WorldWideScience

Sample records for policies tuition remission

  1. The Impacts of State Control Policies on College Tuition Increase

    Science.gov (United States)

    Kim, Mikyong Minsun; Ko, Jangwan

    2015-01-01

    This study examined state efforts to control tuition increases over the past 10 years. Using data from 50 states and 540 public 4-year universities and colleges, we examined average tuition increases in dollar amount and percentage of change by the type of state tuition control policy and by the authority for tuition-setting power. The state…

  2. 29 CFR 1949.1 - Policy regarding tuition fees.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Policy regarding tuition fees. 1949.1 Section 1949.1 Labor... Institute § 1949.1 Policy regarding tuition fees. (a) The OSHA Training Institute shall charge tuition fees for all private sector students attending Institute courses. (b) The following private sector students...

  3. State Tuition, Fees, and Financial Assistance Policies: For Public Colleges and Universities, 2010-11

    Science.gov (United States)

    Bell, Allison C.; Carnahan, Julie; L'Orange, Hans P.

    2011-01-01

    This report, "State Tuition, Fees, and Financial Assistance Policies for Public Colleges and Universities: 2010-11", examines the philosophies, policies, and procedures that influence decision-making regarding public college and university tuition, student fees, and student financial aid programs. This report also provides information…

  4. Legislative Agenda Setting for In-State Resident Tuition Policies: Immigration, Representation, and Educational Access

    Science.gov (United States)

    McLendon, Michael K.; Mokher, Christine G.; Flores, Stella M.

    2011-01-01

    Few recent issues in higher education have been as contentious as that of legislation extending in-state college tuition benefits to undocumented students, initiatives now known as in-state resident tuition (ISRT) policies. Building on several strands of literature in political science and higher education studies, we analyze the effects of…

  5. Nonresident Tuition and Fees at SUNY. Rates, Policies, and Consequences

    Science.gov (United States)

    Abbey, Craig W.; Armour-Garb, Allison

    2010-01-01

    To inform the discussion of out-of-state tuition, SUNY officials asked the Nelson A. Rockefeller Institute of Government to conduct a study that addresses three questions. First, how do SUNY's undergraduate nonresident tuition and fees compare to those charged by comparable higher education institutions? Second, what is known about the effects of…

  6. Demand for private tuition classes under the free education policy. Evidence based on Sri Lanka

    OpenAIRE

    Pallegedara, Asankha

    2011-01-01

    Private tuition classes are growing phenomenon in Sri Lanka especially among students who prepare for competitive national school qualifying examinations. It is one of major education issues under the free education policy in Sri Lanka. It can tarnish the real purpose of free education policy. In this paper, we examine the demand for private tuition classes in Sri Lanka by using two waves of Household Income and Expenditure Surveys (HIES) conducted by the Department of Census and Statistics (...

  7. Educational "When," "Where," and "How" Implications of In-State Resident Tuition Policies for Latino Undocumented Immigrants

    Science.gov (United States)

    Darolia, Rajeev; Potochnick, Stephanie

    2015-01-01

    This paper presents an analysis of the effects of in-state resident tuition (IRT) policies, which allow undocumented immigrants to pay in-state rather than out-of state tuition, on when and where undocumented immigrant students enroll, and how they finance their education. We identify effects based on differences in pre- and post-policy outcomes…

  8. How states can reduce the dropout rate for undocumented immigrant youth: the effects of in-state resident tuition policies.

    Science.gov (United States)

    Potochnick, Stephanie

    2014-05-01

    As of December 2011, 13 states have adopted an in-state resident tuition (IRT) policy that provides in-state tuition to undocumented immigrants and several other states are considering similar legislation. While previous research focuses on how IRT policies affect college entry and attainment, this study examines the effect these policies have on high school dropout behavior. Using the Current Population Survey (CPS) and difference-in-difference models, this paper examines whether IRT policies reduce the likelihood of dropping out of high school for Mexican foreign-born non-citizens (FBNC), a proxy for undocumented youth. The policy is estimated to cause an eight percentage point reduction in the proportion that drops out of high school. The paper develops an integrated framework that combines human capital theory with segmented assimilation theory to provide insight into how IRT policies influence student motivation and educational attainment at the high school level. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. The Impact of "Tuition-Paying" Policy on Retention and Graduation Rates at the University of Ghana

    Science.gov (United States)

    Atuahene, Francis

    2013-01-01

    African universities over the past decade have developed new modes of financial mobilization in search for fiscal solutions to the declining public support for higher education. The creation of the "tuition-paying" ("dual track" or "fee-paying") admission track policy, a variant of cost sharing, is one of such…

  10. State Dream Acts: The Effect of In-State Resident Tuition Policies and Undocumented Latino Students

    Science.gov (United States)

    Flores, Stella M.

    2010-01-01

    This study examines the effect of in-state resident tuition legislation across the United States on the college enrollment odds of individuals likely to be undocumented Latino immigrants. The study employs a differences-indifferences strategy using data from the Current Population Survey's Merged Outgoing Rotation Groups. Foreign-born noncitizen…

  11. Student Tuition Charges: Comparisons, Options, and Implications and An Appendix to Student Tuition Charges: Comparisons, Options, and Implications.

    Science.gov (United States)

    Diaz, Porfirio R.

    National and state comparisons of tuition and fee charges, as well as various policy options presented to the New Mexico Commission on Higher Education, are provided. An introduction to tuition and fee calculation is followed by definitions of tuition, required student fees, and student residency status. A study of tuition and fees at New Mexico…

  12. Balancing Tuition Predictability and Affordability: The Pitfalls of Guaranteed Tuition Plans

    Science.gov (United States)

    Delaney, Jennifer A.; Kearney, Tyler D.; Hemenway, Bradley

    2016-01-01

    As tuition levels rise, predictability is an increasingly important consideration of college financing. In this article, the authors explore contemporary policy tools intended to enhance tuition predictability. They specifically consider guaranteed tuition plans. The authors begin their discussion by considering the prevalence of guaranteed…

  13. Examining Admission Policy Change at a Private, Tuition-Dependent, Baccalaureate Institution in an Urban Setting: A Qualitative Case Study

    Science.gov (United States)

    Gage, Christopher B.

    2017-01-01

    Higher education in America is resilient; in the face of seemingly insurmountable challenges, higher education manages to weather the storm of change, pressure, doubt, and criticism. Consider the following challenges: shifting demographics, escalating tuition, decreased state funding, retention and graduation rates, flat tuition revenue,…

  14. Tuition Tax Credits: Issues of Equity.

    Science.gov (United States)

    Catterall, James S.

    To examine equity issues involving proposed Federal income tax credits for private school tuition, the author uses data from the Bureau of the Census and other governmental sources to estimate the effects of tuition tax credit (TTC) plans. After discussing equity and educational policy, he compares would-be TTC recipients--private school families…

  15. The Political Economy of College Prepaid Tuition Plans

    Science.gov (United States)

    Baird, Katherine

    2006-01-01

    Rising tuition has led many states to offer college prepaid tuition plans. These plans are consistent with the trend in higher education policy toward meeting the needs of wealthier households. The paper argues that the public interest in these plans is hard to find; moreover, median voter theory suggests that prepaid tuition plans may have the…

  16. An Investigation of Student Response to a Potential Tuition Cap Increase at Casper College

    Science.gov (United States)

    Davis, Elizabeth; Aitchison, Thomas; Allen, Eric; Gomez, Carrie; Laird, Sheree; Raczynska, Kaja

    2015-01-01

    Wyoming Community College Commission policy currently states any student enrolled for more than 12 credit hours will be charged tuition for only 12 credit hours. This policy is referred to as the tuition cap. In November 2010, the commission discussed increasing the tuition cap to 15 credits. An increase from 12 to 15 credits would have…

  17. THE POLICY OF GRANTING REMISSION TO CORRUPTION INMATES IN ORDER TO ERADICATE CORRUPTION IN INDONESIA

    Directory of Open Access Journals (Sweden)

    M Ali Zaidan

    2016-01-01

    Full Text Available Corruption is an extraordinary crime, even though the laws have been revised and has a more progressive character has also established Anti-Corruption Commission the number of crimes of corruption still do not show any significant change. In the midst of public pessimism, the Ministry of Justice and Human Rights has initiated efforts to revise the Government Regulation Number 99 Year 2012. The tightening of remission meant that the convict is not easy to get their sentences reduced. Attempts to revise the provisions concerning remission, it should consider how far can reduce corruption and its impact on inmates and the public

  18. College Affordability and the Emergence of Progressive Tuition Models: Are New Financial Aid Policies at Major Public Universities Working? Research and Occasional Paper Series: CSHE.7.16

    Science.gov (United States)

    Lapid, Patrick A.; Douglass, John Aubrey

    2016-01-01

    In an era of significant disinvestment in public higher education by state governments, many public universities are moving toward a "progressive tuition model" that attempts to invest approximately one-third of tuition income into institutional financial aid for lower-income and middle-class students. The objective is to mitigate the…

  19. Battle Continues over In-State Tuition for Illegal Immigrants

    Science.gov (United States)

    Gilroy, Marilyn

    2009-01-01

    Ten states now offer in-state college tuition rates to illegal immigrant students. Others are struggling to enact similar policies. But while many advocates want to open the doors to higher education for undocumented students, critics say the laws granting in-state tuition discriminate against other low-income students and legal residents of the…

  20. Anatomy of a Tuition Freeze: The Case of Ontario

    Science.gov (United States)

    Rexe, Deanna

    2015-01-01

    Using two conceptual frameworks from political science--Kingdon's (2003) multiple streams model and the advocacy coalition framework (Sabatier & Jenkins-Smith, 1993)--this case study examines the detailed history of a major tuition policy change in Ontario in 2004: a tuition freeze. The paper explores the social, political, and economic…

  1. Phantom Dollars: Findings from the 1996 NACUBO Tuition Discounting Survey.

    Science.gov (United States)

    Lapovsky, Lucie

    1997-01-01

    Results of a National Association of College and University Business Officers survey concerning tuition discounting policies found that one-third of higher education's stated revenue stream consists of phantom dollars, with less than 10% of students paying published tuition. Data on freshman and other discounting rates, financial aid strategies,…

  2. The Case Against Tuition Tax Credits.

    Science.gov (United States)

    Shannon, Thomas A.

    Tuition tax credits for private elementary and secondary schools would be bad law, bad economics, and bad public policy. These points are made in this twenty-first chapter of a book on school law. Legal arguments against tax credits are based on a number of court decisions concerning church-state separation, particularly the Supreme Court decision…

  3. The Waldorf Tuition and Grant Reduction Experiment.

    Science.gov (United States)

    Hamm, William E.

    1995-01-01

    Counter to national trends at private colleges, Waldorf College (Iowa) found it could increase enrollment by reducing tuition and institution-based student aid. The context for implementing this policy, short- and long-term results of the decisions, lessons learned, and some more-recent initiatives are reviewed. (MSE)

  4. The tuition fee ‘shock’: Analysing the response of first-year students to a spatially discontinuous policy change in Germany

    DEFF Research Database (Denmark)

    Mitze, Timo Friedel; Burgard, Claudia; Alecke, Björn

    2015-01-01

    students. Second, changes in migration behaviour are sensitive to geographical distance. Finally, comparing different types of higher education institutions, we find that the migration effect is larger for universities compared to technical colleges and colleges of arts or music....... variation in tuition fee regimes as a result of a Federal Constitutional Court decision. Our empirical results show that the introduction of tuition fees had a particular impact on student migration. We observe three effects: first, male students show a stronger migration response compared to female...

  5. Losing Sleep over Tuition

    Science.gov (United States)

    Fogg, Piper

    2009-01-01

    With two children already in college and three more in the wings, the Nwanguma family knows about sacrifice. The annual tuition bill for Prince George's Community College typically comes to between $3,500 and $4,000 for the oldest son, Chuka. To afford it, Chuma Nwanguma, a Nigerian immigrant, often works overtime in addition to his regular night…

  6. In-state tuition for undocumented immigrants and its impact on college enrollment, tuition costs, student financial aid, and indebtedness

    OpenAIRE

    Amuedo-Dorantes, Catalina; Sparber, Chad

    2012-01-01

    The 1996 Immigration Reform and Responsibility Act barred states from giving unlawful residents postsecondary education benefits that states do not offer to U.S. citizens. In contrast to this federal law, several states have passed legislation explicitly allowing undocumented immigrants to pay in-state tuition rates. We use a difference-in-difference estimation methodology to assess intended and unintended consequences of this tuition policy. First, we find evidence consistent with past studi...

  7. The First State Dream Act: In-State Resident Tuition and Immigration in Texas

    Science.gov (United States)

    Flores, Stella M.

    2010-01-01

    In 2001, Texas became the first state to pass an in-state resident tuition policy that benefits undocumented immigrant students, a majority of whom are of Latino/a origin. This analysis estimates the effect of the Texas in-state resident tuition policy on students likely to be undocumented. Using a differences-in-differences strategy and two…

  8. Tuition Discounting for Revenue Management

    Science.gov (United States)

    Hillman, Nicholas W.

    2012-01-01

    Over the past decade, institutionally-funded financial aid (or "tuition discounts") have been the fastest-growing item within most public four-year college and university operating budgets. One explanation for this trend is due to the changing structure of public colleges' revenue streams, as tuition and fees have replaced state appropriations as…

  9. Why Tuition Keeps Going Up.

    Science.gov (United States)

    Frances, Carol

    1985-01-01

    While tuition is increasing faster than the cost of living, a longer perspective indicates that colleges and universities are victims of past rather than current inflation. Fiscal pressures will continue for some time, reflected in higher tuition, but the rate of return on investment in a college degree should rise. (MSE)

  10. Cognitive remission

    DEFF Research Database (Denmark)

    Bortolato, Beatrice; Miskowiak, Kamilla W; Köhler, Cristiano A

    2016-01-01

    BACKGROUND: Cognitive dysfunction in major depressive disorder (MDD) encompasses several domains, including but not limited to executive function, verbal memory, and attention. Furthermore, cognitive dysfunction is a frequent residual manifestation in depression and may persist during the remitted...... antidepressant, has significant precognitive effects in MDD unrelated to mood improvement. Lisdexamfetamine dimesylate was shown to alleviate executive dysfunction in an RCT of adults after full or partial remission of MDD. Preliminary evidence also indicates that erythropoietin may alleviate cognitive...

  11. Do Prepaid Tuition Plans Affect State Support for Higher Education?

    Science.gov (United States)

    Baird, Katherine E.

    2006-01-01

    Subsidies to higher education in the United States have long been guided by the belief that policy should encourage college attendance. In principle, if not always in practice, policy has for some time sought to accomplish this by addressing college affordability. General subsidies that keep tuition at public institutions low are coupled with…

  12. The Impact of Tuition Increases on Undocumented College Students' Schooling Decisions

    Science.gov (United States)

    Conger, Dylan

    2014-01-01

    This paper examines the effect of a short-lived increase in tuition rates on undocumented college students' schooling decisions. In the spring of 2002, the City University of New York (CUNY) reversed its policy of charging in-state tuition rates to undocumented college students who could demonstrate that they migrated to New York at a relatively…

  13. In-State-Tuition for Unauthorized Residents: Teaching a Person to Fish

    Science.gov (United States)

    Dryden, Joe; Martinez, Cristina

    2014-01-01

    Illegal immigration has become one of the most important issues we face as a nation, and as greater attention is focused on the sociological and economic impact of illegal immigration, policies related to in-state-tuition for unauthorized residents are in a state of flux. Since 2005, the number of states offering in-state-tuition for unauthorized…

  14. Internationalisation as Marketisation? Tuition Fees for International Students in Finland

    Science.gov (United States)

    Kauko, Jaakko; Medvedeva, Anna

    2016-01-01

    Having been on the agenda in Finnish policy-making for a decade, tuition fees for students outside the European Union and the European Economic Area became reality in the beginning of 2016. Drawing on institutional theory the current article tracks this development through the analysis of documents and interviews on different levels. The…

  15. Tuition and Fees Report: Fiscal Year 2014-15

    Science.gov (United States)

    Colorado Department of Higher Education, 2015

    2015-01-01

    Tuition policy for Colorado's public institutions has been impacted by two statutory requirements that were added in the 2014 legislative session. First, the Governor requested, and the General Assembly approved in the College Affordability Act (SB14-001), a historic $60 million (11 percent) increase for public institutions of higher education.…

  16. A Tuition Bubble? Lessons from the Housing Bubble

    Science.gov (United States)

    Gillen, Andrew

    2008-01-01

    Systemic increases in tuition across the board indicate that the structure of the higher education market plays a fundamental role in encouraging these increases. Part of the problem is that public policy attempts to subsidize attendance for too many students on the assumption that this will increase access to higher education. These subsidies,…

  17. A Model of College Tuition Maximization

    Science.gov (United States)

    Bosshardt, Donald I.; Lichtenstein, Larry; Zaporowski, Mark P.

    2009-01-01

    This paper develops a series of models for optimal tuition pricing for private colleges and universities. The university is assumed to be a profit maximizing, price discriminating monopolist. The enrollment decision of student's is stochastic in nature. The university offers an effective tuition rate, comprised of stipulated tuition less financial…

  18. The Issue of Private Tuition: An Analysis of the Practice in Mauritius and Selected South-east Asian Countries

    Science.gov (United States)

    Foondun, A. Raffick

    2002-11-01

    Private tuition is an issue of growing concern and is practised in both developed and developing countries. Although it has certain positive effects, it imposes a considerable financial burden on parents and often gives rise to abuses. The present study, which focuses on the primary level, addresses a number of questions, such as the extent of the practice, its implications, the various forms that it takes, attitudes towards it, why children take private tuition, why teachers provide it, and policies to deal with the issue. The discussion ends with a plea for more research on private tuition in order to provide a basis for policies to address the problem.

  19. State Legislatures Debate Tuition for Illegal Immigrants

    Science.gov (United States)

    Keller, Josh

    2007-01-01

    With plans for a sweeping federal immigration bill stuck in Congress, Arizona and a growing number of states have decided to try to deal with the in-state-tuition issue themselves. This spring lawmakers in at least 22 states have already considered or are debating legislation concerning in-state tuition to illegal immigrants. In about half of…

  20. Adam Smith, Religion, and Tuition Tax Credits.

    Science.gov (United States)

    Alexander, Kern

    1983-01-01

    Examines tuition tax credit programs in framework of Adam Smith's ideas on the economic impact of established churches. Finds that tuition tax credits would amount to state expenditures to relieve the financial burden of parochial school parents and would allow churches to invest commercially to maintain their charitable functions. (JW)

  1. Taxes, Tuition Fees and Education for Pleasure

    DEFF Research Database (Denmark)

    Malchow-Møller, Nikolaj; Nielsen, Søren Bo; Skaksen, Jan Rose

    2011-01-01

    The fact that education provides both a productive and a consumptive (nonproductive) return has important and, in some cases, dramatic implications for optimal taxes and tuition fees. Using a simple model, we show that when the consumption share in education is endogenous and tuition fees...

  2. The Adoption of Prepaid Tuition and Savings Plans in the American States: An Event History Analysis

    Science.gov (United States)

    Doyle, William R.; McLendon, Michael K.; Hearn, James C.

    2010-01-01

    The past two decades have been a period of far-reaching policy experimentation in state financing of higher education. Between 1986 and 1999, 21 states adopted prepaid college tuition plans. Thirty-one states adopted some form of college savings plan. Both kinds of policies were designed to enhance the affordability of higher education during a…

  3. Accounting for the Rise in College Tuition

    OpenAIRE

    Grey Gordon; Aaron Hedlund

    2015-01-01

    We develop a quantitative model of higher education to test explanations for the steep rise in college tuition between 1987 and 2010. The framework extends the quality- maximizing college paradigm of Epple, Romano, Sarpca, and Sieg (2013) and embeds it in an incomplete markets, life-cycle environment. We measure how much changes in underlying costs, reforms to the Federal Student Loan Program (FSLP), and changes in the college earnings premium have caused tuition to increase. All these change...

  4. The Effect of Tuition Increases on Business Student Decisions

    Science.gov (United States)

    Godek, John; Murray, Kyle B.; Karns, Gary

    2015-01-01

    Tuition increases have become all too common as states have cut spending to public institutions and private schools face declining enrollments. As such, understanding the effects of various methods of framing tuition increases is an important, but infrequently researched topic. The authors examine different ways to frame tuition increases…

  5. Financial Condition and Tuition in Private Nonprofit Baccalaureate Higher Education

    Science.gov (United States)

    Peruso, Dominick F., Jr.

    2012-01-01

    The rate of tuition inflation at U.S. colleges and universities is alarming and threatens both access and choice. Private nonprofit baccalaureate colleges often possess the highest tuition rates but routinely face financial challenges. This study was designed to better understand the relationship between tuition and financial condition for the…

  6. Medical school tuition and young physicians' indebtedness.

    Science.gov (United States)

    Jolly, Paul

    2005-01-01

    Medical school tuition and medical student debt have increased dramatically during the past two decades, but loans are available on favorable terms, which makes it possible for students without personal or family means to get a medical education. As an investment, medical education is an excellent choice; its net present value is more than a million dollars. Cost is nevertheless a strong deterrent to potential applicants, especially minority applicants. If tuition and indebtedness continue to increase while physician incomes do not, there may come a time when only the wealthy can finance a medical education, and medical schools may have increasing difficulty recruiting qualified students.

  7. Remission in IDDM

    DEFF Research Database (Denmark)

    Agner, T; Damm, P; Binder, C

    1987-01-01

    To elucidate beta-cell function, insulin requirement, and remission period in insulin-dependent diabetes mellitus (IDDM), a study was undertaken comprising 268 patients consecutively admitted to Steno Memorial Hospital with newly diagnosed IDDM. The patients were characterized by sex, age......, and seasonal variation at onset of diabetes mellitus. During the first 36 mo of the disease, an evaluation was performed for basal C-peptide, HbA1c, and insulin dose per kilogram. Total remission was interpreted as complete discontinuation of insulin therapy for at least 1 wk while still metabolically well...

  8. The Changing Landscape of Tuition and Enrollment in American Public Higher Education

    Directory of Open Access Journals (Sweden)

    Steven W. Hemelt

    2016-04-01

    Full Text Available The costs of public higher education have risen dramatically in recent years, causing anger among students and concern among policymakers worried about falling college completion rates. In this paper, we explore how public tuition costs affect postsecondary enrollment choices. We examine changes over time in the enrollment decisions of students in states where tuition and fees at public four-year institutions increased rapidly, compared with changes for observationally similar students in states with more modest tuition increases. Using student-level data on twelfth graders in 1992 and 2004 linked to institution-level data, we find a relative decline in the likelihood of attending an in-state public four-year institution among high school graduates from states where public tuition costs increased substantially over this period. Students in states where public tuition increased the most were considerably more likely to enroll in a public two-year college than their counterparts in states that adopted more modest increases. We explore heterogeneity in this pattern of substitution between institutions of varying selectivity and control and for students in policy-relevant socio-demographic subgroups, including those in different parts of the twelfth-grade achievement distribution. Generally, large tuition increases at public four-year colleges have weakened the propensity of high school graduates to enroll in such institutions in their state, and increased their likelihood of enrollment in less prestigious in-state public colleges, out-of-state public institutions, or private universities. These effects are most pronounced among students from families of low socioeconomic status, and nonelite students who perform below the 90th percentile on twelfth-grade math tests.

  9. Partial Remission Definition

    DEFF Research Database (Denmark)

    Andersen, Marie Louise Max; Hougaard, Philip; Pörksen, Sven

    2014-01-01

    OBJECTIVE: To validate the partial remission (PR) definition based on insulin dose-adjusted HbA1c (IDAA1c). SUBJECTS AND METHODS: The IDAA1c was developed using data in 251 children from the European Hvidoere cohort. For validation, 129 children from a Danish cohort were followed from the onset...

  10. Remission in IDDM

    DEFF Research Database (Denmark)

    Agner, T; Damm, P; Binder, C

    1987-01-01

    , and seasonal variation at onset of diabetes mellitus. During the first 36 mo of the disease, an evaluation was performed for basal C-peptide, HbA1c, and insulin dose per kilogram. Total remission was interpreted as complete discontinuation of insulin therapy for at least 1 wk while still metabolically well...

  11. The Goals for Regulating College Tuition

    Science.gov (United States)

    Zeng, Xiaodong

    2009-01-01

    Regulation refers to governmental restrictions over enterprise in order to protect public interest. Research on governmental regulation in China primarily focuses on public utility, and inadequate attention has been paid to regulating college tuition. Currently, although the educational administrative agencies have successfully kept college…

  12. Remission of allergic rhinitis

    DEFF Research Database (Denmark)

    Bødtger, Uffe; Linneberg, Allan

    2004-01-01

    BACKGROUND: Allergic rhinitis (AR) and sensitization are considered chronic conditions. However, few studies have reported remission rates in adults. OBJECTIVE: We sought to estimate the incidence of remission of AR during an 8-year period. METHODS: Participants in a population-based study of 15......- to 69-year-old patients in 1990 were invited to a follow-up in 1998. Questionnaires on respiratory symptoms and serum for specific IgE (s-IgE) analyses were collected at both visits in 734 subjects (69% of those invited). Pollen AR was defined as rhinitis symptoms on pollen exposure within the last 12...... months and s-IgE levels of class 2 or greater against pollen (birch, grass, or mugwort). This was similar for AR to animals (cat or dog) or house dust mites (HDMs). Remission of AR was defined as AR at baseline but no rhinitis symptoms at follow-up and sensitization (s-IgE level class > or =2 at baseline...

  13. Tuition Fees, as User Prices, and Private Incentives

    OpenAIRE

    Economides, George; Philippopoulos, Apostolis; Sakkas, Stelios

    2016-01-01

    This paper studies the aggregate and distributional implications of introducing tuition fees for public education services into a tax system with income and consumption taxes. The setup is a neoclassical growth model where agents differ in capital holdings. We show that the introduction of tuition fees (a) improves individual incentives to work and/or save and (b) can be both efficient and equitable. The focus is on the role of tuition fees as an extra price and how this affects private incen...

  14. Tuition reimbursement for special education students.

    Science.gov (United States)

    Zirkel, P A

    1997-01-01

    The spring 1996 issue of The Future of Children on special education reviewed the legislative and litigation history of the Individuals with Disabilities Education Act (IDEA). This Revisiting article examines the impact of the two U.S. Supreme Court cases setting forth school districts' responsibility to reimburse parents of students with disabilities for private school tuition under certain circumstances. An extensive examination of published cases reveals that the number of cases litigated has increased but that the courts are no more likely to decide in favor of parents than they were before the Supreme Court rulings.

  15. Who Benefits from Tuition Discounts at Public Universities?

    Science.gov (United States)

    Hillman, Nicholas W.

    2010-01-01

    This article uses data from the 2004 National Postsecondary Student Aid Study to provide insight about the range of tuition discounting practices at public institutions. Specifically, it examines the characteristics of students who receive tuition discounts from public four-year colleges and universities. A binary logistic regression is applied to…

  16. Tuition Discounting and Socioeconomic Diversity at Larger Private Universities

    Science.gov (United States)

    Reinoehl, Jason K.; Kowalski, Theodore J.

    2015-01-01

    Tuition discounting is a tactic deployed by many private four-year institutions as a means for enhancing either tuition revenue or institutional image. This study examines associations between "socioeconomic diversity" and two aspects of institutional grants--"freshman discount rate" and "freshman grant recipient discount…

  17. Affordable Online Maths Tuition: Evaluation Report and Executive Summary

    Science.gov (United States)

    Torgerson, Carole; Ainsworth, Hannah; Buckley, Hannah; Hampden-Thompson, Gillen; Hewitt, Catherine; Humphry, Deborah; Jefferson, Laura; Mitchell, Natasha; Torgerson, David

    2016-01-01

    "Affordable Online Maths Tuition" is a one-to-one tutoring programme where pupils receive maths tuition over the internet from trained maths graduates in India and Sri Lanka. It is delivered by the organisation Third Space Learning (TSL). Tutors and pupils communicate using video calling and a secure virtual classroom. Before each…

  18. 42 CFR 136.373 - Scholarship and tuition.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Scholarship and tuition. 136.373 Section 136.373... J-8-Health Professions Pregraduate Scholarship Program for Indians § 136.373 Scholarship and tuition. (a) Scholarship grant awards under this subdivision shall consist of: (1) A stipend of $400 per month...

  19. 42 CFR 136.323 - Scholarship and tuition.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Scholarship and tuition. 136.323 Section 136.323... J-3-Health Professions Preparatory Scholarship Program for Indians § 136.323 Scholarship and tuition. (a) Scholarship grant awards under this subdivision shall consist of: (1) A stipend of $400 per month...

  20. College Tuition and Perceptions of Private University Quality

    Science.gov (United States)

    Tang, Thomas Li-Ping; Tang, David Shin-Hsiung; Tang, Cindy Shin-Yi

    2004-01-01

    This research employs institutional characteristics and market-related factors to predict undergraduate students' tuition at 190 private colleges and universities in the USA. Results showed that the strongest correlations among variables for college tuition were reputation ranking and SAT scores. Results of a hierarchical multiple regression…

  1. The Demand for Higher Education: Pennsylvania's Nonresident Tuition Experience.

    Science.gov (United States)

    Noorbakhsh, Abbas; Culp, David

    2002-01-01

    Explores the estimation of tuition elasticity of resident and nonresident demand for higher education in the Pennsylvania State System of Higher Education. Finds that nonresident demand is price elastic, thus explaining the 40 percent decline in nonresident enrollment between 1991 and 1996 after average nonresident tuition increased nearly 20…

  2. A Study of the Tuition of Middle Schools in Prwear Tokyo Prefecture

    OpenAIRE

    Karasuda, Naoya

    2002-01-01

    The purpose of this paper is to clarifying the tuition in middle schools at the prewar Tokyo prefecture. The tuition differed between the public schools and the private schools. In the 1890s, most expenses required for management of middle schools was provided with tuition in both private amd public schools. At this time, the tuition of public schools was higher than the private schools. After 1900 tuition of public schools became cheaper than private schools. As expenses of public schools, i...

  3. WHAT ARE THEY BUYING IN PRIVATE TUITION? MICRO-LEVEL PERSPECTIVE ON THE PRACTICE OF PRIVATE TUITION BY GRADE 9 STUDENTS IN KALE TOWNSHIP, MYANMAR

    OpenAIRE

    Kam Tung Tuang Suante

    2017-01-01

    Private tuition is the practice of academic teaching and learning from outside of the school with a fee but a few of studies acknowledged what private tuition provides to the receivers beyond the teaching of academic subjects. This study explored the intensity and nature of private tuition through 1119 Grade 9 students’ survey reports and 18 interviewees’ responses. The study revealed the common practice of private tuition in Myanmar and 69.5% of the participants are in private boarding tuiti...

  4. Tracking the Discount: Tuition Discount Rates, Net Tuition Revenue, and Efforts to Inform Institutional Practices. Professional File. Article 133, Fall 2013

    Science.gov (United States)

    Davis, Natalie Pullaro; Redd, Kenneth E.

    2013-01-01

    This article uses findings from the 2012 Tuition Discounting Study (TDS) conducted by the National Association of College and University Business Officers (NACUBO) to provide a framework for institutional researchers to develop and adapt their own custom tuition discounting definitions and formulas. Under tuition discounting, colleges and…

  5. A Hidden Cause of Rising Tuition: Tuition Discounting in Public Colleges and Universities. The Progress of Education Reform. Volume 15, Number 4

    Science.gov (United States)

    Gianneschi, Matt; Pingel, Sarah

    2014-01-01

    Why does tuition increase faster than inflation? And why does tuition continue to increase even when states increase their investments in public colleges and universities? These questions have perplexed policymakers and higher education consumers alike. Though tuition setting can be very complicated, one of the drivers for rising costs is price…

  6. A Polychoric Correlation to Identify the Principle Component in Classifying Single Tuition Fee Capabilities on the Students Socio-Economic Database

    Science.gov (United States)

    Yustanti, W.; Anistyasari, Y.

    2018-01-01

    The government has issued the regulation number 55 of 2013 about the enactment of a single tuition fee based on the socio-economic conditions of each student. All public universities are required to implement this policy. Therefore, each university needs to create a formulation that can be used to categorize a student into which cost group. The results of the data collection found that the parameters used to determine the classification of tuition fees between one universities with another are different. In this research, taken a sampling of student data at one public university which is using 43 predictor variables and 8 categories of single tuition. The sample data used are socioeconomic data of students of 2016 and 2017 classes received through public university entrance selections. The results of this study reveal that from 43 variables, there are 16 variables which are the most significant in influencing single tuition category with goodness-of-fit index is 0.866. This value means that the proposed model can indicate student’s ability to pay the tuition fee.

  7. What goes around, comes around: a history of medical tuition*

    Science.gov (United States)

    Duffin, Jacalyn

    2001-01-01

    IN THIS ARTICLE THE ACTUAL AND RELATIVE COSTS OF TUITION AT 3 Ontario medical schools are traced over the past 150 years. In addition, the factors that led to Ontario's nearly 4-decade experiment in private medical education (and to its eventual demise) are presented. In relative terms, tuition was stable for over a century, then declined (after 1960) as government support rose. Access to medical training for students from middle-income families may also have improved steadily until the late 1980s. Because there is no shortage of people wanting to become doctors, there seems to be no limit to the price that could be set for a medical education. The recent hikes in tuition have outstripped inflation and may be reducing accessibility to restrictive levels, similar to those that prevailed in the 19th century. The author invites readers to question current trends. PMID:11202668

  8. What goes around, comes around: a history of medical tuition.

    Science.gov (United States)

    Duffin, J

    2001-01-09

    In this article the actual and relative costs of tuition at 3 Ontario medical schools are traced over the past 150 years. In addition, the factors that led to Ontario's nearly 4-decade experiment in private medical education (and to its eventual demise) are presented. In relative terms, tuition was stable for over a century, then declined (after 1960) as government support rose. Access to medical training for students from middle-income families may also have improved steadily until the late 1980s. Because there is no shortage of people wanting to become doctors, there seems to be no limit to the price that could be set for a medical education. The recent hikes in tuition have outstripped inflation and may be reducing accessibility to restrictive levels, similar to those that prevailed in the 19th century. The author invites readers to question current trends.

  9. Variability in United States Allopathic Medical School Tuition.

    Science.gov (United States)

    Gil, Joseph A; Park, Sarah H; Daniels, Alan H

    2015-11-01

    Over the course of the last generation, the cost of medical school attendance and medical student debt has increased drastically. Medical student debt has been reported as high as $350,000, and the Association of American Medical Colleges (AAMC) reports that medical school tuition continues to increase annually. The increasing cost of medical education and associated financial burden is now beginning to deter potential applicants from pursuing a career in medicine. In this study we aimed to assess medical school tuition across the US. We hypothesized that the cost of medical school attendance is variable across all regions of the US, and as a result, the financial burden on medical students is inconsistent. All 123 allopathic medical schools accredited by the AAMC were assessed in this investigation. In-state and out-of-state tuitions for the year 2016 were obtained from U.S. News and World Report. Additionally, medical school size was collected. Regions were defined according to the US Census Bureau definition, with the US being divided into 4 regions: Northeast, Midwest, South, and West. There was no difference in average medical school size among the 4 regions (P > .05). Average in-state tuition was $38,291.56 ± $9801.38 (95% confidence interval [CI], $34,658.07-$41,513.46) in the Midwest, $45,923.04 ± $9178.87 (95% CI, $42,566.28-$49,216.78) in the Northeast, $32,287.78 ± $12,277.53 (95% CI, $28,581.90-$35,378.68) in the South, and $37,745.40 ± $11,414.37 (95% CI, $30,063.28-$40,458.99) in the West. In-state tuition in the South was significantly lower than in the Northeast, West, and Midwest (P tuition in the Northeast was significantly higher than in the South, West, and Midwest (P tuition is $54,104.04 ± $8227.65 (95% CI, $51,207.6-$57,000.39) in the Midwest, $53,180.10 ± $3963.71 (95% CI, $51,761.71-$54,598.50) in the Northeast, $48,191.86 ± $12,578.13 (95% CI, $44,595.84-$51,787.89) in the South, and $52,920.47 ± $7400.83 (95% CI, $49

  10. Tuition Discounting through Unfunded Institutional Aid at Private Baccalaureate Colleges

    Science.gov (United States)

    Martin, Jeremy Paul

    2012-01-01

    Colleges and universities discount tuition by providing institutional aid to reduce the actual amount paid by a student. Discount rates are substantial and continue to increase, particularly at private institutions. Funded institutional discounts are linked to gifts or endowment income restricted to financial aid. Unfunded institutional discounts…

  11. Where Does All That Tuition Go? Education Outlook. No. 12

    Science.gov (United States)

    Schneider, Mark

    2009-01-01

    As any parent with a college-bound child knows, college tuitions are rising much faster than inflation. One way to control costs is to make parents better consumers by giving them better price and outcome information. But the true cost of a college education is hard to calculate because of complex and opaque pricing structures. Today, colleges are…

  12. The Politics of Public College Tuition and State Financial Aid

    Science.gov (United States)

    Doyle, William R.

    2012-01-01

    What explains the different levels of tuition and financial aid observed in the United States? This study hypothesizes that state-level political characteristics account for much of the variation observed. Of particular importance are the ideology of state legislators and the relative influence of public and private institutions. Estimates of a…

  13. Global Tuition Pricing: An In-Depth Analysis

    Science.gov (United States)

    Cupp, Jason W.

    2012-01-01

    This study was conducted to determine if there is a relationship between select pricing schemes used throughout the world and positive social outcomes. The rising costs of college tuition and escalating student debt has raised the concern about how students should pay for financing their education and whether the current system is the most…

  14. An Assessment of College Tuition Increases and Retention

    Science.gov (United States)

    Karasek, Ray, III

    2016-01-01

    This study examines the relationship between tuition increases, retention, and Pell Grant recipients attending college for the first time at 279 four-year public universities in the southeastern and southwestern regions of the United States. The data for this study was gathered from the Integrated Postsecondary Education Data System (IPEDS) using…

  15. Calculating the True Cost of Tuition Freezes at Public Colleges

    Science.gov (United States)

    Kelderman, Eric

    2009-01-01

    Maryland's governor, Martin J. O'Malley, didn't get much of his legislative agenda through the General Assembly this year, but he did succeed on one front: preserving enough state aid for the public-university system to stave off a tuition increase for the fourth consecutive year. Like politicians in several states, Mr. O'Malley, a Democrat, made…

  16. Use of the Maple System in Math Tuition at Universities

    OpenAIRE

    Kovacheva, Tsvetanka

    2007-01-01

    The following article explores the application of educational technologies at a University level and their contribution in enhancing the educational effectiveness. It discusses the capabilities of computer algebra systems, such as Maple. It is integrated in the math tuition of the Technical University (TU) in Varna and is used by its students during laboratory exercises.

  17. Climbing Walls and Climbing Tuitions. A Delta Perspective

    Science.gov (United States)

    Kirshstein, Rita J.; Kadamus, James A.

    2012-01-01

    High-end amenities like rock climbing walls on college campuses have become an easy target for those attempting to explain rising tuitions. This Delta Perspective looks beyond the media attention surrounding these "frills" to examine more serious questions about spending on campus facilities, college spending in general, and the real drivers of…

  18. Can You Beat the SC Tuition Prepayment Program?

    Science.gov (United States)

    Fitzkee, Thomas L.

    This paper consists of a learning unit for college algebra in which the problem presents three different payment plans for a tuition plan to pay for college expenses. The details of each payment plan are presented, each followed by several exercises so that comparisons of the results can be made across payment plans. (MM)

  19. Remission and functioning in major depressive disorder.

    Science.gov (United States)

    Romera, Irene; Perez, Víctor; Gilaberte, Inmaculada

    2013-01-01

    Evidence from numerous clinical studies has shown that the optimal goal for the treatment of depression is remission. Remission implies that the signs and symptoms of the disease are absent or virtually absent, which is typically associated with a return to the patient s previous daily functioning. Functioning in depression is a broad concept that covers different domains. There are many validated instruments for its assessment, these being reviewed in this article. Furthermore, recovering the pre-morbid level of functioning level is increasingly being identified as a significant target in addition to symptomatic remission. In this sense, functional recovery has been associated with better prognosis of depression and is also a clinical goal expressed by the patient. Several factors, like complete remission of symptoms, with no residual symptoms, maintenance of remission, quality of remission, early remission, have been identified as contributors to functional recovery. In order to facilitate the clinical outcomes, evaluation of and search for symptomatic remission as well as functional recovery need to be integrated into the clinical practice.

  20. DO PUBLIC TUITION SUBSIDIES PROMOTE COLLEGE ENROLLMENT? EVIDENCE FROM COMMUNITY COLLEGE TAXING DISTRICTS IN TEXAS

    OpenAIRE

    Paco Martorell; Brian McCall; Isaac McFarlin

    2014-01-01

    This paper estimates the effect of tuition rates on college enrollment using data for Texas from the 1990 and 2000 Censuses and the 2004 – 2010 American Community Surveys and geographical data on Community College Taxing Districts. The effect of tuition on enrollment is identified by the facts that tuition rates for those living within a taxing district are lower than those living outside the taxing district and in Texas not all geographic locations are in a taxing district. While the estimat...

  1. Credit supply and the rise in college tuition: evidence from the expansion in federal student aid programs

    OpenAIRE

    Lucca, David O.; Nadauld, Taylor D.; Shen, Karen

    2015-01-01

    When students fund their education through loans, changes in student borrowing and tuition are interlinked. Higher tuition costs raise loan demand, but loan supply also affects equilibrium tuition costs - for example, by relaxing students' funding constraints. To resolve this simultaneity problem, we exploit detailed student-level financial data and changes in federal student aid programs to identify the impact of increased student loan funding on tuition. We find that institutions more expos...

  2. The International Market for MBA Qualifications: The Relationship between Tuition Fees and Applications

    Science.gov (United States)

    Elliott, Caroline; Soo, Kwok Tong

    2013-01-01

    This paper explores the relationship between tuition fees charged by MBA programmes and the number of applications to these programmes, using a panel dataset comprising universities from countries across the world. Using Three-Stage-Least-Squares methods for simultaneous equations, we find a two-way relationship between tuition fees and…

  3. Misplaying the Angles: A Closer Look at the Illinois Tuition Tax Credit Law.

    Science.gov (United States)

    Pathak, Arohi; Wessely, Mike; Mincberg, Elliot

    In 1999, Illinois enacted its tuition tax credit law, which offers tax credits to taxpayers whose own children are attending school, as opposed to tax credits to businesses and/or individuals who contribute to tuition scholarship programs. Recent data suggest that the Illinois tax credit program is benefiting middle- and upper-class families more…

  4. Independent Thinking: HBCUs Explore Ways to Liberate Themselves from Tuition Dependence

    Science.gov (United States)

    Hernandez, Arelis

    2010-01-01

    Historically Black colleges and universities (HBCUs) are heavily tuition-dependent. When enrollment goes down, the schools are vulnerable. This article discusses how HBCUs explore ways to liberate themselves from tuition dependence. It describes how historically Black college and university leaders are moving their institutions from a model of…

  5. Issues 2016: Will Free Tuition Increase the Number of College Graduates? Issue Brief

    Science.gov (United States)

    Eden, Max

    2016-01-01

    To increase the number of graduates, a growing number of pundits and politicians favor providing free tuition for students attending public colleges and universities. This proposal is flawed. Affordability is not the main obstacle to getting a degree. There is also a risk that a tuition-free system for public institutions would leave them solely…

  6. Many Public Colleges Have Raised Tuition Despite Increases in State Support

    Science.gov (United States)

    Smith, Lauren

    2007-01-01

    Public colleges often blame their tuition increases on state lawmakers who the colleges say have not given them enough extra money to keep up with rising costs. This year, many states' public colleges received sizable infusions of public money and still raised tuition. In nearly half of the states, both state appropriations for higher education…

  7. Tuition and Financial Aid: Nine Points for Boards to Consider in Keeping College Affordable

    Science.gov (United States)

    Baum, Sandy

    2011-01-01

    The headlines report that college tuition is rising rapidly and students are struggling to pay for college. Financial-aid issues have also been in the news lately, with questions about student debt particularly prominent. Non-tuition revenues are weak because of declining state appropriations, depleted endowments, and anemic annual giving. At the…

  8. Net Tuition and Net Price Trends in the United States: 2000-2009

    Science.gov (United States)

    Gillen, Andrew; Robe, Jonathan; Garrett, Daniel

    2011-01-01

    While the most visible measure of college costs is published tuition, because of financial aid, this "sticker price" does not necessarily reflect the costs that students and their families actually pay. To the extent that students and their families are concerned about what costs they will need to pay to cover tuition charges, the…

  9. Perceptions of Parents on the Practice of Private Tuition in Public Learning Institutions in Kenya

    Science.gov (United States)

    Mwebi, Robert B.; Maithya, Redempta

    2016-01-01

    The practice of private tuition outside normal class hours is a phenomenon which has prevailed in Kenyan basic learning institutions despite the repeated ban by the government. The purpose of the study was to establish parental perceptions on extra tuition in public schools in Kenya. Descriptive survey design was used for the study. A total of 40…

  10. The More, the Better? Intensity of Involvement in Private Tuition and Examination Performance

    Science.gov (United States)

    Smyth, Emer

    2008-01-01

    Private tuition, or "shadow education", has become a prominent feature in many countries internationally. A number of studies have found that such tuition is associated with improved examination performance and enhanced access to tertiary education. However, these studies have generally not taken into account important attitudinal…

  11. Prevalence for Private Tuition among Parents, Teachers and Pupils in Public Primary Schools in Machakos County

    Science.gov (United States)

    Kirigwi, Lucy Wambui; Maithya, Redempta

    2016-01-01

    Private tuition refers to tutoring offered outside mainstream teaching. The study sought to establish the difference in prevalence for private tuition among parents, teachers and pupils in public primary schools in Machakos County. The study employed descriptive survey design. The target populations were all teachers, parents and pupils of public…

  12. Buying Your Way into College? Private Tuition and the Transition to Higher Education in Ireland

    Science.gov (United States)

    Smyth, Emer

    2009-01-01

    A number of countries, including Ireland, have experienced a recent growth in the prevalence of "shadow education", that is, paid private tuition outside the schooling system. Previous international studies have indicated that such tuition can enhance academic performance and facilitate access to tertiary education. However, such studies…

  13. Mother Tongue Tuition in Sweden--Curriculum Analysis and Classroom Experience

    Science.gov (United States)

    Reath Warren, Anne

    2013-01-01

    The model of Mother Tongue Tuition (MTT) which has developed in Sweden since the 1970's offers speakers of languages other than Swedish the opportunity to request tuition in their mother tongue, from kindergarten through to year 12. It is unique among the major immigrant-receiving countries of the world yet little is known about MTT and its…

  14. One-to-One Tuition in a Conservatoire: The Perceptions of Instrumental and Vocal Students

    Science.gov (United States)

    Gaunt, Helena

    2010-01-01

    This paper analyses the perceptions of 20 students in a conservatoire in the UK about one-to-one tuition, and forms part of research also investigating the perceptions of the students' teachers. Findings suggested that these students had significantly different experiences of one-to-one tuition in terms of frequency and length of lessons.…

  15. Employment-Based Tuition Assistance: Decisions and Checklists for Employers, Educators, and Unions.

    Science.gov (United States)

    Gold, Gerard G.

    This guide is intended to assist employers, educators, and union officials in understanding the rationale behind developing and implementing tuition assistance plans. Examined in the introductory section are the importance of tuition assistance programs in light of contemporary economic and labor market conditions. The first chapter outlines the…

  16. Determining a Relationship between Higher Education Financial Position and Tuition Discount Rates

    Science.gov (United States)

    Browning, Julianna

    2013-01-01

    Institutions have increased the practice of tuition discounting, that is, the strategic use of price discrimination. During the past 30 years, both the average percent discount given to students and the proportion of students receiving tuition breaks have increased. As this practice has increased, there are financial determinants and implications…

  17. Low-Income Engineering Students: Considering Financial Aid and Differential Tuition

    Science.gov (United States)

    George-Jackson, Casey E.; Rincon, Blanca; Martinez, Mariana G.

    2012-01-01

    This paper explores the relationship between tuition differentials and low-income students in Engineering fields at two public, research-intensive universities. Although current reports indicate the need for increased participation within the Science, Technology, Engineering, and Mathematics (STEM) fields, rising tuition prices at the university…

  18. A framework for remission in SLE

    DEFF Research Database (Denmark)

    van Vollenhoven, Ronald; Voskuyl, Alexandre; Bertsias, George

    2017-01-01

    /day), maintenance immunosuppressives and/or maintenance biologics.The task force also agreed that the most appropriate outcomes (dependent variables) for testing the prognostic value (construct validity) of potential remission definitions are: death, damage, flares and measures of health-related quality of life....... CONCLUSIONS: The work of this international task force provides a framework for testing different definitions of remission against long-term outcomes....

  19. Investigating the status of supplementary tuition in the teaching and learning of mathematics

    Directory of Open Access Journals (Sweden)

    David Mogari

    2009-09-01

    Full Text Available The study seeks to investigate the status of supplementary tuition in the teaching and learning of mathematics and mathematical literacy. The study followed a descriptive survey design involving the use of learner and teacher questionnaires. A convenient sample of mathematics and mathematical literacy teachers together with a stratified sample of their Grade 11 learners were drawn from a purposive sample of highperforming high schools in the East London district of the Eastern Cape, South Africa. The results show that supplementary tuition is popular, especially among girls, and it is in three forms (i.e. private tuition, vacation school and problem-solving classes: Problemsolving classes dominated by working on past/model examination papers is the most preferred; in some instances supplementary tuition is offered for a fee; it is not only confined to poor performing learners; and participation in supplementary tuition is influenced by a variety of factors.

  20. Methods and procedures of mathematic self-tuition process for technicians training

    Directory of Open Access Journals (Sweden)

    Martínez E. C.

    2013-07-01

    Full Text Available The paper describes the mathematic self-tuition process for technicians training. Once a theoretical framework was built up, the process of self-tuition in mathematics was modeled and introduced at experimental scale. The structure of the process is fully described together with the connections between subsystems and components. The methods and procedures of self-tuition are also described. The guiding principle is that designing a mathematic self-tuition process requires didactic procedures illustrating how professional technical problems may be contextualized for planning, organizing, performing and controlling the study of mathematics. The feasibility appraisal of the model proved that it favors the learning technical contents under the basis of strengthening a mathematic culture. Key words: self-tuition process, technicians´ training, self-control

  1. Challenges of Tuition fee’s decision: Private Universities case in Kosovo

    Directory of Open Access Journals (Sweden)

    Besa Shahini

    2013-12-01

    Full Text Available This study assesses Challenges that Private Universities in Kosovo face when employing tuition fee strategies. Data are collected on May - June 2012 through in-depth interview and questioners with supervisors and students of three Private Universities in Kosovo. As of low purchasing power of students and overall economic crises in Kosovo, students are very sensitive to pricing strategies employed and according to fee they evaluate before and after -enrollment assessment. Students’ academic expectations are much higher relative to their low tuition requirements. In transition economies, employing tuition strategies that satisfy both Universities and students is a challenge for higher educational institutions.

  2. 27 CFR 40.474 - Remission.

    Science.gov (United States)

    2010-04-01

    ... the tax where cigarette papers and tubes in bond are lost (other than by theft) or destroyed, by fire... THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Claims by Manufacturers § 40.474 Remission...

  3. Remission of eating disorder during pregnancy

    DEFF Research Database (Denmark)

    Madsen, Ida Ringsborg; Hørder, Kirsten; Støving, René Klinkby

    2009-01-01

    Eating disorder during pregnancy is associated with a diversity of adverse outcomes and is of potential danger to both mother and child. There is, however, a tendency for remission of the eating disorder during pregnancy with improvement of symptoms such as restrictive dieting, binging and purgin...

  4. College Cost and Time to Complete a Degree: Evidence from Tuition Discontinuities

    OpenAIRE

    Pietro Garibaldi; Francesco Giavazzi; Andrea Ichino; Enrico Rettore

    2007-01-01

    For many students throughout the world the time to obtain an academic degree extends beyond the normal completion time while college tuition is typically constant during the years of enrollment. In particular, it does not increase when a student remains in a program beyond the normal completion time. Using a Regression Discontinuity Design on data from Bocconi University in Italy, this paper shows that a tuition increase of 1,000 euro in the last year of studies would reduce the probability o...

  5. Comparative Study of Parental Involvement and Private Tuition regarding Educational Attainment of Students

    OpenAIRE

    Malik Amer Atta; Shabnam Razzaq Khan; Shehla Sheikh; Fahmida Akbar

    2014-01-01

    This research work was focused on the “comparative study of parental involvement and private tuition regarding educational attainments of students at secondary school level”. A sample of 80 students of 10th class from ten different secondary schools was taken. To analyze the results t-test was used. In this comparison it was conducted that parental involvement turn out significant effect on student educational attainments as compared to private tuition. On the bases of results researcher has ...

  6. Factors affecting students’ attitude towards introduction of tuition fees for higher education in the Czech Republic

    Directory of Open Access Journals (Sweden)

    Martina Zámková

    2013-01-01

    Full Text Available Introduction of tuition fees has been much discussed in the Czech Republic over the recent years. Unfortunately, the current system of non-discriminate higher-education funding is no longer supportable, that is, provided that we do not want all universities to be evenly “mediocre”. A well configured tuition-fee system with low payments, suitably complemented by student loans covering not only the tuition fees but also the subsistence costs could be an acceptable vision of the future higher education. The obligation to pay for the study should also prevent from enrolment those applicants that only enter a university to avoid having to cater for themselves in real life. A survey was conducted to find out the views of Czech university students on the introduction of tuition fees and the possible methods of their payment. A subsequent analysis was made to see whether the introduction of tuition fees would aggravate students’ financial situation, whether they would be more motivated to complete the studies in due time, and whether they would be more concerned with the quality of teaching. The survey also analysed the relationship between a respondent’s view on the introduction of tuition fees and the current methods of financing the studies (accommodation, transport, meals, textbooks, …, the household income, and the gender. It also takes into account the attitude of respondents on the system of student loans proposed. In order to interpret the results correspondence and dependence analysis were used.

  7. National Estimates of Recovery-Remission From Serious Mental Illness.

    Science.gov (United States)

    Salzer, Mark S; Brusilovskiy, Eugene; Townley, Greg

    2018-02-01

    A broad range of estimates of recovery among previously institutionalized persons has been reported, but no current, community-based national estimate of recovery from serious mental illness exists. This study reports recovery rate results, based on a remission definition, and explores related demographic factors. A national, geographically stratified, and random cross-sectional survey conducted from September 2014 to December 2015 resulted in responses from more than 41,000 individuals. Lifetime prevalence of serious mental illness was assessed by asking about receipt of a diagnosis (major depression, bipolar disorder, manic depression, and schizophrenia or schizoaffective disorder) and hospitalization and impairment associated with the diagnosis. Recovery was determined by asking about impairments over the past 12 months. Almost 17% reported receiving one of the diagnoses in their lifetime, 6% had a lifetime rate of a serious mental illness, and nearly 4% continued to experience interference associated with serious mental illness. One-third of those with a lifetime serious mental illness reported having been in remission for at least the past 12 months. Recovery rates were low until age 32 and then progressively increased. Lifetime estimates of diagnosed illness and current prevalence of serious mental illness are consistent with previous research. Results indicate that recovery is possible and is associated with age. Further research is needed to understand factors that promote recovery, and sustained evaluation efforts using similar parsimonious approaches may be useful in conducting timely assessments of national and local mental health policies.

  8. Drug-free remission: is it already possible?

    NARCIS (Netherlands)

    van den Broek, M.; Huizinga, T.W.J.; Dijkmans, B.A.C.; Allaart, C.F.

    2011-01-01

    Purpose of Review: To give an overview of recently published articles covering drug-free remission in rheumatoid arthritis (RA). Recent Findings: Recent studies covering drug-free remission showed differences in numbers studied, remission definition, disease duration and medication used. Drug-free

  9. Analyzing the Market for Shadow Education in Pakistan: Does Private Tuition Affect the Learning Gap between Private and Public Schools?

    OpenAIRE

    Bisma Haseeb Khan; Sahar Amjad Shaikh

    2013-01-01

    Over the past decade, Pakistan has seen the rapid growth of a third sector in education: shadow education. According to the Annual Survey of Education Report (2013), 34 percent of private school students and 17 percent of public school students undertake private tuition in Punjab. Anecdotal evidence suggests that private tuition has a positive impact on learning outcomes. Keeping this in view, it is possible that private tuition, rather than a difference inschooling quality, is driving the ob...

  10. Higher education: free tuition vs. quotas vs. targeted vouchers

    Directory of Open Access Journals (Sweden)

    Eduardo de Carvalho Andrade

    2010-03-01

    Full Text Available This paper compares theoretically three alternative university systems: the current one adopted in Brazil, in which students who perform better in the entering exam obtain the right to attend the public university without paying the full tuition; a system of affirmative action quotas in public universities, to benefit low income students; and a targeted vouchers system that can be used either to pay private or public university tuiton. The comparison indicates that the last system leads to: (i a higher quality of the labor force; (ii a more efficient allocation of resources; and (iii a greater social mobility.Este trabalho compara, do ponto de vista teórico, três sistemas universitários alternativos: o atual adotado pelo Brasil, no qual os alunos das universidades públicas, que são praticamente gratuitas, são escolhidos através de um processo seletivo; um sistema de quotas nas universidades públicas para beneficiar estudantes de baixa renda; e um sistema de vouchers direcionados para estudantes de baixa renda que podem ser utilizados nas universidades privadas ou públicas. A comparação destes três sistemas indica que o último é o mais eficiente, pois gera: (i maior qualidade da mão de obra; (ii alocação mais eficiente dos recursos; e (iii maior mobilidade social.

  11. The impact of tuition fees amount on mental health over time in British students.

    Science.gov (United States)

    Richardson, T; Elliott, P; Roberts, R

    2015-09-01

    Previous studies have shown a relationship between debt and mental health problems in students. This study aimed to examine the effect of differences in tuition fees amount on changes in mental health over time. A prospective cohort study followed 390 first-year British students who differed on their tuition fees level at 4 time points across their first 2 years at university. Participants completed measures of global mental health, depression, anxiety, stress, alcohol-related problems at up to four time points in their first two years at university. Mixed-factorial ANOVAs were used to assess the impact of tuition fees amount on changes in scores over time. There was no difference based on fees at Time 1 for anxiety, stress, depression and global mental health. At Time 2, those charged £0-2.9k or £3-4k improved while those charged £8-9k stayed the same. However, this trend reversed by Times 3 and 4. Undergraduates mental health is partially affected by the level of tuition fees; however, the recent increase in tuition fees does not appear to have had a lasting impact at present. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Tuition Discounting: Institutional Aid Patterns at Public and Private Colleges and Universities. Trends in Higher Education Series

    Science.gov (United States)

    Baum, Sandy; Ma, Jennifer

    2010-01-01

    Recent data from the College Board's Annual Survey of Colleges reveal significant variation in institutional aid patterns among colleges and universities. The undergraduate tuition discount rate--the ratio of institutional grant aid to published tuition and fee charges--is higher at private institutions than at public institutions, but there are…

  13. Body composition in remission of childhood cancer

    International Nuclear Information System (INIS)

    Tseytlin, G Ja; Konovalova, M V; Vashura, A Yu; Anisimova, A V; Godina, E Z; Khomyakova, I A; Nikolaev, D V; Starunova, O A; Rudnev, S G

    2012-01-01

    Here, we describe the results of a cross-sectional bioimpedance study of body composition in 552 Russian children and adolescents aged 7-17 years in remission of various types of cancer (remission time 0-15 years, median 4 years). A sample of 1500 apparently healthy individuals of the same age interval was used for comparison. Our data show high frequency of malnutrition in total cancer patients group depending on type of cancer. 52.7% of patients were malnourished according to phase angle and percentage fat mass z-score with the range between 42.2% in children with solid tumors located outside CNS and 76.8% in children with CNS tumors. The body mass index failed to identify the proportion of patients with malnutrition and showed diagnostic sensitivity 50.6% for obesity on the basis of high percentage body fat and even much less so for undernutrition – 13.4% as judged by low phase angle. Our results suggest an advantage of using phase angle as the most sensitive bioimpedance indicator for the assessment of metabolic alterations, associated risks, and the effectiveness of rehabilitation strategies in childhood cancer patients.

  14. Validation of a functional remission threshold for the Functional Remission of General Schizophrenia (FROGS) scale.

    Science.gov (United States)

    Boyer, Laurent; Richieri, Raphaëlle; Guedj, Eric; Faget-Agius, Catherine; Loundou, Anderson; Llorca, Pierre-Michel; Auquier, Pascal; Lançon, Christophe

    2013-10-01

    The aim of this study was to develop a functional remission threshold for the Functional Remission Of General Schizophrenia (FROGS) scale, and test its validity regarding clinical and quality of life outcomes. Cross-sectional study. Schizophrenia according to DSM-IV-TR criteria. Functioning was assessed using the FROGS and the Global Assessment of Functioning (GAF) scales; psychotic symptoms using the Positive and Negative Syndrome Scale; memory, attention, and executive functions were assessed using the California Verbal Learning Test, the D2 attention task, the Stroop color-word test, the verbal fluency test, the Trail Making Test A and B and the Wechsler Adult Intelligence Scale; and quality of life using the schizophrenia quality of life (S-QoL 18) scale. A logistic regression analysis including the different dimensions of the FROGS was used to create a composite score to classify patients into remitted and non-remitted according a gold standard (cut-off: GAF>= 61). Receiver operating characteristics analyses were then performed to determine the area under the curve (AUC). Of 137 patients enrolled, 26 were functionally remitted and 111 were not remitted according to GAF score. The AUC for the combination of the FROGS's dimensions to detect functional remission was 0.903 (pspecificity for the combination of the FROGS dimensions using the Youden index were 88.5 [69.8; 97.6] and 81.1 [72.5; 87.9], respectively. Validity of this combination was satisfactory. Patients in functional remission had a lower severity of the disease, especially for PANSS negative (p<0.001) and general psychopathology (p<0.001) symptoms. Only two cognitive functions (i.e. fluency and episodic memory) were improved in remitted patients. Higher quality of life levels were globally associated with better functioning. These findings provide for first accurate FROGS thresholds to detect functional remission in schizophrenia. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Value of direct immunofluorescence in predicting remission in pemphigus vulgaris.

    Science.gov (United States)

    Balighi, Kamran; Taheri, Arash; Mansoori, Parisa; Chams, Cheida

    2006-11-01

    Pemphigus vulgaris is characterized by the presence of autoantibodies to desmogleins. Multiple relapses and remission may occur during the course of the disease. The goal of this study was to determine whether direct immunofluorescence study has any value in detecting immunological remission of pemphigus vulgaris. Fifty-seven patients with pemphigus vulgaris who were in clinical remission for at least 3 months, while taking prednisolone 5-7.5 mg/day, were recruited retrospectively for the study. Direct immunofluorescence study had been performed in all patients after a period of at least 3 months in clinical remission. Treatment had been discontinued in all patients with negative results of direct immunofluorescence. Of 57 patients who were in clinical remission, 24 patients (42%) had negative and 33 patients (58%) had positive results of direct immunofluorescence. Eleven patients (46%) with negative results of direct immunofluorescence relapsed within the first year of the follow-up period. Nine patients with negative direct immunofluorescence had a history of more than 6 months of clinical remission before direct immunofluorescence study. Among them, two patients (22%) relapsed. None of four patients with history of more than 12 months of clinical remission before a negative direct immunofluorescence study relapsed. Negative direct immunofluorescence is an indicator of immunological remission in patients with pemphigus vulgaris after 6-12 months in clinical remission.

  16. The Relationship of Institutional Tuition Discounts with Enrollment at Private, Not-for-Profit Institutions

    Science.gov (United States)

    Lassila, Nathan E.

    2010-01-01

    Empirical studies exploring the impact of student aid on postsecondary enrollment often stop short of the specific examination of institutional tuition discounting. This research uses separate empirical ordinary least squares (OLS) regression models to examine three questions using public choice theory, positing that enrollment decisions may be…

  17. The Incidence of the Tuition-Free High School Program in Japan

    Science.gov (United States)

    Hori, Masahiro; Shimizutani, Satoshi

    2018-01-01

    This paper examines the effect of a tuition-free high school program launched in FY2010 in Japan on the high school enrollment rate and household spending. We have some interesting findings. First, the program contributed to improvement in the high school enrollment rate for poorer households. Second, the program stimulated household spending…

  18. Who Gets the Credit? Who Pays the Consequences? The Illinois Tuition Tax Credit. Special Report.

    Science.gov (United States)

    Pathak, Arohi; Keenan, Nancy

    In 1999, Illinois enacted a tuition tax credit program. Tax credit supporters suggest tax credits help low-income students. However, opponents argue that they disproportionately benefit higher-income families whose children are already attending private schools and may decrease already limited resources available to public schools. New data from…

  19. Deferred and Income-Contingent Tuition Fees: An Empirical Assessment Using Belgian, German and UK Data

    Science.gov (United States)

    Vandenberghe, V.; Debande, O.

    2007-01-01

    This paper is a numerical exploration of the following. Assume, in the European Union context, that decision-makers want to spend more on higher education via higher tuition fees, but also want payments to be deferred and income-contingent. There are several possible ways to achieve this. First, ask graduates to repay a fixed amount each year if…

  20. The Evolution of Student Activism and Its Influence on Tuition Fees in South Korean Universities

    Science.gov (United States)

    Shin, Jung Cheol; Kim, Hoon-Ho; Choi, Hong-Sam

    2014-01-01

    This article briefly overviews the student movement working for political democratisation during the authoritarian governments in South Korea. The article focuses on how student activism has changed as a reflection of political developments from the dictatorship through to the civilian democratic governments. Further, it analyses how tuition-fee…

  1. Tuition Pricing and Aid Strategies: A Practical Approach. AIR 1994 Annual Forum Paper.

    Science.gov (United States)

    Fine, Paul L.

    This paper examines the applicability of net tuition revenue models for a highly selective, elite priced, private research university in the southern U.S. Pricing and aid strategies for this university seem to be driven by intuitive assumptions about the economy, market forces, needs-blind admissions, student satisfaction, net price…

  2. Assessing Tuition and Student Aid Strategies: Using Price-Response Measures to Simulate Pricing Alternatives.

    Science.gov (United States)

    St. John, Edward P.

    1994-01-01

    A study used price-response measures from recent national studies to assess college and university pricing (tuition and student aid) alternatives in diverse institutional settings. It is concluded that such analyses are feasible. Analysis indicated limits to "Robin Hood" pricing patterns are predominant in private colleges. Consideration…

  3. Tax justice of the reform of higher education: tuition fees or tax relief?

    Directory of Open Access Journals (Sweden)

    Pavel Semerád

    2012-01-01

    Full Text Available This paper deals with the current reform of higher education which is now being discussed in the Czech Republic. The Government and the Ministry of Education, Youth and Sports propose a tuition fee for students at universities but there is still no clear concept of it. University leaders and students are against the tuition fee because of their fear of getting into debt during their study. The aim of this paper is to show an alternative way of funding higher education without tuition fee loans and from the point of view of tax justice. According to the concept of horizontal justice (Mankiw, 1999 taxpayers should pay taxes at the same rate, but it does not work this way. The result of research is that changes in Act 586/1992 Coll., on income tax and in Act 117/1995 Coll., on state social welfare are required. Abolition of tax relief is proposed where discrimination against other taxpayers and groups of students could occur. By abolition of tax relief for a student and tax relief for a dependent child the amounts of 4,020 CZK and 13,404 CZK respectively could be saved. Changes in legislation could be politically more acceptable than the tuition fee. The solution could also lead to simplification for taxpayers. The target should be equal access to higher education for all students.

  4. Florida's Prepaid College Tuition Program: Marketing a Pre-Need Service.

    Science.gov (United States)

    Gauff, Joseph F., Jr.

    1994-01-01

    A discussion of Florida's college tuition prepayment program describes the plan and its options and examines its marketing implications as a preneed service. It is concluded that the program makes saving for college easy, economical, and completely safe but requires rethinking of conventional marketing strategies and mix. (MSE)

  5. Improving Quality: How Leaders Advance Student Engagement at Private, Tuition-Driven Institutions

    Science.gov (United States)

    Sluis, Kimberly A.

    2017-01-01

    Students and families, lawmakers, and the general public have become increasingly concerned about the quality of U.S. higher education. Given the competitive higher education landscape, private, tuition-driven colleges and universities are particularly vulnerable to concerns about quality. This study investigates how faculty and administrative…

  6. One-to-One Tuition in a Conservatoire: The Perceptions of Instrumental and Vocal Teachers

    Science.gov (United States)

    Gaunt, Helena

    2008-01-01

    One-to-one instrumental/vocal tuition forms a core part of the professional education offered to undergraduate and postgraduate music students in a conservatoire. However, whilst anecdotal evidence is plentiful, there is little research underpinning its practices. This article provides an analysis of the perceptions of 20 principal study teachers…

  7. Hope, Opportunity, and Access: The In-State Tuition Debate in North Carolina

    Science.gov (United States)

    Sanders, Marla S.

    2010-01-01

    This qualitative case study explores the political debate that surrounded North Carolina's House Bill 1183, also known as Access to Higher Education and A Better Economic Future. This bill would have made undocumented students eligible for in-state tuition at North Carolina's colleges and universities. This article discusses the political debate,…

  8. Elasticity of Demand for Tuition Fees at an Institution of Higher Education

    Science.gov (United States)

    Langelett, George; Chang, Kuo-Liang; Ola' Akinfenwa, Samson; Jorgensen, Nicholas; Bhattarai, Kopila

    2015-01-01

    Using a conjoint survey of 161 students at South Dakota State University (SDSU), we mapped a probability-of-enrolment curve for SDSU students, consistent with demand theory. A quasi-demand curve was created from the conditional-logit model. This study shows that along with the price of tuition fees, distance from home, availability of majors, and…

  9. Didactic friction – challenges and reflections n interlinking PBL and discipline-specific tuition practices

    DEFF Research Database (Denmark)

    Bejder, Anne Kirkegaard; Larsen, Gunvor Riber; Wind, Simon

    2017-01-01

    This is a discussion paper that is based on the didactics reflections of three junior academics at the Architecture and Urban Design (A&UD) programme at Aalborg University. The discussion is moored in two narratives representing two typical student tuition situations. Unfolding two touch points...

  10. Verbal memory functioning in recurrent depression during partial remission and remission-Brief report

    Directory of Open Access Journals (Sweden)

    Åsa eHammar

    2013-10-01

    Full Text Available The aim of the present study was to investigate verbal memory performance in a group of patients with remitted and partial remitted major depressive disorder. Thirty-one patients and 31 healthy matched controls were included in the study. Results from the California Verbal Learning Test show intact verbal memory performance in the patient group regarding learning, recall and recognition. However, patients had significantly poorer performance compared to healthy controls in immediate recall of the first trial in the verbal memory test. In conclusion, the patient group showed intact memory performance, when material is presented more than once. These findings indicate that memory performance in MDD patients with partial remission and remission benefit from repetition of material.

  11. Privacy Impact Assessment for the Childcare Tuition Assistance Program

    Science.gov (United States)

    This system collects contact information and other Personally Identifiable Information (PII). Learn how this data is collected, how it will be used, access to the data, the purpose of data collection, and record retention policies for this data.

  12. Re-conceptualizing mother tongue tuition of Estonian abroad as a transnational phenomenon

    Directory of Open Access Journals (Sweden)

    Maarja Siiner

    2017-05-01

    Full Text Available The governmental initiative called the Compatriots Programme, which supports language tuition in Estonian schools and societies abroad, reveals an increased interest in developing intergenerational language transmission in the growing Estonian diaspora. This transnational language political activity signals a new era in language policy, where nation states are increasingly decentralized by migration. The evaluation of the program furthermore reveals that organizing such schools requires a willingness to take language political agency, typically conducted by well-educated and well-integrated resourceful transnational multilingual parents. The present article outlines the results of an ethnographic study of the process of establishing the Estonian School in Copenhagen. This step has demanded a change in the mindset still prevailing in Estonia that language political activities, such as planning language acquisition, are solely the responsibility of the state. Since the prevailing language ideology in Denmark is not favorable towards multilingualism in migrant languages, intergenerational language transmission furthermore presupposes a feeling of ownership of the language and high language self-esteem. "Hargmaise keelepoliitika sünd. Eesti keeleõppe korraldamise võimalikkusest välismaal Taani näitel" Hargmaisus, kasvav väljarändajate arv ja sellega ka eesti keele rääkijate hulk välismaal on jätnud oma jälje eesti keelepoliitikale. Kui varem uuriti peamiselt seda, kuidas eesti keel muukeelses kontekstis muutub, siis viimasel kümnendil on riik asunud aktiivselt toetama eesti keele jätkuvat kasutamist välismaal, rahastades rahvuskaaslaste programmi abil haridusprogramme. Kuid millised faktorid määravad selle, kas uus eestlaste põlvkond oskab ja tahab eesti keelt rääkida? Artikkel hindab etnograafilises ja sotsiolingvistilises võtmes Kopenhaagenis kolm aastat tegutsenud Eesti Kooli ja Lasteklubi näitel, millised on keelekasutust

  13. Tuition reduction is the key factor determining tax burden of graduate students under the Tax Cuts and Job Act.

    Science.gov (United States)

    Lawston, Patricia M; Parker, Michael T

    2017-01-01

    Background : The proposed Tax Cuts and Jobs Act (H.R.1) has stirred significant public debate on the future of American economics.  While supporters of the plan have championed it as a necessity for economic revitalization, detractors have pointed out areas of serious concern, particularly for low- and middle-income Americans.  One particularly alarming facet of the plan is the radical change to education finance programs and taxation of students in higher education.  Methods :  By analyzing actual income and tuition of a public and a private university student, as well as the 'average' graduate student, we investigated the effect of both the House and Senate versions of H.R. 1 on taxation of students of various family structures.  Results :  Our findings indicate that taxable tuition would be the greatest contributor to graduate student tax burden across all four categories of filing status.  However, when tuition reduction is upheld or a student is on sustaining fees rather than full tuition, graduate students would realize decreases in taxation. Conclusions :  Overall, we conclude that removal of tuition reduction would result in enormous tax burdens for graduate students and their families and that these effects are dependent not only on the status of the student in their degree program but also on their tuition and stipend, and therefore the institution they attend.

  14. Tuition reduction is the key factor determining tax burden of graduate students under the Tax Cuts and Job Act

    Science.gov (United States)

    Lawston, Patricia M.; Parker, Michael T.

    2018-01-01

    Background: The proposed Tax Cuts and Jobs Act (H.R.1) has stirred significant public debate on the future of American economics.  While supporters of the plan have championed it as a necessity for economic revitalization, detractors have pointed out areas of serious concern, particularly for low- and middle-income Americans.  One particularly alarming facet of the plan is the radical change to education finance programs and taxation of students in higher education.  Methods:  By analyzing actual income and tuition of a public and a private university student, as well as the ‘average’ graduate student, we investigated the effect of both the House and Senate versions of H.R. 1 on taxation of students of various family structures.  Results:  Our findings indicate that taxable tuition would be the greatest contributor to graduate student tax burden across all four categories of filing status.  However, when tuition reduction is upheld or a student is on sustaining fees rather than full tuition, graduate students would realize decreases in taxation. Conclusions:  Overall, we conclude that removal of tuition reduction would result in enormous tax burdens for graduate students and their families and that these effects are dependent not only on the status of the student in their degree program but also on their tuition and stipend, and therefore the institution they attend. PMID:29487740

  15. The Effects of the Tax Deduction for Postsecondary Tuition: Implications for Structuring Tax-Based Aid

    OpenAIRE

    Caroline M. Hoxby; George B. Bulman

    2015-01-01

    The federal tax deduction for tuition potentially increases investments in postsecondary education at minimal administrative cost. We assess whether it actually does this using regression discontinuity methods on the income cutoffs that govern eligibility for the deduction. Although many eligible households take nearly the maximum deduction allowed, we find no evidence that it affects attending college (at all), attending full- versus part-time, attending four- versus two-year college, the re...

  16. Spontaneous remission of a diffuse brainstem lesion in a neonate

    Energy Technology Data Exchange (ETDEWEB)

    Schomerus, Leena; Kahn, Thomas [University of Leipzig, Department of Diagnostic and Interventional Radiology, Leipzig (Germany); Merkenschlager, Andreas [University of Leipzig, Department of Pediatric Neurology, Leipzig (Germany); Hirsch, Wolfgang [University of Leipzig, Pediatric Radiology, Department of Diagnostic and Interventional Radiology, Leipzig (Germany)

    2007-04-15

    We describe here the spontaneous remission of a diffuse brainstem lesion found in an infant at the age of 7 weeks. Clinical and MRI characteristics strongly suggested a diffuse pontine glioma. Repeated MRI studies showed a continuous decrease in the size of the lesion, which was no longer visible by the age of 27 months. Spontaneous remission of diffuse pontine glioma is extremely rare; to our knowledge there are reports of only three similar cases. (orig.)

  17. Making College More Expensive: The Unintended Consequences of Federal Tuition Aid. Policy Analysis. No. 531

    Science.gov (United States)

    Wolfram, Gary

    2005-01-01

    As Congress debates the reauthorization of the Higher Education Act (HEA), it should heed Friedrich Hayek's warning that democracy is "peculiarly liable, if not guided by accepted common principles, to produce over-all results that nobody wanted." One result of the federal government's student financial aid programs is higher tuition…

  18. Prognosis of Preschool Eczema and Factors of Importance for Remission.

    Science.gov (United States)

    Johansson, Emma Kristin; Bergström, Anna; Kull, Inger; Lind, Tomas; Söderhäll, Cilla; Melén, Erik; Asad, Samina; Bradley, Maria; Liedén, Agne; Ballardini, Natalia; Wahlgren, Carl-Fredrik

    2018-03-02

    Information on factors of importance for remission of eczema is scarce. This study explored factors related to the remission and course of preschool eczema (eczema at 1, 2 and/or 4 years of age) to 16 years of age (n = 889) in a Swedish cohort. Half of the children were in complete remission by school age. In multivariate prognostic models, persistent preschool eczema (eczema at 1, 2 and 4 years of age) (odds ratio 0.27 (95% confidence interval 0.18-0.41)), preschool eczema with sleep disturbance (due to itch at least once a week at 1, 2 and/or 4 years of age) (0.59 (0.43-0.81)), parental allergy (0.73 (0.55-0.96)), parental smoking at child's birth (0.70 (0.50-0.99)) and filaggrin mutation (R501X, R2447X, 2282del4) (0.47 (0.26-0.85)) were inversely associated with complete remission by school age. Male sex (1.37 (1.03-1.82)) and exclusive breastfeeding ≥4 months (1.44 (1.01-2.05)) were positively associated with complete remission by school age. In conclusion, half of the children with preschool eczema were in complete remission by school age. The most important prognostic factors were persistent preschool eczema and preschool eczema with sleep disturbance due to itch.

  19. Airway function, inflammation and regulatory T cell function in subjects in asthma remission.

    Science.gov (United States)

    Boulet, Louis-Philippe; Turcott, Hélène; Plante, Sophie; Chakir, Jamila

    2012-01-01

    Factors associated with asthma remission need to be determined, particularly when remission occurs in adulthood. To evaluate airway responsiveness and inflammation in adult patients in asthma remission compared with adults with mild, persistent symptomatic asthma. Adenosine monophosphate and methacholine responsiveness were evaluated in 26 patients in complete remission of asthma, 16 patients in symptomatic remission of asthma, 29 mild asthmatic patients and 15 healthy controls. Blood sampling and induced sputum were also obtained to measure inflammatory parameters. Perception of breathlessness at 20% fall in forced expiratory volume in 1 s was similar among groups. In subjects with symptomatic remission of asthma, responsiveness to adenosine monophosphate and methacholine was intermediate between mild asthma and complete asthma remission, with the latter group similar to controls. Asthma remission was associated with a shorter duration of disease. Blood immunoglobulin E levels were significantly increased in the asthma group, and blood eosinophils were significantly elevated in the complete asthma remission, symptomatic remission and asthma groups compared with controls. The suppressive function of regulatory T cells was lower in asthma and remission groups compared with controls. A continuum of asthma remission was observed, with patients in complete asthma remission presenting features similar to controls, while patients in symptomatic asthma remission appeared to be in an intermediate state between complete asthma remission and symptomatic asthma. Remission was associated with a shorter disease duration. Despite remission of asthma, a decreased suppressor function of regulatory T cells was observed, which may predispose patients to future recurrence of the disease.

  20. Preparing the next generation of health care providers: A description and comparison of nurse practitioner and medical student tuition in 2015.

    Science.gov (United States)

    Riley, Lydia; Litsch, Tyler; Cook, Michelle L

    2016-01-01

    The purpose of this study was twofold: to describe the average cost of nurse practitioner (NP) tuition based on degree program, program type, and geography; and to compare the cost of NP tuition to medical school tuition. A listing of all NP degree granting universities was obtained from the American Association of Colleges of Nursing during the fall of 2014, and tuition data were obtained from university websites. Medical school tuition data were obtained online during the fall of 2014 from the American Association of Medical Colleges. Average 1-year tuition rates were calculated for NP programs and medical schools and compared across private and public institutions. Average 1-year resident tuition for public university NP programs ranges between $8671 and $11,077 based on type of program. The cost of 1-year NP program tuition at the master's and the doctoral level is much lower than the cost of 1-year medical school tuition at both private and public universities. NPs can perform many of the same services as physicians in the primary care setting with comparable outcomes, yet the cost of educating NPs is much lower. NPs are a cost-effective solution to the healthcare workforce shortage. ©2015 American Association of Nurse Practitioners.

  1. Severity of Depression Predicts Remission Rates Using Transcranial Magnetic Stimulation.

    Science.gov (United States)

    Grammer, Geoffrey G; Kuhle, Andrew R; Clark, Caroline C; Dretsch, Michael N; Williams, Kathy A; Cole, Jeffrey T

    2015-01-01

    Multiple factors likely impact response and remission rates in the treatment of depression with repetitive transcranial magnetic stimulation (rTMS). Notably, the role of symptom severity in outcomes with rTMS is poorly understood. This study investigated the predictors of achieving remission in patients suffering from depression who receive ≥3 rTMS treatments per week. Available data on 41 patients treated at Walter Reed National Military Medical Center from 2009 to 2014 were included for analysis. Patients received a range of pulse sequences from 3,000 to 5,000 with left-sided or bilateral coil placement. Primary outcome measures were total score on the Patient Health Questionnaire-9 or the Quick Inventory of Depressive Symptomatology-Self Rated. Remission was defined as a total score less than five, and response was defined as a 50% decrease in the total score on both outcome metrics. Outcomes in patients diagnosed as suffering from mild or moderate depression were compared to those suffering from severe depression. Of the 41 patients receiving treatment, 16 reached remission and 18 reached response by the end of treatment. Remission rate was associated with the initial severity of depression, with patients with mild or moderate depression reaching remission at a significantly higher rate than those with severe depression. Total number of rTMS sessions or length of treatment was not predictors of remission. Patients with a baseline level of depression characterized as mild or moderate had significantly better outcomes following rTMS compared to patients with severe depression.

  2. Fluorescence--remission sensoring of skin tumours: preliminary results.

    Science.gov (United States)

    Wollina, Uwe; Nelskamp, Cornelia; Scheibe, Armin; Fassler, Dieter; Schmidt, Wolf-Dieter

    2007-11-01

    Nonmelanoma skin cancer (NMSC) is one of the most common malignancies in men. Objective evaluation by digital dermoscopy, as for pigmented lesions, does not provide sufficient data to discriminate between benign and malignant lesions. Therefore, other techniques have to be developed. Hospitalized patients of an academic teaching hospital were evaluated. Because the simultaneous measurement of fluorescence and remission of skin is impossible, a principle of subsequent measurement of remission and fluorescence had been developed by our group. This was combined with dermoscopic imaging. VIS-NIR remission spectroscopy was performed using the laboratory device TIDAS. Fluorescence spectroscopy was realized using a SKINSKAN. Fluorescence emission was detected by a highly sensitive PMT-detector. Based on this evaluation, we developed an optimized measuring device (FRIS, fluorescence-remission-imaging sensor) combining sensors for fluorescence, remission and digital imaging with a white light ring illumination, a drilled mirror and fibre optics. FRIS consists of an industrial personal computer with a touch screen combining three UV-VIS spectrometer modules and a white light source for remission measurements and referencing. Furthermore, included are a CCD coloured camera module and an LED white light ring-illumination. Fluorescence emission is realized by a UV-LED with a peak wavelength of 370 nm. System control uses Window frames and a specifically developed software Skinrem3.exe . Using this technology, we performed a pilot study in 19 patients with 30 NMSC-suspicious lesions including: actinic keratosis (n=10), basal cell carcinoma (BCC; n=16) and squamous cell carcinoma (SCC; n=4 with two in situ carcinomas). Reproducibility measured or FRIS by relative standard deviation of repeated spectroscopic measurements was 2 AU indicates BCC. To substantiate the diagnostic potency of this technology, further studies are needed. A combination of fluorescence and remission

  3. Lactobacillus GG in inducing and maintaining remission of Crohn's disease

    Directory of Open Access Journals (Sweden)

    Vanderhoof Jon A

    2004-03-01

    Full Text Available Abstract Background Experimental studies have shown that luminal antigens are involved in chronic intestinal inflammatory disorders such as Crohn's disease and ulcerative colitis. Alteration of the intestinal microflora by antibiotic or probiotic therapy may induce and maintain remission. The aim of this randomized, placebo-controlled trial was to determine the effect of oral Lactobacillus GG (L. GG to induce or maintain medically induced remission. Methods Eleven patients with moderate to active Crohn's disease were enrolled in this trial to receive either L. GG (2 × 109 CFU/day or placebo for six months. All patients were started on a tapering steroid regime and received antibiotics for the week before the probiotic/placebo medication was initiated. The primary end point was sustained remission, defined as freedom from relapse at the 6 months follow-up visit. Relapse was defined as an increase in CDAI of >100 points. Results 5/11 patients finished the study, with 2 patients in each group in sustained remission. The median time to relapse was 16 ± 4 weeks in the L. GG group and 12 ± 4.3 weeks in the placebo group (p = 0.5. Conclusion In this study we could not demonstrate a benefit of L. GG in inducing or maintaining medically induced remission in CD.

  4. Sustained remission of Cushing's disease with mitotane and pituitary irradiation

    International Nuclear Information System (INIS)

    Schteingart, D.E.; Tsao, H.S.; Taylor, C.I.; McKenzie, A.; Victoria, R.; Therrien, B.A.

    1980-01-01

    Low doses of mitotane were given orally to 36 patients with Cushing's disease, concurrently with or after pituitary cobalt irradiation. Clinical and biochemical remission occurred in 29. The response to treatment occurred early in 17 patients and late in 12. The different pattern of response to mitotane was not related to the dose given or to its serum level. Early biochemical indicators of adrenal suppression with mitotane were a sharp decrease in adrenal response to the infusion of ACTH and in plasma levels of dehydroepiandrosterone sulfate. Although mitotane was given together with pituitary irradiation, initial remission was due mainly to the adrenal effect of mitotane. Plasma ACTH levels were still elevated when cortisol had returned to normal. In seventeen of the 29 patients who responded to treatment drug therapy has been discontinued, and they remain in remission of Cushing's syndrome. Side-effects have been dose dependent, with anorexia, nausea, decreased memory, and gynecomastia in men being the commonest

  5. Predictors of diabetes remission after bariatric surgery in Asia.

    Science.gov (United States)

    Lee, Wei-Jei; Chong, Keong; Chen, Jung-Chien; Ser, Kong-Han; Lee, Yi-Chih; Tsou, Jun-Juin; Chen, Shu-Chun

    2012-04-01

    Obesity and type II diabetes mellitus (T2DM) are closely related and difficult to control by current medical treatment. Bariatric surgery has been proposed for inadequately controlled T2DM in association with obesity. However, prediction of successful T2DM remission after surgery has not been clearly studied in Asian patients. This information might be helpful for applying gastrointestinal surgery as metabolic surgery for T2DM. This was a retrospective clinical study. From January 2002 to December 2008, 88 consecutive patients with morbid obesity, who were enrolled into a surgically supervised weight loss program, and who had T2DM before surgery with at least 1 year complete follow-up data were included. Sixty-eight (77.2%) patients received gastric bypass procedures, and the remaining 20 (22.8%) received restrictive procedures. We analyzed the available information during the initial evaluation of patients who were referred for bariatric surgery, by logistic regression analysis and data mining methods for predictors of successful diabetes remission after surgery. Overall, 68 (77.2%) of the 88 patients had remission of their T2DM 1 year after surgery. Patients in the bypass group had a higher remission rate than those in the restrictive group [59/68 (86.7%) vs. 9/20 (45.0%), p=0.000]. In univariate analysis, patients who had T2DM remission after surgery were younger, heavier, had a wider waist, less severe disease, shorter duration, and higher C-peptide levels than those without remission. Type of operation and T2DM duration remained independent predictors of success after multivariate logistical regression analysis (pBariatric surgery is a treatment option for T2DM. Duration of diabetes is the most predictor of success after surgery. Copyright © 2012. Published by Elsevier B.V.

  6. Factors associated with sustained remission in patients with rheumatoid arthritis.

    Science.gov (United States)

    Martire, María Victoria; Marino Claverie, Lucila; Duarte, Vanesa; Secco, Anastasia; Mammani, Marta

    2015-01-01

    To find out the factors that are associated with sustained remission measured by DAS28 and boolean ACR EULAR 2011 criteria at the time of diagnosis of rheumatoid arthritis. Medical records of patients with rheumatoid arthritis in sustained remission according to DAS28 were reviewed. They were compared with patients who did not achieved values of DAS28<2.6 in any visit during the first 3 years after diagnosis. We also evaluated if patients achieved the boolean ACR/EULAR criteria. Variables analyzed: sex, age, smoking, comorbidities, rheumatoid factor, anti-CCP, ESR, CRP, erosions, HAQ, DAS28, extra-articular manifestations, time to initiation of treatment, involvement of large joints, number of tender joints, number of swollen joints, pharmacological treatment. Forty five patients that achieved sustained remission were compared with 44 controls. The variables present at diagnosis that significantly were associated with remission by DAS28 were: lower values of DAS28, HAQ, ESR, NTJ, NSJ, negative CRP, absence of erosions, male sex and absence of involvement of large joints. Only 24.71% achieved the boolean criteria. The variables associated with sustained remission by these criteria were: lower values of DAS28, HAQ, ESR, number of tender joints and number of swollen joints, negative CRP and absence of erosions. The factors associated with sustained remission were the lower baseline disease activity, the low degree of functional disability and lower joint involvement. We consider it important to recognize these factors to optimize treatment. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  7. Tuition-Setting Authority and Deregulation at State Colleges and Universities. Policy Matters: A Higher Education Policy Brief

    Science.gov (United States)

    McBain, Lesley

    2010-01-01

    State support for public colleges and universities is based on a historic relationship; these institutions were established to perform the public service mission of predominantly educating residents from local and state-wide communities at a lower price than private, independent colleges and universities. In return, the states appropriated funds…

  8. A remissão em esquizofrenia é possível? Is remission in schizophrenia possible?

    Directory of Open Access Journals (Sweden)

    Hélio Elkis

    2007-01-01

    Full Text Available CONTEXTO: O conceito de remissão já está bem definido em algumas patologias psiquiátricas, como é o caso do transtorno depressivo, porém só recentemente foi proposto um critério para esquizofrenia. OBJETIVO: Revisar o novo conceito de remissão em esquizofrenia. MÉTODO: Revisão da literatura usando o PubMed. RESULTADOS: Os conceitos de resposta, remissão, estabilidade e recuperação são amplamente discutidos neste artigo, bem como os itens das escalas utilizados para definição. CONCLUSÃO: O conceito de remissão caracteriza-se pela presença nos últimos 6 meses de sintomas que atingem um nível máximo de gravidade (nível 3 da Panss mas que permitem um certo funcionamento social. As dimensões do conceito e seus respectivos sintomas psicopatológicos são: Positiva: alucinações, delírios, conteúdo incomum do pensamento. Desorganização: desorganização conceitual, maneirismos e postura. Negativa: afeto embotado, afastamento social passivo/apático, falta de espontaneidade no fluxo da conversação.BACKGROUND: The concept of remission is well established in some psychiatric disorders such as depression, but only recently it has been proposed for schizophrenia. OBJECTIVE: The aim of the present paper is to review the new proposed criteria for remission in schizophrenia. METHOD: PubMed search. RESULTS: The concept of remission, response, stability and recover are extensively discussed in the present article, as well as items of the scales used in the definition. CONCLUSION: The concept of remission is characterized by the presence in the last 6 months of symptoms with a maximum threshold severity level (Panss level 3 but which allows a certain degree of social functioning. The dimensions of the concept and respective psychopathological symptoms are: Positive: delusions, hallucinations and unusual thought content. Disorganization: conceptual disorganization and mannerisms and posturing; Negative: blunted affect, passive

  9. Weight Suppression Predicts Time to Remission from Bulimia Nervosa

    Science.gov (United States)

    Lowe, Michael R.; Berner, Laura A.; Swanson, Sonja A.; Clark, Vicki L.; Eddy, Kamryn T.; Franko, Debra L.; Shaw, Jena A.; Ross, Stephanie; Herzog, David B.

    2011-01-01

    Objective: To investigate whether, at study entry, (a) weight suppression (WS), the difference between highest past adult weight and current weight, prospectively predicts time to first full remission from bulimia nervosa (BN) over a follow-up period of 8 years, and (b) weight change over time mediates the relationship between WS and time to first…

  10. Influence of disease remission on renal dimensions in childhood ...

    African Journals Online (AJOL)

    Background: The hallmark of Nephrotic syndrome is massive proteinuria, with associated enlarged kidneys. However the association between remission status and size of the kidneys in patients with nephrotic syndrome is not known. This study is aimed at determining the dimensions of the kidneys of children with nephrotic ...

  11. 46 CFR Sec. 3 - Application for remission of duties.

    Science.gov (United States)

    2010-10-01

    ... Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY GENERAL AGENT'S RESPONSIBILITY IN CONNECTION WITH FOREIGN REPAIR CUSTOM'S ENTRIES Sec. 3 Application for remission... District Director of Customs as defined in 19 CFR 1.1(d) if the following circumstances prevail: (a) When...

  12. Incidence, Remission and Mortality of Convulsive Epilepsy in Rural Northeast South Africa.

    Directory of Open Access Journals (Sweden)

    Ryan G Wagner

    Full Text Available Epilepsy is one of the most common neurological conditions globally, estimated to constitute 0.75% of the global burden of disease, with the majority of this burden found in low- and middle- income countries (LMICs. Few studies from LMICs, including much of sub-Saharan Africa, have described the incidence, remission or mortality rates due to epilepsy, which are needed to quantify the burden and inform policy. This study investigates the epidemiological parameters of convulsive epilepsy within a context of high HIV prevalence and an emerging burden of cardiovascular disease.A cross-sectional population survey of 82,818 individuals, in the Agincourt Health and Socio-demographic Surveillance Site (HDSS in rural northeast South Africa was conducted in 2008, from which 296 people were identified with active convulsive epilepsy. A follow-up survey was conducted in 2012. Incidence and mortality rates were estimated, with duration and remission rates calculated using the DISMOD II software package.The crude incidence for convulsive epilepsy was 17.4/100,000 per year (95%CI: 13.1-23.0. Remission was 4.6% and 3.9% per year for males and females, respectively. The standardized mortality ratio was 2.6 (95%CI: 1.7-3.5, with 33.3% of deaths directly related to epilepsy. Mortality was higher in men than women (adjusted rate ratio (aRR 2.6 (95%CI: 1.2-5.4, and was significantly associated with older ages (50+ years versus those 0-5 years old (RR 4.8 (95%CI: 0.6-36.4.The crude incidence was lower whilst mortality rates were similar to other African studies; however, this study found higher mortality amongst older males. Efforts aimed at further understanding what causes epilepsy in older people and developing interventions to reduce prolonged seizures are likely to reduce the overall burden of ACE in rural South Africa.

  13. Incidence, Remission and Mortality of Convulsive Epilepsy in Rural Northeast South Africa.

    Science.gov (United States)

    Wagner, Ryan G; Bottomley, Christian; Ngugi, Anthony K; Ibinda, Fredrick; Gómez-Olivé, F Xavier; Kahn, Kathleen; Tollman, Stephen; Newton, Charles R; Wagner, Ryan; Twine, Rhian; Connor, Myles; Collinson, Mark; Masanja, Honratio; Mathew, Alexander; Kakooza, Angelina; Pariyo, George; Peterson, Stefan; Ndyo-mughenyi, Donald; Odhiambo, Rachael; Chengo, Eddie; Chabi, Martin; Bauni, Evasius; Kamuyu, Gathoni; Odera, Victor Mung'ala; Mageto, James O; Ae-Ngibise, Ken; Akpalu, Bright; Akpalu, Albert; Agbokey, Francis; Adjei, Patrick; Owusu-Agyei, Seth; Kleinschmidt, Immo; Doku, Victor C K; Odermatt, Peter; Neville, Brian; Sander, Josemir W; White, Steve; Nutman, Thomas; Wilkins, Patricia; Noh, John

    2015-01-01

    Epilepsy is one of the most common neurological conditions globally, estimated to constitute 0.75% of the global burden of disease, with the majority of this burden found in low- and middle- income countries (LMICs). Few studies from LMICs, including much of sub-Saharan Africa, have described the incidence, remission or mortality rates due to epilepsy, which are needed to quantify the burden and inform policy. This study investigates the epidemiological parameters of convulsive epilepsy within a context of high HIV prevalence and an emerging burden of cardiovascular disease. A cross-sectional population survey of 82,818 individuals, in the Agincourt Health and Socio-demographic Surveillance Site (HDSS) in rural northeast South Africa was conducted in 2008, from which 296 people were identified with active convulsive epilepsy. A follow-up survey was conducted in 2012. Incidence and mortality rates were estimated, with duration and remission rates calculated using the DISMOD II software package. The crude incidence for convulsive epilepsy was 17.4/100,000 per year (95%CI: 13.1-23.0). Remission was 4.6% and 3.9% per year for males and females, respectively. The standardized mortality ratio was 2.6 (95%CI: 1.7-3.5), with 33.3% of deaths directly related to epilepsy. Mortality was higher in men than women (adjusted rate ratio (aRR) 2.6 (95%CI: 1.2-5.4)), and was significantly associated with older ages (50+ years versus those 0-5 years old (RR 4.8 (95%CI: 0.6-36.4)). The crude incidence was lower whilst mortality rates were similar to other African studies; however, this study found higher mortality amongst older males. Efforts aimed at further understanding what causes epilepsy in older people and developing interventions to reduce prolonged seizures are likely to reduce the overall burden of ACE in rural South Africa.

  14. Remission and rheumatoid arthritis: Data on patients receiving usual care in twenty-four countries

    DEFF Research Database (Denmark)

    Sokka, Tuulikki; Hetland, Merete Lund; Mäkinen, Heidi

    2008-01-01

    ,848 patients receiving usual care at 67 sites in 24 countries, was used for this study. Patients were clinically assessed by rheumatologists and completed a 4-page self-report questionnaire. The database was analyzed according to the following definitions of remission: American College of Rheumatology (ACR......: The overall remission rate was lowest using the ACR definition of remission (8.6%), followed by the Clin42 (10.6%), Clin28 (12.6%), CDAI (13.8%), MD remission (14.2%), and RAPID3 (14.3%); the rate of remission was highest when remission was defined using the DAS28 (19.6%). The difference between the highest...

  15. Albuminuria in type 2 diabetes mellitus: from remission to progression.

    Science.gov (United States)

    Bentata, Yassamine; Karimi, Ilham; Benabdellah, Nawal; El Alaoui, Fatiha; Haddiya, Intissar; Abouqal, Redouane

    2016-01-01

    Albuminuria is an early marker of renal impairment and a powerful factor of progression of renal disease in type 2 diabetes (T2D). Approximately, one-third of patients with T2D have micro- or macroalbuminuria and these patients have a high risk of progression toward End Stage Renal Disease (ESRD) as well as increased cardiovascular disease. The aim of this study was to determine the prevalence of remission, regression, persistence, and progression of albuminuria, and to evaluate the impact of change in albuminuria on kidney disease and cardiovascular disease in a prospective cohort of patients with T2D. This is a prospective study. The Ethics Committee of Morocco's Mohammed V University in Rabat approved the study protocol. Inclusion criteria targeted patients who were type 2 diabetics with albuminuria >30 mg/day, and who had been regularly followed-up in nephrology consultation for at least 36 months. Five-hundred twenty-four patients were included. 75.8 and 24.6% of all patients had micro- and macroalbuminuria at enrollment in the study. At the end of the study, 91, 141, 199, and 93 patients had remission, regression, persistence, and progression of albuminuria, respectively. Remission of microalbuminuria to normoalbuminuria was observed in 23.6% of cases. Regression of macroalbuminuria to micro- was observed in 29.9% of cases. In our study, the incidence of remission and/or regression of micro- and macroalbuminuria was higher. The incidence of ESRD and the occurrence of cardiac events were greater in the regression, persistence, and progression groups than in the remission of albuminuria group.

  16. Biologic-free remission by orthopaedic surgery in non-responder to infliximab for rheumatoid arthritis.

    Science.gov (United States)

    Kanbe, Katsuaki; Chiba, Junji; Inoue, Yasuo; Taguchi, Masashi; Yabuki, Akiko

    2015-01-01

    The aim of this study was to investigate remission and biologic-free remission after orthopaedic surgery and related clinical factors in non-responder to infliximab for rheumatoid arthritis (RA). We analyzed 74 patients who were treated with 3 mg/kg infliximab and methotrexate and underwent orthopaedic surgery after non-responder to infliximab with disease activity score (DAS) 28 (CRP) of ≥3.2. The rates of remission and biologic-free remission at 52 weeks after orthopaedic surgery were investigated and the clinical factors related to remission and biologic-free remission were analyzed by logistic regression and receiver-operating characteristic analyses. The rates of total remission and biologic-free remission were 37/74 (50 %) and 9/74 (12.2 %), respectively. Regarding orthopaedic surgery, the rates of remission and biologic-free remission were 25/38 (65.8 %) and 7/38 (18.4 %) for synovectomy, 7/20 (35 %) and 0/20 (0 %) for arthroplasty, and 5/16 (31.3 %) and 2/16 12.5) for others including spine surgery and foot surgery. DAS28(CRP) at baseline was significantly related to both remission and biologic-free remission. Prednisolone was negatively associated with remission, and DAS28(CRP) was related to biologic-free remission by logistic regression analyses. DAS28(CRP) below 3.7 was cutoff point for acquiring biologic-free remission of non-responder to infliximab after orthopaedic surgery. Therefore orthopaedic surgery may be effective to obtain remission or biologic-free remission in RA patients treated with biologics.

  17. The Influence of Price on School Enrollment under Uganda's Policy of Free Primary Education

    Science.gov (United States)

    Lincove, Jane Arnold

    2012-01-01

    This study uses household survey data to estimate determinants of schooling in Uganda, with a model that includes the price of school. Uganda's universal education policy offered free tuition, fees, and supplies to up to four children per family, including two daughters. The empirical method includes an estimation of a child-specific price of…

  18. Tuition Rich, Mission Poor: Nonresident Enrollment Growth and the Socioeconomic and Racial Composition of Public Research Universities

    Science.gov (United States)

    Jaquette, Ozan; Curs, Bradley R.; Posselt, Julie R.

    2016-01-01

    Many public research universities fail to enroll a critical mass of low-income and underrepresented minority (URM) students. Though founded with a commitment to access, public research universities face pressure to increase tuition revenue and to recruit high-achieving students. These pressures create an incentive to recruit nonresident students,…

  19. "If I Play My Sax My Parents Are Nice to Me": Opportunity and Motivation in Musical Instrument and Singing Tuition

    Science.gov (United States)

    Driscoll, Jennifer

    2009-01-01

    Little consideration has been given to the factors which motivate children to take up music tuition, or their reasons for giving up. In part, this is a reflection of the limited extent to which children have been consulted directly in relation to issues exclusively affecting them. This study considered opportunity and motivation for young people…

  20. In My Own Time: Tuition Fees, Class Time and Student Effort in Non-Formal (Or Continuing) Education

    Science.gov (United States)

    Bolli, Thomas; Johnes, Geraint

    2015-01-01

    We develop and empirically test a model which examines the impact of changes in class time and tuition fees on student effort in the form of private study. The data come from the European Union's Adult Education Survey, conducted over the period 2005-2008. We find, in line with theoretical predictions, that the time students devote to private…

  1. Determinants of Participation and Expenditure Patterns of Private Tuition Received by Primary School Students in Penang, Malaysia: An Exploratory Study

    Science.gov (United States)

    Jelani, Juliana; Tan, Andrew K. G.

    2012-01-01

    In this exploratory study, the censored Tobit model is applied on primary data collected amongst parents of primary school students in Penang, Malaysia to examine the determinants of participation and expenditures on private tuition (PT). Results of the marginal effects indicate that socio-demographic characteristics--ethnicity, household income,…

  2. Understanding the One-to-One Relationship in Instrumental/Vocal Tuition in Higher Education: Comparing Student and Teacher Perceptions

    Science.gov (United States)

    Gaunt, Helena

    2011-01-01

    The power of one-to-one tuition in Higher Music Education is evidenced by its continuing place at the heart of conservatoire education. The need to examine this student-teacher relationship more closely has been emphasised in the last decades by increasing understanding of processes of student learning in Higher Education as a whole, and in…

  3. Onondaga Community College (NY) Tuition Assistance Program (TAP), 1995-1998. Audit by State Comptroller. Report 98-T-7.

    Science.gov (United States)

    Barber, Jerry

    This document reports on the State Comptroller's audit of records and procedures used in administering the Tuition Assistance Program (TAP) at Onondaga Community College (New York). Onondaga certified 5,543 students for 11,723 TAP awards totaling $8,730,058 during the 1995-96 through 1997-98 academic years. The State Comptroller reviewed a sample…

  4. Tuition & Required Fees. New Jersey Colleges & Universities: 1977-78 Through 1983-84. ORM Volume 4: Brief Number 1.

    Science.gov (United States)

    Delehanty, Kathleen

    1983-01-01

    Recent historical trends (1977-1978 through 1983-1984) in tuition and required fee charges in New Jersey colleges and universities are presented. Differences among New Jersey collegiate sectors and among different types of students (full- and part-time, undergraduate and graduate, resident and nonresident) are analyzed in terms of dollar and…

  5. Is going into stable symptomatic remission associated with a more positive development of life satisfaction?

    DEFF Research Database (Denmark)

    Gardsjord, Erlend Strand; Romm, Kristin Lie; Røssberg, Jan Ivar

    2017-01-01

    by the Remission in Schizophrenia Working Group. One-way ANOVA, mixed model analysis, bivariate correlations and multiple regression analyses were performed. RESULTS: Patients going into stable symptomatic remission showed a more positive S-QoL-development over the follow-up period and reported higher life...... satisfaction at 10-year follow-up compared to non-remission. At 10-year follow-up, depressive symptoms and alcohol abuse or dependence explained a significant amount of variance in S-QoL among patients in remission. Among patients in non-remission, PANSS excitative component explained a significant amount...... implications. While patients in remission might need treatment for depressive symptoms to increase S-QoL, in non-remission measures aiming to decrease hostility and uncooperativeness should be part of the treatment approach. Alcohol problems should be treated regardless of remission status....

  6. Remission in psoriatic arthritis: is it possible and how can it be predicted?

    LENUS (Irish Health Repository)

    Saber, Tajvur P

    2010-01-01

    Since remission is now possible in psoriatic arthritis (PsA) we wished to examine remission rates in PsA patients following anti tumour necrosis factor alpha (TNFalpha) therapy and to examine possible predictors of response.

  7. Comparison of outcomes parameters for induction of remission in new onset pediatric Crohn's disease

    DEFF Research Database (Denmark)

    Levine, Arie; Turner, Dan; Pfeffer Gik, Tamar

    2014-01-01

    BACKGROUND: Robust evaluation of induction therapies using both clinical and inflammatory outcomes in pediatric Crohn's disease (CD) are sparse. We attempted to evaluate clinical, inflammatory, and composite outcomes of induction of remission therapies (normal C reactive protein [CRP] remission) ...

  8. Magnetic resonance imaging of the wrist in defining remission of rheumatoid arthritis

    International Nuclear Information System (INIS)

    Lee, J.; Lee, S.; Suh, J.; Yoon, M.; Song, J.; Lee, C.

    1998-01-01

    MRI is feasible for objectively defining remission and assessing the therapeutic effect of anti-rheumatic drugs ( methotrexate and hydroxy-chloroquine); utility of MRI measures in clinical remissions criteria remains to be verified. (N.C.)

  9. Glycemic Status and Predictors of Relapse for Diabetic Cats in Remission

    OpenAIRE

    Gottlieb, S.; Rand, J.S.; Marshall, R.; Morton, J.

    2014-01-01

    Background It is unknown if diabetic cats in remission have persistent abnormalities of glucose metabolism and should be considered prediabetic, or have normal glucose tolerance. Objective To characterize glycemic status of diabetic cats in remission and to determine predictors of relapse. Animals A total of 21 cats in diabetic remission and 28 healthy control cats. Methods At a median of 107?days after remission, screening blood glucose concentration was measured on entry to the clinic. Afte...

  10. Effects of Private Tuition on the Academic Achievement of Secondary School Students in Subject of Mathematics in Kohat Division, Pakistan

    Directory of Open Access Journals (Sweden)

    Qaiser Suleman

    2014-02-01

    Full Text Available Research reveals that private or home tuition after school time plays a crucial role in strengthening and improving student’s academic achievement. The purpose of the study was to explore the effects of private tuition on the academic achievement of students in subject of mathematics at secondary school level. All the students at secondary school level in Kohat Division (Pakistan constituted the population of the study. The study was delimited to the students of Government High School Ahmadi Banda Karak only. Fifty students of class 09 were selected as sample of the study. Sample students were divided into two groups i.e. control group and experimental group by equating them on the basis of their previous knowledge in subject of mathematics as determined through a pre-test. Each group was composed of 25 students. Students of the experimental group were engaged in tuition for two hours after school time. The study was experimental in nature therefore, “The pre-test-post-test Equivalent Groups Design” was used for the collection of data. Statistical tools i.e. the mean, standard deviation and differences of means were computed for each group. Significance of difference between the mean scores of both the experimental and control groups on the variable of pre-test and post test scores was tested at 0.05 levels by applying t-test. After statistical analysis of the data, the researchers concluded that there is significant positive effect of private tuition on the academic achievement of students in subject of mathematics at secondary school level. Based on the findings, it was recommended that parents should arrange private tuition for their children to move up their achievement level in subject of mathematics.

  11. Remission of migraine after clipping of saccular intracranial aneurysms

    DEFF Research Database (Denmark)

    Lebedeva, E R; Busygina, A V; Kolotvinov, V S

    2015-01-01

    BACKGROUND: Unruptured saccular intracranial aneurysm (SIA) is associated with an increased prevalence of migraine, but it is unclear whether this is altered by clipping of the aneurysm. The aim of our study was to determine whether remission rate of migraine and other recurrent headaches...... was greater in patients with SIA after clipping than in controls. METHODS: We prospectively studied 87 SIA patients with migraine or other recurrent headaches. They were interviewed about headaches in the preceding year before and 1 year after clipping using a validated semi-structured neurologist conducted...... interview. The remission rates of migraine and tension-type headache (TTH) in these patients were compared to 92 patients from a headache center. Diagnoses were made according to the ICHD-2. RESULTS: During 1 year preceding rupture 51 patients with SIA had migraine. During the year after clipping...

  12. 19 CFR 351.517 - Exemption or remission upon export of indirect taxes.

    Science.gov (United States)

    2010-04-01

    ... Exemption or remission upon export of indirect taxes. (a) Benefit. In the case of the exemption or remission upon export of indirect taxes, a benefit exists to the extent that the Secretary determines that the... exemption or remission upon export of an indirect tax, the Secretary normally will consider the benefit as...

  13. 19 CFR 351.519 - Remission or drawback of import charges upon export.

    Science.gov (United States)

    2010-04-01

    ... Remission or drawback of import charges upon export. (a) Benefit—(1) In general. The term “remission or... import charges. In the case of the remission or drawback of import charges upon export, a benefit exists... import charges upon export, a benefit exists to the extent that the exemption extends to inputs that are...

  14. Bariatric surgery and diabetes remission: Who would have thought it?

    Directory of Open Access Journals (Sweden)

    Awadhesh Kumar Singh

    2015-01-01

    Full Text Available Type 2 diabetes mellitus (T2DM and obesity are increasingly common and major global health problems. The Edmonton obesity staging system clearly pointed towards increased mortality proportionate to the severity of obesity. Obesity itself triggers insulin resistance and thereby poses the risk of T2DM. Both obesity and T2DM have been associated with higher morbidity and mortality and this calls for institution of effective therapies to deal with the rising trend of complications arising out of this dual menace. Although lifestyle changes form the cornerstone of therapy for both the ailments, sustained results from this modalities is far from satisfactory. While Look AHEAD (action for HEAalth in diabetes study showed significant weight loss, reduction in glycated hemoglobin and higher remission rate of T2DM at 1 st year following intensive lifestyle measures; recurrence and relapse rate bounced back in half of subjects at 4 years, thereby indicating that weight loss and glycemic control is difficult to maintain in the long term with lifestyle interventions. Same recurrence phenomenon was also observed with pharmacotherapy with rimonabant, sibutramine and orlistat. Bariatric surgery has been seen to associate with substantial and sustained weight loss in morbidly obese patients. Interestingly, bariatric surgeries also induce higher rates of short and long-term diabetes remission. Although the exact mechanism behinds this diabetes remission are not well understood; improved insulin action, beta-cell function and complex interplay of hormones in the entero-insular axis appears to play a major role. This article reviews the effectiveness of bariatric procedures on remission or improvement in diabetes and put a perspective on its implicated mechanisms.

  15. Predictors of diabetes remission after bariatric surgery in Asia

    OpenAIRE

    Wei-Jei Lee, Wei-Jei Lee; Keong Chong, Keong Chong; Jung-Chien Chen, Jung-Chien Chen; Kong-Han Ser, Kong-Han Ser; Yi-Chih Lee, Yi-Chih Lee; Jun-Juin Tsou, Jun-Juin Tsou; Shu-Chun Chen, Shu-Chun Chen

    2017-01-01

    Background: Obesity and type II diabetes mellitus (T2DM) are closely related and difficult to control by current medical treatment. Bariatric surgery has been proposed for inadequately controlled T2DM in association with obesity. However, prediction of successful T2DM remission after surgery has not been clearly studied in Asian patients. This information might be helpful for applying gastrointestinal surgery as metabolic surgery for T2DM. Methods: This was a retrospective clinical study. ...

  16. Factors associated with clinical remission in cats with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Yu-Hsin Lien

    2012-01-01

    Full Text Available Type 2 diabetes mellitus is a common endocrine disease in cats. The aim of this study was to investigate factors that are associated with clinical remission in diabetic cats, and those that might influence survival time. Medical records of 29 cats with diabetes mellitus were evaluated retrospectively. Data collected from each record included breed, age, and sex, types of diet before and after admission, degree of weight loss, duration of clinical signs before admission, elevation of alanine aminotransferase activity and ketonuria at the time of admission, concurrent pancreatitis or renal failure, glipizide administration, insulin supplement, and survival time. The diet after establishing diagnosis (restriction to non-carbohydrate canned food was the only factor that was significantly associated with achieving clinical remission (P P = 0.004 with clinical remission status and the type of diet after admission (P = 0.04 and negatively associated with the presence of chronic renal failure (P = 0.04. This was the first report of feline diabetes mellitus from Taiwan.

  17. Drug-free remission: the goal of the future in management of patients with rheumatoid arthritis.

    Science.gov (United States)

    Filipowicz-Sosnowska, Anna

    2017-01-01

    Management of patients with rheumatoid arthritis according to the "treat-to-target" strategy requires achievement of remission or low disease activity when remission cannot be achieved (mostly in patients with advanced disease). The assessment of remission and low disease activity is based on a number of definitions depending on the applied instruments which do not always correspond to one another. The role of biomarkers and imaging techniques (ultrasound and magnetic resonance imaging) in predicting the risk for disease relapse after achieving remission and tapering disease-modifying antirheumatic drugs treatment are presented. The concept of achieving the full control of inflammation including residua synovial inflammation and drug free-remission is discussed.

  18. [Project REMISSION(PLUS): clinical and radiological remission : new treatment goals in the management of rheumatoid arthritis].

    Science.gov (United States)

    Ostendorf, B; Scherer, A; Kellner, H; Backhaus, M

    2008-12-01

    In a large number of patients with rheumatoid arthritis (RA), chronic inflammatory processes cause joint changes and loss of function even in the early stages of disease. Early, targeted use of disease-modifying antirheumatic drugs [DMARDs and TNF-alpha blockers ("biologicals")] can significantly reduce the risk of aggressive progression and irreversible joint damage. Hence, early identification of disease-specific processes of joint inflammation and erosion - at the onset of disease or later - is of key importance for the patient's prognosis and therapeutic strategy. This can be achieved today with great precision and reliability through the use of modern imaging methods like arthrosonography and magnetic resonance imaging (MRI). The REMISSION(PLUS) initiative aspire to integrate modern imaging technologies as standard methods in the care and management of RA patients. The main areas on which this initiative will be focusing are the conceptualization and implementation of educational programs and training seminars on sonography and MRI, the development and establishment of case report forms for standardized documentation of findings, and the systematic monitoring of patients on treatment, with the aim of producing very precise documentation of structural change processes in RA and also, if possible, to document radiological remission or even progression. The REMISSION(PLUS) project also includes the setting up of specialized centers of excellence, which will network to support the implementation and access to the various imaging procedures at hospitals, rheumatology clinics and rheumatology practices nationwide.

  19. ACR/EULAR Definitions of Remission Are Associated with Lower Residual Inflammatory Activity Compared with DAS28 Remission on Hand MRI in Rheumatoid Arthritis.

    Science.gov (United States)

    Lisbona, Maria Pilar; Solano, Albert; Ares, Jesús; Almirall, Miriam; Salman-Monte, Tarek Carlos; Maymó, Joan

    2016-09-01

    To determine the level of residual inflammation [synovitis, bone marrow edema (BME), tenosynovitis, and total inflammation] quantified by hand magnetic resonance imaging (h-MRI) in patients with rheumatoid arthritis (RA) in remission according to 3 different definitions of clinical remission, and to compare these remission definitions. A cross-sectional study. To assess the level of residual MRI inflammation in remission, cutoff levels associated to remission and median scores of MRI residual inflammatory lesions were calculated. Data from an MRI register of patients with RA who have various levels of disease activity were used. These were used for the analyses: synovitis, BME according to the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring system, tenosynovitis, total inflammation, and disease activity composite measures recorded at the time of MRI. Receiver-operating characteristic analysis was used to identify the best cutoffs associated with remission for each inflammatory lesion on h-MRI. Median values of each inflammatory lesion for each definition of remission were also calculated. A total of 388 h-MRI sets of patients with RA with different levels of disease activity, 130 in remission, were included. Cutoff values associated with remission according to the Simplified Disease Activity Index (SDAI) ≤ 3.3 and the Boolean American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) definitions for BME and tenosynovitis (1 and 3, respectively) were lower than BME and tenosynovitis (2 and 5, respectively) for the Disease Activity Score on 28 joints (DAS28) ≤ 2.6. Median scores for synovitis, BME, and total inflammation were also lower for the SDAI and Boolean ACR/EULAR remission criteria compared with DAS28. Patients with RA in remission according to the SDAI and Boolean ACR/EULAR definitions showed lower levels of MRI-detected residual inflammation compared with DAS28.

  20. Remission and rheumatoid arthritis: Data on patients receiving usual care in twenty-four countries

    DEFF Research Database (Denmark)

    Sokka, Tuulikki; Hetland, Merete Lund; Mäkinen, Heidi

    2008-01-01

    and lowest remission rates was >/=15% in 10 countries, 5-14% in 7 countries, and definition of remission, male sex, higher education, shorter disease duration, smaller number of comorbidities, and regular...... exercise were statistically significantly associated with remission. CONCLUSION: The use of different definitions of RA remission leads to different results with regard to remission rates, with considerable variation among countries and between sexes. Reported remission rates in clinical trials......OBJECTIVE: To compare the performance of different definitions of remission in a large multinational cross-sectional cohort of patients with rheumatoid arthritis (RA). METHODS: The Questionnaires in Standard Monitoring of Patients with RA (QUEST-RA) database, which (as of January 2008) included 5...

  1. A framework for remission in SLE : Consensus findings from a large international task force on definitions of remission in SLE (DORIS)

    NARCIS (Netherlands)

    van Vollenhoven, Ronald F.; Voskuyl, Alexandre E.; Bertsias, George K.; Aranow, Cynthia; Aringer, Martin; Arnaud, Laurent; Askanase, Anca; Balazova, Petra; Bonfa, Eloisa; Bootsma, Hendrika; Boumpas, Dimitrios T.; Bruce, Ian N.; Cervera, Ricard; Clarke, Ann; Coney, Cindy; Costedoat-Chalumeau, Nathalie; Czirjak, Laszlo; Derksen, Ronald; Doria, Andrea; Doerner, Thomas; Fischer-Betz, Rebecca; Fritsch-Stork, Ruth; Gordon, Caroline; Graninger, Winfried; Gyori, Noemi; Houssiau, Frederic A.; Isenberg, David A.; Jacobsen, Soren; Jayne, David; Kuhn, Annegret; Le Guern, Veronique; Lerstrom, Kirsten; Levy, Roger; Machado-Ribeiro, Francinne; Mariette, Xavier; Missaykeh, Jamil; Morand, Eric; Mosca, Marta; Inanc, Murat; Navarra, Sandra; Neumann, Irmgard; Olesinska, Marzena; Petri, Michelle; Rahman, Anisur; Rekvig, Ole Petter; Rovensky, Jozef; Shoenfeld, Yehuda; Smolen, Josef S.; Tincani, Angela; Urowitz, Murray; van Leeuw, Bernadette; Vasconcelos, Carlos; Voss, Anne; Werth, Victoria P.; Zakharova, Helena; Zoma, Asad; Schneider, Matthias; Ward, Michael

    Objectives Treat-to-target recommendations have identified `remission' as a target in systemic lupus erythematosus (SLE), but recognise that there is no universally accepted definition for this. Therefore, we initiated a process to achieve consensus on potential definitions for remission in SLE.

  2. Glutamine for induction of remission in Crohn's disease.

    Science.gov (United States)

    Akobeng, Anthony K; Elawad, Mamoun; Gordon, Morris

    2016-02-08

    Crohn's disease is a chronic relapsing condition of the alimentary tract with a high morbidity secondary to bowel inflammation. Glutamine plays a key role in maintaining the integrity of the intestinal mucosa and has been shown to reduce inflammation and disease activity in experimental models of Crohn's disease. To evaluate the efficacy and safety of glutamine supplementation for induction of remission in Crohn's disease. We searched the following databases from inception to November 15, 2015: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and the Cochrane IBD Group Specialised Register. Study references were also searched for additional trials. There were no language restrictions. Randomised controlled trials (RCTs) that compared glutamine supplementation administered by any route to a placebo, active comparator or no intervention in people with active Crohn's disease were considered for inclusion. Two authors independently extracted data and assessed the methodological quality of the included studies. The Cochrane risk of bias tool was used to assess methodological quality. The primary outcome measure was clinical or endoscopic remission. Secondary outcomes included intestinal permeability, clinical response, quality of life, growth in children and adverse events. Risk ratios and 95% confidence intervals were calculated for dichotomous outcomes. The overall quality of the evidence supporting the primary outcome was evaluated using the GRADE criteria. Two small RCTs (total 42 patients) met the inclusion criteria and were included in the review. One study (18 patients) compared four weeks of treatment with a glutamine-enriched polymeric diet (42% amino acid composition) to a standard polymeric diet (4% amino acid composition) with low glutamine content in paediatric patients ( 18 years of age) with acute exacerbation of inflammatory bowel disease. The paediatric study was rated as low risk of bias. The study in adult patients was rated as

  3. Tuition reduction is the key factor determining tax burden of graduate students under the Tax Cuts and Job Act [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Patricia M. Lawston

    2018-02-01

    Full Text Available Background: The proposed Tax Cuts and Jobs Act (H.R.1 has stirred significant public debate on the future of American economics.  While supporters of the plan have championed it as a necessity for economic revitalization, detractors have pointed out areas of serious concern, particularly for low- and middle-income Americans.  One particularly alarming facet of the plan is the radical change to education finance programs and taxation of students in higher education.  Methods:  By analyzing actual income and tuition of a public and a private university student, as well as the ‘average’ graduate student, we investigated the effect of both the House and Senate versions of H.R. 1 on taxation of students of various family structures.  Results:  Our findings indicate that taxable tuition would be the greatest contributor to graduate student tax burden across all four categories of filing status.  However, when tuition reduction is upheld or a student is on sustaining fees rather than full tuition, graduate students would realize decreases in taxation. Conclusions:  Overall, we conclude that removal of tuition reduction would result in enormous tax burdens for graduate students and their families and that these effects are dependent not only on the status of the student in their degree program but also on their tuition and stipend, and therefore the institution they attend.

  4. CCK response in bulimia nervosa and following remission.

    Science.gov (United States)

    Hannon-Engel, Sandra L; Filin, Evgeniy E; Wolfe, Barbara E

    2013-10-02

    The core defining features of bulimia nervosa (BN) are repeated binge eating episodes and inappropriate compensatory (e.g., purging) behavior. Previous studies suggest an abnormal post-prandial response in the satiety-signaling peptide cholecystokinin (CCK) in persons with BN. It is unknown whether this altered response persists following remission or if it may be a potential target for the development of clinical treatment strategies. To examine the nature of this altered response, this study assessed whether CCK normalizes following remission from BN (RBN). This study prospectively evaluated the plasma CCK response and corresponding eating behavior-related ratings (e.g., satiety, fullness, hunger, urge to binge and vomit) in individuals with BN-purging subtype (n=10), RBN-purging subtype (n=14), and healthy controls (CON, n=13) at baseline, +15, +30, and +60 min following the ingestion of a standardized liquid test meal. Subject groups did not significantly differ in CCK response to the test meal. A significant relationship between CCK response and satiety ratings was observed in the RBN group (r=.59, p<.05 two-tailed). A new and unanticipated finding in the BN group was a significant relationship between CCK response and ratings of "urge to vomit" (r=.86, p<.01, two-tailed). Unlike previous investigations, CCK response did not differ in BN and CON groups. Thus the role of symptom severity remains an area of further investigation. Additionally, findings suggest that in this sample, CCK functioning following remission from BN-purging subtype is not different from controls. It remains unknown whether or not CCK functioning may be a protective or liability factor in the stabilization and recovery process. Replication studies utilizing a larger sample size are needed to further elucidate the role of CCK in recovery from BN and its potential target of related novel treatment strategies. © 2013 Elsevier Inc. All rights reserved.

  5. Influence of Bariatric Surgery on Remission of Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Paweł Nalepa

    2011-12-01

    Full Text Available The plague of obesity afflicts an increasing group of people. Moreover type 2 diabetes, which is the most serious illness accompanying excessive weight, is becoming more and more common. Traditional methods of obesity treatment, such as diet and physical exercise, fail. This applies especially to people with class III obesity. The only successful way of treating obesity in their case is bariatric surgery. There are three types of bariatric surgery: restrictive procedures (reducing stomach volume, malabsorptive procedures, and mixed procedures, which combine both methods. In spite of the risk connected with the surgery and complications after it, bariatric procedures are advised to patients with class III obesity and class II with an accompanying illness which increases the probability of death. It has been proved that bariatric surgery not only eliminates obesity but also very frequently (in 90�0of cases leads to the remission of type 2 diabetes. Moreover, the remission occurs very fast – it takes place a long time before the patients reduce their weight, even within a few days after surgery. Detailed studies have shown that the remission of diabetes is caused mostly by the change of the gastro-intestinal hormones’ profile, resulting from the surgery. These hormones include GLP-1, GIP, peptide YY, ghrelin and oxyntomodulin. Additionally, the change of the amount of adipose tissue after the surgery influences the level of adipokines, i.e. the hormones of the adipose tissue, among which the most important are leptin, adiponectin and resistin. Thus, bariatric surgery not only changes the shape of the gastrointestinal tract but it also modulates the hormonal activity. Bariatric surgery is considered as therapy not only for the obese but also for diabetic patients.

  6. Cluster headache attack remission with sphenopalatine ganglion stimulation

    DEFF Research Database (Denmark)

    Barloese, Mads C J; Jürgens, Tim P; May, Arne

    2016-01-01

    attacks. Methods: We monitored self-reported attack frequency, headache disability, and medication intake in 33 patients with medically refractory, chronic CH (CCH) in an open label follow-up study of the original Pathway CH-1 study. Patients were followed for at least 24 months (average 750 ± 34 days...... disability improvements remained and patient satisfaction measures were positive in 100 % (10/10). Conclusions: In this population of 33 refractory CCH patients, in addition to providing the ability to treat acute attacks, neuromodulation of the SPG induced periods of remission from cluster attacks...

  7. Late recurrence in orbital rhabdomyosarcoma: Complete remission after multimodality management

    Directory of Open Access Journals (Sweden)

    Warrier Arun

    2010-01-01

    Full Text Available A case of orbital rhabdomyosarcoma had a localised recurrence 13 years after being treated with chemo radiotherapy. Late recurrences are rare in orbital RMS. Only two cases have been reported to have recurred after five years of follow up. Pathological similarity of both the lesions and occurrence outside the irradiated field excluded a radiationinduced second neoplasm. Immunohistochemistry staining with p 53 was positive. Patient had good response to chemotherapy and radiotherapy. Surgical resection of residue showed complete necrosis. Retreatment with combined modality therapy resulted in complete remission and the patient is on follow up.

  8. The Effect of Tuition Fees on Student Enrollment and Location Choice – Interregional Migration, Border Effects and Gender Differences

    DEFF Research Database (Denmark)

    Alecke, Björn; Burgard, Claudia; Mitze, Timo

    analysis, we use the variation over time and across regions in this institutional change in order to isolate the causal effect of tuition fees on student enrollment and migration. Controlling for a range of regional- and university-specific effects, our results from Difference-in-Differences estimations...... state. Controlling for these border effects, the relocating trend in long-distance migration of university freshmen does not show any particular gender differences....

  9. The Effect of Tuition Fees on Student Enrollment and Location Choice: Interregional Migration, Border Effects and Gender Differences

    DEFF Research Database (Denmark)

    Alecke, Bjoern; Burgard, Claudia; Mitze, Timo

    analysis, we use the variation over time and across regions in this institutional change in order to isolate the causal effect of tuition fees on student enrollment and migration. Controlling for a range of regional- and university-specific effects, our results from Difference-in-Differences estimations...... state. Controlling for these border effects, the relocating trend in long-distance migration of university freshmen does not show any particular gender differences....

  10. The student and the ovum: The lack of autonomy and informed consent in trading genes for tuition

    Directory of Open Access Journals (Sweden)

    Papadimos Alexa T

    2004-07-01

    Full Text Available Abstract Rising tuition costs have forced university students to become creative in finding ways to fund their education. Some female university students have decided that ova donation may be an acceptable alternative in which to pay for their tuition. This alternative presents itself because of the insufficient number of ova available for assisted reproduction and emerging stem cell technologies. Young female university students are encouraged by Internet sources and respectable electronic and print media to donate their ova in the cause of assisted reproduction for monetary compensation. While university students generally exhibit autonomy, the constraining influence of their financial predicament compromises the elements of informed consent (voluntariness, competence, capacity, understanding, and disclosure as to their making an autonomous decision in regard to egg donation. Thus, any moral possibility of giving informed consent is negated. Informed consent can only occur through autonomy. A female university student in need of financial resources to pay for her education cannot make an autonomous choice to trade her genes for tuition. Donated ova are not only needed for assisted reproduction, but for stem cell technologies. While the long-term health of women who donate their ova is of concern (a potential risk of cancer after long term use of ovulation induction, of equal concern is the possibility of a growth in the trade of ova targeting third world and Eastern European women where the precedence for autonomy and informed consent is not well established.

  11. Fluoxetine promotes remission in acute experimental autoimmune encephalomyelitis in rats.

    Science.gov (United States)

    Yuan, Xi-qiu; Qiu, Guang; Liu, Xiao-jia; Liu, Shan; Wu, Yongming; Wang, Xinyu; Lu, Tianming

    2012-01-01

    This study was carried out to clarify the effects of the antidepressant fluoxetine, a selective serotonin reuptake inhibitor, for its potential use in autoimmune diseases like multiple sclerosis in a rat model of experimental autoimmune encephalomyelitis (EAE). The rat EAE model was induced by subcutaneous injection of guinea pig spinal cord homogenate. Rats received fluoxetine via daily intragastric administration, starting 2 weeks prior to immune induction (fluoxetine pretreatment). Clinical scores and pathological changes in EAE rats were analyzed. Changes in serum cytokine levels were assessed by ELISA. Fluoxetine pretreatment significantly promoted remission in EAE. Histologically, fluoxetine-induced neuroprotection was accompanied by reductions in inflammatory foci and in the degree of demyelination in the spinal cord of EAE rats. The increase in serum IFN-γ in the EAE model was also suppressed by fluoxetine administration. These findings suggest that the prophylactic use of fluoxetine can relieve symptoms during remission in the acute EAE model, and these neuroprotective effects are associated with its anti-inflammatory effects. Copyright © 2012 S. Karger AG, Basel.

  12. Interepisodic Functioning in Patients with Bipolar Disorder in Remission

    Science.gov (United States)

    Wesley, Mareena Susan; Manjula, M.; Thirthalli, Jagadisha

    2018-01-01

    Background and Objectives: Patients with bipolar disorder (BD), despite recovering symptomatically, suffer from several functional impairments even in remission. The actual causes of impaired functioning are less known. Materials and Methods: The study aimed to examine the clinical and psychosocial determinants of functioning in patients with BD in remission. A cross-sectional single-group design was adopted (n = 150). Participants meeting the study criteria were screened with Mini-International Neuropsychiatric Interview Scale. The selected participants were administered various tools to assess the level of functioning and the clinical, psychosocial determinants of functioning. Results: The clinical characteristics of the sample included early age of onset of illness, presence of precipitating factors, fewer episodes, minimal comorbidities, history of psychotic episodes, family history of mental illness, good medication adherence, and low depression and mania scores. Psychosocial factors included higher stress and moderate social support and self-esteem in the sample. Poor functioning patients had a history of longer hospital stay and had greater scores on depression, mania, stress, and maladaptive coping styles than better functioning patients. Conclusion: Higher depression, mania, stress, and maladaptive coping strategies were related to poor functioning, while higher medication adherence, self-esteem, and social support were related to better functioning. PMID:29403131

  13. Obstetric Outcomes in Non-Gynecologic Cancer Patients in Remission.

    Science.gov (United States)

    Timur, Hakan; Tokmak, Aytekin; Iskender, Cantekin; Yildiz, Elif Sumer; Inal, Hasan Ali; Uygur, Dilek; Danisman, Nuri

    2016-06-01

    The aim of the present study was to evaluate the obstetric and perinatal outcomes in treated women who were diagnosed with non-gynecologic cancer and to compare these findings with pregnant women with no history of cancer. This retrospective study was conducted on 21 pregnant women with non-gynecologic cancer who were in remission (study group) and 63 pregnant women with no history of cancer (control group). The women were admitted to the high-risk pregnancy clinic of Zekai Tahir Burak Women's Health Training and Research Hospital with a diagnosis of pregnancy and cancer between January 2010 and January 2015. Obstetric outcomes and demographic characteristics of the patients were recorded. Age, gravida, parity, abortus, body mass index (BMI), gestational week, smoking, mode of delivery, gestational weight, and perinatal outcomes were examined for each woman. The most common cancer types were thyroid (28.5%) and breast cancers (23.8%), which constituted just over half of the non-gynecologic cancer cases during pregnancy. The time elapsed after the diagnosis was 3.8±2.2 (1-9) years. No statistically significant differences were found between the two groups with regard to age, obstetric history, BMI, gestational week, smoking, and obstetric and perinatal outcomes (p>0.05). Negative perinatal outcomes in non-gynecologic cancer patients in remission were found to be within acceptable levels.

  14. What does remission tell us about women with eating disorders? Investigating applications of various remission definitions and their associations with quality of life.

    Science.gov (United States)

    Ackard, Diann M; Richter, Sara A; Egan, Amber M; Cronemeyer, Catherine L

    2014-01-01

    To compare remission rates, determine level of agreement and identify quality of life (QoL) distinctions across a broad spectrum of remission definitions among patients with eating disorders (ED). Women (N=195; 94 AN, 24 BN, and 77 EDNOS) from inpatient and partial hospital ED programs participated in a study of treatment outcomes. Remission rates were evaluated with percentages, kappa coefficients identified level of agreement and Mann-Whitney-Wilcoxon tests with Bonferroni corrections determined differences in quality of life between remitted and not remitted patients by remission definition. Depending on remission definition used, the percent of remitted patients varied from 13.2% to 40.5% for AN, 15.0% to 47.6% for BN and 24.2% to 53.1% for EDNOS. Several definitions demonstrated "very good" agreement across diagnoses. Remission was associated with higher quality of life in psychological, physical/cognitive, financial and work/school domains on a disease-specific measure, and in mental but not physical functioning on a generic measure. Remission rates vary widely depending on the definition used; several definitions show strong agreement. Remission is associated with quality of life, and often approximates scores for women who do not have an eating disorder. The ED field would benefit from adopting uniform criteria, which would allow for more accurate comparison of remission rates across therapeutic interventions, treatment modalities and facilities. We recommend using the Bardone-Cone criteria because it includes assessment of psychological functioning, was found to be applicable across diagnoses, demonstrated good agreement, and was able to distinguish quality of life differences between remitted and not remitted patients. © 2013.

  15. Diabetes Remission after Nonsurgical Intensive Lifestyle Intervention in Obese Patients with Type 2 Diabetes

    OpenAIRE

    Mottalib, Adham; Sakr, Mahmoud; Shehabeldin, Mohamed; Hamdy, Osama

    2015-01-01

    Partial or complete remission from type 2 diabetes was recently observed after bariatric surgeries. Limited data is available about the possibility of inducing diabetes remission through intensive weight reduction. We retrospectively evaluated diabetes remissions after one year of the Weight Achievement and Intensive Treatment (Why WAIT) program, a 12-week intensive program for diabetes weight management in real-world clinical practice. Among 120 obese patients with type 2 diabetes who comple...

  16. Review article: remission rates achievable by current therapies for inflammatory bowel disease

    OpenAIRE

    Peyrin-Biroulet , Laurent; Lémann , Marc

    2011-01-01

    Abstract Background and Aim: To review remission rates with current medical treatments for inflammatory bowel disease (IBD). Methods We searched MEDLINE (source PUBMED, 1966 to January, 2011). Results Induction and maintenance of remission was observed in 20% (range, 9-29.5%) and 53% (range, 36.8-59.6%) of ulcerative colitis (UC) patients treated with oral 5-ASA derivatives. Induction of remission was noted in 52% (range, 48-58%) of Crohn?s disease (CD) patients and 54% of UC...

  17. Individualized vaccination of AML patients in remission is associated with induction of antileukemia immunity and prolonged remissions.

    Science.gov (United States)

    Rosenblatt, Jacalyn; Stone, Richard M; Uhl, Lynne; Neuberg, Donna; Joyce, Robin; Levine, James D; Arnason, Jon; McMasters, Malgorzata; Luptakova, Katarina; Jain, Salvia; Zwicker, Jeffrey I; Hamdan, Ayad; Boussiotis, Vassiliki; Steensma, David P; DeAngelo, Daniel J; Galinsky, Ilene; Dutt, Poorvi Somaiya; Logan, Emma; Bryant, Mary Paty; Stroopinsky, Dina; Werner, Lillian; Palmer, Kristen; Coll, Max; Washington, Abigail; Cole, Leandra; Kufe, Donald; Avigan, David

    2016-12-07

    We developed a personalized cancer vaccine in which patient-derived acute myeloid leukemia (AML) cells are fused with autologous dendritic cells, generating a hybridoma that potently stimulates broad antitumor responses. We report results obtained from the first 17 AML patients, who achieved remission after chemotherapy and were then serially vaccinated to target minimal residual disease and prevent relapse. Vaccination was well tolerated and induced inflammatory responses at the site of administration, characterized by the dense infiltration of T cells. Vaccination was also associated with a marked rise in circulating T cells recognizing whole AML cells and leukemia-specific antigens that persisted for more than 6 months. Twelve of 17 vaccinated patients (71%; 90% confidence interval, 52 to 89%) remain alive without recurrence at a median follow-up of 57 months. The results demonstrate that personalized vaccination of AML patients in remission induces the expansion of leukemia-specific T cells and may be protective against disease relapse. Copyright © 2016, American Association for the Advancement of Science.

  18. Endoscopic transsphenoidal surgery for cushing disease: techniques, outcomes, and predictors of remission.

    Science.gov (United States)

    Starke, Robert M; Reames, Davis L; Chen, Ching-Jen; Laws, Edward R; Jane, John A

    2013-02-01

    The efficacy of endoscopic transsphenoidal surgery (ETS) for Cushing disease has not been clearly established. To assess efficacy of a pure endoscopic approach for treatment of Cushing disease and determine predictors of remission. A prospectively acquired database of 61 patients undergoing ETS was reviewed. Remission was defined as postoperative morning serum cortisol of Cushing [100%], macroadenomas [87%]). At 2- to 3-month evaluations, 45 of 49 patients (91.8%) were in remission. Fifty patients were followed for at least 12 months (mean, 28 months; range, 12-72). Forty-two (84%) achieved remission from a single ETS. In these patients, there was no significant difference in remission rates between microadenomas (93%), magnetic resonance imaging-negative (70%), and macroadenomas (77%). Patients with history of previous surgery (n = 14, 23%) were 9 times less likely to achieve follow-up remission (P = .021). In-house cortisol level of Cushing disease provides high rates of remission with low rates of complications regardless of size. Although patients with a history of previous surgery are less likely to achieve remission, the majority can still achieve remission following treatment.

  19. Spontaneous remission of hepatocellular carcinoma without any treatment

    Directory of Open Access Journals (Sweden)

    Shao-Ciao Luo

    2016-12-01

    A 61 year old asymptomatic woman visited our outpatient clinic (OPC with a high alpha-fetal protein (AFP level. A computed tomogram (CT revealed a 4.1 cm hypervascular tumor (arterial phase at S4 of the liver and washed out in venous phase. Her Hepatitis B Surface Antigen (HBsAg was negative and Hepatitis C Antibody (anti-HCV was positive. This patient also had esophageal varices. She refused any treatment and returned to our OPC about 2 years later. Her AFP level was 11.8 ng/ml. The following CT scan revealed a small amount of cirrhosis, but no mass, in the liver, so that spontaneous remission of HCC was determined. She was treated by oral diuretics. Here we report the case and review of literature.

  20. Complete remission of epileptic psychosis after temporal lobectomy: case report

    Directory of Open Access Journals (Sweden)

    Marchetti Renato Luiz

    2001-01-01

    Full Text Available We report a case of a female patient with refractory complex partial seizures since 15 years of age, recurrent postictal psychotic episodes since 35 which evolved to a chronic refractory interictal psychosis and MRI with right mesial temporal sclerosis (MTS. After a comprehensive investigation (video-EEG intensive monitoring, interictal and ictal SPECT, and a neuropsychological evaluation including WADA test she was submitted to a right temporal lobectomy. Since then, she has been seizure-free with remission of psychosis, although with some persistence of personality traits (hiperreligiosity, viscosity which had been present before surgery. This case supports the idea that temporal lobectomy can be a safe and effective therapeutic measure for patients with MTS, refractory epilepsy and recurrent postictal epileptic psychosis or interictal epileptic psychosis with postictal exacerbation.

  1. Does clinical remission lead to normalization of EQ-5D in patients with rheumatoid arthritis and is selection of remission criteria important?

    DEFF Research Database (Denmark)

    Linde, Louise; Sørensen, Jan; Østergaard, Mikkel

    2010-01-01

    To compare health-related quality of life (HRQOL) of patients with rheumatoid arthritis (RA) to that of the general population and to investigate the association with disease activity, focusing on different clinical remission criteria.......To compare health-related quality of life (HRQOL) of patients with rheumatoid arthritis (RA) to that of the general population and to investigate the association with disease activity, focusing on different clinical remission criteria....

  2. A Study of Teacher Stereotypes: How Do Tuition-Free Teacher Candidates and General Undergraduates Think about Middle School and University Teachers in China?

    Science.gov (United States)

    Zuo, Youxia; Zhao, Yufang; Peng, Chunhua; Chen, Youguo

    2017-01-01

    A tuition-free teacher candidate is an undergraduate who receives tuition-free teacher education and must work as a teacher in a middle school after their graduation. Tuition-free candidates are of the focus of many researchers; however, no study reports how tuition-free teacher candidates think about teachers. The present study explored stereotypes about middle school and university teachers held by teacher candidates. Specifically, we looked for the differences between the stereotypes held by the teacher candidates and general undergraduates. This study attempted to provide a potential tool to predict the actual willingness of teacher candidates to work as middle school teachers. University and middle school teachers were evaluated using descriptive phrases or words on a five-point Likert scale by 116 tuition-free teacher candidates and 155 general undergraduates. Exploratory factor analyses revealed a three-factor stereotype model including occupational cognition, occupational personality, and occupational emotion. Compared with general undergraduates, teacher candidates held more positive occupational personality and emotions toward middle school teachers; they held more negative occupational emotions toward university teachers. Further, the undergraduates' willingness to be middle school teachers positively correlated with positive occupational emotions and negatively correlated with negative occupational personality and emotions toward middle school teachers. This supported previous studies that individuals' professional willingness were influenced by their stereotypes about professions. PMID:28469587

  3. 7 CFR 356.7 - Petition for remission or mitigation of forfeiture.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Petition for remission or mitigation of forfeiture. 356.7 Section 356.7 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE FORFEITURE PROCEDURES § 356.7 Petition for remission or mitigation of forfeiture. (a) Any...

  4. No survival benefit associated with routine surveillance imaging for Hodgkin lymphoma in first remission

    DEFF Research Database (Denmark)

    Jakobsen, Lasse H; Hutchings, Martin; de Nully Brown, Peter

    2016-01-01

    The use of routine imaging for patients with classical Hodgkin lymphoma (HL) in complete remission (CR) is controversial. In a population-based study, we examined the post-remission survival of Danish and Swedish HL patients for whom follow-up practices were different. Follow-up in Denmark includ...

  5. The Language of the Internet – The Use of Concessive Conjunctions in Blogs by Companies Providing Private Tuition

    Directory of Open Access Journals (Sweden)

    Jindřiška Kraťkova

    2017-05-01

    Full Text Available Concessions are said to be a key aspect of English semantics because concessive constructions create a place for contrast, i.e. contradicting relations. Several studies have been carried out on this topic (i.e. on the positioning of conjunctions, linguistic interference, etc.. The aim of this paper is to focus on the frequency of use of the most common concessive conjunctions in Internet discussions with native speakers who give private tuition. The focus is primarily on the main, most commonly used concessive conjunctions in tutoring blogs.

  6. Remission of diabetes mellitus in cats cannot be predicted by the arginine stimulation test.

    Science.gov (United States)

    Tschuor, F; Zini, E; Schellenberg, S; Wenger, M; Kaufmann, K; Furrer, D; Lutz, T A; Reusch, C E

    2011-01-01

    Cats with diabetes mellitus frequently achieve clinical remission, suggesting residual β-cell function. Responsiveness of β-cells to arginine persists the longest during diabetes progression, making the intravenous arginine stimulation test (IVAST) a useful tool to assess residual insulin and glucagon secretion. Diabetic cats with and without remission will have different arginine-induced insulin or glucagon response. Seventeen cats with diabetes, 7 healthy cats. Blood samples collected on admission and during subsequent IVAST. Glucose, insulin, and glucagon were measured. Response to IVAST was assessed by calculating the insulin and glucagon area under the curve (AUC) and the AUC glucagon-to-insulin ratio. Diabetic cats were treated with insulin and were followed for 18 weeks. Remission was defined as normoglycemia and disappearance of clinical signs of diabetes for ≥4 weeks, without requiring insulin. Seven diabetic cats (41%) achieved remission. On admission, blood glucose concentration was significantly lower in cats with remission (median, 389 mg/dL; range, 342-536 mg/dL) than in those without remission (median, 506 mg/dL; range, 266-738 mg/dL). After IVAST, diabetic cats with remission had higher AUC glucagon-to-insulin ratios (median, 61; range, 34-852) than did cats without remission (median, 26; range, 20-498); glucose, insulin, and glucagon AUCs were not different. Diabetic cats had lower insulin AUC than did healthy cats but comparable glucagon AUC. Diabetic cats with and without remission have similar arginine-stimulated insulin secretion on admission. Although cats with remission had lower blood glucose concentrations and higher AUC glucagon-to-insulin ratios, large overlap between groups prevents use of these parameters in clinical practice. Copyright © 2010 by the American College of Veterinary Internal Medicine.

  7. Long-term remission in biopsy proven giant cell arteritis: A retrospective cohort study.

    Science.gov (United States)

    Restuccia, Giovanna; Boiardi, Luigi; Cavazza, Alberto; Catanoso, Mariagrazia; Macchioni, Pierluigi; Muratore, Francesco; Soriano, Alessandra; Cimino, Luca; Aldigeri, Raffaella; Crescentini, Filippo; Pipitone, Nicolò; Salvarani, Carlo

    2017-02-01

    To evaluate the frequency of long-term remission after glucocorticoids (GCs) suspension in an Italian cohort of patients with biopsy-proven GCA and to identify factors that may predict long-term remission. We evaluated 131 patients with biopsy-proven transmural GCA diagnosed and followed up at the Rheumatology Unit of Reggio Emilia Hospital (Italy) for whom sufficient information was available from the time of diagnosis until at least 18 months of follow-up. Long-term remission was defined as complete clinical remission without elevation of inflammatory markers for at least one year after the GC withdrawal. 73 patients (56%) experienced long-term remission. Disease flares were less frequently observed in patients with long-term remission compared to those without (p = 0.002). The cumulative doses of prednisone at 1 year and for the entire followup duration were significantly lower (p < 0.0001 for both parameters) in patients with long-term remission; similarly, the duration of prednisone treatment was also significantly lower (p < 0.0001). The presence of PMR at diagnosis (HR 0.46) was significantly negatively associated with long-term remission (p = 0.008), while hemoglobin levels (HR 1.48) were significantly positively associated (p < 0.0001). Patients with long-term remission were able to reach 10 mg/day and 5 mg/day of prednisone sooner than the patients without (p = 0.02 and p < 0.0001, respectively). In our cohort of GCA patients around half of the patients were able to attain long-term remission. Recognition of findings which predict disease course may aid decisions regarding therapy. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Antigens from Leishmania amastigotes inducing clinical remission of psoriatic arthritis.

    Science.gov (United States)

    O'Daly, J A; Gleason, J; Lezama, R; Rodriguez, P J; Silva, E; Indriago, N R

    2011-08-01

    A first generation vaccine (AS100-1) was manufactured with protein from four cultured Leishmania species, which proved to be effective in the treatment of psoriasis. A single blind trial on 3,132 psoriasis patients revealed 508 (16.2%) subjects with psoriatic arthritis (PsA) that received AS100-1 antigens. The study group was distributed according to percent psoriasis area and severity index (PASI) reduction from PASI 10 to PASI 100. All groups decreased in arthritis score (AS), tender joints counts and nail changes after treatment; the highest decreased in the PASI 100 group. Relapses of psoriasis and PsA had PASI and AS lower than initial values before treatment. Clinical remissions were at lower doses and less time, after the second course of treatment. Peripheral blood mononuclear cells (PBMC) lymphocyte subsets (LS) varied with PASI range (1-10, 11-20 and 21-72). Pre-treatment, absolute values of gated LS: CD4+, CD8+HLA-, CD8+HLA+, CD8+CD3-, CD8+CD3+ decreased in PBMC as PASI increased, suggesting migration from the blood to the skin. In contrary to the previous finding, the following LS: CD8+CD4-, CD3+CD8-, HLA+CD8-, CD19, CD8+CD4+ and membrane surface immunoglobulin IgA+, IgD+, IgM+, IgE+, and IgG+ increased in PBMC as PASI increased suggesting activation and proliferation by unknown antigens creating a homeostatic cycle between skin/joints and peripheral blood. After nine doses of AS100-1, the following LS: CD8+CD3+, CD8+HLA+, CD3+CD8-, CD4+CD8-, CD8+HLA-, HLA+CD8-, CD8+CD3-, CD19+, CD8+CD4-, CD8+CD4+, IgA+, IgD+, IgM+, IgE+, and IgG+ decreased significantly as compared with values before treatment. The LS decreased stops the vicious cycle between skin/joints and blood explaining clinical remission of lesions.

  9. Anti-MuSK myasthenia gravis with prolonged remission.

    Science.gov (United States)

    Bouwyn, Jean Paul; Magnier, Patrick; Bédat-Millet, Anne-Laure; Ahtoy, Patrick; Maltête, David; Lefaucheur, Romain

    2016-07-01

    Myasthenia gravis (MG) with antibodies against muscle-specific tyrosine kinase (MuSK) is a rare disorder of neuromuscular transmission affecting preferentially bulbar, neck and respiratory muscles. We report the case of a 22-year-old man who presented with diplopia on lateral gaze to both sides, facial diplegia, nasal dysarthria and dysphagia. Repetitive nerve stimulation of the trapezius and orbicularis oculi muscles showed amplitude decrements of 19% and 41% respectively supporting the diagnosis of myasthenia gravis. MUsK antibodies were positive. Corticosteroids were introduced and then tapered and discontinued at 6 months after initiation. The patient remained in remission and asymptomatic for 4 years without ongoing treatment or prior treatment with rituximab after this first relapse of MuSK-MG. MuSK- MG is considered a hard-to-treat condition and patients generally remain dependent on immunosuppression or prior treatment with rituximab. Our observation highlights that patients with MuSK-MG can have a benign course and that continued immunosuppressive or immunomodulatory therapy may not always be required. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. [Symptomatic remission and its relationship to social functioning in Tunisian out-patients with schizophrenia].

    Science.gov (United States)

    El Gharbi, I; Chhoumi, M; Mechri, A

    2017-11-28

    The concept of symptomatic and functional remission represents an important challenge in the care of the mentally ill, particularly in patients with schizophrenia. Operational criteria for symptomatic remission in schizophrenia have been proposed by Andreasen et al. (2005). Over the last decade, these criteria have been widely validated; however few studies have been conducted outside developed countries. Moreover, the association of symptomatic remission with functional outcome has not yet been established in developing countries including Tunisia, as there may be variability in the social and familial environment. To determine the frequency and associated factors of symptomatic remission in a sample of Tunisian out-patients with schizophrenia and to explore the relationship between symptomatic remission and some indicators of social functioning. A cross-sectional study was carried-out on 115 out-patients with schizophrenia (87 males, 28 females, mean age=37.56±10.2 years) in the psychiatry department of the university hospital in Monastir (Tunisia). Nearly all of the patients (98.26%) had been hospitalized at least once in a psychiatric unit. The last hospitalization dated back to 39 months on average (range=6 months to 16 years). Symptomatic remission was assessed by the eight core items of the positive and negative syndrome scale (PANSS). These are the items P1 "Delusions"; P3 "Hallucinatory behavior" and G9 "Unusual thought content" for the positive dimension, the items P2 "Conceptual disorganization" and G5 "Mannerism and disorders of posture" for the disorganization dimension and the items N1 "Blunted affect", N4 "Social withdrawal" and N6 "Lack of spontaneity and flow of conversation" for the negative dimension. A score of mild or less on all eight-core symptoms constitutes symptomatic remission. This symptom level should have been maintained for six months. The social functioning was assessed by the Social and Occupational Functioning Assessment Scale

  11. Early detection, early symptom progression and symptomatic remission after ten years in a first episode of psychosis study

    DEFF Research Database (Denmark)

    Simonsen, Erik; ten Velden Hegelstad, Wenche; Haahr, Ulrik Helt

    2013-01-01

    years, 50% of patients were in symptomatic remission. Non-remission was predicted by positive symptoms at inclusion and during the first year of treatment. Of individual symptoms only hallucinations were significantly predictive of ten-year non-remission. Early symptom differences were not reflected...

  12. Outcome after discontinuation of infliximab in patients with inflammatory bowel disease in clinical remission

    DEFF Research Database (Denmark)

    Steenholdt, Casper; Molazahi, Akbar; Ainsworth, Mark Andrew

    2012-01-01

    Abstract Objective. To investigate duration of remission, including risk factors for relapse and response to retreatment with infliximab (IFX), in patients with Crohn's disease (CD) and ulcerative colitis (UC) who had discontinued IFX while in clinical remission. Methods. Observational, single......-1673)), respectively; p = 0.057. Twelve percent with CD and 40% with UC were in remission at the end of follow-up after 10 and 4.5 years, respectively. Longer disease duration was associated with relapse in univariate analysis in CD, OR 1.1 (1.0-1.1), p = 0.022. Of 25, 24 CD patients (96%), and 5 of 7 UC patients (71...

  13. Model Legislation on Student Residency. An Act Providing for Classification of Students for Tuition Purposes at Public Institutions of Higher Education.

    Science.gov (United States)

    Education Commission of the States, Denver, CO.

    On January 26, 1971 the Chairman of the Education Commission of the States issued a statement of principles and possible model legislation for the various states in the highly complex area of determination of student residency for tuition purposes at public institutions of higher education. The original model legislation was related to the…

  14. Federal Student Loans: Patterns in Tuition, Enrollment, and Federal Stafford Loan Borrowing up to the 2007-08 Loan Limit Increase. GAO-11-470R

    Science.gov (United States)

    Scott, George A.

    2011-01-01

    Although a postsecondary education is vitally important to many individuals and the nation's ability to compete globally, high college tuition rates are prompting concerns that it may remain an elusive goal for some. To help students finance their education, Congress recently raised the ceiling on the amount individual students can borrow under…

  15. Slight Decline in Use of Private School Tuition Vouchers in 2010-2011: Loss of Schools Results in Fewer Students. Research Brief. Volume 99, Number 2

    Science.gov (United States)

    Dickman, Anneliese; Schmidt, Jeffrey

    2011-01-01

    For the first time since its 1998 expansion to include religious schools, enrollment in the Milwaukee Parental Choice Program (MPCP) did not grow in the 2010-2011 school year. Currently, 20,996 private school students receive taxpayer-funded tuition vouchers (of $6,442 per pupil), a decrease of 66 students over last year. Chart 1 shows program…

  16. Effect of Psychosocial Skills Training on Functional Remission of Patients With Schizophrenia.

    Science.gov (United States)

    Uzdil, Nurcan; Tanrıverdi, Derya

    2015-09-01

    This study was conducted as a two-group pretest-posttest design to determine the effect of psychosocial skills training on functional remission levels of patients with schizophrenia. A total of 100 patients were divided into the training group (n = 50) and the control group (n = 50). The data were collected using a Personal Information Form and Functional Remission of General Schizophrenia (FROGS) scale. The 13-session training program was given in the form of face-to-face group training and 45- to 60-min sessions twice a week. Training was completed by five groups. Every group comprised of 9 to 12 individuals on average. The training group had higher scores significantly on functional remission levels compared with the control group after psychosocial skills training (p training has become considerably effective in increasing the functional remission levels of patients with schizophrenia. © The Author(s) 2014.

  17. Crohn's disease genotypes of patients in remission vs relapses after infliximab discontinuation.

    Science.gov (United States)

    Lu, Cathy; Waugh, Alistair; Bailey, Robert J; Cherry, Raeleen; Dieleman, Levinus A; Gramlich, Leah; Matic, Kata; Millan, Mario; Kroeker, Karen I; Sadowski, Daniel; Teshima, Christopher W; Todoruk, Dennis; Wong, Clarence; Wong, Karen; Fedorak, Richard N

    2012-09-28

    To investigate genetic differences between Crohn's disease (CD) patients with a sustained remission vs relapsers after discontinuing infliximab while in corticosteroid-free remission. Forty-eight CD patients received infliximab and were in full corticosteroid-free clinical remission but then discontinued infliximab for reasons other than a loss of response, were identified by review of an electronic database and charts. Infliximab-associated remission was defined as corticosteroid-free plus normalization of clinical disease activity [CD activity index (CDAI) 220) and a therapeutic intervention with CD medication(s), or a hospitalization with complications related to active CD. Genetic analyses were performed on samples from 14 patients (n = 6 who had a sustained long term remission after stopping infliximab, n = 8 who rapidly relapsed after stopping infliximab). Nucleotide-binding oligomerization domain 2 (NOD2)/caspase activation recruitment domain 15 (CARD15) polymorphisms (R702W, G908R and L1007fs) and the inflammatory bowel disease 5 (IBD5) polymorphisms (IGR2060a1 and IGR3081a1) were analyzed in each group. Five single nucleotide polymorphisms of IBD5 and NOD2/CARD15 genes were successfully analyzed for all 14 subjects. There was no significant increase in frequency of the NOD2/CARD15 polymorphisms (R702W, G908R and L1007fs) and the IBD5 polymorphisms (IGR2060a1 and IGR3081a1) in either group of patients; those whose disease relapsed rapidly or those who remained in sustained long term remission following the discontinuation of infliximab. Nearly a third of patients in full clinical remission who stopped infliximab for reasons other than loss of response remained in sustained clinical remission, while two-thirds relapsed rapidly. There was a marked difference in the duration of clinical remission following discontinuance of infliximab between the two groups. The patients who lost remission did so after 1.0 years ± 0.6 years, while those still in remission

  18. Crohn’s disease genotypes of patients in remission vs relapses after infliximab discontinuation

    Science.gov (United States)

    Lu, Cathy; Waugh, Alistair; Bailey, Robert J; Cherry, Raeleen; Dieleman, Levinus A; Gramlich, Leah; Matic, Kata; Millan, Mario; Kroeker, Karen I; Sadowski, Daniel; Teshima, Christopher W; Todoruk, Dennis; Wong, Clarence; Wong, Karen; Fedorak, Richard N

    2012-01-01

    AIM: To investigate genetic differences between Crohn’s disease (CD) patients with a sustained remission vs relapsers after discontinuing infliximab while in corticosteroid-free remission. METHODS: Forty-eight CD patients received infliximab and were in full corticosteroid-free clinical remission but then discontinued infliximab for reasons other than a loss of response, were identified by review of an electronic database and charts. Infliximab-associated remission was defined as corticosteroid-free plus normalization of clinical disease activity [CD activity index (CDAI) 220) and a therapeutic intervention with CD medication(s), or a hospitalization with complications related to active CD. Genetic analyses were performed on samples from 14 patients (n = 6 who had a sustained long term remission after stopping infliximab, n = 8 who rapidly relapsed after stopping infliximab). Nucleotide-binding oligomerization domain 2 (NOD2)/caspase activation recruitment domain 15 (CARD15) polymorphisms (R702W, G908R and L1007fs) and the inflammatory bowel disease 5 (IBD5) polymorphisms (IGR2060a1 and IGR3081a1) were analyzed in each group. RESULTS: Five single nucleotide polymorphisms of IBD5 and NOD2/CARD15 genes were successfully analyzed for all 14 subjects. There was no significant increase in frequency of the NOD2/CARD15 polymorphisms (R702W, G908R and L1007fs) and the IBD5 polymorphisms (IGR2060a1 and IGR3081a1) in either group of patients; those whose disease relapsed rapidly or those who remained in sustained long term remission following the discontinuation of infliximab. Nearly a third of patients in full clinical remission who stopped infliximab for reasons other than loss of response remained in sustained clinical remission, while two-thirds relapsed rapidly. There was a marked difference in the duration of clinical remission following discontinuance of infliximab between the two groups. The patients who lost remission did so after 1.0 years ± 0.6 years, while

  19. Remission Time after Rituximab Treatment for Autoimmune Bullous Disease: A Proposed Update Definition.

    Science.gov (United States)

    Iranzo, Pilar; Pigem, Ramon; Giavedoni, Priscila; Alsina-Gibert, Mercè

    2015-01-01

    A therapeutic endpoint is a very important tool to evaluate response in clinical trials. In 2005, a consensus statement identified two late endpoints of disease activity in pemphigus: complete remission off therapy and complete remission on therapy, both definitions applying to patients without lesions for at least 2 months. The same period of time was considered for partial remission off/on therapy. These definitions were later applied to bullous pemphigoid and are considered in most studies on autoimmune bullous disease. These endpoints were established for different adjuvant agents, but at that moment, rituximab was not considered. Rituximab is known for the long duration of its effect, and in most studies relapses have been reported later than 6 months after treatment. In our opinion, time to remission after rituximab treatment should be redefined. © 2015 S. Karger AG, Basel.

  20. Paternal alcoholism predicts the occurrence but not the remission of alcoholic drinking

    DEFF Research Database (Denmark)

    Knop, J; Penick, E C; Nickel, E J

    2007-01-01

    OBJECTIVE: To test the effects of father's alcoholism on the development and remission from alcoholic drinking by age 40. METHOD: Subjects were selected from a Danish birth cohort that included 223 sons of alcoholic fathers (high risk; HR) and 106 matched controls (low risk; LR). Clinical...... examinations were performed at age 40 (n = 202) by a psychiatrist using structured interviews and DSM-III-R diagnostic criteria. RESULTS: HR subjects were significantly more likely than LR subjects to develop alcohol dependence (31% vs. 16%), but not alcohol abuse (17% vs. 15%). More subjects with alcohol...... abuse were in remission at age 40 than subjects with alcohol dependence. Risk did not predict remission from either alcohol abuse or alcohol dependence. CONCLUSION: Familial influences may play a stronger role in the development of alcoholism than in the remission or recovery from alcoholism....

  1. Self-reported remission of obstructive sleep apnea following bariatric surgery: cohort study.

    Science.gov (United States)

    Nagendran, Myura; Carlin, Arthur M; Bacal, Daniel; Genaw, Jeffrey A; Hawasli, Abdelkader A; Birkmeyer, Nancy J; Finks, Jonathan F

    2015-01-01

    Evidence on remission of obstructive sleep apnea (OSA) after bariatric surgery and its relation to weight loss is conflicting. We sought to identify factors associated with successful self-reported OSA remission in a large cohort of bariatric surgery patients. We analyzed data from the statewide, prospective clinical registry of the Michigan Bariatric Surgery Collaborative and identified 3,550 patients with OSA who underwent a primary bariatric procedure between June 2006 and October 2011 and had at least 1 year of follow-up data. We used multivariate logistic regression to identify preoperative factors associated with successful self-reported OSA remission, defined as discontinuation of continuous positive airway pressure or bilevel positive airway pressure at 1 year. Our regression model also included procedure type and weight loss at 1 year, divided into equal quintiles, as covariates. The overall 1-year self-reported OSA remission rate was 60%. Significant predictors of remission included age category (per 10 yr) (OR .73, CI .69-.78), body mass index category (per 10 units) (OR .57, CI .54-.62), male gender (OR .58, CI .52-.69), hypertension (OR .83, CI .74-.99), depression (OR .78, CI .69-.88), pulmonary disease (OR .88, CI .78-.98), and baseline Health and Activities Limitations Index score (OR 1.70, CI 1.32-2.23). Relative to gastric banding, the adjusted odds of OSA remission were greater with gastric bypass (OR 2.38, CI 1.89-3.08), sleeve gastrectomy (OR 2.01, CI 1.44-2.55), and duodenal switch (OR 2.57, CI 1.02-7.26). The odds ratio of OSA remission increased stepwise through quintiles of 1-year weight loss. Relative to the lowest quintile, the odds ratios of remission in the 2(nd) through 5(th) quintiles were 1.44 (CI 1.11-1.84), 2.03 (CI 1.48-2.57), 2.47 (1.85-3.40), and 3.53 (CI 2.56-4.85). Weight loss is an important predictor of self-reported OSA remission after bariatric surgery. However, independent of weight loss, there remain significant

  2. A Gut Feeling to Cure Diabetes: Potential Mechanisms of Diabetes Remission after Bariatric Surgery

    OpenAIRE

    Cho, Young Min

    2014-01-01

    A cure for type 2 diabetes was once a mere dream but has now become a tangible and achievable goal with the unforeseen success of bariatric surgery in the treatment of both obesity and type 2 diabetes. Popular bariatric procedures such as Roux-en-Y gastric bypass and sleeve gastrectomy exhibit high rates of diabetes remission or marked improvement in glycemic control. However, the mechanism of diabetes remission following these procedures is still elusive and appears to be very complex and en...

  3. Circadian secretion of cortisol and melatonin in cluster headache during active cluster periods and remission.

    OpenAIRE

    Waldenlind, E; Gustafsson, S A; Ekbom, K; Wetterberg, L

    1987-01-01

    The cyclic nature of cluster headache warranted a study of the 24-hour rhythms of serum cortisol and melatonin. They were both altered during cluster periods as compared with periods of remission and healthy controls. The 24-hour mean and maximal cortisol levels were higher and the timing of the cortisol minimum was delayed as compared to the same patients in remission. Although there was no relation between the cortisol and melatonin levels and headaches, the rise of cortisol following many ...

  4. Video-based instructions for surgical hand disinfection as a replacement for conventional tuition? A randomised, blind comparative study

    Directory of Open Access Journals (Sweden)

    Weber, Uwe

    2016-08-01

    Full Text Available Introduction: Various different learning methods are available for planning tuition regarding the introduction to surgical hand disinfection. These learning methods should help to organise and deal with this topic. The use of a video film is an alternative to conventional tuition due to the real presentation possibilities of practical demonstration. Objective: This study examines by way of comparison which form of communication is more effective for learning and applying surgical hand disinfection for medical students in their first year of studies: video-based instruction or conventional tuition. Methodology: A total of 50 first-year medical students were randomly allocated either to the “Conventional Instruction” (CI study group or to the “Video-based Instruction” (VI study group. The conventional instruction was carried out by an experienced nurse preceptor/nurse educator for the operating theatre who taught the preparatory measures and the actual procedure in a two-minute lesson. The second group watched a two-minute video sequence with identical content. Afterwards, both groups demonstrated practically the knowledge they had acquired at an individual practical test station. The quality (a of the preparation and (b of the procedure as well as (c the quality of the results was assessed by 6 blind experts using a check list. The acceptability of the respective teaching method was also asked about using a questionnaire.Results: The group performance did not differ either in the preparation (=-78, <0.44 or in the quality (=-99, <0.34. With respect to performance, it was possible to demonstrate a strong treatment effect. In the practical (=-3.33, <0.002, =0.943 and in the total score (=-2.65, <0.011, =0.751, the group with video-based instruction achieved a significantly better result. In response to the question as to which of the two learning methods they would prefer, the significant majority (60.4% of students stated video instruction

  5. Adherence predicts symptomatic and psychosocial remission in schizophrenia: Naturalistic study of patient integration in the community.

    Science.gov (United States)

    Bernardo, Miguel; Cañas, Fernando; Herrera, Berta; García Dorado, Marta

    Psychosocial functioning in patients with schizophrenia attended in daily practice is an understudied aspect. The aim of this study was to assess the relationship between symptomatic and psychosocial remission and adherence to treatment in schizophrenia. This cross-sectional, non-interventional, and multicenter study assessed symptomatic and psychosocial remission and community integration of 1,787 outpatients with schizophrenia attended in Spanish mental health services. Adherence to antipsychotic medication in the previous year was categorized as≥80% vs.<80%. Symptomatic remission was achieved in 28.5% of patients, and psychosocial remission in 26.1%. A total of 60.5% of patients were classified as adherent to antipsychotic treatment and 41% as adherent to non-pharmacological treatment. During the index visit, treatment was changed in 28.4% of patients, in 31.1% of them because of low adherence (8.8% of the total population). Adherent patients showed higher percentages of symptomatic and psychosocial remission than non-adherent patients (30.5 vs. 25.4%, P<.05; and 32 vs. 17%, P<.001, respectively). Only 3.5% of the patients showed an adequate level of community integration, which was also higher among adherent patients (73.0 vs. 60.1%, P<.05). Adherence to antipsychotic medication was associated with symptomatic and psychosocial remission as well as with community integration. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Remission of screen-detected metabolic syndrome and its determinants: an observational study

    Directory of Open Access Journals (Sweden)

    den Engelsen Corine

    2012-09-01

    Full Text Available Abstract Background Early detection and treatment of the metabolic syndrome may prevent diabetes and cardiovascular disease. Our aim was to assess remission of the metabolic syndrome and its determinants after a population based screening without predefined intervention in the Netherlands. Methods In 2006 we detected 406 metabolic syndrome cases (The National Cholesterol Education Program’s Adult Treatment Panel III (NCEP ATP III definition among apparently healthy individuals with an increased waist circumference. They received usual care in a primary care setting. After three years metabolic syndrome status was re-measured. We evaluated which baseline determinants were independently associated with remission. Results The remission rate among the 194 participants was 53%. Baseline determinants independently associated with a remission were the presence of more than three metabolic syndrome components (OR 0.46 and higher levels of waist circumference (OR 0.91, blood pressure (OR 0.98 and fasting glucose (OR 0.60. Conclusions In a population with screen-detected metabolic syndrome receiving usual care, more than half of the participants achieved a remission after three years. This positive result after a relatively simple strategy provides a solid basis for a nation-wide implementation. Not so much socio-demographic variables but a higher number and level of the metabolic syndrome components were predictors of a lower chance of remission. In such cases, primary care physicians should be extra alert.

  7. Stopping epilepsy treatment in seizure remission: Good or bad or both?

    Science.gov (United States)

    Schmidt, Dieter; Sillanpää, Matti

    2017-01-01

    To review the outcome of epilepsy after stopping antiepileptic drugs in remission. Stopping antiepileptic drugs (AEDs) in remission is routinely done in many patients. Although the consequences of an unexpected relapse seizure in the 2 years after stopping AEDs may cause anguish and social issues, the impact on the long term seizure outlook of the epilepsy is minimal, if any. Discontinuation of drug treatment does not seem to affect the long-term prognosis but exposes patients who were seizure-free for years to a transient two-fold risk of seizures for the first 2 years after stopping AEDs. In addition, 20% of patients who were seizure-free for years, do not become seizure-free immediately after restarting AED treatment after relapse. The list of potential pitfalls is long. Patients with juvenile myoclonic epilepsy, those with prior withdrawal attempts and late remission have a higher risk of relapse. Stopping AEDs in remission does not affect the long-term patterns of epilepsy and some patients report a better general health in a life without AEDs. High-risk patients should not be generally encouraged to stop their AEDs in remission. We need new drugs that combine anti-seizure and antiepileptogenic effects to prevent seizure relapse and flare up of epilepsy after stopping AEDs in remission. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  8. Volumetric measurement of the inflamed synovium of rheumatoid wrist joint for evaluation of synovitis and remission

    International Nuclear Information System (INIS)

    Huh, Yong Min; Suh, Jin Suck; Jeong, Eun Kee; Lee, Soo Kon; Lee, Ji Soo; Choi, Byoung Wook

    1997-01-01

    To evaluate the changes and remission of disease activity with changes in inflamed synivial volumes of rheumatoid joints after therapy. Seven rheumatoid arthritis patients who had been treated with antiinflammatory drugs were followed up. Using NIH imaging and a segmentation technique, pre-and post-enhanced images were measured in subtracted images. Intra- and interobserver variation were evaluated by two radiologists (A and B), using two independent measurements. For comparison, the cases were assigned to one of two groups:remission and non-remission. Changes in ESR and total joint counts (TJC) after therapy were compared with inflamed synovial volumes. Intraobserver variations were 3.2% and 2.7% in A and B, respectively, interobserver variation between A and B was 7.1%. Changes in inflamed synovial volumes correlated well with those in ESR (r=0.88, p<0.009) and TJC (r=0.78, p<0.037) after therapy. Changes between the remission and non-remission group were insignificant, however. Changes in inflamed synovial volumes reflect those in the activity of rheumatoid arthritis between pre- and post- treatment. This technique may be used as a tool for predicting therapeutic response in rheumatoid arthritis cases. Changes in inflamed synovial volumes are of limited value, however, in predicting the remission of rheumatoid arthritis after therapy

  9. Hyperlipidemia in childhood idiopathic nephrotic syndrome during initial remission and relapse.

    Science.gov (United States)

    Mahmud, S; Jahan, S; Hossain, M M

    2011-07-01

    The objective of this study was to correlate hyperlipidemia during initial remission of nephrotic child with relapse. This observational prospective study was carried out among 26 children, between 1 to 8 years age with first attack idiopathic nephrotic syndrome, who was seen at Paediatric Nephrology Department of BSMMU and Paediatric Nephrology Department, NIKDU, from December'2005 to August'2006 and were followed-up for at least 6 months after initial attack. Twenty two age and sex matched hospitalized children, suffering from non-renal diseases, were enrolled as controls. Fasting blood samples for lipid profile were taken at the time of diagnosis of both cases and controls and also during remission of cases only. These patients were divided into two groups based on serum lipid profile during remission. Group-I consisted 16 patients who had normal lipid profile during remission and Group-II consisted 10 patients who had abnormal lipid profile during remission. Both Groups I & II had higher mean levels of serum cholesterol, LDL, TG and Lp(a) than those of controls during initial diagnosis. Between two groups on remission, Group-II patients showed higher mean serum cholesterol (332.9±105.19 mg/dL vs. 183.13±16.89 mg/dL; pchildhood idiopathic nephrotic syndrome.

  10. Remission in a prospective study of patients with rheumatoid arthritis. American rheumatism association preliminary remission criteria in relation to the disease activity score

    NARCIS (Netherlands)

    Prevoo, MLL; VanGestel, AM; VantHof, MA; VanRijswijk, MH; VandePutte, LBA; vanRiel, PLCM

    1996-01-01

    In a prospective follow-up study of patients with early-onset rheumatoid arthritis, the prevalence of remission according to the 1981 American Rheumatism Association (ARA) preliminary criteria was evaluated. A total of 227 patients with a median follow-up of 3.9 yr and a total of 2832 follow-up

  11. Glycemic status and predictors of relapse for diabetic cats in remission.

    Science.gov (United States)

    Gottlieb, S; Rand, J S; Marshall, R; Morton, J

    2015-01-01

    It is unknown if diabetic cats in remission have persistent abnormalities of glucose metabolism and should be considered prediabetic, or have normal glucose tolerance. To characterize glycemic status of diabetic cats in remission and to determine predictors of relapse. A total of 21 cats in diabetic remission and 28 healthy control cats. At a median of 107 days after remission, screening blood glucose concentration was measured on entry to the clinic. After a 24-hour fast in hospital, fasting blood glucose, fructosamine and feline pancreatic lipase concentrations were measured, and 3 hours later, a simplified IV glucose tolerance test (1 g glucose/kg) performed. Twenty cats were monitored for relapse for at least 9 months. Of the 21 cats in remission, 19% (4/21) had impaired fasting glucose concentration and 76% (16/21) had impaired glucose tolerance. Of cats followed up for 9 months after testing, 30% (6/20) had relapsed and required insulin treatment. Fasting blood glucose concentration ≥ 7.5 mmol/L (≥ 135 mg/dL) (odds ratio [OR] = 12.8) and severely impaired glucose tolerance (≥ 5 hours to return to glucose concentration >14 mmol/L; 252 mg/dL at 3 hours was significantly associated with relapse (OR = 10.1). Most cats in diabetic remission have impaired glucose tolerance and a minority have impaired fasting glucose concentration and should be considered prediabetic. More severe glucose intolerance and impaired fasting glucose concentration are predictors of relapse. Ongoing glucose monitoring of diabetic cats in remission is recommended. Copyright © 2014 by the American College of Veterinary Internal Medicine.

  12. Complete remission of childhood-onset epilepsy: stability and prediction over two decades.

    Science.gov (United States)

    Berg, Anne T; Rychlik, Karen; Levy, Susan R; Testa, Francine M

    2014-12-01

    The ultimate seizure outcome of childhood epilepsy is complete resolution of all seizures without further treatment. How often this happens and how well it can be predicted early in the course of epilepsy could be valuable in helping families understand the nature of childhood epilepsy and what to expect over time. In the Connecticut study of epilepsy, a prospective cohort of 613 children with newly-diagnosed epilepsy (onset age 0-15 years), complete remission, ≥5 years both seizure-free and medication-free, was examined as a proxy of complete seizure resolution. Predictors at initial diagnosis were tested. Information about seizure outcomes within 2 years and from 2-5 years after diagnosis was sequentially added in a proportional hazards model. The predictive value of the models was determined with logistic regression. Five hundred and sixteen subjects were followed ≥10 years. Three hundred and twenty-eight (63%) achieved complete remission; 23 relapsed. The relapse rate was 8.2 per 1000 person-years and decreased over time: 10.7, 6.7, and 0 during first 5 years, the next 5 years, and then >10 years after complete remission (P=0.06 for trend). Six participants regained complete remission; 311 (60%) were in complete remission at last contact. Baseline factors predicting against complete remission at last contact included onset age≥10 years (hazard ratio=0.55, P=0.0009) and early school or developmental problems (hazard ratio=0.74, P=0.01). Factors predicting for complete remission were uncomplicated epilepsy presentation (hazard ratio=2.23, P<0.0001), focal self-limited epilepsy syndrome (hazard ratio=2.13, P<0.0001), and uncharacterized epilepsy (hazard ratio=1.61, P=0.04). Remission (hazard ratio=1.95, P<0.0001) and pharmaco-resistance (hazard ratio=0.33, P<0.0001) by 2 years respectfully predicted in favour and against complete remission. From 2 to 5 years after diagnosis, relapse (hazard ratio=0.21, P<0.0001) and late pharmaco-resistance (hazard ratio=0

  13. Tuition Fees for International Students in Finland: Where to Go from Here?

    Science.gov (United States)

    Cai, Yuzhuo; Kivisto, Jussi

    2013-01-01

    Recent Finnish policies have encouraged Finnish higher education institutions to develop a market-oriented approach to international higher education by implementing fee-based educational programmes for students from outside the European Union (EU) and the European Economic Area (EEA). From the Finnish government's perspective, higher education is…

  14. Gut-directed hypnotherapy significantly augments clinical remission in quiescent ulcerative colitis

    Science.gov (United States)

    Keefer, Laurie; Taft, Tiffany H; Kiebles, Jennifer L; Martinovich, Zoran; Barrett, Terrence A; Palsson, Olafur S

    2013-01-01

    Summary Background Psychotherapy is not routinely recommended for in ulcerative colitis (UC). Gut-directed hypnotherapy (HYP) has been linked to improved function in the gastrointestinal tract and may operate through immune-mediated pathways in chronic diseases. Aims To determine the feasibility and acceptability of hypnotherapy and estimate the impact of hypnotherapy on clinical remission status over a 1 year period in patients with an historical flare rate of 1.3 times per year. Methods 54 patients were randomized at a single site to 7 sessions of gut-directed hypnotherapy (N = 26) or attention control (CON; N = 29) and followed for 1 year. The primary outcome was the proportion of participants in each condition that had remained clinically asymptomatic (clinical remission) through 52 weeks post-treatment. Results One-way ANOVA comparing hypnotherapy and control subjects on number of days to clinical relapse favored the hypnotherapy condition [F = 4.8 (1, 48), p = .03] by 78 days. Chi square analysis comparing the groups on proportion maintaining remission at 1 year was also significant [X2(1) = 3.9, p = .04], with 68% of hypnotherapy and 40% of control patients maintaining remission for 1 year. There were no significant differences between groups over time in quality of life, medication adherence, perceived stress or psychological factors. Conclusions This is the first prospective study that has demonstrated a significant effect of a psychological intervention on prolonging clinical remission in patients with quiescent UC. Clinical Trial # NCT00798642 PMID:23957526

  15. Outcomes in major depressive disorder: the evolving concept of remission and its implications for treatment.

    Science.gov (United States)

    Möller, Hans-Jürgen

    2008-01-01

    It is increasingly recognised that major depressive disorder can be a chronic condition with many patients experiencing recurrent episodes. Remission from a depressive episode implies the absence or near absence of depressive symptoms. However, for many patients the periods between depressive episodes are not symptom free. Residual symptoms are predictors of relapse or recurrence, and may be associated with residual psychosocial impairment. In clinical studies, remission is commonly defined using a cut-off score on a rating scale for depressive symptoms, such as a score of < or = 7 on the 17-item Hamilton scale. However, there is debate about which scales and cut-offs are optimal and full-length rating scales are not widely used in clinical practice. In spite of such issues, it seems clear that a therapy should aim at the most complete remission possible. Unfortunately, recent studies have highlighted that in clinical practice usually only a low rate of remission is achieved. Although long-term treatment with antidepressants can reduce the risk of relapse or recurrence only a minority of patients in clinical practice achieve this as treatment is often prematurely stopped due to long-term side effects such as sleep disturbance, sexual dysfunctioning and weight gain. Therefore, it represents an unmet need to come up with antidepressant drugs of greater efficacy and improved tolerability as such treatments could lead to more complete remission in more patients.

  16. Lupus nephritis. Remissions and relapses. Long-term follow up of 84 patients

    Directory of Open Access Journals (Sweden)

    Gerardo Oscar Mogni

    2014-06-01

    Full Text Available Introduction: Nephritis is the most common of all serious manifestations of SLE. The proliferative forms require immunosuppressive treatment, but responses are not consistent and exacerbations are frequent during or after the treatment has been completed. Methods: We retrospectively analyzed the evolution of a cohort of 84 patients with proliferative lupus nephritis with immunosuppressive treatment, in a long-term (up to 203 months follow up. Were taken as basal: sex, age, latency between onset and diagnosis of SLE nephritis, serum complement, plasmatic creatinine and proteinuria. We evaluated: initial response to therapy, occurrence of relapse or recurrence and score at the end of the observation period. Results: Remission of initial nephritis was seen in 73% of the cases, although at the end of monitoring only 54% of patients were in remission. 45 patients had one episode of nephritis, 32 patients had two, and 7 patients had three. Most of the remissions took place during the maintenance period. Complete remission had better evolution than partial remission. High serum creatinine levels and proteinuria at baseline were indicators of bad prognosis. Oral Azathioprine was more effective than quarterly IV Cylophosphamide as maintenance therapy, despite of a high incidence of relapses. Mycophenolate was not more effective than Cyclophosphamide/azathioprine for the treatment of relapses or recurrences. Conclusions: Our results are similar to the literature. Extended follow up enables the evaluation of the long term result of the initial symptoms, any possible future outbreaks, the effectiveness of the treatment and its evolution after its interruption.

  17. Remission to normoalbuminuria during multifactorial treatment preserves kidney function in patients with type 2 diabetes and microalbuminuria

    DEFF Research Database (Denmark)

    Gaede, Peter; Tarnow, Lise; Vedel, Pernille

    2004-01-01

    -up. Overt nephropathy was diagnosed as a urinary albumin excretion rate (AER) >300 mg/24 h and remission to normoalbuminuria was defined as an AER ... (odds ratio: 1.48; 95% CI: 1.11-1.97). CONCLUSIONS: Remission to normoalbuminuria was associated with a decreased GFR decline during 7.8 years of follow-up in type 2 diabetic patients with microalbuminuria. Antihypertensive therapy and improved glycaemic control were independent predictors for remission....

  18. Does clinical remission lead to normalization of EQ-5D in patients with rheumatoid arthritis and is selection of remission criteria important?

    DEFF Research Database (Denmark)

    Linde, Louise; Sørensen, Jan; Østergaard, Mikkel

    2010-01-01

    patient as the difference from the age and sex-matched general population and adjusted for age, marital status, education, body mass index, smoking, exercise habits, disease duration, IgM-rheumatoid factor status, joint surgery, extraarticular features, treatment, and comorbidity in multiple linear...... regression models. RESULTS: 37% vs 22% fulfilled the DAS28 and CDAI remission criteria, respectively. The DeltaEQ-5D values for women/men in clinical remission were DAS28 0.05/0.06 vs CDAI 0.01/0.02; low disease activity: DAS28 0.12/0.13 vs CDAI 0.11/0.14; moderate disease activity: DAS28 0.18/0.20 vs CDAI 0...

  19. Ultrasound of the hand is sufficient to detect subclinical inflammation in rheumatoid arthritis remission

    DEFF Research Database (Denmark)

    Hammer, Hilde Berner; Kvien, Tore K; Terslev, Lene

    2017-01-01

    BACKGROUND: Ultrasound (US) is a sensitive method for detecting joint/tendon inflammation in patients with rheumatoid arthritis (RA). Subclinical inflammation is often found in patients with RA in composite score remission. The purpose of the present study was to explore whether US of only...... the hands is sufficient to identify subclinical inflammation in patients with established RA in clinical remission. METHODS: A total of 209 patients with established RA (81% women, mean [SD] age 53.3 (13.2) years, disease duration 10.0 [8.8] years) were examined when initiating biologic disease...... inflammation and could be feasible for assessing bDMARD-treated patients with RA in remission. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12610000284066 . Registered on 8 April 2010....

  20. Remission of encephalopathy with status epilepticus (ESES) during sleep renormalizes regulation of slow wave sleep

    DEFF Research Database (Denmark)

    Bölsterli, Bigna K.; Gardella, Elena; Pavlidis, Elena

    2017-01-01

    Objective: In previous studies, we showed an altered overnight decrease of non–rapid-eye-movement (NREM) sleep slow waves in children with encephalopathy related to status epilepticus during sleep (ESES). Here, we test the hypothesis that these alterations renormalize after remission of ESES...... with idiopathic ESES. Automated slow wave detection and calculation of slope of slow waves during the first and last hour of NREM sleep were employed. Intraindividual comparisons were undertaken of the slope during active phase and after remission of ESES, and between patients after remission of ESES and healthy...... evidence that alterations of overnight changes of NREM-sleep slow waves during active ESES are reversible when ESES resolves, and that the severity of neuropsychological compromise might be related to the extent of slow wave impairment during ESES. Our findings suggest that analysis of slow waves might...

  1. In-vivo remission spectroscopy on tattoos and topically applied photosensitizers in man

    Science.gov (United States)

    Koenig, Karsten; Beck, Gerd C.; Boehncke, Wolf-Henning; Kaufmann, Roland; Hibst, Raimund

    1994-02-01

    In-vivo remission spectra of the human skin in the spectral region of 400 nm to 800 nm were recorded using a xenon lamp as an excitation source, a fiberoptical sensor combined with a polychromator, and a multichannel analyzer. The remission of amateur tattoos before and after laser treatment (Q-switched Nd:YAG) was measured and the degree of blanching determined. It was found that the process of blanching proceeds partly reversible. In another study, the time-dependent remission of human skin after topical administration of the photosensitizer Methylene Blue was studied. The additional application of the ceratolytic agent urea promotes the penetration of the thiazine dye. The experimental data were analyzed by the Kubelka Munk theory.

  2. Circadian secretion of cortisol and melatonin in cluster headache during active cluster periods and remission.

    Science.gov (United States)

    Waldenlind, E; Gustafsson, S A; Ekbom, K; Wetterberg, L

    1987-02-01

    The cyclic nature of cluster headache warranted a study of the 24-hour rhythms of serum cortisol and melatonin. They were both altered during cluster periods as compared with periods of remission and healthy controls. The 24-hour mean and maximal cortisol levels were higher and the timing of the cortisol minimum was delayed as compared to the same patients in remission. Although there was no relation between the cortisol and melatonin levels and headaches, the rise of cortisol following many attacks might in part represent an adaptive response to pain. The nocturnal melatonin maximum was lower during cluster periods than in remission. This finding, and the dysautonomic signs during attacks, may reflect a change of the vegetative tone in a hyposympathetic direction.

  3. Circadian secretion of cortisol and melatonin in cluster headache during active cluster periods and remission.

    Science.gov (United States)

    Waldenlind, E; Gustafsson, S A; Ekbom, K; Wetterberg, L

    1987-01-01

    The cyclic nature of cluster headache warranted a study of the 24-hour rhythms of serum cortisol and melatonin. They were both altered during cluster periods as compared with periods of remission and healthy controls. The 24-hour mean and maximal cortisol levels were higher and the timing of the cortisol minimum was delayed as compared to the same patients in remission. Although there was no relation between the cortisol and melatonin levels and headaches, the rise of cortisol following many attacks might in part represent an adaptive response to pain. The nocturnal melatonin maximum was lower during cluster periods than in remission. This finding, and the dysautonomic signs during attacks, may reflect a change of the vegetative tone in a hyposympathetic direction. Images PMID:3572435

  4. A Gut Feeling to Cure Diabetes: Potential Mechanisms of Diabetes Remission after Bariatric Surgery

    Directory of Open Access Journals (Sweden)

    Young Min Cho

    2014-12-01

    Full Text Available A cure for type 2 diabetes was once a mere dream but has now become a tangible and achievable goal with the unforeseen success of bariatric surgery in the treatment of both obesity and type 2 diabetes. Popular bariatric procedures such as Roux-en-Y gastric bypass and sleeve gastrectomy exhibit high rates of diabetes remission or marked improvement in glycemic control. However, the mechanism of diabetes remission following these procedures is still elusive and appears to be very complex and encompasses multiple anatomical and physiological changes. In this article, calorie restriction, improved β-cell function, improved insulin sensitivity, and alterations in gut physiology, bile acid metabolism, and gut microbiota are reviewed as potential mechanisms of diabetes remission after Roux-en-Y gastric bypass and sleeve gastrectomy.

  5. Maintaining remission in ulcerative colitis – role of once daily extended-release mesalamine

    Directory of Open Access Journals (Sweden)

    Lilliana Oliveira

    2011-02-01

    Full Text Available Lilliana Oliveira, Russell D CohenThe Department of Medicine, Section of Gastroenterology, University of Chicago Medical Center, Chicago, IL, USAAbstract: The aminosalicylates (5-ASA; also referred to as mesalamine-based agents are considered as first-line in the maintenance of remission of mild to moderate ulcerative colitis (UC. Traditionally these agents have required a large pill burden and multiple daily dosing regimens which may account for the low adherence rates, especially in patients in remission. Extended-release mesalamine is the first once daily mesalamine product approved by the Food and Drug Administration for the maintenance of UC remission. This review will examine the pharmacokinetics, dosing, efficacy, and safety data of extended-release mesalamine, and discuss the potential role of improving medication compliance and decreasing costs in UC maintenance.Keywords: ulcerative colitis, 5-ASA, mesalamine, adherence, compliance, quality of life, costs

  6. The role of depression, anxiety, fatigue, and fibromyalgia on the evaluation of the remission status in patients with rheumatoid arthritis.

    Science.gov (United States)

    Inanc, Nevsun; Yilmaz-Oner, Sibel; Can, Meryem; Sokka, Tuulikki; Direskeneli, Haner

    2014-09-01

    To investigate the effect of depression, anxiety, fatigue, and fibromyalgia (FM) on the remission status in patients with rheumatoid arthritis (RA), defined according to the 28-joint count Disease Activity Score (DAS28)-erythrocyte sedimentation rate (ESR) and the Boolean-based new American College of Rheumatology/European League Against Rheumatism remission criteria. The subjects were patients with RA who participated in a hospital-based observational cohort. Patients who met the DAS28-ESR remission criteria at their latest visit were invited to participate in our study. The patient groups fulfilling or not fulfilling the Boolean remission criteria were identified and compared with each other with regard to the presence of depression, anxiety, fatigue (0-50), and FM. The relationship between psychosocial factors and Simplified Disease Activity Index (SDAI) remission, which is the index-based definition of remission in RA, was also investigated. A total of 87 out of 428 patients (20%) with RA met the DAS28-ESR remission criteria and 32 (37%) of these also met the Boolean remission criteria, while 55 (63%) did not. Forty patients were also in SDAI remission. In the Boolean remission group, 2 patients had depression and 2 had anxiety (p = 0.004). In the Boolean nonremission group, 19 patients had depression and 13 had anxiety (p = 0.04). Continuous scales of anxiety (3.34 ± 3.76 vs 5.83 ± 4.70, p = 0.012) and depression (2.18 ± 2.75 vs 4.63 ± 4.10, p = 0.001) were also lower in the Boolean remission group in comparison with the nonremission group. Though FM syndrome was detected in only 1 patient of the Boolean remission group and in 7 patients of the Boolean nonremission group (p = 0.249), patients' polysymptomatic distress scores of FM in the Boolean remission group were significantly lower than those of the nonremission group (3.12 ± 3.25 vs 6.27 ± 5.19, p = 0.001). The mean fatigue scores were 9.5 ± 10.6 in the Boolean remission group and 16.8 ± 12.8 in

  7. Discontinuation of infliximab therapy in patients with Crohn's disease in sustained complete remission (the STOP IT study)

    DEFF Research Database (Denmark)

    Buhl, Sine Schnoor; Steenholdt, Casper; Brynskov, Jørn

    2014-01-01

    INTRODUCTION: Infliximab (IFX), a monoclonal chimeric antibody against tumour necrosis factor (TNF) α, is effective for induction and maintenance of remission in moderate to severe Crohn's disease. Discontinuation of IFX maintenance therapy in patients in remission should be considered in order......, biochemical and endoscopic remission (ie, Crohn's Disease Activity Index (CDAI) score therapy. The primary end point...... a patient exhibits sustained remission. Study results will be published in an English language scientific medical journal. The study is approved by the Danish Medicines Agency (EudraCT-number: 2012-002702-51) and the Regional Ethics Committee of Region Hovedstaden Denmark (Approval-number: H-4...

  8. EVALUATION OF ULTRASOUND REMISSION CRITERIA IN PATIENTS WITH RHEUMATOID ARTHRITIS DURING TOCILIZUMAB THERAPY

    Directory of Open Access Journals (Sweden)

    Rita Aleksandrovna Osipyants

    2013-01-01

    Full Text Available Objective: to study the association of ultrasound (US remission criteria with the clinical and laboratory indicators of inflammatory activity, functional status, and X-ray changes in patients with rheumatoid arthritis (RA during tocilizumab (TCZ therapy.Subjects and methods. The trial included 36 patients with RA (meeting the 1987 American College of Rheumatology (ACR criteria who had received TCZ for 6 months. The authors made a clinical and laboratory assessment of RA activity (DAS28-CRP, and SDAI, functional impairments (HAQ index and US verification of wrist joint synovitis (a Voluson-i device, GE, 4-13-MHz linear transducer at baseline and 6 months after therapy. No signs of grey-scale (B-mode and power Doppler (PD synovitis (B = 0; PD = 0 or minimal B-mode synovitis, and not more one PD hypervascular signal (В ≤1; PD ≤1 were arbitrarily taken as US remission criteria. Destruction changes were evaluated by hand and foot X-ray using the Sharp method modified by van der Heijde (SHS.Results. After 6 months of therapy, about 80% of the patients in clinical remission retained moderate or significant synovitis, as evidenced by US studies. There were no clinical differences in clinical activity indices and functional impairments between the patients who were and were not in US remission (p > 0.05. The 12-month follow-up SHS score was significantly higher with the preservation of 6-month therapy signs of B-mode synovitis and PD hypervascularization (of not more than one signal than that in US remission (p < 0.05. There was no relationship of X-ray progression to the clinical and functional statuses (p > 0.05.Conclusion. Subclinical synovitis is observed even in clinical remission of RA. Destruction progression is significantlyrelated to synovitis persistence, as shown by ultrasonography.

  9. Komplet remission af højmalignt lymfom i ventriklen efter eradikation af Helicobacter pylori

    DEFF Research Database (Denmark)

    Høeg, Rasmus Tetens; Skau, Anne-Marie; Nørgaard, Peter

    2011-01-01

    . The recommended treatment of DLBCL is chemotherapy followed by involved-field irradiation. However, small prospective trials have shown high rates of complete remission after eradication of H. pylori alone and this treatment is an option in patients of advanced age or with severe co-morbidities.......A 91 year-old man was found to have diffuse large cell B-cell lymphoma (DLBCL), localized to the stomach. Because of his age, his only treatment was anti-Helicobacter pylori therapy. He achieved a complete remission, and six months after the initial presentation, there were no signs of recurrence...

  10. Rituximab for Remission Induction and Maintenance in Refractory Systemic Lupus Erythematosus

    Science.gov (United States)

    Coronel Restrepo, Nicolás; Tobón, Gabriel J.; Echeverri, Andrés F.; Muñoz-Buitrón, Evelyn; Castro, Andres Mauricio; Bejarano, Mercedes Andrade; Cañas, Carlos A.

    2014-01-01

    Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease with high morbidity if untreated. Sometimes, despite aggressive treatments, the disease remains active with cumulative organic damage. We conducted a retrospective and descriptive observational study of patients with SLE refractory to conventional treatment who were treated with rituximab (RTX) as remission induction therapy and maintenance. There was a significant reduction in the conventional immunosuppressive drug dose and the number of relapses of disease. RTX appeared to be effective and safe for the induction and maintenance of remission in patient with SLE refractory to conventional treatment. PMID:24527208

  11. Cryopreserved ovarian cortex from patients with leukemia in complete remission contains no apparent viable malignant cells

    DEFF Research Database (Denmark)

    Greve, Tine; Clasen-Linde, Erik; Andersen, Morten T

    2012-01-01

    before and after transplantation by histology and immunohistochemistry, and reverse transcription quantitative polymerase chain reaction (RT-qPCR) (in the seven patients with a known marker). Seventeen patients had ovarian cortex retrieved when they were in complete remission. Before transplantation four...... of seven pieces (two from patients in complete remission) of ovarian cortex had a positive RT-qPCR. After transplantation, none of the mice revealed any sign of disease neither in the pieces of ovarian cortex transplanted nor in any of the murine organs evaluated. Thus, the ovaries from patients...

  12. Komplet remission af højmalignt lymfom i ventriklen efter eradikation af Helicobacter pylori

    DEFF Research Database (Denmark)

    Høeg, Rasmus Tetens; Skau, Anne-Marie; Nørgaard, Peter

    2011-01-01

    A 91 year-old man was found to have diffuse large cell B-cell lymphoma (DLBCL), localized to the stomach. Because of his age, his only treatment was anti-Helicobacter pylori therapy. He achieved a complete remission, and six months after the initial presentation, there were no signs of recurrence....... The recommended treatment of DLBCL is chemotherapy followed by involved-field irradiation. However, small prospective trials have shown high rates of complete remission after eradication of H. pylori alone and this treatment is an option in patients of advanced age or with severe co-morbidities....

  13. An Adult Patient with Ocular Myasthenia and Unusually Long Spontaneous Remission

    Directory of Open Access Journals (Sweden)

    Jasem Al-Hashel

    2014-01-01

    Full Text Available A male patient developed ocular myasthenia gravis (MG at the age of 33. He was anti-acetylcholine receptor antibody (anti-AChR Ab negative. He received cholinesterase blocker for 5 months and went into a complete clinical remission that lasted untreated for 17 years. He relapsed recently with ocular symptoms only. He is now anti-AChR Ab positive and SFEMG is abnormal in a facial muscle. The patient is controlled with steroids. He had one of the longest spontaneous remissions reported in the natural history of MG, particularly unusual for an adult with the disease.

  14. Safety and efficacy of Profermin(R) to induce remission in ulcerative colitis

    DEFF Research Database (Denmark)

    Krag, Aleksander; Israelsen, Hans; von Ryberg, Bjørn

    2012-01-01

    AIM: To test the efficacy and safety of Profermin(R) in inducing remission in patients with active ulcerative colitis (UC). METHODS: The study included 39 patients with mild to moderate UC defined as a Simple Clinical Colitis Activity Index (SCCAI) > 4 and ... in SCCAI. Our secondary endpoint, the proportion of patients in remission defined as SCCAI ≤ 2.5, was in ITT analysis reached in 18 of the 39 patients (46%). In a repeated-measure regression analysis, the estimated mean reduction in score was 5.0 points (95% CI: 4.1-5.9, P

  15. Remission of nephrotic syndrome diminishes urinary plasmin content and abolishes activation of ENaC

    DEFF Research Database (Denmark)

    Andersen, Mikkel René; Buhl, Kristian B; Jensen, Boye L

    2013-01-01

    BACKGROUND: Urinary plasmin activates the epithelial Na(+) channel (ENaC) in vitro and may possibly be a mechanism of sodium retention in nephrotic syndrome (NS). This study used a paired design to test the hypothesis that remission of NS is associated with a decreased content of urinary plasmin...... and reduced ability of patients' urine to activate ENaC. METHODS: Samples were collected during active NS and at stable remission from 20 patients with idiopathic NS, aged 9.1 ± 3.2 years. Plasminogen-plasmin concentration was measured with an enzyme-linked immunosorbent assay. Western immunoblotting...

  16. Simplified Disease Activity Index remission at month 6 is an independent predictor of functional and structural remissions at month 12 during abatacept treatment in patients with rheumatoid arthritis: A multi-center, prospective cohort study in Japan.

    Science.gov (United States)

    Yamazaki, Hayato; Hirano, Fumio; Takeuchi, Tsutomu; Amano, Koichi; Kikuchi, Jun; Kihara, Mari; Yokoyama, Waka; Sugihara, Takahiko; Nagasaka, Kenji; Hagiyama, Hiroyuki; Nonomura, Yoshinori; Sakai, Ryoko; Tanaka, Michi; Koike, Ryuji; Nanki, Toshihiro; Kohsaka, Hitoshi; Miyasaka, Nobuyuki; Harigai, Masayoshi

    2017-09-01

    To evaluate association of clinical remission at month 6 with functional and structural remissions at month 12 during abatacept treatment in patients with rheumatoid arthritis (RA). This 12-month prospective, multicenter cohort study enrolled 168 patients with RA who started abatacept. Outcomes were assessed using composite measures, quality of life indices, and the van der Heijde-modified total Sharp score (mTSS). The logistic regression analysis was applied to identify factors associated with outcomes and their odds ratios (OR) with 95% confidence interval (95% CI). At month 6 and 12, 21.4% and 26.2% of the patients achieved Simplified Disease Activity Index (SDAI) remission (SDAI <3.3), and 40.6% and 41.7% achieved Health Assessment Questionnaire-Disability Index (HAQ-DI <0.5) remission. Among 129 patients whose mTSS progression was evaluated at month 12, 83 (64.3%) achieved structural remission (ΔmTSS ≤0.5 for 12 months). SDAI remission at month 6 was identified as a significant predictor of both functional (OR, 3.732; 95% CI, 1.328-10.489) and structural remissions (OR, 4.301; 95% CI, 1.298-14.243) at month 12 after adjusting for covariates. Aiming for SDAI remission at month 6 is an appropriate strategy to obtain good functional and structural outcomes at month 12.

  17. Development of Preliminary Remission Criteria for Gout Using Delphi and 1000Minds® Consensus Exercises

    DEFF Research Database (Denmark)

    de Lautour, Hugh; Taylor, William J; Adebajo, Ade

    2016-01-01

    OBJECTIVES: The aim of this study was to establish consensus for potential remission criteria for use in clinical trials of gout. METHODS: Experts (n=88) in gout from multiple countries were invited to participate in a web-based questionnaire study. Three rounds of Delphi consensus exercises were...

  18. Continuation-Phase Cognitive Therapy's Effects on Remission and Recovery from Depression

    Science.gov (United States)

    Vittengl, Jeffrey R.; Clark, Lee Anna; Jarrett, Robin B.

    2009-01-01

    The authors tested the effects of continuation-phase cognitive therapy (C-CT) on remission and recovery from recurrent major depressive disorder, defined as 6 weeks and 8 months, respectively, of continuously absent or minimal symptoms. Responders to acute-phase cognitive therapy were randomized to 8 months of C-CT (n = 41) or assessment control…

  19. Diabetes and obesity not associated with 6-month remission rates for primary care patients with depression.

    Science.gov (United States)

    Wade, Todd W; Oberhelman, Sara S; Angstman, Kurt B; Sawchuk, Craig N; Meunier, Matthew R; Angstman, Gregory L; Rohrer, James E

    2015-01-01

    Complex interrelationships appear to exist among depression, diabetes, and obesity, and it has been proposed that both diabetes and obesity have an association with depression. The purpose of our study was to explore the effect of obesity and diabetes on response to the treatment of depression. Our hypothesis was that obesity and the diagnosis of diabetes in primary care patients with depression would have no effects on depression remission rates 6 months after diagnosis. A retrospective chart review analysis of 1894 adult (age ≥18y) primary care patients diagnosed with major depressive disorder or dysthymia and a Patient Health Questionnaire-9 score ≥10 from January 1, 2008, through September 30, 2012. Multiple logistic regression modeling retaining all independent variables was performed for the outcome of remission (Patient Health Questionnaire-9 obesity (odds ratio = 0.937, 95% CI: 0.770-1.140, p = 0.514) or the diagnosis of diabetes (odds ratio = 0.740, 95% CI: 0.535-1.022, p = 0.068) did not affect the likelihood of remission, while controlling for the other independent variables. In primary care patients treated for depression, the presence of diabetes or obesity at the time of diagnosis of depression does not appear to significantly affect remission of depressive symptoms 6 months after diagnosis. Copyright © 2015 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  20. Inequality and ethics in paediatric HIV remission research: From Mississippi to South Africa and back.

    Science.gov (United States)

    Crane, Johanna T; Rossouw, Theresa M

    2017-02-01

    In 2013, physician-researchers announced that a baby in Mississippi had been 'functionally cured' of HIV [Persaud, D., Gay, H., Ziemniak, C. F., Chen, Y. H., Piatak, M., Chun, T.-W., … Luzuriaga, K. (2013b, March). Functional HIV cure after very early ART of an infected infant. Paper presented at the 20th conference on retroviruses and opportunistic infections, Atlanta, GA]. Though the child later developed a detectable viral load, the case remains unprecedented, and trials to build on the findings are planned [National Institute of Allergy and Infectious Diseases. (2014). 'Mississippi baby' now has detectable HIV, researchers find. Retrieved from http://www.niaid.nih.gov/news/newsreleases/2014/pages/mississippibabyhiv.aspx ]. Whether addressing HIV 'cure' or 'remission', scrutiny of this case has focused largely on scientific questions, with only introductory attention to ethics. The social inequalities and gaps in care that made the discovery possible - and their ethical implications for paediatric HIV remission - have gone largely unexamined. This paper describes structural inequalities surrounding the 'Mississippi baby' case and a parallel case in South Africa, where proof-of-concept studies are in the early stages. We argue that an ethical programme of research into infant HIV remission ought to be 'structurally competent', and recommend that paediatric remission studies consider including a research component focused on social protection and barriers to care.

  1. New definition for the partial remission period in children and adolescents with type 1 diabetes

    DEFF Research Database (Denmark)

    Mortensen, Henrik B; Hougaard, Philip; Swift, Peter

    2009-01-01

    OBJECTIVE To find a simple definition of partial remission in type 1 diabetes that reflects both residual beta-cell function and efficacy of insulin treatment. RESEARCH DESIGN AND METHODS A total of 275 patients aged type 1 diabetes. After 1, 6, and 12 months...

  2. Antipsychotic medication and remission of psychotic symptoms 10years after a first-episode psychosis.

    Science.gov (United States)

    Wils, Regitze Sølling; Gotfredsen, Ditte Resendal; Hjorthøj, Carsten; Austin, Stephen F; Albert, Nikolai; Secher, Rikke Gry; Thorup, Anne Amalie Elgaard; Mors, Ole; Nordentoft, Merete

    2017-04-01

    Several national guidelines recommend continuous use of antipsychotic medication after a psychotic episode in order to minimize the risk of relapse. However some studies have identified a subgroup of patients who obtain remission of psychotic symptoms while not being on antipsychotic medication for a period of time. This study investigated the long-term outcome and characteristics of patients in remission of psychotic symptoms with no use of antipsychotic medication at the 10-year follow-up. The study was a cohort study including 496 patients diagnosed with schizophrenia spectrum disorders (ICD 10: F20 and F22-29). Patients were included in the Danish OPUS Trial and followed up 10years after inclusion, where patient data was collected on socio-demographic factors, psychopathology, level of functioning and medication. 61% of the patients from the original cohort attended the 10-year follow up and 30% of these had remission of psychotic symptoms at the time of the 10-year follow up with no current use of antipsychotic medication. This outcome was associated with female gender, high GAF-F score, participation in the labour market and absence of substance abuse. Our results describe a subgroup of patients who obtained remission while not being on antipsychotic medication at the 10-year follow-up. The finding calls for further investigation on a more individualized approach to long-term treatment with antipsychotic medication. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Female Overweight and Obesity in Adolescence: Developmental Trends and Ethnic Differences in Prevalence, Incidence, and Remission

    Science.gov (United States)

    Huh, David; Stice, Eric; Shaw, Heather; Boutelle, Kerri

    2012-01-01

    Despite substantial increases in the prevalence of adolescent overweight and obesity documented in recent decades, few studies have prospectively tracked their development during the entire adolescent period. The aims of this study were to characterize developmental trends in prevalence, incidence, and remission of overweight and obesity using…

  4. Spontaneous remission of acromegaly and Cushing’s disease following pituitary apoplexy: Two case reports

    NARCIS (Netherlands)

    Roerink, S.H.P.P.; Lindert, E.J. van; Ven, A.C. van de

    2015-01-01

    In this double case report, we present two special cases of pituitary apoplexy. First, we describe a patient with growth hormone deficiency despite clinical suspicion of acromegaly. Imaging showed evidence of a recent pituitary apoplexy, which might have caused spontaneous remission of the

  5. Female Overweight and Obesity in Adolescence: Developmental Trends and Ethnic Differences in Prevalence, Incidence, and Remission

    Science.gov (United States)

    Huh, David; Stice, Eric; Shaw, Heather; Boutelle, Kerri

    2012-01-01

    Despite substantial increases in the prevalence of adolescent overweight and obesity documented in recent decades, few studies have prospectively tracked their development during the entire adolescent period. The aims of this study were to characterize developmental trends in prevalence, incidence, and remission of overweight and obesity using annual data collected from ages 12 to 19 for 496 adolescent females. Ethnic differences between African American (n = 37), Latina (n = 96), and European American (n = 348) adolescents were also compared. The prevalence of overweight decreased slightly across adolescence and remission rates exceeded incidence (onset). Obesity was more chronic, with increasing incidence accompanied by decreasing remission rates. Middle through late adolescence was the period of greatest risk for the transition from overweight to obesity. African American and Latina females had higher overweight and obesity prevalence than European American females throughout adolescence. Differences in prevalence were driven by higher onset rates for African American and Latina females, whereas remission rates were comparable across ethnic groups. Results suggest that adolescence is not a high-risk period for onset of obesity for European American adolescent females, but is for African American and Latina adolescent females. PMID:21499888

  6. Diabetes mellitus remission after resolution of inflammatory and progesterone-related conditions in bitches.

    Science.gov (United States)

    Pöppl, A G; Mottin, T S; González, F H D

    2013-06-01

    Canine diabetes mellitus (CDM) remission is a rare event that is possible after the resolution of insulin resistance conditions, especially those related to the estrus cycle. A retrospective study was carried out at the Division of Veterinary Endocrinology from 2006 to 2011 to assess CDM remission rates after the resolution of problems associated with ovarian activity. Out of 117 female dogs diagnosed with CDM, six diabetes remission cases were identified and described after resolution of diestrus (1), or after ovariohysterectomy for pregnancy (1), ovarian remnant syndrome (1), and pyometra (3), even after initial presentation in severe diabetic ketosis or long after diagnosis (ovariohysterectomy was performed from 3 to 81 days after diagnosis, and diabetes resolution was achieved within 4-39 days after gonadectomy). Several factors may lead to diabetes remission. However, in these cases, ovariohysterectomy was crucial for the restoration of normal blood glucose levels, suggesting that diabetic bitches be spayed independently of the length of time after diagnosis. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Dose-remission of pulsating electromagnetic fields as augmentation in therapy-resistant depression

    DEFF Research Database (Denmark)

    Straasø, Birgit; Lauritzen, Lise; Lunde, Marianne

    2014-01-01

    OBJECTIVE: To evaluate to what extent a twice daily dose of Transcranial Pulsating ElectroMagnetic Fields (T-PEMF) was superior to once daily in patients with treatment-resistant depression as to obtaining symptom remission after 8 weeks of augmentation therapy. METHODS: A self-treatment set...

  8. Tissue Augmentation with Allograft Adipose Matrix For the Diabetic Foot in Remission

    Directory of Open Access Journals (Sweden)

    Tala B. Shahin, BS

    2017-10-01

    Conclusion:. The results from this preliminary experience suggest that allograft adipose matrix delivered to the high risk diabetic foot may have promise in reducing tissue stress over pre- and postulcerative lesions. This may ultimately assist the clinician in extending ulcer-free days for patients in diabetic foot remission.

  9. Antigen Concentrations as an Indicator of Clinical Remission and Disease Relapse in Cats with Histoplasmosis.

    Science.gov (United States)

    Hanzlicek, A S; Meinkoth, J H; Renschler, J S; Goad, C; Wheat, L J

    2016-07-01

    Treatment monitoring is subjective and disease relapse is common in cats with histoplasmosis. The Histoplasma antigen enzyme immunoassay (EIA) is a noninvasive test used for determining disease remission and detecting disease relapse in humans with histoplasmosis. The utility of the antigen EIA for these purposes in cats remains unknown. Those Histoplasma antigen concentrations in urine and serum would decline with antifungal treatment and that antigen elimination would be an indicator of clinical remission in cats with histoplasmosis treated with antifungal treatment. Fifteen client-owned cats with histoplasmosis. Masked observational study. Cats were monitored monthly during antifungal treatment. Time of clinical remission and serum and urine antigen elimination were determined for each cat. Twelve of 15 cats achieved clinical remission. At the time of diagnosis, antigen was detectable in urine in 14/15 (93%) cats and in serum in 11/15 (73%) cats. Both serum (P histoplasmosis. Further research is needed to investigate the importance of low-level antigenemia and antigenuria. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  10. Ability to perform Actvities of Daily Living among patients with bipolar disorder in remission

    DEFF Research Database (Denmark)

    Decker, Lone; Träger, Conny; Miskowiak, Kamilla

    2017-01-01

    , a standardized assessment providing interpretation of ADL ability in relation to competence, independence, and normative age expectations. Self-reported ADL ability was assessed with the standardized ADLQuestionnaire. Results: Forty-three patients with bipolar disorder in remission (median age 35 years, range 19...

  11. Early response as predictor of final remission in elderly depressed patients

    NARCIS (Netherlands)

    Kok, Rob M.; van Baarsen, Carlijn; Nolen, Willem A.; Heeren, Thea J.

    2009-01-01

    Background Several studies have attempted to predict the final response or remission based on improvement during the early Course of treatment of major depression. There is however a great variation in cut offs used to define early response and in the optimal week to predict final results. Objective

  12. Suppression of p21Rac signaling and increased innate immunity mediate remission in Crohn's disease

    NARCIS (Netherlands)

    Parikh, Kaushal; Zhou, Lu; Somasundaram, Rajesh; Fuhler, Gwenny M; Deuring, J Jasper; Blokzijl, Tjasso; Regeling, Anouk; Kuipers, Ernst J; Weersma, Rinse K; Nuij, Veerle J; Alves, Maria; Vogelaar, Lauran; Visser, Lydia; de Haar, Colin; Krishnadath, Kausilia K; van der Woude, C Janneke; Dijkstra, Gerard; Faber, Klaas Nico; Peppelenbosch, Maikel P

    2014-01-01

    In inflammatory bowel disease (IBD), large areas of apparently healthy mucosa lie adjacent to ulcerated intestine. Knowledge of the mechanisms that maintain remission in an otherwise inflamed intestine could provide important clues to the pathogenesis of this disease and provide rationale for

  13. Spontaneous remission of chiasmatic/hypothalamic masses in neurofibromatosis type 1: report of two cases

    International Nuclear Information System (INIS)

    Gottschalk, S.; Tavakolian, R.; Lehmann, R.; Buske, A.; Tinschert, S.

    1999-01-01

    We report two children with neurofibromatosis type 1 showing enhancing masses on MRI suggesting neoplasms in the chiasm and hypothalamic region. In both patients no visual or endocrinal dysfunction was present. On serial MRI spontaneous partial remission was found, implying that a cautious approach to therapeutic management of similar cases should be taken. (orig.) (orig.)

  14. Cognitive deficits in unipolar depression during remission-Auditory Verbal Learning test findings

    Czech Academy of Sciences Publication Activity Database

    Preiss, M.; Kučerová, H.; Štěpánková, H.; Sos, P.; Lukavský, Jiří; Kawaciuková, R.

    2007-01-01

    Roč. 11, Suppl. 3 (2007), s. 79-83 ISSN 1211-7579 Institutional research plan: CEZ:AV0Z70250504 Keywords : major depressive episode * remission * cognitive function Subject RIV: AN - Psychology http://www.tigis.cz/PSYCHIAT/Psych_suppl_3_07/21Preiss_suppl_3_07.pdf)

  15. Response and Remission in Adolescent Mania: Signal Detection Analyses of the Young Mania Rating Scale

    Science.gov (United States)

    Patel, Nick C.; Patrick, Danielle M.; Youngstrom, Eric A.; Strakowski, Stephen M.; Delbello, Melissa P.

    2007-01-01

    Objective: The purpose of this study was to determine optimal criteria for defining response and remission in adolescents with acute mania. Method: Data were analyzed from three treatment studies of adolescents with acute mania (N = 99). Trained raters completed the Young Mania Rating Scale (YMRS), and clinicians completed the Clinical Global…

  16. Remission of type 2 diabetes mellitus after bariatric surgery - comparison between procedures.

    Science.gov (United States)

    Fernández-Soto, María L; Martín-Leyva, Ana; González-Jiménez, Amalia; García-Rubio, Jesús; Cózar-Ibáñez, Antonio; Zamora-Camacho, Francisco J; Leyva-Martínez, María S; Jiménez-Ríos, Jose A; Escobar-Jiménez, Fernándo

    2017-01-01

    We aimed to assess the mid-term type 2 diabetes mellitus recovery patterns in morbidly obese patients by comparing some relevant physiological parameters of patients of bariatric surgery between two types of surgical procedures: mixed (roux-en-Y gastric bypass and biliopancreatic diversion) and restrictive (sleeve gastrectomy). This is a prospective and observational study of co-morbid, type 2 diabetes mellitus evolution in 49 morbidly obese patients: 37 underwent mixed surgery procedures and 12 a restrictive surgery procedure. We recorded weight, height, body mass index, and glycaemic, lipid, and nutritional blood parameters, prior to procedure, as well as six and twelve months post-operatively. In addition, we tested for differences in patient recovery and investigated predictive factors in diabetes remission. Both glycaemic and lipid profiles diminished significantly to healthy levels by 6 and 12 months post intervention. Type 2 diabetes mellitus showed remission in more than 80% of patients of both types of surgical procedures, with no difference between them. Baseline body mass index, glycated haemoglobin, and insulin intake, among others, were shown to be valuable predictors of diabetes remission one year after the intervention. The choice of the type of surgical procedure did not significantly affect the remission rate of type 2 diabetes mellitus in morbidly obese patients. (Endokrynol Pol 2017; 68 (1): 18-25).

  17. Remission after Acute Treatment in Children and Adolescents with Anxiety Disorders: Findings from the CAMS

    Science.gov (United States)

    Ginsburg, Golda S.; Kendall, Philip C.; Sakolsky, Dara; Compton, Scott N.; Piacentini, John; Albano, Anne Marie; Walkup, John T.; Sherrill, Joel; Coffey, Kimberly A.; Rynn, Moira A.; Keeton, Courtney P.; McCracken, James T.; Bergman, Lindsey; Iyengar, Satish; Birmaher, Boris; March, John

    2011-01-01

    Objective: To report on remission rates in anxious youth who participated in the Child/Adolescent Anxiety Multimodal Study (CAMS). The CAMS, a multisite clinical trial, randomized 488 children and adolescents (ages 7-17 years; 79% Caucasian; 50% female) with separation, social, and/or generalized anxiety disorder to a 12-week treatment of…

  18. Remission and rheumatoid arthritis: Data on patients receiving usual care in twenty-four countries

    DEFF Research Database (Denmark)

    Sokka, Tuulikki; Hetland, Merete Lund; Mäkinen, Heidi

    2008-01-01

    OBJECTIVE: To compare the performance of different definitions of remission in a large multinational cross-sectional cohort of patients with rheumatoid arthritis (RA). METHODS: The Questionnaires in Standard Monitoring of Patients with RA (QUEST-RA) database, which (as of January 2008) included 5...

  19. Clinical Outcomes of Remission Induction Therapy for Severe Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

    NARCIS (Netherlands)

    Miloslavsky, E. M.; Specks, U.; Merkel, P. A.; Seo, P.; Spiera, R.; Langford, C. A.; Hoffman, G. S.; Kallenberg, C. G. M.; St Clair, E. W.; Tchao, N. K.; Viviano, L.; Ding, L.; Sejismundo, L. P.; Mieras, K.; Ikle, D.; Jepson, B.; Mueller, M.; Brunetta, P.; Allen, N. B.; Fervenza, F. C.; Geetha, D.; Keogh, K.; Kissin, E. Y.; Monach, P. A.; Peikert, T.; Stegeman, C.; Ytterberg, S. R.; Stone, J. H.

    Objective. To evaluate the reasons that complete remission is not achieved or maintained with original treatment in some patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) treated with rituximab (RTX) or with cyclophosphamide/azathioprine (CYC/AZA). Methods. The

  20. Evolução para remissão clínica completa em esclerose sistêmica Progression into clinical remission in systemic sclerosis

    Directory of Open Access Journals (Sweden)

    Leandro Antônio Cichoski

    2004-10-01

    Full Text Available OBJETIVO: mostrar a evolução de quatro pacientes para remissão clínica completa da esclerose sistêmica (ES, sem necessidade de tratamento medicamentoso atual, após uso de D-penicilamina como medicação principal. MÉTODOS: revisão dos prontuários de pacientes com diagnóstico de ES (ARA, 1980 que entraram em remissão após acompanhamento ambulatorial continuado. Foram relacionados dados como sexo, raça, idade do paciente quando do diagnóstico, manifestações iniciais, envolvimento sistêmico, perfil laboratorial, exames complementares, tratamento proposto, resposta medicamentosa e tempo total de tratamento. RESULTADOS: todos os pacientes eram brancos, sendo um homem e três mulheres, tendo como idade média 51,2 anos na instalação dos primeiros sintomas. O tempo médio decorrido entre o início dos sintomas e o diagnóstico foi de 8,2 meses. Todos os pacientes apresentaram alterações cutâneas, comprometimento sistêmico e FAN reagente em células HEp-2. Nenhum deles apresentou os auto-anticorpos específicos para ES (anticentrômero e anti Scl-70/topo I. Depois de instituída D-penicilamina, o tempo médio de tratamento para alcançar a remissão foi de 60,7±27,4 meses. Todos se encontram atualmente sem tratamento de qualquer natureza por períodos de 31 a 120 meses e sem manifestações que indiquem atividade da ES, mesmo fenômeno de Raynaud. CONCLUSÕES: a no espectro clínico da ES há pacientes que entram em remissão com auxílio da D-penicilamina, permanecendo assintomáticos e sem medicação por muitos anos; b nota-se na amostra a ausência dos auto-anticorpos mais característicos da ES (anticentrômero e anti-Scl-70/topo I em todos os casos, um achado a ser explorado em amostra maior; c a ausência de auto-anticorpos considerados como mais específicos da ES poderia ser indicativa de melhor resposta à terapia com D-penicilamina ou de possível evolução para remissão clínica espontânea.OBJECTIVE: to report four

  1. Systems Signatures Reveal Unique Remission-path of Type 2 Diabetes Following Roux-en-Y Gastric Bypass Surgery

    DEFF Research Database (Denmark)

    Li, Qing-Run; Wang, Zi-Ming; Wewer Albrechtsen, Nicolai J

    2018-01-01

    Roux-en-Y Gastric bypass surgery (RYGB) is emerging as a powerful tool for treatment of obesity and may also cause remission of type 2 diabetes. However, the molecular mechanism of RYGB leading to diabetes remission independent of weight loss remains elusive. In this study, we profiled plasma...

  2. Remission and Recovery in the Treatment for Adolescents with Depression Study (TADS): Acute and Long-Term Outcomes

    Science.gov (United States)

    Kennard, Betsy D.; Silva, Susan G.; Tonev, Simon; Rohde, Paul; Hughes, Jennifer L.; Vitiello, Benedetto; Kratochvil, Christopher J.; Curry, John F.; Emslie, Graham J.; Reinecke, Mark; March, John

    2009-01-01

    The remission and recovery rates of adolescent patients with depression who were treated with fluoxetine, cognitive-behavioral therapy, their combination, and placebos were examined through a multisite clinical trial. It is concluded that most depressed adolescents who received such therapies achieved remission at the end of nine months.

  3. Rifaximin-extended intestinal release induces remission in patients with moderately active Crohn's disease.

    Science.gov (United States)

    Prantera, Cosimo; Lochs, Herbert; Grimaldi, Maria; Danese, Silvio; Scribano, Maria Lia; Gionchetti, Paolo

    2012-03-01

    Bacteria might be involved in the development and persistence of inflammation in patients with Crohn's disease (CD), and antibiotics could be used in therapy. We performed a clinical phase 2 trial to determine whether a gastroresistant formulation of rifaximin (extended intestinal release [EIR]) induced remission in patients with moderately active CD. We performed a multicenter, randomized, double-blind trial of the efficacy and safety of 400, 800, and 1200 mg rifaximin-EIR, given twice daily to 402 patients with moderately active CD for 12 weeks. Data from patients given rifaximin-EIR were compared with those from individuals given placebo, and collected during a 12-week follow-up period. The primary end point was remission (Crohn's Disease Activity Index <150) at the end of the treatment period. At the end of the 12-week treatment period, 62% of patients who received the 800-mg dosage of rifaximin-EIR (61 of 98) were in remission, compared with 43% of patients who received placebo (43 of 101) (P = .005). A difference was maintained throughout the 12-week follow-up period (45% [40 of 89] vs 29% [28 of 98]; P = .02). Remission was achieved by 54% (56 of 104) and 47% (47 of 99) of the patients given the 400-mg and 1200-mg dosages of rifaximin-EIR, respectively; these rates did not differ from those of placebo. Patients given the 400-mg and 800-mg dosages of rifaximin-EIR had low rates of withdrawal from the study because of adverse events; rates were significantly higher among patients given the 1200-mg dosage (16% [16 of 99]). Administration of 800 mg rifaximin-EIR twice daily for 12 weeks induced remission with few adverse events in patients with moderately active CD. Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.

  4. Mixed-state bipolar I and II depression: time to remission and clinical characteristics.

    Science.gov (United States)

    Shim, In Hee; Woo, Young Sup; Jun, Tae-Youn; Bahk, Won-Myong

    2014-01-01

    We compared the time to achieve remission and the clinical characteristics of patients with bipolar depressive mixed state and those with bipolar depressive non-mixed state. The subjects (N=131) were inpatients diagnosed between 2006 and 2012 with bipolar I or II disorder, depression and were classified into the following three groups: "pure depressive state" (PD, n=70), "sub-threshold mixed state" (SMX, n=38), and "depressive mixed state" (DMX, n=23). Diagnosis of a DMX was in accordance with Benazzi's definition: three or more manic symptoms in a depressive episode. The subjects' charts were retrospectively reviewed to ascertain the time to achieve remission from the index episode and to identify other factors, such as demographic and clinical characteristics, specific manic symptoms, and pharmacological treatment, that may have contributed to remission. The time to achieve remission was significantly longer in the DMX (p=0.022) and SMX (p=0.035) groups than in the PD group. Adjustment for covariates using a Cox proportional hazards model did not change these results. Clinically, subjects with a DMX were more likely to have manic symptoms in the index episode, especially inflated self-esteem and psychomotor agitation than those in the PD. We investigated only inpatients and therefore could not comment on outpatients. These findings showed that sub-syndromal manic symptoms in bipolar depression had different clinical characteristics and a more severe illness course, including a longer time to achieve remission, than did a pure depressive state. © 2013 Elsevier B.V. All rights reserved.

  5. Early patterns of symptom change signal remission with interpersonal psychotherapy for depressed adolescents.

    Science.gov (United States)

    Gunlicks-Stoessel, Meredith; Mufson, Laura

    2011-07-01

    This study examined whether reductions in depression symptoms at different time points over the course of therapy predict remission for depressed adolescents treated with interpersonal psychotherapy (IPT-A) or treatment as usual (TAU) delivered in school-based health clinics. Participants were 63 adolescents (ages 12-18) drawn from a randomized controlled clinical trial examining the effectiveness of IPT-A Mufson et al. [2004; Archives of General Psychiatry 61:577-584]. Adolescents were randomized to receive IPT-A or TAU delivered by school-based mental health clinicians. Assessments were completed at baseline and weeks 4, 8, 12, and 16 (or at early termination) and included the Hamilton Rating Scale for Depression (HRSD; Hamilton [1967; British Journal of Social and Clinical Psychology 6:278-2962]). Receiver operating characteristic analysis was used to identify the time point and degree of reduction in HRSD that best predicted remission (HRSD <7) at the end of the trial (week 16). Week 4 was the best time point for classifying adolescents as likely to remit or not likely to remit for both IPT-A and TAU. A 16.2% reduction in HRSD from baseline represented the best combined sensitivity and specificity in predicting week 16 remission status for adolescents treated with IPT-A. A 24.4% reduction in depressive symptoms represented the best combined sensitivity and specificity in predicting remission status for TAU. These findings provide preliminary evidence of one early marker of remission with IPT-A. Replication with larger samples would suggest that depressed adolescents who have not demonstrated at least a 16.2% reduction in their depressive symptoms after 4 weeks of IPT-A may benefit from a change in the treatment plan. © 2011 Wiley-Liss, Inc.

  6. Sustained Remission Improves Physical Function in Patients with Established Rheumatoid Arthritis, and Should Be a Treatment Goal

    DEFF Research Database (Denmark)

    Einarsson, Jon Thorkell; Geborek, Pierre; Saxne, Tore

    2016-01-01

    of the strongest predictors of longterm outcomes. The purpose of this study was to investigate the physical function over a long time in patients with RA who achieved sustained remission (SR) compared with that of patients occasionally achieving remission [non-sustained remission (NSR)]. METHODS: Patients with RA...... treated with antitumor necrosis factor and included in the South Swedish Arthritis Treatment Group register were eligible for this study. We identified patients with a Disease Activity Score at 28 joints (DAS28) achieved...... SR, i.e., remission during consecutive visits for at least 6 months. The course of functional status was assessed using the HAQ at each visit. RESULTS: Of the 2416 patients, 1177 (48.7%) reached DAS28 remission at some point. SR was achieved by 382 (15.8%) for the DAS28 and 186 (7.7%) for the SDAI...

  7. Rates and predictors of remission, recurrence and conversion to bipolar disorder after the first lifetime episode of depression

    DEFF Research Database (Denmark)

    Bukh, J. D.; Andersen, P. K.; Kessing, L. V.

    2016-01-01

    .6% converted to bipolar disorder (6.3% within the first 2 years). Non-remission increased with younger age, co-morbid anxiety and suicidal ideations. Recurrence increased with severity and treatment resistance of the first depression, and conversion to bipolar disorder with treatment resistance, a family......BACKGROUND: In depression, non-remission, recurrence of depressive episodes after remission and conversion to bipolar disorder are crucial determinants of poor outcome. The present study aimed to determine the cumulative incidences and clinical predictors of these long-term outcomes after the first...... to 2013. Cumulative incidences and the influence of clinical variables on the rates of remission, recurrence and conversion to bipolar disorder, respectively, were estimated by survival analysis techniques. RESULTS: Within 5 years, 83.3% obtained remission, 31.5% experienced recurrence of depression and 8...

  8. Does early improvement in depressive symptoms predict subsequent remission in patients with depression who are treated with duloxetine?

    Directory of Open Access Journals (Sweden)

    Sueki A

    2016-05-01

    Full Text Available Akitsugu Sueki, Eriko Suzuki, Hitoshi Takahashi, Jun Ishigooka Department of Neuropsychiatry, Tokyo Women’s Medical University, Tokyo, Japan Purpose: In this prospective study, we examined whether early reduction in depressive symptoms predicts later remission to duloxetine in the treatment of depression, as monitored using the Montgomery–Asberg Depression Rating Scale (MADRS. Patients and methods: Among the 106 patients who were enrolled in this study, 67 were included in the statistical analysis. A clinical evaluation using the MADRS was performed at weeks 0, 4, 8, 12, and 16 after commencing treatment. For each time point, the MADRS total score was separated into three components: dysphoria, retardation, and vegetative scores. Results: Remission was defined as an MADRS total score of ≤10 at end point. From our univariate logistic regression analysis, we found that improvements in both the MADRS total score and the dysphoria score at week 4 had a significant interaction with subsequent remission. Furthermore, age and sex were significant predictors of remission. There was an increase of approximately 4% in the odds of remission for each unit increase in age, and female sex had an odds of remission of 0.318 times that of male sex (remission rate for men was 73.1% [19/26] and for women 46.3% [19/41]. However, in the multivariate model using the change from baseline in the total MADRS, dysphoria, retardation, and vegetative scores at week 4, in which age and sex were included as covariates, only sex retained significance, except for an improvement in the dysphoria score. Conclusion: No significant interaction was found between early response to duloxetine and eventual remission in this study. Sex difference was found to be a predictor of subsequent remission in patients with depression who were treated with duloxetine, with the male sex having greater odds of remission. Keywords: antidepressant, early response, sex difference, serotonin

  9. Prediction of response to remission induction therapy by gene expression profiling of peripheral blood in Japanese patients with microscopic polyangiitis.

    Science.gov (United States)

    Ishizu, Akihiro; Tomaru, Utano; Masuda, Sakiko; Sada, Ken-Ei; Amano, Koichi; Harigai, Masayoshi; Kawaguchi, Yasushi; Arimura, Yoshihiro; Yamagata, Kunihiro; Ozaki, Shoichi; Dobashi, Hiroaki; Homma, Sakae; Okada, Yasunori; Sugiyama, Hitoshi; Usui, Joichi; Tsuboi, Naotake; Matsuo, Seiichi; Makino, Hirofumi

    2017-05-31

    Microscopic polyangiitis (MPA), which is classified as an anti-neutrophil cytoplasmic antibody (ANCA)-associated small vessel vasculitis, is one of the most frequent primary vasculitides in Japan. We earlier nominated 16 genes (IRF7, IFIT1, IFIT5, OASL, CLC, GBP-1, PSMB9, HERC5, CCR1, CD36, MS4A4A, BIRC4BP, PLSCR1, DEFA1/DEFA3, DEFA4, and COL9A2) as predictors of response to remission induction therapy against MPA. The aim of this study is to determine the accuracy of prediction using these 16 predictors. Thirty-nine MPA patients were selected randomly and retrospectively from the Japanese nationwide RemIT-JAV-RPGN cohort and enrolled in this study. Remission induction therapy was conducted according to the Guidelines of Treatment for ANCA-Associated Vasculitis published by the Ministry of Health, Labour, and Welfare of Japan. Response to remission induction therapy was predicted by profiling the altered expressions of the 16 predictors between the period before and 1 week after the beginning of treatment. Remission is defined as the absence of clinical manifestations of active vasculitis (Birmingham Vasculitis Activity Score 2003: 0 or 1 point). Persistent remission for 18 months is regarded as a "good response," whereas no remission or relapse after remission is regarded as a "poor response." "Poor" and "good" responses were predicted in 7 and 32 patients, respectively. Five out of 7 patients with "poor" prediction and 1 out of 32 patients with "good" prediction experienced relapse after remission. One out of 7 patients with "poor" prediction was not conducted to remission. Accordingly, the sensitivity and specificity to predict poor response was 85.7% (6/7) and 96.9% (31/32), respectively. Response to remission induction therapy can be predicted by monitoring the altered expressions of the 16 predictors in the peripheral blood at an early point of treatment in MPA patients.

  10. Clinical Global Impression of Improvement (CGI-I) as a valid proxy measure for remission in schizophrenia: analyses of ziprasidone clinical study data.

    Science.gov (United States)

    Masand, Prakash; O'Gorman, Cedric; Mandel, Francine S

    2011-03-01

    To determine the degree to which a proxy measure of remission in schizophrenia correlates with the criteria identified by the Remission in Schizophrenia Working Group, and how well early treatment response to ziprasidone predicts remission. Data from 10 ziprasidone studies were analyzed to determine rates of remission achieved with ziprasidone using a remission definition of Clinical Global Impression of Improvement (CGI-I) of 1, and compared with rates of remission achieved using the remission working group criteria. Positive and Negative Syndrome Scale (PANSS) and Brief Psychiatric Rating Scale (BPRS) scores were then investigated as predictors of remission. A CGI-I score of 1 correlated with the remission criteria developed by the remission working group. In the combined ziprasidone arms, BPRS scores at Weeks 1, 3, and 4 successfully predicted PANSS remission (pproxy measure for the assessment of remission should be easy to apply in a clinical setting and facilitates the prediction of remission in schizophrenia. Copyright © 2010 Elsevier B.V. All rights reserved.

  11. Toward an online cognitive and emotional battery to predict treatment remission in depression

    Directory of Open Access Journals (Sweden)

    Gordon E

    2015-02-01

    Full Text Available Evian Gordon,1 A John Rush,2 Donna M Palmer,3,4 Taylor A Braund,3 William Rekshan1 1Brain Resource, San Francisco, CA, USA; 2Duke-NUS, Singapore; 3Brain Resource, Sydney, NSW, Australia; 4Brain Dynamics Center, Sydney Medical School – Westmead and Westmead Millennium Institute, The University of Sydney, Sydney, NSW, Australia Purpose: To evaluate the performance of a cognitive and emotional test battery in a representative sample of depressed outpatients to inform likelihood of remission over 8 weeks of treatment with each of three common antidepressant medications. Patients and methods: Outpatients 18–65 years old with nonpsychotic major depressive disorder (17 sites were randomized to escitalopram, sertraline or venlafaxine-XR (extended release. Participants scored ≥12 on the baseline 16-item Quick Inventory of Depressive Symptomatology – Self-Report and completed 8 weeks of treatment. The baseline test battery measured cognitive and emotional status. Exploratory multivariate logistic regression models predicting remission (16-item Quick Inventory of Depressive Symptomatology – Self-Report score ≤5 at 8 weeks were developed independently for each medication in subgroups stratified by age, sex, or cognitive and emotional test performance. The model with the highest cross-validated accuracy determined the participant proportion in each arm for whom remission could be predicted with an accuracy ≥10% above chance. The proportion for whom a prediction could be made with very high certainty (positive predictive value and negative predictive value exceeding 80% was calculated by incrementally increasing test battery thresholds to predict remission/non-remission. Results: The test battery, individually developed for each medication, improved identification of remitting and non-remitting participants by ≥10% beyond chance for 243 of 467 participants. The overall remission rates were escitalopram: 40.8%, sertraline: 30.3%, and

  12. “Everyone Needs a Friend Sometimes” – Social Predictors of Long-term Remission In first Episode psychosis

    Directory of Open Access Journals (Sweden)

    Jone Bjornestad

    2016-10-01

    Full Text Available BackgroundPredictors of long-term symptomatic remission are crucial to the successful tailoring of treatment in first episode psychosis. There is lack of studies distinguishing the predictive effects of different social factors. This prevents a valid evaluating of their independent effects.ObjectivesTo test specific social baseline predictors of long-term remission. We hypothesized that first, satisfaction with social relations predicts remission; second, that frequency of social interaction predicts remission; and third, that the effect of friend relationship satisfaction and frequency will be greater than that of family relations satisfaction and frequency.Material and MethodsA sample of first episode psychosis (n=186 completed baseline measures of social functioning, as well as clinical assessments. We compared groups of remitted and non-remitted individuals using generalized estimating equations analyses.ResultsFrequency of social interaction with friends was a significant positive predictor of remission over a two-year period. Neither global perceived social satisfaction nor frequency of family interaction showed significant effects. ConclusionsThe study findings are of particular clinical importance since frequency of friendship interaction is a possibly malleable factor. Frequency of interaction could be affected through behavioral modification and therapy already from an early stage in the course, and thus increase remission rates.KeywordsFirst-Episode Psychosis, Schizophrenia, Social factors, Baseline predictors, Long-term remission.

  13. APPEARANCE OF OCULAR MULTIPLE MYELOMA DURING REMISSION PERIOD: A RARE CASE REPORT

    Directory of Open Access Journals (Sweden)

    Lohit Kumar

    2015-04-01

    Full Text Available We report a case of a 54 - year - old female with history of multiple myeloma on remission with botizomib - dexamethasone regien treatment presents with enlargement and coming out of her right eye with pain, swelling, tearing and pain in the backbone. On examination, it was found that she has proptosis, chemosis, and diplopia along with marked diminision of vision. Initial workup and treatment did not yield significant results; eventually she was found to have myelomatous changes in her right orbit on CT scan & magnetic resonance imaging (MRI of orbit and was diagnosed with multiple myeloma of the orbit that resolved some amount with radiation. This case tends to highlight the importance of considering myeloma of the orbit in a multiple myeloma patient who is on remission with chemotherapy

  14. Granulocytic sarcoma in a patient with chronic myeloid leukaemia in complete haematological, cytogenetic and molecular remission.

    Science.gov (United States)

    Kittai, Adam; Yu, Eun-Mi; Tabbara, Imad

    2014-12-23

    Granulocytic sarcoma, also known as myeloid sarcoma, is an extramedullary tumour composed of immature myeloid cells. Granulocytic sarcoma is typically found in patients with acute myeloid leukaemia, accelerated phase or blast crisis of chronic myeloid leukaemia, myelodysplastic syndrome, or as an isolated event without bone marrow involvement. We present a case of granulocytic sarcoma in a patient with chronic myeloid leukaemia in the setting of complete haematological, molecular and cytogenetic remission. Our patient was first treated with imatinib for chronic-phase chronic myeloid leukaemia. After maintaining remission for 42 months, he developed a granulocytic sarcoma in his spine. In this case report, we describe our case, along with the three other cases reported in the literature. In addition to being a rare diagnosis, this case demonstrates the importance of being vigilant in diagnosing the cause of back pain and atypical symptoms in patients with a history of leukaemia. 2014 BMJ Publishing Group Ltd.

  15. Pioglitazone could induce remission in major depression: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Colle R

    2016-12-01

    Full Text Available Romain Colle,1,* Delphine de Larminat,1,* Samuel Rotenberg,1 Franz Hozer,1 Patrick Hardy,1 Céline Verstuyft,2 Bruno Fève,3,* Emmanuelle Corruble1,* 1Psychiatry Department, Hôpital Bicêtre, INSERM, UMR S1178, University Paris-Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France; 2Molecular Genetic, Pharmacogenetics and Hormonology Department, Hôpital Bicêtre, INSERM UMR_S1184, Centre IMVA, University Paris-Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France; 3Endocrinology Department, INSERM UMR_S938, Hôpital Saint-Antoine, Centre de Recherche Saint-Antoine, Institut Hospitalo-Universitaire ICAN, Sorbonne Universités, Université Pierre et Marie Curie, Assistance Publique des Hôpitaux de Paris, Paris, France *These authors contributed equally to this work Background: Pioglitazone, a selective agonist of the nuclear transcription factor peroxisome proliferator-activated receptor-gamma (PPAR-γ, prescribed for the treatment of type 2 diabetes, could have antidepressant properties. However, its potential to induce remission of major depressive episodes, the optimal clinical target for an antidepressant drug, is a matter of concern. Indeed, only one out of four double-blind randomized controlled trials show higher remission rates with pioglitazone than with control treatments. Hence, the main aim of this study was to perform a meta-analysis of the efficacy of pioglitazone for the treatment of MDE, focusing on remission rates.Methods: Four double-blind randomized controlled trials, comprising 161 patients with an MDE, were included in this meta-analysis. Pioglitazone was studied either alone (one study or as add-on therapy to conventional treatments (antidepressant drugs or lithium salts. It was compared either to placebo (three studies or to metformin (one study. Remission was defined by a Hamilton Depression Rating Scale score <8 after treatment.Results: Pioglitazone could induce higher remission

  16. Temporary remission of disseminated paecilomycosis in a German shepherd dog treated with ketoconazole : case report

    Directory of Open Access Journals (Sweden)

    M.J. Booth

    2001-07-01

    Full Text Available Disseminated mycosis caused by Paecilomyces varioti in a female German shepherd dog presented with chronic forelimb lameness is described. Radiographs of the swollen carpal joint revealed geographic lysis of the radial epiphysis. Diagnosis was based on cytological demonstration of fungal hyphae and chlamydiospores, as well as fungal culture of fluid obtained by arthrocentesis. Temporary remission was characterised by markedly improved clinical signs and laboratory parameters, following treatment with ketoconazole. The dog was euthanased 9 months after the initial diagnosis, following the diagnosis of multifocal discospondylitis. This appears to be the longest described period of temporary remission obtained with treatment in dogs with paecilomycosis. Clinical, clinicopathological and necropsy findings of this disease in another German shepherd dog are briefly described.

  17. Antibodies to Infliximab and Adalimumab in Patients with Rheumatoid Arthritis in Clinical Remission

    DEFF Research Database (Denmark)

    Eng, Grith P; Bendtzen, Klaus; Bliddal, Henning

    2015-01-01

    Objective. To investigate if antibodies towards biological TNF-α inhibitors (anti-TNFi Abs) are present in patients with rheumatoid arthritis (RA) in clinical remission and to relate any anti-TNFi Abs to circulating level of TNF-α inhibitor (TNFi). Methods. Patients with RA, treated with infliximab....../44 patients (18%) treated with infliximab and 1/49 patients (2%) treated with adalimumab (p = 0.012). In the former group, anti-TNFi Abs corresponded with low levels of TNFi (p = 0.048). Anti-TNFi Ab-positive patients had shorter disease duration at initiation of TNFi therapy (p = 0.023) but were similar...... for the rest of the compared parameters. Conclusions. In RA patients in clinical remission, anti-TNFi Abs occur frequently in patients treated with infliximab, while they occur rarely in patients treated with adalimumab. Presence of anti-infliximab Abs is accompanied by low or undetectable levels of infliximab...

  18. Microbial shifts and signatures of long-term remission in ulcerative colitis after faecal microbiota transplantation.

    Science.gov (United States)

    Fuentes, Susana; Rossen, Noortje G; van der Spek, Mirjam J; Hartman, Jorn Ha; Huuskonen, Laura; Korpela, Katri; Salojärvi, Jarkko; Aalvink, Steven; de Vos, Willem M; D'Haens, Geert R; Zoetendal, Erwin G; Ponsioen, Cyriel Y

    2017-08-01

    Faecal microbiota transplantation (FMT) may contribute towards disease remission in ulcerative colitis (UC), but it is unknown which factors determine long-term effect of treatment. Here, we aimed to identify bacterial signatures associated with sustained remission. To this end, samples from healthy donors and UC patients-grouped into responders and non-responders at a primary end point (week 12) and further stratified by sustained clinical remission and relapse assessed at ⩾1-year follow-up were analysed, comparing the efficacy of FMT from either a healthy donor or autologous faeces. Microbiota composition was determined with a 16S rRNA gene-based phylogenetic microarray on faecal and mucosal samples, and functional profiles were predicted using PICRUSt with quantitative PCR verification of the butyrate production capacity; short-chain fatty acids were measured in faecal samples. At baseline, UC patients showed reduced amounts of bacterial groups from the Clostridium cluster XIVa, and significantly higher levels of Bacteroidetes as compared with donors. These differences were reduced after FMT mostly in responders. Sustained remission was associated with known butyrate producers and overall increased butyrate production capacity, while relapse was associated with Proteobacteria and Bacteroidetes. Ruminococcus gnavus was found at high levels in donors of failed FMT. A microbial ecosystem rich in Bacteroidetes and Proteobacteria and low in Clostridium clusters IV and XIVa observed in UC patients after FMT was predictive of poor sustained response, unless modified with a donor microbiota rich in specific members from the Clostridium clusters IV and XIVa. Additionally, sustained response was associated with restoration of the butyrate production capacity.

  19. The Diabetes Remission Clinical Trial (DiRECT): protocol for a cluster randomised trial

    OpenAIRE

    Leslie, Wilma S.; Ford, Ian; Sattar, Naveed; Hollingsworth, Kieren G.; Adamson, Ashley; Sniehotta, Falko F.; McCombie, Louise; Brosnahan, Naomi; Ross, Hazel; Mathers, John C.; Peters, Carl; Thom, George; Barnes, Alison; Kean, Sharon; McIlvenna, Yvonne

    2016-01-01

    Background Despite improving evidence-based practice following clinical guidelines to optimise drug therapy, Type 2 diabetes (T2DM) still exerts a devastating toll from vascular complications and premature death. Biochemical remission of T2DM has been demonstrated with weight loss around 15kg following bariatric surgery and in several small studies of non-surgical energy-restriction treatments. The non-surgical Counterweight-Plus programme, running in Primary Care where obesity and T2DM are r...

  20. Achieving Remission in Gulf War Illness: A Simulation-Based Approach to Treatment Design.

    Directory of Open Access Journals (Sweden)

    Travis J A Craddock

    Full Text Available Gulf War Illness (GWI is a chronic multi-symptom disorder affecting up to one-third of the 700,000 returning veterans of the 1991 Persian Gulf War and for which there is no known cure. GWI symptoms span several of the body's principal regulatory systems and include debilitating fatigue, severe musculoskeletal pain, cognitive and neurological problems. Using computational models, our group reported previously that GWI might be perpetuated at least in part by natural homeostatic regulation of the neuroendocrine-immune network. In this work, we attempt to harness these regulatory dynamics to identify treatment courses that might produce lasting remission. Towards this we apply a combinatorial optimization scheme to the Monte Carlo simulation of a discrete ternary logic model that represents combined hypothalamic-pituitary-adrenal (HPA, gonadal (HPG, and immune system regulation in males. In this work we found that no single intervention target allowed a robust return to normal homeostatic control. All combined interventions leading to a predicted remission involved an initial inhibition of Th1 inflammatory cytokines (Th1Cyt followed by a subsequent inhibition of glucocorticoid receptor function (GR. These first two intervention events alone ended in stable and lasting return to the normal regulatory control in 40% of the simulated cases. Applying a second cycle of this combined treatment improved this predicted remission rate to 2 out of 3 simulated subjects (63%. These results suggest that in a complex illness such as GWI, a multi-tiered intervention strategy that formally accounts for regulatory dynamics may be required to reset neuroendocrine-immune homeostasis and support extended remission.

  1. Remission of diabetes mellitus in cats cannot be predicted by the arginine stimulation test

    OpenAIRE

    Tschuor, F

    2011-01-01

    Background: Responsiveness of β-cells to arginine persists the longest during diabetes progression, making the intravenous arginine stimulation test (IVAST) a useful tool to assess residual insulin and glucagon secretion. Hypothesis: Diabetic cats with and without remission will have different arginine-induced insulin or glucagon response. Animals: 17 cats with diabetes, 7 healthy cats. Methods: Response to IVAST was assessed by calculating insulin and glucagon area under the c...

  2. Complete Remission of Unresectable Hepatocellular Carcinoma After Combined Sorafenib and Adjuvant Yttrium-90 Radioembolization.

    Science.gov (United States)

    Lorenzin, Dario; Pravisani, Riccardo; Leo, Cosimo Alex; Bugiantella, Walter; Soardo, Giorgio; Carnelutti, Alessia; Umberto, Baccarani; Risaliti, Andrea

    2016-03-01

    Sorafenib has improved the median overall survival of unresectable or otherwise untreatable hepatocellular carcinoma (HCC) of ∼3 months, compared to supportive cares. Complete response, although rare, has been reported. The authors reported herein a case of complete biochemical and radiological remission of advanced unresectable HCC with lymph node metastasis and tumoral portal vein thrombosis treated by 5 months therapy with sorafenib followed by adjuvant Yttrium-90 radioembolization. At 12 months follow-up, there is no evidence of HCC recurrence.

  3. Persistent glucocorticoid resistance in systemic lupus erythematosus patients during clinical remission.

    Science.gov (United States)

    Melo, A K G; Melo, M R; Saramago, A B A; Demartino, G; Souza, B D B; Longui, C A

    2013-06-20

    Glucocorticoids (GCs) are key drugs in the treatment of systemic lupus erythematosus (SLE). GC dose reduction during remission is related to disease activity, GC dose used, length of treatment, and individual GC sensitivity. We compared GC receptor α (GRα) isoform and nuclear factor kappaB (NF-κB) messenger RNA quantitation and in vivo GC sensitivity between SLE patients during remission and healthy controls. We performed a cross-sectional study of 19 women aged 22-49 years, including 9 SLE patients in clinical remission taking ≤5 mg prednisone and 10 matched controls. We evaluated GC sensitivity using 2 cortisol suppression tests: a very-low-dose intravenous dexamethasone suppression test (VLD-IV-DST) and a low-dose oral dexamethasone suppression test. GRα and NF-κB mRNA were quantified using real-time polymerase chain reaction. Although basal cortisol and adrenocorticotropic hormone levels were similar between the groups, the percentage of cortisol reduction after the VLD-IV-DST was 56% lower in SLE patients than in controls (P = 0.014). GRα and NF-κB gene expression levels were similar between the groups. The low-dose oral dexamethasone test caused intense cortisol suppression in all individuals, limiting the ability of this test to discriminate individual GC sensitivity. A positive correlation was found between the extent of cortisol suppression in vivo (VLD-IV-DST) and the number of days elapsed since the last flare of lupus activity. Despite clinical remission, SLE patients displayed partial GC resistance recognized by the VLD-IV-DST. The mechanism of this resistance is unrelated to altered GRα and NF-κB mRNA expression.

  4. The Diabetes Remission Clinical Trial (DiRECT): protocol for a cluster randomised trial.

    Science.gov (United States)

    Leslie, Wilma S; Ford, Ian; Sattar, Naveed; Hollingsworth, Kieren G; Adamson, Ashley; Sniehotta, Falko F; McCombie, Louise; Brosnahan, Naomi; Ross, Hazel; Mathers, John C; Peters, Carl; Thom, George; Barnes, Alison; Kean, Sharon; McIlvenna, Yvonne; Rodrigues, Angela; Rehackova, Lucia; Zhyzhneuskaya, Sviatlana; Taylor, Roy; Lean, Mike E J

    2016-02-16

    Despite improving evidence-based practice following clinical guidelines to optimise drug therapy, Type 2 diabetes (T2DM) still exerts a devastating toll from vascular complications and premature death. Biochemical remission of T2DM has been demonstrated with weight loss around 15kg following bariatric surgery and in several small studies of non-surgical energy-restriction treatments. The non-surgical Counterweight-Plus programme, running in Primary Care where obesity and T2DM are routinely managed, produces >15 kg weight loss in 33% of all enrolled patients. The Diabetes UK-funded Counterpoint study suggested that this should be sufficient to reverse T2DM by removing ectopic fat in liver and pancreas, restoring first-phase insulin secretion. The Diabetes Remission Clinical Trial (DiRECT) was designed to determine whether a structured, intensive, weight management programme, delivered in a routine Primary Care setting, is a viable treatment for achieving durable normoglycaemia. Other aims are to understand the mechanistic basis of remission and to identify psychological predictors of response. Cluster-randomised design with GP practice as the unit of randomisation: 280 participants from around 30 practices in Scotland and England will be allocated either to continue usual guideline-based care or to add the Counterweight-Plus weight management programme, which includes primary care nurse or dietitian delivery of 12-20weeks low calorie diet replacement, food reintroduction, and long-term weight loss maintenance. Main inclusion criteria: men and women aged 20-65 years, all ethnicities, T2DM 0-6years duration, BMI 27-45 kg/m(2). Tyneside participants will undergo Magnetic Resonance (MR) studies of pancreatic and hepatic fat, and metabolic studies to determine mechanisms underlying T2DM remission. Co-primary endpoints: weight reduction ≥ 15 kg and HbA1c service strategy. Current Controlled Trials ISRCTN03267836 . Date of Registration 20/12/2013.

  5. Achieving Remission in Gulf War Illness: A Simulation-Based Approach to Treatment Design.

    Science.gov (United States)

    Craddock, Travis J A; Del Rosario, Ryan R; Rice, Mark; Zysman, Joel P; Fletcher, Mary Ann; Klimas, Nancy G; Broderick, Gordon

    2015-01-01

    Gulf War Illness (GWI) is a chronic multi-symptom disorder affecting up to one-third of the 700,000 returning veterans of the 1991 Persian Gulf War and for which there is no known cure. GWI symptoms span several of the body's principal regulatory systems and include debilitating fatigue, severe musculoskeletal pain, cognitive and neurological problems. Using computational models, our group reported previously that GWI might be perpetuated at least in part by natural homeostatic regulation of the neuroendocrine-immune network. In this work, we attempt to harness these regulatory dynamics to identify treatment courses that might produce lasting remission. Towards this we apply a combinatorial optimization scheme to the Monte Carlo simulation of a discrete ternary logic model that represents combined hypothalamic-pituitary-adrenal (HPA), gonadal (HPG), and immune system regulation in males. In this work we found that no single intervention target allowed a robust return to normal homeostatic control. All combined interventions leading to a predicted remission involved an initial inhibition of Th1 inflammatory cytokines (Th1Cyt) followed by a subsequent inhibition of glucocorticoid receptor function (GR). These first two intervention events alone ended in stable and lasting return to the normal regulatory control in 40% of the simulated cases. Applying a second cycle of this combined treatment improved this predicted remission rate to 2 out of 3 simulated subjects (63%). These results suggest that in a complex illness such as GWI, a multi-tiered intervention strategy that formally accounts for regulatory dynamics may be required to reset neuroendocrine-immune homeostasis and support extended remission.

  6. Remission rate of implant-related infections following revision surgery after fractures.

    Science.gov (United States)

    Al-Mayahi, Mohamed; Betz, Michael; Müller, Daniel A; Stern, Richard; Tahintzi, Phedon; Bernard, Louis; Hoffmeyer, Pierre; Suvà, Domizio; Uçkay, Ilker

    2013-11-01

    In contrast to a large amount of epidemiological data regarding the incidence of implant infections after fracture management, surprisingly few have been published concerning the success of their treatment. This was a single-centre cohort study at Geneva University Hospitals from 2000 to 2012 investigating the remission rates of orthopaedic implant infections after fracture repair and associated variables. A total of 139 episodes were included: There were 51 women (37%) and 28 immunosuppressed (20%) patients with a median age and American Society of Anaesthesiologists (ASA) score of 51 years and 2 points, respectively. The infected implants were plates (n = 75, 54 %), nails (24, 17%), wires (20), screws (10), cerclage cables or wires (3), hip screws (4) or material for spondylodesis (3). A pathogen was identified in 135 (97%) cases, including Staphylococcus aureus (73, 52%), coagulase-negative staphylococci (20), streptococci (7) and 19 Gram-negative rods. All patients underwent antibiotic treatment, and 128 (92%) remained in remission at a median follow-up time of 2.6 years (range one to 13 years). In multivariate logistic regression analysis, the plate infections were significantly associated with lower remission rates [65/75, 87%, odds ratio (OR) 0.1, 95% confidence interval (CI) 0.01-0.90]. No associations were found for gender, age, immune status, ASA score, additional surgical interventions (OR 0.4, 95% CI 0.1-4.1) or duration of antibiotic treatment (OR 1.0, 95% CI 0.98-1.01). Among all infected and removed orthopaedic implants, plates were associated with slightly lower remission rates, while the overall treatment success exceeded 90%. The duration of antibiotic therapy did not alter the outcome.

  7. Serotonin transporter binding as a possible predictor of one-year remission in major depressive disorder.

    Science.gov (United States)

    Miller, Jeffrey M; Oquendo, Maria A; Ogden, R Todd; Mann, J John; Parsey, Ramin V

    2008-10-01

    Lower serotonin transporter (5-HTT) binding (BP(P)=f(P)B(avail)/K(D)) is reported during a major depressive episode (MDE) compared to healthy controls. Higher 5-HTT binding in the diencephalon has previously been associated with acute response to antidepressant treatment. We assessed baseline 5-HTT binding as a predictor of one-year remission from a MDE, examining binding in brain regions implicated in the pathophysiology of major depressive disorder (MDD). 5-HTT binding was quantified using positron emission tomography (PET) with [(11)C]McN5652 in 19 currently depressed subjects with MDD and 41 healthy controls. Depressed subjects received open, naturalistic antidepressant treatment. Remission status was determined one year after PET scan and treatment initiation. Significant differences in 5-HTT binding among the three groups (healthy controls, remitters, and non-remitters) were observed in a linear mixed-effects model. Post hoc, non-remitters had lower 5-HTT binding than controls in midbrain, amygdala, and anterior cingulate. Remitters did not differ significantly from controls or non-remitters in 5-HTT binding. Remitters did not differ from non-remitters in clinical characteristics apart from greater family history of depression among non-remitters. A logistic regression model fit to determine the capacity of baseline 5-HTT binding to predict remission status at one year yielded a coefficient that was suggestive but not significant (p=0.057). The small sample size and heterogeneous treatments received reduced statistical power to detect differences in binding based on clinical outcome. Lower pretreatment 5-HTT binding may be predictive of non-remission from major depression following one year of naturalistic antidepressant treatment. Future studies using standardized treatment are warranted.

  8. Influence of dietary isoflavone intake on gastrointestinal symptoms in ulcerative colitis individuals in remission.

    Science.gov (United States)

    Głąbska, Dominika; Guzek, Dominika; Grudzińska, Dominika; Lech, Gustaw

    2017-08-07

    To analyse the association between isoflavone intake and ulcerative colitis motility symptoms in individuals in remission. Cross-sectional study was conducted in a group of ulcerative colitis remission individuals, in sub-groups characterised by various intestinal motility and functioning characteristics (abdominal pain, flatulence, constipations, tenesmus). Total of 56 individuals with ulcerative colitis in remission (19 males and 37 females) were recruited for the study. Assessment of diet was based on self-reported data from each patient's dietary records taken over a period of three typical, random days (2 weekdays and 1 d of the weekend). The daily isoflavone intake (daidzein, genistein, glycitein and total isoflavones) and daily isoflavone intake per 1000 kcal of diet were assessed. No correlations between isoflavone intake levels and number of bowel movements per day were observed both in the case of intake and intake per 1000 kcal of diet. In the group of individuals declaring lack of abdominal pain, the higher intakes of daidzein ( P = 0.0075), daidzein per 1000 kcal of diet ( P = 0.0358) and total isoflavone ( P = 0.0358) were stated, than in the group of individuals declaring abdominal pain. In the group of individuals declaring lack of constipations, the lower intakes of glycitein ( P = 0.0213) and glycitein per 1000 kcal of diet ( P = 0.0213) were stated, than in the group of individuals declaring presence of constipations. No differences were observed in isoflavone intake between groups of ulcerative colitis individuals declaring lack of flatulence and declaring presence of flatulence, as well as between groups declaring lack of tenesmus and declaring presence of tenesmus. The moderate dietary isoflavone intake may be beneficial for individuals with ulcerative colitis in remission, however, before including it into recommendations, further prospective studies are needed.

  9. Establishing the cut-off score for remission and severity-ranges on the Psychotic Depression Assessment Scale (PDAS)

    DEFF Research Database (Denmark)

    Østergaard, Søren D; Rothschild, Anthony J; Flint, Alastair J

    2016-01-01

    BACKGROUND: The Psychotic Depression Assessment Scale (PDAS) is a rating scale dedicated to the measurement of severity in psychotic depression (PD). The aim of this study was to establish the PDAS cut-off for remission of PD as well as PDAS score-ranges for mild, moderate, and severe PD....... The secondary aim was to test how remission, as defined by the PDAS, would perform as outcome measure when applied to the data from a large randomized controlled trial (RCT) in PD. METHODS: The study was based on data from the Study of Pharmacotherapy in Psychotic Depression (STOP-PD). The cut-off for remission...

  10. Persistence and remission of ADHD during adulthood: a 7-year clinical follow-up study.

    Science.gov (United States)

    Karam, R G; Breda, V; Picon, F A; Rovaris, D L; Victor, M M; Salgado, C A I; Vitola, E S; Silva, K L; Guimarães-da-Silva, P O; Mota, N R; Caye, A; Belmonte-de-Abreu, P; Rohde, L A; Grevet, E H; Bau, C H D

    2015-07-01

    Course and predictors of persistence of attention deficit hyperactivity disorder (ADHD) in adults are still largely unknown. Neurobiological and clinical differences between child and adult ADHD raise the need for follow-up studies of patients diagnosed during adulthood. This study investigates predictors of ADHD persistence and the possibility of full remission 7 years after baseline assessment. A 7-year follow-up study of adults with ADHD (n = 344, mean age 34.1 years, 49.9% males) was conducted. Variables from different domains (social demographics, co-morbidities, temperament, medication status, ADHD measures) were explored with the aim of finding potential predictors of ADHD persistence. Retention rate was 66% (n = 227). Approximately a third of the sample (n = 70, 30.2%) did not maintain ADHD criteria and 28 (12.4%) presented full remission (brain maturation in adults suggests stability, approximately one third of the sample did not keep full DSM-IV diagnosis at follow-up, regardless if at early, middle or older adulthood. Although full remission is less common than in childhood, it should be considered as a possible outcome among adults.

  11. Ibrutinib treatment of a patient with relapsing chronic lymphocytic leukemia and sustained remission of Richter syndrome.

    Science.gov (United States)

    Albi, Elisa; Baldoni, Stefano; Aureli, Patrizia; Dorillo, Erica; Del Papa, Beatrice; Ascani, Stefano; Di Ianni, Mauro; Falzetti, Franca; Sportoletti, Paolo

    2017-11-15

    Richter syndrome (RS) is a rare event in chronic lymphocytic leukemia (CLL) that is influenced by biological factors and prior CLL treatments. Ibrutinib is a Bruton tyrosine kinase inhibitor that has shown remarkable efficacy in CLL; however, little is known about its relationship to RS. We report a case of ibrutinib efficacy against CLL in a patient with prolonged remission of RS. The patient was diagnosed with CLL in 2003. Biological findings at onset included absent ZAP70 expression, mutated IGVH, and NOTCH1 mutation. He was treated with FCR with partial response. In 2013, he progressed to RS, not clonally related to the underlying CLL. The patient was treated with anthracycline- and platinum-based regimens, obtaining a complete remission. After 3 years, he presented a CLL progression with worsening lymphocytosis, anemia, thrombocytopenia, increased splenomegaly, and lymphadenopathies. Positron emission tomography-computed tomography scan excluded pathologic uptake. Thus, he was started on ibrutinib. At 12 months' follow-up, we observed white blood cell normalization, increased hemoglobin and platelet levels, disappearance of lymphadenopathy, and spleen size reduction. Therapy was well-tolerated with no evidence of RS. This case demonstrates sustained RS remission in a patient with CLL under ibrutinib therapy, thus improving our knowledge on the use of this new drug in CLL and beyond.

  12. Decreased prefrontal functional brain response during memory testing in women with Cushing's syndrome in remission.

    Science.gov (United States)

    Ragnarsson, Oskar; Stomby, Andreas; Dahlqvist, Per; Evang, Johan A; Ryberg, Mats; Olsson, Tommy; Bollerslev, Jens; Nyberg, Lars; Johannsson, Gudmundur

    2017-08-01

    Neurocognitive dysfunction is an important feature of Cushing's syndrome (CS). Our hypothesis was that patients with CS in remission have decreased functional brain responses in the prefrontal cortex and hippocampus during memory testing. In this cross-sectional study we included 19 women previously treated for CS and 19 controls matched for age, gender, and education. The median remission time was 7 (IQR 6-10) years. Brain activity was studied with functional magnetic resonance imaging during episodic- and working-memory tasks. The primary regions of interest were the prefrontal cortex and the hippocampus. A voxel-wise comparison of functional brain responses in patients and controls was performed. During episodic-memory encoding, patients displayed lower functional brain responses in the left and right prefrontal gyrus (pmemory retrieval, the patients displayed lower functional brain responses in several brain areas with the most predominant difference in the right prefrontal cortex (pmemory task, patients had lower response in the prefrontal cortices bilaterally (pmemory task compared with a simpler one. In conclusion, women with CS in long-term remission have reduced functional brain responses during episodic and working memory testing. This observation extends previous findings showing long-term adverse effects of severe hypercortisolaemia on brain function. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Remission spectrometry for blood vessel detection during stereotactic biopsy of brain tumors.

    Science.gov (United States)

    Markwardt, Niklas A; Stepp, Herbert; Franz, Gerhard; Sroka, Ronald; Goetz, Marcus; Zelenkov, Petr; Rühm, Adrian

    2017-08-01

    Stereotactic biopsy is used to enable diagnostic confirmation of brain tumors and treatment planning. Despite being a well-established technique, it is related to significant morbidity and mortality rates mostly caused by hemorrhages due to blood vessel ruptures. This paper presents a method of vessel detection during stereotactic biopsy that can be easily implemented by integrating two side-view fibers into a conventional side-cutting biopsy needle. Tissue within the needle window is illuminated through the first fiber; the second fiber detects the remitted light. By taking the ratio of the intensities at two wavelengths with strongly differing hemoglobin absorption, blood vessels can be recognized immediately before biopsy sampling. Via ray tracing simulations and phantom experiments, the dependency of the remission ratio R = I 578 /I 650 on various parameters (blood oxygenation, fiber-to-vessel and inter-fiber distance, vessel diameter and orientation) was investigated for a bare-fiber probe. Up to 800-1200 µm away from the probe, a vessel can be recognized by a considerable reduction of the remission ratio from the background level. The technique was also successfully tested with a real biopsy needle probe on both optical phantoms and ex-vivo porcine brain tissue, thus showing potential to improve the safety of stereotactic biopsy. Dual-wavelength remission measurement for the detection of blood vessels during stereotactic biopsy. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. Leukopenia predicts remission in patients with inflammatory bowel disease and Behcet's disease on thiopurine maintenance.

    Science.gov (United States)

    Park, Mi Sung; Kim, Dong Hyun; Kim, Duk Hwan; Park, Soo Jung; Hong, Sung Pil; Kim, Tae Il; Kim, Won Ho; Cheon, Jae Hee

    2015-01-01

    The thiopurine drugs, azathioprine (AZA), and 6-mercaptopurine (6-MP) are well-established drugs for the treatment of inflammatory bowel disease (IBD). Although leukopenia is a well-recognized side effect of AZA/6-MP treatment, its association with therapeutic effects has yet to be determined. We therefore evaluated the influences of thiopurine-induced leukopenia on the long-term prognosis of IBD. We included 196 IBD patients [45 with ulcerative colitis (UC), 68 with Crohn's disease (CD), and 83 with intestinal Behçet's disease (BD)] who were treated with AZA/6-MP and achieved remission between January 2006 and December 2012. We retrospectively analyzed patient characteristics, AZA/6-MP maintenance dose (mg/kg), the lowest white blood cell (WBC) count during AZA/6-MP treatment, duration of remission, and the occurrence of relapse. We compared the clinical variables between leukopenic (n = 120, WBC count leukopenia were negatively associated with relapse (odds ratios 0.975, 0.988, 0.563, and 0.390, respectively). On subgroup analysis, the cumulative relapse-free survival rate was significantly higher in the leukopenic group than in the nonleukopenic group for all types of IBDs, including UC, CD, and intestinal BD (log-rank test, P = 0.032, 0.047, and 0.002, respectively). Leukopenia during thiopurine maintenance therapy was associated with prolonged remission in patients with IBD and Behcet's disease.

  15. Sustained remission of Cushing's disease with mitotane and pituitary irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Schteingart, D.E.; Tsao, H.S.; Taylor, C.I.; McKenzie, A.; Victoria, R.; Therrien, B.A.

    1980-05-01

    Low doses of mitotane were given orally to 36 patients with Cushing's disease, concurrently with or after pituitary cobalt irradiation. Clinical and biochemical remission occurred in 29. The response to treatment occurred early in 17 patients and late in 12. The different pattern of response to mitotane was not related to the dose given or to its serum level. Early biochemical indicators of adrenal suppression with mitotane were a sharp decrease in adrenal response to the infusion of ACTH and in plasma levels of dehydroepiandrosterone sulfate. Although mitotane was given together with pituitary irradiation, initial remission was due mainly to the adrenal effect of mitotane. Plasma ACTH levels were still elevated when cortisol had returned to normal. In seventeen of the 29 patients who responded to treatment drug therapy has been discontinued, and they remain in remission of Cushing's syndrome. Side-effects have been dose dependent, with anorexia, nausea, decreased memory, and gynecomastia in men being the commonest.

  16. The microbiome and HIV persistence: implications for viral remission and cure.

    Science.gov (United States)

    Koay, Wei Li A; Siems, Lilly V; Persaud, Deborah

    2018-01-01

    This article discusses the interaction between HIV infection, the gut microbiome, inflammation and immune activation, and HIV reservoirs, along with interventions to target the microbiome and their implications for HIV remission and cure. Most studies show that HIV-infected adults have a gut microbiome associated with decreased bacterial richness and diversity, and associated systemic inflammation and immune activation. A unique set of individuals, elite controllers, who spontaneously control HIV replication, have a similar microbiome to HIV-uninfected individuals. Conversely, exposure to maternal HIV in infants was shown to alter the gut microbiome, even in infants who escaped perinatal infection. Emerging research highlights the importance of the metabolomics and metaproteomics of the gut microbiome, which may have relevance for HIV remission and cure. Together, these studies illustrate the complexity of the relationship between HIV infection, the gut microbiome, and its systemic effects. Understanding the association of HIV with the microbiome, metabolome, and metaproteome may lead to novel therapies to decrease inflammation and immune activation, and impact HIV reservoir size and vaccine responses. Further research in this area is important to inform HIV remission and cure treatments.

  17. Weekly injection of histaglobulin produces long-term remission in chronic urticaria: A prospective clinical study

    Science.gov (United States)

    Rajesh, Gurumoorthy; Keerthi, Subramaniam; Karthikeyan, Kaliaperumal; Venkatesan, Murugan

    2016-01-01

    Objective: Treatment of chronic urticaria (CU) can be difficult in many patients. Achieving long-term remission and reducing the requirement of antihistamines are vital in CU. The objective of this study was to assess the effectiveness of injection histaglobulin, a complex of histamine and human immunoglobulin, in producing relief in patients with CU. Materials and Methods: Fifty-one patients with CU were enrolled into this prospective clinical study. Patients were administered 1 ml of injection histaglobulin subcutaneous for 8 consecutive weeks. They were also prescribed tablet levocetirizine 5 mg to be taken when required (but not more than the permitted dosage). Efficacy was assessed using urticaria activity score (UAS) which has a maximum score of 33/day, during each weekly visit. Final assessment was done after 24 weeks. Results: Twenty-nine patients had completed the entire 8-week drug regimen. Mean basal UAS was 18.9 ± 6.3 and it reduced to 80.4% by 8 weeks. The angioedema sub-score reduced by 89.8%. Anti-histamine pill burden also reduced significantly. By 24 weeks of starting the therapy, 23 patients (45%) had attained complete remission. No adverse effects to the drug were observed. Conclusions: Histaglobulin was found to be effective in producing long-term remission and it reduced the antihistamine requirement as well. Thus, it can serve as an effective alternative to existing treatment modalities. PMID:27298500

  18. Unrevealed Depression Involves Dysfunctional Coping Strategies in Crohn’s Disease Patients in Clinical Remission

    Directory of Open Access Journals (Sweden)

    Caterina Viganò

    2016-01-01

    Full Text Available Background and Aims. This study investigated the proportion of CD patients in clinical remission with clinical depression, and coping strategies in those with severe depressive disorders. Materials and Methods. One hundred consecutive CD patients in clinical remission were screened for anxiety and depression by using Hospital Anxiety and Depression Scale and patients with depressive symptoms were further investigated by means of Cognitive Behavioural Assessment 2.0 and Beck Depression Inventory (BDI. Afterwards the coping strategies were assessed through the Brief-COPE questionnaire. Results. Twenty-one patients had anxious symptoms and 16 had depressive symptoms with or without anxiety. Seven of these patients (43.8% showed significant depressive symptoms. Compared to patients without psychiatric disorders, these patients showed significant lower score in “positive reframing” (p: 0.017 and in “planning” (p: 0.046 and higher score in “use of instrumental social support” (p<0.001, in “denial” scale (p: 0.001, and in “use of emotional social support” (p: 0.003. Conclusions. Depressed CD patients in clinical remission may have dysfunctional coping strategies, meaning that they may not be able to implement functional strategies to manage at best stress related with their disease.

  19. Quality of life in schizophrenia and bipolar disorder: The impact of symptomatic remission and resilience.

    Science.gov (United States)

    Hofer, A; Mizuno, Y; Wartelsteiner, F; Wolfgang Fleischhacker, W; Frajo-Apor, B; Kemmler, G; Mimura, M; Pardeller, S; Sondermann, C; Suzuki, T; Welte, A; Uchida, H

    2017-10-01

    Health-related quality of life (HRQOL) is significantly affected in individuals with schizophrenia or bipolar I disorder (BD-I). The current study investigated whether symptomatic remission and resilience might differently impact HRQOL in these patients. Fifty-two patients with schizophrenia and 60 patients suffering from BD-I from outpatient mental health services as well as 77 healthy control subjects from the general community were included into a cross-sectional study. HRQOL and resilience were assessed using the WHOQOL-BREF and the Resilience Scale. In patients, psychopathology was quantified by the Positive and Negative Syndrome Scale or the Montgomery Asberg Depression Rating Scale and the Young Mania Rating Scale, respectively. Notably, both patient groups showed lower HRQOL and resilience compared to control subjects, non-remitted patients indicated lower HRQOL than remitted ones. The effect of remission on HRQOL was significantly larger in patients with BD-I than in those with schizophrenia but did not explain the difference in HRQOL between groups. Resilience predicted HRQOL in all three groups. When accounting for the effect of resilience among remitted patients, only the difference in HRQOL between schizophrenia patients and control subjects was significant. These findings demonstrate the impact of symptomatic remission and resilience on HRQOL of both patients suffering from schizophrenia and BD-I and indicate that these factors are especially relevant for HRQOL of patients with BD-I. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  20. Decreased activation and subsyndromal manic symptoms predict lower remission rates in bipolar depression.

    Science.gov (United States)

    Caldieraro, Marco Antonio; Walsh, Samantha; Deckersbach, Thilo; Bobo, William V; Gao, Keming; Ketter, Terence A; Shelton, Richard C; Reilly-Harrington, Noreen A; Tohen, Mauricio; Calabrese, Joseph R; Thase, Michael E; Kocsis, James H; Sylvia, Louisa G; Nierenberg, Andrew A

    2017-11-01

    Activation encompasses energy and activity and is a central feature of bipolar disorder. However, the impact of activation on treatment response of bipolar depression requires further exploration. The aims of this study were to assess the association of decreased activation and sustained remission in bipolar depression and test for factors that could affect this association. We assessed participants with Diagnostic and Statistical Manual of Mental Disorders (4th ed) bipolar depression ( n = 303) included in a comparative effectiveness study of lithium- and quetiapine-based treatments (the Bipolar CHOICE study). Activation was evaluated using items from the Bipolar Inventory of Symptoms Scale. The selection of these items was based on a dimension of energy and interest symptoms associated with poorer treatment response in major depression. Decreased activation was associated with lower remission rates in the raw analyses and in a logistic regression model adjusted for baseline severity and subsyndromal manic symptoms (odds ratio = 0.899; p = 0.015). The manic features also predicted lower remission (odds ratio = 0.934; p bipolar depression. Patients with these features may require specific treatment approaches, but new studies are necessary to identify treatments that could improve outcomes in this population.

  1. Roux-en-Y Gastric Bypass Surgery Induces Early Plasma Metabolomic and Lipidomic Alterations in Humans Associated with Diabetes Remission

    DEFF Research Database (Denmark)

    Arora, Tulika; Velagapudi, Vidya; Pournaras, Dimitri J

    2015-01-01

    -surgery levels. At 4 days after surgery, insulin levels correlated positively with metabolites of branched chain and aromatic amino acid metabolism and negatively with triglycerides with long-chain fatty acids. Of the 14 subjects with diabetes prior to surgery, 7 were in remission 2 years after surgery......Roux-en-Y gastric bypass (RYGB) is an effective method to attain sustained weight loss and diabetes remission. We aimed to elucidate early changes in the plasma metabolome and lipidome after RYGB. Plasma samples from 16 insulin-resistant morbidly obese subjects, of whom 14 had diabetes, were...... subjected to global metabolomics and lipidomics analysis at pre-surgery and 4 and 42 days after RYGB. Metabolites and lipid species were compared between time points and between subjects who were in remission and not in remission from diabetes 2 years after surgery. We found that the variables that were...

  2. The discrepancy between clinical and ultrasonographic remission in rheumatoid arthritis is not related to therapy or autoantibody status.

    Science.gov (United States)

    Spinella, Amelia; Sandri, Gilda; Carpenito, Giacomo; Belletti, Lorenza; Mascia, Maria Teresa

    2012-12-01

    To evaluate the clinical remission by means of power Doppler ultrasonographic (PDUS) monitoring in a group of patients with rheumatoid arthritis (RA) in clinical remission (DAS28 therapy with DMARDS, anti-TNF, or no therapy in clinical remission according to ACR criteria and DAS 28 therapy with anti-TNF or other therapies showed similar US assessment without significant statistical differences. Among eleven patients that presented swollen and tender joints at the latest physical examination, which preceded US exam, just 5 patients had an US confirmation too. In the other patients, the PDUS did not confirm the presence of inflammation in the corresponding swollen and tender joints or showed a positive ultrasonographic assessment in other locations. The remission state is a great therapy target and not only through the biological therapy. Synovial inflammation could persist independently from type of therapy or autoantibody status.

  3. Choking phobia: full remission following behavior therapy Fobia de deglutição: remissão com terapia comportamental

    Directory of Open Access Journals (Sweden)

    Silvia Scemes

    2009-09-01

    Full Text Available OBJECTIVE: A phobic behavior pattern is learned by classical and operant conditioning mechanisms. The present article reviews the main determinants of choking phobia etiology and describes the behavior therapy of an adult patient. METHOD: Psychoeducation, functional analysis, and graded exposure to aversive stimuli were used to treat the patient, after extensive psychiatric and psychological assessment. Ingesta and anxiety levels were measured along treatment and at follow-up. RESULTS: A multiple assessment baseline design was used to demonstrate the complete remission of symptoms after seven sessions, each of them exposing the patient to a different group of foods. CONCLUSION: Psychoeducation and exposure were critical components of a successful choking phobia treatment.OBJETIVO: O padrão comportamental da fobia é adquirido com base no condicionamento clássico e mecanismos operantes de aprendizagem. Este artigo faz uma revisão dos principais determinantes da etiologia da fobia de deglutição e descreve o tratamento da terapia comportamental em uma paciente adulta. MÉTODO: Foram usadas psicoeducação, análise funcional e gradativa exposição a estímulos aversivos no tratamento da paciente, depois de uma extensiva avaliação psiquiátrica e psicológica. Níveis de ingesta e ansiedade foram medidos ao longo de todo o tratamento e no follow-up. RESULTADOS: Para demonstrar a completa remissão dos sintomas, após sete sessões de exposição a diferentes grupos de alimentos foi usado um delineamento de linha de base de avaliações múltiplas. CONCLUSÃO: Terapia de exposição e psicoeducação foram componentes que contribuíram de modo crítico para a obtenção de resultados positivos ao tratamento.

  4. American College of Rheumatology/European League against Rheumatism Preliminary Definition of Remission in Rheumatoid Arthritis for Clinical Trials

    Science.gov (United States)

    Felson, David T.; Smolen, Josef S.; Wells, George; Zhang, Bin; van Tuyl, Lilian H. D.; Funovits, Julia; Aletaha, Daniel; Allaart, Renée; Bathon, Joan; Bombardieri, Stefano; Brooks, Peter; Brown, Andrew; Matucci-Cerinic, Marco; Choi, Hyon; Combe, Bernard; de Wit, Maarten; Dougados, Maxime; Emery, Paul; Furst, Dan; Gomez-Reino, Juan; Hawker , Gillian; Keystone, Edward; Khanna, Dinesh; Kirwan, John; Kvien, Tore; Landewé, Robert; Listing, Joachim; Michaud, Kaleb; Mola, Emilio Martin; Montie, Pam; Pincus, Ted; Richards, Pam; Siegel, Jeff; Simon, Lee; Sokka, Tuulikki; Strand, Vibeke; Tugwell, Peter; Tyndall, Alan; van der Heijde, Desirée; Verstappen, Suzan; White, Barbara; Wolfe, Fred; Zink, Angela; Boers, Maarten

    2010-01-01

    Background With remission in rheumatoid arthritis (RA) an increasingly attainable goal, there is no widely used definition of remission that is stringent but achievable and could be applied uniformly as an outcome in clinical trials. Methods A committee consisting of members of the American College of Rheumatology, the European League Against Rheumatism and the Outcome Measures in Rheumatology Initiative (OMERACT) met to guide the process and review prespecified analyses from clinical trials of patients with RA. The committee requested a stringent definition (little, if any, active disease) and decided to use core set measures to define remission including at least joint counts and an acute phase reactant. Members were surveyed to select the level of each core set measure consistent with remission. Candidate definitions of remission were tested including those that constituted a number of individual measures in remission (Boolean approach) as well as definitions using disease activity indexes. To select a definition of remission, trial data were analyzed to examine the added contribution of patient reported outcomes and the ability of candidate measures to predict later good x-ray and functional outcomes. Results Survey results for the definition of remission pointed to indexes at published thresholds and to a count of core set measures with each measure scored as 1 or less (e.g. tender and swollen joint counts, CRP and global assessments on 0-10 scale). Analyses suggested the need to include a patient reported measure. Examination of 2 year follow-up data suggested that many candidate definitions performed comparably in terms of predicting later good x-ray and functional outcomes, although DAS28 based measures of remission did not predict good radiographic outcomes as well as did the other candidate definitions. Given these and other considerations, we propose that a patient be defined as in remission based on one of two definitions : 1: When their scores on the

  5. Baseline red blood cell distribution width predicts long-term glycemic remission in patients with type 2 diabetes.

    Science.gov (United States)

    Xu, Lijuan; Wang, Liangjiao; Huang, Xinwei; Liu, Liehua; Ke, Weijian; He, Xiaoying; Huang, Zhimin; Liu, Juan; Wan, Xuesi; Cao, Xiaopei; Li, Yanbing

    2017-09-01

    We explored whether red blood cell distribution width (RDW), a routinely checked item of complete blood cell counts, was an indicator of long-term euglycemia remission in patients with type 2 diabetes after short-term continuous subcutaneous insulin infusion (CSII). We analyzed the original data of patients enrolled in three randomized control trials from 2002 to 2014. CSII was administered to drug-naїve patients with newly diagnosed type 2 diabetes to achieve and maintain euglycemia for 2weeks. A total of 185 patients were involved and 98 patients (52.97%) who achieved and maintained euglycemia for at least 12months were classified as the remission group, and the others as the non-remission group. Patients in remission group had a relatively lower value for baseline RDW (38.82±2.76vs 39.89±2.78fL, p=0.017) compared with those in non-remission group. A graded decrease of remission rate (67.50%, 55.00%, 53.66% and 30.77% for Quartile 1 to Quartile 4 respectively, P<0.05) was observed with the increasing of RDWs. The risk of hyperglycemic relapse was significantly increased for those in the highest quartile compared with the lowest (hazard ratio=2.68; 95% CI, 1.38-5.22). Those who achieved euglycemia within 7days or obtained a better fasting glucose after therapy had preferable remission rates. Patients with lower baseline RDWs are more likely to maintain a one-year euglycemia remission after short-term CSII. A faster normalization of glucose during treatment and a lower fasting glucose after therapy are correlated with a long-term glucose control. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Fedmekirurgi er mere effektiv end medicinsk behandling til opnåelse af remission af type 2-diabetes

    DEFF Research Database (Denmark)

    Klein, Mads; Rosenberg, Jacob; Gögenur, Ismail

    2013-01-01

    Observational studies have shown that bariatric surgery can lead to remission of diabetes mellitus type 2 (DMII), but randomized controlled trials have been lacking. Recently, randomized controlled trials comparing bariatric surgery with optimal medical treatment in patients suffering from poorly...... controlled DMII, have been performed. These trials show that bariatric surgery in general, and the malabsorptive procedures in particular, are more effective than medical treatment in achieving remission of DMII. These procedures should therefore be considered in the treatment of patients with DMII...

  7. Roux-en-Y Gastric Bypass Surgery Induces Early Plasma Metabolomic and Lipidomic Alterations in Humans Associated with Diabetes Remission.

    Directory of Open Access Journals (Sweden)

    Tulika Arora

    Full Text Available Roux-en-Y gastric bypass (RYGB is an effective method to attain sustained weight loss and diabetes remission. We aimed to elucidate early changes in the plasma metabolome and lipidome after RYGB. Plasma samples from 16 insulin-resistant morbidly obese subjects, of whom 14 had diabetes, were subjected to global metabolomics and lipidomics analysis at pre-surgery and 4 and 42 days after RYGB. Metabolites and lipid species were compared between time points and between subjects who were in remission and not in remission from diabetes 2 years after surgery. We found that the variables that were most discriminatory between time points were decanoic acid and octanoic acid, which were elevated 42 days after surgery, and sphingomyelins (18:1/21:0 and 18:1/23:3, which were at their lowest level 42 days after surgery. Insulin levels were lower at 4 and 42 days after surgery compared with pre-surgery levels. At 4 days after surgery, insulin levels correlated positively with metabolites of branched chain and aromatic amino acid metabolism and negatively with triglycerides with long-chain fatty acids. Of the 14 subjects with diabetes prior to surgery, 7 were in remission 2 years after surgery. The subjects in remission displayed higher pre-surgery levels of tricarboxylic acid cycle intermediates and triglycerides with long-chain fatty acids compared with subjects not in remission. Thus, metabolic alterations are induced soon after surgery and subjects with diabetes remission differ in the metabolic profiles at pre- and early post-surgery time points compared to patients not in remission.

  8. Relapse from remission at two- to four-year follow-up in two treatments for adolescent anorexia nervosa.

    Science.gov (United States)

    Le Grange, Daniel; Lock, James; Accurso, Erin C; Agras, W Stewart; Darcy, Alison; Forsberg, Sarah; Bryson, Susan W

    2014-11-01

    Long-term follow-up studies documenting maintenance of treatment effects are few in adolescent anorexia nervosa (AN). This exploratory study reports relapse from full remission and attainment of remission during a 4-year open follow-up period using a convenience sample of a subgroup of 65% (n = 79) from an original cohort of 121 participants who completed a randomized clinical trial comparing family-based therapy (FBT) and adolescent-focused individual therapy (AFT). Follow-up assessments were completed up to 4 years posttreatment (average, 3.26 years). Available participants completed the Eating Disorder Examination as well as self-report measures of self-esteem and depression at 2 to 4 years posttreatment. Two participants (6.1%) relapsed (FBT: n = 1, 4.5%; AFT: n = 1, 9.1%), on average 1.98 years (SD = 0.14 years) after remission was achieved at 1-year follow-up. Ten new participants (22.7%) achieved remission (FBT: n = 1, 5.9%; AFT: n = 9, 33.3%). Mean time to remission for this group was 2.01 years (SD = 0.82 years) from 1-year follow-up. There were no differences based on treatment group assignment in either relapse from full remission or new remission during long-term follow-up. Other psychopathology was stable over time. There were few changes in the clinical presentation of participants who were assessed at long-term follow-up. These data suggest that outcomes are generally stable posttreatment regardless of treatment type once remission is achieved. Clinical trial registration information-Effectiveness of Family-Based Versus Individual Psychotherapy in Treating Adolescents With Anorexia Nervosa; http://www.clinicaltrials.gov/; NCT00149786. Copyright © 2014 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  9. Clinical remission in patients with active psoriatic arthritis treated with adalimumab and correlations in joint and skin manifestations.

    Science.gov (United States)

    Van den Bosch, Filip; Kavanaugh, Arthur; Kron, Martina; Kupper, Hartmut; Mease, Philip J

    2015-06-01

    Adalimumab (ADA) was evaluated for its efficacy in patients with moderate to severely active psoriatic arthritis (PsA) and for the presence of correlations in disease change variables. Patients with inadequate response to standard PsA therapy were given 40 mg of ADA every other week for up to 12 weeks or 20 weeks. Outcome variables encompassed tender joint count (TJC), swollen joint count (SJC), physician's global assessment (PGA) of psoriasis, Health Assessment Questionnaire (HAQ), patient's global assessment (PtGA) of disease activity and pain, C-reactive protein, as well as composite measures of disease activity. Patients with inactive skin disease symptoms at baseline were excluded from the remission analyses. Of 268 patients with active baseline joint and skin disease and data available at Week 12 following open-label ADA therapy, 73 achieved joint remission (27.2%, TJC ≤ 1 + SJC ≤ 1) and 144 achieved skin remission criteria (53.7%, PGA = clear/almost clear). Simultaneous joint and skin remission criteria were achieved in 16.0% and 24.8% of patients at weeks 12 and 20, respectively. In patients who did not achieve skin and/or joint remission, 12-week ADA treatment improved mean clinical and functional scores. Joint remission was more frequently associated with achieving clinically relevant outcomes including HAQ, PtGA disease activity, and PtGA pain compared to skin remission. No correlation between improvement in skin and joint disease was observed. ADA was effective in achieving strict criteria for remission in joint or skin disease in many patients with active PsA within 12 weeks and sustained through 20 weeks. (NCT00235885).

  10. Is Internet addiction transitory or persistent? Incidence and prospective predictors of remission of Internet addiction among Chinese secondary school students.

    Science.gov (United States)

    Lau, Joseph T F; Wu, Anise M S; Gross, Danielle L; Cheng, Kit-Man; Lau, Mason M C

    2017-11-01

    Internet addiction (IA) is prevalent among adolescents but it is potentially revertible. Only three Taiwan adolescent studies reported IA remission and a few related factors. We investigated incidence and predictors of remission among Hong Kong Chinese secondary school students with a 12-month longitudinal study. IA was defined as Chen Internet Addiction Scale (CIAS) score>63. Validated measures were used to assess students' psychosocial wellbeing at baseline and follow-up. Of 1545 students with IA at baseline, 1296 (83.9%) provided matched baseline/12-month follow-up data; their data were analyzed. Incidence of remission (CIAS≤63 at follow-up) was 59.29/100 person-years. Significant predictors included: 1) baseline CIAS score (ORa=.95), 2) baseline health belief model (HBM) constructs [perception of having severe IA (ORa=.34), perceived susceptibility to IA (ORa=0.82), perceived barrier (ORa=0.95), cue to action from parents (ORa=0.82), and self-efficacy for reducing Internet use (ORa=1.13)], and 3) baseline psychosocial health measures [self-esteem (ORa=1.03), severe depression (ORa=0.72) and social anxiety (ORa=0.96)] and their changes over time [depression (ORa=.95), anxiety (ORa=.94), loneliness (ORa=.93), self-esteem (ORa=1.07), positive affect (ORa=1.10) and family support (ORa=1.03)]. Two-thirds (64.3%) of the remission group presented reduced CIAS score>1.5 SD, and recorded larger improvements in psychosocial status over time than the non-remission group. Without noticeable interventions, incidence of remission was high and related to improvements in psychosocial health. Most of the HBM constructs, and baseline/changes in psychosocial measures predicted remission. Interventions to increase remission should modify these factors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Psychological state is related to the remission of the Boolean-based definition of patient global assessment in patients with rheumatoid arthritis.

    Science.gov (United States)

    Fusama, Mie; Miura, Yasushi; Yukioka, Kumiko; Kuroiwa, Takanori; Yukioka, Chikako; Inoue, Miyako; Nakanishi, Tae; Murata, Norikazu; Takai, Noriko; Higashi, Kayoko; Kuritani, Taro; Maeda, Keiji; Sano, Hajime; Yukioka, Masao; Nakahara, Hideko

    2015-09-01

    To evaluate whether the psychological state is related to the Boolean-based definition of patient global assessment (PGA) remission in patients with rheumatoid arthritis (RA). Patients with RA who met the criteria of swollen joint count (SJC) ≤ 1, tender joint count (TJC) ≤ 1 and C-reactive protein (CRP) ≤ 1 were divided into two groups, PGA remission group (PGA ≤ 1 cm) and non-remission group (PGA > 1 cm). Anxiety was evaluated utilizing the Hospital Anxiety and Depression Scale-Anxiety (HADS-A), while depression was evaluated with HADS-Depression (HADS-D) and the Center for Epidemiologic Studies Depression Scale (CES-D). Comparison analyses were done between the PGA remission and non-remission groups in HADS-A, HADS-D and CES-D. Seventy-eight patients met the criteria for SJC ≤ 1, TJC ≤ 1 and CRP ≤ 1. There were no significant differences between the PGA remission group (n = 45) and the non-remission group (n = 33) in age, sex, disease duration and Steinbrocker's class and stage. HADS-A, HADS-D and CES-D scores were significantly lower in the PGA remission group. Patients with RA who did not meet the PGA remission criteria despite good disease condition were in a poorer psychological state than those who satisfied the Boolean-based definition of clinical remission. Psychological support might be effective for improvement of PGA, resulting in the attainment of true remission.

  12. Psychological trauma and help seeking behaviour amongst resettled Iraqi refugees in attending English tuition classes in Australia.

    Science.gov (United States)

    Slewa-Younan, Shameran; Mond, Jonathan M; Bussion, Elise; Melkonian, Maral; Mohammad, Yaser; Dover, Hanan; Smith, Mitchell; Milosevic, Diana; Jorm, Anthony Francis

    2015-01-01

    To examine levels of psychological distress and help seeking behaviour in resettled refugees attending English tuition classes in Australia, and their associations with participants' demographic characteristics. Data was collected by bilingual interviewers between March and November 2013. A volunteer sample of attendees of Adult Migrant English Programs (AMEP) in Western Sydney were recruited. Participants were two hundred and twenty five Iraqi refugees resettled in Western Sydney, who had left Iraq no earlier than 1991, were fluent in Arabic and/or English, and were between the ages of 18 and 70. The chief outcome measures used were the Kessler Psychological Distress Scale (K-10) as well as The Harvard Trauma Questionnaire (HTQ). On the K-10, 39.8% of participants had severe psychological distress, 19.4% moderate distress, and 40.7% had low to mild distress. Ninety-five percent of participants reported having experienced one or more potentially traumatic event (PTE) as defined by the HTQ prior to leaving Iraq, with a mean of 14.28 events (SD = 8.69). Thirty-one percent of participants met the threshold (≥2.5) for clinically significant PTSD symptomatology, with a significantly higher occurrence among participants with lower education attainment (χ (2) (3) = 8.26, p = .04). Of those participants with clinically significant PTSD symptomatology according to the HTQ, only 32.9% reported ever having ever sought help for a mental health problem. The high level of distress found in this sample, combined with low uptake of mental health care, highlights the need for programs targeted to promote help-seeking among Iraqi refugees who have resettled in Australia. Further, the higher level of PTSD symptomatology found amongst those with lower education attainment has mental health promotion and treatment implications. Specifically, in designing service and treatment programs, consideration should be given to the possible impact excessive levels of psychological

  13. The predictive role of histopathological findings in renal insufficiency and complete remission in Iranian adults with primary focal segmental glomerulosclerosis

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    Diana Taheri

    2010-01-01

    Full Text Available Objectives: to identify the histopathological findings that may act as possible predictors of complete remission or progression to chronic kidney disease in Iranian adults with primary focal segmental glomerulosclerosis (FSGS. Methods: In this historical cohort study, pathological findings of 50 patients with primary FSGS were reviewed by single renal pathologist without knowing about patient’s identities or outcomes. We divided the patients based on their histopathological findings, and compared the outcomes (renal insufficiency and complete remission among these groups. Results: There were significant differences in the complete remission in subject with and without mesangial hypercellularity (p<0.05, and in patients with and without hyalinosis (p<0.05. According to the cut off points based on ROC curve analysis for the quantitative data, there was significant difference in renal insufficiency between the patients with and without global scars more than 12% (p<0.05.Also multiple logistic regression analysis strongly suggest the association of mesangial hypercellularity and global scar with no complete remission and progression to renal insufficiency, respectively. Conclusion: In the studied patients, presence of mesangial hypercellularity and hyalinosis have been suggested as prognostic factors for lower remission rate. According to multivariate analysis, only the presence of mesangial hypercellularity and global scar were found as independent prognostic predictors to lower complete remission rate and progression to renal insufficiency in patients with FSGS, respectively.

  14. Synovial features of patients with rheumatoid arthritis and psoriatic arthritis in clinical and ultrasound remission differ under anti-TNF therapy: a clue to interpret different chances of relapse after clinical remission?

    Science.gov (United States)

    Alivernini, Stefano; Tolusso, Barbara; Petricca, Luca; Bui, Laura; Di Sante, Gabriele; Peluso, Giusy; Benvenuto, Roberta; Fedele, Anna Laura; Federico, Franco; Ferraccioli, Gianfranco; Gremese, Elisa

    2017-07-01

    To define the synovial characteristics of patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) in clinical and ultrasound remission achieved by combination therapy with methotrexate (MTX) and tumour necrosis factor (TNF) blockers. Patients with RA in remission (n=25) (disease activity score (DAS)<1.6 for at least 6 months), patients with RA in low disease activity (LDA) (n=10) (1.6remission (n=18) (DAS<1.6 and Psoriasis Area Severity Index (PASI)=0 for at least 6 months) achieved by MTX+anti-TNF (adalimumab 40 mg or etanercept 50 mg) with power Doppler (PDUS)-negative synovial hypertrophy underwent synovial tissue biopsy. Patients with RA with high/moderate disease naïve to treatment (n=50) were included as a comparison group. Immunostaining for cluster designation (CD)68, CD21, CD20, CD3, CD31 and collagen was performed. PDUS-negative patients with RA in remission showed lower histological scores for synovial CD68 + , CD20 + , CD3 + cells and CD31 + vessels and collagen deposition (p<0.05 for both lining and sublining) compared with PDUS-positive patients with RA with high/moderate disease. In addition, there was no significant difference in terms of lining and sublining CD68 + , CD20 + , CD3 + , CD31 + cells and collagen comparing PDUS-negative patients with RA in remission and in LDA, respectively. On the contrary, PDUS-negative patients with PsA in remission showed higher histological scores for sublining CD68 + (p=0.02) and CD3 + cells (p=0.04) as well as CD31 + vessels (p<0.001) than PDUS-negative patients with RA in remission. PDUS-negative patients with RA in remission have comparable synovial histological features than PDUS-negative patients with RA in LDA. However, patients with PsA in remission are characterised by a higher degree of residual synovial inflammation than patients with RA in remission, despite PDUS negativity under TNF inhibition. Published by the BMJ

  15. Design and validation of standardized clinical and functional remission criteria in schizophrenia

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    Mosolov SN

    2014-01-01

    Full Text Available Sergey N Mosolov,1 Andrey V Potapov,1 Uriy V Ushakov,2 Aleksey A Shafarenko,1 Anastasiya B Kostyukova11Department of Mental Disorders Therapy, Moscow Research Institute of Psychiatry, Moscow, Russia; 2Moscow Psychiatric Outpatient Services #21, Moscow, RussiaBackground: International Remission Criteria (IRC for schizophrenia were developed recently by a group of internationally known experts. The IRC detect only 10%–30% of cases and do not cover the diversity of forms and social functioning. Our aim was to design a more applicable tool and validate its use – the Standardized Clinical and Functional Remission Criteria (SCFRC.Methods: We used a 6-month follow-up study of 203 outpatients from two Moscow centers and another further sample of stable patients from a 1-year controlled trial of atypical versus typical medication. Diagnosis was confirmed by International Classification of Diseases Version 10 (ICD10 criteria and the Mini-International Neuropsychiatric Interview (MINI. Patients were assessed by the Positive and Negative Syndrome Scale, including intensity threshold, and further classified using the Russian domestic remission criteria and the level of social and personal functioning, according to the Personal and Social Performance Scale (PSP. The SCFRC were formulated and were validated by a data reanalysis on the first population sample and on a second independent sample (104 patients and in an open-label prospective randomized 12-month comparative study of risperidone long-acting injectable (RLAI versus olanzapine.Results: Only 64 of the 203 outpatients (31.5% initially met the IRC, and 53 patients (26.1% met the IRC after 6 months, without a change in treatment. Patients who were in remission had episodic and progressive deficit (39.6%, or remittent (15% paranoid schizophrenia, or schizoaffective disorder (17%. In addition, 105 patients of 139 (51.7%, who did not meet symptomatic IRC, remained stable within the period. Reanalysis of

  16. Assessment of cerebrovascular reactivity during major depression and after remission of disease

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    Vakilian Alireza

    2010-01-01

    Full Text Available Background: There are a growing number of studies suggesting that depression may increase the risk of stroke. Impaired autoregulation of vascular tone may contribute to a higher risk of developing cerebrovascular diseases. Cerebrovascular reactivity (CVR reflects the compensatory dilatory capacity of cerebral arterioles to a dilatory stimulus and is an important mechanism that ensures constant cerebral blood flow. There is a hypothesis that CVR is reduced in major depression, which would explain the association between depression and stroke. Objectives: The aim of this study was to investigate the effect of depression on CVR in cerebral vessels by comparing CVR during the depression phase with that during remission. Material and Methods: Using the apnea test, we assessed CVR in 16 patients with unipolar depression during disease and after remission of disease by calculating the increase in cerebral blood flow velocity after breath-holding (the apnea test. Blood flow velocities were measured by transcranial Doppler ultrasound (TCD. Results: CVR was significantly reduced in the depression phase in comparison to that in the remission phase. However, this change was not seen in all the patients. Conclusion: CVR was reduced in most of the depressed patients. The decreased CVR, as indicated by the changes in peak systolic velocity (PSV and mean flow velocity (MFV of the middle cerebral artery, in depressed patients was more marked on the right side, which could point to a vascular basis for some kinds of depression. We recommend that other studies, with larger samples, be done; future studies should assess whether the changes in the CVR varies with the severity and type of depression.

  17. A Cross-sectional, Comparative Study of Insight in Schizophrenia and Bipolar Patients in Remission.

    Science.gov (United States)

    Ramachandran, Arul Saravanan; Ramanathan, Rajkumar; Praharaj, Samir Kumar; Kanradi, Haridas; Sharma, Podila Satya Venkata Narasimha

    2016-01-01

    To study insight correlates in schizophrenia and bipolar mood disorder in remission among out-patients attending the Psychiatry Department of a Tertiary Care Hospital. In a cross-sectional, naturalistic study, adult patients with schizophrenia and bipolar mood disorder in remission (n = 80; schizophrenia-40, mania-20, bipolar depression-20) were compared on insight measures and clinical correlates. Scale to Assess the Unawareness of Mental Disorders (SUMD) was used as the main tool to assess current and past measures of insight. Hogan's Drug Attitude Inventory was used to assess the drug attitude and compliance. Positive and Negative Symptom Scale for Schizophrenia, Young's Mania Rating Scale, and HAMD were used to rate psychopathology. Clinical Global Improvement was used as a screening tool for remission. For comparison of the three clinical groups, analysis of variance and Chi-square test were used. In the post-hoc analysis, the Ryan-Einot-Gabriel-Welsch test was used to find the group difference. About 40% in the schizophrenia group were unaware of their mental illness as against none in the bipolar group. The awareness of mental disorder for the current period, the awareness of the achieved effects of medications, and the awareness of social consequence was better in the bipolar group. The drug attitude (compliant positive attitude) increased as the SUMD item scale decreased or in other words, as the insight improved. Insight, both current and retrospect, showed significant differences between the schizophrenia and bipolar patients. Insight is significantly correlated with the observed compliance and drug attitude of the patient groups.

  18. CYTOTOXIC LYMPHOCYTES: THE ROLE IN INFLAMMATION IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE EXACERBATION AND REMISSION

    Directory of Open Access Journals (Sweden)

    N. A. Raspopina

    2014-01-01

    Full Text Available Background: Despite the number of publications related to the expression of surface antigens of periphery blood lymphocytes in chronic obstructive pulmonary disease (COPD, algorithm for interpreting of the results and implicating pathogene-tic treatments still needs to be developed. Aim: To assess the role of cytotoxic lymphocytes in the maintaining of inflammation in COPD. Materials and methods: To examine immune status in 37 patients with COPD exacerbation or remission and 24 healthy donors (control group, blood cytotoxic T-lymphocytes and NK-cells contents were measured using indirect immunofluorescence method. Absolute and relative numbers of lymphocytes expressing CD3, CD4, CD8, CD16, CD20, CD23, CD25, CD54, CD71, CD72, HLA-DR, CD95 antigens, membrane immunoglobulins  M (mIgM and G (mIgG were estimated. Results: In COPD, significantly increased numbers of blood cytotoxic lymphocytes were demonstrated independently from the disease stage (p < 0.001. During COPD exacerbation, significant elevations of CD4, CD8, CD20, CD72, NК-cells numbers, serum mIgM and mIgG were demonstrated. During remission, CD20 and CD72 content returned to normal, though, increased numbers of other cytotoxic cells persisted promoting inflammation and progressive damage of pulmonary and bronchial tissues. Conclusion: Observed changes may be due to excessive stimulation of T-cell component of immune system in COPD patients both in exacerbation and remission. Relative reduction of total T-lymphocyte numbers indicates non-specific (non-infectious inflammation type. High cytotoxic potential of immune system results in pulmonary damage and promotes development of pneumosclerosis and emphysema.

  19. Obesity and rates of clinical remission and low MRI inflammation in rheumatoid arthritis.

    Science.gov (United States)

    George, Michael D; Østergaard, Mikkel; Conaghan, Philip G; Emery, Paul; Baker, Daniel G; Baker, Joshua F

    2017-10-01

    Obesity has been proposed as a risk factor for refractory rheumatoid arthritis (RA). We evaluated the impact of obesity on achieving clinical and imaging definitions of low disease activity. This study evaluated 470 patients with RA from GO-BEFORE and GO-FORWARD randomised clinical trials. Included patients had blinded clinical disease activity measures and MRI at baseline, 24 and 52 weeks. Synovitis, osteitis and total inflammation scores were determined using the RA MRI scoring system. Multivariable logistic regression analyses compared odds of achieving Disease Activity Score using 28 joints and C-reactive protein (DAS28-CRP) remission, low component measures, or low MRI inflammation measures at 24 weeks in patients with obesity versus no obesity. At 24 weeks, patients with obesity were significantly less likely to achieve DAS28(CRP) remission (OR 0.47; 95% CI 0.24 to 0.92, p=0.03). In contrast, patients with obesity had similar odds of achieving low synovitis (OR 0.94; 95% CI 0.51 to 1.72, p=0.84) and inflammation scores (OR 1.16; 95% CI 0.61 to 2.22, p=0.64) and greater odds of achieving low osteitis scores (OR 2.06; 95% CI 1.10 to 3.84, p=0.02) versus normal weight patients. Patients with RA and obesity have lower rates of DAS28 remission but similar rates of low MRI activity compared with patients without obesity, suggesting that obesity and its associated comorbidities can bias clinical disease activity measures. NCT00361335 and NCT00264550; Post-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Does length of common limb influence remission of diabetes? Short-term results

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    Ramraj V Nagendra Gupta

    2016-01-01

    Full Text Available Background: Despite strict patient selection criteria, diabetes remission is not seen in all patients after gastric bypass. Can length of the common limb influence diabetes remission? Aim: To find if any correlation exists between the length of the common limb and remission of diabetes. Study Design: Prospective study. Materials and Methods: Twenty-five consecutive patients with Type II diabetes mellitus and a fasting C-peptide >1 ng/ml who underwent laparoscopic Roux-en-y gastric bypass were included. All patients had standard limb lengths and length of the common limb was measured in all patients. Patients were followed up and glycated haemoglobin (HbA1c was repeated at 6 months postoperatively. Pre- and postoperative HbA1c were then correlated with the lengths of common limb to look for any relation. Statistical Analysis: Descriptive and inferential statistical analysis, analysis of variance (ANOVA. Results: Of the 25 patients, 15 were females and 10 were males. The mean age was 44.16 years and the mean body mass index (BMI was 43.96 kg/m 2 . Preoperative HbA1c varied from 5.8 to 12.3%. Length of the common limb varied from 210 to 790 cm (mean 470.4 cm. HbA1c at 6 months ranged from 4.8 to 7.7% (mean 5.81%. On comparison of preoperative and 6 months postoperative HbA1c and correlating with the length of common limb, we found that patients with a common limb of length 600 cm length (P = 0.004. Conclusion: A shorter common limb does appear to have better chances of resolution of Type II diabetes mellitus in our study, thus paving the way for further studies.

  1. A case of Lennert's lymphoma which had a complete remission by radiotherapy

    International Nuclear Information System (INIS)

    Hamada, Fumio; Ogawa, Yoshihiro; Inomata, Taisuke

    1982-01-01

    A 49-year-old woman, who complained of sore throat and swelling of bilateral tonsils, was pathologically diagnosed Lennert's lymphoma by biopsy of tonsils. She was treated by radiation with combined chemotherapy. She was restored to complete remission and still alive now. Lennert's lymphoma which was histologically characterized by a high content of epithelioid histocytes was first reported by Lennert and Mestdagh in 1968. Since then, some cases have been reported. But it's clinical entity is still a controversial entity, difficult to classify. Some consider it as a distinct entity, the others as a variant of the disease which have been already established. (author)

  2. Elevated Plasma Chemokines for Eosinophils in Neuromyelitis Optica Spectrum Disorders during Remission

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    Yanping Tong

    2018-02-01

    Full Text Available BackgroundA prominent pathological feature of neuromyelitis optica spectrum disorders (NMOSD is markedly greater eosinophilic infiltration than that seen in other demyelinating diseases, like multiple sclerosis (MS. Eosinophils express the chemokine receptor CCR3, which is activated by eotaxins (CCL11/eotaxin-1, CCL24/eotaxin-2, CCL26/eotaxin-3 and CCL13 [monocyte chemoattractant protein (MCP-4]. Moreover, CCL13 is part of the chemokine set that activates CCR2. The present study aimed to evaluate plasma levels of eotaxins (CCL11, CCL24, and CCL26 and MCPs (CCL13, CCL2, CCL8, and CCL7 in patients with NMOSD during remission.MethodsHealthy controls (HC; n = 30 and patients with MS (n = 47 and NMOSD (n = 58 in remission were consecutively enrolled in this study between January 2016 and August 2017. Plasma CCL11, CCL24, CCL26, CCL2, CCL8, CCL7, CCL13, tumor necrosis factor (TNF-α, and interleukin (IL-1β levels were detected using the human cytokine multiplex assay.ResultsPlasma CCL13, CCL11, and CCL26 levels were all significantly higher in patients with NMOSD than in HC and patients with MS. No significant differences were found in the CCL13, CCL11, or CCL26 levels between patients with NMOSD receiving and not receiving immunosuppressive therapy. The plasma levels of TNF-α and IL-1β, which stimulate the above chemokines, were higher in patients with NMOSD than in HC. There was no difference in CCL24 levels among the three groups. In most cases, the CCL7 levels were below the threshold value of the human cytokine multiplex assay, which is in line with other studies. Adjusted multiple regression analyses showed a positive association of CCL13 levels with the number of relapses after controlling gender, age, body mass index, and disease duration in patients with NMOSD.ConclusionThe study indicates that in NMOSD, the overproduction of cytokines such as IL-1β and TNF-α during remission stimulates eosinophilic chemoattractants such as

  3. EVALUATION OF ULTRASOUND REMISSION CRITERIA IN PATIENTS WITH RHEUMATOID ARTHRITIS DURING TOCILIZUMAB THERAPY

    OpenAIRE

    Rita Aleksandrovna Osipyants; D E Karateev; E Yu Panasyuk; G V Lukina; A V Smirnov; S I Glukhova; E N Aleksandrova; A V Volkov; E L Nasonov

    2013-01-01

    Objective: to study the association of ultrasound (US) remission criteria with the clinical and laboratory indicators of inflammatory activity, functional status, and X-ray changes in patients with rheumatoid arthritis (RA) during tocilizumab (TCZ) therapy.Subjects and methods. The trial included 36 patients with RA (meeting the 1987 American College of Rheumatology (ACR) criteria) who had received TCZ for 6 months. The authors made a clinical and laboratory assessment of RA activity (DAS28-C...

  4. Data-driven criteria to assess fear remission and phenotypic variability of extinction in rats.

    Science.gov (United States)

    Shumake, Jason; Jones, Carolyn; Auchter, Allison; Monfils, Marie-Hélène

    2018-03-19

    Fear conditioning is widely employed to examine the mechanisms that underlie dysregulations of the fear system. Various manipulations are often used following fear acquisition to attenuate fear memories. In rodent studies, freezing is often the main output measure to quantify 'fear'. Here, we developed data-driven criteria for defining a standard benchmark that indicates remission from conditioned fear and for identifying subgroups with differential treatment responses. These analyses will enable a better understanding of individual differences in treatment responding.This article is part of a discussion meeting issue 'Of mice and mental health: facilitating dialogue between basic and clinical neuroscientists'. © 2018 The Author(s).

  5. Sudden death due to disseminated cryptococcosis in a child with leukemia in remission.

    Science.gov (United States)

    Lascari, A D; Pearce, J M; Swanson, H

    1997-12-01

    Cryptococcus neoformans typically causes an insidious illness with symptoms related to meningitis or to lung involvement. This is the first reported sudden death due to cryptococcosis, which occurred in a child with leukemia that was in remission. The child had suddenly looked seriously ill and cried with abdominal pain and then died within 25 minutes. Disseminated cryptococcal infection of the lungs, heart, and pancreas was an unexpected finding at autopsy. This clinical experience raises the question whether fungal infections should now be considered in immunosuppressed patients who have an apparent septic collapse.

  6. Metabolic syndrome remission after Roux-en-Y gastric bypass or sleeve gastrectomy

    Directory of Open Access Journals (Sweden)

    Nassour I

    2017-09-01

    Full Text Available Ibrahim Nassour,1 Jaime P Almandoz,2 Beverley Adams-Huet,3,4 Sachin Kukreja,5 Nancy Puzziferri1,5 1Department of Surgery, 2Department of Internal Medicine, Division of Endocrinology, 3Department of Clinical Sciences, 4Department of Internal Medicine, University of Texas Southwestern Medical Center, 5Department of Surgery, Veterans Affairs North Texas Health Care System, Dallas, TX, USA Background: Bariatric surgery is known to decrease weight and the prevalence of comorbidities, but there is little evidence on the differential effect of Roux-en-Y gastric bypass (RYGB and sleeve gastrectomy (SG on the remission of the aggregate outcome, metabolic syndrome, 4 years after surgery. The purpose of this study was to determine the effectiveness of RYGB and SG on metabolic syndrome in veterans. Methods: We retrospectively reviewed consecutive patients who underwent SG and RYGB at the Dallas Veterans Affairs Medical Center from 2003 to 2012. We determined the effect of both the operations on the remission of metabolic syndrome, its individual components, and medium-term morbidity and mortality. A sensitivity analysis was performed using propensity matching.Results: A total of 266 patients were identified (159 RYGB and 107 SG with 96% follow-up after 4 years. The mean age of the cohort was 51.4 years; the majority of patients were male (59% and Caucasian (69%. RYGB patients had a greater mean body mass index and were more likely to have hypertension or hypertriglyceridemia. RYGB was associated with a similar metabolic syndrome remission to SG (37.6% vs 26.8%; P=0.09. The percentage of weight loss was 26.5% after RYGB and 10.8% after SG at 4 years post operation (P<0.01. Predictors of metabolic syndrome persistence were male gender, type 2 diabetes, and low high-density lipoprotein. While both the operations were associated with similar mortality (RYGB 4.4%, SG 2.8%; P=0.74, RYGB was associated with a greater rate of morbidity. Conclusion: RYGB and SG seem

  7. Spontaneous remission of Crohn's disease following a febrile infection: case report and literature review

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    van Netten Johannes P

    2011-05-01

    Full Text Available Abstract Crohn's disease is a chronic illness that may often follow a relapsing-remitting course. Many of the factors that may be associated with the spontaneous remission of this disease (i.e. not related to specific treatment remain to be determined. In the present report, we review the medical history of a patient with a long history of moderate to severe Crohn's whose complete remission immediately followed the development of a febrile infection. The patient first developed symptoms of Crohn's in her late adolescent years. At the time of diagnosis at age 23, she was placed on mesalamine - without effective control her disease symptoms. Due to progressive deterioration, the patient underwent a bowel resection at age 25. Soon afterwards symptoms recurred, gradually increasing in severity. In February 2005, at age 36, the patient developed a painful abscess associated with a rectal fistula. Other symptoms at the time included chronic bone and stomach pain, swollen joints, and debilitating fatigue. Surgical correction was scheduled in mid-March. In late February, the patient developed a respiratory infection associated with fevers of 103-104°F. After the onset of fever, the abscess pain disappeared and this was soon followed by a disappearance of all other disease symptoms. By the time the corrective surgery occurred, she had no Crohn's symptoms. Her remission lasted 10 weeks when the previous symptoms then reappeared. The patient has subsequently used a variety of conventional therapies, but still suffers from severe symptoms of her disease. In recent years, a growing body of literature has emphasized the important role that innate immunity plays in the etiology of Crohn's disease; however, a key component of innate immunity, the febrile response, has been overlooked. Other cases of spontaneous remission following febrile infection in inflammatory bowel disease have been reported. Moreover, induction of a febrile response was in the past used

  8. Improving Clinical Remission Rates in Pediatric Inflammatory Bowel Disease with Previsit Planning.

    Science.gov (United States)

    Savarino, Jeffrey R; Kaplan, Jess L; Winter, Harland S; Moran, Christopher J; Israel, Esther J

    2016-01-01

    Inflammatory Bowel Disease (IBD) is a chronic autoimmune inflammatory disease of the intestine which can lead to malnutrition, poor quality of life, and colon cancer.(1-4) Although there is no cure for the disease, clinical remission is the primary goal.(5) The Center for Inflammatory Bowel Disease at MassGeneral Hospital for Children (MGHfC) adopted a Previsit Planning (PVP) model to identify and discuss symptomatic patients prior to their appointments to identify specific issues that impact disease management.(6-8) The Registry from ImproveCareNow (ICN), the international Quality Improvement Collaborative for the management of Crohn's Disease and Ulcerative Colitis in pediatric and adolescent patients, was used to capture information from each ambulatory visit and hospitalization. Using the Model for Improvement framework, the team began a weekly review and made care recommendations of patients with active disease who were cared for by one physician. Interventions were modified over multiple Plan-Do-Study-Act (PDSA) improvement cycles to increase the number of providers and to include patients with mild or moderate disease activity.(9) Feedback from the providers regarding this process was elicited via a REDCap survey and the clinical remission rate was tracked using the ICN Registry. The clinical remission rate for the Center's patients increased from 77% (n=597) in September 2014 to 83% (n=585) in August 2015 and has been maintained. 78% of responding providers indicated that they found the PVP recommendations helpful "all of the time". One hundred percent who responded to the survey said that they have used at least one recommendation provided to them. PVP for management of a chronic disease in pediatrics is feasible, even in a high volume practice. This process at MGHfC has resulted in the improvement of clinical remission rate. PDSA cycles were used to document successes and failures to help guide the work. Ongoing expansion of this PVP practice to all

  9. Histamine release positive test associates with disease remission in chronic spontaneous urticaria

    DEFF Research Database (Denmark)

    Berti, A; Yacoub, M R; Skov, Per Stahl

    2017-01-01

    Summary: Background. Histamine release (HR) test has previously been shown to predict the presence of endogenous histamine-releasing factors in chronic spontaneous urticaria (CSU). Objectives and methods. Twenty CSU patients unresponsive to antihistamine treatment were enrolled in order to evaluate...... with a positive HR test had a significant reduction of disease activity (p = 0.003) whereas patients with a negative HR test did not (p > 0.05), leading to disease remission and antihistamine treatment withdrawal in 67% (6/9) of positive HR test patients versus 18% (2/11) of negative HR test patients (p = 0...

  10. A new model for describing remission times: the generalized beta-generated Lindley distribution

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    MARIA DO CARMO S. LIMA

    Full Text Available New generators are required to define wider distributions for modeling real data in survival analysis. To that end we introduce the four-parameter generalized beta-generated Lindley distribution. It has explicit expressions for the ordinary and incomplete moments, mean deviations, generating and quantile functions. We propose a maximum likelihood procedure to estimate the model parameters, which is assessed through a Monte Carlo simulation study. We also derive an additional estimation scheme by means of least square between percentiles. The usefulness of the proposed distribution to describe remission times of cancer patients is illustrated by means of an application to real data.

  11. Remote Music Tuition

    NARCIS (Netherlands)

    S. Duffy; D. Williams; I. Kegel; T. Stevens; A.J. Jansen (Jack); P.S. Cesar Garcia (Pablo Santiago); P. Healey

    2012-01-01

    htmlabstractIt is common to learn to play an orchestral musical instrument through one-to-one lessons with an experienced tutor. For musicians who choose to study performance at an undergraduate level and beyond, their tutor is an important part of their professional musical development. For many

  12. TDAH: remissão na adolescência e preditores de persistência em adultos ADHD: Remission in adolescence and predictors of persistence into adulthood

    Directory of Open Access Journals (Sweden)

    Marcelo Schmitz

    2007-01-01

    Full Text Available Embora no passado se acreditasse que o TDAH persistia somente até a adolescência, atualmente já há um corpo sólido de conhecimento científico evidenciando que o TDAH freqüentemente persiste em adultos que foram diagnosticados como tendo TDAH na infância. São poucos os relatos na literatura sobre o padrão dessa evolução dos sintomas e, principalmente, sobre os fatores que predizem esse desfecho. O objetivo deste artigo é revisar a literatura científica sobre o TDAH, com foco específico em dados sobre remissão dos sintomas na adolescência e preditores de persistência do transtorno até a vida adulta. São apresentados dados de prevalência na adolescência e idade adulta, fatores relacionados à variabilidade de resultados entre os estudos, potenciais fatores de risco de persistência e o único estudo delineado especificamente com o objetivo de avaliar um conjunto abrangente de preditores do transtorno da infância à idade adulta.Although in the past it was thought that ADHD did not continue beyond adolescence, nowadays there is a consistent body of scientific knowledge showing that ADHD often persists in adults who had been diagnosed as having ADHD in childhood. There are very few studies in the literature on the pattern of the evolution of the symptoms and mainly on the factors that predict this outcome in adulthood. The aim of this paper is to review the scientific literature on ADHD with specific focus on data about symptom remission during adolescence and predictors of the disorder persistence into adulthood. The authors present data on prevalence in adolescence and adulthood, factors associated to results variability among studies, potential risk factors of persistence, and the only study delineated specifically with the objective of assessing a comprehensive set of predictors of the disorder from childhood up to adulthood.

  13. Treating to the target of remission in early rheumatoid arthritis is cost-effective: results of the DREAM registry.

    Science.gov (United States)

    Vermeer, Marloes; Kievit, Wietske; Kuper, Hillechiena H; Braakman-Jansen, Louise M A; Bernelot Moens, Hein J; Zijlstra, Theo R; den Broeder, Alfons A; van Riel, Piet L C M; Fransen, Jaap; van de Laar, Mart A F J

    2013-12-13

    Where health economic studies are frequently performed using modelling, with input from randomized controlled trials and best guesses, we used real-life data to analyse the cost-effectiveness and cost-utility of a treatment strategy aiming to the target of remission compared to usual care in early rheumatoid arthritis (RA). We used real-life data from comparable cohorts in the Dutch Rheumatoid Arthritis Monitoring (DREAM) registry: the DREAM remission induction cohort (treat-to-target, T2T) and the Nijmegen early RA inception cohort (usual care, UC). Both cohorts were followed prospectively using the DREAM registry methodology. All patients fulfilled the American College of Rheumatology criteria for RA and were included in the cohort at the time of diagnosis. The T2T cohort was treated according to a protocolised strategy aiming at remission (Disease Activity Score in 28 joints (DAS28) costs were collected. The incremental cost effectiveness ratio (ICER) per patient in remission and incremental cost utility ratio (ICUR) per quality-adjusted life year (QALY) gained were calculated over two and three years of follow-up. Two year data were available for 261 T2T patients and 213 UC patients; an extended follow-up of three years was available for 127 and 180 patients, respectively. T2T produced higher remission percentages and a larger gain in QALYs than UC. The ICER was € 3,591 per patient in remission after two years and T2T was dominant after three years. The ICUR was € 19,410 per QALY after two years and T2T was dominant after three years. We can conclude that treating to the target of remission in early RA is cost-effective compared with UC. The data suggest that in the third year, T2T becomes cost-saving.

  14. Dyadic discord at baseline is associated with lack of remission in the acute treatment of chronic depression.

    Science.gov (United States)

    Denton, W H; Carmody, T J; Rush, A J; Thase, M E; Trivedi, M H; Arnow, B A; Klein, D N; Keller, M B

    2010-03-01

    Dyadic discord, while common in depression, has not been specifically evaluated as an outcome predictor in chronic major depressive disorder. This study investigated pretreatment dyadic discord as a predictor of non-remission and its relationship to depressive symptom change during acute treatment for chronic depression. Out-patients with chronic depression were randomized to 12 weeks of treatment with nefazodone, the Cognitive Behavioral Analysis System of Psychotherapy or their combination. Measures included the Marital Adjustment Scale (MAS) and the Inventory of Depressive Symptomatology - Self Report (IDS-SR30). Of 681 original patients, 316 were partnered and 171 of these completed a baseline and exit MAS, and at least one post-baseline IDS-SR30. MAS scores were analysed as continuous and categorical variables ('dyadic discord' v. 'no dyadic discord' defined as an MAS score >2.36. Remission was defined as an IDS-SR30 of 14 at exit (equivalent to a 17-item Hamilton Rating Scale for Depression of 7). Patients with dyadic discord at baseline had lower remission rates (34.1%) than those without dyadic discord (61.2%) (all three treatment groups) (chi2=12.6, df=1, p=0.0004). MAS scores improved significantly with each of the treatments, although the change was reduced by controlling for improvement in depression. Depression remission at exit was associated with less dyadic discord at exit than non-remission for all three groups [for total sample, 1.8 v. 2.4, t(169)=7.3, p<0.0001]. Dyadic discord in chronically depressed patients is predictive of a lower likelihood of remission of depression. Couple therapy for those with dyadic discord may increase remission rates.

  15. Interleukin-6 receptor inhibition with tocilizumab and attainment of disease remission in rheumatoid arthritis: the role of acute-phase reactants.

    Science.gov (United States)

    Smolen, Josef S; Aletaha, Daniel

    2011-01-01

    To determine the effects of tocilizumab on rheumatoid arthritis (RA) disease activity and remission assessment, using measures that do or do not comprise acute-phase reactants. Simplified Disease Activity Index (SDAI) scores, Clinical Disease Activity Index (CDAI) scores, and the Disease Activity Score in 28 joints (DAS28) were calculated using data from tocilizumab trials in patients with RA in whom disease had remained active despite treatment with disease-modifying antirheumatic drugs. The CDAI does not contain an acute-phase reactant component. Disease activity states, including remission, were defined using established cut points; for the DAS28, an alternative cut point of acute-phase reactant values in order to fulfill the criteria. However, DAS28 remission rates were higher (even when using the lower cut point) than the SDAI and CDAI remission rates. Only a minority of tocilizumab-treated patients with DAS28 remission also had disease remission according to the SDAI (26%) or CDAI (∼21%). With infliximab treatment, SDAI and CDAI remission rates were of the same magnitude as those observed with tocilizumab treatment, and DAS28 remission rates were lower. Tocilizumab-treated patients with DAS28 remission but without CDAI remission had significantly higher swollen joint counts but lower erythrocyte sedimentation rates (ESRs) compared with patients with SDAI or CDAI remission. Disease activity in RA is reduced by tocilizumab treatment, irrespective of the type of composite measure used to evaluate disease activity. Remission rates were much higher using the DAS28 compared with the SDAI and CDAI, due to the high weight of the ESR in the DAS28 and the effect of tocilizumab on the ESR. Using the stringent SDAI and CDAI criteria, however, remission rates in patients treated with tocilizumab were in the same range as those seen in patients treated with tumor necrosis factor inhibitors. Copyright © 2011 by the American College of Rheumatology.

  16. Can Ultrasound Be Used to Predict Loss of Remission in Patients with RA in a Real-life Setting? A Multicenter Cohort Study.

    Science.gov (United States)

    Zufferey, Pascal; Scherer, Almut; Nissen, Michael J; Ciurea, Adrian; Tamborrini, Giorgio; Brulhart, Laure; Blumhardt, Sandra; Toniolo, Martin; Möller, Burkhard; Ziswiler, Hans-Ruedi

    2018-01-15

    Several studies have suggested that patients with rheumatoid arthritis (RA) presenting with ultrasound (US) synovitis despite clinical remission have more subsequent flares than those who show both clinical and sonographic remission. The objective of our study was to investigate whether these results could be translated to a real-life setting. We compared the time from the first US performed in clinical remission to loss of remission (defined by a DAS28 > 2.6 or the need for stepping up treatment with disease-modifying antirheumatic drugs) within the Swiss Clinical Quality Management cohort of patients with RA, and we adjusted for relevant confounders. Analyses were repeated for different definitions of US-detected synovitis (US+) using greyscale, Doppler, and combined modes based on previously validated scores, and they were adjusted for relevant confounders. There were 318 RA patients with 378 remission phases included. Loss of clinical remission was observed in 60% of remission phases. Residual US synovitis was associated with a shorter duration of clinical remission (median 2-5 mos) and a moderately increased hazard ratio (HR) for loss of remission (HR 1.2-1.5), with the highest HR for the combined US score. The association between US+ and loss of remission was strongest when the US measurement had taken place early in remission (shorter median duration of 6-20 mos) and when followup time was limited to the first 3 or 6 months (most HR between 2-4). US-detected synovitis, particularly when US is performed early in clinical remission, has a moderate predictive power for loss of remission in a real-life setting.

  17. Remission induction by Raising the dose of Remicade in RA (RRRR study: Rationale and study protocol for a randomized controlled trial comparing for sustained clinical remission after discontinuation of infliximab in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Koji Oba

    2017-12-01

    Full Text Available Infliximab, an inhibitor of TNF-α, is one of the most widely used biological disease-modifying antirheumatic drugs. Recent studies indicated that baseline serum TNF-α could be considered as a key indicator for optimal dosing of infliximab for RA treatment to achieve the clinical response and its sustained remission. The Remission induction by Raising the dose of Remicade in RA (RRRR study is an open-label, parallel group, multicenter randomized controlled trial to compare the proportions of clinical remission based on the simplified disease activity index (SDAI after 1 year of treatment and its sustained remission rate after another 1 year between the investigational treatment strategy (for which the dose of infliximab was chosen based on the baseline serum TNF and the standard strategy of 3 mg/kg per 8 weeks of infliximab administration in infliximab-naïve patients with RA showing an inadequate response to MTX. The primary endpoint is the proportion of patients who kept discontinuation of infliximab 1 year after discontinued infliximab at the time of 54 weeks after the first administration of infliximab. The secondary endpoints are the proportion of clinical remission based on SDAI and changes in SDAI from baseline at each time point, other clinical parameters, quality of life measures and adverse events. Target sample size of randomized patients is 400 patients in total. The main results of the RRRR study are expected to be published at the end of 2017.

  18. Tough Policies, Incredible Policies?

    OpenAIRE

    Andres Velasco; Alejandro Neut

    2003-01-01

    We revisit the question of what determines the credibility of macroeconomic policies here, of promises to repay public debt. Almost all thinking on the issue has focused on governments' strategic decision to default (or erode the value of outstanding debt via inflation/devaluation). But sometimes governments default not because they want to, but because they cannot avoid it: adverse shocks leave them no option. We build a model in which default/devaluation can occur deliberately (for strategi...

  19. Remission and regression in the nephropathy of type 1 diabetes when blood pressure is controlled aggressively

    DEFF Research Database (Denmark)

    Hovind, P; Rossing, P; Tarnow, L

    2001-01-01

    BACKGROUND: Diabetic nephropathy is a chronic, progressive kidney disease with a mean rate of decline of in glomerular filtration rate (GFR) of 10 to 12 mL/min/year (natural history). The introduction of aggressive antihypertensive treatment has improved the renal prognosis during the last decade...... and regression in a sizable fraction of patients with diabetic nephropathy. Lower arterial blood pressure, reduced albuminuria, and better glycemic control were predictors of regression of diabetic nephropathy....... years) in 301 consecutive type 1 diabetic patients with diabetic nephropathy. Diabetic nephropathy was diagnosed clinically if the following criteria were fulfilled: persistent albuminuria> 200 microg/min, presence of diabetic retinopathy, and no evidence of other kidney or renal tract disease. Blood......: The total number of patients who obtained remission was 92 (31%), with a duration of remission of [median (range)] 3.4 (1.0 to 14.1) years, and regression 67 (22%). The patients were stratified in quintiles by the average value of office mean arterial blood pressure (mean +/- SE): 93 +/- 0.5, 99 +/- 0...

  20. Treating to target in major depressive disorder: response to remission to functional recovery.

    Science.gov (United States)

    McIntyre, Roger S; Lee, Yena; Mansur, Rodrigo B

    2015-12-01

    Treating to target in chronic diseases [e.g. Major Depressive Disorder (MDD)] fosters precision, consistency, and appropriateness of treatment selection and sequencing. Therapeutic target definitions/endpoints in MDD should satisfy patient-, provider-, and societal expectations. Functional recovery in depression and return to both physical and mental health are the overarching therapeutic objectives. Treating to target in MDD implies multidimensional symptomatic remission, with a particular emphasis on cognitive function and aspects of positive mental health. Several atypical antipsychotic agents (i.e. brexpiprazole, aripiprazole, quetiapine) are FDA-approved as augmentation agents in MDD. Vortioxetine, duloxetine, and psychostimulants have evidence of independent, direct, and robust effects on cognitive function in MDD. Vortioxetine is the only agent that demonstrates efficacy across multiple cognitive domains in MDD associated with functional recovery. Measurement-based care, health information technology/systems, and integrated care models (e.g. medical homes) provide requisite tools and health environments for optimal health outcomes in MDD. Achieving remission in MDD does not equate to health. Return to positive mental health as well as full functioning provide the impetus to pivot away from traditional provider-defined outcomes toward an inclusive perspective involving patient- and society-defined outcomes (i.e. optimization of human capital). As in other chronic diseases, treating to target (e.g. cognitive function) further increases the probability of achieving optimal health outcomes.

  1. Residuals in post-chemotherapy, non-depressed patients with leukemia that is in remission

    Directory of Open Access Journals (Sweden)

    Peterson K. Rachel

    2016-04-01

    Full Text Available Debate persists regarding the occurrence and etiology of neurocognitive deficits associated with the utilization of chemotherapeutic agents, commonly referred to as “chemobrain”. While some have previously attributed these features to other factors such as fatigue, emotional reactivity, etc., growing literature suggests that in fact chemotherapeutic agents may be the cause. Although research has investigated these deficits, greater investigation is warranted. The current study investigated the presence of residual neurocognitive deficits in non-depressed patients post-chemotherapy with a history of leukemia that was in remission in comparison to healthy controls. Methods: participants included 16 individuals with a history of leukemia post-chemotherapy, in remission and without depression and 48 healthy controls. Participants were assessed using the WJ-III with data from the first seven subtests entered for analysis. A multivariate analysis of variance revealed significant differences existed between groups. By way of a discriminant function analysis, subtest/domain specific discrepancies were noted. Specifically, participants with a history of leukemia who were post-chemotherapy and without depression were found to perform significantly worse on visual-auditory learning, concept formations, and sound blending than did healthy controls. Findings are seen as additional support of the idea that neurocognitive deficits do in fact occur following chemotherapy. However, they are particularly of interest as they are seen even in the absence of emotional distress and outside the active treatment phase. Additional findings of importance and clinical relevance will be discussed.

  2. Fibromyalgia Syndrome: A Metabolic Approach Grounded in Biochemistry for the Remission of Symptoms

    Directory of Open Access Journals (Sweden)

    Silvia Maria Lattanzio

    2017-11-01

    Full Text Available Fibromyalgia syndrome (FMS is a chronic, complex, and heterogeneous disorder of still poorly understood etiopathophysiology associated with important musculoskeletal widespread pain, fatigue, non-restorative sleep, and mood disturbances. It is estimated to afflict 2–3% of the worldwide population, with clean prevalence among women. The objective of this paper is to propose a novel treatment for symptomatic remission of FMS, grounded in biochemistry and consisting in the withdrawal from the diet of molecules that can indirectly trigger the symptoms. The hypothesis develops from the evidence that low serotonin levels are involved in FMS. Serotonin is synthesized starting from the essential amino acid tryptophan. The presence of non-absorbed molecules in the gut, primarily fructose, reduces tryptophan absorption. Low tryptophan absorption leads to low serotonin synthesis that triggers FMS symptoms. Moreover not-absorbed sugars could also produce a microbiota deterioration activating a positive feedback loop: the increasing microbiota deterioration reduces the functionality of absorption both of fructose and tryptophan in the gut, entering a vicious circle. The therapeutic idea is to sustain serotonin synthesis allowing the proper tryptophan absorption. The core of the cure treatment is the exclusion from the diet of some carbohydrates and the marked reduction of some others. The main target is the limitation of total dietary fructose as marked as possible. It could be an effective strategy to get the remission of symptoms acting on the impaired biochemical pathways. The straying from the treatment is expected to cause the reappear of the symptoms.

  3. Malnutrition in remission of childhood cancers as assessed by bioelectric impedance analysis

    Directory of Open Access Journals (Sweden)

    M. V. Konovalova

    2014-07-01

    Full Text Available The results of our cross-sectional bioimpedance study of children aged 7–17 years cured of cancer during follow-up (patients’ group, n = 552, remission time range 0–15 years and of age-matched healthy controls (n = 1,500 show significant intergroup differences in body height and body composition parameters. The most pronounced alterations in the patients’ group were observed in standardized values of phase angle reflecting a sharp decrease in the percentage of metabolically active body cell mass in fat-free mass. Malnutrition, judged from the prevalence of obesity and low phase angle, was observed in 52.7 % of our patients reaching a maximum of 76.8 % in a subgroup of children with CNS tumors. In view of known association that exists between malnutrition and reduced tolerance to chemotherapy, increased susceptibility to infections and adverse outcomes rate, we recommend using bioimpedance analysis in remission of childhood cancers in order to monitoring and timely correction of nutritional state as well as for prevention of delayed cardiovascular risks.

  4. Malnutrition in remission of childhood cancers as assessed by bioelectric impedance analysis

    Directory of Open Access Journals (Sweden)

    M. V. Konovalova

    2012-01-01

    Full Text Available The results of our cross-sectional bioimpedance study of children aged 7–17 years cured of cancer during follow-up (patients’ group, n = 552, remission time range 0–15 years and of age-matched healthy controls (n = 1,500 show significant intergroup differences in body height and body composition parameters. The most pronounced alterations in the patients’ group were observed in standardized values of phase angle reflecting a sharp decrease in the percentage of metabolically active body cell mass in fat-free mass. Malnutrition, judged from the prevalence of obesity and low phase angle, was observed in 52.7 % of our patients reaching a maximum of 76.8 % in a subgroup of children with CNS tumors. In view of known association that exists between malnutrition and reduced tolerance to chemotherapy, increased susceptibility to infections and adverse outcomes rate, we recommend using bioimpedance analysis in remission of childhood cancers in order to monitoring and timely correction of nutritional state as well as for prevention of delayed cardiovascular risks.

  5. Illness history: Not associated with remission during treatment of major depression in 515 mood disorder patients.

    Science.gov (United States)

    Baldessarini, Ross J; Tondo, Leonardo; Visioli, Caterina; Vázquez, Gustavo H

    2016-02-01

    There is suggestive evidence that prior illness history may have little association with response to long-term treatment in bipolar disorder (BD) or recurrent major depressive disorder (MDD), but relationships of illness-history to treatment-response in acute episodes of depression require further testing. We tested for associations of selected measures of illness history with remission during treatment of an acute index episode of major depression in 515 mood-disorder patients (327 MDD, 188 BD), using bivariate and multivariate methods. Remission of depression was more likely with lesser initial symptom-severity and bipolar diagnosis, but not related to years since illness-onset, previous depressions or episodes (based on counts, yearly rates, or %-of months ill), or other indices of illness-severity (hospitalization, co-morbidity, suicide attempt). Likelihood of response to standard treatments for acute major depressive episodes in MDD or BD appeared to be largely independent of prior illness-history. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Rituximab Leads to Long Remissions in Patients with Chronic Immune Thrombocytopenia

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    Khalid Al-Habsi

    2015-03-01

    Full Text Available Objectives: To assess the response rate and duration of response in patients with chronic immune thrombocytopenia (ITP receiving rituximab. Methods: We retrospectively analyzed 32 consecutive patients with chronic ITP who were treated in two tertiary centers in Oman. Response assessment was based on the American Society of Hematology criteria. Results: Nineteen patients (59% had an initial response. However, six of the 19 patients lost their response leaving 13 patients with long-lasting remissions. The median age at diagnosis was 25 years (range 14–58. The median time from diagnosis to rituximab therapy was 21 months. The median follow-up after starting rituximab was 26 months. The overall cumulative response rate was 59% (complete response 44%, partial response 15% and the median time to respond was 30 days with a response rate of 44% at four weeks. In all responders, the cumulative rate of loss of response was 32% with a median time to lose response of 54 months. Conclusions: The use of rituximab in ITP achieves high response rate and long remission duration. Our study was limited by the small sample size and further larger prospective studies are recommended.

  7. Advances and hope for perinatal HIV remission and cure in children and adolescents.

    Science.gov (United States)

    Rainwater-Lovett, Kaitlin; Uprety, Priyanka; Persaud, Deborah

    2016-02-01

    The known timing of HIV infection in perinatal transmission, combined with the capacity for early antiretroviral therapy (ART) initiation and immune reconstitution, can provide unique insights into HIV persistence. The scientific basis for a pediatric-specific research agenda aimed at HIV remission and cure is discussed. Accumulating evidence supports a favorable biomarker profile for immunotherapeutic interventions in early treated, perinatally infected individuals. HIV DNA concentrations in infected cells of early treated infants decrease over the first few years of life and, after more than 10 years of ART, the overwhelming majority of noninduced proviral genomes are replication-deficient. With early ART initiation, approximately half of perinatally infected individuals become seronegative. Studies of untreated infants and vaccine trials indicate that infected infants can generate HIV-specific humoral responses. Taken together, this evidence suggests that early treatment results in low levels of replication-competent provirus, an absence of HIV-specific immunity, and the capacity to generate immune responses to potential immunotherapeutic interventions. Perinatally HIV-infected individuals require lifelong ART because of the prompt establishment of viral latency in long-lived resting memory CD4 T cells that rekindle viremia upon treatment cessation. However, intense research efforts are ongoing to perturb HIV latency toward reservoir clearance for virologic remission and cure in which perinatally infected individuals can discontinue ART.

  8. A case of remission from pre-diabetes following intermittent hypoxic training.

    Science.gov (United States)

    Fuller, Nicholas R; Courtney, Rosalba

    2016-01-01

    A female patient (49 years of age) with obesity (body mass index: 35.3kg/m(2)) and diagnosed with pre-diabetes presented to the clinic of one of the authors (RC) with recent weight gain (approximately 10kg) over the preceding 12 months, despite several unsuccessful attempts at weight loss. She reported being short of breath performing light activities and feeling fatigued the majority of the time. Treatment consisted of a run in period of five weeks following the Commonwealth Scientific and Industrial Research Organisation (CSIRO) diet, followed by four weeks of the CSIRO diet plus intermittent hypoxic training (IHT) using the GO2(®) altitude training device. Anthropometric measures, bloods and questionnaires were completed before treatment (week 0), end of diet phase (week 5), and end of diet plus IHT phase (week 9). At the end of week five, the patient had lost some weight and had an improvement in glycaemic control. However, there was a clinically greater improvement in weight loss and glycaemic control from week five to nine following the IHT, resulting in remission from pre-diabetes. This case study shows that incorporation of IHT has benefits existing beyond a standard dietary approach, helping to achieve remission from pre-diabetes back to a normal fasting glucose state. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  9. Cognitive processes and their association with persistence and remission of insomnia: findings from a longitudinal study in the general population.

    Science.gov (United States)

    Norell-Clarke, Annika; Jansson-Fröjmark, Markus; Tillfors, Maria; Harvey, Allison G; Linton, Steven J

    2014-03-01

    Insomnia is a common health problem that affects about 10% of the population. The purpose of this investigation was to examine the association between cognitive processes and the persistence and remission from insomnia in the general population. In a longitudinal design, 2333 participants completed a survey on night time and daytime symptoms, and cognitive processes. Follow-up surveys were sent out six months and 18 months after the first assessment. Participants were categorised as having persistent insomnia, being in remission from insomnia or being a normal sleeper. Cognitive processes distinguished between people with persistent insomnia and normal sleepers. Specifically, worry, dysfunctional beliefs, somatic arousal, selective attention and monitoring, and safety behaviours increased the likelihood of reporting persistent insomnia rather than normal sleep. For people with insomnia, more worry about sleep at baseline predicted persistent insomnia but not remission later on. Lower selective attention and monitoring, and use of safety behaviours over time increased the likelihood of remission from insomnia. In general, these results remained, when psychiatric symptoms and medical complaints were added to the models. The findings support that certain cognitive processes may be associated with persistence and remission of insomnia. Clinical implications are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Acute kidney injury in patients with newly diagnosed high-grade hematological malignancies: impact on remission and survival.

    Directory of Open Access Journals (Sweden)

    Emmanuel Canet

    Full Text Available BACKGROUND: Optimal chemotherapy with minimal toxicity is the main determinant of complete remission in patients with newly diagnosed hematological malignancies. Acute organ dysfunctions may impair the patient's ability to receive optimal chemotherapy. DESIGN AND METHODS: To compare 6-month complete remission rates in patients with and without acute kidney injury (AKI, we collected prospective data on 200 patients with newly diagnosed high-grade malignancies (non-Hodgkin lymphoma, 53.5%; acute myeloid leukemia, 29%; acute lymphoblastic leukemia, 11.5%; and Hodgkin disease, 6%. RESULTS: According to RIFLE criteria, 137 (68.5% patients had AKI. Five causes of AKI accounted for 91.4% of cases: hypoperfusion, tumor lysis syndrome, tubular necrosis, nephrotoxic agents, and hemophagocytic lymphohistiocytosis. Half of the AKI patients received renal replacement therapy and 14.6% received suboptimal chemotherapy. AKI was associated with a lower 6-month complete remission rate (39.4% vs. 68.3%, P<0.01 and a higher mortality rate (47.4% vs. 30.2%, P<0.01 than patients without AKI. By multivariate analysis, independent determinants of 6-month complete remission were older age, poor performance status, number of organ dysfunctions, and AKI. CONCLUSION: AKI is common in patients with newly diagnosed high-grade malignancies and is associated with lower complete remission rates and higher mortality.

  11. Relationship between the general condition of acute lymphoblastic leukemia patients with remission rate and convulsion as an adverse effect chemotherapy

    Directory of Open Access Journals (Sweden)

    Rusdi Andid

    2017-02-01

    Full Text Available A retrospective study on the relationship between the general condition of acute lymphoblastic leukemia patients with remission rale and convulsion as an adverse effect of chemotherapy was conducted in leukemia patients of the hematology-oncology subdivision, Departmenl of Child Health, Medical School, University of North Sumatra, Medan. Of 114 children with acute lymphoblastic leukemia, 81 (71.05% received chemotherapy, 31 patients among them was in good general condition. Remission rate of the 31 patients was 80.6% (25 children. Whereas in the remaining 50 patients, the remission rate among them was 84% (42 patients. There was no significant relationship between their general condition to the recurrence rate of acute lymphoblastic leukemia patients who had been administered chemotherapy during induction phase. Convulsion was found In 2 cases, due to CNS leukemia.

  12. Pulse versus daily oral cyclophosphamide for induction of remission in antineutrophil cytoplasmic antibody-associated vasculitis: a randomized trial

    DEFF Research Database (Denmark)

    de Groot, Kirsten; Harper, Lorraine; Jayne, David R W

    2009-01-01

    BACKGROUND: Current therapies for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis are limited by toxicity. OBJECTIVE: To compare pulse cyclophosphamide with daily oral cyclophosphamide for induction of remission. DESIGN: Randomized, controlled trial. Random assignments were...... generalized ANCA-associated vasculitis with renal involvement but not immediately life-threatening disease. INTERVENTION: Pulse cyclophosphamide, 15 mg/kg every 2 to 3 weeks (76 patients), or daily oral cyclophosphamide, 2 mg/kg per day (73 patients), plus prednisolone. MEASUREMENT: Time to remission (primary.......7%). Thirteen patients in the pulse group and 6 in the daily oral group achieved remission by 9 months and subsequently had relapse. Absolute cumulative cyclophosphamide dose in the daily oral group was greater than that in the pulse group (15.9 g [interquartile range, 11 to 22.5 g] vs. 8.2 g [interquartile...

  13. Pulse versus daily oral cyclophosphamide for induction of remission in antineutrophil cytoplasmic antibody-associated vasculitis: a randomized trial

    DEFF Research Database (Denmark)

    de Groot, Kirsten; Harper, Lorraine; Jayne, David R W

    2009-01-01

    BACKGROUND: Current therapies for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis are limited by toxicity. OBJECTIVE: To compare pulse cyclophosphamide with daily oral cyclophosphamide for induction of remission. DESIGN: Randomized, controlled trial. Random assignments were...... generalized ANCA-associated vasculitis with renal involvement but not immediately life-threatening disease. INTERVENTION: Pulse cyclophosphamide, 15 mg/kg every 2 to 3 weeks (76 patients), or daily oral cyclophosphamide, 2 mg/kg per day (73 patients), plus prednisolone. MEASUREMENT: Time to remission (primary...... regimen induced remission of ANCA-associated vasculitis as well as the daily oral regimen at a reduced cumulative cyclophosphamide dose and caused fewer cases of leukopenia. PRIMARY FUNDING SOURCE: The European Union....

  14. Proinsulin, GLP-1, and glucagon are associated with partial remission in children and adolescents with newly diagnosed type 1 diabetes

    DEFF Research Database (Denmark)

    Kaas, A.; Andersen, M. L. M.; Fredheim, Siri

    2012-01-01

    Objective: Proinsulin is a marker of beta-cell distress and dysfunction in type 2 diabetes and transplanted islets. Proinsulin levels are elevated in patients newly diagnosed with type 1 diabetes. Our aim was to assess the relationship between proinsulin, insulin dose-adjusted haemoglobin A1c (IDAA......1C), glucagon-like peptide-1 (GLP-1), glucagon, and remission status the first year after diagnosis of type 1 diabetes. Methods: Juvenile patients (n = 275) were followed 1, 6, and 12 months after diagnosis. At each visit, partial remission was defined as IDAA1C = 9%. The patients had a liquid meal.......002) were significantly lower in remitters than in non-remitters at 6 and 12 months. Proinsulin associated positively with GLP-1 at 1 month (p = 0.004) and negatively at 6 (p = 0.002) and 12 months (p = 0.0002). Conclusions: In type 1 diabetes, patients in partial remission have higher levels of proinsulin...

  15. [The phenomenon of attachment to parents, the duration of therapeutic remissions and autoaggressive behavior among inpatients with alcohol addiction].

    Science.gov (United States)

    Fedotov, I A; Shustov, D I

    2016-01-01

    To determine the role of phenomenon of attachment to parents in the formation of therapeutic remission and the relationship between attachment styles and autoaggressive behavior in patients with alcohol addiction (AA). Sixty-two patients with AA and 30 controls were examined. Insecure attachment styles were most frequents in AA patients that indicated a role of attachment pathology in the development of the disease. Higher frequency of secure and preoccupied styles were noted in patients with AA with the duration of therapeutic remissions more than one year compared to those with shorter duration. No effect of duration of therapeutic remission on autoaggressive behavior was found in patients who did not receive special treatment. In AA patients, avoidant style was correlated with autoaggression in family and professional spheres, and high-anxious style was correlated with classical autoaggression in the form of antisocial behavior.

  16. Clinical Outcomes of Remission Induction Therapy for Severe Antineutrophil Cytoplasmic Antibody–Associated Vasculitis

    Science.gov (United States)

    Miloslavsky, E. M.; Specks, U.; Merkel, P. A.; Seo, P.; Spiera, R.; Langford, C. A.; Hoffman, G. S.; Kallenberg, C. G. M.; St.Clair, E. W.; Tchao, N. K.; Viviano, L.; Ding, L.; Sejismundo, L. P.; Mieras, K.; Iklé, D.; Jepson, B.; Mueller, M.; Brunetta, P.; Allen, N. B.; Fervenza, F. C.; Geetha, D.; Keogh, K.; Kissin, E. Y.; Monach, P. A.; Peikert, T.; Stegeman, C.; Ytterberg, S. R.; Stone, J. H.

    2016-01-01

    Objective To evaluate the reasons that complete remission is not achieved or maintained with original treatment in some patients with antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV) treated with rituximab (RTX) or with cyclophosphamide/azathioprine (CYC/AZA). Methods The Rituximab in AAV trial was a randomized, double-blind, placebo-controlled trial comparing the rate of remission induction among patients treated with RTX (n = 99) and patients treated with CYC followed by AZA (n = 98). Glucocorticoids were tapered over a period of 5 months. The primary outcome measure was lack of disease activity without glucocorticoid treatment at 6 months. To determine the most important reason for failure to achieve the primary outcome, 7 hierarchical categories of reasons were defined retrospectively (uncontrolled disease, adverse event leading to therapy discontinuation, severe flare, limited flare, Birmingham Vasculitis Activity Score for Wegener’s Granulomatosis >0, prednisone treatment at any dosage, and other). Results Although remission (lack of disease activity) was achieved in 170 of the 197 patients (86%) in the first 6 months, the primary outcome measure was not achieved in 42%. There were 3 deaths. Twenty-four percent of the patients failed to achieve the primary end point due to active disease: 10 (5%) experienced uncontrolled disease in the first month and 37 (19%) experienced flares after initial improvement. In the majority of such patients, treatment with blinded crossover or according to best medical judgment led to disease control. Ninety-one percent of patients who had uncontrolled disease or experienced a severe flare had proteinase 3 (PR3)–ANCA. When patients with uncontrolled disease were excluded from analysis, those who were PR3-ANCA positive were found to experience fewer flares when treated with RTX compared to CYC/AZA (8 of 59 [14%] versus 20 of 62 [32%]; P = 0.02). Neither ANCA titers nor B cell counts predicted disease

  17. Bipolar depression: the importance of being on remission Depressão bipolar: a importância da remissão

    Directory of Open Access Journals (Sweden)

    Fernando Kratz Gazalle

    2006-06-01

    Full Text Available OBJECTIVE: The aim of the present study is to compare quality of life among currently depressed, subsyndromal and remitted patients with bipolar disorder (BD and to assess whether the level of depression correlates with the scores of quality of life in BD patients. METHOD: Sixty bipolar outpatients diagnosed using the Structured Clinical Interview for DSM-IV who met criteria for diagnosis of BD type I, II or not otherwise specified (BD-NOS, and who were not currently on a manic or mixed episode were included. The main variables of interest were quality of life (QOL assessed using the 26-item World Health Organization QOL instrument (WHOQOL-BREF and depression assessed using the 17-item Hamilton Depression Rating Scale (HDRS. RESULTS: A linear trend test showed a dose response association between patients' current mood state and all domains of quality of life. Higher quality of life scores were found among remitted patients, followed by subsyndromal patients; depressed patients presented lower scores of quality of life, except for the social domain. The four domains of the WHOQOL scale correlated negatively with the HDRS. CONCLUSIONS: Our findings suggest that bipolar depression and residual symptoms of depression are negatively correlated with QOL in BD patients.OBJETIVO: O objetivo deste estudo é o de comparar a qualidade de vida entre pacientes com transtorno bipolar que estão atualmente deprimidos, com depressão subsindrômica e com remissão de sintomas, e avaliar se o nível de depressão tem correlação com os escores de qualidade de vida em pacientes com transtorno bipolar. MÉTODO: Sessenta pacientes bipolares tratados ambulatorialmente, diagnosticados pela Entrevista Clínica Estruturada do DSM-IV, que preencheram critérios diagnósticos de transtorno bipolar tipo I, tipo II ou sem outra especificação (TB-SOE, e que não estavam atualmente em um episódio maníaco ou misto foram incluídos. As principais variáveis de interesse

  18. Subclinical Synovitis Measured by Ultrasound in Rheumatoid Arthritis Patients With Clinical Remission Induced by Synthetic and Biological Modifying Disease Drugs.

    Science.gov (United States)

    Cruces, Marcos; Al Snih, Soham; Serra-Bonett, Natalí; Rivas, Juan C

    2017-10-09

    Rheumatoid arthritis (RA) patients with disease in clinical remission might show subclinical synovitis, which can be related to the progress of structural joint damage. To determine and compare the degree of synovial inflammation by ultrasound (US) in patients with RA in clinical remission, treated with DMARD or combination therapy with DMARD and anti-TNF. Hospital-based cross-sectional study of 58 patients with RA in sustained remission for at least 6 months by DAS28 <2.6, who attended the Rheumatology Service at the Hospital Universitario de Caracas. Patients underwent clinical, functional, and laboratory assessments. Ultrasound was performed in hands measuring synovial effusion, synovial hypertrophy and power Doppler signal; using a semiquantitative 4-point scale of 0=none to 3=severe. Chi-square and t-test were used to compare the clinical, functional, laboratory and US assessments between the DMARD (N=37) and combination therapy with DMARD and anti-TNF (N=21) groups. A p-value <0.05 was considered statistically significant. Out of 58 patients, 25.9% had remission by US and 74.1% had synovial effusion or hypertrophy or positive power Doppler signal. Non-significant differences in US synovitis between the two groups were found. Persistent US activity was evident in a high percentage of rheumatoid arthritis patients in clinical remission by DAS28. No differences in subclinical synovitis measured by US were found between patients with DMARD and anti-TNF-induced clinical remission. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  19. Mucosa-Associated Lymphoid Tissue Lymphoma of the Lacrimal Gland: Sustained Remission after Eradication of Helicobacter Pylori Infection

    Directory of Open Access Journals (Sweden)

    Mohammed Hasosah

    2011-01-01

    Full Text Available Mucosa-associated lymphoid tissue (MALT lymphoma is the third most common non-Hodgkin lymphoma, and it is strongly associated with helicobacter pylori infection of the stomach. MALT lymphoma of the lacrimal gland usually presents as a localized disease process in extranodal tissues. The treatment options of MALT lymphoma of the lacrimal gland chiefly include radiation of the tumor, chemotherapy, surgical removal, or a combination of these strategies. We report a case of localized MALT lymphoma of the lacrimal gland, with prolonged sustained remission after eradication of gastric Helicobacter pylori (H. Pylori infection. He sustains in remission of lacrimal MALT lymphoma for four years without chemotherapy or radiotherapy.

  20. Anakinra induces complete remission of nephrotic syndrome in a patient with familial mediterranean fever and amyloidosis.

    Science.gov (United States)

    Sevillano, Ángel M; Hernandez, Eduardo; Gonzalez, Esther; Mateo, Isabel; Gutierrez, Eduardo; Morales, Enrique; Praga, Manuel

    2016-01-01

    Renal amyloidosis is one of the most severe complications of familial Mediterranean fever (FMF). Colchicine has reduced the incidence of this complication, which now only appears in untreated, under-treated and resistant patients, but it is usually ineffective in patients with advanced amyloidosis. Here we report a patient with FMF and biopsy-proven amyloidosis who presented with nephrotic syndrome despite colchicine treatment. Anakinra (an interleukin-1β inhibitor) was started and a dramatic complete remission of nephrotic syndrome was observed in the following months. Anakinra can be an effective treatment for FMF patients with severe secondary amyloidosis. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  1. Deep molecular responses for treatment-free remission in chronic myeloid leukemia.

    Science.gov (United States)

    Dulucq, Stéphanie; Mahon, Francois-Xavier

    2016-09-01

    Several clinical trials have demonstrated that some patients with chronic myeloid leukemia in chronic phase (CML-CP) who achieve sustained deep molecular responses on tyrosine kinase inhibitor (TKI) therapy can safely suspend therapy and attempt treatment-free remission (TFR). Many TFR studies to date have enrolled imatinib-treated patients; however, the feasibility of TFR following nilotinib or dasatinib has also been demonstrated. In this review, we discuss available data from TFR trials and what these data reveal about the molecular biology of TFR. With an increasing number of ongoing TFR clinical trials, TFR may become an achievable goal for patients with CML-CP. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  2. Impact of highly active antiretroviral therapy in the development and remission of oral plasmablastic lymphoma

    Directory of Open Access Journals (Sweden)

    Vivian Petersen Wagner

    2016-01-01

    Full Text Available Plasmablastic lymphoma (PBL represents a rare type of non-Hodgkin lymphoma associated with human immunodeficiency virus (HIV infection. The impact of highly active antiretroviral therapy (HAART in this tumor is poorly known due to its small incidence. This study reports a case of a 33-year-old HIV-positive woman who was referred to the Stomatology Department complaining about a painful gingival growth and cervical nodule both with 20 days of evolution. The lesions appeared 7 months after the patient stopped HAART. The final diagnosis was PBL. After resuming HAART for 45 days, the gingival lesion presented complete remission. The patient continued with HAART alongside chemotherapy. At 24 months follow-up, the patient was stable. The dental surgeon plays an essential role in orientation and retention in care of HIV patients once the adherence of HAART seems to play an important role in PBL development and response to treatment.

  3. Daily chlorhexidine bathing does not increase skin toxicity after remission induction or stem cell transplantation.

    Science.gov (United States)

    Deeren, Dries; Dewulf, Evelyne; Verfaillie, Lydie

    2016-12-01

    A recent multicenter study demonstrated that bathing with chlorhexidine reduces the transmission of resistant organisms and the risk of hospital-acquired bloodstream infections in ICUs. We wanted to confirm the feasibility of this strategy in a cohort of patients in a typical intensive haematology unit. Patients treated with remission induction chemotherapy, autologous or allogeneic stem cell transplantation received daily chlorhexidine bathing. To avoid deshydratation of skin, we used prophylactic application of hydrating lotion, replaced by corticosteroid cream in case of skin toxicity of chemotherapy or conditioning. We studied 15 consecutive admissions of 12 patients. Daily chlorhexidine bathing never needed to be interrupted, even though 53% of patients were treated with intravenous cytarabine. Patients were satisfied with the skin treatment and reported few unwanted effects. Daily chlorhexidine bathing was feasible in our intensive haematology unit in all patients and did not increase skin toxicity, even when treated with IV cytarabine.

  4. Predictors of impaired work functioning in employees with major depression in remission.

    Science.gov (United States)

    de Vries, Gabe; Koeter, Maarten W J; Nieuwenhuijsen, Karen; Hees, Hiske L; Schene, Aart H

    2015-10-01

    This study aims to (i) assess work functioning in employees returning to work with a major depression in remission, (ii) study the predictors of impaired work functioning. Participants diagnosed with major depressive disorder (MDD), on long term sick leave (mean 27 weeks) and treated in a specialized mental healthcare setting, were selected from an intervention study sample. They were eligible for this study if they were remitted from their depression and had returned to work for at least 50% of their contract hours at 18 month follow-up. Work functioning was assessed with the Work Limitations Questionnaire (WLQ) and the Need For Recovery scale (NFR). Potential predictors of impaired work functioning were demographic characteristics (assessed at baseline), health characteristics (assessed at baseline, six and twelve month follow-up), and personality- and work characteristics (assessed at 18 month follow-up). After their return to work with MDD in remission, employees were on average still impaired in their work functioning. Personality characteristics were the strongest predictor of this impaired work functioning, followed by health and work characteristics. In the final prediction model, only a passive reaction coping style remained as predictor. We used self-report data with respect to work functioning and work characteristics and not an assessment by a supervisor. Personality trait, coping style, and ability to manage the work environment should be addressed in mental health and return-to-work interventions. Subsequent improved work functioning may be beneficial for mental health and may reduce societal costs. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Immunologic prediction of relapse in patients with pemphigus vulgaris (PV) in clinical remission.

    Science.gov (United States)

    Daneshpazhooh, Maryam; Zafarmand Sedigh, Vahid; Balighi, Kamran; Hosseini, S Hamed; Ramezani, Ali; Kalantari, Mohammad-Sadegh; Ghandi, Narges; Ghiasi, Maryam; Nikoo, Azita; Chams-Davatchi, Cheyda

    2016-06-01

    Pemphigus vulgaris (PV) is characterized by multiple relapses, occurring especially in patients on minimal therapy or off therapy. To identify immunologic predictors (anti-desmoglein [Dsg] 1 and 3 antibodies; direct immunofluorescence [DIF]) for relapse in PV patients. Eighty-nine patients in complete clinical remission for at least 6 months and receiving less than or equal to 10 mg prednisolone daily and no immunosuppressive drugs were evaluated using DIF (n=89) and Dsg ELISA (n=46). They were followed until relapse or for at least 18 months. DIF was positive in 44 of 89 patients (49.5%); anti-Dsg 3 antibodies were detected in 18 of 46 patients (39.1%) and anti-Dsg 1 antibodies were detected in 4 of 46 patients (8.7%). Relapse occurred in 38 patients (42.7%). Mean relapse-free time was significantly shorter in anti-Dsg 3-positive patients compared to anti-Dsg 3- negative patients (P = .015) and in DIF-positive patients compared to DIF-negative patients (P = .047), but not in anti-Dsg 1- positive patients compared to anti-Dsg 1-negative patients (P = .501). Sensitivity and predictive values of neither of these tests were high. Small number of anti-Dsg 1-positive patients and use of conventional ELISA. Positive anti-Dsg 3 ELISA and, to a lesser degree, positive DIF are predictors of relapse in PV patients in clinical remission. Decision on discontinuing treatment should be based on the results of these tests as well as on clinical findings. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  6. Remission of histiocytic ulcerative colitis in Boxer dogs correlates with eradication of invasive intramucosal Escherichia coli.

    Science.gov (United States)

    Mansfield, C S; James, F E; Craven, M; Davies, D R; O'Hara, A J; Nicholls, P K; Dogan, B; MacDonough, S P; Simpson, K W

    2009-01-01

    Historically, histiocytic ulcerative (HUC) (or granulomatous) colitis of Boxer dogs was considered an idiopathic immune-mediated disease with a poor prognosis. Recent reports of dramatic responses to enrofloxacin and the discovery of invasive Escherichia coli within the colonic mucosa of affected Boxer dogs support an infectious etiology. Invasive E. coli is associated with colonic inflammation in Boxer dogs with HUC, and eradication of intramucosal E. coli correlates with clinical and histologic remission. Seven Boxer dogs with HUC. Prospective case series. Colonic biopsies were obtained at initial evaluation in 7 dogs, and in 5 dogs after treatment with enrofloxacin. Biopsies were evaluated by standardized histopathology, and fluorescence in situ hybridization (FISH) with probes to eubacteria and E. coli. Intramucosal E. coli was present in colonic biopsies of 7/7 Boxers with HUC. Clinical response was noted in all dogs within 2 weeks of enrofloxacin (7 + or - 3.06 mg/kg q24 h, for 9.5 + or - 3.98 weeks) and was sustained in 6 dogs (median disease-free interval to date of 47 months, range 17-62). FISH was negative for E. coli in 4/5 dogs after enrofloxacin. E. coli resistant to enrofloxacin were present in the FISH-positive dog that relapsed. The correlation between clinical remission and the eradication of mucosally invasive E. coli during treatment with enrofloxacin supports the causal involvement of E. coli in the development of HUC in susceptible Boxer dogs. A poor response to enrofloxacin treatment might be due to colonization with enrofloxacin-resistant E. coli.

  7. Epidermal growth factor enemas for induction of remission in left-sided ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Hugo Nodarse-Cuní

    2013-03-01

    Full Text Available Introduction: ulcerative colitis is a little known chronic inflammatory disease in colonic mucosa. The positive effect of epidermal growth factor was shown in a previous report, with enema use for treatment of mild to moderate left-sided manifestation of the disease. This evidence provided the basis for evaluating the efficacy and safety profile of a viscous solution of this product. Methods: thirty-one patients were randomized to three groups for daily medications during 14 days. Twelve received one 10 mg enema of epidermal growth factor dissolved in 100 mL of viscous solution whereas nine were treated with placebo enema; both groups also received 1.2 g of oral mesalamine per day. The other group included ten patients with 3 g / 100 mL of mesalamine enema. Primary end point was clinical responses after two weeks of treatment, defined as a decreased of, at least three points from baseline, the Disease Activity Index and endoscopic or histological evidences of improvement. Results: remission of disease was observed in all patients in the epidermal growth factor group, and six in both, mesalamine enema and placebo group. All the comparisons between groups showed statistically significant superiority for epidermal growth factor, the only product with significant reduction in disease activity index as well as the presence and intensity of digestive symptoms in patients after treatment. None adverse event was reported. Conclusions: the results agree with previous molecular and clinical evidences, indicating that the epidermal growth factor is effective to reduce disease activity and to induce remission. A new study involving more patients should be conducted to confirm the efficacy of the epidermal growth factor enemas.

  8. The policies

    International Nuclear Information System (INIS)

    Laruelle, Ph.; Snegaroff, Th.; Moreau, S.; Tellenne, C.; Brunel, S.

    2005-01-01

    Fourth chapter of the book on the geo-policy of the sustainable development, this chapter deal with the different and international policies concerned by the problem. The authors analyze the american energy attitude and policy, the economical equilibrium facing the environmental equilibrium for the european policy, the sanctified and sacrificed nature and the japanese attitude, India and China, the great fear of the 21 century and the sustainable development in Africa. (A.L.B.)

  9. 27 CFR 25.286 - Claims for remission of tax on beer lost in transit between breweries.

    Science.gov (United States)

    2010-04-01

    ... tax on beer lost in transit between breweries. 25.286 Section 25.286 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS BEER Refund or Adjustment of Tax or Relief From Liability § 25.286 Claims for remission of tax on beer lost in transit...

  10. Histiocytic lymphoma in the brain as the only manifestation of relapse following remission maintainance with BCG immunotherapy.

    Science.gov (United States)

    Snyder, R D; Mavligit, G M; Valdivieso, M; Gutterman, J U; Burke, J S

    1977-05-01

    This report describes an unusual case of lymphoma which, after 54 months of complete remission induced with chemotherapy and maintained with BCG immunotherapy, relapsed in the brain alone. It is possible that the immunotherapy led to this pattern of relapse: this is supported by several other studies. The difficulty in diagnosing brain lymphoma is emphasized.

  11. The provisional ACR/EULAR definition of remission in RA: a comment on the patient global assessment criterion

    NARCIS (Netherlands)

    Vermeer, M.; Kuper, Hillechina H.; van der Bijl, Arie E.; Baan, H.; Posthumus, Marcel D.; Brus, Herman L.M.; van Riel, Piet L.C.M.; van de Laar, Mart A F J

    2012-01-01

    Objectives. The provisional ACR/European League Against Rheumatism (EULAR) definition of remission in RA requires a score of ≤1 on the patient global assessment (PGA, 0–10 scale). We explored the relation between the PGA criterion and the patient's clinical disease state in an observational dataset.

  12. The provisional ACR/EULAR definition of remission in RA : a comment on the patient global assessment criterion

    NARCIS (Netherlands)

    Vermeer, Marloes; Kuper, Hillechiena H.; van der Bijl, Arie E.; Baan, Henriette; Posthumus, Marcel D.; Brus, Herman L. M.; van Riel, Piet L. C. M.; van de Laar, Mart A. F. J.

    Objectives. The provisional ACR/European League Against Rheumatism (EULAR) definition of remission in RA requires a score of 41 on the patient global assessment (PGA, 0-10 scale). We explored the relation between the PGA criterion and the patient's clinical disease state in an observational dataset.

  13. Phase II study of intensive chemotherapy with autologous bone marrow transplantation in patients in complete remission of disseminated breast cancer

    NARCIS (Netherlands)

    deVries, EGE; Rodenhuis, S; Hupperets, PSGJ; Dolsma, WV; Lebesque, JV; Blijham, GH; Bontenbal, M; Mulder, NH

    1996-01-01

    Background: This trial studied the disease-free survival after high-dose chemotherapy in patients in complete remission of metastatic breast cancer. Patients and methods: Thirty women, mean age 42.2 years (range 33-55) with metastatic breast cancer, received high-dose chemotherapy in a phase II

  14. Testicular function in young men in long-term remission after treatment for the early stages of Hodgkin's disease

    DEFF Research Database (Denmark)

    Specht, L; Geisler, C; Hansen, M M

    1984-01-01

    16 young men in long-term remission after standard treatment for the early stages of Hodgkin's disease were examined for testicular function 48 to 125 months after termination of therapy. The patients had received mantle field irradiation, plus either irradiation of infradiaphragmatic lymph nodes...... to chemotherapy, especially including alkylating agents....

  15. Role of Microglial M1/M2 Polarization in Relapse and Remission of Psychiatric Disorders and Diseases

    Directory of Open Access Journals (Sweden)

    Yutaka Nakagawa

    2014-11-01

    Full Text Available Psychiatric disorders such as schizophrenia and major depressive disorder were thought to be caused by neurotransmitter abnormalities. Patients with these disorders often experience relapse and remission; however the underlying molecular mechanisms of relapse and remission still remain unclear. Recent advanced immunological analyses have revealed that M1/M2 polarization of macrophages plays an important role in controlling the balance between promotion and suppression in inflammation. Microglial cells share certain characteristics with macrophages and contribute to immune-surveillance in the central nervous system (CNS. In this review, we summarize immunoregulatory functions of microglia and discuss a possible role of microglial M1/M2 polarization in relapse and remission of psychiatric disorders and diseases. M1 polarized microglia can produce pro-inflammatory cytokines, reactive oxygen species, and nitric oxide, suggesting that these molecules contribute to dysfunction of neural network in the CNS. Alternatively, M2 polarized microglia express cytokines and receptors that are implicated in inhibiting inflammation and restoring homeostasis. Based on these aspects, we propose a possibility that M1 and M2 microglia are related to relapse and remission, respectively in psychiatric disorders and diseases. Consequently, a target molecule skewing M2 polarization of microglia may provide beneficial therapies for these disorders and diseases in the CNS.

  16. Treating to the target of remission in early rheumatoid arthritis is cost-effective: results of the DREAM registry

    NARCIS (Netherlands)

    Vermeer, M.; Kievit, Wietske; Kuper, Hillechina H.; Braakman-Jansen, Louise Marie Antoinette; Bernelot Moens, Hein J.; Zijlstra, Theo; den Broeder, Alfons A.; van Riel, Piet L.C.M.; Fransen, Jaap; van de Laar, Mart A F J

    2013-01-01

    Background Where health economic studies are frequently performed using modelling, with input from randomized controlled trials and best guesses, we used real-life data to analyse the costeffectiveness and cost-utility of a treatment strategy aiming to the target of remission compared to usual care

  17. Adherence to a treat-to-target strategy in early rheumatoid arthritis : results of the DREAM remission induction cohort

    NARCIS (Netherlands)

    Vermeer, Marloes; Kuper, Hillechiena H.; Moens, Hein J. Bernelot; Hoekstra, Monique; Posthumus, Marcel D.; van Riel, Piet L. C. M.; van de Laar, Mart A. F. J.

    2012-01-01

    Introduction: Clinical trials have demonstrated that treatment-to-target (T2T) is effective in achieving remission in early rheumatoid arthritis (RA). However, the concept of T2T has not been fully implemented yet and the question is whether a T2T strategy is feasible in daily clinical practice. The

  18. Adalimumab for induction of clinical remission in moderately to severely active ulcerative colitis: results of a randomised controlled trial

    NARCIS (Netherlands)

    Reinisch, W.; Sandborn, W.J.; Hommes, D.W.; D'Haens, G.; Hanauer, S.; Schreiber, S.; Panaccione, R.; Fedorak, R.N.; Tighe, M.B.; Huang, B.; Kampman, W.; Lazar, A.; Thakkar, R.

    2011-01-01

    Objective The aim of this study was to assess the efficacy and safety of adalimumab (ADA), a recombinant human monoclonal antibody against tumour necrosis factor alpha (TNF), for the induction of clinical remission in anti-TNF naive patients with moderately to severely active ulcerative colitis.

  19. Differential Changes in Gut Microbiota After Gastric Bypass and Sleeve Gastrectomy Bariatric Surgery Vary According to Diabetes Remission.

    Science.gov (United States)

    Murphy, Rinki; Tsai, Peter; Jüllig, Mia; Liu, Amy; Plank, Lindsay; Booth, Michael

    2017-04-01

    It is unclear whether specific gut microbiota is associated with remission of type 2 diabetes (T2D) after distinct types of bariatric surgery. The aim of this study is to examine gut microbiota changes after laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) surgery in obese patients with T2D. Whole-metagenome shotgun sequencing of DNA fragments using Illumina HiSeq2000 was obtained from stool samples collected from 14 obese T2D patients pre-operatively (while on very low calorie diet) and 1 year after randomisation to laparoscopic SG (n = 7) or RYGB (n = 7). Resulting shotgun reads were annotated with Kyoto Encyclopedia of Genes and Genomes (KEGG). Body weight reduction and dietary change was similar 1 year after both surgery types. Identical proportions (n = 5/7) achieved diabetes remission (HbA1c surgery types. KEGG Orthology and pathway analysis predicted contrasting and greater gut microbiota metabolism changes after diabetes remission following RYGB than after SG. Those with persistent diabetes post-operatively had higher Desulfovibrio species pre-operatively. Overall, RYGB produces greater and more predicted favourable changes in gut microbiota functional capacity than SG. An increase in Roseburia species was the only compositional change common to both types of surgery among those achieving diabetes remission.

  20. REMISSION OF CHILDHOOD ASTHMA AFTER LONG-TERM TREATMENT WITH AN INHALED CORTICOSTEROID (BUDESONIDE) - CAN IT BE ACHIEVED

    NARCIS (Netherlands)

    VANESSENZANDVLIET, EE; HUGHES, MD; WAALKENS, HJ; DUIVERMAN, EJ; KERREBIJN, KF

    This study was undertaken in order to determine whether long-term treatment with inhaled corticosteroid can induce a remission in childhood asthma, and to decide when stabilization of airway responsiveness occurred. We therefore carried out, an extended follow-up of 28-36 months in one of two groups

  1. Emotional functioning of parents of children with cancer: the first five years of continuous remission after the end of treatment

    NARCIS (Netherlands)

    Maurice-Stam, Heleen; Oort, Frans J.; Last, Bob F.; Grootenhuis, Martha A.

    2008-01-01

    OBJECTIVES: The aim of this study is to investigate parental emotional functioning during the first five years of continuous remission after the end of their child's treatment and to identify predictors of parental emotional functioning. METHODS: Psychological distress and situation-specific

  2. Emotional functioning of parents of children with cancer: The first five years of continuous remission after the end of treatment

    NARCIS (Netherlands)

    Maurice-Stam, H.; Oort, F.J.; Last, B.F.; Grootenhuis, M.A.

    2007-01-01

    Objectives: The aim of this study is to investigate parental emotional functioning during the first five years of continuous remission after the end of their child's treatment and to identify predictors of parental emotional functioning. Methods: Psychological distress and situation-specific

  3. Emotional functioning of parents of children with cancer: the first five years of continuous remission after the end of treatment

    NARCIS (Netherlands)

    Maurice-Stam, H.; Oort, F.J.; Last, B.F.; Grootenhuis, M.A.

    2008-01-01

    Objectives: The aim of this study is to investigate parental emotional functioning during the first five years of continuous remission after the end of their child's treatment and to identify predictors of parental emotional functioning. Methods: Psychological distress and situation-specific

  4. 19 CFR 351.518 - Exemption, remission, or deferral upon export of prior-stage cumulative indirect taxes.

    Science.gov (United States)

    2010-04-01

    ... production of an exported product, a benefit exists to the extent that the exemption extends to inputs that... prior-stage cumulative indirect taxes on an exported product, a benefit exists to the extent that the... 19 Customs Duties 3 2010-04-01 2010-04-01 false Exemption, remission, or deferral upon export of...

  5. Ranking factors involved in diabetes remission after bariatric surgery using machine-learning integrating clinical and genomic biomarkers

    DEFF Research Database (Denmark)

    Pedersen, Helle Krogh; Gudmundsdottir, Valborg; Pedersen, Mette Krogh

    2016-01-01

    classification performance to 84% accuracy (AUC 0.92). The eight SNPs mapped to eight genes — ABCA1, ARHGEF12, CTNNBL1, GLI3, PROK2, RYBP, SMUG1 and STXBP5 — three of which are known to have a role in insulin secretion, insulin sensitivity or obesity, but have not been indicated for diabetes remission after...

  6. The Diagnostic Apathia Scale predicts a dose-remission relationship of T-PEMF in treatment-resistant depression

    DEFF Research Database (Denmark)

    Bech, Per; Lunde, Marianne; Lauritzen, Lise

    2014-01-01

    . The remaining 31 patients received active T-PEMF twice daily. Duration of treatment was 8 weeks in both groups. The Hamilton Depression Scale (HAM-D17) and the Bech-Rafaelsen Melancholia Scale (MES) were used to measure remission. We also focused on the Diagnostic Apathia Scale, which is based on a mixture...

  7. When should patients receive consolidation chemotherapy before allogeneic hematopoietic cell transplantation for acute myeloid leukemia in first complete remission?

    Science.gov (United States)

    Yeshurun, Moshe; Wolach, Ofir

    2018-03-01

    Allogeneic hematopoietic cell transplantation (alloHCT) is a potentially curative therapy for patients with acute myeloid leukemia. Despite the associated graft-versus-leukemia effect, leukemia relapse remains the most common cause of treatment failure after alloHCT. Here, we review the available data on whether there is an advantage in providing pretransplant consolidation chemotherapy prior to alloHCT. Randomized controlled studies are lacking. Data derive largely from four large retrospective registry studies. These analyses are consistent in demonstrating the lack of any survival benefit for pretransplant consolidation chemotherapy once a patient achieves a complete remission and a donor is readily available. These results are valid across conditioning regimen intensities, donor sources, and doses of cytarabine administered during consolidation. Available evidence suggests that patients with acute myeloid leukemia in first complete remission for whom a suitable donor is readily available should not be given pretransplant consolidation before proceeding to alloHCT, regardless of conditioning regimen intensity and that transplantation should be offered promptly at the time remission is achieved without undue delay. Nevertheless, patients for whom a suitable donor is not readily available after achieving first remission, should probably receive 'bridging' consolidation chemotherapy while waiting for a donor to be identified in an attempt to decrease the risk of early disease recurrence before transplantation. The role of minimal residual disease and genetic markers in directing consolidation choices are unclear to date.

  8. [Thymoma Associated with Pure Red Cell Aplasia Treated with Ciclosporin as Remission-induction Therapy before Thymectomy].

    Science.gov (United States)

    Kawakami, Toru; Ishida, Itaru; Yoshimura, Ryuichi; Sugawara, Takafumi; Oura, Hiroyuki; Miyairi, Yasuro

    2015-06-01

    A thymoma with pure red cell aplasia( PRCA) is relatively rare, and the treatment of the disease has not established yet. We describe a case of a thymoma associated with PRCA treated with a surgery and remission-induction therapy by ciclosporin. An 80-year-old man complained of dizziness and his blood cell count showed a severe anemia. He was diagnosed as PRCA by bone-marrow aspiration biopsy, which showed abatement of erythroblasts. In addition, the chest computed tomography revealed a solid tumor in the anterior mediastinum, strongly suggesting a thymoma. Oral administration of ciclosporin as remission-induction therapy for PRCA was started at 1st. The treatment contributed to partial remission for PRCA without blood transfusion. Consecutively thymectomy through median sternotomy was performed at 6 weeks after initiation of the treatment without any transfusions or complications. Histology of the solid tumor showed the thymoma of type B2 in World Health Organization (WHO) category. We continued to treat PRCA with ciclosporin after the surgery. The patient has been surviving for 2 years after surgery without any recurrence of thymoma or relapse of anemia. Combined therapy of surgery and remission-induction therapy with ciclosporin assumed to be a good strategy of the treatment for the patient with a thymoma associated with PRCA.

  9. Effects of prednisone and splenectomy in patients with idiopathic thrombocytopenic purpura : only splenectomy induces a complete remission

    NARCIS (Netherlands)

    Louwes, H; Vellenga, E; Houwerzijl, EJ; de Wolf, JTM

    2001-01-01

    Idiopathic thrombocytopenic purpura (ITP) is a heterogeneous disease, whereby it is unclear if and in which way prednisone and splenectomy affect the platelet kinetics leading to a complete remission. To determine the effects of prednisone and splenectomy on the mean platelet life (MPL) and platelet

  10. Defining Treatment Response and Remission in Child Anxiety: Signal Detection Analysis Using the Pediatric Anxiety Rating Scale

    Science.gov (United States)

    Caporino, Nicole E.; Brodman, Douglas M.; Kendall, Philip C.; Albano, Anne Marie; Sherrill, Joel; Piacentini, John; Sakolsky, Dara; Birmaher, Boris; Compton, Scott N.; Ginsburg, Golda; Rynn, Moira; McCracken, James; Gosch, Elizabeth; Keeton, Courtney; March, John; Walkup, John T.

    2013-01-01

    Objective: To determine optimal Pediatric Anxiety Rating Scale (PARS) percent reduction and raw score cut-offs for predicting treatment response and remission among children and adolescents with anxiety disorders. Method: Data were from a subset of youth (N = 438; 7-17 years of age) who participated in the Child/Adolescent Anxiety Multimodal Study…

  11. Association of interferon-gamma and interleukin 10 genotypes and serum levels with partial clinical remission in type 1 diabetes

    DEFF Research Database (Denmark)

    Alizadeh, B Z; Hanifi-Moghaddam, P; Eerligh, P

    2006-01-01

    We studied whether serum interferon (IFN)-gamma or interleukin (IL)-10 levels and their corresponding functional polymorphic genotypes are associated with partial remission of type 1 diabetes (T1D). A multi-centre study was undertaken in patients with newly diagnosed T1D and matched controls. T1D...

  12. Defining therapy goals for major molecular remission in chronic myeloid leukemia: results of the randomized CML Study IV.

    Science.gov (United States)

    Saussele, Susanne; Hehlmann, Rüdiger; Fabarius, Alice; Jeromin, Sabine; Proetel, Ulrike; Rinaldetti, Sebastien; Kohlbrenner, Katharina; Einsele, Hermann; Falge, Christiane; Kanz, Lothar; Neubauer, Andreas; Kneba, Michael; Stegelmann, Frank; Pfreundschuh, Michael; Waller, Cornelius F; Oppliger Leibundgut, Elisabeth; Heim, Dominik; Krause, Stefan W; Hofmann, Wolf-Karsten; Hasford, Joerg; Pfirrmann, Markus; Müller, Martin C; Hochhaus, Andreas; Lauseker, Michael

    2018-02-26

    Major molecular remission (MMR) is an important therapy goal in chronic myeloid leukemia (CML). So far, MMR is not a failure criterion according to ELN management recommendation leading to uncertainties when to change therapy in CML patients not reaching MMR after 12 months. At monthly landmarks, for different molecular remission status Hazard ratios (HR) were estimated for patients registered to CML study IV who were divided in a learning and a validation sample. The minimum HR for MMR was found at 2.5 years with 0.28 (compared to patients without remission). In the validation sample, a significant advantage for progression-free survival (PFS) for patients in MMR could be detected (p-value 0.007). The optimal time to predict PFS in patients with MMR could be validated in an independent sample at 2.5 years. With our model we provide a suggestion when to define lack of MMR as therapy failure and thus treatment change should be considered. The optimal response time for 1% BCR-ABL at about 12-15 months was confirmed and for deep molecular remission no specific time point was detected. Nevertheless, it was demonstrated that the earlier the MMR is achieved the higher is the chance to attain deep molecular response later.

  13. Variations in diabetes remission rates after bariatric surgery in Spanish adults according to the use of different diagnostic criteria for diabetes.

    Science.gov (United States)

    Alhambra-Expósito, María R; Molina-Puerta, María J; Prior-Sánchez, María I; Manzano-García, Gregorio; Calañas-Continente, Alfonso; Gálvez-Moreno, María A

    2017-08-15

    There are multiple criteria to define remission of type 2 diabetes (DM2) after bariatric surgery but there is not a specific one widely accepted. Our objectives were to compare diagnostic criteria for DM2 remission after bariatric surgery: Criteria from Spanish scientific associations (SEEN/SEEDO/SED) and from the American Diabetes Association (ADA). We also aim to analyse the degree of correlation between these sets of criteria. Retrospective observational study in 127 patients undergoing bariatric surgery in a single centre (Hospital Universitario Reina Sofía, Córdoba, Spain) between January 2001 and December 2009. We analysed DM2 remission following bariatric surgery comparing DM2 diagnostic criteria approved by Spanish scientific associations and ADA criteria. In total, 62.2% of patients were women; mean age was 47.1 years. Following surgery, 52% achieved complete remission according to ADA criteria, and 63.8% following the criteria approved by Spanish associations (p = 0.001);18.9 and 8.7%, respectively, showed partial remission (p = 0.007), and 29.1 and 27.6% no remission, according to the criteria approved by each association (p = 0.003). There was good correlation between both sets of criteria (Rho 0.781; p DM2 remission (ADA criteria) results in a lower rate of remission, although we found a a high degree of correlation between both sets of criteria.

  14. Treating to target with etanercept in rheumatoid arthritis: cost-effectiveness of dose reductions when remission is achieved.

    Science.gov (United States)

    Kobelt, Gisela

    2014-07-01

    Current management of rheumatoid arthritis (RA) focuses on inducing remission as early as possible to avoid lasting joint damage, and maintenance of remission has become important. A 12-month clinical trial in 834 patients with moderate RA investigated whether etanercept 50 mg/wk could be reduced to half dose or discontinued in patients who achieved low disease activity after 36 weeks. The objective of this study was to estimate the cost-effectiveness of the three maintenance strategies. A Markov model integrated the three strategies from the clinical trial and extrapolated to 10 years using data from the Swedish RA registry. Assumed treatment strategies after the trial were similar in all three arms, with patients failing to maintain remission on half-dose etanercept or methotrexate alone switching to the full dose of etanercept and patients maintaining remission on full-dose etanercept allowed switching to half dose. Resource use and utilities were taken from an observational study. Results are presented as cost/quality-adjusted life-year (QALY) (both discounted 3%) in the societal perspective. The cost/QALY gained with half-dose etanercept versus methotrexate ranged from €14,000 to €29,000: Longer simulations result in a higher cost/QALY, as the acquisition cost of etanercept increases. Half-dose etanercept technically dominates the full dose (lower costs [€-3000 to 6300] and similar effectiveness [0.007-0.011]). Although ultimately all three strategies explored achieve a similar outcome as all three continuously manage patients to maintain remission, it appears that a dose reduction is the most advantageous strategy in patients with moderate disease activity. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  15. Establishing Clinical Cutoffs for Response and Remission on the Screen for Child Anxiety Related Emotional Disorders (SCARED).

    Science.gov (United States)

    Caporino, Nicole E; Sakolsky, Dara; Brodman, Douglas M; McGuire, Joseph F; Piacentini, John; Peris, Tara S; Ginsburg, Golda S; Walkup, John T; Iyengar, Satish; Kendall, Philip C; Birmaher, Boris

    2017-08-01

    To determine optimal percent reduction and raw score cutoffs on the parent- and child-report Screen for Child Anxiety Related Emotional Disorders (SCARED) for predicting treatment response and remission among youth with anxiety disorders. Data were obtained from youth (N = 438; 7-17 years old) who completed treatment in the Child/Adolescent Anxiety Multimodal treatment Study, a multisite, randomized clinical trial that examined the relative efficacy of medication (sertraline), cognitive-behavioral therapy (Coping Cat), their combination, and pill placebo for the treatment of separation anxiety disorder, generalized anxiety disorder, and social phobia. The parent- and youth-report SCARED were administered at pre- and posttreatment. Quality receiver operating characteristic methods evaluated the performance of various SCARED percent reduction and absolute cutoff scores in predicting treatment response and remission, as defined by posttreatment ratings on the Clinical Global Impression scales and the Anxiety Disorders Interview Schedule. Reductions of 55% on the SCARED-Parent and 50% on the SCARED-Youth optimally predicted treatment response. Posttreatment absolute raw scores of 10 (SCARED-Parent) and 12 (SCARED-Youth) optimally predicted remission in the total sample, although separate SCARED-Parent cutoffs for children (12-13) and adolescents (9) showed greatest quality of efficiency. Each cutoff significantly predicted response and remission at 6-month follow-up. Results serve as guidelines for operationalizing treatment response and remission on the SCARED, which could help clinicians systematically monitor treatment outcomes of youth with anxiety disorders in a cost- and time-efficient manner. Clinical trial registration information-Child and Adolescent Anxiety Disorders (CAMS); http://clinicaltrials.gov/; NCT00052078. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  16. Effect of Contemporary Bariatric Surgical Procedures on Type 2 Diabetes Remission. A Population-Based Matched Cohort Study.

    Science.gov (United States)

    Gulliford, Martin C; Booth, Helen Pascale; Reddy, Marcus; Charlton, Judith; Fildes, Alison; Prevost, A Toby; Khan, Omar

    2016-10-01

    The objective of the study is to evaluate the effect of gastric banding, gastric bypass and sleeve gastrectomy on medium to long-term diabetes control in obese participants with type 2 diabetes mellitus. Matched cohort study using primary care electronic health records from the UK Clinical Practice Research Datalink. Obese participants with type 2 diabetes who received bariatric surgery from 2002 to 2014 were compared with matched control participants who did not receive BS. Remission was defined for each year of follow-up as HbA1c <6.5 % and no antidiabetic drugs prescribed. There were 826 obese participants with T2DM who received bariatric surgery including adjustable gastric banding (LAGB) 220; gastric bypass (GBP) 449; or sleeve gastrectomy (SG) 153; with four procedures undefined. Mean HbA1c declined from 8.0 % before BS to 6.5 % in the second postoperative year; proportion with HbA1c <6.5 % (<48 mmol/mol) increased from 17 to 47 %. The proportion of patients in remission was 30 % in the second year, being 20 % for LAGB, 34 % for GBP and 38 % for SG. The adjusted relative rate of remission over the first six postoperative years was 5.97 (4.86 to 7.33, P < 0.001) overall; for LAGB 3.32 (2.27 to 4.86); GBP 7.16 (5.64 to 9.08); and SG 6.82 (5.05 to 9.19). Rates of remission were maintained into the sixth year of follow-up. Remission of diabetes may continue for up to 6 years after bariatric surgical procedures. Diabetes outcomes are generally more favourable after gastric bypass or sleeve gastrectomy than LAGB.

  17. PREDICTORS OF BIOCHEMICAL REMISSION AND RECURRENCE AFTER SURGICAL AND RADIATION TREATMENTS OF CUSHING DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS.

    Science.gov (United States)

    Abu Dabrh, Abd Moain Abu; Singh Ospina, Naykky M; Al Nofal, Alaa; Farah, Wigdan H; Barrionuevo, Patricia; Sarigianni, Maria; Mohabbat, Arya B; Benkhadra, Khalid; Carranza Leon, Barbara G; Gionfriddo, Michael R; Wang, Zhen; Mohammed, Khaled; Ahmed, Ahmed T; Elraiyah, Tarig A; Haydour, Qusay; Alahdab, Fares; Prokop, Larry J; Murad, Mohammad Hassan

    2016-04-01

    We conducted a systematic review and meta-analysis to synthesize the evidence about predictors that may affect biochemical remission and recurrence after transsphenoidal surgery (TSS), radiosurgery (RS), and radiotherapy (RT) in Cushing disease. We searched multiple databases through December 2014 including original controlled and uncontrolled studies that enrolled patients with Cushing disease who received TSS (first-line), RS, or RT. We extracted data independently, in duplicates. Outcomes of interest were biochemical remission and recurrence. A meta-analysis was conducted using the random-effects model to estimate event rates with 95% confidence intervals (CIs). First-line TSS was associated with high remission (76% [95% CI, 72 to 79%]) and low recurrence rates (10% [95% CI, 6 to 16%]). Remission after TSS was higher in patients with microadenomas or positive-adrenocorticotropic hormone tumor histology. RT was associated with a high remission rate (RS, 68% [95% CI, 61 to 77%]; RT, 66% [95% CI, 58 to 75%]) but also with a high recurrence rate (RS, 32% [95% CI, 16 to 60%]; RT, 26% [95% CI, 14 to 48%]). Remission after RS was higher at short-term follow-up (≤2 years) and with high-dose radiation, while recurrence was higher in women and with lower-dose radiation. Remission was after RT in adults who received TSS prior to RT, and with lower radiation doses. There was heterogeneity (nonstandardization) in the criteria and cutoff points used to define biochemical remission and recurrence. First-line TSS is associated with high remission and low recurrence, while RS and RT are associated with reasonable remission rates but important recurrence rates. The current evidence warrants low confidence due to the noncomparative nature of the studies, high heterogeneity, and imprecision.

  18. Physical function continues to improve when clinical remission is sustained in rheumatoid arthritis patients.

    Science.gov (United States)

    Radner, Helga; Alasti, Farideh; Smolen, Josef S; Aletaha, Daniel

    2015-08-11

    To investigate the course of functional status assessed by health assessment questionnaire (HAQ) in rheumatoid arthritis (RA) patients with sustained clinical remission (REM). In recent RA clinical trials, we identified patients with subsequent visits of ≥24 weeks in clinical REM according to the disease activity score using 28-joint counts including C-reactive protein (DAS28) (≤2.6), or simplified disease activity index (SDAI) (≤3.3). Area under the curve (AUC) and mean HAQ scores throughout the time in sustained REM were compared using t test, analyses of variance (ANOVA) and adjusted general linear modeling (GLM) with repeated measures. In Cox regression analyses, the time to regain full physical function was modeled. Sensitivity analyses were performed in patients of sustained SDAI low disease activity (LDA; SDAI ≤11). A total of 610 out of 4364 patients achieved sustained DAS28 REM (14%) and 252 SDAI REM (5.8%). ANOVA testing for linear trend showed significant decrease of mean HAQ from week 0 (start of REM) to week 24, regardless of REM criteria used. AUC of HAQ throughout 24 weeks of REM was higher in DAS28 compared to SDAI REM (p ≤0.01). GLM adjusting for covariates showed significant decrease of monthly HAQ scores from week 0 to 24 (DAS28: 0.276, 0.243, 0.229, 0.222, 0.219, 0.209 to 0.199; p = 0.0001; SDAI: 0.147, 0.142, 0.149, 0.129, 0.123, 0.117 to 0.114; p = 0.029). Similarly, a decrease of HAQ over time was found in patients of sustained SDAI LDA. In DAS28 REM, the chance of regaining full physical function was higher for female (hazard ratio HR [95% confidence interval]: 1.41 [1.13-1.76]) and early RA patients (disease duration ≤2 years: HR 1.29 [1.01-1.65]); in SDAI REM no significant differences were found. Physical function continues to improve if the target of REM or LDA is sustained. The stringency of the remission criteria determines achievement of the best possible functional improvement.

  19. Natural Remission of Major Periprosthetic Osteolysis following Total Hip Arthroplasty with Metal-on-Metal Bearings

    Directory of Open Access Journals (Sweden)

    Tatsuya Tamaki

    2017-01-01

    Full Text Available The natural course of adverse events following the use of metal-on-metal (MoM bearings in total hip arthroplasty (THA is not well known. In this article, we report the case of a patient with asymptomatic major acetabular osteolysis following MoM THA that diminished gradually without any surgical intervention. A 58-year-old male underwent one-stage bilateral MoM THA for bilateral osteoarthritis. Four years after THA, major acetabular osteolysis developed in his right hip without any local or systemic symptoms. The patient underwent a careful radiographic and clinical observation without any surgical intervention because he did not want to undergo revision surgery. The lesion gradually diminished after 7 years, and most of the osteolytic area was replaced by newly formed bone at 10 years. He continues to be followed with no evidence of cup loosening or migration. Our observation suggests that a periprosthetic osteolytic change related to the use of MoM bearings has the potential for natural remission.

  20. Efficacy evaluation of clonazepam for symptom remission in burning mouth syndrome: a meta-analysis.

    Science.gov (United States)

    Cui, Y; Xu, H; Chen, F M; Liu, J L; Jiang, L; Zhou, Y; Chen, Q M

    2016-09-01

    Clonazepam has been used in the treatment of burning mouth syndrome (BMS) for several decades. We conducted a meta-analysis to investigate the efficacy of clonazepam in the treatment of BMS. We conducted a search of the PubMed, MEDLINE, EMBASE, Web of Science (TS), and the Cochrane Library databases for relevant studies that met our eligibility criteria (up to September 22, 2015). Statistical analyses were conducted using RevMan 5.2 and STATA 11.0 software. Three randomized controlled trials (RCTs) and two high-quality case-control studies involving 195 BMS patients were selected for this study. Our results show that clonazepam can reduce the oral pain sensation in patients with BMS (WMD: -3.72, 95% CI: -4.57, -2.86; P 10 weeks) application (WMD: -4.50, 95% CI: -4.98, -4.03; P clonazepam were confirmed to be effective. Clonazepam is effective in inducing symptom remission in patients with BMS. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Helicobacter pylori-Negative Primary Rectal MALT Lymphoma: Complete Remission after Radiotherapy

    Directory of Open Access Journals (Sweden)

    Takuma Okamura

    2012-05-01

    Full Text Available Rectal mucosa-associated lymphoid tissue (MALT lymphoma is a rare condition. Although the majority of patients undergo surgical resection, a definitive treatment for rectal MALT lymphoma has not yet been established. In the present study, we report the outcome of radiotherapy in 3 patients with rectal MALT lymphoma. Our cohort ranged from 56 to 65 years of age. The male/female ratio was 1:2, and all patients were in stage I (Lugano classification of the disease. Endoscopic findings revealed elevated lesions resembling submucosal tumors in 2 patients, and a sessile elevated lesion with a nodular surface in 1 patient. One of the 3 patients underwent magnifying endoscopy with crystal violet staining that demonstrated a type I pit pattern (Kudo’s classification lesion with a broad intervening area caused by the upthrust of the tumor from the submucosa. All patients tolerated radiotherapy at doses of 30 Gy without major complications and achieved complete remission. Follow-up ranged from 13 to 75 months (mean 51.0 months, revealing no recurrence of MALT lymphoma. As such, we propose radiotherapy to be a safe and effective means for treating rectal MALT lymphoma.

  2. Sparse generalized functional linear model for predicting remission status of depression patients.

    Science.gov (United States)

    Liu, Yashu; Nie, Zhi; Zhou, Jiayu; Farnum, Michael; Narayan, Vaibhav A; Wittenberg, Gayle; Ye, Jieping

    2014-01-01

    Complex diseases such as major depression affect people over time in complicated patterns. Longitudinal data analysis is thus crucial for understanding and prognosis of such diseases and has received considerable attention in the biomedical research community. Traditional classification and regression methods have been commonly applied in a simple (controlled) clinical setting with a small number of time points. However, these methods cannot be easily extended to the more general setting for longitudinal analysis, as they are not inherently built for time-dependent data. Functional regression, in contrast, is capable of identifying the relationship between features and outcomes along with time information by assuming features and/or outcomes as random functions over time rather than independent random variables. In this paper, we propose a novel sparse generalized functional linear model for the prediction of treatment remission status of the depression participants with longitudinal features. Compared to traditional functional regression models, our model enables high-dimensional learning, smoothness of functional coefficients, longitudinal feature selection and interpretable estimation of functional coefficients. Extensive experiments have been conducted on the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) data set and the results show that the proposed sparse functional regression method achieves significantly higher prediction power than existing approaches.

  3. Policy Innovation in Innovation Policy

    DEFF Research Database (Denmark)

    Borras, Susana

    as with national and sub-national governments in Europe, all of them introducing interesting novelties in their innovation policy. These changes refer to different aspects of policy, mainly the content of policy initiatives towards science, technology and innovation; the instruments governments are using...... to achieve their goals; and the actors in the policy system that are being mobilised in pursuing these goals. This paper deals with these policy changes, paying special attention to the novelties introduced since the early 1990s in Europe. The perspective of this paper deals mainly on the changes introduced...... at the EU level, and mentions similar trends taking place at national and sub-national levels. The questions that guide the contents here are essentially three, namely, what are the main traits of innovation policies in Europe since the 1990s and how have the EU and different national governments approached...

  4. Persistent inflammation and its relationship to leptin and insulin in phases of bipolar disorder from acute depression to full remission.

    Science.gov (United States)

    Tsai, Shang-Ying; Chung, Kuo-Hsuan; Huang, Shou-Hung; Chen, Pao-Huan; Lee, Hsin-Chien; Kuo, Chian-Jue

    2014-12-01

    A proinflammatory phase with various immunomodulatory mechanisms has been noted in bipolar mania and major depression. Weight gain and increased production of leptin may be associated with immunomodulation and insulin resistance in bipolar disorder. However, immunomodulation and its linkage with leptin and insulin in the depressive episode of bipolar disorder remain unclear. We investigated alterations in inflammatory markers and their relationship with leptin and insulin levels in patients with phases of bipolar disorder from acute depression to full remission. Thirty-two physically healthy bipolar I depressed patients aged insulin, high-sensitivity C-reactive protein (hs-CRP), soluble interleukin-2 receptor (sIL-2R), soluble interleukin-6 receptor (sIL-6R), soluble tumor necrosis factor receptor 1 (sTNF-R1), and interleukin-1 receptor antagonist (IL-1Ra) in three phases, i.e., acute depression, subsequent partial remission, and full remission. In acute depression, subsequent partial remission, and full remission, patients with bipolar disorder had significantly higher mean levels of hs-CRP, IL-1Ra, sTNF-R1, and sIL-2R compared with control subjects. The IL-1Ra and sTNF-R1 levels in various affective phases were significantly correlated to body mass index, leptin level, circulating lipids, and medication status. The sIL-2R levels in the three affective phases were all independent of other inflammatory markers and clinical and laboratory variables. Patients showed no alteration of sIL-6R levels through the depressive episode. Patients with bipolar disorder in depressive episodes may exhibit persistent inflammation with elevated levels of hs-CRP, IL-1Ra, sTNF-R1, and sIL-2R but not sIL-6R from the acute phases to full remission. Only sIL-2R production seems to be tightly linked with the pathophysiology of bipolar depression and is independent of insulin and leptin levels. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Modeling of Antilatency Treatment in HIV: What Is the Optimal Duration of Antiretroviral Therapy-Free HIV Remission?

    Science.gov (United States)

    Cromer, Deborah; Pinkevych, Mykola; Rasmussen, Thomas A; Lewin, Sharon R; Kent, Stephen J; Davenport, Miles P

    2017-12-15

    A number of treatment strategies are currently being developed to promote antiretroviral therapy-free HIV cure or remission. While complete elimination of the HIV reservoir would prevent recurrence of infection, it is not clear how different remission lengths would affect viral rebound and transmission. In this work, we use a stochastic model to show that a treatment that achieves a 1-year average time to viral remission will still lead to nearly a quarter of subjects experiencing viral rebound within the first 3 months. Given quarterly viral testing intervals, this leads to an expected 39 (95% uncertainty interval [UI], 22 to 69) heterosexual transmissions and up to 262 (95% UI, 107 to 534) homosexual transmissions per 1,000 treated subjects over a 10-year period. Thus, a balance between high initial treatment levels, risk of recrudescence, and risk of transmission should be considered when assessing the "useful" or optimal length of antiretroviral therapy-free HIV remission to be targeted. We also investigate the trade-off between increasing the average duration of remission versus the risk of treatment failure (viral recrudescence) and the need for retreatment. To minimize drug exposure, we found that the optimal target of antilatency interventions is a 1,700-fold reduction in the size of the reservoir, which leads to an average time to recrudescence of 30 years. Interestingly, this is a significantly lower level of reduction than that required for complete elimination of the viral reservoir. Additionally, we show that when shorter periods are targeted, there is a real probability of viral transmission occurring between tests for viral rebound. IMPORTANCE Current treatment of HIV involves patients taking antiretroviral therapy to ensure that the level of virus remains very low or undetectable. Continuous therapy is required, as the virus persists in a latent state within cells, and when therapy is stopped, the virus rebounds, usually within 2 weeks. A major

  6. Apoplexia pituitária seguida de remissão endócrina: relato de dois casos Pituitary apoplexy followed by endocrine remission: report of two cases

    Directory of Open Access Journals (Sweden)

    MARCELO MIRANDA

    1998-09-01

    Full Text Available A apoplexia pituitária é evento raro e a ocorrência de remissão endócrina em pacientes portadores de tumores secretores é ainda mais incomum. O presente estudo relata os casos de dois pacientes portadores de macroadenomas (um com doença de Cushing e outro com acromegalia nos quais houve remissão endócrina após apoplexia tumoral. A primeira paciente era portadora de doença de Cushing e teve episódio ictal espontâneo de cefaléia e vômitos, após o qual iniciou remissão endócrina. Como houvesse persistência de imagem de macroadenoma à ressonância magnética, a paciente foi submetida a cirurgia transesfenoidal, sendo encontrado apenas cisto hemorrágico hipertensivo, sem sinais de tumor. O segundo paciente apresentava acromegalia e enquanto realizava um teste de LHRH teve evento agudo de cefaléia e vômitos, sem perda visual e instalação de diabetes insipidus. A tomografia computadorizada de sela túrcica mostrou sinais de sangue. Como não houve quadro visual agudo, o paciente foi seguido com exames de imagens seriadas, que demonstraram o desaparecimento completo da lesão e o aparecimento de sela vazia. A avaliação endócrina mostrou remissão da acromegalia. Tendo em vista a tendência à recidiva já documentada na literatura, esses pacientes devem continuar em seguimento a longo prazo.Pituitary apoplexy is rare and endocrine remission in patients with apopletic secreting pituitary adenomas is even rarer. This study reports on two patients with pituitary macroadenomas (one with Cushing's disease and the other with acromegaly in whom endocrine remission occurred after apoplexy. The first patient had Cushing's disease and had an ictus of headache and vomiting after which she started a progressive remission of hypercortisolism. A post-apoplexy MRI disclosed persistence of a sellar and supra-sellar mass. She was submitted to transesphenoidal surgery. An hypertensive hemorhagic cyst was found with no tumor. The second patient

  7. Informed policies

    International Development Research Centre (IDRC) Digital Library (Canada)

    cation technology (ICT) and now. Minister of Science and Technology, was one of the architects of Mozam- bique's ICT policy in 2000 — the first in Africa. Nationwide access to these technologies is one of the pillars of the government's science and technology policy. “We don't believe in politicians, but we believe in politics.

  8. Predictors of biologic discontinuation due to insufficient response in patients with rheumatoid arthritis who achieved clinical remission with biologic treatment: A multicenter observational cohort study.

    Science.gov (United States)

    Asai, Shuji; Fujibayashi, Takayoshi; Oguchi, Takeshi; Hanabayashi, Masahiro; Hayashi, Masatoshi; Matsubara, Hiroyuki; Ito, Takayasu; Yabe, Yuichiro; Watanabe, Tsuyoshi; Hirano, Yuji; Kanayama, Yasuhide; Kaneko, Atsushi; Kato, Takefumi; Takagi, Hideki; Takahashi, Nobunori; Funahashi, Koji; Takemoto, Toki; Asai, Nobuyuki; Watanabe, Tatsuo; Ishiguro, Naoki; Kojima, Toshihisa

    2018-03-01

    This study aimed to investigate predictors of biologic discontinuation due to insufficient response as a surrogate for relapse in patients with rheumatoid arthritis (RA) who achieved clinical remission with biologic treatment. This study was performed based on data from a multicenter registry, and included 404 patients who achieved clinical remission within the first year of treatment with their first biologic. Cumulative retention rate of the first biologic was estimated using Kaplan-Meier curves, and the impact of patient characteristics on biologic discontinuation was assessed with Cox proportional hazards models. During follow-up, 50 patients discontinued their first biologic due to insufficient response. Overall discontinuation rates due to insufficient response after achieving remission were 6%, 11%, and 19% at 1, 2, and 5 years, respectively. Multivariate analysis revealed that concomitant glucocorticoids at achieving remission [hazard ratio (HR): 3.80, 95% confidence interval (CI): 1.89-7.64)] and a higher level of C-reactive protein (CRP) at achieving remission (HR: 1.47 per 1 mg/dL, 95% CI: 1.09-1.99) independently predict discontinuation due to insufficient response after achieving remission. Patients with RA who achieved remission with concomitant glucocorticoid treatment and a higher level of CRP are at high risk of subsequent biologic discontinuation due to insufficient response.

  9. Preoperative use of incretins is associated with increased diabetes remission after RYGB surgery among patients taking insulin: a retrospective cohort analysis.

    Science.gov (United States)

    Wood, G Craig; Gerhard, Glenn S; Benotti, Peter; Petrick, Anthony T; Gabrielsen, Jon D; Strodel, William E; Ibele, Anna; Rolston, David D; Still, Christopher D; Argyropoulos, George

    2015-01-01

    The main goal of this study was to determine the effects of incretins on type 2 diabetes (T2D) remission after Roux-en-Y gastric bypass (RYGB) surgery for patients taking insulin. Type 2 diabetes is a chronic disease with potentially debilitating consequences. RYGB surgery is one of the few interventions that can remit T2D. Preoperative use of insulin, however, predisposes to significantly lower T2D remission rates. A retrospective cohort of 690 T2D patients with at least 12 months follow-up and available electronic medical records was used to identify 37 T2D patients who were actively using a Glucagon-like peptide 1 (GLP-1) agonist in addition to another antidiabetic medication, during the preoperative period. Here, we report that use of insulin, along with other antidiabetic medications, significantly diminished overall T2D remission rates 14 months after RYGB surgery (9%) compared with patients not taking insulin (56%). Addition of the GLP-1 agonist, however, increased significantly T2D early remission rates (22%), compared with patients not taking the GLP-1 agonist (4%). Moreover, the 6-year remission rates were also significantly higher for the former group of patients. The GLP-1 agonist did not improve the remission rates of diabetic patients not taking insulin as part of their pharmacotherapy. Preoperative use of antidiabetic medication, coupled with an incretin agonist, could significantly improve the odds of T2D remission after RYGB surgery in patients also using insulin.

  10. Sustained Remission Improves Physical Function in Patients with Established Rheumatoid Arthritis, and Should Be a Treatment Goal: A Prospective Observational Cohort Study from Southern Sweden.

    Science.gov (United States)

    Einarsson, Jon Thorkell; Geborek, Pierre; Saxne, Tore; Kristensen, Lars Erik; Kapetanovic, Meliha C

    2016-06-01

    It has been proposed that remission should be maintained throughout the course of rheumatoid arthritis (RA); however, the evidence supporting this is limited. Physical function measured by the Health Assessment Questionnaire (HAQ) is a major outcome in RA, and HAQ is shown to be one of the strongest predictors of longterm outcomes. The purpose of this study was to investigate the physical function over a long time in patients with RA who achieved sustained remission (SR) compared with that of patients occasionally achieving remission [non-sustained remission (NSR)]. Patients with RA treated with antitumor necrosis factor and included in the South Swedish Arthritis Treatment Group register were eligible for this study. We identified patients with a Disease Activity Score at 28 joints (DAS28) physical function. In patients with established RA, physical function measured by the HAQ improves in patients reaching SR compared with patients who only occasionally reach remission. The improvement continues while in remission, which supports that maintaining remission should be a treatment goal.

  11. Normal serum matrix metalloproteinase-3 levels can be used to predict clinical remission and normal physical function in patients with rheumatoid arthritis.

    Science.gov (United States)

    Hattori, Yosuke; Kida, Daihei; Kaneko, Atsushi

    2017-09-22

    This study aimed to evaluate whether normal serum matrix metalloproteinase-3 (MMP-3) levels can be used to predict clinical remission and normal physical function at a single time point when treating patients with rheumatoid arthritis (RA) in daily practice settings. Subjects were all 1321 RA patients who were treated at our hospital. The accuracy of serum MMP-3 levels was larger than those of C-reactive protein (CRP) levels for predicting clinical remission [Simplified Disease Activity Index (SDAI) ≤ 3.3], normal function [Disability Index of the Health Assessment Questionnaire (HAQ-DI) ≤ 0.5], and both in clinical remission and with normal function (clinical remission + normal function) using receiver operating characteristic curve analysis. Serum MMP-3 levels were significantly correlated with CRP levels [r 0.229 (men), r 0.476 (women)] using Pearson's correlation coefficients. Among patients with normal CRP levels (n = 807), the percentage of patients in clinical remission, with normal function, and with clinical remission + normal function having normal serum MMP-3 levels was significantly higher than those with abnormal serum MMP-3 levels. In addition, among patients with the 28-point count Disease Activity Score-CRP (DAS28-CRP) remission (DAS28-CRP normal function, and with clinical remission + normal function having normal serum MMP-3 levels was significantly higher than those with abnormal serum MMP-3 levels. Our findings suggest that normal serum MMP-3 levels, in combination with CRP levels or disease activity, are useful for predicting clinical remission and normal physical function in patients with RA.

  12. Defining and Predicting Complete Remission of Type 2 Diabetes: A Short-Term Efficacy Study of Open Gastric Bypass

    Directory of Open Access Journals (Sweden)

    Hongtao Yan

    2013-04-01

    Full Text Available Objective: To investigate the metabolic effects of open Roux-en Y gastric bypass (RYGB on pancreatic endocrine reserve in overweight/obese Chinese patients with type 2 diabetes during postoperative year 1. Methods: Retrospective analysis comparing pre- and postoperative results of oral glucose tolerance tests (OGTT with determinations of insulin and C-peptide, glycated hemoglobin (HbA1c, insulin resistance (HOMA-IR, and BMI at 1, 3, 6, and 12 months in 99 overweight patients (BMI 26.3 ± 4.0 kg/m2; 59 men with type 2 diabetes at the General Hospital of Chengdu Military Region. Results: 79 patients (80% achieved complete remission (maintaining random blood glucose levels Conclusion: Open gastric bypass achieved complete remission of type 2 diabetes in Chinese overweight/obese, heavier, younger, predominantly male patients with shorter duration of disease exhibiting greater pancreatic endocrine reserve.

  13. Adolescentes em conflito com a lei : remissão : ambiguidades e educação

    OpenAIRE

    Magda Susel Konrath

    2013-01-01

    A presente pesquisa tem o objetivo de averiguar o potencial educativo/socioeducativo das medidas associadas à remissão. A partir de considerações acerca da Doutrina da Proteção Integral analisa o referido instituto; seu conceito, natureza jurídica, critérios de aplicação; conformação ao sistema jurídico pátrio, à Constituição Federal, aos princípios constitucionais, ao sistema acusatório e ao Pacto de São José da Costa Rica. Coteja as práticas relacionadas à remissão com os conceitos da epist...

  14. Treatment of Children and Adolescents With Hodgkin Lymphoma Without Radiotherapy for Patients in Complete Remission After Chemotherapy

    DEFF Research Database (Denmark)

    Dörffel, Wolfgang; Rühl, Ursula; Lüders, Heike

    2013-01-01

    UNLABELLED: PURPOSE To minimize the risk of late effects in pediatric Hodgkin lymphoma (HL) by omitting radiotherapy (RT) in patients in complete remission (CR) after chemotherapy and reducing the standard radiation dose to 20 Gy in patients in incomplete remission. PATIENTS AND METHODS: Between...... 1995 and 2001, 925 patients with classical HL (cHL) were registered from seven European countries in German Society of Pediatric Oncology and Hematology Hodgkin Lymphoma Trial 95. Patients in treatment group 1 (TG1; early stages) received two cycles of vincristine, prednisone, procarbazine...... results in TG3 (82.6% ± 5.4% v 88.7% ± 2.0%, P = .259). Reduction of the standard radiation dose from 25 to 20 Gy did not increase failure rate. CONCLUSION: RT can be omitted in early stage HL in so defined CR following this chemotherapy. RT with 20(-35) Gy proved to be sufficient in patients...

  15. Serum C-reactive protein concentration as an indicator of remission status in dogs with multicentric lymphoma

    DEFF Research Database (Denmark)

    Nielsen, Lise; Toft, Nils; Eckersall, David

    2007-01-01

    -two dogs with untreated multicentric lymphoma. Methods: Prospective observational study. Blood samples were collected at the time of diagnosis, before each chemotherapy session, and at follow-up visits, resulting in 287 serum samples. Results: Before therapy, a statistically significant majority......Background: The acute-phase protein C-reactive protein (CRP) is used as a diagnostic and prognostic marker in humans with various neoplasias, including non-Hodgkin's lymphoma. Objective: To evaluate if CRP could be used to detect different remission states in dogs with lymphoma. Animals: Twenty...... of the dogs (P = .0019) had CRP concentrations above the reference range (68%, 15/22). After achieving complete remission 90% (18/20) of the dogs had CRP concentrations within the reference range, and the difference in values before and after treatment was statistically significant (P

  16. Loss rather than downregulation of CD4+ T cells as a mechanism for remission from experimental allergic encephalomyelitis

    DEFF Research Database (Denmark)

    Zeine, R; Owens, T

    1993-01-01

    reduction in the number of CNS CD4+ T cells in remitted mice 10 days following the initial attack. More than 60% of CNS CD4+ cells were of a CD44high, CD45RBlow memory/effector phenotype both in active EAE, peak EAE and in remission, in contrast to lymph nodes where this phenotype never constituted more...... than 17%. The proportion of CD8+ T cells was not increased in remitted mice, and we detected no TCR gamma delta+ cells within the CNS. Our findings demonstrate an overt loss of CD4+ T cells from the CNS and the maintenance of an activated state by T cells within the CNS and during remission from EAE...

  17. Eating Disorders in Girls and Women With Type 1 Diabetes: A Longitudinal Study of Prevalence, Onset, Remission, and Recurrence.

    Science.gov (United States)

    Colton, Patricia A; Olmsted, Marion P; Daneman, Denis; Farquhar, Jamie C; Wong, Harmonie; Muskat, Stephanie; Rodin, Gary M

    2015-07-01

    Girls and women with type 1 diabetes are at increased risk for developing eating disorders (EDs), and these disorders are associated with serious diabetes-related medical complications. This study describes the longitudinal course of disturbed eating behavior (DEB) and EDs in a cohort with type 1 diabetes. A total of 126 girls with type 1 diabetes receiving care for diabetes at The Hospital for Sick Children in Toronto participated in a series of seven interview-based assessments of ED behavior and psychopathology over a 14-year period, beginning in late childhood. Survival analysis was used. Mean age was 11.8 ± 1.5 years at time 1 and 23.7 ± 2.1 years at time 7. At time 7, 32.4% (23/71) met the criteria for a current ED, and an additional 8.5% (6/71) had a subthreshold ED. Mean age at ED onset (full syndrome or below the threshold) was 22.6 years (95% CI 21.6-23.5), and the cumulative probability of onset was 60% by age 25 years. The average time between onset of ED and subsequent ED remission was 4.3 years (95% CI 3.1-5.5), and the cumulative probability of remission was 79% by 6 years after onset. The average time between remission of ED and subsequent recurrence was 6.5 years (95% CI 4.4-8.6), and the cumulative probability of recurrence was 53% by 6 years after remission. In this longitudinal study, EDs were common and persistent, and new onset of ED was documented well into adulthood. Further research regarding prevention and treatment for this vulnerable group is urgently needed. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  18. Alopecia universalis, hypothyroidism and pituitary hyperplasia: polyglandular autoimmune syndrome III in a patient in remission from treated Hodgkin lymphoma.

    LENUS (Irish Health Repository)

    Quintyne, K I

    2010-10-01

    We herein report a case of a 33-year-old man in remission from Hodgkin lymphoma, who presented with reduced potency and hair loss. Initial endocrine tests revealed autoimmune hypothyroidism. An MRI of his pituitary gland at onset revealed hyperplasia. He tolerated replacement endocrine therapy with good response, but with no improvement in his alopecia universalis. A repeat MRI, 6 months after his initial endocrine manipulation, showed resolution of his pituitary hyperplasia.

  19. Increased circulating follicular regulatory T cells are associated with lower auto-antibodies in stable remission rheumatoid arthritis patients.

    Science.gov (United States)

    Liu, Chen; Wang, Dongwei; Lu, Songsong; Xu, Qinzhu; Zhao, Lei; Zhao, Jingzhong; Song, Ying; Wang, Hui

    2018-01-30

    To examine expression and function changes of circulating CD4 + CXCR5 + FoxP3 + Follicular regulatory T (TFR) cells in active and stable remission rheumatoid arthritis (RA) patients and to clarify the role of TFR cells in the pathogenesis of RA. TFR and follicular helper T cells (TFH) levels in peripheral blood of 39 active RA patients, 39 stable remission RA patients and 33 healthy controls were detected by flow cytometry. The function of TFR cells was measured by co-culturing with TFH and B cells. The activated CD45RA - FoxP3 hi TFR cells were analyzed as well. Clinical indicators including serum levels of Ig and auto-antibodies were tested and correlations with TFR cells were systematically analyzed. DAS28 scores were further calculated and correlation analysis with TFR was conducted as well. The level of CD4 + CXCR5 + FOXP3 + TFR cells and the ratio of TFR/TFH in peripheral blood of stable remission RA patients were significantly increased compared with active RA patients and healthy controls. The function of TFR was enhanced and the activated CD45RA - FoxP3 hi TFR subset was increased in stable remission RA patients compared with healthy controls. Furthermore, TFR cells in RA patients were inversely correlated with Ig G, RF, anti-CCP, as well as DAS28 scores. Circulating TFR cells were increased as RA patients develop to a stable state and increased TFR cells could suppress autoimmunity of RA patients to stabilize their condition. Our results provide novel insight into the pathogenesis process of RA. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  20. The association between latent depression subtypes and remission after treatment with citalopram: A latent class analysis with distal outcome.

    Science.gov (United States)

    Ulbricht, Christine M; Rothschild, Anthony J; Lapane, Kate L

    2015-12-01

    The objectives were to characterize latent depression subtypes by symptoms, evaluate sex differences in and examine correlates of these subtypes, and examine the association between subtype and symptom remission after citalopram treatment. Latent class analysis was applied to baseline data from 2772 participants in the Sequenced Treatment Alternatives to Relieve Depression trial. Indicators were from the Quick Inventory of Depressive Symptomatology. Separate multinomial logistic models identified correlates of subtypes and the association between subtype and the distal outcome of remission. Four latent subtypes were identified: Mild (men: 37%, women: 27%), Moderate (men: 24%, women: 21%), Severe with Increased Appetite (men: 13%, women: 22%), and Severe with Insomnia (men: 26%, women: 31%). Generalized anxiety disorder, bulimia, and social phobia were correlated with Severe with Increased Appetite and generalized anxiety disorder, post-traumatic stress disorder, and social phobia with Severe with Insomnia. Relative to those with the Mild subtype, those with Severe with Increased Appetite (odds ratiomen (OR): 0.48; 95% confidence interval (CI): 0.25-0.92; OR women: 0.59; 95% CI: 0.41-0.86) and those with Severe Depression with Insomnia (ORmen: 0.65; 95% CI: 0.41-1.02; ORwomen: 0.45; 95% CI: 0.32-0.64) were less likely to achieve remission. The sample size limited exploration of higher order interactions. Insomnia and increased appetite distinguished latent subtypes. Sex and psychiatric comorbidities differed between the subtypes. Remission was less likely for those with the severe depression subtypes. Sleep disturbances, appetite changes, and other mental disorders may play a role in the etiology and treatment of depression. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Three-dimensional facial analysis in acromegaly: a novel tool to quantify craniofacial characteristics after long-term remission.

    Science.gov (United States)

    Wagenmakers, M A E M; Roerink, S H P P; Maal, T J J; Pelleboer, R H; Smit, J W A; Hermus, A R M M; Bergé, S J; Netea-Maier, R T; Xi, T

    2015-02-01

    The exact quantification of craniofacial characteristics in patients with acromegaly is important because it provides insight in the pathophysiology of the disease and offers a tool to evaluate the effects of treatment on tissue specific endpoints. However, until recently this was not feasible due to limitations of available cephalometric methods. The new technique of three-dimensional (3D) cephalometry enables the accurate quantification of facial anatomical characteristics of both soft tissue and bone. This is the first study that uses 3D cephalometry to analyze craniofacial disproportions in patients in long-term remission of acromegaly. Sixteen patients in remission of acromegaly for over 24 months (50% male, mean age 56.0 ± 10.7 years, mean body mass index 29.3 ± 5.5 kg/m(2)) were compared to 16 matched control subjects. A 3D cone beam computed tomography scan and 3D stereophotograph of each individual were acquired and analyzed using 3D cephalometry. In addition to an accurate quantification of the classical craniofacial characteristics, 3D cephalometry, shows that many typical soft tissue deformities persist, even after long-term remission. Furthermore, we found that, compared to controls, the patients in remission of acromegaly have a wider face at the level of the zygoma and longer maxilla (p cephalometry is an attractive novel imaging modality to accurately investigate craniofacial disproportions of both soft tissue and bony parts of the face in patients with acromegaly, which makes it a promising technique for future research purposes and clinical practice.

  2. Periodontal disease bacteria specific to tonsil in IgA nephropathy patients predicts the remission by the treatment.

    Directory of Open Access Journals (Sweden)

    Yasuyuki Nagasawa

    Full Text Available BACKGROUND: Immunoglobulin (IgA nephropathy (IgAN is the most common form of primary glomerulonephritis in the world. Some bacteria were reported to be the candidate of the antigen or the pathogenesis of IgAN, but systematic analysis of bacterial flora in tonsil with IgAN has not been reported. Moreover, these bacteria specific to IgAN might be candidate for the indicator which can predict the remission of IgAN treated by the combination of tonsillectomy and steroid pulse. METHODS AND FINDINGS: We made a comprehensive analysis of tonsil flora in 68 IgAN patients and 28 control patients using Denaturing gradient gel electrophoresis methods. We also analyzed the relationship between several bacteria specific to the IgAN and the prognosis of the IgAN. Treponema sp. were identified in 24% IgAN patients, while in 7% control patients (P = 0.062. Haemophilus segnis were detected in 53% IgAN patients, while in 25% control patients (P = 0.012. Campylobacter rectus were identified in 49% IgAN patients, while in 14% control patients (P = 0.002. Multiple Cox proportional-hazards model revealed that Treponema sp. or Campylobactor rectus are significant for the remission of proteinuria (Hazard ratio 2.35, p = 0.019. There was significant difference in remission rates between IgAN patients with Treponema sp. and those without the bacterium (p = 0.046, and in remission rates between IgAN patients with Campylobacter rectus and those without the bacterium (p = 0.037 by Kaplan-Meier analysis. Those bacteria are well known to be related with the periodontal disease. Periodontal bacteria has known to cause immune reaction and many diseases, and also might cause IgA nephropathy. CONCLUSION: This insight into IgAN might be useful for diagnosis of the IgAN patients and the decision of treatment of IgAN.

  3. Behavior of the lumbar multifidus during lower extremity movements in people with recurrent low back pain during symptom remission.

    Science.gov (United States)

    Macdonald, David A; Dawson, Anna P; Hodges, Paul W

    2011-03-01

    Cross-sectional design. To investigate lumbar multifidus (LM) thickness differences, using ultrasound imaging in people during remission from recurrent low back pain (LBP) and healthy participants, during the following lower extremity movements: (1) active straight leg raise (ASLR), (2) crook-lying active leg raise (CLR), and (3) prone straight leg raise (PSLR). ASLR, CLR, and PSLR are used clinically to challenge the ability of the trunk muscles to control spinal motion in people with LBP, and it is believed that decreased LM activity is related to altered spinal control in this population. However, it is unclear whether LM behavior differs between healthy individuals and people with recurrent LBP during symptom remission in such tasks. The present study used ultrasound imaging to measure LM percentage thickness change parasagitally at the L4-5 and L5-S1 levels in people with recurrent LBP during symptom remission and in healthy participants, during the ASLR, CLR, and PSLR tasks. LM percentage thickness change was greater in the recurrent LBP group than in healthy participants during the PSLR task (P<.01) and greater in both groups during the PSLR than the ASLR and CLR tasks (P<.01). LM percentage thickness change was greatest at L4-5 in both groups (P<.01) and during all tasks (P≤.02). No difference was found in LM percentage thickness change between groups in either the ASLR (P = .70) or CLR (P = .69) task. These data suggest that, during symptom remission, individuals with recurrent LBP, compared to healthy individuals, may have greater activity in at least some parts of the LM. Further investigation is required to determine whether the LM percentage thickness change observed in this study may be explained by differential changes in deep and/or superficial fibers of LM activity. This observation may have implications for clinical practice, but requires further investigation.

  4. Concordance between clinician and patient ratings as predictors of response, remission, and recurrence in major depressive disorder

    OpenAIRE

    Dunlop, Boadie W.; Li, Thomas; Kornstein, Susan G.; Friedman, Edward S.; Rothschild, Anthony J.; Pedersen, Ron; Ninan, Philip; Keller, Martin; Trivedi, Madhukar H.

    2010-01-01

    We conducted a secondary analysis of data from the Prevention of Recurrent Episodes of Depression With Venlafaxine Extended Release (ER) for Two Years (PREVENT) trial to evaluate whether discrepancies between clinician and patient ratings of depression severity were predictive of response, remission, and recurrence during treatment for a depressive episode. Patients who self-rated depression severity in concordance with the clinician (“concordant patients”) were defined as having a standardiz...

  5. Karyotype in Pediatric Acute Lymphoblastic Leukemia: Impact On Clinical Presentation and Duration of First Remission

    International Nuclear Information System (INIS)

    Khairy, A.M.D.; EL-SISSY, M.D.

    2003-01-01

    In this study we are aiming at investigating the correlation between karyotype and the clinico pathologic features of pediatric acute lymphoblastic leukemia, duration of first remission and outcome of patients. Material and Methods: A total of 40 pediatric patients with the diagnosis of acute ]lymphoblastic leukemia (ALL) were included in this study. The patients were treated according to ALL P.NCI III/98 protocol used at the Pediatric Oncology Unit, National Cancer Institute, Cairo University. Analyzing the patients with respect to their chromosomal pattern; the majority of patients (17/40, 42.5%) showed a pseudo diploid karyotype. Their mean age was 10.2±4.8 years, M/F ratio 2.4: I. Massive hepatosplenomegaly (HSM) was encountered in 64.7%. The mean total leucocyte count (TLC) was 66.53±5.2 cells per μl. Their mean first complete remission (CR]) was 11.05±2.3 months, EFS was 40% at 12 months and 17.78% at 24 months. Patients with normal karyotype came next, representing ]3/40 (32.5%). Their mean age was 8.4±1.8 years, M/F 0.8: I. Massive HSM was found in 62.5%. The mean TLC was 78.74±3.8 cells per μl. Their mean CR 1 was I I.62±1.2 months, EFS was 41.67% at 12 months and 33.33% at 24 months. The third group represented patients with hyper diploidy (8/40; 20%). Their mean age was 8. 8±3. I years, M/F 7: I. Massive HSM was found in 50%. The mean TLC was 45.16±3.1 cells per μl], their mean CR I was 18.] 0±3.4 months, EFS was 75% at 12 months and 62.5% at 24 months. The least group showed a hypo diploid pattern (5/40; 12.5%). Their mean age was] 3±2.6 years, all were males. Massive HSM was encountered in 100%. The mean TLC was 20.00±2.9 cells per Ill. Their mean CRI was 10±2.8 months. Egyptian patients with childhood ALL who have hyper diploid karyotype, specially those having >50 chromosomes carry a better prognosis than patients with other chromosomal abnormalities. Pseudo diploid karyotype is the most frequent among Egyptian ALL cases and this could

  6. Predictive Factors for Sustained Remission after Discontinuation of Antiviral Therapy in Patients with HBeAg-positive Chronic Hepatitis B.

    Science.gov (United States)

    Jun, Baek Gyu; Lee, Sae Hwan; Kim, Hong Soo; Kim, Sang Gyune; Kim, Young Seok; Kim, Boo Sung; Jeong, Soung Won; Jang, Jae Young; Kim, Young Don; Cheon, Gab Jin

    2016-01-25

    The optimal timing for discontinuing oral antiviral therapy in patients with HBeAg-positive chronic hepatitis B (CHB) is unclear. The aim of our study was to investigate sustained remission after stopping antiviral therapy in patients with HBeAg-positive CHB. We analyzed the medical records of 58 patients who were HBeAg-positive and had discontinued antiviral therapy. Antiviral therapy was discontinued after HBeAg seroconversion and HBV DNA negativity for 6-12 months with consolidation therapy. Virologic relapse was defined as an increase in serum HBV DNA >2,000 IU/mL. No difference was observed between the virologic non-relapse and virologic relapse groups in baseline HBV DNA level (p=0.441) or duration of seroconversion (p=0.070). Time-to-undetectable HBV DNA during treatment was shorter in the virologic non-relapse group (29 patients) compared to the relapse group (29 patients) (4.9±2.6 vs. 13.2±12.7 months; pantiviral therapy (p=0.017) were significant predictors for sustained remission. A consolidation period of at least 18 months and early virological response at six months during antiviral therapy were associated with sustained remission in patients with HBeAg-positive CHB after treatment.

  7. Interpersonal conflict strategies and their impact on positive symptom remission in persons aged 55 and older with schizophrenia spectrum disorders.

    Science.gov (United States)

    Cohen, Carl I; Solanki, Dishal; Sodhi, Dimple

    2013-01-01

    Although interpersonal interactions are thought to affect psychopathology in schizophrenia, there is a paucity of data about how older adults with schizophrenia manage interpersonal conflicts. This paper examines interpersonal conflict strategies and their impact on positive symptom remission in older adults with schizophrenia spectrum disorders. The schizophrenia group consisted of 198 persons aged 55 years and over living in the community who developed schizophrenia before age 45. A community comparison group (n = 113) was recruited using randomly selected block-groups. Straus' Conflict Tactics Scale (CTS) was used to assess the ways that respondents handled interpersonal conflicts. Seven conflict management subscales were created based on a principal component analysis with equamax rotation of items from the CTS. The order of the frequency of the tactics that was used was similar for both the schizophrenia and community groups. Calm and Pray tactics were the most commonly used, and the Violent and Aggressive tactics were rarely utilized. In two separate logistic regression analysis, after controlling for confounding variables, positive symptom remission was found to be associated significantly with both the Calm and Pray subscales. The findings suggest that older persons with schizophrenia approximate normal distribution patterns of conflict management strategies and the most commonly used strategies are associated with positive symptom remission.

  8. Policy stories

    DEFF Research Database (Denmark)

    Ren, Carina Bregnholm; Rasmussen, Rasmus Kjærgaard

    planning and execution and of event outcomes beyond the narrow confines of bed nights and legacies. Second, we introduce policies as an entry point to unlock discussions and manifestations of value and futures which connect to AWG. In order to exemplify the workings of the AWG event in these domains, we...... present three central policy stories from the field. The stories tell of how the event was first interested, then activated and finally evaluated. Besides adding a new understanding to policy-driven events as a locus of value creation, we also argue that the AWG 2016 offer speculative bets for new...

  9. BALO’S CONCENTRIC SCLEROSIS: CLINICAL CASE ОF REMISSION

    Directory of Open Access Journals (Sweden)

    L. V. Lorina

    2017-01-01

    Full Text Available Objective. Case report of a rare form of multiple sclerosis, Balo’s concentric sclerosis (BCS.Materials and methods. 66 year old female patient L., admitted with complaints of gait disorder with tendency to fall towards the left side, left upper limb weakness and decreased memory. Neurological examination revealed left sided hemiparesis, and left sided positive Romberg’s test. Contrast brain magnetic resonance imaging (MRI was performed. Treatment was prescribed as well as dynamic follow up during the course of 1.5 years.Results. Based on complaints, clinical picture and MRI result, patient was diagnosed with an atypical form of multiple sclerosis, Balo’s concentric sclerosis. The main diagnostic method used confirm the diagnosis was contrast brain MRI: Non homogenous circular-form space occupying lesion with dimensions 3.7 × 3.4 × 3.5 cm was visualized in the supraventricular area of right parietal lobe with increased and decreased signals on T2 and T1 weighted images respectively. Following intravenous administration of contrast substance, an increased T1-WI signal is observed along the periphery of the described lesion in the right parietal lobe. MRI conclusion: brain demyelination disease with large foci in the right post-frontal lobe region, typical of Balo’s concentric sclerosis. Following the acute clinical state, cytostatic and immunomodulation therapy was prescribed. MRI dynamic observation revealed decrease in dimensions of the significantly enhanced concentric areas. Follow up demonstrated marked remission.Conclusion. This clinical case is of interest due to the rarity of this disease. The basis of diagnosis in our study was MRI investigation which allows for in vivo diagnosis of this pathology. These observations confirm the fact that timely use of modern methods of treatment can achieve not only stabilization of the patients’ state, but also positive clinical and MRI dynamics.

  10. Farnesyl transferase inhibitors induce extended remissions in transgenic mice with mature B cell lymphomas

    Directory of Open Access Journals (Sweden)

    Refaeli Yosef

    2008-05-01

    Full Text Available Abstract Background We have used a mouse model based on overexpression of c-Myc in B cells genetically engineered to be self-reactive to test the hypothesis that farnesyl transferase inhibitors (FTIs can effectively treat mature B cell lymphomas. FTIs are undergoing clinical trials to treat both lymphoid and non-lymphoid malignancies and we wished to obtain evidence to support the inclusion of B cell lymphomas in future trials. Results We report that two FTIs, L-744,832 and SCH66336, blocked the growth of mature B cell lymphoma cells in vitro and in vivo. The FTI treatment affected the proliferation and survival of the transformed B cells to a greater extent than naïve B cells stimulated with antigen. In syngeneic mice transplanted with the transgenic lymphoma cells, L-744,832 treatment prevented the growth of the tumor cells and the morbidity associated with the resulting lymphoma progression. Tumors that arose from transplantation of the lymphoma cells regressed with as little as three days of treatment with L-744,832 or SCH66336. Treatment of these established lymphomas with L-744,832 for seven days led to long-term remission of the disease in approximately 25% of animals. Conclusion FTI treatment can block the proliferation and survival of self-reactive transformed B cells that overexpress Myc. In mice transplanted with mature B cell lymphomas, we found that FTI treatment led to regression of disease. FTIs warrant further consideration as therapeutic agents for mature B cell lymphomas and other lymphoid tumors.

  11. Eosinophilic gastroenteritis in a young girl – long term remission under Montelukast

    Directory of Open Access Journals (Sweden)

    Rump Lars C

    2005-07-01

    Full Text Available Abstract Background Eosinophilic gastrointestinal disorders are an emerging disease entity characterized by eosinophilic infiltration of the intestinal wall. Oral steroids can be still considered as first line treatment. Unfortunately relapses are quite common. Usually long term low-dose prednisone or immunosuppressive therapy is required, which is especially problematic in young patients. Thus a reliable steroid sparing agent with low side effects suitable for long term use is needed. There are strong hints to a similar pathophysiology of eosinophilic gastrointestinal disorders to that of asthma. Indeed leukotriene D4 plays an important role in the recruitment of eosinophils into the intestinal tissue causing damage. This patho-mechanism provides the rationale for the treatment with a leukotriene D4 receptor antagonist. Recently there have been first reports about successful short term use of Montelukast in eosinophilic gastrointestinal disorders. Case presentation We report the case of a 17 year old girl with a long history of severe abdominal complaints leading to several hospitalizations in the past. Mimicking the picture of an intestinal tuberculosis she received an anti mycobacterial treatment without any success. Marked eosinophilia in blood, ascites and tissue samples of the intestinal tract finally lead to the diagnosis eosinophilic gastroenteritis. Tapering off prednisone caused another severe episode of abdominal pain. At that point leukotriene antagonist Montelukast was started at a dose of 10 mg once daily. Steroids could be tapered off completely within six weeks. The patient has been free of symptoms for over two years by now. Routine examinations, blood tests and endoscopy have rendered regular results. So far no side effects were noted. Conclusion Here report about successful long term remission of eosinophilic gastroenteritis under Montelukast. Further randomized control trials are required to asses the full benefits of

  12. Remission and incidence of obstructive sleep apnea from middle childhood to late adolescence.

    Science.gov (United States)

    Spilsbury, James C; Storfer-Isser, Amy; Rosen, Carol L; Redline, Susan

    2015-01-01

    To study the incidence, remission, and prediction of obstructive sleep apnea (OSA) from middle childhood to late adolescence. Longitudinal analysis. The Cleveland Children's Sleep and Health Study, an ethnically mixed, urban, community-based cohort, followed 8 y. There were 490 participants with overnight polysomnography data available at ages 8-11 and 16-19 y. Baseline participant characteristics and health history were ascertained from parent report and US census data. OSA was defined as an obstructive apnea- hypopnea index ≥ 5 or an obstructive apnea index ≥ 1. OSA prevalence was approximately 4% at each examination, but OSA largely did not persist from middle childhood to late adolescence. Habitual snoring and obesity predicted OSA in cross-sectional analyses at each time point. Residence in a disadvantaged neighborhood, African-American race, and premature birth also predicted OSA in middle childhood, whereas male sex, high body mass index, and history of tonsillectomy or adenoidectomy were risk factors among adolescents. Obesity, but not habitual snoring, in middle childhood predicted adolescent OSA. Because OSA in middle childhood usually remitted by adolescence and most adolescent cases were incident cases, criteria other than concern alone over OSA persistence or incidence should be used when making treatment decisions for pediatric OSA. Moreover, OSA's distinct risk factors at each time point underscore the need for alternative risk-factor assessments across pediatric ages. The greater importance of middle childhood obesity compared to snoring in predicting adolescent OSA provides support for screening, preventing, and treating obesity in childhood. © 2014 Associated Professional Sleep Societies, LLC.

  13. The Steroids in the Maintenance of Remission of Proliferative Lupus Nephritis (SIMPL Pilot Trial

    Directory of Open Access Journals (Sweden)

    Lauren Galbraith

    2014-11-01

    Full Text Available Background: Patients with proliferative lupus nephritis are at risk of frequent relapses. Whether low- dose prednisone prevents relapses is uncertain. Objectives: We undertook a pilot RCT to determine the feasibility of a larger trial. Design: Pilot randomized controlled trial. Setting: Single center Canadian outpatient nephrology clinic. Patients: Participants with systemic lupus erythematosus (SLE and a history of class III or IV lupus nephritis that achieved at least partial remission and remained on prednisone were eligible. Measurements: Feasibility: proportion of eligible patients randomized and adherence to tapering regimen. Clinical: occurrence of renal or major non-renal flare of SLE. Methods: We conducted a blinded, two-parallel-group randomized controlled trial of prednisone 7.5 mg/day (continuation compared to a matching placebo (withdrawal. Results: Of nineteen eligible patients screened, 15 (79% were recruited and randomized; 8 to prednisone continuation and seven to withdrawal. All participants adhered to the tapering protocol to their assigned withdrawal or low-dose maintenance target. Over 36 months, the primary outcome occurred in four (50% patients in the continuation group (three renal and one major non-renal flare, compared with one patient (14% in the withdrawal group (one renal flare. Three participants (38% in the continuation group had minor flares, while no patients in the withdrawal group did. Limitations: This pilot RCT was small and not designed to assess the efficacy or safety of maintenance with low-dose prednisone. Conclusions: The high proportion of eligible patients recruited, and success of protocol adherence suggest a large trial of prednisone maintenance therapy compared to withdrawal is feasible. Trial registration: Current Controlled Trials ISRCTN31327267.

  14. Current evidence for a role of GLP-1 in Roux-en-Y gastric bypass-induced remission of type 2 diabetes

    DEFF Research Database (Denmark)

    Rhee, N A; Vilsbøll, T; Knop, F K

    2012-01-01

    Weight-reducing surgical procedures such as Roux-en-Y gastric bypass (RYGB) have proven efficient as means of decreasing excess body weight. Furthermore, some studies report that up to 80% of patients with type 2 diabetes mellitus (T2DM) undergoing RYGB experience complete remission of their T2DM...... antidiabetic effects of GLP-1 are thought to be key mediators in RYGB-induced remission of T2DM. However, the published studies on the impact of RYGB on GLP-1 secretion are few, small and often not controlled properly. Furthermore, mechanistic studies delineating the role of endogenous GLP-1 secretion in RYGB......-induced remission of T2DM are lacking. This article critically evaluates the current evidence for a role of GLP-1 in RYGB-induced remission of T2DM....

  15. The effectiveness of non-pharmacological interventions in improvement of sleep quality among non-remissive cancer patients: A systematic review of randomized trials

    Directory of Open Access Journals (Sweden)

    Fatmawati Fadli

    2016-12-01

    Full Text Available Statistical results estimated that most of non-remissive cancer patients face sleep problem and experience the symptoms of insomnia throughout and after the completion of cancer treatment. The purpose of this review was to compare the effectiveness between several types of non-pharmacological interventions and standard care or treatment to improve the sleep quality among non-remissive cancer patients. All randomized studies focused on non-pharmacological interventions to improve sleep quality among non-remissive cancer patients were included. Thirteen studies were selected with a total of 1,617 participants. The results found that only four interventions were significantly effective to improve sleep quality among non-remissive cancer patients, included cognitive behavioral therapy, relaxation and guided imagery program, self-care behavior education program, and energy and sleep enhancement program.

  16. Clinical and radiological outcomes of 5-year drug-free remission-steered treatment in patients with early arthritis: IMPROVED study.

    Science.gov (United States)

    Akdemir, Gülşah; Heimans, Lotte; Bergstra, Sytske Anne; Goekoop, Robbert J; van Oosterhout, Maikel; van Groenendael, Johannes H L M; Peeters, André J; Steup-Beekman, Gerda M; Lard, Leroy R; de Sonnaville, Peter B J; Grillet, Bernard A M; Huizinga, Tom W J; Allaart, Cornelia F

    2018-01-01

    To determine the 5-year outcomes of early remission induction therapy followed by targeted treatment aimed at drug-free remission (DFR) in patients with early arthritis. In 12 hospitals, 610 patients with early (arthritis (RA) or undifferentiated arthritis (UA) started on methotrexate (MTX) 25 mg/week and prednisone (60 mg/day tapered to 7.5 mg/day). Patients not in early remission (Disease Activity Score 25 points in 5 years. Five years of DFR-steered treatment in patients with early RA resulted in almost normal functional ability without clinically relevant joint damage across treatment groups. Patients who achieved early remission had the best clinical outcomes. There were no differences between the randomisation arms. SDFR is a realistic treatment goal. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Association of bone edema with the progression of bone erosions quantified by hand magnetic resonance imaging in patients with rheumatoid arthritis in remission.

    Science.gov (United States)

    Lisbona, Maria Pilar; Pàmies, Anna; Ares, Jesús; Almirall, Miriam; Navallas, Maria; Solano, Albert; Maymó, Joan

    2014-08-01

    To evaluate the association of synovitis, bone marrow edema (BME), and tenosynovitis in the progression of erosions quantified by hand magnetic resonance imaging (MRI) at 1 year in patients with early rheumatoid arthritis (RA) in remission. A total of 56 of 196 patients with early RA in remission at 1 year and with available MRI data at baseline and at 12 months were included. MRI images were assessed according to the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring (RAMRIS) system. Persistent remission was defined as 28-joint Disease Activity Score-erythrocyte sedimentation rate ≤ 2.6 and/or Simplified Disease Activity Index ≤ 3.3 and/or the new boolean American College of Rheumatology/European League Against Rheumatism remission criteria for a continuous period of at least 6 months. Progression of bone erosions was defined as an increase of 1 or more units in annual RAMRIS score for erosions compared to baseline. At 1 year, the majority of patients with RA in sustained remission showed some inflammatory activity on MRI (94.6% synovitis, 46.4% BME, and 58.9% tenosynovitis) and 19 of the 56 patients (33.9%) showed MRI progression of bone erosions. A significant difference was observed in MRI BME at 1 year, with higher mean score in patients with progression compared to nonprogression of erosions (4.8 ± 5.6 and 1.4 ± 2.6, p = 0.03). Subclinical inflammation was identified by MRI in 96.4% of patients with RA in sustained clinical remission. Significantly higher scores of BME after sustained remission were observed in patients with progression of erosions compared to patients with no progression. The persistence of higher scores of BME may explain the progression of bone erosions in patients with persistent clinical remission.

  18. High incidence and remission of reported food hypersensitivity in Swedish children followed from 8 to 12?years of age ? a population based cohort study

    OpenAIRE

    Winberg, Anna; Strinnholm, ?sa; Hedman, Linnea; West, Christina E; Perzanowski, Matthew S; R?nmark, Eva

    2014-01-01

    Background Few population-based cohort studies have examined reported food hypersensitivity longitudinally. We investigated prevalence, incidence and remission of perceived food hypersensitivity among schoolchildren from 8 to 12?years of age, and risk factors associated with incidence and remission. Methods A population-based cohort including all 7?8 year-old children in three Swedish towns was recruited in 2006. A total of 2,585 (96% of invited) children participated in a parental questionna...

  19. A randomised double-blind placebo-controlled trial with Lactobacillus acidophilus La-5 and Bifidobacterium animalis subsp. lactis BB-12 for maintenance of remission in ulcerative colitis

    DEFF Research Database (Denmark)

    Wildt, Signe; Nordgaard, Inge; Hansen, Ulla

    2011-01-01

    To investigate the clinical effect of treatment with Lactobacillus acidophilus La-5 and Bifidobacterium animalis subsp. lactis BB-12 (Probio-Tec AB-25) to maintain remission in patients with ulcerative colitis.......To investigate the clinical effect of treatment with Lactobacillus acidophilus La-5 and Bifidobacterium animalis subsp. lactis BB-12 (Probio-Tec AB-25) to maintain remission in patients with ulcerative colitis....

  20. Differential expression of NK receptors CD94 and NKG2A by T cells in rheumatoid arthritis patients in remission compared to active disease.

    LENUS (Irish Health Repository)

    Walsh, Ceara E

    2011-01-01

    TNF inhibitors (TNFi) have revolutionised the treatment of rheumatoid arthritis (RA). Natural killer (NK) cells and Natural Killer Cell Receptor+ T (NKT) cells comprise important effector lymphocytes whose activity is tightly regulated through surface NK receptors (NKRs). Dysregulation of NKRs in patients with autoimmune diseases has been shown, however little is known regarding NKRs expression in patients with TNFi-induced remission and in those who maintain remission vs disease flare following TNFi withdrawal.

  1. Differences in Predictive Factors for Sustained Clinical Remission with Abatacept Between Younger and Elderly Patients with Biologic-naive Rheumatoid Arthritis: Results from the ABROAD Study.

    Science.gov (United States)

    Sekiguchi, Masahiro; Fujii, Takao; Matsui, Kiyoshi; Murakami, Kosaku; Morita, Satoshi; Ohmura, Koichiro; Kawahito, Yutaka; Nishimoto, Norihiro; Mimori, Tsuneyo; Sano, Hajime

    2016-11-01

    To differentiate predictive factors for sustained clinical remission between elderly and younger patients with rheumatoid arthritis (RA) receiving abatacept (ABA) as an initial biological disease-modifying antirheumatic drug. The study involved 277 biologic-naive patients with RA with high or moderate disease activity, who were treated with intravenous ABA and evaluated for 48 weeks in 43 Japanese hospitals and rheumatology clinics (the ABatacept Research Outcomes as a First-line Biological Agent in the Real WorlD study: UMIN000004651). Predictive factors associated with sustained clinical remission defined by the 28-joint Disease Activity Score with C-reactive protein (DAS28-CRP) during the 24-48-week or 36-48-week periods were determined in elderly (≥ 65 yrs, n = 148) and younger patient groups (< 65 yrs, n = 129) using logistic regression analysis. Clinical remission was achieved at 24 and 48 weeks in 35.1% and 36.5% of patients in the elderly group and 34.9% and 43.4% in the younger group, respectively. In elderly patients, anticitrullinated protein antibody (ACPA) positivity and a lower DAS28-CRP score were significantly associated with sustained clinical remission; however, a lower Health Assessment Questionnaire-Disability Index (HAQ-DI) score was not related to sustained clinical remission. In younger patients, lower DAS28-CRP and HAQ-DI scores were predictive factors for sustained clinical remission, whereas ACPA positivity was not a useful predictive factor for sustained clinical remission. Although the effectiveness of ABA in biologic-naive patients with RA was equally recognized in elderly and younger patients, the baseline clinical characteristics associated with sustained clinical remission were substantially different.

  2. In cats with newly diagnosed diabetes mellitus, use of a near-euglycemic management paradigm improves remission rate over a traditional paradigm.

    Science.gov (United States)

    Nack, Robert; DeClue, Amy E

    2014-01-01

    The object of this retrospective study was to compare the effect on remission rates of a near euglycemic paradigm (NEP) to a traditional paradigm (TP) of glycemic control in cats with newly diagnosed diabetes mellitus. Medical records of 54 cats with naïve diabetes mellitus managed with low carbohydrate, high protein prescription diets, and twice daily subcutaneous glargine insulin injections were reviewed. Cats were assigned to an NEP or TP group based on frequency of evaluation of blood glucose concentration and the criteria used to assess glycemic control. The two groups were compared with regard to the incidence of clinical and biochemical hypoglycemia and remission rates. Multiple logistic regression was used to evaluate the association between remission and independent variables. Fourteen of 18 cats (78%) in the NEP group achieved remission, whereas five of the 36 (14%) of the TP group achieved remission (p cats. In the TP group, biochemical hypoglycemia was noted in 12/36 (33%) cats and 5/36 (14%) had clinical hypoglycemia. In conclusion, management of newly diagnosed diabetic cats using an NEP of glycemic control results in higher remission rates without an increased incidence of observed clinical or biochemical hypoglycemia. Although an NEP appears to have benefit it should be evaluated further with regard to its overall and long term effects on health and quality of life as well as its overall cost effectiveness.

  3. Immune Effector Recovery in Chronic Myeloid Leukemia and Treatment-Free Remission

    Directory of Open Access Journals (Sweden)

    Agnes S. M. Yong

    2017-04-01

    Full Text Available Chronic myeloid leukemia (CML is a hematological cancer, characterized by a reciprocal chromosomal translocation between chromosomes 9 and 22 [t(9;22], producing the Bcr-Abl oncogene. Tyrosine kinase inhibitors (TKIs represent the standard of care for CML patients and exert a dual mode of action: direct oncokinase inhibition and restoration of effector-mediated immune surveillance, which is rendered dysfunctional in CML patients at diagnosis, prior to TKI therapy. TKIs such as imatinib, and more potent second-generation nilotinib and dasatinib induce a high rate of deep molecular response (DMR, BCR-ABL1 ≤ 0.01% in CML patients. As a result, the more recent goal of therapy in CML treatment is to induce a durable DMR as a prelude to successful treatment-free remission (TFR, which occurs in approximately half of all CML patients who cease TKI therapy. The lack of overt relapse in such patients has been attributed to immunological control of CML. In this review, we discuss an immunological timeline to successful TFR, focusing on the immunology of CML during TKI treatment; an initial period of immune suppression, limiting antitumor immune effector responses in newly diagnosed CML patients, linked to an expansion of immature myeloid-derived suppressor cells and regulatory T cells and aberrant expression of immune checkpoint signaling pathways, including programmed death-1/programmed death ligand-1. Commencement of TKI treatment is associated with immune system re-activation and restoration of effector-mediated [natural killer (NK cell and T cell] immune surveillance in CML patients, albeit with differing frequencies in concert with differing levels of molecular response achieved on TKI. DMR is associated with maximal restoration of immune recovery in CML patients on TKI. Current data suggest a net balance between both the effector and suppressor arms of the immune system, at a minimum involving mature, cytotoxic CD56dim NK cells may be important

  4. Immune Effector Recovery in Chronic Myeloid Leukemia and Treatment-Free Remission

    Science.gov (United States)

    Hughes, Amy; Yong, Agnes S. M.

    2017-01-01

    Chronic myeloid leukemia (CML) is a hematological cancer, characterized by a reciprocal chromosomal translocation between chromosomes 9 and 22 [t(9;22)], producing the Bcr-Abl oncogene. Tyrosine kinase inhibitors (TKIs) represent the standard of care for CML patients and exert a dual mode of action: direct oncokinase inhibition and restoration of effector-mediated immune surveillance, which is rendered dysfunctional in CML patients at diagnosis, prior to TKI therapy. TKIs such as imatinib, and more potent second-generation nilotinib and dasatinib induce a high rate of deep molecular response (DMR, BCR-ABL1 ≤ 0.01%) in CML patients. As a result, the more recent goal of therapy in CML treatment is to induce a durable DMR as a prelude to successful treatment-free remission (TFR), which occurs in approximately half of all CML patients who cease TKI therapy. The lack of overt relapse in such patients has been attributed to immunological control of CML. In this review, we discuss an immunological timeline to successful TFR, focusing on the immunology of CML during TKI treatment; an initial period of immune suppression, limiting antitumor immune effector responses in newly diagnosed CML patients, linked to an expansion of immature myeloid-derived suppressor cells and regulatory T cells and aberrant expression of immune checkpoint signaling pathways, including programmed death-1/programmed death ligand-1. Commencement of TKI treatment is associated with immune system re-activation and restoration of effector-mediated [natural killer (NK) cell and T cell] immune surveillance in CML patients, albeit with differing frequencies in concert with differing levels of molecular response achieved on TKI. DMR is associated with maximal restoration of immune recovery in CML patients on TKI. Current data suggest a net balance between both the effector and suppressor arms of the immune system, at a minimum involving mature, cytotoxic CD56dim NK cells may be important in mediating

  5. Regulatory and effector T cells changes in remission and resistant state of childhood nephrotic syndrome

    Directory of Open Access Journals (Sweden)

    A Jaiswal

    2014-01-01

    Full Text Available Idiopathic minimal change disease is a disorder of T-cell dysfunction. The relative predominance of regulatory T cells (Tregs, Th1, and Th2 cells in nephrotic syndrome (NS remains controversial. Imbalance in peripheral blood regulatory and effector T cells (Teff are linked to cell mediated immune response and may be associated with steroid response in NS. Peripheral blood CD4 + CD25 + FoxP3 + (Tregs, CD4 + IFN-γ + (Th1, and CD4 + IL-4 + (Th2 lymphocytes were analyzed in 22 steroid-sensitive NS (SSNS patients in sustained remission, 21 steroid-resistant NS (SRNS and 14 healthy controls. The absolute percentage values and ratio of Th1/Tregs, Th2/Tregs, and Th1/Th2 were compared between SSNS, SRNS and control subjects. The percentage of Tregs was lower in SRNS patients (P = 0.001 compared with that of SSNS and healthy control. The percentage of Th1 cells was higher in SRNS (P = 0.001 compared to that of SSNS patients; however, it was similar to healthy controls (P = 1.00. The percentage of Th2 cells in SRNS (P = 0.001 was higher as compared to SSNS and controls. The ratio of Th1/Treg cells in SRNS (P = 0.001 was higher as compared to SSNS patients and controls. The ratio of Th2/Treg was also higher in SRNS as compared to SSNS and controls. The ratio of Th1/Th2 cells in SSNS, SRNS, and healthy controls were similar. The cytokines secretion complemented the change in different T-cell subtypes in SSNS, SRNS and healthy controls. However, the IFN-γ secretion in healthy controles was low inspite of similar percentage of Th1 cells among SRNS cases. We conclude that greater ratio of Tregs compared to that Th1 and Th2 favor steroid sensitivity and reverse ratio results in to SRNS. The difference in ratio is related to pathogenesis or it can be used as marker to predict steroid responsiveness needs further evaluation.

  6. Independent prognostic impact of CD15 on complete remission achievement in patients with acute myeloid leukemia.

    Science.gov (United States)

    Chisini, Marta; Stefanizzi, Caterina; Ceglie, Teresa; Raponi, Sara; Vozella, Federico; Colafigli, Gioia; Salaroli, Adriano; D'Angiò, Mariella; Mancini, Marco; Diverio, Daniela; Breccia, Massimo; Mancini, Francesca; Minotti, Clara; Trisolini, Silvia; Capria, Saveria; Testi, Anna Maria; Guarini, Anna; Latagliata, Roberto; De Propris, Maria Stefania; Foà, Robin

    2017-12-01

    The prognostic role of CD15 in acute myeloid leukemia (AML) has been tested in different studies with conflicting results. To address this issue, we retrospectively evaluated a cohort of 460 AML patients of all ages with the exclusion of acute promyelocytic leukemia (M/F 243/217, median age 50.6 years [range 0.9-81.2]) intensively treated at our institute between January 1999 and December 2010. CD15 positivity was found in 171 of 406 evaluable patients (42.1%). Complete remission (CR) was achieved by 334 patients (72.6%), while 82 (17.8%) were resistant and 44 (9.6%) died during induction: the median CR duration was 15.5 months (range 0.6-176.0), with 2-year disease-free survival rate of 45.1% (95% confidence interval 39.6-50.6). The median overall survival was 14.4 months (range 0.3-177.0), with 2-year overall survival rate of 42.2% (95% confidence interval 37.5-46.9). At univariate analysis for CR achievement, age classification (P = .045), low-risk karyotype (P  8 g/dL (P = .020), and white blood cell < 50 × 10 9 /L (P = .034) had a favorable impact. At a multivariate logistic regression model, CD15 positivity (P = .002), age < 60 years (P = .008), white blood cell < 50 × 10 9 /L (P = .017), and low-risk/no high-risk karyotype (P = .026/P = .025) retained an independent prognostic role on CR achievement. The baseline assessment of CD15 positivity appears to have a role in the risk evaluation for CR achievement in AML patients undergoing intensive chemotherapy and should be assessed in prospective studies together with other clinical and biologic features already reported. Copyright © 2016 John Wiley & Sons, Ltd.

  7. Policy Reader

    International Nuclear Information System (INIS)

    1985-09-01

    This policy reader comprises: Correspondence; Memorandum of Understanding between the US Department of Transportation and the US Department of Energy for the Transportation of Radioactive Materials under the Nuclear Waste Policy Act; Internal Guidelines for Interactions with Communities and Local Governments; Statement by Ben C. Rusche before the Committee on Interior and Insular Affairs, Subcommittee on Energy and the Environment, US House of Representatives, September 13, 1985; Speech presented by Ben C. Rusche before the ANS/CNS/AESJ/ENS Topical Meeting, Pasco, Washington, September 24, 1985 - ''Status of the United States' High-Level Nuclear Waste Disposal Program''; and ''DOE Seeks Comments on Nuclear Transportation Planning,'' DOE News, September 30, 1985

  8. Population policy.

    Science.gov (United States)

    1987-03-01

    Participants in the Seminar on Population Policies for Top-level Policy Makers and Program Managers, meeting in Thailand during January 1987, examined the challenges now facing them regarding the implementation of fertility regulation programs in their respective countries -- Bangladesh, China, India, Indonesia, Malaysia, Nepal, Pakistan, the Philippines, the Republic of Korea, and Thailand. This Seminar was organized to coincide with the completion of an Economic and Social Commission for Asia and the Pacific (ESCAP) study investigating the impact and efficiency of family planning programs in the region. Country studies were reviewed at the Seminar along with policy issues about the status of women, incentive and disincentive programs, and socioeconomic factors affecting fertility. In Bangladesh the government recognizes population growth as its top priority problem related to the socioeconomic development of the country and is working to promote a reorientation strategy from the previous clinic-oriented to a multidimensional family welfare program. China's family planning program seeks to postpone marraige, space the births of children between 3-5 years, and promote the 1-child family. Its goal is to reduce the rate of natural increase from 12/1000 in 1978 to 5/1000 by 1985 and 0 by 2000. India's 7th Five-Year-Plan (1986-90) calls for establishing a 2-child family norm by 2000. In Indonesia the government's population policy includes reducing the rate of population growth, achieving a redistribution of the population, adjusting economic factors, and creating prosperous families. The government of Indonesia reversed its policy to reduce the population growth rate in 1984 and announced its goal of achieving a population of 70 million by 2100 in order to support mass consumption industries. It has created an income tax deduction system favoring large families and maternity benefits for women who have up to 5 children as incentives. Nepal's official policy is to

  9. Language Policy

    DEFF Research Database (Denmark)

    Lauridsen, Karen M.

    2008-01-01

    Like any other text, instructive texts function within a given cultural and situational setting and may only be available in one language. However, the end users may not be familiar with that language and therefore unable to read and understand the instructions. This article therefore argues...... that instructive texts should always be available in a language that is understood by the end users, and that a corporate communication policy which includes a language policy should ensure that this is in fact the case for all instructive texts....

  10. Gastric volume reduction is essential for the remission of type 2 diabetes mellitus after bariatric surgery in nonobese rats.

    Science.gov (United States)

    Zhang, Xiong; Yu, Bo; Yang, Dan; Qiao, Zhengdong; Cao, Ting; Zhang, Peng

    Roux-en-Y gastric bypass (RYGB) has shown positive outcomes in the remission of type 2 diabetes (T2D) and weight loss in obese patients by inhibiting food intake and nutrient absorption as well as inducing favorable hormonal changes. The purpose of the present study was to investigate whether gastric volume reduction is still required in addition to intestinal bypass for the purpose of T2D remission in nonobese patients. University Medical Center. Nonobese T2D Goto-Kakizaki rats were employed in the study. All rats were randomized into 3 groups according to the surgical procedure performed, including (1) RYGB, (2) duodeno-jejunal bypass (DJB) without gastric volume reduction, and (3) sham surgery (control). In addition, age-matched Wistar rats were adopted as normal nondiabetic controls. Weight, food intake, fasting plasma glucose, and intraperitoneal glucose tolerance test were measured in vivo before and 2, 4, and 8 weeks after the treatment. Whole body metabolic parameters including respiratory exchange ratio, energy expenditure, and activities were also recorded in all animals at the third week postoperatively. Compared with DJB and sham animals, the RYGB group had lower weight, less food intake, lower fasting plasma glucose, and improved glucose tolerance at all measuring time points postoperatively. By measuring whole body metabolic parameters, we found that RYGB, but not DJB, increased metabolic rate manifested by increased energy expenditure but less activity at night. In the meantime, respiratory exchange ratio was lower in RYGB group than in the other 3 groups at daytime, meaning adipose tissue became the main source of internal energy production during the resting phase in the group. For nonobese T2D patients, adding gastric volume reduction to intestine bypass gave better efficacy in remission of T2D by increasing metabolic rate and adipolysis, especially during the resting period. Copyright © 2016 American Society for Bariatric Surgery. Published by

  11. The Diagnostic Apathia Scale predicts a dose-remission relationship of T-PEMF in treatment-resistant depression.

    Science.gov (United States)

    Bech, Per; Lunde, Marianne; Lauritzen, Lise; Straasø, Birgit; Lindberg, Lone; Vinberg, Maj; Undén, Mogens; Hellström, Lone Christina; Dissing, Steen; Larsen, Erik Roj

    2015-02-01

    The aim of this study was to evaluate the predictive validity of the apathy subsyndrome in patients with therapy-resistant depression in the dose-remission study with transcranial pulsating electromagnetic fields (T-PEMF). The apathy subsyndrome consists of the symptoms of fatigue, concentration and memory problems, lack of interests, difficulties in making decisions, and sleep problems. We evaluated 65 patients with therapy-resistant depression. In total, 34 of these patients received placebo T-PEMF in the afternoon and active T-PEMF in the morning, that is, one daily dose. The remaining 31 patients received active T-PEMF twice daily. Duration of treatment was 8 weeks in both groups. The Hamilton Depression Scale (HAM-D17) and the Bech-Rafaelsen Melancholia Scale (MES) were used to measure remission. We also focused on the Diagnostic Apathia Scale, which is based on a mixture of items from the MINI and the HAM-D17/MES. In patients without apathy, the remission rate after T-PEMF was 83.9% versus 58.8% in patients with apathy (p≤0.05). In patients without apathy receiving one active dose daily 94.4% remitted versus 50% for patients with apathy (p≤0.05). In patients without apathy who received two active doses 69.9% remitted versus 66.7% for patients with apathy (p≤0.05). Taking the baseline diagnosis of the apathy syndrome into consideration, we found that in patients without apathy one daily dose of T-PEMF is sufficient, but in patients with apathy two daily doses are necessary. Including the apathy syndrome as predictor in future studies would seem to be clinically relevant.

  12. The value of power Doppler ultrasound in patients with rheumatoid arthritis in clinical remission: Reclassifying disease activity?

    Science.gov (United States)

    Vergara, Facundo; Ruta, Santiago; Rosa, Javier; Marín, Josefina; García-Mónaco, Ricardo; Soriano, Enrique R

    2017-03-18

    The aim of the present study was to describe the ultrasound (US) findings in patients with rheumatoid arthritis (RA) in clinical remission, and to evaluate the ability of power Doppler (PD) US to reclassify disease activity in these patients. We included consecutive patients with RA according to 2010 American College of Rheumatology/European League Against Rheumatism criteria, who were in clinical remission by the Disease Activity Score (DAS28<2.6). Twenty joints of both hands were assessed by US. PD signal was evaluated on a semi-quantitative scale from 0 to 3. Three different US-modified DAS28 (US-DAS28) were constructed, replacing the clinical swollen joint count by the PD US joint count using PD score ≥1, ≥2 or ≥3, respectively. Eighty-six patients were included. Twenty-three (26.7%) patients had at least one joint with abnormal US-positive PD signal. Thirteen percent of patients were reclassified to low disease activity by applying the US-DAS28 when joints were considered active with a PD signal ≥1; 12%, when a PD signal ≥2 was considered, and 2% of the patients were reclassified when a PD score of 3 was considered. No patients were reclassified to a level of moderate or high activity applying US-DAS28. Although around a quarter of patients with RA in clinical remission showed PD US features indicating residual activity, only a small percentage were reclassified to a state of low activity and none to a level of moderate or high activity, applying the proposed US-DAS28. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  13. Remission in early, aggressive rheumatoid arthritis: a multicentre prospective observational Italian study ARPA (Artrite Reumatoide Precoce Aggressiva).

    Science.gov (United States)

    Ceccarelli, Fulvia; Perricone, Carlo; Trotta, Francesco; Cuomo, Giovanna; Pellerito, Raffaele; Bagnato, Gianfilippo; Salaffi, Fausto; Caporali, Roberto; Cutolo, Maurizio; Galeazzi, Mauro; Fiocco, Ugo; Lapadula, Giovanni; Bombardieri, Stefano; Bianchi, Girolamo; Gorla, Roberto; Giardina, Anna Rita; Gallo, Gaia; Giardino, Angela Maria; Valesini, Guido

    2013-01-01

    To provide a survey of disease activity in patients treated with standard care in Italian clinical practice. This was an observational prospective cohort study in patients with early, aggressive rheumatoid arthritis (RA; duration ≤2 years but ≥6 weeks; DAS28 >3.2) naïve to anti-tumour necrosis factor (TNF) therapy who were treated with disease-modifying anti-rheumatic drugs (DMARDs) and/or biologics according to standard practice at 15 Italian ARPA (Artrite Reumatoide Precoce Aggressiva) centres. Patients were evaluated at baseline and after 6, 12 and 24 months. The primary endpoint was the proportion of patients achieving remission, as defined by disease activity score in 28 joints (DAS28) <2.6, after 1 year. Among the 152 patients enrolled, 92 were evaluable after 1 year and 77 after 2 years for DAS28. At baseline, patients had a mean DAS28 of 6.1±1.0. At 12 months, 62.6% of patients were treated with DMARDs (in monotherapy or in combination), and 37.4% with anti-TNFs (in monotherapy or in association with DMARDs). At 24 months, 35.1% were receiving anti-TNF therapy. The rate of DAS28 remission rates at 12 months and 24 months were 28.3% (95% confidence interval [CI] 19.1-37.5) and 41.6% (95% confidence interval [CI] 30.6-52.6), respectively. The remission rate was lower at 12 months compared with previous large randomised clinical trials for early, aggressive RA, but significantly improved at 24 months. These results suggest that patients in real-world clinical settings in Italy may experience a delay in receiving the best possible care.

  14. Concordance between clinician and patient ratings as predictors of response, remission, and recurrence in major depressive disorder

    Science.gov (United States)

    Dunlop, Boadie W.; Li, Thomas; Kornstein, Susan G.; Friedman, Edward S.; Rothschild, Anthony J.; Pedersen, Ron; Ninan, Philip; Keller, Martin; Trivedi, Madhukar H.

    2013-01-01

    We conducted a secondary analysis of data from the Prevention of Recurrent Episodes of Depression With Venlafaxine Extended Release (ER) for Two Years (PREVENT) trial to evaluate whether discrepancies between clinician and patient ratings of depression severity were predictive of response, remission, and recurrence during treatment for a depressive episode. Patients who self-rated depression severity in concordance with the clinician (“concordant patients”) were defined as having a standardized patient-rated Inventory of Depressive Symptoms-Self Report (IDS-SR30) score minus standardized clinician-rated Hamilton Rating Scale for Depression (HAM-D17) score SR30 during acute and continuation therapy and time to recurrence during maintenance therapy. During acute treatment female patients were more likely to overrate their depression severity compared to the clinician; older age predicted overrating during continuation treatment. Overrating patients had a slower onset of response on the HAM-D17 during acute treatment (P = 0.004). There were no differences between cohorts for remission or response on the HAM-D17 or CGI-S. Overrating patients at week 10 had lower remission and response rates on the IDS-SR30 during continuation therapy (32% and 50%, respectively; P ≤ 0.001) compared with underrating patients (76%, 77%) or concordant patients (64%, 78%). Patient concordance at the end of continuation therapy did not predict recurrence during maintenance therapy, indicating that patient rating scales may be useful in tracking recurrence during maintenance therapy. Poor agreement between patient- and clinician-ratings of depression severity is primarily a state phenomenon, although it is trait-like for some patients. PMID:20537348

  15. Yearly reduction of glucocorticoid dose by 50% as tapering schedule achieves complete remission for 124 pemphigus vulgaris patients.

    Science.gov (United States)

    Wang, Mingyue; Gao, Yu; Peng, Yang; Zhao, Junyu; Chen, Xixue; Zhu, Xuejun

    2016-03-01

    Glucocorticoids are the first-line treatment for pemphigus vulgaris. Among 140 patients receiving systemic glucocorticoids, 124 patients achieved complete remission off or on a prednisone dose of ≤10 mg/day or less for 6 months or more. The mean average steroid controlling doses were 0.65, 0.62, 0.80, 1.08 and 1.38 mg/kg per day for the mucosal-dominant patients and the mild, moderate, severe and extensive cutaneous-involved patients, respectively (P pemphigus vulgaris within 3-6 years. © 2015 Japanese Dermatological Association.

  16. Routine imaging for diffuse large B-cell lymphoma in first remission is not associated with better survival

    DEFF Research Database (Denmark)

    El-Galaly, T. C.; Jakobsen, L. H.; Hutchings, M.

    2015-01-01

    :female ratio, median age, and proportion of IPI high risk disease (IPI > 2). After a median FU of 51months, the 3-yr OS for the entire patient cohort was 92% (95% CI 90-93). There was no survival difference between Danish and Swedish patients (P = 0.5, log-rank). Age >60 years (HR 2.3, P ... no impact on the post-remission OS for patients grouped according to the IPI scores (P = 0.2 for IPI IPI > 2). The cumulative 2-year progression rate was 6% (95% CI 4-9) for patients with IPI IPI > 2. Conclusions: The vast majority of young...

  17. GCN2 kinase plays an important role triggering the remission phase of experimental autoimmune encephalomyelitis (EAE) in mice.

    Science.gov (United States)

    Orsini, Heloisa; Araujo, Leandro P; Maricato, Juliana T; Guereschi, Marcia G; Mariano, Mario; Castilho, Beatriz A; Basso, Alexandre S

    2014-03-01

    Experimental autoimmune encephalomyelitis (EAE) has been widely employed as a model to study multiple sclerosis (MS) and indeed has allowed some important advances in our comprehension of MS pathogenesis. Several pieces of evidence suggest that infiltrating Th1 and Th17 lymphocytes are important players leading to CNS demyelination and lesion during the peak of murine EAE. Subsequently, effector T cell responses rapidly decline and the recovery phase of the disease strongly correlates with the expression of anti-inflammatory cytokines and the enrichment of Foxp3+ regulatory T (Treg) cells within the target organ. However, the mechanisms leading to the increased presence of Treg cells and to the remission phase of the disease are still poorly understood. Recent researches demonstrated that chemically induced amino-acid starvation response might suppress CNS immune activity. Here we verified an important participation of the general control nonrepressible 2 (GCN2), a key regulator kinase of the amino-acid starvation response, in the development of the remission phase of EAE in C57BL/6 mice. By immunizing wild type C57BL/6 (WT) and GCN2 knock-out mice (GCN2 KO) with myelin oligodendrocyte glycoprotein peptide (MOG35-55), it was noticed that GCN2 KO mice did not develop the remission phase of the disease and this was associated with higher levels of CNS inflammation and increased presence of effector T cells (Th1/Th17). These animals also showed lower frequency of Treg cells within the CNS as compared to WT animals. Higher expression of indoleamine 2,3-dioxygenase (IDO) and higher frequency of plasmacytoid dendritic cells (pDCs) were found at the peak of the disease in the CNS of WT animals. Our results suggest that the GCN2 kinase-dependent sensing of IDO activity represents an important trigger to the EAE remission phase. The IDO-mediated immunoregulatory events may include the arresting of effector T cell responses and the differentiation/expansion of Treg cells

  18. New immunotherapy approach leads to remission in patients with the most common type of childhood cancer | Center for Cancer Research

    Science.gov (United States)

    Chimeric antigen receptor (CAR) T-cell immunotherapy has emerged as a promising treatment for pre-B cell acute lymphoblastic leukemia (B-ALL), the most common type of childhood cancer. B-ALL is characterized by an overproduction of immature white blood cells called lymphoblasts. In a trial led by Center for Cancer Research investigators, around 70 to 90 percent of patients whose B-ALL has relapsed or developed resistance to chemotherapy entered remission after CAR T-cell therapy targeting CD19. Read more…

  19. Complete remission of diffuse hepatocellular carcinoma in a young adult after GSP-TACE: a case report.

    Science.gov (United States)

    Liu, Song; Zhang, Yuewei; Zhao, Guangsheng; Liu, Ying

    2014-09-25

    Hepatocellular carcinoma (HCC) is the most common primary tumor of the liver. It mostly occurs in older age groups (usually those 50 to 60 years old), and rarely in young adults. The survival rate of these young HCC patients is usually very low. The authors report a case of a 22-year old man with diffuse-type HCC who successfully achieved complete remission for 46 months after second transcatheter arterial chemoembolization using gelatin sponge particles (Eric Kang Pharmaceutical Technology Co., Ltd. Hangzhou, China) combined with pirarubicin.

  20. Comparison between consecutive and intermittent steroid pulse therapy combined with tonsillectomy for clinical remission of IgA nephropathy.

    Science.gov (United States)

    Kamei, Daigo; Moriyama, Takahito; Takei, Takashi; Wakai, Sachiko; Nitta, Kosaku

    2014-04-01

    In recent years, tonsillectomy and steroid pulse (TSP) therapy have been widely performed in Japan. However, there is no consensus about the treatment protocol and indication. In this retrospective analysis, we compared patients who received tonsillectomy plus intermittent steroid pulse (SP) therapy three times in 6 months (ISP group, n = 44) with patients who received tonsillectomy plus 3 weeks of consecutive SP therapy (CSP group, n = 46) within 1 year after renal biopsy. These two different protocols were performed at two different institutions. We analyzed the clinical and histological background and clinical remission (CR), defined as disappearance of urine abnormalities at 18 months after starting treatment. Before treatment, there was no significant difference in the clinical findings except for sex between the two groups. In ISP group and CSP group, mean estimated glomerular filtration rate was 82.1 ± 20.9 and 85.9 ± 19.1 ml/min/1.73 m(2), median proteinuria was 0.55 and 0.56 g/day, and median urinary red blood cells were 20 (10-20) and 20 (6-30)/high power filed. The histological (H) grade was lower in the CSP than the ISP group (p = 0.022). The remission rate of proteinuria, hematuria, and rate of CR by the Kaplan-Meier method and logrank test were significantly higher in the CSP group than in the ISP group (CSP vs. ISP group; proteinuria: 97.8 vs. 77.3 %, p forced entry), SP protocol and proteinuria before treatment were significantly associated with CR [SP protocol: hazard ratio (HR) 2.50, 95 % confidence interval (CI) 1.46-4.30, p = 0.001, proteinuria: HR 0.81, 95 % CI 0.68-0.96, p = 0.013)]. However H-grade was associated with remission of proteinuria (H-grade: hazard ratio (HR) 0.56, 95 % confidence interval (CI) 0.37-0.85, p = 0.006), and this result meant histological bias affected the remission of proteinuria. The difference of the protocol of TSP therapy may have some effect on the CR of IgAN, though the histological bias was observed in this

  1. 5-aminosalicylsyre til induktion af remission eller respons ved Crohns sygdom--en gennemgang af et Cochranereview

    DEFF Research Database (Denmark)

    Bjerrum, Jacob Tveiten; Munck, Lars Kristian; Nielsen, Ole Haagen

    2011-01-01

    A systematic review to evaluate the efficacy of 5-aminosalicylates for induction of remission or clinical response in patients with mild to moderately active Crohn's disease is described. The effect of either high (3 to 4.5 g/day) or low dose (1 to 2 g/day) 5-aminosalicylic acid was similar...... to that of placebo. Overall, sulfasalazine was not superior to placebo and was inferior to glucocorticoids for the treatment of mild to moderately active Crohn's disease. Neither published nor unpublished data support any use of 5-aminosalicylates for the treatment of Crohn's disease....

  2. The course of asthma in young adults: a population-based nine-year follow-up on asthma remission and control.

    Directory of Open Access Journals (Sweden)

    Lucia Cazzoletti

    Full Text Available BACKGROUND: Only few longitudinal studies on the course of asthma among adults have been carried out. OBJECTIVE: The aim of the present prospective study, carried out between 2000 and 2009 in Italy, is to assess asthma remission and control in adults with asthma, as well as their determinants. METHODS: All the subjects with current asthma (21-47 years identified in 2000 in the Italian Study on Asthma in Young Adults in 6 Italian centres were followed up. Asthma remission was assessed at follow-up in 2008-2009 (n = 214, asthma control at baseline and follow-up. Asthma remission and control were related to potential determinants by a binomial logistic and a multinomial logistic model. Separate models for remission were used for men and women. RESULTS: The estimate of the proportion of subjects who were in remission was 29.7% (95%CI: 14.4%;44.9%. Men who were not under control at baseline had a very low probability of being in remission at follow-up (OR = 0.06; 95%CI:0.01;0.33 when compared to women (OR = 0.40; 95%CI:0.17;0.94. The estimates of the proportion of subjects who were under control, partial control or who were not under control in our sample were 26.3% (95%CI: 21.2;31.3%, 51.6% (95%CI: 44.6;58.7% and 22.1% (95%CI: 16.6;27.6%, respectively. Female gender, increasing age, the presence of chronic cough and phlegm and partial or absent asthma control at baseline increased the risk of uncontrolled asthma at follow-up. CONCLUSION: Asthma remission was achieved in nearly 1/3 of the subjects with active asthma in the Italian adult population, whereas the proportion of the subjects with controlled asthma among the remaining subjects was still low.

  3. Validity of remission and recovery criteria for schizophrenia and major depression: comparison of the results of two one-year follow-up naturalistic studies.

    Science.gov (United States)

    Spellmann, Ilja; Schennach, Rebecca; Seemüller, Florian; Meyer, Sebastian; Musil, Richard; Jäger, Markus; Schmauß, Max; Laux, Gerd; Pfeiffer, Herbert; Naber, Dieter; Schmidt, Lutz G; Gaebel, Wolfgang; Klosterkötter, Joachim; Heuser, Isabella; Bauer, Michael; Adli, Mazda; Zeiler, Joachim; Bender, Wolfram; Kronmüller, Klaus-Thomas; Ising, Marcus; Brieger, Peter; Maier, Wolfgang; Lemke, Matthias R; Rüther, Eckart; Klingberg, Stefan; Gastpar, Markus; Riedel, Michael; Möller, Hans-Jürgen

    2017-06-01

    The objective of the present study was the application and comparison of common remission and recovery criteria between patients with the diagnosis of schizophrenia and major depressive disorder (MDD) under inclusion of other outcome parameters. Patients with schizophrenia and MDD who were treated as inpatients at the beginning of the study were examined within two naturalistic follow-up trials from admission to discharge of an inpatient treatment period and the one-year follow-up assessment. PANSS criteria of the Remission in Schizophrenia Working Group (RSWG) for schizophrenia and HAMD criteria of the ACNP Task Force in MDD for depressive patients as well as the Clinical Global Impression-Severity Scale (CGI-S) were applied as symptomatic outcome measures additionally to functional outcome parameters. Data of 153 schizophrenia patients and 231 patients with a MDD episode have been included in the analysis. More depressive than schizophrenia patients reached a threshold score of ≤3 on the CGI-S, indicating symptomatic remission at discharge and at the one-year follow-up. In contrast similar proportions of patients reaching symptomatic remission at discharge from inpatient treatment and at the one-year follow-up in the schizophrenia and in the MDD group were found when disease-related consensus criteria (RSWG vs. ACNP Task Force) were used. Functional remission and recovery rates were significantly lower in schizophrenia than in depressive patients at the one-year follow-up visit. Common outcome criteria for remission and recovery in schizophrenia and major depression were not directly comparable. However, our results indicated a significantly poorer outcome in schizophrenia than in depressive patients according to terms of remission and recovery.

  4. Serum and urine nitric oxide levels in children with Henoch-Schonlein purpura during activity and remission: a study from North India.

    Science.gov (United States)

    Mahajan, Vikas; Singh, Surjit; Khullar, Madhu; Minz, Ranjana W

    2009-07-01

    The objective of this study is to compare serum and urine reactive nitrogen intermediates (RNI) and citrulline levels in children with Henoch-Schonlein purpura (HSP) during activity and remission. The study group consisted of 14 children with HSP. We measured serum and urine RNI and citrulline levels by spectrophotometry in the active phase of the disease and then during remission. Serum RNI levels were 303.95 +/- 221.44 nmol/ml in children with active HSP and 72.57 +/- 26.56 nmol/ml during remission, the differences being statistically significant (P = 0.002). Mean urine RNI levels in children with active HSP were significantly higher than that seen during remission (3.25 +/- 1.80 vs. 1.68 +/- 0.65 nmol/ml; P = 0.003). Similarly, serum citrulline levels during disease activity were 790.65 +/- 707.87 nmol/ml as compared to 281.49 +/- 307.29 nmol/ml at the time of remission, the differences being statistically significant (P = 0.002). Mean urine citrulline levels in children with active disease was 1,969.94 +/- 1655.42 nmol/ml as compared to 1,099.34 +/- 955.82 nmol/ml in children with remission, (P = 0.007). Serum and urine RNI and citrulline levels were significantly higher during the acute phase of HSP as compared to the levels obtained during the phase of disease remission. These findings suggest that nitric oxide may perhaps have a role in the pathogenesis of HSP. Further, these laboratory parameters could be of value in monitoring disease activity. To the best of our knowledge, this study is the most comprehensive work published on the subject so far. Our findings, however, need to be confirmed on a larger study sample before firm conclusions can be drawn.

  5. Complete remission of a lymphoma-associated chylothorax by radiotherapy of the celiac trunk and thoracic duct

    Energy Technology Data Exchange (ETDEWEB)

    Gerstein, J.; Fruehauf, J.; Bremer, M. [Dept. of Radiation Oncology, Hannover Medical School (Germany); Kofahl-Krause, D. [Dept. of Hematology, Hemostasis, Stem Cell Transplantation and Oncology, Hannover Medical School (Germany)

    2008-09-15

    Background: a chylothorax is a rare complication of mostly advanced malignant lymphomas. A case of a refractory chylothorax unresponsive to chemotherapy and successfully treated with radiotherapy is reported. Case report: a 45-year-old woman with recurrent stage IV low-grade follicular non-Hodgkin's lymphoma and a progressive chylothorax is described. The CT scans showed bulky lymphadenopathy at the thoracic trunk but no detectable enlargement of mediastinal lymph nodes. After ineffective pretreatment including chemotherapy and chest drainage, fractionated radiotherapy to the celiac trunk (20.4 Gy) and the thoracic duct (15 Gy) was performed. Result: already after 7.5 Gy a rapid decline of chylothorax was noted and the chest drain could be removed. A complete remission of the chylothorax could be achieved after 20.4 Gy. During a follow-up of 16 months no recurrence of chylothorax occurred. CT scans showed nearly complete remission of the lymphadenopathy of the celiac trunk 12 months after radiotherapy. Conclusion: radiotherapy with limited total doses is an effective treatment option for lymphoma-associated chylothorax and should always be taken into consideration, especially in cases unresponsive to chemotherapy. (orig.)

  6. Consolidation of first remission using radioimmunotherapy with yttrium-90-ibritumomab-tiuxetan in adult patients with Burkitt lymphoma.

    Science.gov (United States)

    Koechli, Valentin; Klaeser, Bernd; Banz, Yara; Mueller, Beatrice U; Pabst, Thomas

    2015-03-01

    The addition of anti-CD20 antibodies to high intensity polychemotherapy regimens has improved response and survival rates in newly diagnosed patients with Burkitt lymphoma (BL). However, the role of additional anti-CD20 directed radioimmunotherapy for consolidation of first remission (CR1) has not been reported so far in BL patients receiving rituximab during first-line treatment. We compared five BL patients receiving Y-90-IT radioimmunotherapy consolidation in CR1 to 22 consecutive BL patients without consolidation. We observed that Y-90-IT treatment was associated with clinically relevant myelosuppression. After a median follow-up of 50 months, none of the patients with Y-90-IT treatment relapsed, and no patient died. In contrast, one patient (4.5%) in the non-Y-90-IT group relapsed (50 months-PFS 95.5%; p=0.6336), and one patient died (50 months-OS 95.5%; p=0.6171). In conclusion, our data suggest that survival rates are excellent and equal in rituximab pretreated BL patients with or without Y-90-IT consolidation in first remission. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Radiological remission and recovery of thirst appreciation after infliximab therapy in adipsic diabetes insipidus secondary to neurosarcoidosis.

    Science.gov (United States)

    O'Reilly, M W; Sexton, D J; Dennedy, M C; Counihan, T J; Finucane, F M; O'Brien, T; O'Regan, A W

    2015-08-01

    Neurosarcoidosis is a rare and aggressive variant of systemic sarcoidosis which may result in hypothalamic-pituitary dysfunction. We report a case of hypothalamic hypopituitarism secondary to neurosarcoidosis complicated by adipsic diabetes insipidus (ADI). Initiation of anti-tumour necrosis factor-α (TNF-α) therapy resulted in both radiological disease remission and recovery of osmoregulated thirst appreciation after 3 months. A 22-year-old man was referred to the endocrinology service with profound weight gain, polyuria and lethargy. Biochemical testing confirmed anterior hypopituitarism while posterior pituitary failure was confirmed by hypotonic polyuria responding to desmopressin. Magnetic resonance imaging (MRI) demonstrated extensive hypothalamic infiltration; neurosarcoidosis was confirmed histologically after excisional cervical lymph node biopsy. Osmoregulated thirst appreciation was normal early in the disease course despite severe hypotonic polyuria. However, subsequent subjective loss of thirst appreciation and development of severe hypernatraemia in the setting of normal cognitive function indicated onset of ADI. Clinical management involved daily weighing, regular plasma sodium measurement, fixed daily fluid intake and oral desmopressin. We initiated immunosuppressive therapy with pulsed intravenous anti-TNF-α therapy (infliximab) after multidisciplinary team consultation. Infliximab therapy resulted in successful radiological disease remission and complete recovery of osmoregulated thirst appreciation. This was confirmed by subjective return of thirst response and maintenance of plasma sodium in the normal range in the absence of close biochemical monitoring. © The Author 2013. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Incidence and remission of lower urinary tract symptoms during 12 years after the first delivery: A cohort study

    DEFF Research Database (Denmark)

    Viktrup, L.; Lose, G.

    2008-01-01

    delivery. Results: From 3 months to 5 years after first delivery the incidence of stress urinary incontinence, urge urinary incontinence, urgency, diurnal frequency and nocturia was 56 of 213 cases (26.3%), 33 of 219 (15.1%), 33 of 206 (16.0%), 49 of 219 (22.4%) and 6 of 225 (2.7%), respectively. Remission...... of stress urinary incontinence, urge urinary incontinence, urgency, diurnal frequency and nocturia during the same period occurred in 1 of 11 cases (9.1%), 2 of 5 (40%), 2 of 5 (40%), 4 of 7 (57.1%) and I of 1 (100%), respectively. From 5 to 12 years after the first delivery the incidence of stress urinary...... incontinence, urge urinary incontinence, urgency, diurnal frequency and nocturia was 40 of 158 cases (25.3%), 25 of 188 (13.3%), 24 of 175 (13.7%), 40 of 174 (23.0%) and 13 of 220 (5.9%), respectively. Remission of stress urinary incontinence, urge urinary incontinence, urgency, diurnal frequency and nocturia...

  9. Iron chelation therapy with deferasirox induced complete remission in a patient with chemotherapy-resistant acute monocytic leukemia.

    Science.gov (United States)

    Fukushima, Toshihiro; Kawabata, Hiroshi; Nakamura, Takuji; Iwao, Haruka; Nakajima, Akio; Miki, Miyuki; Sakai, Tomoyuki; Sawaki, Toshioki; Fujita, Yoshimasa; Tanaka, Masao; Masaki, Yasufumi; Hirose, Yuko; Umehara, Hisanori

    2011-05-01

    A patient with chemotherapy-resistant acute monocytic leukemia who achieved complete remission (CR) after iron chelation therapy (ICT) with deferasirox is reported for the first time. A 73-year-old Japanese man with acute monocytic leukemia who was refractory to conventional remission induction chemotherapies achieved a partial response, with some improvement of his hemoglobin level and white blood cell count after gemtuzumab ozogamicin (GO) treatment. Seven months after GO treatment, the disease relapsed and the patient developed pancytopenia. He declined further chemotherapy, and started receiving 1,200-1,800 ml of packed red blood cell transfusion per month together with ICT with deferasirox (baseline serum ferritin level was 1,412 ng/ml). Twelve months after the initiation of deferasirox, the patient's serum ferritin level decreased to below 1,000 ng/ml and deferasirox was discontinued. Four months after discontinuation of deferasirox, the blood cell count normalized and the patient became transfusion-independent. Bone marrow aspiration and biopsy revealed hematological and cytogenetic CR. CR was achieved after ICT with deferasirox in a patient with acute myelogenous leukemia, suggesting that deferasirox may have an antileukemic effect in the clinical setting.

  10. Comprehension of metaphor and irony in schizophrenia during remission: the role of theory of mind and IQ.

    Science.gov (United States)

    Mo, Shuliang; Su, Yanjie; Chan, Raymond C K; Liu, Jianxin

    2008-01-15

    The study reported herein explored the comprehension of metaphor and irony in schizophrenia during remission, and examined the role of IQ and a theory of mind. Performance of 29 Schizophrenic patients in remission and 22 healthy controls was compared on metaphor and irony comprehension tasks and first- and second-order theory of mind tasks. Participants' IQs were measured using the Wechsler Adult Intelligence Scale-Revised, and the symptoms of individuals with schizophrenia were assessed using the Positive and Negative Syndrome Scale. The results showed that patients with schizophrenia were impaired in their comprehension of metaphor and irony as compared with healthy controls. A theory of mind deficit was found in patients with remitted schizophrenia. The comprehension of metaphor was significantly correlated with second-order false belief understanding and the comprehension of irony was not significantly related to theory of mind. IQ and verbal IQ did not explain the deficit of metaphor and irony comprehension. These findings were not explained by Happé's [Happé, F.G.E., 1993. Communication competence and theory of mind in autism: a test of relevance theory. Cognition 48, 101-119] theory and the shared semantic understanding requirement was discussed.

  11. Antibiotic policy

    OpenAIRE

    Gyssens, Inge

    2011-01-01

    There is a clear association between antibiotic use and resistance both on individual and population levels. In the European Union, countries with large antibiotic consumption have higher resistance rates. Antibiotic resistance leads to failed treatments, prolonged hospitalisations, increased costs and deaths. With few new antibiotics in the Research & Development pipeline, prudent antibiotic use is the only option to delay the development of resistance. Antibiotic policy consists of prescrib...

  12. Internet Policy

    Science.gov (United States)

    Lehr, William H.; Pupillo, Lorenzo Maria

    The Internet is now widely regarded as essential infrastructure for our global economy and society. It is in our homes and businesses. We use it to communicate and socialize, for research, and as a platform for E-commerce. In the late 1990s, much was predicted about what the Internet has become at present; but now, we have actual experience living with the Internet as a critical component of our everyday lives. Although the Internet has already had profound effects, there is much we have yet to realize. The present volume represents a third installment in a collaborative effort to highlight the all-encompassing, multidisciplinary implications of the Internet for public policy. The first installment was conceived in 1998, when we initiated plans to organize an international conference among academic, industry, and government officials to discuss the growing policy agenda posed by the Internet. The conference was hosted by the European Commission in Brussels in 1999 and brought together a diverse mix of perspectives on what the pressing policy issues would be confronting the Internet. All of the concerns identified remain with us today, including how to address the Digital Divide, how to modify intellectual property laws to accommodate the new realities of the Internet, what to do about Internet governance and name-space management, and how to evolve broadcast and telecommunications regulatory frameworks for a converged world.

  13. Duration of remission after halving of the etanercept dose in patients with ankylosing spondylitis: a randomized, prospective, long-term, follow-up study

    Directory of Open Access Journals (Sweden)

    Nannini C

    2013-01-01

    Full Text Available Fabrizio Cantini, Laura Niccoli, Emanuele Cassarà, Olga Kaloudi, Carlotta NanniniDivision of Rheumatology, Misericordia e Dolce Hospital, Prato, ItalyBackground: The aim of this study was to evaluate the proportion of patients with ankylosing spondylitis maintaining clinical remission after reduction of their subcutaneous etanercept dose to 50 mg every other week compared with that in patients receiving etanercept 50 mg weekly.Methods: In the first phase of this randomized, prospective, follow-up study, all biologic-naïve patients identified between January 2005 and December 2009 as satisfying the modified New York clinical criteria for ankylosing spondylitis treated with etanercept 50 mg weekly were evaluated for disease remission in January 2010. In the second phase, patients meeting the criteria for remission were randomized to receive subcutaneous etanercept as either 50 mg weekly or 50 mg every other week. The randomization allocation was 1:1. Remission was defined as Bath Ankylosing Spondylitis Disease Activity Index < 4, no extra-axial manifestations of peripheral arthritis, dactylitis, tenosynovitis, or iridocyclitis, and normal acute-phase reactants. The patients were assessed at baseline, at weeks 4 and 12, and every 12 weeks thereafter. The last visit constituted the end of the follow-up.Results: During the first phase, 78 patients with ankylosing spondylitis (57 males and 21 females, median age 38 years, median disease duration 12 years were recruited. In January 2010, after a mean follow-up of 25 ± 11 months, 43 (55.1% patients achieving clinical remission were randomized to one of the two treatment arms. Twenty-two patients received etanercept 50 mg every other week (group 1 and 21 received etanercept 50 mg weekly (group 2. At the end of follow-up, 19 of 22 (86.3% subjects in group 1 and 19 of 21 (90.4% in group 2 were still in remission, with no significant difference between the two groups. The mean follow-up duration in group

  14. Clinical response and symptomatic remission in short- and long-term trials of lisdexamfetamine dimesylate in adults with attention-deficit/hyperactivity disorder

    Directory of Open Access Journals (Sweden)

    Mattingly Greg W

    2013-01-01

    Full Text Available Abstract Background Despite the overall high degree of response to pharmacotherapy, consensus is lacking on how to judge clinical response or define optimal treatment/remission when treating adults with attention-deficit/hyperactivity disorder (ADHD. This study examined clinical response and symptomatic remission in analyses of 2 studies of lisdexamfetamine dimesylate (LDX in adults with ADHD. Methods In a 4-week, double-blind, forced-dose trial, adults with ADHD were randomized to LDX 30, 50, and 70 mg/day (mg/d or placebo. In a second, open-label, follow-up trial, adults entering from the 4-week study were titrated to an “optimal” LDX dose (30 mg/d [n=44], 50 mg/d [n=112], and 70 mg/d [n=171] over 4 weeks, and maintained for 11 additional months. The ADHD Rating Scale IV (ADHD-RS-IV with adult prompts and the Clinical Global Impressions-Improvement (CGI-I scale assessed efficacy. Clinical response was defined, post hoc, as ≥30% reduction from baseline in ADHD-RS-IV and CGI-I rating of 1 or 2; symptomatic remission was defined as ADHD-RS-IV total score ≤18. Log rank analysis examined overall significance among the treatment groups in time to response or remission. Results Four hundred and fourteen participants in the 4-week study and 345 in the open-label, extension study were included in the efficacy populations. All LDX groups improved by ADHD-RS-IV and CGI-I scores in both studies. In the 4-week study (n=414, 69.3% responded and 45.5% achieved remission with LDX (all doses; 37.1% responded and 16.1% achieved remission with placebo; time (95% CI to median clinical response (all LDX doses was 15.0 (15.0, 17.0 days and to remission was 31.0 (28.0, 37.0 days (P Conclusion In the long-term study, with open-label, dose-optimized LDX treatment, most adults with ADHD achieved clinical response and/or symptomatic remission; almost two-thirds maintained symptomatic remission over the remaining 11 months. Trial registration Clinical Trial

  15. High rate of improvement in serum matrix metalloproteinase-3 levels at 4 weeks predicts remission at 52 weeks in RA patients treated with adalimumab.

    Science.gov (United States)

    Hattori, Yosuke; Kojima, Toshihisa; Kaneko, Atsushi; Kida, Daihei; Hirano, Yuji; Fujibayashi, Takayoshi; Yabe, Yuichiro; Oguchi, Takeshi; Kanayama, Yasuhide; Miyake, Hiroyuki; Kato, Takefumi; Takagi, Hideki; Hayashi, Masatoshi; Ito, Takayasu; Shioura, Tomone; Takahashi, Nobunori; Ishikawa, Hisato; Funahashi, Koji; Ishiguro, Naoki

    2018-01-01

    This study aimed to determine whether serum matrix metalloproteinase-3 (MMP-3) levels can predict remission in rheumatoid arthritis (RA) patients treated with adalimumab (ADA). Subjects were 114 RA patients continuously treated with ADA for 52 weeks. Predictive factors at baseline and 4 weeks after initiation of ADA therapy for the achievement of remission (28-point count Disease Activity Score-CRP (DAS28-CRP) < 2.3) at 52 weeks were evaluated by multivariate logistic regression analysis. DAS28-CRP at 4 weeks (odds ratio (OR) 0.614, 95% confidence interval (CI) 0.382-0.988) and improvement in serum MMP-3 levels at 4 weeks (OR 1.057, 95% CI 1.002-1.032) were independent predictors of remission at 52 weeks. The best cut-off level of DAS28-CRP and improvement in serum MMP-3 levels at 4 weeks for predicting remission at 52 weeks was 3.73 (sensitivity: 90%, specificity: 50%, area under the receiver operating characteristic curve (AUC): 62%) and 39.93% (sensitivity: 47%, specificity: 83%, AUC: 64%), respectively. Our findings suggest that a high rate of improvement in serum MMP-3 levels at 4 weeks after initiation of ADA therapy can predict remission at 52 weeks in RA patients.

  16. Rates and predictors of remission, recurrence and conversion to bipolar disorder after the first lifetime episode of depression--a prospective 5-year follow-up study.

    Science.gov (United States)

    Bukh, J D; Andersen, P K; Kessing, L V

    2016-04-01

    In depression, non-remission, recurrence of depressive episodes after remission and conversion to bipolar disorder are crucial determinants of poor outcome. The present study aimed to determine the cumulative incidences and clinical predictors of these long-term outcomes after the first lifetime episode of depression. A total of 301 in- or out-patients aged 18-70 years with a validated diagnosis of a single depressive episode were assessed from 2005 to 2007. At 5 years of follow-up, 262 patients were reassessed by means of the life chart method and diagnostic interviews from 2011 to 2013. Cumulative incidences and the influence of clinical variables on the rates of remission, recurrence and conversion to bipolar disorder, respectively, were estimated by survival analysis techniques. Within 5 years, 83.3% obtained remission, 31.5% experienced recurrence of depression and 8.6% converted to bipolar disorder (6.3% within the first 2 years). Non-remission increased with younger age, co-morbid anxiety and suicidal ideations. Recurrence increased with severity and treatment resistance of the first depression, and conversion to bipolar disorder with treatment resistance, a family history of affective disorder and co-morbid alcohol or drug abuse. The identified clinical characteristics of the first lifetime episode of depression should guide patients and clinicians for long-term individualized tailored treatment.

  17. Education policy and gender in Zimbabwe.

    Science.gov (United States)

    Gordon, R

    1994-01-01

    It is concluded that equality for women in education, which was a state aim in 1980, is no longer a state concern in Zimbabwe. It is argued that protection of the patriarchal order has been the operating principle of both colonial and post-colonial periods, and education is used to maintain the gender imbalance. Black women under colonialism were subjected to both sexism and racism. The socioeconomic order was maintained by ensuring that Blacks remained uneducated and unskilled. Colonial policy was race specific. Education was free and compulsory for Whites only. Black parents paid fees for a son's education. Post colonialism and in 1971, only 43.5% of Black children were enrolled in school, of which 3.9% were in secondary school. Only 19 girls with at the highest level in school. School curriculum was gender based, which meant girls were taught cooking and typing. During independence, education policy was instituted, and education was considered as a human right and gender neutral. Tuition fees in primary grades were eliminated, and education was expanded. However, changes after independence did not result in equal advantage for girls. By 1985-91, girls had lower enrollments at all grade levels. The widest gaps in enrollment were at the highest levels. School curriculum changed very little, and girls were directed to the "feminine" courses of study. Girls performed poorly in math and sciences. Girls were underenrolled in technical and vocational institutions. After 1989, structural adjustment programs negatively impacted on women. There was reduced access to employment, limited access to services, and increased demands on women's time in order to compensate for gaps created by cuts in services. New changes in education policy are expected to negatively impact on girl's education. Fees for primary school were reintroduced in urban areas, and secondary school fees were increased. The government dropped the requirement of certification for technical and commercial

  18. Current evidence for a role of GLP-1 in Roux-en-Y gastric bypass-induced remission of type 2 diabetes

    DEFF Research Database (Denmark)

    Rhee, Nicolai Alexander; Vilsbøll, T; Knop, F K

    2012-01-01

    antidiabetic effects of GLP-1 are thought to be key mediators in RYGB-induced remission of T2DM. However, the published studies on the impact of RYGB on GLP-1 secretion are few, small and often not controlled properly. Furthermore, mechanistic studies delineating the role of endogenous GLP-1 secretion in RYGB......Weight-reducing surgical procedures such as Roux-en-Y gastric bypass (RYGB) have proven efficient as means of decreasing excess body weight. Furthermore, some studies report that up to 80% of patients with type 2 diabetes mellitus (T2DM) undergoing RYGB experience complete remission of their T2DM....... Interestingly, the majority of remissions occur almost immediately following the operation and long before significant weight loss has taken place. Following RYGB, dramatic increases in postprandial plasma concentrations of the incretin hormone glucagon-like peptide-1 (GLP-1) have been recorded, and the known...

  19. HIV Reactivation from Latency after Treatment Interruption Occurs on Average Every 5-8 Days--Implications for HIV Remission.

    Directory of Open Access Journals (Sweden)

    Mykola Pinkevych

    2015-07-01

    Full Text Available HIV infection can be effectively controlled by anti-retroviral therapy (ART in most patients. However therapy must be continued for life, because interruption of ART leads to rapid recrudescence of infection from long-lived latently infected cells. A number of approaches are currently being developed to 'purge' the reservoir of latently infected cells in order to either eliminate infection completely, or significantly delay the time to viral recrudescence after therapy interruption. A fundamental question in HIV research is how frequently the virus reactivates from latency, and thus how much the reservoir might need to be reduced to produce a prolonged antiretroviral-free HIV remission. Here we provide the first direct estimates of the frequency of viral recrudescence after ART interruption, combining data from four independent cohorts of patients undergoing treatment interruption, comprising 100 patients in total. We estimate that viral replication is initiated on average once every ≈6 days (range 5.1- 7.6 days. This rate is around 24 times lower than previous thought, and is very similar across the cohorts. In addition, we analyse data on the ratios of different 'reactivation founder' viruses in a separate cohort of patients undergoing ART-interruption, and estimate the frequency of successful reactivation to be once every 3.6 days. This suggests that a reduction in the reservoir size of around 50-70-fold would be required to increase the average time-to-recrudescence to about one year, and thus achieve at least a short period of anti-retroviral free HIV remission. Our analyses suggests that time-to-recrudescence studies will need to be large in order to detect modest changes in the reservoir, and that macaque models of SIV latency may have much higher frequencies of viral recrudescence after ART interruption than seen in human HIV infection. Understanding the mean frequency of recrudescence from latency is an important first step in

  20. HIV Reactivation from Latency after Treatment Interruption Occurs on Average Every 5-8 Days—Implications for HIV Remission

    Science.gov (United States)

    Pinkevych, Mykola; Cromer, Deborah; Tolstrup, Martin; Grimm, Andrew J.; Cooper, David A.; Lewin, Sharon R.; Søgaard, Ole S.; Rasmussen, Thomas A.; Kent, Stephen J.; Kelleher, Anthony D.; Davenport, Miles P.

    2015-01-01

    HIV infection can be effectively controlled by anti-retroviral therapy (ART) in most patients. However therapy must be continued for life, because interruption of ART leads to rapid recrudescence of infection from long-lived latently infected cells. A number of approaches are currently being developed to ‘purge’ the reservoir of latently infected cells in order to either eliminate infection completely, or significantly delay the time to viral recrudescence after therapy interruption. A fundamental question in HIV research is how frequently the virus reactivates from latency, and thus how much the reservoir might need to be reduced to produce a prolonged antiretroviral-free HIV remission. Here we provide the first direct estimates of the frequency of viral recrudescence after ART interruption, combining data from four independent cohorts of patients undergoing treatment interruption, comprising 100 patients in total. We estimate that viral replication is initiated on average once every ≈6 days (range 5.1- 7.6 days). This rate is around 24 times lower than previous thought, and is very similar across the cohorts. In addition, we analyse data on the ratios of different ‘reactivation founder’ viruses in a separate cohort of patients undergoing ART-interruption, and estimate the frequency of successful reactivation to be once every 3.6 days. This suggests that a reduction in the reservoir size of around 50-70-fold would be required to increase the average time-to-recrudescence to about one year, and thus achieve at least a short period of anti-retroviral free HIV remission. Our analyses suggests that time-to-recrudescence studies will need to be large in order to detect modest changes in the reservoir, and that macaque models of SIV latency may have much higher frequencies of viral recrudescence after ART interruption than seen in human HIV infection. Understanding the mean frequency of recrudescence from latency is an important first step in approaches to