnaire was employed to measure the personality factors associated with communication skills. The comparison of the personality factors associated to social skills, communication, in both groups, show us that nurses from ICU obtain in social receptivity: 5,6 (A+), 5,2 (C-), 6,2 (O+), 5,1 (H-), 5,3 (Q1-), and emotional control: 6,1 (B+), 5,9 (N+). Meanwhile the data doesn't adjust to the expected to emotional and social expressiveness, emotional receptivity and social control, there are not evidence. The personality factors associated to communication skills in ICU nurses are below those of hospitalisation unit nurses. The present results suggest the necessity to develop training actions, focusing on nurses from intensive care units to improve their communication social skills. Copyright © 2016 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Improving the quality of the intensive care follow-up of ventilated patients during a national registration program.

    Science.gov (United States)

    Reper, P; Dicker, D; Damas, P; Huyghens, L; Haelterman, M

    2017-07-01

    The Belgian Public Health Organization is concerned with rates of hospital-acquired infections like ventilator-associated pneumonia (VAP). Implementing best practice guidelines for these nosocomial infections has variable success in the literature. This retrospective study was undertaken to see whether implementation of the evidence-based practices as a bundle was feasible, would influence compliance, and could reduce the rates of VAP. We utilized easily collectable data about regular care to rapidly assess whether interventions already in place were effectively successfully applied. This avoided cumbersome data collection and review. Retrospective compliance rates and VAP ratios were compared using z tests with P-values education campaigns, staff meetings, in-services, physician checklist, nurse checklist, charge nurse checklist implementation, systematic VAP bundle application, and systematic protocols for oral care and sedation protocols. Additionally, VAP ratio could be registered by the participating centers. A total of 10,211 intensive care unit (ICU) patients were included in the study which represents 66,817 ICU days under artificial ventilation with an endotracheal tube. The general compliance for VAP bundle raised from VAP was 61% in February 2012 and 74.16% in December 2012 (P education, and checklist implementation resulted in an increase in compliance for VAP bundle and a decrease in VAP ratio. This study confirms the applicability of best practice guidelines about regular care but results on VAP incidence have to be confirmed. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  4. Psychosocial work characteristics as predictors for burnout: findings from 3-year follow up of the PUMA Study

    DEFF Research Database (Denmark)

    Borritz, Marianne; Bültmann, Ute; Rugulies, Reiner

    2005-01-01

    OBJECTIVE: The objective of this study was to investigate the impact of psychosocial work characteristics on burnout. METHODS: A total of 1772 participants in different human service sector organizations were eligible for the cross-sectional analyses (baseline) and 952 for the prospective analyses....... We measured 14 psychosocial work characteristics and three types of burnout. Linear regression models were used for analyzing associations between psychosocial work characteristics at baseline and burnout at baseline and at 3 years of follow up. RESULTS: Low possibilities for development, high...... meaning of work, low predictability, high quality of leadership, low role clarity, and high role conflicts predicted burnout at 3 years of follow up after the psychosocial work characteristics were adjusted for each other, potential confounders, and burnout level at baseline. CONCLUSION: Psychosocial work...

  5. Personnel monitoring- overexposure investigations and follow-up in non-DAE institutions during 1994-2003

    International Nuclear Information System (INIS)

    Mahajan, J.M.; Massand, O.P.

    2004-04-01

    Personnel Monitoring Section, Bhabha Atomic Research Centre, Mumbai, is entrusted with the responsibility of providing a countrywide personnel monitoring to radiation workers using external radiation like X, beta, gamma and neutron. As per Radiation Protection Rules (RPR) of 1971 promulgated by the competent authority the personnel monitoring service is mandatory for all the workers working with radiation. The radiation exposures received by them should be within the limits prescribed by AERB. For effective control of doses to the radiation workers the reporting, investigation and follow-up of overexposure cases play an important part in the countrywide personnel monitoring programme. Various aspects of overexposure investigations and follow-up as well as the analysis of overexposure doses recorded or received by the radiation workers during 1994 to 2003 are presented in this report. (author)

  6. New methods for estimating follow-up rates in cohort studies

    Directory of Open Access Journals (Sweden)

    Xiaonan Xue

    2017-12-01

    Full Text Available Abstract Background The follow-up rate, a standard index of the completeness of follow-up, is important for assessing the validity of a cohort study. A common method for estimating the follow-up rate, the “Percentage Method”, defined as the fraction of all enrollees who developed the event of interest or had complete follow-up, can severely underestimate the degree of follow-up. Alternatively, the median follow-up time does not indicate the completeness of follow-up, and the reverse Kaplan-Meier based method and Clark’s Completeness Index (CCI also have limitations. Methods We propose a new definition for the follow-up rate, the Person-Time Follow-up Rate (PTFR, which is the observed person-time divided by total person-time assuming no dropouts. The PTFR cannot be calculated directly since the event times for dropouts are not observed. Therefore, two estimation methods are proposed: a formal person-time method (FPT in which the expected total follow-up time is calculated using the event rate estimated from the observed data, and a simplified person-time method (SPT that avoids estimation of the event rate by assigning full follow-up time to all events. Simulations were conducted to measure the accuracy of each method, and each method was applied to a prostate cancer recurrence study dataset. Results Simulation results showed that the FPT has the highest accuracy overall. In most situations, the computationally simpler SPT and CCI methods are only slightly biased. When applied to a retrospective cohort study of cancer recurrence, the FPT, CCI and SPT showed substantially greater 5-year follow-up than the Percentage Method (92%, 92% and 93% vs 68%. Conclusions The Person-time methods correct a systematic error in the standard Percentage Method for calculating follow-up rates. The easy to use SPT and CCI methods can be used in tandem to obtain an accurate and tight interval for PTFR. However, the FPT is recommended when event rates and

  7. Perceptions of ICU Diary Utility and Feasibility in a Combat ICU.

    Science.gov (United States)

    Hester, Marisa; Ingalls, Nichole K; Hatzfeld, Jennifer J

    2016-08-01

    Severely injured patients have difficulty recalling their intensive care unit (ICU) experience which may contribute to emotional trauma. An ICU patient journal contains a short summary of key events during the ICU stay, and has been shown to improve emotional well-being. This project evaluated the feasibility and perceptions of ICU journals in a combat ICU. A one-page survey was distributed to ICU nursing staff at Craig Joint Theater Hospital before and after the use of ICU journals as a process improvement initiative. 16 preimplementation and 10 postimplementation surveys were collected to determine the perception of the utility and feasibility of ICU journals, as well as changes to nursing job satisfaction. Overall, nurses had positive perceptions of ICU journaling; after implementation they felt it could also benefit nurses (31% vs. 80%, p = 0.002). ICU nurses that used journals were also more likely to feel their work makes a difference (90%, p = 0.012) and they could connect with their patient on a personal level (50%, p = 0.037). Primary barriers were time to journal and legal concerns. This study demonstrates with the right guidance, ICU journals can be incorporated into an ICU in a deployed environment and nursing staff feel they benefit the patient, family, unit, and staff. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  8. CMS proposes prioritizing patient preferences, linking patients to follow-up care in discharge planning process.

    Science.gov (United States)

    2016-03-01

    Hospital providers voice concerns about a proposed rule by the Centers for Medicare and Medicaid Services (CMS) that would require providers to devote more resources to discharge planning. The rule would apply to inpatients as well as emergency patients requiring comprehensive discharge plans as opposed to discharge instructions. CMS states that the rule would ensure the prioritization of patient preferences and goals in the discharge planning process, and also would prevent avoidable complications and readmissions. However, hospital and emergency medicine leaders worry that community resources are not yet in place to facilitate the links and follow-up required in the proposed rule, and that the costs associated with implementation would be prohibitive. The proposed rule would apply to acute care hospitals, EDs, long-term care facilities, inpatient rehabilitation centers, and home health agencies. Regardless of the setting, though, CMS is driving home the message that patient preferences should be given more weight during the discharge planning process. Under the rule, hospitals or EDs would need to develop a patient-centered discharge plan within 24 hours of admission or registration, and complete the plan prior to discharge or transfer to another facility. Under the rule, emergency physicians would determine which patients require a comprehensive discharge plan. Both the American Hospital Association and the American College of Emergency Physicians worry that hospitals will have to take on more staff, invest in training, and make changes to their electronic medical record systems to implement the provisions in the proposed rule.

  9. Lost to follow-up for appointments in a dedicated dry eye clinic

    Science.gov (United States)

    Poon, Kip Hoe; Yeo, Sharon; Tong, Louis

    2014-01-01

    Objective Dry eye is a prevalent condition with significant socioeconomic burden. This study evaluates the extent and reasons for loss to follow-up (LTF) in a dedicated dry eye clinic. LTF refers to patient who discontinued visits for >2 years. Method The proportion of patients LTF and the demographics in a cohort of dry eye patients (2006 to 2010) were determined. A telephone survey was prospectively conducted for patients who were LTF. Results Of 505 patients, 240 (47.5%) were LTF. Associated demographic factors for LTF were male sex, non-Chinese ethnicity, and age group dry eye condition (47%), personal/social factors (25%) and perceived insufficiency of healthcare delivery (28%). Only two (1.1%) were considered as management failures. The younger patients (age dry eye disease, compared to older patients who were more likely to be LTF due to personal/social reasons (P=0.02). Poor communication and service factors under healthcare delivery were found to be higher (P=0.002) in those who visited once before they were LTF (8.5%) compared to those who visited multiple times before they were LTF (0.1%). Conclusion LTF was relatively common in hospital-based dry eye management. Female and older patients were less likely to stop consultation. Stabilized dry eye condition, common in younger patients, was the most common reason for LTF. Elderly patients have difficulty attending clinics due to nonmedical problems, which may require a more holistic approach. PMID:25336929

  10. [Four year follow-up of a screening program for prostate cancer in workers].

    Science.gov (United States)

    Reinoso-Barbero, Luis; Díaz-Garrido, Ramón; Piñaga-Solé, Montserrat; Fernández-Fernández, Miguel; Belanger-Quintana, Diego; Gómez-Gallego, Félix

    2013-01-01

    To analyze our four-year follow-up experience (2008-2011) with a prostate cancer screening program offered to employees of a banking company. Data were obtained from the health examinations carried out by the bank's in-house occupational health service (with centers in Barcelona, Madrid and Valencia). PSA (prostate-specific antigen) blood levels were measured and cases with high levels (>4 ng/ml) were followed through diagnosis and treatment, including a telephone survey of confirmed cases. Personal and occupational characteristics of the participants were analyzed as well. 750 workers (99% with administrative and/or commercial jobs) met the inclusion criteria for the screening program. Of these, 110 had elevated PSA levels on at least one occasion. The diagnosis of prostate cancer was confirmed in 21 cases. There were no associations between a diagnosis of cancer and the remaining analyzed variables. Urology and pathology records were retrieved for 76% of the contacted cases. The most frequent histological type was adenocarcinoma (98%), the most common Gleason grade at diagnosis was 6-7% (88%), and the majority of cases were treated surgically (90%).With respect to adverse effects, 48% of cases described erectile dysfunction and 33% reported urinary incontinence. In our program the observed prevalence of prostate cancer was above that expected (respectively, 21 confirmed cases vs. 12 expected). The identified cases unanimously expressed their support for the screening program. Copyright belongs to the Societat Catalana de Seguretat i Medicina del Treball.

  11. A qualitative follow-up study of women's experiences with oocyte donation.

    Science.gov (United States)

    Kalfoglou, A L; Gittelsohn, J

    2000-04-01

    Oocyte donation is growing at an exponential rate. Currently, thousands of women donate each year. The health services that donors receive deserve evaluation. Thirty-three former donors were recruited from IVF clinics, a matching agency, the Internet, advertisements, and word of mouth. In-depth interviews were conducted to learn what motivated the donation, to determine how satisfied donors were with the experience and what issues played a role in donor satisfaction, and to identify recommendations to improve the process. None of the participants regretted their decision to donate, but they were not always completely satisfied with the donation experience. The physical process, compensation, quality of medical care, and level of involvement in the process were the primary factors that affected satisfaction. Matching agencies and IVF clinics may improve donor satisfaction by: minimizing trips to the clinic; using protocols that limit the number of intramuscular injections; reducing the risk of hyperstimulation syndrome; providing follow-up care; reimbursing for expenses such as lost work, travel, and child care; separating direct reimbursements from 'income' to decrease the amount of taxes donors must pay on compensation; treating donors with respect and appreciation; and informing them about the outcome. Improved donor satisfaction is likely to improve donor recruitment and retention.

  12. Early discharge care with ongoing follow-up support may reduce hospital readmissions in COPD.

    LENUS (Irish Health Repository)

    Lawlor, Maria

    2012-02-01

    BACKGROUND: Early discharge care and self-management education, although effective in the management of chronic obstructive pulmonary disease (COPD), do not typically reduce hospital re-admission rates for exacerbations of the disease. We hypothesized that a respiratory outreach programme that comprises early discharge care followed by continued rapid-access out-patient support would reduce the need for hospital readmission in these patients. METHODS: Two hundred and forty-six patients, acutely admitted with exacerbations of COPD, were recruited to the respiratory outreach programme that included early discharge care, follow-up education, telephone support and rapid future access to respiratory out-patient clinics. Sixty of these patients received self-management education also. Emergency department presentations and admission rates were compared at six and 12 months after, compared to prior to, participation in the programme for the same patient cohort. RESULTS: The frequency of both emergency department presentations and hospital admissions was significantly reduced after participation in the programme. CONCLUSIONS: Provision of a respiratory outreach service that includes early discharge care, followed by education, telephone support and ongoing rapid access to out-patient clinics is associated with reduced readmission rates in COPD patients.

  13. [Follow-up of patients with osteoarthritis. Coordinated management and criteria for referral between healthcare levels].

    Science.gov (United States)

    Nieto Pol, Enrique

    2014-01-01

    The correct management of osteoarthritis requires an accurate diagnosis, evaluation of its spread and functional repercussions, and the application of comprehensive and effective individually-tailored treatment aimed at relieving pain and improving physical function with a consequent improvement in quality of life; treatment should also aim to prevent or delay disease progression and its effects. In the National Health Service, primary care is the basic level and the first point of access to healthcare; this level guarantees the continuity of care, coordinates patients, and regulates clinical workflow. Family physicians coordinate the healthcare processes related to chronic diseases and are responsible for the management, diagnosis, evaluation, treatment, and follow-up of patients with osteoarthritis. The clinical practice guidelines internationally accepted as the standard of care for the management of osteoarthritis should be adapted by both Spanish health planning strategies and clinical practice guidelines to the Spanish healthcare setting. The comprehensive assessment of osteoarthritis includes evaluation of its effects on the patient's physical function and quality of life; formulating a treatment plan in collaboration with the patient and adapted to his or her comorbidities; providing advice on basic treatments and their risks and benefits; and carrying out an individually-tailored periodic review. Referral criteria are based on diagnostic confirmation, poor treatment response, and surgical evaluation. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  14. Treatment of active duty military with PTSD in primary care: A follow-up report.

    Science.gov (United States)

    Cigrang, Jeffrey A; Rauch, Sheila A M; Mintz, Jim; Brundige, Antoinette; Avila, Laura L; Bryan, Craig J; Goodie, Jeffrey L; Peterson, Alan L

    2015-12-01

    First-line trauma-focused therapies offered in specialty mental health clinics do not reach many veterans and active duty service members with posttraumatic stress disorder (PTSD). Primary care is an ideal environment to expand access to mental health care. Several promising clinical case series reports of brief PTSD therapies adapted for primary care have shown positive results, but the long-term effectiveness with military members is unknown. The purpose of this study was to determine the long-term outcome of an open trial of a brief cognitive-behavioral primary care-delivered protocol developed specifically for deployment-related PTSD in a sample of 24 active duty military (15 men, 9 women). Measures of PTSD symptom severity showed statistically and clinically significant reductions from baseline to posttreatment that were maintained at the 6-month and 1-year follow-up assessments. Similar reductions were maintained in depressive symptoms and ratings of global mental health functioning. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Screening and Follow-Up Monitoring for Substance Use in Primary Care: An Exploration of Rural-Urban Variations.

    Science.gov (United States)

    Chan, Ya-Fen; Lu, Shou-En; Howe, Bill; Tieben, Hendrik; Hoeft, Theresa; Unützer, Jürgen

    2016-02-01

    Rates of substance use in rural areas are close to those of urban areas. While recent efforts have emphasized integrated care as a promising model for addressing workforce shortages in providing behavioral health services to those living in medically underserved regions, little is known on how substance use problems are addressed in rural primary care settings. To examine rural-urban variations in screening and monitoring primary care- based patients for substance use problems in a state-wide mental health integration program. This was an observational study using patient registry. The study included adult enrollees (n = 15,843) with a mental disorder from 133 participating community health clinics. We measured whether a standardized substance use instrument was used to screen patients at treatment entry and to monitor symptoms at follow-up visits. While on average 73.6 % of patients were screened for substance use, follow-up on substance use problems after initial screening was low (41.4 %); clinics in small/isolated rural settings appeared to be the lowest (13.6 %). Patients who were treated for a mental disorder or substance abuse in the past and who showed greater psychiatric complexities were more likely to receive a screening, whereas patients of small, isolated rural clinics and those traveling longer distances to the care facility were least likely to receive follow-up monitoring for their substance use problems. Despite the prevalent substance misuse among patients with mental disorders, opportunities to screen this high-risk population for substance use and provide a timely follow-up for those identified as at risk remained overlooked in both rural and urban areas. Rural residents continue to bear a disproportionate burden of substance use problems, with rural-urban disparities found to be most salient in providing the continuum of services for patients with substance use problems in primary care.

  16. Epidemiology, Characteristics, and Outcomes of ICU-Managed Homeless Patients: A Population-Based Study

    Directory of Open Access Journals (Sweden)

    Lavi Oud

    2018-01-01

    Full Text Available Background. The population-level demand for critical care services among the homeless (H remains unknown, with only sparse data on the characteristics and outcomes of those managed in the ICU. Methods. The Texas Inpatient Public Use Data File and annual federal reports were used to identify H hospitalizations and annual estimates of the H population between 2007 and 2014. The incidence of ICU admissions in the H population, the characteristics of ICU-managed H, and factors associated with their short-term mortality were examined. Results. Among 52,206 H hospitalizations 15,553 (29.8% were admitted to ICU. The incidence of ICU admission among state H population rose between 2007 and 2014 from 28.0 to 96.6/1,000 (p<0.0001, respectively. Adults aged ≥ 45 years and minorities accounted for 70.2% and 57.6%, respectively, of the growth in volume of ICU admissions. Short-term mortality was 3.2%, with odds of death increased with age, comorbidity burden, and number of failing organs. Conclusions. The demand for critical care services was increasingly high among the H and was contrasted by low short-term mortality among ICU admissions. These findings, coupled with the persistent health disparities among minority H, underscore the need to effectively address homelessness and reduce barriers to longitudinal appropriate prehospital care among the H.

  17. The role of the follow-up chest radiograph in suspected non-accidental injury

    Energy Technology Data Exchange (ETDEWEB)

    Anilkumar, Adikesavalu; Fender, Laura J; Broderick, Nigel J; Somers, John M; Halliday, Katharine E [Nottingham University Hospital NHS Trust, Department of Radiology, Queen' s Medical Centre, Nottingham (United Kingdom)

    2006-03-15

    Rib fractures in children under the age of 2 years have a strong correlation with non-accidental injury (NAI). Follow-up radiographs can improve detection. To evaluate the value of the follow-up chest radiograph in suspected non-accidental injury. The study included all children less than 2 years of age who were investigated for suspected NAI in our institution between January 1998 and October 2003. Prior to January 2000, only selected patients were asked to attend for a follow-up chest radiograph. From January 2000 onwards all children were asked to reattend. Of 200 children included in the study, 59 (29.5%) reattended for a follow-up chest radiograph. The follow-up film provided useful additional information in 7 (12%) of the 59 children. In two children rib fractures were noted only on the follow-up chest radiograph. In a further two patients additional rib fractures were noted. Additional dating information was obtained for two patients. For one child both additional fractures and dating information were noted. The follow-up chest radiograph provides useful information in children with suspected NAI and it is recommended that it should be included routinely in the imaging investigations of these children. (orig.)

  18. The role of the follow-up chest radiograph in suspected non-accidental injury

    International Nuclear Information System (INIS)

    Anilkumar, Adikesavalu; Fender, Laura J.; Broderick, Nigel J.; Somers, John M.; Halliday, Katharine E.

    2006-01-01

    Rib fractures in children under the age of 2 years have a strong correlation with non-accidental injury (NAI). Follow-up radiographs can improve detection. To evaluate the value of the follow-up chest radiograph in suspected non-accidental injury. The study included all children less than 2 years of age who were investigated for suspected NAI in our institution between January 1998 and October 2003. Prior to January 2000, only selected patients were asked to attend for a follow-up chest radiograph. From January 2000 onwards all children were asked to reattend. Of 200 children included in the study, 59 (29.5%) reattended for a follow-up chest radiograph. The follow-up film provided useful additional information in 7 (12%) of the 59 children. In two children rib fractures were noted only on the follow-up chest radiograph. In a further two patients additional rib fractures were noted. Additional dating information was obtained for two patients. For one child both additional fractures and dating information were noted. The follow-up chest radiograph provides useful information in children with suspected NAI and it is recommended that it should be included routinely in the imaging investigations of these children. (orig.)

  19. Passive versus active follow-up to investigate the efficacy of primary prevention programs

    Directory of Open Access Journals (Sweden)

    Högel, Josef

    2005-04-01

    Full Text Available Before general application of a primary prevention program its efficacy has to be demonstrated. For this purpose a randomized controlled trial with active or passive follow-up may be conducted. In the last 5 years, the ratio of controlled trials with passive versus those with active follow-up was 1:13. However, under certain circumstances a passive follow-up may be more appropriate and useful to overcome the drawbacks of an active follow-up, as e.g. high costs and many drop-outs. In a randomized controlled trial, a passive follow-up is based on the reporting of cases by physicians or hospitals instead of actively following up all study participants individually. The statistical evaluation can be carried out using a one-sample chi2-test. Advantages and limitations are discussed. A passive follow-up may be advantageous in situations with low incidence, large number of participants, complete ascertainment of conditions with obligatory notification or effective disease registries and should be preferred in such a context.

  20. Can follow-up examination of tuberculosis patients be simplified? A study in Chhattisgarh, India.

    Directory of Open Access Journals (Sweden)

    Debashish Kundu

    Full Text Available BACKGROUND: Each follow-up during the course of tuberculosis treatment currently requires two sputum examinations. However, the incremental yield of the second sputum sample during follow-up of different types of tuberculosis patients has never been determined precisely. OBJECTIVES: To assess the incremental yield of the second sputum sample in the follow-up of tuberculosis patients under the Revised National Tuberculosis Control Programme (RNTCP in Chhattisgarh, India. METHODOLOGY: A record review of tuberculosis (TB patients registered in 2009 using a structured proforma from two sources, Tuberculosis and Laboratory Register, was undertaken in the six districts of Chhattisgarh, India. RESULTS: In smear positive cases, of 10,048 follow-up examinations, 45 (0.5% were found to be smear positive only on the second sputum when the result of the first sample was negative. In smear negative pulmonary and extra pulmonary TB patients, of 6,206 follow-up smear examinations, 11(0.2% were found to be smear positive. CONCLUSIONS: The incremental yield of a second smear examination was very low, indicating that examination of one sputum sample is enough during follow-up among TB patients. There is insufficient yield to support sputum smear microscopy for monitoring smear negative pulmonary TB and extra pulmonary TB patients. These results indicate that the follow-up smear microscopy can be substantially simplified with favourable resource implications.

  1. Adherence to Follow-Up Recommendations by Triathlon Competitors Receiving Event Medical Care.

    Science.gov (United States)

    Joslin, Jeremy D; Lloyd, Jarem B; Copeli, Nikoli; Cooney, Derek R

    2017-01-01

    Introduction . We sought to investigate triathlete adherence to recommendations for follow-up for participants who received event medical care. Methods . Participants of the 2011 Ironman Syracuse 70.3 (Syracuse, NY) who sought evaluation and care at the designated finish line medical tent were contacted by telephone approximately 3 months after the initial encounter to measure adherence with the recommendation to seek follow-up care after event. Results . Out of 750 race participants, 35 (4.6%) athletes received event medical care. Of these 35, twenty-eight (28/35; 80%) consented to participate in the study and 17 (61%) were available on telephone follow-up. Of these 17 athletes, 11 (11/17; 65%) of participants reported that they had not followed up with a medical professional since the race. Only 5 (5/17; 29%) confirmed that they had seen a medical provider in some fashion since the race; of these, only 2 (2/17; 12%) sought formal medical follow-up resulting from the recommendation whereas the remaining athletes merely saw their medical providers coincidentally or as part of routine care. Conclusion . Only 2 (2/17; 12%) of athletes who received event medical care obtained postrace follow-up within a one-month time period following the race. Event medical care providers must be aware of potential nonadherence to follow-up recommendations.

  2. Adherence to Follow-Up Recommendations by Triathlon Competitors Receiving Event Medical Care

    Directory of Open Access Journals (Sweden)

    Jeremy D. Joslin

    2017-01-01

    Full Text Available Introduction. We sought to investigate triathlete adherence to recommendations for follow-up for participants who received event medical care. Methods. Participants of the 2011 Ironman Syracuse 70.3 (Syracuse, NY who sought evaluation and care at the designated finish line medical tent were contacted by telephone approximately 3 months after the initial encounter to measure adherence with the recommendation to seek follow-up care after event. Results. Out of 750 race participants, 35 (4.6% athletes received event medical care. Of these 35, twenty-eight (28/35; 80% consented to participate in the study and 17 (61% were available on telephone follow-up. Of these 17 athletes, 11 (11/17; 65% of participants reported that they had not followed up with a medical professional since the race. Only 5 (5/17; 29% confirmed that they had seen a medical provider in some fashion since the race; of these, only 2 (2/17; 12% sought formal medical follow-up resulting from the recommendation whereas the remaining athletes merely saw their medical providers coincidentally or as part of routine care. Conclusion. Only 2 (2/17; 12% of athletes who received event medical care obtained postrace follow-up within a one-month time period following the race. Event medical care providers must be aware of potential nonadherence to follow-up recommendations.

  3. Naturalistic Follow-up of Youths Treated for Pediatric Anxiety Disorders

    Science.gov (United States)

    Ginsburg, Golda S.; Becker, Emily M.; Keeton, Courtney P.; Sakolsky, Dara; Piacentini, John; Albano, Anne Marie; Compton, Scott N.; Iyengar, Satish; Sullivan, Kevin; Caporino, Nicole; Peris, Tara; Birmaher, Boris; Rynn, Moira; March, John; Kendall, Philip C.

    2014-01-01

    IMPORTANCE Pediatric anxiety disorders are highly prevalent and impairing and are considered gateway disorders in that they predict adult psychiatric problems. Although they can be effectively treated in the short term, data are limited on the long-term outcomes in treated children and adolescents, particularly those treated with medication. OBJECTIVE To determine whether acute clinical improvement and treatment type (ie, cognitive behavioral therapy, medication, or their combination) predicted remission of anxiety and improvement in global functioning at a mean of 6 years after randomization and to examine predictors of outcomes at follow-up. DESIGN, SETTING, AND PARTICIPANTS This naturalistic follow-up study, as part of the Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS), was conducted at 6 academic sites in the United States and included 288 youths (age range, 11–26 years; mean age, 17 years). Youths were randomized to 1 of 4 interventions (cognitive behavioral therapy, medication, combination, or pill placebo) in the Child/Adolescent Anxiety Multimodal Study (CAMS) and were evaluated a mean of 6 years after randomization. Participants in this study constituted 59.0% of the original CAMS sample. EXPOSURES Participants were assessed by independent evaluators using a semistructured diagnostic interview to determine the presence of anxiety disorders, the severity of anxiety, and global functioning. Participants and their parents completed questionnaires about mental health symptoms, family functioning, life events, and mental health service use. MAIN OUTCOMES AND MEASURES Remission, defined as the absence of all study entry anxiety disorders. RESULTS Almost half of the sample (46.5%) were in remission a mean of 6 years after randomization. Responders to acute treatment were significantly more likely to be in remission (odds ratio, 1.83; 95% CI, 1.08–3.09) and had less severe anxiety symptoms and higher functioning; the assigned treatment

  4. Compliance with follow-up after cataract surgery in rural China.

    Science.gov (United States)

    Huang, Guofu; Crooms, Rita; Chen, Qianyun; Congdon, Nathan; He, Mingguang

    2012-04-01

    To evaluate reasons for non-compliance with post-cataract surgical follow-up in rural China, and assess the impact of incentives on improving compliance. Patients having undergone cataract surgery more than 3 months previously at cataract surgery training hospitals in Guangdong were invited by telephone and advertisements to a hospital-based study examination, with compensation for travel costs (US$7). Information on prior post-surgical follow up was collected by questionnaire at the hospital or by telephone. Logistic regression was used to assess predictors of post-operative attendance with or without compensation. Among 518 eligible patients, 426 (82.2%) underwent interviews and 342 (66.0%) attended the compensated study examination. Ninety nine participants (23.2%) reported previously returning for uncompensated follow-up ≥ 3 months post-operatively, and 225 (52.8%) had returned for any prior post-operative examination. Uncompensated follow-up at ≥ 3 months was associated with higher income (P = 0.037), and recalling instruction by a doctor to follow-up (P = 0.001), while age, gender, travel cost, and post-operative satisfaction and vision were not associated. Younger (P = 0.002) patients and those reporting being instructed to follow up (P = 0.008) were more likely to return for the compensated research examination. Among all interviewed subjects, only 170 (39.9%) reported knowing they were to return to hospital. Modest compensation, advertisements and telephone contact can increase medium-term follow-up rates after cataract surgery by three-fold. Better communication of specific targets for follow-up may improve follow-up compliance.

  5. A Facebook Follow-Up Strategy for Rural Drug-Using Women.

    Science.gov (United States)

    Dickson, Megan F; Staton-Tindall, Michele; Smith, Kirsten E; Leukefeld, Carl; Webster, J Matthew; Oser, Carrie B

    2017-06-01

    Facebook (FB) use has grown exponentially over the past decade, including in rural areas. Despite its popularity, FB has been underutilized as a research follow-up approach to maintain contact with research participants and may have advantages in less densely populated areas and among more hard-to-reach, at-risk groups. The overall goal of this study was to examine FB as a supplemental follow-up approach to other follow-up strategies with rural drug-using women. Face-to-face interviews were conducted with randomly selected women who completed baseline interviews in 3 rural jails in 1 state. Analyses focus on participants who were released from jail and were eligible for 3-month follow-up (n = 284). Bivariate analyses were used to examine differences between FB users and nonusers, and multivariate logistic regression models examined predictors of 3-month follow-up participation and being located for follow-up using FB. About two-thirds (64.4%) of participants were regular FB users. Bivariate analyses indicated that FB users were younger, more educated, and more likely to have used alcohol in the 30 days before incarceration but less likely to have a chronic health problem. Regression analyses indicated that rural FB users had more than 5 times the odds of being located for the 3-month follow-up interview, even after controlling for other variables. There were no significant predictors of being followed up using FB. Findings suggest that FB is widely used and well accepted among rural drug-using women. Among hard-to-reach populations, including those in rural, geographically isolated regions, FB serves as a method to improve participant follow-up. © 2016 National Rural Health Association.

  6. Services

    International Nuclear Information System (INIS)

    Hardeman, F.

    1998-01-01

    The objectives of the services section is (1) to offer complete services in health-physics measurements according to international quality standards, (2) to improve continuously these measurement techniques and to follow up international recommendations and legislation concerning the surveillance of workers, (3) to support and advise nuclear and non-nuclear industry on problems of radioactive contamination. Achievements related to gamma spectrometry, whole-body counting, beta and alpha spectrometry, dosimetry, radon measurements, calibration, instrumentation, and neutron activation analysis are described

  7. Occupational disease disclosed by preventive follow-up of former uranium ore miners

    International Nuclear Information System (INIS)

    Pacina, V.; Vich, Z.; Elterlein, E.

    1982-01-01

    The aim of preventive follow-up examinations of former employees of the concern Czechoslovak Uranium Mines is to determine possible health damage of chronically exposed workers in an area that can become manifest even following a long time after leaving the high-risk working environment. In a group of 1,139 persons that had undergone preventive follow-up examinations in the years 1977 to 1980 there were 63 cases of newly detected affections that were reported as occupational diseases, and other serious affections. The system of preventive follow-up examinations represents a significant contribution to the improvement of health care of the workers. (author)

  8. 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 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....

  9. Long-term follow-up of echolalia and question answering.

    OpenAIRE

    Foxx, R M; Faw, G D

    1990-01-01

    A long-term follow-up of echolalia and correct question answering was conducted for 6 subjects from three previously published studies. The follow-up periods ranged from 26 to 57 months. In a training site follow-up, subjects were exposed to baseline/posttraining conditions in which the original trainer and/or a novel person(s) presented trained and untrained questions. Four subjects displayed echolalia below baseline levels, and another did so in some assessments. Overall, echolalia was lowe...

  10. Long-term adherence to follow-up after treatment of cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Barken, Sidsel S; Lynge, Elsebeth; Andersen, Erik S.

    2013-01-01

    OBJECTIVE: To measure adherence to annual follow-up among women treated for cervical intraepithelial neoplasia. DESIGN: Prospective, population-based, register study. SETTING: Denmark, 1996-2007. POPULATION: All women treated for cervical intraepithelial neoplasia with conization. METHODS: Treated...... was poor in Denmark. Our findings suggest that because of this poor adherence, recommendations for long-term annual follow-up after treatment of cervical intraepithelial neoplasia may not be highly effective. Shorter follow-up schedules using highly sensitive tests appear attractive....

  11. What Happens Next? Follow-Up From the Children's Toddler School Program

    OpenAIRE

    Akshoomoff, Natacha; Stahmer, Aubyn C.; Corsello, Christina; Mahrer, Nicole E.

    2010-01-01

    This study was a follow-up of a group of 29 children diagnosed with autism spectrum disorders at age 2 who attended an inclusive toddler program until age 3. Children ranged in age from 4 to 12 years at the time of the parent survey and follow-up testing. The majority of children were placed in a special education (noninclusive) preschool class, but among the children who were in elementary school at the time of follow-up, 63% were in general education classroom placement. Diagnoses of autism...

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

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Videbaek, Lars

    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...

  13. Interpretable Topic Features for Post-ICU Mortality Prediction.

    Science.gov (United States)

    Luo, Yen-Fu; Rumshisky, Anna

    2016-01-01

    Electronic health records provide valuable resources for understanding the correlation between various diseases and mortality. The analysis of post-discharge mortality is critical for healthcare professionals to follow up potential causes of death after a patient is discharged from the hospital and give prompt treatment. Moreover, it may reduce the cost derived from readmissions and improve the quality of healthcare. Our work focused on post-discharge ICU mortality prediction. In addition to features derived from physiological measurements, we incorporated ICD-9-CM hierarchy into Bayesian topic model learning and extracted topic features from medical notes. We achieved highest AUCs of 0.835 and 0.829 for 30-day and 6-month post-discharge mortality prediction using baseline and topic proportions derived from Labeled-LDA. Moreover, our work emphasized the interpretability of topic features derived from topic model which may facilitates the understanding and investigation of the complexity between mortality and diseases.

  14. Icu Pathogens: A Continuous Challenge

    International Nuclear Information System (INIS)

    Hafeez, A.; Munir, T.; Najeeb, S.; Rehman, S.; Gilani, M.

    2016-01-01

    Objective: To determine the frequency and antibiogram of pathogens in an intensive care unit (ICU). Study Design: Cross-sectional, observational study. Place and Duration of Study: Department of Microbiology, Army Medical College, National University of Science and Technology, Islamabad, from January 2013 to January 2014. Methodology: Clinical samples, received from patients admitted in ICU, were inoculated on various medias like blood agar, chocolate agar, MacConkey agar and urine samples on CLED. These were then incubated at 37 degree C for 24 hours. Isolates were identified by colony morphology, Gram reaction, catalase test, oxidase test. Species identification in case of Gram Negative Rods was done by using API 20E (BioMerieux). Antibiotic susceptibility was done by using modified KirbyBauer disc diffusion technique. Bacterial isolates were prepared and inoculated on Mueller-Hinton agar plates followed by application of various antibiotic disc (Oxoid, UK) as per manufacturer's instructions. The plates were then incubated at 37 degree C aerobically for 18 - 24 hours. Zone diameters were measured and interpreted as sensitive and resistant, according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: Out of the 367 positive cultures, 116 (31.08 percent) were Acinetobacter baumanniisusceptible to minocycline and tigecycline followed by Klebsiella pneumoniae (n=71, 16 percent) susceptible to tigecycline and meropenem. Others were Pseudomonas aeruginosa, Escherichia coli Coagulase Negative Staphylococcus, Staphylococcus aureus, Enterococcus spp., Streptococcus spp., Klebsiella oxytoca, Stenotrophomonas maltophilia, and Candida spp. Conclusion: Acinetobacter baumannii was the most frequently isolated pathogen. Most of the cultures yielding pathogens were from respiratory tract samples. Gram negative isolates were multidrug resistant but most were tigecycline and susceptible to meropenem. (author)

  15. Dormaier and Chester Butte 2007 Follow-up Habitat Evaluation Procedures Report.

    Energy Technology Data Exchange (ETDEWEB)

    Ashley, Paul R.

    2008-01-01

    Follow-up habitat evaluation procedures (HEP) analyses were conducted on the Dormaier and Chester Butte wildlife mitigation sites in April 2007 to determine the number of additional habitat units to credit Bonneville Power Administration (BPA) for providing funds to enhance, and maintain the project sites as partial mitigation for habitat losses associated with construction of Grand Coulee Dam. The Dormaier follow-up HEP survey generated 482.92 habitat units (HU) or 1.51 HUs per acre for an increase of 34.92 HUs over baseline credits. Likewise, 2,949.06 HUs (1.45 HUs/acre) were generated from the Chester Butte follow-up HEP analysis for an increase of 1,511.29 habitat units above baseline survey results. Combined, BPA will be credited with an additional 1,546.21 follow-up habitat units from the Dormaier and Chester Butte parcels.

  16. Strain concentration at structural discontinuities and its quantification by elastic follow-up parameter

    International Nuclear Information System (INIS)

    Kasahara, Naoto; Takasho, Hideki

    1998-12-01

    Elevated temperature structural design codes pay attention to strain concentration at structural discontinuities due to creep and plasticity, since it causes to enlarge creep-fatigue damage of material. One of the difficulties to predict strain concentration is its dependency on loading, constitutive equations, and relaxation time. This study investigated fundamental mechanism of strain concentration and its main factors. It was clarified that strain concentration was caused from strain redistribution between elastic and inelastic regions, which can be quantified by the elastic follow-up parameter. As a function of inelastic strain, the elastic follow-up parameter can describe variation of strain concentration during incremental loading and relaxation process, caused by transition of strain distribution from peak strain concentration to secondary stress redistribution. Structures have their own elastic follow-up characteristics as a function of inelastic strain, which is insensitive to constitutive equations. It means that application of inelastic analysis is not difficult to obtain elastic follow-up characteristics. (author)

  17. Long-term follow-up after bariatric surgery in a national cohort.

    Science.gov (United States)

    Thereaux, J; Lesuffleur, T; Païta, M; Czernichow, S; Basdevant, A; Msika, S; Millat, B; Fagot-Campagna, A

    2017-09-01

    Lifelong medical follow-up is mandatory after bariatric surgery. The aim of this study was to assess the 5-year follow-up after bariatric surgery in a nationwide cohort of patients. All adult obese patients who had undergone primary bariatric surgery in 2009 in France were included. Data were extracted from the French national health insurance database. Medical follow-up (medical visits, micronutrient supplementation and blood tests) during the first 5 years after bariatric surgery was assessed, and compared with national and international guidelines. Some 16 620 patients were included in the study. The percentage of patients with at least one reimbursement for micronutrient supplements decreased between the first and fifth years for iron (from 27.7 to 24.5 per cent; P bariatric surgery is poor, especially for young men with poor early follow-up. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  18. A Long-Term Follow-Up of Treatment for Severe Self-Injury.

    Science.gov (United States)

    Williams, Don E.; And Others

    1994-01-01

    Treatment of a woman with severe mental retardation with the Self-Injurious Behavior Inhibiting System (SIBIS) resulted in significant reductions in SIB behavior which generalized to the natural environment and the brief follow-up sessions. (Author/DB)

  19. Postoperative follow-up studies in congenital dilatation of the common bile duct using hepatobiliary scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Hirobe, Seiichi; Ishida, Haruo; Hayashi, Akira; Kamagata, Shoichiro; Fuchimoto, Yasufumi; Mizuno, Dai; Yano, Tsunehiro [Tokyo Metropolitan Kiyose Children`s Hospital (Japan); Ishii, Katsumi

    1995-03-01

    Follow-up studies in congenital dilatation of the common bile duct were done in 20 cases ranging 3 to 20 years after operation. Operative cholangiography had shown dilatation of the intrahepatic bile ducts in 15 patients (75%), of these, 7 patients had cystic dilatation. Five cases of these 7 patients showed prolonged stasis of the nuclide in the cystic dilated intrahepatic bile ducts by {sup 99m}Tc-PMT hepatobiliary scintigraphy in the follow-up studies even at 10 years after operation. But none of 20 cases had complication such as intrahepatic lithiasis, cholangitis, and liver dysfunction. Hepatobiliary scintigraphy could provide moderate anatomic and excellent functional information which were useful for these follow-up studies and careful follow-up should be done in the case of cystic dilatation of the intrahepatic bile ducts. (author).

  20. Health status and follow-up of the liquidators in Belarus

    International Nuclear Information System (INIS)

    Okeanov, A.E.; Antipova, S.I.; Polyakov, S.M.; Sobolev, A.V.; Bazulko, N.V.; Cardis, E.

    1996-01-01

    This paper presents information on the organization of the follow-up of Chernobyl liquidators in Belarus. The characteristics of the liquidators cohort and results of preliminary analyses of their health status, including cancer incidence and general morbidity, are presented

  1. Posttreatment follow-up of radiation oncology patients in a managed care environment

    International Nuclear Information System (INIS)

    Steinberg, Michael L.; Rose, Christopher M.

    1996-01-01

    Purpose: Health care delivery in the United States is in the midst of a structural revolution called managed care. Demands for cost control within the managed care environment force radiation oncologists to defend the need and obligation to follow their patients. Methods and Materials: We have analyzed this follow-up requirement from six potential justifications: patient care, medical-legal, quality assurance, outcome measurement, cost, and improvement of care. Results: Practical recommendations for discussing the need for follow-up with the medical directors and primary care physicians of managed care entities are given. Follow-up without valid documentation of benefit is hard to justify in this era of managed care. Conclusions: Collaborative follow-up between the referring physician, the treating radiation oncologist, and the other oncologic specialists will allow for outcome measurement and improvement in practice without driving up cost or exposing the patient to undue risk.

  2. Osteogenesis imperfecta in childhood: impairment and disability--a follow-up study

    NARCIS (Netherlands)

    Engelbert, R. H.; Beemer, F. A.; van der Graaf, Y.; Helders, P. J.

    1999-01-01

    To evaluate differences over time (mean follow-up, 14 months) on impairment parameters (range of joint motion and muscle strength), functional limitation parameters (functional ability), and disability parameters (caregiver assistance in achieving functional skills) in osteogenesis imperfecta (OI),

  3. Chondrodysplasia punctata after warfarin. Case report with 18-month follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Tamburrini, O.; Bartolomeo-De Iuri, A.; Di Guglielmo, G.L.

    1987-05-01

    Administration of warfarin during pregnancy may cause a rare syndrome characterized by nasal hypoplasia, usually associated with stippled epiphyseal and extraepiphyseal calcifications ressembling chondrodysplasia punctata. A case of chondrodysplasia punctata after warfarin with 18 months follow-up is reported.

  4. Nurse-led telephone follow-up after total knee arthroplasty

    DEFF Research Database (Denmark)

    Szöts, Kirsten; Konradsen, Hanne; Solgaard, Søren

    2015-01-01

    AIM AND OBJECTIVES: To generate information on how telephone follow-up consultations, structured by nursing status according to the VIPS-model, functioned after total knee arthroplasty. The objectives were to unfold the content of the telephone follow-ups according to the structure for nursing...... status and to explore the patients' views of the telephone follow-ups. BACKGROUND: The length of stay in hospital following total knee arthroplasty has fallen markedly, and patients now have to be responsible for their recovery from a very early stage. After discharge, patients may experience a variety...... Telephone follow-up was valued by total knee arthroplasties patients as representing a holistic approach and providing adequate information, counselling and support after discharge to home. Three categories were identified with regard to the patients' views: 'A means for reflection and provision of adequate...

  5. 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

    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....... 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...... of 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...

  6. Early Primary Care Provider Follow-up and Readmission After High-Risk Surgery

    Science.gov (United States)

    Brooke, Benjamin S.; Stone, David H.; Cronenwett, Jack L.; Nolan, Brian; DeMartino, Randall R.; MacKenzie, Todd A.; Goodman, David C.; Goodney, Philip P.

    2014-01-01

    IMPORTANCE Follow-up with a primary care provider (PCP) in addition to the surgical team is routinely recommended to patients discharged after major surgery despite no clear evidence that it improves outcomes. OBJECTIVE To test whether PCP follow-up is associated with lower 30-day readmission rates after open thoracic aortic aneurysm (TAA) repair and ventral hernia repair (VHR), surgical procedures known to have a high and low risk of readmission, respectively. DESIGN, SETTING, AND PARTICIPANTS In a cohort of Medicare beneficiaries discharged to home after open TAA repair (n = 12 679) and VHR (n = 52 807) between 2003 to 2010, we compared 30-day readmission rates between patients seen and not seen by a PCP within 30 days of discharge and across tertiles of regional primary care use. We stratified our analysis by the presence of complications during the surgical (index) admission. MAIN OUTCOMES AND MEASURES Thirty-day readmission rate. RESULTS Overall, 2619 patients (20.6%) undergoing open TAA repair and 4927 patients (9.3%) undergoing VHR were readmitted within 30 days after surgery. Complications occurred in 4649 patients (36.6%) undergoing open TAA repair and 4528 patients (8.6%) undergoing VHR during their surgical admission. Early follow-up with a PCP significantly reduced the risk of readmission among open TAA patients who experienced perioperative complications, from 35.0% (without follow-up) to 20.4% (with follow-up) (P < .001). However, PCP follow-up made no significant difference in patients whose hospital course was uncomplicated (19.4% with follow-up vs 21.9% without follow-up; P = .31). In comparison, early follow-up with a PCP after VHR did not reduce the risk of readmission, regardless of complications. In adjusted regional analyses, undergoing open TAA repair in regions with high compared with low primary care use was associated with an 18% lower likelihood of 30-day readmission (odds ratio, 0.82; 95% CI, 0.71–0.96; P = .02), whereas no significant

  7. Electronic Detection of Delayed Test Result Follow-Up in Patients with Hypothyroidism.

    Science.gov (United States)

    Meyer, Ashley N D; Murphy, Daniel R; Al-Mutairi, Aymer; Sittig, Dean F; Wei, Li; Russo, Elise; Singh, Hardeep

    2017-07-01

    Delays in following up abnormal test results are a common problem in outpatient settings. Surveillance systems that use trigger tools to identify delayed follow-up can help reduce missed opportunities in care. To develop and test an electronic health record (EHR)-based trigger algorithm to identify instances of delayed follow-up of abnormal thyroid-stimulating hormone (TSH) results in patients being treated for hypothyroidism. We developed an algorithm using structured EHR data to identify patients with hypothyroidism who had delayed follow-up (>60 days) after an abnormal TSH. We then retrospectively applied the algorithm to a large EHR data warehouse within the Department of Veterans Affairs (VA), on patient records from two large VA networks for the period from January 1, 2011, to December 31, 2011. Identified records were reviewed to confirm the presence of delays in follow-up. During the study period, 645,555 patients were seen in the outpatient setting within the two networks. Of 293,554 patients with at least one TSH test result, the trigger identified 1250 patients on treatment for hypothyroidism with elevated TSH. Of these patients, 271 were flagged as potentially having delayed follow-up of their test result. Chart reviews confirmed delays in 163 of the 271 flagged patients (PPV = 60.1%). An automated trigger algorithm applied to records in a large EHR data warehouse identified patients with hypothyroidism with potential delays in thyroid function test results follow-up. Future prospective application of the TSH trigger algorithm can be used by clinical teams as a surveillance and quality improvement technique to monitor and improve follow-up.

  8. Costs and role of ultrasound follow-up of polytrauma patients after initial computed tomography

    International Nuclear Information System (INIS)

    Maurer, M.H.; Winkler, A.; Powerski, M.J.; Elgeti, F.; Huppertz, A.; Roettgen, R.; Marnitz, T.; Wichlas, F.

    2012-01-01

    Purpose: To assess the costs and diagnostic gain of abdominal ultrasound follow-up of polytrauma patients initially examined by whole-body computed tomography (CT). Materials and Methods: A total of 176 patients with suspected multiple trauma (126 men, 50 women; age 43.5 ± 17.4 years) were retrospectively analyzed with regard to supplementary and new findings obtained by ultrasound follow-up compared with the results of exploratory FAST (focused assessment with sonography for trauma) at admission and the findings of whole-body CT. A process model was used to document the staff, materials, and total costs of the ultrasound follow-up examinations. Results: FAST yielded 26 abdominal findings (organ injury and/or free intra-abdominal fluid) in 19 patients, while the abdominal scan of whole-body CT revealed 32 findings in 25 patients. FAST had 81 % sensitivity and 100 % specificity. Follow-up ultrasound examinations revealed new findings in 2 of the 25 patients with abdominal injuries detected with initial CT. In the 151 patients without abdominal injuries in the initial CT scan, ultrasound follow-up did not yield any supplementary or new findings. The total costs of an ultrasound follow-up examination were EUR 28.93. The total costs of all follow-up ultrasound examinations performed in the study population were EUR 5658.23. Conclusion: Follow-up abdominal ultrasound yields only a low overall diagnostic gain in polytrauma patients in whom initial CT fails to detect any abdominal injuries but incurs high personnel expenses for radiological departments. (orig.)

  9. Occurrence of gastric cancer and carcinoids in atrophic gastritis during prospective long-term follow up.

    Science.gov (United States)

    Lahner, Edith; Esposito, Gianluca; Pilozzi, Emanuela; Purchiaroni, Flaminia; Corleto, Vito D; Di Giulio, Emilio; Annibale, Bruno

    2015-07-01

    Atrophic gastritis (AG) is a risk condition for gastric cancer and type I gastric carcinoids. Recent studies assessing the overall risk of gastric cancer and carcinoids in AG at long-term follow up are lacking. This study aimed to investigate in a prospective cohort of AG patients the occurrence of gastric cancer and carcinoids at long-term follow up. A total of 200 AG patients from a prospective cohort (67% female, median age 55 years) with a follow up of 7.5 (range: 4-23.4) years were included. Inclusion criteria were presence of AG and at least one follow-up gastroscopy with biopsies at ≥4 years after AG diagnosis. Follow-up gastroscopies at 4-year intervals were performed. Overall, 22 gastric neoplastic lesions were detected (crude incidence 11%). Gastric cancer was diagnosed in four patients at a median follow up of 7.2 years (crude incidence 2%). Eleven type I gastric carcinoids were detected at a median follow up of 5.1 years (crude incidence of 5.5%). In seven patients, six low-grade and one high-grade dysplasia were found. The annual incidence rate person-year were 0.25% (95% confidence interval [CI]: 0.067-0.63%), 0.43% (95% CI: 0.17-0.89%), and 0.68% (95% CI: 0.34-1.21%) for gastric cancer, dysplasia, and type I-gastric carcinoids, respectively. The incidence rates of gastric cancer and carcinoids were not different (p = 0.07). This study shows an annual incidence rate of 1.36% person-year for gastric neoplastic lesions in AG patients at long-term follow up. AG patients are similarly exposed to gastric cancer and type I gastric carcinoids.

  10. Follow-up Evaluation of Air Force Blood Donors Screening Positive for Chagas Disease

    Science.gov (United States)

    2017-08-27

    Blood Donors Screening Positive for Cbagas Disease presented at/published to Military Health System Research Symposium (Florida, 27-30 Aug 2017) in...disease upon blood donation at JBSA -Lackland 6. TITLE OF MATERIAL TO BE PUBLISHED OR PRESENTED: Follow-up evaluation of Air Force blood donors ...Designated Exempt Reviewer Follow-up evaluation of Air Force blood donors screening positive for Chagas disease Joseph Marcus1, Bryant Webber2, Leo Cropper2

  11. The value of gynecologic cancer follow-up: evidence-based ignorance?

    Science.gov (United States)

    Lajer, Henrik; Jensen, Mette B; Kilsmark, Jannie; Albæk, Jens; Svane, Danny; Mirza, Mansoor R; Geertsen, Poul F; Reerman, Diana; Hansen, Kåre; Milter, Maya C; Mogensen, Ole

    2010-11-01

    To explore the extent of evidence-based data and cost-utility of follow-up after primary treatment of endometrial and ovarian cancer, addressing perspectives of technology, organization, economics, and patients. Systematic literature searches according to the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions were conducted separately for each of the 4 perspectives. In addition, the organizational analysis included a nationwide questionnaire survey among all relevant hospital departments, and the operating costs were calculated. None of the identified studies supported a survival benefit from hospital-based follow-up after completion of primary treatment of endometrial or ovarian cancer. The methods for follow-up were of low technology (gynecologic examination with or without ultrasound examination). Other technologies had poor sensitivity and specificity in detecting recurrence. Small changes in applied technologies and organization lead to substantial changes in costs. Substantial differences especially in frequency and applied methods were found between departments. The literature review did not find evidence that follow-up affects the women's quality of life. The main purpose of follow-up after treatment of cancer is improved survival. Our review of the literature showed no evidence of a positive effect on survival in women followed up after primary treatment of endometrial or ovarian cancer. The conception of follow-up among physicians, patients, and their relatives therefore needs revision. Follow-up after treatment should have a clearly defined and evidence-based purpose. Based on the existing literature, this purpose should presently focus on other end points rather than early detection of relapse and improved survival. These end points could be quality of life, treatment toxicity, and economy.

  12. Factors Associated with Remission of Eczema in Children: a Population-based Follow-up Study.

    OpenAIRE

    von Kobyletzki, Laura; Bornehag, Carl-Gustaf; Breeze, Elizabeth; Larsson, Malin; Boman Lindström, Cecilia; Svensson, Åke

    2014-01-01

    The aim of this study was to analyse factors associated with remission of atopic dermatitis (AD) in childhood. A population-based AD cohort of 894 children aged 1-3 years from a cross-sectional baseline study in 2000 was followed up in 2005. The association between remission, background, health, lifestyle, and environmental variables was estimated with crude and multivariable logistic regression. At follow-up, 52% of the children had remission. Independent factors at baseline predicting remis...

  13. The value of gynecologic cancer follow-up: evidence-based ignorance?

    DEFF Research Database (Denmark)

    Lajer, Henrik; Jensen, Mette B; Kilsmark, Jannie

    2010-01-01

    To explore the extent of evidence-based data and cost-utility of follow-up after primary treatment of endometrial and ovarian cancer, addressing perspectives of technology, organization, economics, and patients.......To explore the extent of evidence-based data and cost-utility of follow-up after primary treatment of endometrial and ovarian cancer, addressing perspectives of technology, organization, economics, and patients....

  14. Annual Trends in Follow-Up Visits for Pediatric Concussion in Emergency Departments and Physicians' Offices.

    Science.gov (United States)

    Fridman, Liraz; Scolnik, Michal; Macpherson, Alison; Rothman, Linda; Guttmann, Astrid; Grool, Anne M; Rodriguez Duque, Daniel; Zemek, Roger L

    2018-01-01

    To assess whether children and youth with concussion receive follow-up visits in accordance with the recommended guidelines. We conducted a retrospective, population-based study using linked health administrative data from all concussion-related visits to emergency department and physician offices by children aged 5 through 18 years (range, 5.00-18.99) in Ontario between 2003 and 2013. We analyzed the percentage of children and youth seen for follow-up. The Mann-Kendall test for trends was used to assess a monotonic increasing trend over time in concussion follow-up visits. A total of 126 654 children and youth were evaluated for an index concussion visit. The number of children and youth assessed for concussion follow-up (N = 45 155) has increased significantly over time (P < .001). In 2003, 781 of 7126 patients (11.0%; 95% CI, 10.3-11.7) with an index visit for concussion had a follow-up assessment. By 2013, 6526 of 21 681 (30.1%; 95% CI, 29.5-30.7) patients received follow-up care. The proportion of children and youth receiving follow-up after an acute concussion has significantly increased between 2003 and 2013. Nevertheless, more than two-thirds of all patients do not seek medical follow-up or clearance as recommended by current concussion guidelines, suggesting that ongoing efforts to improve and monitor compliance with recommended guidelines by patients and physicians are important. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. An audit of follow-up chest radiography after coronary artery bypass graft

    Energy Technology Data Exchange (ETDEWEB)

    Karthik, S. [Department of Cardiothoracic Surgery, Yorkshire Heart Centre, Leeds General Infirmary, Leeds (United Kingdom); O' Regan, D.J. [Department of Cardiothoracic Surgery, Yorkshire Heart Centre, Leeds General Infirmary, Leeds (United Kingdom)]. E-mail: regan@leedsth.nhs.uk

    2006-07-15

    AIM: To investigate the clinical value and audit chest radiography, which is currently undertaken as part of routine practice, in the follow-up of coronary artery bypass graft (CABG) patients. MATERIAL AND METHODS: Six hundred and sixty-six first time CABG patients were identified from the Patient Analysis and Tracking System database representing the work of a single surgeon between February 2001 and September 2005. The data regarding the clinical and radiological findings on follow-up were collected from the follow-up clinic letters and case notes. Any need for re-admission/intervention was also noted. RESULTS: Of the 666 patients, 11 died and a further 10 either refused or failed to arrive for follow-up. Chest radiography was undertaken in 645 patients. Only 13 patients (2%) were found to have an abnormality on chest radiography. In all cases this was a pleural effusion that was confirmed on clinical examination in seven patients (53.9%) patients. Only one patient needed re-admission and intervention. In this case the effusion had been noted on clinical examination. Seven patients were discharged and the remaining five were followed up with repeat chest radiography before discharge. Seventy-four patients had a respiratory complication postoperatively, but only three had any evidence of an effusion on follow-up. CONCLUSION: The diagnostic yield of a routine chest radiography in a CABG follow-up clinic is low (2%) and the need for intervention is rare and is determined by clinical examination. The practice of routine radiography in this group of patients has now stopped and follow-up audit will be conducted in 12 months.

  16. Adherence to Follow-Up Recommendations by Triathlon Competitors Receiving Event Medical Care

    OpenAIRE

    Joslin, Jeremy D.; Lloyd, Jarem B.; Copeli, Nikoli; Cooney, Derek R.

    2017-01-01

    Introduction. We sought to investigate triathlete adherence to recommendations for follow-up for participants who received event medical care. Methods. Participants of the 2011 Ironman Syracuse 70.3 (Syracuse, NY) who sought evaluation and care at the designated finish line medical tent were contacted by telephone approximately 3 months after the initial encounter to measure adherence with the recommendation to seek follow-up care after event. Results. Out of 750 race participants, 35 (4.6%) ...

  17. The family economic status and outcome of people with schizophrenia in Xinjin, Chengdu, China: 14-year follow-up study.

    Science.gov (United States)

    Ran, Mao-Sheng; Yang, Lawrence H; Liu, Yu-Jun; Huang, Debbie; Mao, Wen-Jun; Lin, Fu-Rong; Li, Jie; Chan, Cecilia Lai-Wan

    2017-05-01

    Little is known about whether family economic status might influence the long-term (e.g. over 10 years) outcome of persons with schizophrenia in the community. To examine the differences in outcome at 14-year follow-up of persons with schizophrenia from high versus low family economic status backgrounds in a Chinese rural area. A prospective 14-year follow-up study was conducted in six townships in Xinjin County, Chengdu, China. All participants with schizophrenia ( n = 510) were identified in an epidemiological investigation of 123,572 people aged 15 years and older and followed up from 1994 to 2008. Individuals from low family economic status (economic status (⩾mean; 3.2% and 76.6%, respectively). Individuals from low family economic status had significantly lower rates of marriage and complete remission, higher mean scores on Positive and Negative Syndrome Scale (PANSS) and lower mean score on Global Assessment of Functioning (GAF) than those from high family economic status in 2008. The predictors of low family economic status of individuals in 2008 encompassed the baseline low family economic status, poor families' attitude toward the patient, younger age, older age of first onset and longer duration of illness. Low family economic status is a predictive factor of poor long-term outcome of persons with schizophrenia in the rural community. Individuals' family economic status should be considered in making mental health policy and providing community-based mental health services.

  18. Radiology-led Follow-up System for IVC Filters: Effects on Retrieval Rates and Times

    International Nuclear Information System (INIS)

    Lee, L.; Taylor, J.; Munneke, G.; Morgan, R.; Belli, A.-M.

    2012-01-01

    Purpose: Successful IVC filter retrieval rates fall with time. Serious complications have been reported following attempts to remove filters after 3–18 months. Failed retrieval may be associated with adverse clinical sequelae. This study explored whether retrieval rates are improved if interventional radiologists organize patient follow-up, rather than relying on the referring clinicians. Methods: Proactive follow-up of patients who undergo filter placement was implemented in May 2008. At the time of filter placement, a report was issued to the referring consultant notifying them of the advised timeframe for filter retrieval. Clinicians were contacted to arrange retrieval within 30 days. We compared this with our practice for the preceding year. Results: The numbers of filters inserted during the two time periods was similar, as were the numbers of retrieval attempts and the time scale at which they occurred. The rate of successful retrievals increased but not significantly. The major changes were better documentation of filter types and better clinical follow-up. After the change in practice, only one patient was lost to follow-up compared with six the preceding year. Conclusions: Although there was no significant improvement in retrieval rates, the proactive, radiology-led approach improved follow-up and documentation, ensuring that a clinical decision was made about how long the filter was required and whether retrieval should be attempted and ensuring that patients were not lost to follow-up.

  19. Effects of enterostomal nurse telephone follow-up on postoperative adjustment of discharged colostomy patients.

    Science.gov (United States)

    Zhang, Jun-e; Wong, Frances Kam Yuet; You, Li-ming; Zheng, Mei-chun; Li, Qiong; Zhang, Bing-yan; Huang, Man-rong; Ye, Xin-Mei; Liang, Ming-juan; Liu, Jin-ling

    2013-01-01

    People with a new colostomy encounter many difficulties as they struggle to adjust to their ostomies. Nurse telephone follow-up is a convenient way to ensure continuity of care. There is a paucity of studies testing if nurse telephone follow-up can enhance adjustment of postdischarged colostomy patients. The purpose of this study was to evaluate the effect of enterostomal nurse telephone follow-up on the adjustment levels of discharged colostomy patients. This was a randomized controlled trial. Participants (n = 103) who had undergone colostomy operations in China were recruited and randomly assigned to the study or control group. Both the study and control groups received routine discharge care, whereas the study group received 2-3 nurse telephone calls in the follow-up period. The outcome measures included Ostomy Adjustment Scale, Stoma Self-efficacy Scale, satisfaction with care, and stoma complications. Results of this study indicated that participants in the study group had significantly better ostomy adjustment, higher stoma self-efficacy, higher satisfaction with care, and less stoma complications compared with those in the control group. This study provided evidence to support that enterostomal nurse telephone follow-up can improve patient ostomy adjustment level and other related outcomes. Nurse telephone follow-up is an effective intervention to support the adjustment of stoma patients after hospital discharge.

  20. Comfort monitoring? Environmental assessment follow-up under community-industry negotiated environmental agreements

    International Nuclear Information System (INIS)

    Noble, Bram; Birk, Jasmine

    2011-01-01

    Negotiated environmental agreements are becoming common practice in the mining industry. In principle, negotiated environmental agreements are said to respond to many of the shortcomings of environmental impact assessment by providing for improved follow-up of project impacts through, among other things, data provision, engaging stakeholders in the monitoring and management of project impacts, and building capacity at the local level to deal with project-induced environmental change. In practice, however, little is known about the efficacy of follow-up under negotiated environmental agreements between proponents and communities and the demonstrated value added to project impact management. This paper examines follow-up practice under negotiated environmental agreements with a view to understanding whether and how community-based monitoring under privatized agreements actually contributes to improved follow-up and impact management. Based on lessons emerging from recent experiences with environmental agreements in Canada's uranium industry, we show that follow-up under negotiated agreements may be described as 'comfort monitoring'. While such monitoring does improve community-industry relations and enhance corporate image, it does little to support effects-based management. If follow-up under negotiated agreements is to be credible over the long term, there is a need to ensure that monitoring results are useful for, and integrated with, regulatory-based monitoring and project impact management practices.

  1. Long-term follow-up of two interventional procedures for achalasia

    International Nuclear Information System (INIS)

    Cheng Yingsheng; Li Minghua; Shang Kezhong

    2005-01-01

    Objective: To observed the long-term follow-up of the two types of interventional procedure for achalasia. Methods: The study cohort was comprised of 140 patients of achalasia including 70 patients treated under fluoroscopy with pneumatic dilation (group A) and 70 with temporary partially covered metal stent dilation (group B). Results: One hundred and forty dilations were performed on the 70 patients of group A with complications of chest pain (n=35), reflux (n=18), and bleeding (n=8); 38 patients of relapsing dysphagia during a 12-month follow-up, and 50 patients out of 60 of recurrent dysphagia during a 36-month follow-up. Seventy partially covered expandable metal stents were temporarily placed in the 70 patients of group B and withdrawn after 3-7 days via gastroscopy with complications of chest pain (n=28), reflux (n=15), and bleeding (n=9); 7 patients out of 70 exhibited dysphagia relapse during a 12-month followup, and 9 out of 58 patients exhibited dysphagia relapse during a 36-month follow-up. All the stents were inserted and withdrawn successfully. The follow-up in groups A-B lasted for 12-96 months. Conclusion: Temporary partially covered metal stent dilation is one of the best methods of interventional procedure for achalasia in long-term follow-up. (authors)

  2. Effects of bioaerosol exposure on respiratory health in compost workers: a 13-year follow-up study.

    Science.gov (United States)

    van Kampen, V; Hoffmeyer, F; Deckert, A; Kendzia, B; Casjens, S; Neumann, H D; Buxtrup, M; Willer, E; Felten, C; Schöneich, R; Brüning, T; Raulf, M; Bünger, J

    2016-12-01

    To determine the risk of German compost workers developing chronic respiratory effects from long-term exposure to bioaerosols. Respiratory health was determined in 74 currently exposed compost workers and 37 non-exposed controls after 13 years of follow-up. In addition, 42 former compost workers (drop-outs) who left their work during the follow-up period were also examined. Respiratory symptoms and working conditions were assessed using identical questionnaires as at baseline. In addition, lung function was measured using the same spirometer as in the initial study. Sera from both surveys were tested for specific IgE and IgG antibodies to moulds and the risk of work-related symptoms was evaluated using regression approaches for prospective studies with binary data. In the follow-up period, the number of participants reporting cough significantly increased in compost workers and drop-outs compared to the controls. Working as a compost worker for at least 5 years increased the relative risk for cough (RR 1.28; 95% CI 1.2 to 1.4) and for cough with phlegm (RR 1.32; 95% CI 1.2 to 1.5). Current and former compost workers had slightly lower predicted percentage of forced expiratory volume in 1 s and predicted percentage of forced vital capacity than controls, but decrease in lung function during follow-up was not different among the 3 groups. In addition, no significant changes could be detected in antibody concentrations. Our results suggest that chronic exposure to bioaerosols in composting plants is related to a significantly higher risk for cough with phlegm, indicating chronic bronchitis. However, compost workers showed no higher incidence of deterioration of pulmonary function over the study. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. Long-Term Follow-up of Acoustic Schwannoma Radiosurgery With Marginal Tumor Doses of 12 to 13 Gy

    International Nuclear Information System (INIS)

    Chopra, Rahul; Kondziolka, Douglas; Niranjan, Ajay; Lunsford, L. Dade; Flickinger, John C.

    2007-01-01

    Purpose: To define long-term tumor control and clinical outcomes of radiosurgery with marginal tumor doses of 12 to 13 Gy for unilateral acoustic schwannoma. Methods and Materials: A total of 216 patients with previously untreated unilateral acoustic schwannoma underwent Gamma Knife radiosurgery between 1992 and 2000 with marginal tumor doses of 12 to 13 Gy (median, 13 Gy). Median follow-up was 5.7 years (maximum, 12 years; 41 patients with >8 years). Treatment volumes were 0.08-37.5 cm 3 (median, 1.3 cm 3 ). Results: The 10-year actuarial resection-free control rate was 98.3% ± 1.0%. Three patients required tumor resection: 2 for tumor growth and 1 partial resection for an enlarging adjacent subarachnoid cyst. Among 121 hearing patients with >3 years of follow-up, crude hearing preservation rates were 71% for keeping the same Gardner-Robertson hearing level, 74% for serviceable hearing, and 95% for any testable hearing. For 25 of these patients with intracanalicular tumors, the respective rates for preserving the same Gardner-Robertson level, serviceable hearing, and testable hearing were 80%, 88%, and 96%. Ten-year actuarial rates for preserving the same Gardner-Robertson hearing levels, serviceable hearing, any testable hearing, and unchanged facial and trigeminal nerve function were 44.0% ± 11.7%, 44.5% ± 10.5%, 85.3% ± 6.2%, 100%, and 94.9% ± 1.8%, respectively. Conclusions: Acoustic schwannoma radiosurgery with 12 to 13 Gy provides high rates of long-term tumor control and cranial nerve preservation after long-term follow-up

  4. Information-seeking behaviour and information needs of LGBTQ health professionals: a follow-up study.

    Science.gov (United States)

    Morris, Martin; Roberto, K R

    2016-09-01

    Except for one study in 2004, the literature has no data on the information-seeking behaviour of lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) health professionals. After a decade of change for LGBTQ people, and the growth of electronic information sources and social networks, it is appropriate to revisit this subject. To gain an updated understanding of the information-seeking behaviour of LGBTQ health professionals and of how medical libraries can provide a culturally competent service to such users. A mixed-methods approach was adopted combining a Web-based questionnaire with email follow-up discussions. One hundred and twenty-three complete responses were received, mostly from the USA and Canada, between November 2012 and October 2013. LGBTQ health professionals remain more comfortable seeking LGBTQ health information from a medical librarian whom they know to be LGBTQ because they perceive LGBTQ librarians as more likely to have specialist knowledge, or through concern that non-LGBTQ librarians may be more likely to react in a stigmatising or discriminatory way. The study also provides evidence suggesting that online chat has marginal appeal for respondents seeking LGBTQ health information, despite its anonymity. Medical libraries seeking to demonstrate their cultural competency should provide visible evidence of this, such as through the creation of dedicated resource lists, promotion of LGBTQ literature on the library's website, and display of other symbols or statements supporting diversity. Opportunities exist for LGBTQ health professionals and medical librarians to work together to ensure that medical libraries are culturally competent and welcoming spaces for LGBTQ patrons, that library collections match their needs, and in the creation of guides to ensure maximum access to the results of LGBTQ health research. Medical libraries should also consider nominating and, if necessary, training a specialist in LGBTQ health information. Such

  5. Vaccine financing and billing in practices serving adult patients: A follow-up survey.

    Science.gov (United States)

    Lindley, Megan C; Hurley, Laura P; Beaty, Brenda L; Allison, Mandy A; Crane, Lori A; Brtnikova, Michaela; Snow, Megan; Bridges, Carolyn B; Kempe, Allison

    2018-02-14

    Financial concerns are often cited by physicians as a barrier to administering routinely recommended vaccines to adults. The purpose of this study was to assess perceived payments and profit from administering recommended adult vaccines and vaccine purchasing practices among general internal medicine (GIM) and family medicine (FM) practices in the United States. We conducted an interviewer-administered survey from January-June 2014 of practices stratified by specialty (FM or GIM), affiliation (standalone or ≥ 2 practice sites), and level of financial decision-making (independent or larger system level) in FM and GIM practices that responded to a previous survey on adult vaccine financing and provided contact information for follow-up. Practice personnel identified as knowledgeable about vaccine financing and billing responded to questions about payments relative to vaccine purchase price and payment for vaccine administration, perceived profit on vaccination, claim denial, and utilization of various purchasing strategies for private vaccine stocks. Survey items on payment and perceived profit were assessed for various public and private payer types. Descriptive statistics were calculated and responses compared by physician specialty, practice affiliation, and level of financial decision-making. Of 242 practices approached, 43% (n = 104) completed the survey. Reported payment levels and perceived profit varied by payer type. Only for preferred provider organizations did a plurality of respondents report profiting on adult vaccination services. Over half of respondents reported losing money vaccinating adult Medicaid beneficiaries. One-quarter to one-third of respondents reported not knowing about Medicare Part D payment levels for vaccine purchase and vaccine administration, respectively. Few respondents reported negotiating with manufacturers or insurance plans on vaccine purchase prices or payments for vaccination. Practices vaccinating adults may

  6. Health correlates of workplace bullying: a 3-wave prospective follow-up study.

    Science.gov (United States)

    Bonde, Jens Peter; Gullander, Maria; Hansen, Åse Marie; Grynderup, Matias; Persson, Roger; Hogh, Annie; Willert, Morten Vejs; Kaerlev, Linda; Rugulies, Reiner; Kolstad, Henrik A

    2016-01-01

    This study aimed to examine the course of workplace bullying and health correlates among Danish employees across a four-year period. In total, 7502 public service and private sector employees participated in a 3-wave study from 2006 through 2011. Workplace bullying over the past 6-12 months and data on health characteristics were obtained by self-reports. We identified major depression using Schedules for Clinical Assessment in Neuropsychiatry interviews and the Major Depression Inventory. We performed cross-sectional and longitudinal analyses of outcomes according to self-labelled bullying at baseline using logistic regression. Reports of bullying were persistent across four years in 22.2% (57/257) of employees who initially reported bullying. Baseline associations between self-labelled bullying and sick-listing, poor self-rated health, poor sleep, and depressive symptoms were significant with adjusted odds ratios (OR) ranging from 1.8 [95% confidence interval (95% CI) 1.5-2.4] for poor sleep quality among those bullied "now and then" to 6.9 (95% CI 3.9-12.3) for depression among those reporting being bullied on a daily to monthly basis. In longitudinal analyses adjusting for bullying during follow-up, all health correlates except poor sleep quality persisted up to four years. Self-reported health correlates of workplace bullying including sick-listing, poor self-rated health, depressive symptoms, and a diagnosis of depression tend to persist for several years regardless of whether bullying is discontinued or not. Independent measures of bullying and outcomes are needed to learn whether these findings reflect long lasting health consequences of workplace bullying or whether self-labelled workplace bullying and health complaints are correlated because of common underlying factors.

  7. Early discharge care with ongoing follow-up support may reduce hospital readmissions in COPD

    Directory of Open Access Journals (Sweden)

    Maria Lawlor

    2008-10-01

    Full Text Available Maria Lawlor1, Sinead Kealy1, Michelle Agnew1, Bettina Korn1, Jennifer Quinn1, Ciara Cassidy1, Bernard Silke2, Finbarr O’Connell1, Rory O’Donnell11Department of Respiratory Medicine, CResT Directorate, St. James’ Hospital, Dublin 8, Ireland; 2Department of General Internal Medicine, Gems Directorate, St. James’ Hospital, Dublin 8, IrelandBackground: Early discharge care and self-management education, although effective in the management of chronic obstructive pulmonary disease (COPD, do not typically reduce hospital re-admission rates for exacerbations of the disease. We hypothesized that a respiratory outreach programme that comprises early discharge care followed by continued rapid-access out-patient support would reduce the need for hospital readmission in these patients.Methods: Two hundred and forty-six patients, acutely admitted with exacerbations of COPD, were recruited to the respiratory outreach programme that included early discharge care, followup education, telephone support and rapid future access to respiratory out-patient clinics. Sixty of these patients received self-management education also. Emergency department presentations and admission rates were compared at six and 12 months after, compared to prior to, participation in the programme for the same patient cohort.Results: The frequency of both emergency department presentations and hospital admissions was significantly reduced after participation in the programme.Conclusions: Provision of a respiratory outreach service that includes early discharge care, followed by education, telephone support and ongoing rapid access to out-patient clinics is associated with reduced readmission rates in COPD patients.Keywords: COPD management outreach, follow-up, out-patient clinics

  8. Genealogical databases as a tool for extending follow-up in clinical reviews.

    Science.gov (United States)

    Ho, Thuy-Van; Chowdhury, Naweed; Kandl, Christopher; Hoover, Cindy; Robinson, Ann; Hoover, Larry

    2016-08-01

    Long-term follow-up in clinical reviews often presents significant difficulty with conventional medical records alone. Publicly accessible genealogical databases such as Ancestry.com provide another avenue for obtaining extended follow-up and added outcome information. No previous studies have described the use of genealogical databases in the follow-up of individual patients. Ancestry.com, the largest genealogical database in the United States, houses extensive demographic data on an increasing number of Americans. In a recent retrospective review of esthesioneuroblastoma patients treated at our institution, we used this resource to ascertain the outcomes of patients otherwise lost to follow-up. Additional information such as quality of life and supplemental treatments the patient may have received at home was obtained through direct contact with living relatives. The use of Ancestry.com resulted in a 25% increase (20 months) in follow-up duration as well as incorporation of an additional 7 patients in our study (18%) who would otherwise not have had adequate hospital chart data for inclusion. Many patients within this subset had more advanced disease or were remotely located from our institution. As such, exclusion of these outliers can impact the quality of subsequent outcome analysis. Online genealogical databases provide a unique resource of public information that is acceptable to institutional review boards for patient follow-up in clinical reviews. Utilization of Ancestry.com data led to significant improvement in follow-up duration and increased the number of patients with sufficient data that could be included in our retrospective study. © 2016 ARS-AAOA, LLC.

  9. Use of imaging during symptomatic follow-up after resection of pancreatic ductal adenocarcinoma.

    Science.gov (United States)

    Groot, Vincent P; Daamen, Lois A; Hagendoorn, Jeroen; Borel Rinkes, Inne H M; van Santvoort, Hjalmar C; Molenaar, I Quintus

    2018-01-01

    Controversy exists whether follow-up after resection of pancreatic ductal adenocarcinoma (PDAC) should include standardized imaging for the detection of disease recurrence. The purpose of this study was to evaluate how often patients undergo imaging in a setting where routine imaging is not performed. Secondly, the pattern, timing, and treatment of recurrent PDAC were assessed. This was a post hoc analysis of a prospective database of all consecutive patients undergoing pancreatic resection of PDAC between January 2011 and January 2015. Data on imaging procedures during follow-up, recurrence location, and treatment for recurrence were extracted and analyzed. Associations between clinical characteristics and post-recurrence survival were assessed with the log-rank test and Cox univariable and multivariable proportional hazards models. A total of 85 patients were included. Seventy-four patients (87%) underwent imaging procedures during follow-up at least once, with a mean amount of 3.1 ± 1.9 imaging procedures during the entire follow-up period. Sixty-eight patients (80%) were diagnosed with recurrence, 58 (85%) of whom after the manifestation of clinical symptoms. Additional tumor-specific treatment was administered in 17 of 68 patients (25%) with recurrence. Patients with isolated local recurrence, treatment after recurrence, and a recurrence-free survival >10 mo had longer post-recurrence survival. Even though a symptomatic follow-up strategy does not include routine imaging, the majority of patients with resected PDAC underwent additional imaging procedures during their follow-up period. Further prospective studies are needed to determine the actual clinical value, psychosocial implications, and cost-effectiveness of different forms of follow-up after resection of PDAC. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Follow-up CT Evaluation of the Mural Changes in Active Takayasu Arteritis

    International Nuclear Information System (INIS)

    Kim, Sang Young; Park, Jae Hyung; Chung, Jin Wook; Kim, Hyo Cheol; Lee, Whal; So, Young Ho; Jae, Hwan Jun

    2007-01-01

    We wanted to evaluate the mural changes by CT on the follow-up examination of patients with active Takayasu arteritis. The study included 18 patients, (4 males and 14 females), with active Takayasu arteritis. A total of 44 CT examinations were done during the follow-up period (mean: 55.6 months). At the time of the last follow-up CT, the disease, on the basis of the erythrocyte sedimentation rate (ESR), was found to be inactive in five patients and the disease was active and persistent in 13 patients. The thickness and CT attenuation of the aortic wall on the precontrast, arterial and venous phases were measured on the initial and the follow-up CT examinations. The ratio of the mural attenuation over that of the back muscle on the initial CT was compared with the ratio found on the follow-up CT. The initial CT findings included high density and calcifications of the aortic wall in the precontrast images and a thickened wall with enhancements in the arterial and the venous phases. A low-attenuation ring was demonstrated in the venous phase in 15 patients (83%). On the follow-up evaluation, the mean mural thickness decreased significantly from 4.1 mm to 2.4 mm. The mean mural attenuation ratio in the venous phase decreased significantly from 1.9 to 1.3 (p 0.001). The low attenuation ring was identified in seven patients (39%) who had only with active, persistent Takayasu arteritis. The mural changes demonstrated by the follow-up CT evaluations for the patients with active Takayasu arteritis included a decrease of the mural thickness and enhancement, disappearance of the low-attenuation ring on the venous phase, and an increase of the mural attenuation and calcification on the precontrast phase

  11. Integrating forensic science into nursing processes in the ICU.

    Science.gov (United States)

    Hoyt, Constance A

    2006-01-01

    The critical care nurse is in an ideal position to assume responsibilities related to the identification of forensic cases and the preservation of associated evidence. Victims of child and elder abuse and neglect, individuals involved in vehicular or industrial accidents, substance abusers, and incarcerated populations are among the several types of patients that are likely to managed in the intensive care unit (ICU). Hospitals and their personnel assume considerable liability in such cases for detecting, collecting, and preserving evidence, as well as for reporting and referring the cases to appropriate law enforcement or judicial authorities. The Joint Commission for the Accreditation of Healthcare Organizations has published specific regulatory guidance to ensure that all healthcare personnel are properly educated to assume certain forensic responsibilities. The orientation and in-service programs of the ICU nurse should include specific guidance regarding forensic principles, practices, and procedures.

  12. 12-month follow-up study of drug treatment in pathological gamblers: a primary outcome study.

    Science.gov (United States)

    Dannon, Pinhas N; Lowengrub, Katherine; Musin, Ernest; Gonopolsky, Yehudit; Kotler, Moshe

    2007-12-01

    Pathological gambling (PG) is a relatively common and highly disabling impulse control disorder. A range of psychotherapeutic agents including selective serotonin reuptake inhibitors, antiepileptic drugs, and opioid antagonists are shown to be effective in the short-term treatment of PG. The use of a wide range of pharmacological treatments for PG is consistent with the observation that PG shares features of obsessive-compulsive spectrum disorders, impulse control disorders, and addictive disorders. The aim of the study is to assess the rate of relapse in treatment-responder pathological gamblers after discontinuation of the active treatment. Our study sample was composed of 43 male pathological gamblers who had been full responders to 1 of 4 drug treatment regimens (fluvoxamine, topiramate, bupropion SR, or naltrexone) from several previous acute open-label (12-week) comparison studies. Full response was defined as the absence of gambling for a 1-month duration together with improvement on the Clinical Global Improvement scale. The 43 full responders were then followed prospectively for an additional 9 months, which included a 3-month open-label continuation phase and a 6-month medication-free follow-up phase. Follow-up visits were performed on a monthly basis throughout the duration of study. At every follow-up visit, a comprehensive psychiatric diagnostic evaluation was performed on all patients, and patients were assessed for symptoms of gambling using a self-report instrument and collateral family reports. The Clinical Global Impression Improvement scale was also administered at every follow-up visit. Raters were blind to the previous drug treatment. Most patients did not relapse during the 6-month medication-free follow-up phase. Three of 6 patients with fluvoxamine, 3 of 9 with topiramate, 7 of 18 with bupropion SR, and 4 of 10 with naltrexone relapsed. Relapse was strictly defined as gambling behavior at any time during the 6-month medication-free follow-up

  13. Value of early follow-up CT in paediatric tuberculous meningitis

    International Nuclear Information System (INIS)

    Andronikou, Savvas; Wieselthaler, Nicky; Smith, Bruce; Douis, Hassan; Fieggen, A. Graham; Toorn, Ronald van; Wilmshurst, Jo

    2005-01-01

    The value of CT in the diagnosis of tuberculous meningitis (TBM) in children is well reported. Follow-up CT scanning for these patients is, however, not well described and, in particular, the value of early follow-up CT has not been addressed for children with TBM. To assess the value of early follow-up CT in children with TBM in identifying diagnostic, prognostic and therapeutically relevant features of TBM. A retrospective 4-year review of CT scans performed within 1 week and 1 month of initial CT in children with proven (CSF culture-positive) and probable TBM (CSF profile-positive but culture-negative) and comparison with initial CT for the diagnostic, prognostic and therapeutic CT features of TBM. The CT scans of 50 children were included (19 ''definite'' TBM; 31 ''probable'' TBM). Of these, 30 had CT scans performed within 1 week of the initial CT. On initial CT, 44 patients had basal enhancement. Only 24 patients had contrast medium-enhanced follow-up scans. Important findings include: 8 of 29 patients (who were not shunted) developed new hydrocephalus. New infarcts developed in 24 patients; 45% of those who did not have infarction initially developed new infarcts. Three of the six patients who did not show basal enhancement on initial scans developed this on the follow-up scans, while in seven patients with pre-existing basal enhancement this became more pronounced. Two patients developed hyperdensity in the cisterns on non-contrast medium scans. Eight patients developed a diagnostic triad of features. Three patients developed CT features of TBM where there was none on the initial scans. Early follow-up CT is useful in making a diagnosis of TBM by demonstrating features that were not present initially and by demonstrating more sensitive, obvious or additional features of TBM. In addition, follow-up CT is valuable as a prognostic indicator as it demonstrates additional infarcts which may have developed or become more visible since the initial study. Lastly

  14. Value of early follow-up CT in paediatric tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Andronikou, Savvas [University of Cape Town, Department of Radiology, Cape Town (South Africa); Wieselthaler, Nicky; Smith, Bruce; Douis, Hassan [Red Cross Children' s Hospital, Department of Paediatric Radiology, School of Child and Adolescent Health, Cape Town (South Africa); Fieggen, A. Graham; Toorn, Ronald van; Wilmshurst, Jo [Red Cross Children' s Hospital, Department of Paediatric Radiology, School of Child and Adolescent Health, Cape Town (South Africa); Red Cross Children' s Hospital, Department of Neurosciences, School of Child and Adolescent Health, Cape Town (South Africa)

    2005-11-01

    The value of CT in the diagnosis of tuberculous meningitis (TBM) in children is well reported. Follow-up CT scanning for these patients is, however, not well described and, in particular, the value of early follow-up CT has not been addressed for children with TBM. To assess the value of early follow-up CT in children with TBM in identifying diagnostic, prognostic and therapeutically relevant features of TBM. A retrospective 4-year review of CT scans performed within 1 week and 1 month of initial CT in children with proven (CSF culture-positive) and probable TBM (CSF profile-positive but culture-negative) and comparison with initial CT for the diagnostic, prognostic and therapeutic CT features of TBM. The CT scans of 50 children were included (19 ''definite'' TBM; 31 ''probable'' TBM). Of these, 30 had CT scans performed within 1 week of the initial CT. On initial CT, 44 patients had basal enhancement. Only 24 patients had contrast medium-enhanced follow-up scans. Important findings include: 8 of 29 patients (who were not shunted) developed new hydrocephalus. New infarcts developed in 24 patients; 45% of those who did not have infarction initially developed new infarcts. Three of the six patients who did not show basal enhancement on initial scans developed this on the follow-up scans, while in seven patients with pre-existing basal enhancement this became more pronounced. Two patients developed hyperdensity in the cisterns on non-contrast medium scans. Eight patients developed a diagnostic triad of features. Three patients developed CT features of TBM where there was none on the initial scans. Early follow-up CT is useful in making a diagnosis of TBM by demonstrating features that were not present initially and by demonstrating more sensitive, obvious or additional features of TBM. In addition, follow-up CT is valuable as a prognostic indicator as it demonstrates additional infarcts which may have developed or become more

  15. Caffeine use and dependence in adolescents: one-year follow-up.

    Science.gov (United States)

    Oberstar, Joel V; Bernstein, Gail A; Thuras, Paul D

    2002-01-01

    The objectives were to conduct a 1-year follow-up of daily caffeine-using adolescents to further describe caffeine dependence symptoms and to determine whether caffeine dependence is associated with other substance dependence disorders. Twenty-one of 36 (58.3%) adolescents who participated in a study of caffeine dependence returned for follow-up. The previous study was a case series of adolescents who consumed caffeine daily and met some Diagnostic and Statistical Manual of Mental Disorders (fourth edition) substance dependence criteria as applied to caffeine. At follow-up, caffeine consumption from beverages was 179.9 +/- 151.8 mg/day. Of the 21 teenagers, 23.8% (n = 5) met criteria for caffeine dependence. Four of these participants developed caffeine dependence during the follow-up period. Other substance dependence disorders were not overrepresented in the caffeine dependent group compared to the caffeine nondependent group. The most commonly reported withdrawal symptoms in dependent teenagers (at baseline and follow-up combined) were feeling drowsy/tired, fatigued, or sluggish/slowed down (83.3% each) and headache (75.0%). Caffeine dependence occurs in some adolescents who drink caffeine daily and is marked by symptoms similar to those found in adults.

  16. Assessing factors for loss to follow-up of HIV infected patients in Guinea-Bissau

    DEFF Research Database (Denmark)

    Nordentoft, Pernille Bejer; Engell-Sørensen, Thomas; Jespersen, Sanne

    2017-01-01

    reasons were moving (29.1 %), travelling (17.5 %), and transferring to other clinics (11.7 %). Conclusion: A large proportion of the patients at the clinic were lost to follow-up. The main reason for this was found to be the geographic mobility of the population in Guinea-Bissau.......Purpose: The objective of this study was to ascertain vital status of patients considered lost to follow-up at an HIV clinic in Guinea-Bissau, and describe reasons for loss to follow-up (LTFU). Methods: This study was a cross-sectional sample of a prospective cohort, carried out between May 15...... and 12.6 % HIV-1/2) living within the DSS, 292 patients had been lost to follow-up and were, therefore, eligible for active follow-up. Vital status was ascertained in 65.9 % of eligible patients and 42.7 % were alive, while 23.2 % had died. Information on reasons for LTFU existed for 103 patients. Major...

  17. Improving Neurodevelopmental Surveillance and Follow-up in Infants with Congenital Heart Disease.

    Science.gov (United States)

    Michael, Mark; Scharf, Rebecca; Letzkus, Lisa; Vergales, Jeffrey

    2016-01-01

    We hypothesize that neurodevelopmental surveillance of targeted patients with congenital heart disease during the admission for their cardiac surgery would improve neurodevelopmental assessment and outpatient follow-up rates. All patients under 12 months of age who were operated on between October 2013 and October 2014 and were considered at risk for neurodevelopmental delay in accordance with the 2012 American Heart Association Scientific Statement were included. A protocol was implemented to increase surveillance of targeted patients during the hospitalization for their cardiac surgery. A historical control cohort was used from a 6-month period that preceded initiation of the program from July 2012 to December 2012. Univariate analysis assessed the effects of patient demographics, anatomy, postoperative course, and distance from clinic on inpatient screening and follow-up to evaluate areas for future improvement. Neurodevelopmental surveillance in the post-protocol period increased from 21% to 82% (P neurodevelopmental surveillance of high risk patients. Individuals that were younger and in the hospital longer were more likely to be successfully seen and comply with outpatient follow-up than those not receiving inpatient risk assessment. Patients with single ventricle anatomy may benefit from a modified follow-up schedule to improve compliance rates. Travel distance has no effect on likelihood of outpatient cardiac neurodevelopmental follow-up. © 2016 Wiley Periodicals, Inc.

  18. Pediatric superficial scald burns--reassessment of our follow-up protocol.

    Science.gov (United States)

    Egro, Francesco M; O'Neill, Jennifer K; Briard, Robert; Cubison, Tania C S; Kay, Alan R; Estela, Catalina M; Burge, Timothy S

    2010-01-01

    The most common pediatric burn injury is a superficial scald. The current follow-up protocol for such burns includes review of the patient at 2 weeks postinjury and then 2 months later. The authors decided to review the protocol to assess the need for this second follow-up. A retrospective study reviewed the case notes of patients younger than 16 years at the time of their injury presenting with a scald over 5% TBSA. The progress of healing and scar development up to 5 years follow-up was assessed. This study showed that scalds healing within 2 weeks following injury rarely became hypertrophic. A prospective study was performed over a 10-month period. All children who suffered a superficial partial-thickness scald injury were included. At the 2-week appointment, the need for further follow-up was predicted. The accuracy of this prediction was assessed 2 months later. This study showed that an experienced member of the burns team could reliably predict at 2-week appointment those children who could be safely discharged with no subsequent need for scar management. This study suggests that it will be safe to modify the follow-up protocol, reducing the number of clinic attendances.

  19. Parental Involvement in Cognitive Behavior Therapy for Children with Anxiety Disorders: 3-Year Follow-Up.

    Science.gov (United States)

    Walczak, Monika; Esbjørn, Barbara H; Breinholst, Sonja; Reinholdt-Dunne, Marie Louise

    2017-06-01

    Parental factors have been linked to childhood anxiety, hence, parental involvement in cognitive behavioral therapy (CBT) for anxious children has been examined. However, findings do not consistently show added effects of parent-enhanced CBT, longitudinal investigations are scarce and long-term effects unclear. In the present study, 40 out of 54 families who, 3 years previously, completed one of two types of CBT treatment: with limited or active parental involvement, were assessed using semi-structured diagnostic interviews. Diagnostic status at 3-years follow-up was compared between groups. Changes in diagnostic status across assessment points: posttreatment, 6-month and 3-year follow-up were analyzed within groups. Diagnostic change from 6-month to 3-year follow-up was compared between groups. Intent-to-treat analyses revealed no significant difference in diagnostic status between groups at 3-year follow-up. Nonetheless, children whose parents actively participated in treatment showed significantly more remission from 6-month to 3-year follow-up than children with limited parental participation.

  20. [Gender dysphoria in children and adolescents - treatment guidelines and follow-up study].

    Science.gov (United States)

    Meyenburg, Bernd; Kröger, Anne; Neugebauer, Rebecca

    2015-01-01

    Treatment guidelines for transidentity in children and adolescents are presently under discussion. We present an overview of the various treatment modalities. Further, follow-up data on children and adolescents referred for gender-identity problems are presented. Of the 84 patients seen for the first time more than 3 years before follow-up, 37 mailed in the completed questionnaires. In addition, 33 patients agreed to answer some short follow-up questions. We assessed steps of treatment, gender role, psychopathology, and psychotherapy. We compared differences in psychopathology in patients with vs. without gender role change and in patients with intense vs. less intense psychotherapy. A total of 22 patients had completely changed gender role, and some had started hormonal treatment und sex reassignment surgery. Most patients were satisfied with the treatment results. All patients showed less psychopathology on follow-up, independent of role change or intensity of psychotherapy. In general, the patients reported little psychopathology. Our follow-up results support the present treatment approach. In patients with little psychopathology, low-frequency supportive treatment appears sufficient to obtain safe judgement on hormonal of surgical treatment.

  1. Long-term follow-up of functional hypothalamic amenorrhea and prognostic factors.

    Science.gov (United States)

    Falsetti, Leopoldo; Gambera, Alessandro; Barbetti, Lorena; Specchia, Cristina

    2002-02-01

    This study evaluated the prognosis of functional hypothalamic amenorrhea (FHA) and the predictive factors of recovery, through a long-term follow-up. Ninety-three women affected by FHA underwent a follow-up for an average period of 8.1 yr (range 7-9 yr). At the end of the follow-up, 65 (70.7%) patients recovered. Statistical analysis showed that there was no association between recovery and anamnestic causes of FHA or with the echographic ovarian morphology but identified the predictive factors of recovery as the basal body mass index (BMI), the basal cortisol, and androstenedione plasma levels. A higher basal BMI and A, and lower cortisol values are positive prognostic factors for the recovery. Also the BMI, acquired during the follow-up, is important for FHA resolution: in fact, in recovered women the BMI increased or remained stable, whereas in nonrecovered women it decreased or remained stable. At the end of the follow-up, 52 (74.3%) patients treated with hormone replacement therapy and 8 (80%) with no therapy recovered, but only 5 (41.7%) with oral contraceptive pills recovered.

  2. Congenital arterioportal fistulas: radiological treatment and color Doppler US follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Teplisky, Dario; Tincani, Eliana Uruena; Lipsich, Jose; Sierre, Sergio [Department of Interventional Radiology, Pichincha 1890, Buenos Aires (Argentina)

    2012-11-15

    Congenital intrahepatic arterioportal fistulas (APFs) are a rare cause of portal hypertension in children. Doppler US is a useful diagnostic imaging modality. Transarterial embolization is a minimally invasive and effective therapy allowing occlusion of the fistula and restoration of liver hemodynamics. To describe the clinical and radiologic findings, percutaneous treatment and role of D-US in the postembolization follow-up of children with APF. Between 2002 and 2011, four children with APF were treated. Initial diagnosis and follow-up was performed with D-US and confirmed by arteriography, followed by endovascular embolization in all patients. D-US demonstrated abnormal arterioportal communications in all patients. Six endovascular procedures were performed in these four children. In two children, no residual fistula was seen on D-US after the first procedure and symptoms resolved. In the other two children, D-US demonstrated residual flow through the fistula, with resolution of pathological D-US findings and symptoms after the second endovascular procedure. All four children were successfully treated and asymptomatic at the end of follow-up. The mean follow-up was 24 months. Interventional radiology has a key role in the treatment of congenital APF. D-US is a noninvasive and effective tool for the diagnosis and follow-up of these patients. (orig.)

  3. 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

    2010-01-01

    in headache index at the end of follow-up were reported in only one and two of nine studies, respectively. The present review demonstrated a lack of uniform end points used in recently published follow-up studies. Guidelines for presenting follow-up data on MOH are needed and we propose end points......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 minimum of one predefined end point. In total, nine studies were identified. The 1,589 MOH patients (22% men) had an overall mean frequency of 25.3 headache days/month at baseline. Headache days/month at the end of follow-up was reported in six studies (mean 13.8 days/month). The decrease was more...

  4. Long-term follow-up of patients with Bartter syndrome type I and II.

    Science.gov (United States)

    Puricelli, Elena; Bettinelli, Alberto; Borsa, Nicolò; Sironi, Francesca; Mattiello, Camilla; Tammaro, Fabiana; Tedeschi, Silvana; Bianchetti, Mario G

    2010-09-01

    Little information is available on a long-term follow-up in Bartter syndrome type I and II. Clinical presentation, treatment and long-term follow-up (5.0-21, median 11 years) were evaluated in 15 Italian patients with homozygous (n = 7) or compound heterozygous (n = 8) mutations in the SLC12A1 (n = 10) or KCNJ1 (n = 5) genes. Thirteen new mutations were identified. The 15 children were born pre-term with a normal for gestational age body weight. Medical treatment at the last follow-up control included supplementation with potassium in 13, non-steroidal anti-inflammatory agents in 12 and gastroprotective drugs in five patients. At last follow-up, body weight and height were within normal ranges in the patients. Glomerular filtration rate was Bartter syndrome had a lower renin ratio (P Bartter syndrome. Patients with Bartter syndrome type I and II tend to present a satisfactory prognosis after a median follow-up of more than 10 years. Gallstones might represent a new complication of antenatal Bartter syndrome.

  5. International clinical guideline for the management of classical galactosemia: diagnosis, treatment, and follow-up.

    Science.gov (United States)

    Welling, Lindsey; Bernstein, Laurie E; Berry, Gerard T; Burlina, Alberto B; Eyskens, François; Gautschi, Matthias; Grünewald, Stephanie; Gubbels, Cynthia S; Knerr, Ina; Labrune, Philippe; van der Lee, Johanna H; MacDonald, Anita; Murphy, Elaine; Portnoi, Pat A; Õunap, Katrin; Potter, Nancy L; Rubio-Gozalbo, M Estela; Spencer, Jessica B; Timmers, Inge; Treacy, Eileen P; Van Calcar, Sandra C; Waisbren, Susan E; Bosch, Annet M

    2017-03-01

    Classical galactosemia (CG) is an inborn error of galactose metabolism. Evidence-based guidelines for the treatment and follow-up of CG are currently lacking, and treatment and follow-up have been demonstrated to vary worldwide. To provide patients around the world the same state-of-the-art in care, members of The Galactosemia Network (GalNet) developed an evidence-based and internationally applicable guideline for the diagnosis, treatment, and follow-up of CG. The guideline was developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. A systematic review of the literature was performed, after key questions were formulated during an initial GalNet meeting. The first author and one of the working group experts conducted data-extraction. All experts were involved in data-extraction. Quality of the body of evidence was evaluated and recommendations were formulated. Whenever possible recommendations were evidence-based, if not they were based on expert opinion. Consensus was reached by multiple conference calls, consensus rounds via e-mail and a final consensus meeting. Recommendations addressing diagnosis, dietary treatment, biochemical monitoring, and follow-up of clinical complications were formulated. For all recommendations but one, full consensus was reached. A 93 % consensus was reached on the recommendation addressing age at start of bone density screening. During the development of this guideline, gaps of knowledge were identified in most fields of interest, foremost in the fields of treatment and follow-up.

  6. Social epidemiology and political economy: ICU as point of convergence

    Directory of Open Access Journals (Sweden)

    Segura, Omar

    2016-10-01

    Full Text Available Questions around epidemiology, economics and critical care are often in the mind of almost any healthcare professional. However, it is seldom realized that epidemiology and economy may converge -in spite of being apparently separated fields of study- in order to explain the present situation or future trends of a hospital or public health service. This essay briefly depicts how social epidemiology and political economy have developed and how both academic activities may find a common ground about the Intensive Care Unit (ICU, particularly to pose questions, to create possible research lines and feasible alternatives towards more efficient, effective and humane health services.

  7. Scanning usefulness for bone metastases diagnosis in the breast cancer follow-up

    International Nuclear Information System (INIS)

    Guillen, G.; Martinez, P.; Garcia, F.; Tres, A.

    1988-01-01

    It is studied the incidence of osseus metastases and the usefulness of 179 bone scanning realized in the diagnosis and follow-up (average: 23,6 months) of 87 patients operated by breast cancer. It is obvious the scan sensitivity and its unspecificity (15,08% phase-positives). In 13 (14,9%) patients who showed them, during the follow-up, scan was pathological at the moment of the osseus metastases diagnosis or a bit later; there were other clinical data or abnormal analytical ones of suspicion in 77% of them. The time average of appearance is 27 months after surgery. We concluded that the bone scan in the follow-up of breast cancer will be realized only when clinical or analytical suspicion of bone metastases. (Author)

  8. Weight Suppression Predicts Maintenance and Onset of Bulimic Syndromes at 10-Year Follow-up

    Science.gov (United States)

    Keel, Pamela K.; Heatherton, Todd F.

    2010-01-01

    Conflicting results have emerged regarding the prognostic significance of weight suppression for maintenance of bulimic symptoms. This study examined whether the magnitude of weight suppression would predict bulimic syndrome maintenance and onset in college-based samples of men (n=369) and women (n=968) at 10-year follow-up. Data come from a longitudinal study of body weight and disordered eating with high retention (80%). Among those with a bulimic syndrome at baseline, greater weight suppression significantly predicted maintenance of the syndrome, and, among those without a bulimic syndrome at baseline, greater weight suppression predicted onset of a bulimic syndrome at 10-year follow-up in multivariate models that included baseline body mass index, diet frequency, and weight perception. Future research should address mechanisms that could account for the effects of weight suppression over a long duration of follow-up. PMID:20455599

  9. Balloon catheter dilatation in esophageal achalasia: long term follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Cheol Yong; Park, Hyun Mee; Kim, So Eun; Lee, Shin Hyung; Kim, Seung Hyeon; Lee, Chang Joon [National Medical Center, Seoul (Korea, Republic of)

    1994-12-15

    To evaluate the clinical efficacy of balloon catheter dilatation in the treatment of esophageal achalasia. Seven patients(three males and four females) with esopha-geal achalasia were treated with balloon catheter dilatation. Balloon catheters of variable sizes were used depending on patient's conditions. The patients were followed up over a period of 12-39 months. Balloon catheter dilatation in esophageal achalasia was successful in all patients without esophageal perforation. All patients were relieved from dysphagia. Recurrence was not found in 5 patients on long term follow-up study, but was seen in 2 patients after 18 and 21 months, respectively. Balloon catheter dilatation was a safe and effective method in the treatment of esophageal achalasia with low recurrence rate of 29% on follow-up study.

  10. Balloon catheter dilatation in esophageal achalasia: long term follow-up

    International Nuclear Information System (INIS)

    Shin, Cheol Yong; Park, Hyun Mee; Kim, So Eun; Lee, Shin Hyung; Kim, Seung Hyeon; Lee, Chang Joon

    1994-01-01

    To evaluate the clinical efficacy of balloon catheter dilatation in the treatment of esophageal achalasia. Seven patients(three males and four females) with esopha-geal achalasia were treated with balloon catheter dilatation. Balloon catheters of variable sizes were used depending on patient's conditions. The patients were followed up over a period of 12-39 months. Balloon catheter dilatation in esophageal achalasia was successful in all patients without esophageal perforation. All patients were relieved from dysphagia. Recurrence was not found in 5 patients on long term follow-up study, but was seen in 2 patients after 18 and 21 months, respectively. Balloon catheter dilatation was a safe and effective method in the treatment of esophageal achalasia with low recurrence rate of 29% on follow-up study

  11. The Effect of Auditor Quality on the Follow-Up of Audit Recommendation

    Directory of Open Access Journals (Sweden)

    Dyah Setyaningrum

    2013-08-01

    Full Text Available The purpose of this study is to measure auditor quality of The Audit Board of the Republic of Indonesia (BPK and investigates the effect of auditor quality on the follow-up of audit recommendation. This study uses sample of local government financial statements in Indonesia from 2010-2012. Using principle component analysis method, the result shows that there are four components extracted that form auditor quality which is experience, training, motivation, and education. All four components are then combined into a single auditor quality index that represents comprehensive measure of auditor quality. The test result shows positive effect between auditor quality and follow-up of audit recommendation. This indicates that high quality auditor is able to produce appropriate recommendations that can be easily followed up by the auditee. The more recommendations are acted upon, the better the quality of local government financial statements.

  12. DESGW: Optical Follow-up of BBH LIGO-Virgo Events with DECam

    Energy Technology Data Exchange (ETDEWEB)

    Butler, Robert E. [Indiana U.; Soares-Santos, M. [Brandeis U.; Annis, j. [Fermilab; Herner, K. [Fermilab

    2017-12-14

    The DESGW program is a collaboration between members of the Dark Energy Survey, the wider astronomical community, and the LIGO-Virgo Collaboration to search for optical counterparts of gravitational wave events, such as those expected from binary neutron star mergers or neutron star-black hole mergers. While binary black hole (BBH) events are not expected to produce an electromagnetic (EM) signature, emission is certainly not impossible. The DESGW program has performed follow-up observations of four BBH events detected by LIGO in order to search for any possible EM counterpart. Failure to nd such counterparts is still relevant in that it produces limits on optical emission from such events. This is a review of follow-up results from O1 BBH events and a discussion of the status of ongoing uniform re-analysis of all BBH events that DESGW has followed up to date.

  13. Loss to follow up did not bias associations between early life factors and adult depression

    DEFF Research Database (Denmark)

    Osler, Merete; Kriegbaum, Margit; Christensen, Ulla

    2008-01-01

    a single mother at birth, low educational attainment at age 18, and low cognitive function at ages 12 and 18. Hospitalizations for depression and having claimed a prescription for an antidepressive drug were also most frequent among men who did not respond in the follow up. However, the effect......OBJECTIVE: This study examines the consequences of nonresponse in a follow-up survey for the associations of early life factors with adult depression. STUDY DESIGN AND SETTING: A cohort of 11,532 Danish men born in 1953 had nearly complete follow up for outcomes retrieved from the Danish...... characteristics and four measures of depression were described by odd ratios (OR), estimated by logistic regression. For the register-based measures the effect of nonresponse was described by a relative OR(OR(responders)/OR(entire cohort)=ROR). RESULTS: Nonresponse at 50 years of age was related to having...

  14. Prognosis on follow-up CT of chronic subdural hematomas treated by burr hole evacuation

    International Nuclear Information System (INIS)

    Higeta, Toshiaki; Yamada, Hiroshi; Itoh, Hakuji

    1986-01-01

    A consecutive series of 47 adult patients with chronic subdural hematoma was studied in respect to postoperative follow-up CT after burr hole evacuation. In 15 of our patients, the CT scan was normalized within 60 days. Six patients required reoperation because of reaccumulation or of poor re-expansion, and in 13 patients the follow-up CT showed a persisting subdural fluid collection even after 60 postoperative days. Further studying the correlation between the prognosis on follow-up CT and various factors, such as patient's age, preoperative neurological condition and CT findings or others, authors found that the elderly, especially older than 70 years, had a poor prognosis, and that the prognosis was correlated to the density and the thickness of hematoma on preoperative CT scan. (author)

  15. A simplified approach for ratcheting analysis in structures with elastic follow-up

    International Nuclear Information System (INIS)

    Berton, M.N.; Cabrillat, M.T.

    1991-01-01

    In the framework of an elastic analysis, the RCC-MR design code uses the concept of the efficiency diagram to assess the behaviour of a structure relatively to ratcheting. This diagram was obtained from a lot of experimental results and allows to cover many reactor situations. However this approach needs to classify stresses between primary and secondary stresses and for a few cases, in particular for structures with significant elastic follow-up, this classification is not obvious. After a recall of elastic follow-up definition and a few considerations on the way to evaluate it, an approach is proposed to take it into account in an elastic analysis verifying the avoidance of ratcheting. An experimental program has been developed to study this interaction between elastic follow-up and ratcheting. The first results are presented together with interpretations with the proposed method. (author)

  16. Slow-growing labyrinthine masses: contribution of MRI to diagnosis, follow-up and treatment

    International Nuclear Information System (INIS)

    Deux, J.F.; Marsot-Dupuch, K.; Tubiana, J.M.; Tran Ba Huy, P.; Sterkers, J.M.

    1998-01-01

    We report the use of MRI in the diagnosis, follow-up and therapeutic management of three cases of intralabyrinthine Schwannoma. The diagnosis was based on the history and initial and follow-up MRI findings. The main feature suggesting the diagnosis was a nodular intralabyrinthine mass of low signal intensity on T2-weighted images, and high or isointense signal on T1-weighted images (relative to cerebrospinal fluid), which showed contrast enhancement. Follow-up imaging showed growth of the tumour in one patient. One patient underwent surgery for severe tinnitus. To detect these lesions, MRI should be focussed on the inner ear, using thin-section T2-weighted and T1-weighted images before and after contrast medium. MRI allowed informed surgical planning. (orig.) (orig.)

  17. Slow-growing labyrinthine masses: contribution of MRI to diagnosis, follow-up and treatment

    Energy Technology Data Exchange (ETDEWEB)

    Deux, J F; Marsot-Dupuch, K; Tubiana, J M [Hopital Saint-Antoine, Paris (France). Service de Radiology; Ouayoun, M; Meyer, B [Service d` ORL, Hopital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, F-75012 Paris (France); Tran Ba Huy, P [Service d` ORL, Hopital Lariboisiere, 2 rue Ambroise Pare, F-75010 Paris (France); Sterkers, J M

    1998-10-01

    We report the use of MRI in the diagnosis, follow-up and therapeutic management of three cases of intralabyrinthine Schwannoma. The diagnosis was based on the history and initial and follow-up MRI findings. The main feature suggesting the diagnosis was a nodular intralabyrinthine mass of low signal intensity on T2-weighted images, and high or isointense signal on T1-weighted images (relative to cerebrospinal fluid), which showed contrast enhancement. Follow-up imaging showed growth of the tumour in one patient. One patient underwent surgery for severe tinnitus. To detect these lesions, MRI should be focussed on the inner ear, using thin-section T2-weighted and T1-weighted images before and after contrast medium. MRI allowed informed surgical planning. (orig.) (orig.) With 3 figs., 1 tab., 21 refs.

  18. [Testicular cancer: a model to optimize the radiological follow-up].

    Science.gov (United States)

    Stebler, V; Pauchard, B; Schmidt, S; Valerio, M; De Bari, B; Berthold, D

    2015-05-20

    Despite being rare cancers, testicular seminoma and non-seminoma play an important role in oncology: they represent a model on how to optimize radiological follow-up, aiming at a lowest possible radiation exposure and secondary cancer risk. Males diagnosed with testicular cancer undergo frequently prolonged follow-up with CT-scans with potential toxic side effects, in particular secondary cancers. To reduce the risks linked to ionizing radiation, precise follow-up protocols have been developed. The number of recommended CT-scanners has been significantly reduced over the last 10 years. The CT scanners have evolved technically and new acquisition protocols have the potential to reduce the radiation exposure further.

  19. Follow-up of abnormal or inadequate test results in the Danish Cervical Cancer Screening Program

    DEFF Research Database (Denmark)

    Kristiansen, Bettina Kjær

    2014-01-01

    Denmark has a higher incidence of cervical cancer than other Nordic countries, although all Danish women (aged 23–65) are screened regularly to identify possible cervical dysplasia or asymptomatic invasive cancer. Annually 40 000 women receives an abnormal or inadequate test result and a follow......-up recommendation. However problems with delayed follow-up may threaten the effectiveness of the Danish Cervical Cancer Screening Program, as 20% of women are delayed and dysplasia potentially can progress into cancer. Delayed follow-up is found in situations where women either consciously or unconsciously postpone...... up will be sent to the women (RCT). The intention is to ensure that all women will be notified about the test result, quickly, homogenously and in layman’s written language, still with the opportunity to contact or be contacted by the GP, if there is special needs. Furthermore, it is assumed that GP...

  20. Gynecologic follow up of 129 women on dialysis and after kidney transplantation: a retrospective cohort study.

    Science.gov (United States)

    Chakhtoura, Zeina; Meunier, Marie; Caby, Jacqueline; Mercadal, Lucile; Arzouk, Nadia; Barrou, Benoît; Touraine, Philippe

    2015-04-01

    To describe the gynecologic issues and follow-up in our referral center of women on dialysis and after kidney transplantation. This retrospective cohort study included 129 dialysed women among whom 102 had had transplants. Data on menstrual pattern, pregnancies, contraception, and cervical cytology were retrieved from patients' files. The follow-up started at age 41.6±14.2 years and lasted for 9.5±10.2 years. Of the women, 78.7% had regular menses before dialysis, decreasing to 30.6% on dialysis (pirregular menses and metrorrhagia which was improved by chlormadinone acetate. We noted high rates of obstetrical complications and abnormal smear tests. Consequently, this population must have close follow-up to identify and treat gynecologic issues. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Results of remote follow-up and monitoring in young patients with cardiac implantable electronic devices.

    Science.gov (United States)

    Silvetti, Massimo S; Saputo, Fabio A; Palmieri, Rosalinda; Placidi, Silvia; Santucci, Lorenzo; Di Mambro, Corrado; Righi, Daniela; Drago, Fabrizio

    2016-01-01

    Remote monitoring is increasingly used in the follow-up of patients with cardiac implantable electronic devices. Data on paediatric populations are still lacking. The aim of our study was to follow-up young patients both in-hospital and remotely to enhance device surveillance. This is an observational registry collecting data on consecutive patients followed-up with the CareLink system. Inclusion criteria were a Medtronic device implanted and patient's willingness to receive CareLink. Patients were stratified according to age and presence of congenital/structural heart defects (CHD). A total of 221 patients with a device - 200 pacemakers, 19 implantable cardioverter defibrillators, and two loop recorders--were enrolled (median age of 17 years, range 1-40); 58% of patients were younger than 18 years of age and 73% had CHD. During a follow-up of 12 months (range 4-18), 1361 transmissions (8.9% unscheduled) were reviewed by technicians. Time for review was 6 ± 2 minutes (mean ± standard deviation). Missed transmissions were 10.1%. Events were documented in 45% of transmissions, with 2.7% yellow alerts and 0.6% red alerts sent by wireless devices. No significant differences were found in transmission results according to age or presence of CHD. Physicians reviewed 6.3% of transmissions, 29 patients were contacted by phone, and 12 patients underwent unscheduled in-hospital visits. The event recognition with remote monitoring occurred 76 days (range 16-150) earlier than the next scheduled in-office follow-up. Remote follow-up/monitoring with the CareLink system is useful to enhance device surveillance in young patients. The majority of events were not clinically relevant, and the remaining led to timely management of problems.

  2. Emphysema Quantification Using Low Dose Chest CT: Changes in Follow-Up Examinations of Asymptomatic Smokers

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Eun Ho; Sun, Joo Sung; Kang, Doo Kyung [Dept. of Radiology, Ajou University School of Medicine, Suwon (Korea, Republic of); Park, Kwang Joo; Park, Kyung Joo [Dept. of Pulmolary Medicine, Ajou University School of Medicine, Suwon (Korea, Republic of)

    2012-01-15

    To evaluate the changes of emphysema quantification in a follow-up low dose CT compared with pulmonary function test (PFT) results in asymptomatic smokers. We selected 66 asymptomatic smokers (> 40 years old) who underwent a follow-up low dose CT at least one year after the first CT as well as PFT within the same time period. Emphysema quantification was performed using an automated measurement software and an emphysema index (EI) was calculated using multiple threshold values (-970--900 HU). The interval change of EI ({Delta} EI) was compared with the change in the PFT values. Mean follow-up %forced expiratory volume in 1 second (88.1), %forced vital capacity (FVC) (89.5) and forced expiratory flow between 25 and 75% of vital capacity (3.21) were significantly lower compared with the values of initial tests (93.3, 93.1, 3.48). The mean EIs (2.4-25.6%) increased on follow-up CTs compared with initial EIs (2.1-24.5%), though the increase was not statistically significant. In a group with a follow-up period of 2 years or more (n = 32), EI significantly increased when using -900 HU as the threshold. The ({Delta} EIs were poorly correlated with the ({Delta} PFT values, but significantly correlated with ({Delta} FVC (r = -0.32--0.27). Emphysema quantification using low dose CT was not effective for the evaluation of short-term changes in less than a 2-year period, but may be used for long term follow-up series in asymptomatic smokers.

  3. Seven-year follow-up of percutaneous closure of patent foramen ovale.

    Science.gov (United States)

    Mirzada, Naqibullah; Ladenvall, Per; Hansson, Per-Olof; Johansson, Magnus Carl; Furenäs, Eva; Eriksson, Peter; Dellborg, Mikael

    2013-12-01

    Observational studies favor percutaneous closure of patent foramen ovale (PFO) over medical treatment to reduce recurrent stroke while randomized trials fail to demonstrate significant superiority of percutaneous PFO closure. Few long-term studies are available post PFO closure. This study reports long-term clinical outcomes after percutaneous PFO closure. Between 1997 and 2006, 86 consecutive eligible patients with cerebrovascular events, presumably related to PFO, underwent percutaneous PFO closure. All 86 patients were invited to a long-term follow-up, which was carried out during 2011 and 2012. Percutaneous PFO closure was successfully performed in 85 of 86 patients. The follow-up rate was 100%. No cardiovascular or cerebrovascular deaths occurred. Two patients (both women) died from lung cancer during follow-up. Follow-up visits were conducted for 64 patients and the remaining 20 patients were followed up by phone. The mean follow-up time was 7.3 years (5 to 12.4 years). Mean age at PFO closure was 49 years. One patient had a minor stroke one month after PFO closure and a transient ischemic attack (TIA) two years afterwards. One other patient suffered from a TIA six years after closure. No long-term device-related complications were observed. Percutaneous PFO closure was associated with very low risk of recurrent stroke and is suitable in most patients. We observed no mortality and no long-term device-related complications related to PFO closure, indicating that percutaneous PFO closure is a safe and efficient treatment even in the long term.

  4. Follow-up of pineal cysts in children. Is it necessary?

    Energy Technology Data Exchange (ETDEWEB)

    Jussila, Miro-Pekka [Oulu University Hospital and University of Oulu, Department of Diagnostic Radiology, Oulu (Finland); Oulu University Hospital and University of Oulu, Department of Children and Adolescents, Oulu (Finland); Olsen, Paeivi [Oulu University Hospital and University of Oulu, Department of Children and Adolescents, Oulu (Finland); University of Oulu, PEDEGO Research Group, Medical Research Center, Oulu (Finland); Salokorpi, Niina [Oulu University Hospital and University of Oulu, Department of Neurosurgery, Oulu (Finland); University of Oulu, Medical Research Center, Oulu (Finland); Suo-Palosaari, Maria [Oulu University Hospital and University of Oulu, Department of Diagnostic Radiology, Oulu (Finland); University of Oulu, Medical Research Center, Oulu (Finland)

    2017-12-15

    Pineal cysts are common incidental findings in children undergoing magnetic resonance imaging (MRI). Several studies have suggested MRI follow-up if the cyst is larger than 10 mm. However, cysts do not usually change during follow-up. Prevalence, growth, and structure of the pineal cysts were analyzed to decide if follow-up MRI is necessary. A retrospective review between 2010 and 2015 was performed using 3851 MRI examinations of children aged 0-16 years to detect pineal cysts having a maximum diameter ≥ 10 mm. Eighty-one children with pineal cysts were identified and 79 of them had been controlled by MRI. Cysts were analyzed for the size, growth, and structure. A total of 1.8% of the children had a pineal cyst with a diameter ≥ 10 mm. Cysts were present in 48 girls (59.3%) and 33 boys (40.7%). Most pineal cysts (70/79) did not significantly grow during the follow-up (median 10 months, range 3-145 months). A total of 11.4% (9/79) of the cysts grew with the biggest change measured from the outer cyst wall sagittal anteroposterior dimension (mean 3.4 mm ± 1.7 mm). Only one cyst grew more than 5 mm. We found no factors correlating with the cyst growth among 9 cysts that grew > 2 mm. A majority of pineal cysts remained unchanged during the MRI follow-up. Results of this study suggest that routine MRI follow-up of pineal cysts is not necessary in the absence of unusual radiological characteristics or related clinical symptoms. (orig.)

  5. Timeliness of abnormal screening and diagnostic mammography follow-up at facilities serving vulnerable women.

    Science.gov (United States)

    Goldman, L Elizabeth; Walker, Rod; Hubbard, Rebecca; Kerlikowske, Karla

    2013-04-01

    Whether timeliness of follow-up after abnormal mammography differs at facilities serving vulnerable populations, such as women with limited education or income, in rural areas, and racial/ethnic minorities is unknown. We examined receipt of diagnostic evaluation after abnormal mammography using 1998-2006 Breast Cancer Surveillance Consortium-linked Medicare claims. We compared whether time to recommended breast imaging or biopsy depended on whether women attended facilities serving vulnerable populations. We characterized a facility by the proportion of mammograms performed on women with limited education or income, in rural areas, or racial/ethnic minorities. We analyzed 30,874 abnormal screening examinations recommended for follow-up imaging across 142 facilities and 10,049 abnormal diagnostic examinations recommended for biopsy across 114 facilities. Women at facilities serving populations with less education or more racial/ethnic minorities had lower rates of follow-up imaging (4%-5% difference, Pfacilities serving more rural and low-income populations had lower rates of biopsy (4%-5% difference, Pfacilities serving vulnerable populations had longer times until biopsy than those at facilities serving nonvulnerable populations (21.6 vs. 15.6 d; 95% confidence interval for mean difference 4.1-7.7). The proportion of women receiving recommended imaging within 11 months and biopsy within 3 months varied across facilities (interquartile range, 85.5%-96.5% for imaging and 79.4%-87.3% for biopsy). Among Medicare recipients, follow-up rates were slightly lower at facilities serving vulnerable populations, and among those women who returned for diagnostic evaluation, time to follow-up was slightly longer at facilities that served vulnerable population. Interventions should target variability in follow-up rates across facilities, and evaluate effectiveness particularly at facilities serving vulnerable populations.

  6. 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.

  7. Long-term follow-up of psilocybin-facilitated smoking cessation.

    Science.gov (United States)

    Johnson, Matthew W; Garcia-Romeu, Albert; Griffiths, Roland R

    2017-01-01

    A recent open-label pilot study (N = 15) found that two to three moderate to high doses (20 and 30 mg/70 kg) of the serotonin 2A receptor agonist, psilocybin, in combination with cognitive behavioral therapy (CBT) for smoking cessation, resulted in substantially higher 6-month smoking abstinence rates than are typically observed with other medications or CBT alone. To assess long-term effects of a psilocybin-facilitated smoking cessation program at ≥12 months after psilocybin administration. The present report describes biologically verified smoking abstinence outcomes of the previous pilot study at ≥12 months, and related data on subjective effects of psilocybin. All 15 participants completed a 12-month follow-up, and 12 (80%) returned for a long-term (≥16 months) follow-up, with a mean interval of 30 months (range = 16-57 months) between target-quit date (i.e., first psilocybin session) and long-term follow-up. At 12-month follow-up, 10 participants (67%) were confirmed as smoking abstinent. At long-term follow-up, nine participants (60%) were confirmed as smoking abstinent. At 12-month follow-up 13 participants (86.7%) rated their psilocybin experiences among the five most personally meaningful and spiritually significant experiences of their lives. These results suggest that in the context of a structured treatment program, psilocybin holds considerable promise in promoting long-term smoking abstinence. The present study adds to recent and historical evidence suggesting high success rates when using classic psychedelics in the treatment of addiction. Further research investigating psilocybin-facilitated treatment of substance use disorders is warranted.

  8. Randomized controlled trial of physiotherapy for postpartum stress incontinence: 7-year follow-up.

    Science.gov (United States)

    Dumoulin, Chantale; Martin, Claudine; Elliott, Valérie; Bourbonnais, Daniel; Morin, Mélanie; Lemieux, Marie-Claude; Gauthier, Robert

    2013-06-01

    To estimate the long-term effect of intensive, 6-week physiotherapy programs, with and without deep abdominal muscle (TrA) training, on persistent postpartum stress urinary incontinence (SUI). The study was a single-blind randomized controlled trial. Fifty-seven postnatal women with clinically demonstrated persistent SUI 3 months after delivery participated in 8 weeks of either pelvic floor muscle training (PFMT) (28) or PFMT with deep abdominal muscle training (PFMT + TrA) (29). Seven years post-treatment, 35 (61.4%) participants agreed to the follow-up; they were asked to complete a 20-min pad test and three incontinence-specific questionnaires with an assessor blinded to each participant's group assignment. Of the 35 (61.4%) who agreed to the follow-up: 26 (45.6%) took the 20-min pad test (12 PFMT and 14 PFMT + TrA) and 35 (61.4%) completed the questionnaires (18 PFMT and 17 PFMT + TrA). The baseline clinical characteristics of the follow-up and non-follow-up participants were not significantly different; nor did they differ between PFMT and PFMT + TrA participants enrolled in the follow-up study. At 7 years, the pad test scores for the PFMT group did not differ statistically from those of the PFMT + TrA group. When combining both treatment groups, a total of 14/26 (53%) follow-up participants were still continent according to the pad test. The addition of deep abdominal training does not appear to further improve the outcome of PFM training in the long term. However, benefits of physiotherapy for postpartum SUI, although not as pronounced as immediately after the initial intervention, is still present 7 years post-treatment. Copyright © 2013 Wiley Periodicals, Inc.

  9. Adherence to Follow-up Recommendations Among Individuals in the Philadelphia Glaucoma Detection and Treatment Project.

    Science.gov (United States)

    Hark, Lisa A; Leiby, Benjamin E; Waisbourd, Michael; Myers, Jonathan S; Fudemberg, Scott J; Mantravadi, Anand V; Dai, Yang; Gilligan, John P; Resende, Arthur F; Katz, L Jay

    2017-08-01

    To evaluate rates of adherence to free follow-up eye exam appointments among participants in the Philadelphia Glaucoma Detection and Treatment Project. Ophthalmologists and testing equipment were brought directly to participants at risk for glaucoma at 43 community sites in Philadelphia. Those diagnosed with glaucoma-related pathology were recommended to return for follow-up to be reexamined on site. Rates of adherence and clinical and demographic risk factors for adherence were evaluated. Five hundred thirty-one participants were diagnosed with glaucoma-related conditions and recommended to attend community-based follow-up exams. Follow-up adherence rate was 61.2% (n=325/531). Significant factors associated with greater eye exam appointment adherence, based on our univariable analysis, included final diagnosis of glaucoma (risk ratio [RR]=1.33; 95% confidence interval [CI], 1.13-1.57), male sex (RR=1.19; 95% CI, 1.04-1.36), white race (RR=1.26; 95% CI, 1.08-1.48), age (RR=1.17; 95% CI, 1.00-1.37) recommendation for glaucoma medication (RR=1.52; 95% CI, 1.35-1.71), recommendation for laser peripheral iridotomy (RR=1.18; 95% CI, 1.02-1.35), diagnosis of age-related macular degeneration (RR=1.42; 95% CI, 1.13-1.77) and an increased intraocular pressure (>22 mm Hg in the worse eye) (RR=1.23; 95% CI, 1.06-1.42). On the basis of our multivariable model, diagnosis, sex, and recommended glaucoma medications were significantly associated with follow-up adherence. This study demonstrates that individuals living in underserved urban communities would take advantage of free eye exams in community sites and return for follow-up eye exams in these same settings. Future studies could investigate interventions to improve eye exam appointment adherence in community-based settings to detect glaucoma-eye conditions.

  10. Disparities in Barriers to Follow-up Care between African American and White Breast Cancer Survivors

    Science.gov (United States)

    Palmer, Nynikka R. A.; Weaver, Kathryn E.; Hauser, Sally P.; Lawrence, Julia A.; Talton, Jennifer; Case, L. Douglas; Geiger, Ann M.

    2015-01-01

    Purpose Despite recommendations for breast cancer survivorship care, African American women are less likely to receive appropriate follow-up care, which is concerning due to their higher mortality rates. This study describes differences in barriers to follow-up care between African American and White breast cancer survivors. Methods We conducted a mailed survey of women treated for non-metastatic breast cancer in 2009–2011, 6–24 months post-treatment (N=203). Survivors were asked about 14 potential barriers to follow-up care. We used logistic regression to explore associations between barriers and race, adjusting for covariates. Results Our participants included 31 African American and 160 White survivors. At least one barrier to follow-up care was reported by 62%. Compared to White survivors, African Americans were more likely to identify barriers related to out-of-pocket costs (28% vs. 51.6%, p=0.01), other healthcare costs (21.3% vs. 45.2%, p=0.01), anxiety/worry (29.4% vs. 51.6%, p=0.02), and transportation (4.4% vs. 16.1%, p=0.03). After adjustment for covariates, African Americans were three times as likely to report at least one barrier to care (OR=3.3, 95%CI=1.1–10.1). Conclusions Barriers to care are common among breast cancer survivors, especially African American women. Financial barriers to care may prevent minority and underserved survivors from accessing follow-up care. Enhancing insurance coverage or addressing out-of-pocket costs may help address financial barriers to follow-up care among breast cancer survivors. Psychosocial care aimed at reducing fear of recurrence may also be important to improve access among African American breast cancer survivors. PMID:25821145

  11. Survival analysis with functional covariates for partial follow-up studies.

    Science.gov (United States)

    Fang, Hong-Bin; Wu, Tong Tong; Rapoport, Aaron P; Tan, Ming

    2016-12-01

    Predictive or prognostic analysis plays an increasingly important role in the era of personalized medicine to identify subsets of patients whom the treatment may benefit the most. Although various time-dependent covariate models are available, such models require that covariates be followed in the whole follow-up period. This article studies a new class of functional survival models where the covariates are only monitored in a time interval that is shorter than the whole follow-up period. This paper is motivated by the analysis of a longitudinal study on advanced myeloma patients who received stem cell transplants and T cell infusions after the transplants. The absolute lymphocyte cell counts were collected serially during hospitalization. Those patients are still followed up if they are alive after hospitalization, while their absolute lymphocyte cell counts cannot be measured after that. Another complication is that absolute lymphocyte cell counts are sparsely and irregularly measured. The conventional method using Cox model with time-varying covariates is not applicable because of the different lengths of observation periods. Analysis based on each single observation obviously underutilizes available information and, more seriously, may yield misleading results. This so-called partial follow-up study design represents increasingly common predictive modeling problem where we have serial multiple biomarkers up to a certain time point, which is shorter than the total length of follow-up. We therefore propose a solution to the partial follow-up design. The new method combines functional principal components analysis and survival analysis with selection of those functional covariates. It also has the advantage of handling sparse and irregularly measured longitudinal observations of covariates and measurement errors. Our analysis based on functional principal components reveals that it is the patterns of the trajectories of absolute lymphocyte cell counts, instead of

  12. Patients with computed tomography-proven acute diverticulitis require follow-up to exclude colorectal cancer

    Directory of Open Access Journals (Sweden)

    Shafquat Zaman

    2017-04-01

    Full Text Available Background/Aims: Traditionally, patients with acute diverticulitis undergo follow-up endoscopy to exclude colorectal cancer (CRC. However, its usefulness has been debated in this era of high-resolution computed tomography (CT diagnosis. We assessed the frequency and outcome of endoscopic follow-up for patients with CT-proven acute diverticulitis, according to the confidence in the CT diagnosis.Methods: Records of patients with CT-proven acute diverticulitis between October 2007 and March 2014 at Sandwell & West Birmingham Hospitals NHS Trust were retrieved. The National Cancer Registry confirmed the cases of CRC. Endoscopy quality indicators were compared between these patients and other patients undergoing the same endoscopic examination over the same period.Results: We identified 235 patients with CT-proven acute diverticulitis, of which, 187 were managed conservatively. The CT report was confident of the diagnosis of acute diverticulitis in 75% cases. Five of the 235 patients were subsequently diagnosed with CRC (2.1%. Three cases of CRC were detected in the 187 patients managed conservatively (1.6%. Forty-eight percent of the conservatively managed patients underwent follow-up endoscopy; one case of CRC was identified. Endoscopies were often incomplete and caused more discomfort for patients with diverticulitis compared with controls.Conclusions: CRC was diagnosed in patients with CT-proven diverticulitis at a higher rate than in screened asymptomatic populations, necessitating follow-up. CT reports contained statements regarding diagnostic uncertainty in 25% cases, associated with an increased risk of CRC. Follow-up endoscopy in patients with CT-proven diverticulitis is associated with increased discomfort and high rates of incompletion. The use of other follow-up modalities should be considered.

  13. The effect of race on postsurgical ambulatory medical follow-up among United States Veterans.

    Science.gov (United States)

    Schonberger, Robert B; Dai, Feng; Brandt, Cynthia; Burg, Matthew M

    2017-08-01

    To investigate the association between self-identified black or African American race and the presence of ambulatory internal medicine follow-up in the year after surgery. Our hypothesis was that among US Veterans who presented for surgery, black or African American race would be associated with a decreased likelihood to receive ambulatory internal medicine follow-up in the year after surgery. Retrospective observational. All US Veterans Affairs hospitals. A total of 236,200 Veterans undergoing surgery between 2006 and 2011 who were discharged within 10 days of surgery and survived the full 1-year exposure period. None. Attendance at an internal medicine follow-up appointment within 1 year after surgery. After controlling for year of surgery, age, age ≥65 years, sex, Hispanic ethnicity, and number of inpatient days, black or African American patients were 11% more likely to lack internal medicine follow-up after surgery (adjusted odds ratio, 1.11; 95% confidence interval, 1.06-1.16). When accounting for geographic region, this difference remained significant at the Bonferoni-corrected P < .007 level only in the Midwest United States where black or African American patients were 28% more likely to lack medical follow-up in the year after surgery (odds ratio, 1.28; 95% confidence interval, 1.16-1.42; P < .0001). The disparity in ambulatory medical follow-up following surgery among black or African American vs nonblack or non-African American Veterans in the Midwest region deserves further study and may lead to important quality improvement initiatives aimed specifically at this population. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Obese patients lose weight independently of nutritional follow-up after bariatric surgery

    Directory of Open Access Journals (Sweden)

    Beatriz Helena Tess

    2015-04-01

    Full Text Available Summary Objective: to examine the association between preoperative body weight, adherence to postsurgical nutritional follow-up, length of postoperative period, and weight loss during the first 18 months among adults who have undergone bariatric surgery. Methods: a retrospective cohort study was conducted on 241 consecutive patients who underwent open Roux-en-Y gastric bypass (RYGBP from January 2006 to December 2008, in a teaching hospital in São Paulo (Brazil. Data were collected through hospital records review and the variables analyzed included sex, age, immediate preoperative weight, adherence to postsurgical nutritional visits and length of postoperative period. Proportional body weight reductions during the 18-month follow-up period were examined using generalized estimating equations. Results: 81% (n=195 of participants were female, with overall mean age of 44.4 ± 11.6 years, mean preoperative weight of 123.1± 21.2 kg and mean preoperative body mass index of 47.2± 6.2 kg/m2. The overall adherence to postoperative follow- up schedule was 51% (95%CI: 44.5-57.5%. Preoperative body weight and adherence were not associated with proportional weight reduction (Wald’s test p > 0.18. Weight loss leveled off at the end of the 18-month follow-up period for both compliant and non-compliant patients (Wald’s test p = 0.00. Conclusions: our study showed that weight loss occurred steadily over the first 18 months after RYGBP, leveling off at around 40% weight reduction. It was associated with neither presurgical weight, nor nutritional follow-up and it may be primarily dependent on the surgical body alterations themselves. This finding may have implications for intervention strategies aimed at motivating patients to comply with early postsurgical and life-long follow-up.

  15. Improving the Patient Experience by Implementing an ICU Diary for Those at Risk of Post-intensive Care Syndrome

    Directory of Open Access Journals (Sweden)

    K Taylor A Blair BA, RN

    2017-03-01

    Full Text Available The critical care literature in the US has recently brought attention to the impact an ICU experience can have long after the patient survives critical illness, particularly if delirium was present. Current recommendations to mitigate post-intensive care syndrome (PICS are embedded in patient and family-centered care and aim to promote family presence in the ICU, provide support for decision-making, and enhance communication with the health-care team. Evidence-based interventions are few in number but include use of an ICU diary to minimize the psychological and emotional sequelae affecting patients and family members in the months following the ICU stay. In this paper we describe our efforts to implement an ICU diary and solicit feedback on its role in fostering teamwork and communication between patients, family members, and ICU staff. Next steps will involve a PICS follow-up clinic where trained staff will coordinate specialty referrals and perform long-term monitoring of mental health and other quality of life outcomes.

  16. Improving the Patient Experience by Implementing an ICU Diary for Those at Risk of Post-intensive Care Syndrome.

    Science.gov (United States)

    Blair, K Taylor A; Eccleston, Sarah D; Binder, Hannah M; McCarthy, Mary S

    2017-03-01

    The critical care literature in the US has recently brought attention to the impact an ICU experience can have long after the patient survives critical illness, particularly if delirium was present. Current recommendations to mitigate post-intensive care syndrome (PICS) are embedded in patient and family-centered care and aim to promote family presence in the ICU, provide support for decision-making, and enhance communication with the health-care team. Evidence-based interventions are few in number but include use of an ICU diary to minimize the psychological and emotional sequelae affecting patients and family members in the months following the ICU stay. In this paper we describe our efforts to implement an ICU diary and solicit feedback on its role in fostering teamwork and communication between patients, family members, and ICU staff. Next steps will involve a PICS follow-up clinic where trained staff will coordinate specialty referrals and perform long-term monitoring of mental health and other quality of life outcomes.

  17. Follow-up of the ovarial carcinoma from the point of view of the gynecologist

    International Nuclear Information System (INIS)

    Vahrson, H.

    1983-01-01

    A co-operation between the different institutions and doctors and the tumor centre is indispensable for an adequate follow-up of the ovarial carcinoma. Besides diagnosis and therapy of side effects of the treatment as well as early diagnosis of recurrences, a psychical and social care is particularly necessary. The follow-up treatment aims at a full social rehabilitation of probably cured patients and, in case of incurable patients, at a relief of pain until death. The determination of t-RNA as a reliable tumor marker and the examinations necessary for routine controls (minimal and maximal programme) are indicated. (orig.) [de

  18. CYSTINURIA - A TEN-YEAR FOLLOW-UP OF THE PATIENTS

    Directory of Open Access Journals (Sweden)

    Anđelka Slavković

    2001-09-01

    Full Text Available In the period from 1991 to 2001 there were four patients followed up who suffered from cystinuria and cystine calcinosis. The therapy consisting of the cystine dilution in the urine by a great taking-in of liquids and the urine alkalization was combined with alphamercaptopropione glycine and captoprile that bind cystine as well as a respective diet. Alphamercaptopropione glycine leads to the reduction of the already-formed calculus and their easier treatment in the case of a possible need for extracorporeal lithotripsy (ESWEL. During the ten-year follow-up of a small series of patients there were no complications related to the medicament treatment.

  19. Treatment and follow-up of children with common chronic liver diseases in children

    Directory of Open Access Journals (Sweden)

    LYU Xintong

    2017-10-01

    Full Text Available Chronic liver diseases in children greatly affect their growth and development and quality of life in future. There are many causes of chronic liver diseases in children, and such causes, diet, and treatment guidance are closely associated with prognosis. This article discusses the guidance and follow-up of common chronic liver diseases in children, such as infantile cholestatic liver disease, chronic hepatitis B, hepatolenticular degeneration, and nonalcoholic fatter liver disease, in order to deepen the understanding of these diseases among patients, raise the awareness of follow-up in medical staff, and improve the cure rate of liver diseases with different causes and children’s quality of life.

  20. Hepatic pseudoaneurysm after traumatic liver injury; is CT follow-up warranted?

    DEFF Research Database (Denmark)

    Østerballe, Lene; Helgstrand, Frederik; Axelsen, Thomas

    2014-01-01

    INTRODUCTION: Hepatic pseudoaneurysm (HPA) is a rare complication after liver trauma, yet it is potentially fatal, as it can lead to sudden severe haemorrhage. The risk of developing posttraumatic HPA is one of the arguments for performing follow-up CT of patients with liver injuries. The aim...... no treatment failures. There was no correlation between the severity of the liver injury and development of HPA. 5 out of 7 patients were asymptomatic and would have been discharged without treatment if the protocol did not include a default follow-up CT. CONCLUSIONS: In conclusion, this study shows that HPA...

  1. 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...... with irritable bowel syndrome as the final and only abdominal diagnosis in the period 1977-79 were followed up in 1984. Seventeen patients died during the follow-up period; two of these were considered diagnostic failures (chronic pancreatitis and pancreatic cancer). Of the remaining 95 patients, 93 were...

  2. Pulmonary function and autoantibodies in a long-term follow-up of juvenile dermatomyositis patients

    DEFF Research Database (Denmark)

    Mathiesen, Pernille Raasthøj; Buchvald, Frederik Fouirnaies; Nielsen, Kim G

    2014-01-01

    outcome, and (iii) identify possible associations between pulmonary impairment and myositis-specific autoantibodies (MSAs).Methods. Fifty-one JDM patients performed conventional spirometry in a cross-sectional follow-up study. The scores of the Myositis Damage Index (MDI), Myositis Damage by visual...... analogue scale (MYODAM-VAS) and physician's global damage assessment were used to estimate JDM outcome. ANAs, MSAs and myositis-associated autoantibodies were analysed in all patients.Results. Forty-two patients (82%) (mean follow-up time 14.3 years) had normal lung function. Four patients (8%) were...

  3. Socioeconomic position and participation in baseline and follow-up visits

    DEFF Research Database (Denmark)

    Bender, Anne M; Jørgensen, Torben; Hansen, Bodil Helbech

    2012-01-01

    Background:The aim of this paper was to identify the extent of socioeconomic inequality in participation at baseline and follow-up visits.Design:The Inter99 study is a randomized intervention with the aim of investigating the effects of an individualized lifestyle consultation on ischaemic heart ...... inequality in participation at baseline and follow-up visits. Effort should be made to increase participation in individualized lifestyle interventions among persons of low socioeconomic position. Otherwise, the consequence may be increased socioeconomic inequality in IHD....

  4. Pediatric vocal fold immobility: natural history and the need for long-term follow-up.

    Science.gov (United States)

    Jabbour, Jad; Martin, Timothy; Beste, David; Robey, Thomas

    2014-05-01

    IMPORTANCE The clinical course and outcomes of pediatric vocal fold immobility (VFI) vary widely in the literature, and follow-up in these patients varies accordingly. A better understanding of the natural history of pediatric VFI is crucial to improved management. OBJECTIVE To characterize the natural history of pediatric VFI, including symptoms and rates of resolution and surgical intervention. DESIGN, SETTING, AND PARTICIPANTS Retrospective review at an academically affiliated private pediatric otolaryngology practice in a metropolitan area of all patients seen between July 15, 2001, and September 1, 2012, with a diagnosis of complete or partial VFI. After elimination of 92 incomplete or duplicate files, 404 patient records were reviewed for demographic characteristics, etiologies, symptoms, follow-up, resolution, and interventions. Follow-up records were available for 362 patients (89.6%). MAIN OUTCOMES AND MEASURES Resolution of VFI confirmed by repeated laryngoscopy, length of follow-up, and surgical intervention rates. RESULTS Among the 404 patients, left VFI was present in 66.8%, right VFI in 7.9%, and bilateral VFI in 25.3%. Median (range) age at presentation was 2.9 (0-528.1) months. Major etiological categories included cardiac surgery in 68.8%, idiopathic immobility in 21.0%, and neurologic disease in 7.4%. At presentation, 61.4%experienced dysphonia, 54.0%respiratory symptoms, and 49.5%dysphagia. Tracheotomy was performed in 25.7%and gastrostomy in 40.8%. Median (range) duration of follow-up among the 89.6%of patients with follow-up was 17.2 (0.2-173.5) months. Resolution evidenced by laryngoscopy was found in 28.0%, with a median (range) time to resolution of 4.3 (0.4-38.7) months. In patients without laryngoscopic resolution, median follow-up was 26.0 months, and 28.9% reported symptomatic resolution. CONCLUSIONS AND RELEVANCE The natural history of pediatric VFI involves substantial morbidity, with lasting symptoms and considerable rates of surgical

  5. Predictors of Attendance and Dropout at the Lung Health Study 11-Year Follow-Up

    OpenAIRE

    Snow, Wanda M.; Connett, John E.; Sharma, Shweta; Murray, Robert P.

    2006-01-01

    Participant attrition and attendance at follow-up were examined in a multicenter, randomized, clinical trial. The Lung Health Study (LHS) enrolled a total of 5, 887 adults to examine the impact of smoking cessation coupled with the use of an inhaled bronchodilator on chronic obstructive pulmonary disease (COPD). Of the initial LHS 1 volunteers still living at the time of enrolment in LHS 3 (5,332), 4,457 (84%) attended the LHS 3 clinic visit, a follow-up session to determine current smoking s...

  6. The importance of complete follow-up for results after femoro-infrapopliteal vascular surgery

    DEFF Research Database (Denmark)

    Jensen, L P; Nielsen, O M; Schroeder, T V

    1996-01-01

    intervals and all data have been recorded prospectively in a vascular registry. As part of a randomised trial on adjuvant medication in femorocrural bypass surgery, 102 patients, operated on between 1990 and 1992 were independently and simultaneously monitored. This subgroup was examined at 3 and 12 months...... is lost to follow-up, since failure to examine the patient for any reason may be related to the patients health. In addition to the number of patients at risk, it is suggested, that life-table plots should be supplemented with information on the number of patients lost to follow-up....

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

    International Nuclear Information System (INIS)

    Guss, K.

    1981-01-01

    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) [de

  8. 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

    to the rare and unforeseeable nature of anaphylaxis, mainly includes case series and expert opinion (grade of evidence IV and V). These guidelines include an overview of the epidemiology of anaphylactic reactions during anaesthesia. A treatment algorithm is suggested, with emphasis on the incremental...... advice concerning follow-up procedures is provided. In addition, an algorithm is included with advice on how to manage patients with previous suspected anaphylaxis during anaesthesia. Lastly, Appendix 2 provides an overview of the incidence, mechanisms and possibilities for follow-up for some common drug...

  9. Outpatient follow-up system using a personal computer for patients with hepatocellular carcinoma after surgery.

    Science.gov (United States)

    Itasaka, H; Matsumata, T; Taketomi, A; Yamamoto, K; Yanaga, K; Takenaka, K; Akazawa, K; Sugimachi, K

    1994-12-01

    A simple outpatient follow-up system was developed with a laptop personal computer to assist management of patients with hepatocellular carcinoma after hepatic resections. Since it is based on a non-relational database program and the graphical user interface of Macintosh operating system, those who are not a specialist of the computer operation can use it. It is helpful to promptly recognize current status and problems of the patients, to diagnose recurrences of the disease and to prevent lost from follow-up cases. A portability of the computer also facilitates utilization of these data everywhere, such as in clinical conferences and laboratories.

  10. FOLLOW-UP DATA ON 179 DANISH CHILDREN AFTER THEIR FIRST PYELONEPHRITIS

    DEFF Research Database (Denmark)

    Breinbjerg, Anders; Kamperis, Konstantinos; Frøkjær, Jørgen

    Introduction: Controversy exists regarding follow-up investigations in children diagnosed with their first pyelonephritis. In our centre children with upper urinary tract infections are subjected to a DMSA or MAG3 scan to assess renal parenchymal damage app. 6 months following the UTI. We aimed...... to analyse follow-up data on 179 consecutive Danish children after their first pyelonephritis. Material and methods:We examined the records of children diagnosed with their first upper UTI confirmed by urine culture during the years 2011-2013.We collected data on the clinical course of the pyelonephritis...

  11. Nuclear Experts Complete IAEA Follow-up Review of German Regulatory System

    International Nuclear Information System (INIS)

    2011-01-01

    Full text: Nuclear safety experts concluded a seven-day mission to review the German Regulatory System, conducted from 4-10 September in Bonn, Stuttgart and Berlin. At the request of the Government of the Federal Republic of Germany, the International Atomic Energy Agency assembled a peer-review team of six high-level regulatory experts from six nations (Finland, France, the Netherlands, Switzerland, the UK, the US and three IAEA senior staff members) to conduct a follow-up assessment of an Integrated Regulatory Review Service (IRRS) mission conducted in 2008. This follow-up IRRS mission examined the progress in acting upon the recommendations and suggestions made during the 2008 IRRS mission and reviewed the areas of significant regulatory changes since that review at both the Federal Ministry of Environment, Nature Conservation and Nuclear Safety (BMU) and the Ministry of Environment of the federal state of Baden-Wurttemberg (UM BW). The first mission reviewed Germany's regulatory framework against IAEA Safety Standards and fostered the exchange of information and experience on safety regulation. This is a peer review based on IAEA Standards. It is not an inspection, nor an audit. The scope of the mission was limited to the safety regulation of nuclear power plants. IRRS team leader, Mr. McCree, of the US Nuclear Safety Commission (USNRC), said, ''This was an important IRRS mission, particularly given the recent Fukushima Daiichi Nuclear Power Plant accident and the related insights which underscore the importance of having an independent, credible nuclear safety regulator.'' ''The IRRS team identified several strengths of the German nuclear safety regulators, including the prompt and coordinated incident response activities of BMU and UM BW to the Fukushima accident. Some suggestions were also made to further strengthen nuclear safety regulations concerning the future work of BMU,'' he said. The review team found that important progress has been made toward

  12. Follow-up study and evaluation of benign stricture of upper gastrointestinal tract with interventional procedure

    International Nuclear Information System (INIS)

    Cheng Yingsheng; Li Minghua; Zhuang Qixin; Shang Kezhong; Chen Weixiong; Chen Niwei

    2001-01-01

    Objective: To make follow-up study and evaluation of benign stricture of upper gastrointestinal tract (UGIT) with interventional procedure. Methods: There were 85 cases of benign stricture of UGIT with interventional procedure. There were 35 cases with pneumatic dilation (group A), 25 cases with permanent (group B) placement, and 25 cases with temporary (group C) placement of expandable metallic stent, respectively. All cases were completed under fluoroscopy. 35 cases of group A had 67 times dilations (mean 1.9 times). Fifteen partial covered and 10 uncovered expandable metallic stents were permanently placed in the 25 cases of group B. 25 partial covered expandable metallic stents were temporarily placed in the 25 cases of group C, and the stents were drawn out via gastroscopy 3-7 days later. All stents placement and drawing were technically successful. The most strictured diameters of UGIT were 0.7-8.5 mm before dilations and 5.1-20.0 mm after dilations. Dysphagia scores of all cases were from grade 2 to 4 before dilations, and from grade 0 to 1 after dilations. Follow-up time of all cases was from 6 months to 36 months (mean 19.1 months). Results: Complications in group A included chest pain (n =10), reflux (n = 8), and bleeding (n = 3). Seven (20%) in 35 cases of group A had dysphagia relapse during follow-up over 6 months; 32 (91%) in 35 cases of group A had dysphagia relapse during follow-up over 12 months; 19(95%) in 20 cases of group A had dysphagia relapse during follow-up over 36 months. Complications in group B included chest pain (n = 10), reflux (n = 15), bleeding (n = 3), and stent migration (n = 4). Five (20%) in 25 cases of group B had dysphagia relapse during follow-up over 6 months; 3(25%) in 12 cases of group B had dysphagia relapse during follow-up over 12 months; 3 (60%) in 5 cases of group B had dysphagia relapse during follow-up over 36 months. Complications in group C included chest pain (n = 10), reflux (n = 3), and bleeding (n = 4). 3

  13. Predictors of hyperglycaemic individuals who do not follow up with physicians after screening in Japan: a cohort study.

    Science.gov (United States)

    Tsujimura, Yuka; Takahashi, Yoshimitsu; Ishizaki, Tatsuro; Kuriyama, Akira; Miyazaki, Kikuko; Satoh, Toshihiko; Ikeda, Shunya; Kimura, Shinya; Nakayama, Takeo

    2014-08-01

    Although people screened as being hyperglycaemic often fail to follow up with physicians for clinical assessment, epidemiologic findings on the frequency and predictors of not following up (hereafter, "no follow-up") are lacking. The purpose of this study was to examine the no follow-up rate with physicians after screening for diabetes and predictors of no follow-up. We assessed cases of no follow-up with physicians within six months after screening based on medical claims data from employee-based social health insurance programs in Japan, for people aged 20 to 68 years from 2005 to 2010. Among 3878 screened participants with hyperglycaemia, 2527 (65%) did not follow up with their physicians within six months after screening. Multiple logistic regression analysis revealed that younger age and lower blood glucose level predicted no follow-up among both men and women, while lower body mass index and negative proteinuria also predicted no follow-up among men. Treatment for dyslipidaemia facilitated follow-up among both genders, and treatment for hypertension or depression facilitated follow-up among men. Approximately two thirds of individuals screened as having hyperglycaemia did not follow up with their physicians within six months after screening. Predictors of no follow-up were younger age and milder hyperglycaemia. Being on treatment for co-morbidities tended to facilitate follow-up. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Forensic state patients at Sterkfontein Hospital: A 3-year follow-up study

    Directory of Open Access Journals (Sweden)

    Belinda Marais

    2015-08-01

    Full Text Available Background. State patients are individuals who have been charged with offences involving serious violence and who have been declared unfit to stand trial and/or who are not criminally responsible because of their mental illness or defect. They are referred by the courts for treatment, rehabilitation and indefinite detention at a forensic psychiatric facility. However, many of these state patients may ultimately be released back into the community. As these individuals may be considered a high-risk group, their rates of relapse and recidivism are of importance. There is a paucity of South African literature on the long-term outcome of state patients.  Objective. To describe the profile of state patients, and to examine their outcomes after 3 years, including recidivism rates.  Methods. A descriptive, retrospective study of the clinical records of 114 state patients admitted to Sterkfontein Hospital in 2004 and 2005 was conducted, and their profile and 3-year outcomes were determined. Results. The majority of state patients were male, single, unemployed, had a past psychiatric history (59%, and substance abuse history (71%. A third reported a past criminal history. The most common offences were assault with the intention to do grievous bodily harm (19%, rape (18% and murder (13%. Psychotic disorders represented the most common diagnostic category (69%, with schizophrenia being the most frequent diagnosis (44%. Most state patients had been found unfit to stand trial (96% and not criminally responsible (89%. At the end of the 3-year follow-up, the majority were in the community (69%, of whom most (72% were out on leave of absence (LOA, while a quarter had absconded and a minority were reclassified (3%. Most absconders (83% were state patients who had not returned from LOA. The recidivism rate was 4%.  Conclusion. Most state patients were out in the community at the end of the 3-year period. The following recommendations are suggested: improved

  15. Trabeculectomy with double low dose of mitomycin C – two years of follow-up

    Directory of Open Access Journals (Sweden)

    Errico D

    2011-12-01

    Full Text Available Donato Errico1, Francesca Scrimieri1, Roberta Riccardi1, Romolo Fedeli1, Giancarlo Iarossi21Opthalmology Unit, Glaucoma Service, Azienda Ospedaliera, Cardinale G Panìco, Tricase (Le, Italy; 2Department of Opthalmology, Ospedale Pediatrico Bambino Gesù, Rome, ItalyPurpose: To evaluate the efficacy and the safety of a surgical technique in which classic trabeculectomy ab externo is performed with a double application of low-dose mitomycin C (MMC in uncontrolled open-angle glaucoma (OAG patients.Method: A consecutive series of 43 white patients (43 eyes with uncontrolled primary OAG underwent trabeculectomy surgery. A double application of MMC (0.1% was performed: the first under the Tenon's capsule for 3 minutes, and the second below the scleral flap for 1 or 2 minutes, according to the risk factors. Complete success was defined as intraocular pressure (IOP <14 mmHg without any additional glaucoma surgery or medication. Qualified success was defined as IOP <14 mmHg with additional needling revision.Results: Mean preoperative IOP was 29.9 mmHg (SD 3.8 for all eyes evaluated. At 1 day postoperative, mean IOP was 6.7 mmHg (SD 1.26. At the end of the first 2 weeks postoperative, mean IOP was 8.6 mmHg (SD 1.7, at 12 months mean IOP was 11.3 mmHg (SD 1.4; P < 0.0001 and at 24 months mean IOP was 11.4 mmHg (SD 1.5; P < 0.0001. At 3 months, two eyes (5.4% underwent needling of the bleb for cystic blebs formation.Conclusion: In this study we presented the results after 2 years of follow-up of OAG undergoing trabeculectomy with dual administration of MMC (0.1 mg/mL. After 24 months, complete success was achieved in 93% of patients and a qualified success in 100% of patients.Keywords: glaucoma, trabeculectomy, mitomycin C

  16. Periodontitis in early and chronic rheumatoid arthritis: a prospective follow-up study in Finnish population.

    Science.gov (United States)

    Äyräväinen, Leena; Leirisalo-Repo, Marjatta; Kuuliala, Antti; Ahola, Kirsi; Koivuniemi, Riitta; Meurman, Jukka H; Heikkinen, Anna Maria

    2017-01-31

    To investigate the association between rheumatoid arthritis (RA) and periodontitis with special emphasis on the role of antirheumatic drugs in periodontal health. Prospective follow-up study. Patients with early untreated RA and chronic active RA were examined at baseline and 16 months later. Controls were examined once. The study was conducted in Finland from September 2005 to May 2014 at the Helsinki University Hospital. Overall, 124 participants were recruited for dental and medical examinations: 53 were patients with early disease-modifying antirheumatic drug (DMARD) naїve RA (ERA), 28 were patients with chronic RA (CRA) with insufficient response to conventional DMARDs. After baseline examination, patients with ERA started treatment with synthetic DMARDs and patients with CRA with biological DMARDs. Controls were 43 age-matched, gender-matched and community-matched participants. Degree of periodontitis (defined according to the Center for Disease Control and Prevention and the American Academy of Periodontology). Prevalence of periodontal bacteria (analysed from plaque samples), clinical rheumatological status by Disease Activity Score, 28-joint count (DAS28), function by Health Assessment Questionnaire (HAQ) and treatment response by European League Against Rheumatism (EULAR) criteria. Moderate periodontitis was present in 67.3% of patients with ERA, 64.3% of patients with CRA and 39.5% of control participants (p=0.001). Further, patients with RA had significantly more periodontal findings compared with controls, recorded with common periodontal indexes. In the re-examination, patients with RA still showed poor periodontal health in spite of treatment with DMARDs after baseline examination. The prevalence of Porphyromonas gingivalis was higher in patients with ERA with periodontal probing depth ≥4 mm compared with patients with CRA and controls. Antirheumatic medication did not seem to affect the results. Moderate periodontitis was more frequent in

  17. Prophylaxis and follow-up after possible exposure to HIV, hepatitis B virus, and hepatitis C virus outside hospital: evaluation of policy 2000-3

    NARCIS (Netherlands)

    Sonder, Gerard J. B.; Regez, Rosa M.; Brinkman, Kees; Prins, Jan M.; Mulder, Jan-Willem; Spaargaren, Joke; Coutinho, Roel A.; van den Hoek, Anneke

    2005-01-01

    Problem Prophylactic treatment and follow-up after exposure to HIV, hepatitis B, and hepatitis C outside hospital needs to be improved. Background and setting Until January 2000, people in Amsterdam Could report exposure outside hospital to either a hospital or the municipal health service. If they

  18. Follow-up protocol was useful for children whose parents attended emergency departments after partner violence, substance abuse or a suicide attempt

    NARCIS (Netherlands)

    van Konijnenburg, Eva M. M. Hoytema; Gigengack, Maj; Teeuw, Arianne H.; Sieswerda-Hoogendoorn, Tessa; Brilleslijper-Kater, Sonja N.; Flapper, Boudien C.; Lindauer, Ramon J. L.; van Goudoever, Johannes B.; van der Lee, Johanna H.

    Aim: This was a one-year follow-up of families referred to support services after the parents visited the emergency department due to intimate partner violence, substance abuse or a suicide attempt. Its aim was to evaluate the well-being of any children. Methods: Data on families identified a year

  19. Follow-up protocol was useful for children whose parents attended emergency departments after partner violence, substance abuse or a suicide attempt

    NARCIS (Netherlands)

    Hoytema van Konijnenburg, Eva M. M.; Gigengack, Maj; Teeuw, Arianne H.; Sieswerda-Hoogendoorn, Tessa; Brilleslijper-Kater, Sonja N.; Flapper, Boudien C.; Lindauer, Ramón J. L.; van Goudoever, Johannes B.; van der Lee, Johanna H.; Biezeveld, Maarten H.; Edelenbos, Esther; van Sommeren, Pauwlina G. W.; Mahdi, Ulrike; Poldervaart, Jacoba D.; Sanders, Marian K.; Schoonenberg, N.; Vogt, Anne; Wilms, Janneke F.

    2018-01-01

    AimThis was a one-year follow-up of families referred to support services after the parents visited the emergency department due to intimate partner violence, substance abuse or a suicide attempt. Its aim was to evaluate the well-being of any children. MethodsData on families identified a year

  20. Multicentre European study of thalamic stimulation for parkinsonian tremor: a 6 year follow-up

    NARCIS (Netherlands)

    Hariz, M. I.; Krack, P.; Alesch, F.; Augustinsson, L.-E.; Bosch, A.; Ekberg, R.; Johansson, F.; Johnels, B.; Meyerson, B. A.; N'Guyen, J.-P.; Pinter, M.; Pollak, P.; von Raison, F.; Rehncrona, S.; Speelman, J. D.; Sydow, O.; Benabid, A.-L.

    2008-01-01

    To evaluate the results of ventral intermediate (Vim) thalamic deep brain stimulation (DBS) in patients with tremor predominant Parkinson's disease (PD) at 6 years post surgery. This was a prolonged follow-up study of 38 patients from eight centres who participated in a multicentre study, the 1 year

  1. TEX-SIS First-Year Graduate Follow-Up, Vol. 2, #1.

    Science.gov (United States)

    Gose, Frank J.

    A follow-up study was conducted of Yavapai College students who completed a certificate or graduated with a degree in spring 1980 to obtain demographic data and information on the graduates' current status, purpose for enrolling at Yavapai, and views of the college, and on the relationship between their current activities and their coursework at…

  2. Importance of post-treatment follow-up to secure sufficient eradication therapy for Helicobacter pylori

    DEFF Research Database (Denmark)

    Roug, Stine; Madsen, Lone Galmstrup

    2012-01-01

    To optimize the care for Helicobacter pylori-associated diseases, we wanted to evaluate the completeness of follow-up after H. pylori eradication therapy in a single Danish endoscopy unit. Furthermore, the eradication rates and possible clinical characteristics associated with failure of eradicat...

  3. An Exploration of Online Environments Supporting Follow-Up to Face-to-Face Professional Development

    Science.gov (United States)

    Green, Marybeth; Cifuentes, Lauren

    2008-01-01

    In this study we examined the effects of online follow-up and online peer interaction following a face-to face professional development workshop on attitudes towards that professional development and completion of a professional development task. School librarians were invited to work online on a three page plan outlining interventions a library…

  4. AVETH follow-up survey on salary and duties of ETH doctoral students

    OpenAIRE

    Schalko, Isabella; Jacob, Romain; Kuzmanovska, Irena

    2017-01-01

    The present survey was conducted as a follow-up of the AVETH survey in 2014. Based on 1′052 completed answers this report summarizes the current employment situation and the corresponding opinion of doctoral students at ETH Zurich about their salary rate and additional duties.

  5. Mortality in myasthenia gravis: A nationwide population-based follow-up study in Denmark

    DEFF Research Database (Denmark)

    Hansen, Julie S; Danielsen, Ditte H; Somnier, Finn E

    2016-01-01

    INTRODUCTION: In previous studies of myasthenia gravis (MG), increased mortality has been reported. The aim of this study was to estimate mortality in patients with acetylcholine receptor antibody-positive (AChR-Ab-seropositive) MG in a nationwide population-based, long-term follow-up study...

  6. Preserving the Beneficial Effects of Evangelistic Preaching: Billy Graham's Follow-Up Strategies.

    Science.gov (United States)

    Keefe, Carolyn

    A study investigated evangelist Billy Graham's numerical success in using "the invitation" and the Billy Graham Evangelistic Association's (BGEA) follow-up plan to preserve the beneficial effects of Christian commitment and to minimize commitment attrition. Statistics on audience response gathered throughout Graham's ministry attest to…

  7. Neurocognitive development in first episode psychosis 5 years follow-up

    DEFF Research Database (Denmark)

    Barder, Helene Eidsmo; Sundet, Kjetil; Rund, Bjørn Rishovd

    2013-01-01

    , as measured by relapses and diagnostic subgroups. The study is an extension of previous findings from the TIPS-project, reporting stability over the first two years. Sixty-two FEP patients (53% male, age 28 ± 9 years) were neuropsychologically examined at baseline and at 1, 2, and 5 year follow-ups. The test...

  8. Conceptualizing patient empowerment in cancer follow-up by combining theory and qualitative data

    DEFF Research Database (Denmark)

    Johnsen, Anna Thit; Eskildsen, Nanna Bjerg; Thomsen, Thora Grothe

    2017-01-01

    and sensitive questionnaire for this population. Material and Methods: A theoretical model of PE was made, based on Zimmerman’s theory of psychological empowerment. Patients who were in follow-up after first line treatment for their cancer (n = 16) were interviewed about their experiences with follow...

  9. Self-esteem and depression: ten year follow-up of mothers and offspring.

    Science.gov (United States)

    Miller, L; Warner, V; Wickramaratne, P; Weissman, M

    1999-01-01

    The association between maternal bonding style, offspring low self-esteem and offspring depression status was assessed by maternal depression status. Sixty mothers and 137 offspring were independently assessed over the course of a ten year follow-up study. Assessments included the Schedule for Affective Disorders and Schizophrenia (SADS-LA), Schedule for Affective Disorders and Schizophrenia for School-Aged Children (K-SADS), the Coopersmith Self-Esteem Inventory (CSEI) and the Parental Bonding Instrument (PBI). Among daughters of mothers with a history of depression, maternal affectionless-control was associated with daughter low self-esteem which was associated with daughter depression at ten year follow-up. Among daughters of mothers without a history of depression, maternal affectionless-control was not associated with daughter low self-esteem, which was not associated with daughter depression at ten year follow-up but which was associated with a history of childhood depression. None of these associations were found to be significant among sons. As self-esteem was not measured at ten year follow-up, among offspring the stability of self-esteem could not be assessed, nor could the association between adult self-esteem and adult depression. Clinical presentation of low self-esteem in girls should be assessed in the context of maternal depression status.

  10. Multimodal follow-up questions to multimodal answers in a QA system

    NARCIS (Netherlands)

    van Schooten, B.W.; op den Akker, Hendrikus J.A.

    2007-01-01

    We are developing a dialogue manager (DM) for a multimodal interactive Question Answering (QA) system. Our QA system presents answers using text and pictures, and the user may pose follow-up questions using text or speech, while indicating screen elements with the mouse. We developed a corpus of

  11. Predictors of ADHD Persistence in Girls at 5-Year Follow-Up

    Science.gov (United States)

    Mick, Eric; Byrne, Deirdre; Fried, Ronna; Monuteaux, Michael; Faraone, Stephen V.; Biederman, Joseph

    2011-01-01

    Objective: The main aim of this study was to examine the age-dependent remission from ADHD in girls transitioning through childhood into adolescence and early adulthood. Method: We conducted a 5-year prospective follow-up study of 123 girls with ADHD and 106 non-ADHD control girls aged between 6 and 17 years at ascertainment. ADHD was considered…

  12. Dynamic hyperinflation after metronome-paced hyperventilation in COPD--a 2 year follow-up.

    NARCIS (Netherlands)

    Hannink, J.D.C.; Lahaije, A.J.; Bischoff, E.W.M.A.; Helvoort, H.A.C. van; Dekhuijzen, R.; Schermer, T.R.J.; Heijdra, Y.F.

    2010-01-01

    In contrast to the decline in FEV(1), the behavior of dynamic hyperinflation (DH) over time is unknown in patients with COPD. Metronome-paced hyperventilation (MPH) is a simple applicable surrogate for exercise to detect DH. OBJECTIVE: To evaluate changes in MPH-induced DH during two years follow-up

  13. Biochemical markers in the follow-up of medullary thyroid cancer

    NARCIS (Netherlands)

    de Groot, Jan Willem B.; Kema, Ido P.; Breukelman, Henk; van der Veer, Eveline; Wiggers, Theo; Plukker, John T. M.; Wolffenbuttel, Bruce H. R.; Links, Thera P.

    2006-01-01

    Medullary thyroid cancer (MTC) shares biochemical features with other neuroendocrine tumors but the particular characteristics are largely unexplored. We investigated the biochemical neuroendocrine profile of MTC and whether specific markers could be useful in follow-up. In addition to the standard

  14. Use of mini dental implants in ectodermal dysplasia children: follow-up of three cases.

    Science.gov (United States)

    Sfeir, E; Nassif, N; Moukarzel, C

    2014-07-01

    Ectodermal dysplasia is a hereditary genodermatosis characterised by a congenital defect of ectodermal structures, causing tooth malformations and anomalies. Implantology has become accepted in these subjects. However cases are often complicated by a reduction in the size of the alveolar process, making the insertion of conventional implants difficult without bone grafting. The reduced diameter of mini-implants and their ease of insertion provide an interesting solution in supporting removable or fixed prosthesis. The purpose of this paper is to report the follow-up of three cases of children (11-12 year- old) with ectodermal dysplasia in which mini-implants were used to support the prostheses. In the first case, two mini-implants were inserted into the anterior part of the mandible for stabilising a removable denture (2 years follow-up). In the other two cases, mini- implants were inserted in the maxilla and mandible to replace missing front teeth with fixed prostheses. Patients were called for follow- up every 6 months: in the sencod case follow-up lasted 4 years in the mandible and 2 years in the maxilla; in the third case, 2 years in the maxilla and 1 year in the mandible. The use of mini-implants in children with ectodermal dysplasia can enhance aesthetics, and functional and psychosocial development.

  15. Resilience dimensions and mental health outcomes in bipolar disorder in a follow-up study.

    Science.gov (United States)

    Echezarraga, A; Calvete, E; González-Pinto, A M; Las Hayas, C

    2018-02-01

    The individual process of resilience has been related to positive outcomes in mental disorders. We aimed (a) to identify the resilience domains from the Resilience Questionnaire for Bipolar Disorder that are associated cross sectionally and longitudinally with mental health outcomes in bipolar disorder (BD) and (b) to explore cross-lagged associations among resilience factors. A clinical adult sample of 125 patients diagnosed with BD (62.10% female, mean age = 46.13, SD = 10.89) gave their informed consent and completed a battery of disease-specific tools on resilience, personal recovery, symptomatology, psychosocial functioning, and quality of life, at baseline and at follow-up (n = 63, 58.10% female, mean age = 45.13, SD = 11.06, participation rate = 50.40%). Resilience domains of self-management of BD, turning point, self-care, and self-confidence were significantly associated with mental health indicators at baseline. In addition, self-confidence at baseline directly predicted an increase in personal recovery at follow-up, and self-confidence improvement mediated the relationship between interpersonal support and self-care at baseline and personal recovery at follow-up. These findings highlight that resilience domains are significantly associated with positive mental health outcomes in BD and that some predict personal recovery at follow-up. Moreover, some resilience factors improve other resilience factors over time. Copyright © 2017 John Wiley & Sons, Ltd.

  16. Smith-Petersen Vitallium mould arthroplasty: a 62-year follow-up.

    LENUS (Irish Health Repository)

    Baker, J F

    2011-09-01

    A variety of materials were used for early hip prostheses. The introduction of Vitallium by Smith-Petersen represented a further advance in this surgical field. We present the longest known follow-up of a Smith-Petersen Vitallium mould arthroplasty.

  17. ATLANTIC DIP: simplifying the follow-up of women with previous gestational diabetes.

    LENUS (Irish Health Repository)

    Noctor, E

    2013-11-01

    Previous gestational diabetes (GDM) is associated with a significant lifetime risk of type 2 diabetes. In this study, we assessed the performance of HbA1c and fasting plasma glucose (FPG) measurements against that of 75 g oral glucose tolerance testing (OGTT) for the follow-up screening of women with previous GDM.

  18. In Retrospect: A Fifteen-Year Follow-Up Report of Speech-Language-Disordered Children.

    Science.gov (United States)

    King, Rella R.; And Others

    1982-01-01

    A 15-year follow-up of 50 children initially diagnosed as communicatively impaired is reported. The survey describes Ss in terms of the educational levels they have attained, their motor skills, their social skills as perceived by their families, and any communication problems that may exist. (Author/DB)

  19. 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.

  20. Evolution of Costs of Inflammatory Bowel Disease over Two Years of Follow-Up

    NARCIS (Netherlands)

    Valk, M. van der; Mangen, M.J.; Severs, M.; Have, M. van der; Dijkstra, G.; Bodegraven, A.A. van; Fidder, H.H.; Jong, D.J. de; Woude, C.J. van der; Romberg-Camps, M.J.; Clemens, C.H.; Jansen, J.M.; Meeberg, P.C. van de; Mahmmod, N.; Meulen-de Jong, A.E. van der; Ponsioen, C.Y.; Bolwerk, C.; Vermeijden, J.R.; Siersema, P.D.; Leenders, M.; Oldenburg, B.

    2016-01-01

    BACKGROUND: With the increasing use of anti-TNF therapy in inflammatory bowel disease (IBD), a shift of costs has been observed with medication costs replacing hospitalization and surgery as major cost driver. We aimed to explore the evolution of IBD-related costs over two years of follow-up.