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Sample records for post treatment follow-up

  1. Treatment and Follow Up

    Science.gov (United States)

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

  2. Risk of cervical cancer after completed post-treatment follow-up of cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Helmerhorst, Theo; Habbema, Dik

    2012-01-01

    To compare the risk of cervical cancer in women with histologically confirmed cervical intraepithelial neoplasia who returned to routine screening after having completed post-treatment follow-up with consecutive normal smear test results with women with a normal primary smear test result....

  3. Importance of post-treatment follow-up to secure sufficient eradication therapy for Helicobacter pylori

    DEFF Research Database (Denmark)

    Roug, Stine; Madsen, Lone Galmstrup

    2012-01-01

    To optimize the care for Helicobacter pylori-associated diseases, we wanted to evaluate the completeness of follow-up after H. pylori eradication therapy in a single Danish endoscopy unit. Furthermore, the eradication rates and possible clinical characteristics associated with failure of eradicat...

  4. Post-treatment follow-up study of abdominal cystic echinococcosis in tibetan communities of northwest Sichuan Province, China.

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    Tiaoying Li

    2011-10-01

    cysts without any previous intervention showed negative specific IgG antibody response to E. granulosus recombinant antigen B (rAgB. However, following 3 months to 18 months albendazole therapy, six of these 7 initially seronegative CE1 cases sero-converted to be specific IgG antibody positive, and concurrently ultrasound scan showed that cysts changed to CE3a from CE1 type in all the six CE cases. Two major profiles of serum specific IgG antibody dynamics during albendazole treatment were apparent in CE cases: (i presenting as initial elevation followed by subsequent decline, or (ii a persistent decline. Despite a decline, however, specific antibody levels remained positive in most improved or cured CE cases.This was the first attempt to follow up community-screened cystic echinococcosis patients after albendazole therapy using ultrasonography and serology in an endemic Tibetan region. Cyclic albendazole treatment proved to be effective in the great majority of CE cases in this resource-poor area, but periodic abdominal ultrasound examination was necessary to guide appropriate treatment. Oral albendazole for over 18 months was more likely to result in CE cure. Poor drug compliance resulted in less good outcomes. Serology with recombinant antigen B could provide additional limited information about the effectiveness of albendazole in CE cases. Post-treatment positive specific IgG antibody seroconversion, in initially seronegative, CE1 patients was considered a good indication for positive therapeutic efficacy of albendazole.

  5. Potentialities of aberrantly methylated circulating DNA for diagnostics and post-treatment follow-up of lung cancer patients.

    Science.gov (United States)

    Ponomaryova, Anastasia A; Rykova, Elena Yu; Cherdyntseva, Nadezda V; Skvortsova, Tatiana E; Dobrodeev, Alexey Yu; Zav'yalov, Alexander A; Bryzgalov, Leonid O; Tuzikov, Sergey A; Vlassov, Valentin V; Laktionov, Pavel P

    2013-09-01

    To date, aberrant DNA methylation has been shown to be one of the most common and early causes of malignant cell transformation and tumors of different localizations, including lung cancer. Cancer cell-specific methylated DNA has been found in the blood of cancer patients, indicating that cell-free DNA circulating in the blood (cirDNA) is a convenient tumor-associated DNA marker that can be used as a minimally invasive diagnostic test. In the current study, we investigated the methylation status in blood samples of 32 healthy donors and 60 lung cancer patients before and after treatment with neoadjuvant chemotherapy followed by total tumor resection. Using quantitative methylation-specific PCR, we found that the index of methylation (IM), calculated as IM = 100 × [copy number of methylated/(copy number of methylated + unmethylated gene)], for the RASSF1A and RARB2 genes in the cirDNA isolated from blood plasma and cell-surface-bound cirDNA was elevated 2- to 3-fold in lung cancer patients compared with healthy donors. Random forest classification tree model based on these variables combined (RARB2 and RASSF1A IM in both plasma and cell-surface-bound cirDNA) lead to NSCLC patients' and healthy subjects' differentiation with 87% sensitivity and 75% specificity. An association of increased IM values with an advanced stage of non-small-cell lung cancer was found for RARB2 but not for RASSF1A. Chemotherapy and total tumor resection resulted in a significant decrease in the IM for RARB2 and RASSF1A, in both cirDNA fractions, comparable to the IM level of healthy subjects. Importantly, a rise in the IM for RARB2 was detected in patients within the follow-up period, which manifested in disease relapse at 9 months, confirmed with instrumental and pathologic methods. Our data indicate that quantitative analysis of the methylation status of the RARB2 and RASSF1A tumor suppressor genes in both cirDNA fractions is a useful tool for lung cancer diagnostics, evaluation of cancer

  6. Development and evaluation of a holistic surgical head and neck cancer post-treatment follow-up clinic using touchscreen technology-Feasibility study.

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    Semple, C J; Lannon, D; Qudairat, E; McCaughan, E; McCormac, R

    2018-03-01

    The efficacy of traditional follow-up care is being challenged, as cancer survivors' supportive and psychological needs are often neither identified, nor addressed. This study's aim was to develop a holistic surgical follow-up clinic for oral and oropharyngeal cancer patients were participants completed a disease-specific health-related quality of life tool (UWQOLv4) and item prompt list (Patient Concern Inventory) on a touchscreen computer. Information generated was used to focus the consultation on patient's identified needs and concerns. By means of a prospective non-randomised, pre-test post-test design, this follow-up clinic was evaluated using the patient enablement instrument (PEI) and patient content checklist (PCC). Feasibility was explored from the patient perspective (satisfaction survey) and clinician perspective (qualitative interview). Forty-four consecutive patients were recruited. Findings demonstrating five of the eight topics (overall QOL, emotions, head and neck symptoms, side-effects of treatment, chronic non-specific) on PCC were discussed more frequently, but changes were not statistically significant. The PEI highlighted a trend towards perceived improvement in four of the six items. Using touchscreen computers to aid communication during routine follow-up was reported as both feasible and beneficial by patients and clinicians. Providing a patient-focused follow-up consultation can facilitate the identification of unmet needs, permitting timely and appropriate intervention being initiated. © 2018 John Wiley & Sons Ltd.

  7. Follow-up of the fate of imazalil from post-harvest lemon surface treatment to a baking experiment.

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    Vass, Andrea; Korpics, Evelin; Dernovics, Mihály

    2015-01-01

    Imazalil is one of the most widespread fungicides used for the post-harvest treatment of citrus species. The separate use of peel during food preparation and processing may hitherto concentrate most of the imazalil into food products, where specific maximum residue limits hardly exist for this fungicide. In order to monitor comprehensively the path of imazalil, our study covered the monitoring of the efficiency of several washing treatments, the comparison of operative and related sample preparation methods for the lemon samples, the validation of a sample preparation technique for a fatty cake matrix, the preparation of a model cake sample made separately either with imazalil containing lemon peel or with imazalil spiking, the monitoring of imazalil degradation into α-(2,4-dichlorophenyl)-1H-imidazole-1-ethanol because of the baking process, and finally the mass balance of imazalil throughout the washing experiments and the baking process. Quantification of imazalil was carried out with an LC-ESI-MS/MS set-up, while LC-QTOF was used for the monitoring of imazalil degradation. Concerning the washing, none of the addressed five washing protocols could remove more than 30% of imazalil from the surface of the lemon samples. The study revealed a significant difference between the extraction efficiency of imazalil by the EN 15662:2008 and AOAC 2007.1 methods, with the advantage of the former. The use of the model cake sample helped to validate a modified version of the EN 15662:2008 method that included a freeze-out step to efficiently recover imazalil (>90%) from the fatty cake matrix. The degradation of imazalil during the baking process was significantly higher when this analyte was spiked into the cake matrix than in the case of preparing the cake with imazalil-containing lemon peel (52% vs. 22%). This observation calls the attention to the careful evaluation of pesticide stability data that are based on solution spiking experiments.

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

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

  9. Intravenous immunoglobulin treatment of the post-polio syndrome: sustained effects on quality of life variables and cytokine expression after one year follow up

    Directory of Open Access Journals (Sweden)

    Gonzalez Henrik

    2012-07-01

    Full Text Available Abstract Background Expression of inflammatory cytokines in cerebrospinal fluid (CSF has led to the hypothesis of intrathecal chronic inflammation to explain the denervation observed in post-polio syndrome (PPS. It has been shown that therapy with intravenous immunoglobulin (IVIG improves physical performance and dampens down the inflammatory process at 6 months in PPS patients. We here examined the effects of IVIG on cytokine expression and clinical outcome one year after IVIG treatment. Methods From a previous study with 135 PPS patients included, 41 patients were further evaluated before un-blinding for one year (21 placebo and 20 treated with IVIG, Xepol® 50 mg/ml, and were assessed for clinical variables by performing the Short Form-36 survey (SF-36 questionnaire assessment, the 6 minute walk distance test (6MWT and registering pain level by Visual Analogue Scale (VAS after IVIG treatment. A separate cohort of 37 PPS patients went through lumbar puncture (LP at baseline and 20 patients, treated with IVIG, repeated the LP one year later. Thirty patients affected with other neurological diseases (OND were used as control group. Inflammatory cytokines TNF, TGFβ, IFNγ, IL-23, IL-13 and IL-10 were measured in blood cells and CSF cells with RT-PCR. Results Scores of the physical components of SF-36 were significantly higher at the one year follow up time-point in the IVIG-treated patients when compared to baseline as well as to the control subjects. Pain VAS score and 6MWT improved significantly in the IVIG-treated patients when compared with baseline Relative expression of TNF and IFN-γ in both PBMCs and CSF from PPS patients were increased compared to OND subjects at baseline (p  Conclusions IVIG has effects on relevant QoL variables and inflammatory cytokines up to one year in patients with PPS. This gives a basis for scheduling IVIG in upcoming trials with this therapy.

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

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    Pacik, Peter T; Geletta, Simon

    2017-06-01

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

  11. Follow-up Medical Care After Cancer Treatment

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

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

    International Nuclear Information System (INIS)

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

    1996-01-01

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

  13. Rectal carcinoma under 40 years of age: seven-year post-treatment follow-up at a tertiary care hospital in Pakistan

    International Nuclear Information System (INIS)

    Haroon, N.; Khan, S.; Alvi, R.

    2013-01-01

    Objectives: To determine epidemiological characteristics, clinical presentation, histopathological features, and long-term follow-up of patients below 40 years of age with carcinoma rectum. Methods: The retrospective case series comprised all patients presenting with histopathological diagnosis of carcinoma rectum with age 15-40 years at the Aga Khan University Hospital between January 1994 and December 2004. Details regarding patient demographics, pre-operative assessment, management and tumour grade and stage were obtained from a prospectively maintained database. Continuous and categorical variables in the data were analysed. Results: Of the 23 patients in the study, 14 (60.89%) were male and 9 (39.13%) were female. Mean age of the subjects was 31+-5 years. Overall, 22 (95.6%) patients presented with rectal bleeding and 12 (52%) had altered bowel habit. The most common site for the tumour was lower rectum (n=20; 87%) and 13 (56.5%) required abdominoperineal resection. Local recurrence rate was 13% (n=3) and distant metastasis occurred in 2 (8.6%) patients during the seven year follow-up. Two (8.6%) patients died, and both had distant metastasis. Conclusion: Carcinoma rectum is uncommon but an important malignancy in patients aged below 40 years. The clinician should have a high index of suspicion in young patients presenting with bleeding per rectum, altered bowel habit and weight-loss. (author)

  14. Long-term post-marketing surveillance of mizoribine for the treatment of lupus nephritis: Safety and efficacy during a 3-year follow-up

    Directory of Open Access Journals (Sweden)

    Nobuyuki Yagi

    2014-05-01

    Full Text Available Objective: To determine the safety and efficacy of long-term use of mizoribine by undertaking a 3-year post-marketing surveillance study. Methods: Subjects were all lupus nephritis patients newly treated with mizoribine between 1 October 2003 and 30 September 2005 at contracted study sites. Results: Mizoribine was administered to 881 lupus nephritis patients in the safety analysis set consisting of 946 patients recruited from 281 contracted study sites after satisfying the eligibility criteria. There were 301 events of adverse drug reactions that were observed in 196 (20.7% of the 946 subjects. There were 34 events of serious adverse drug reactions in 31 patients (3.2%. No deterioration in hematological and biochemical test values was observed, but immunological testing showed significant improvements in C3, CH50, and anti-DNA antibody titers. The negative rate of proteinuria also increased over time. The median steroid dosage was 15 mg/day at the commencement of treatment, but was reduced to 10 mg/day at 12 months and 8 mg/day at 36 months. Conclusion: The findings of the 3-year long-term drug use surveillance study indicated that mizoribine can be used over the long term with relatively few adverse drug reactions, suggesting its suitability for use in maintenance drug therapy.

  15. Follow-up study of patients treated by x-ray epilation for Tinea capitis. Resurvey of post-treatment illness and mortality experience

    International Nuclear Information System (INIS)

    Shore, R.E.; Albert, R.E.; Pasternack, B.S.

    1976-01-01

    This is the second follow-up study of 2,215 persons who during childhood between 1940 and 1959 had been given x-ray therapy for tinea capitis and of 1,395 persons well matched for age, sex, and race who were treated for the same disease during the same period without the use of x-ray therapy. The major finding of the study was an excess incidence in the irradiated cases of tumors of the head and neck including the skin, brain, thyroid, and parotid. However, between the groups there was no difference in death due to malignant neoplasms or any other cause. Among white patients, a 40 percent excess of treated psychiatric disorders was observed in the irradiated group, but there was no difference among blacks

  16. Parents of children diagnosed with cancer: work situation and sick leave, a five-year post end-of-treatment or a child's death follow-up study.

    Science.gov (United States)

    Wikman, Anna; Hovén, Emma; Cernvall, Martin; Ljungman, Gustaf; Ljungman, Lisa; von Essen, Louise

    Cancer in a child is associated with a significant impact on parental employment. We assessed the proportions of parents of survivors and bereaved parents working and reporting sick leave five years after end of successful treatment (ST)/child's death (T7) compared with one year after end of ST/child's death (T6) and the association between partial post-traumatic stress disorder (PTSD) and work situation and sick leave at T7. Participants and procedure: The sample included 152 parents of survivors (77 mothers, 75 fathers) and 42 bereaved parents (22 mothers, 20 fathers) of children diagnosed with cancer in Sweden. The proportions of parents working or reporting sick leave did not differ among mothers and fathers of survivors (92% vs. 96% working, 20% vs. 18% on sick leave) or among bereaved mothers and fathers (91% vs. 90% working, 14% vs. 20% on sick leave) at T7. There was no change from T6 to T7 in the proportion of fathers working (fathers of survivors 91% vs. 96%, bereaved fathers 95% vs. 90%). Although more mothers of survivors (92% vs. 82%) and bereaved mothers (91% vs. 77%) worked at T7 than at T6, this increase was not significant. Fewer bereaved mothers reported sick leave at T7 than at T6 (14% vs. 59%, p leave at T7 than at T6 (fathers of survivors 18% vs. 8%, bereaved fathers 20% vs. 15%), this was not significant. Partial PTSD was not associated with parents' work situation or sick leave at T7. Results suggest little adverse effect on work situation and sick leave among parents of survivors and bereaved parents five years after end of ST/child's death from cancer. However, the pattern of change observed differed between parents, which could potentially indicate possible delayed consequences for fathers not captured in the present paper.

  17. Nimh Treatment Study of ADHD Follow-Up

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2004-04-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  19. Therapeutic management for post-traumatic treatment of the anterior dental region: a case report with long-term follow up.

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    Savi, Andrea; Turillazzi, Oliviero; Pizzi, Silvia; Bonanini, Mauro; Manfredi, Maddalena

    2013-06-01

    The treatment plan represents the final step in every diagnostic procedure and is the result of a series of assessments based on information gathered from a detailed clinical history. This clinical case reports the replacement of two central incisors that were lost because of a trauma. The advantages and disadvantages of the two treatment options (i.e. implantology or prosthetic restoration) were carefully evaluated in relation to the case in hand. Patient compliance and aesthetic requirements had been also considered. In this case, a conventional prosthetic restoration was performed using a metal-ceramic bridge, utilising full crowns between the right and left maxillary lateral incisors associated with minimal canine preparation. By this strategy, the treatment plan allows for a future implant restoration, should this become necessary. © 2011 John Wiley & Sons A/S.

  20. Treatment of craniopharyngioma estimated by follow-up CT

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

    1981-12-01

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

  1. Treatment of craniopharyngioma estimated by follow-up CT

    International Nuclear Information System (INIS)

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

    1981-01-01

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

  2. Mental health and functional impairment outcomes following a 6-week intensive treatment programme for UK military veterans with post-traumatic stress disorder (PTSD): a naturalistic study to explore dropout and health outcomes at follow-up.

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    Murphy, Dominic; Hodgman, Georgina; Carson, Carron; Spencer-Harper, Lucy; Hinton, Mark; Wessely, Simon; Busuttil, Walter

    2015-03-20

    Combat Stress, a UK national charity for veterans with mental health problems, has been funded by the National Health Service (NHS) to provide a national specialist service to deliver treatment for post-traumatic stress disorder (PTSD). This paper reports the efficacy of a PTSD treatment programme for UK veterans at 6 months follow-up. A within subject design. UK veterans with a diagnosis of PTSD who accessed Combat Stress. 246 veterans who received treatment between late 2012 and early 2014. An intensive 6-week residential treatment programme, consisting of a mixture of individual and group sessions. Participants were offered a minimum of 15 individual trauma-focused cognitive behavioural therapy sessions. In addition, participants were offered 55 group sessions focusing on psychoeducational material and emotional regulation. Clinicians completed measures of PTSD and functional impairment and participants completed measures of PTSD, depression, anger and functional impairment. We observed significant reductions in PTSD scores following treatment on both clinician completed measures (PSS-I: -13.0, 95% CI -14.5 to -11.5) and self-reported measures (Revised Impact of Events Scale (IES-R): -16.5, 95% CI -19.0 to -14.0). Significant improvements in functional impairment were also observed (eg, Health of the Nation Outcome Scales (HONOS): -6.85, 95% CI -7.98 to -5.72). There were no differences in baseline outcomes between those who completed and those who did not complete the programme, or post-treatment outcomes between those we were able to follow-up at 6 months and those lost to follow-up. In a naturalistic study we observed a significant reduction in PTSD scores and functional impairment following treatment. These improvements were maintained at 6 month follow-up. Our findings suggest it may be helpful to take a closer look at combining individual trauma-focused cognitive behaviour therapy and group sessions when treating veterans with PTSD. This is the first

  3. Gestational Diabetes Mellitus: Post-partum Risk and Follow Up.

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    Poola-Kella, Silpa; Steinman, Rachel A; Mesmar, Bayan; Malek, Rana

    2018-01-31

    Women with gestational diabetes mellitus (GDM) are at an increased risk for developing metabolic syndrome, type 2 diabetes mellitus (T2DM), and cardiovascular disease. In this review, we will discuss postpartum cardiovascular and diabetes risk in women with a history of GDM and different ways to improve postpartum screening. This review involves a comprehensive literature review on gestational diabetes and postpartum risk for cardiovascular disease and diabetes mellitus as well as post-partum screening methods. Cardiovascular risk post-partum is potentiated by increased inflammatory markers leading to worsening atherosclerosis and cardiovascular events downstream. Decreased insulin sensitivity and β cell compensation, recurrent GDM, maternal factors such as pre and post-partum weight gain and lactation may contribute to T2DM risk. Postpartum glucose testing is essential in screening women as hyperglycemia in pregnancy has long term effects on both cardiovascular disease and diabetes risk on the mother. Long and short term improvement to post-partum glucose testing is essential to decreasing cardiometabolic and diabetes risk in women with gestational diabetes mellitus. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

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

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    Langhammer, Birgitta; Stanghelle, Johan K

    2003-11-01

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

  5. Predictors of Post-concussion Rehabilitation Outcomes at Three-month Follow-up.

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    Scott, Katie L; Strong, Carrie-Ann H; Gorter, Bethany; Donders, Jacobus

    2016-01-01

    To determine factors related to three-month follow-up outcomes for individuals participating in an outpatient rehabilitative treatment program for mild traumatic brain injury (TBI). Fifty participants underwent neuropsychological screening prior to treatment initiation and completed the Mayo-Portland Adaptability Inventory-4 (MPAI-4) at treatment initiation, discharge from treatment, and three months following discharge. Regression models indicated that information garnered from the neuropsychological screening prior to treatment initiation (e.g., mood symptoms and prior psychiatric history) accounted for unique variance in three-month post-discharge outcomes on several MPAI-4 subscales. Specifically, after controlling for baseline MPAI-4 ratings, higher Beck Depression Inventory-second edition (BDI-II) scores were associated with worse MPAI-4 Ability scores at three-month follow-up, and the presence of a psychiatric history was associated with worse MPAI-4 Adjustment scores at three-month follow-up. Neuropsychological screening prior to the initiation of treatment for mild TBI can help to identify patients who may be at greater risk for poorer rehabilitation outcomes, thus allowing for the implementation of specific interventions to address these risk factors.

  6. Novel use of a flowable collagen-glycosaminoglycan matrix (Integra™ Flowable Wound Matrix) combined with percutaneous cannula scar tissue release in treatment of post-burn malfunction of the hand--A preliminary 6 month follow-up.

    Science.gov (United States)

    Hirche, C; Senghaas, A; Fischer, S; Hollenbeck, S T; Kremer, T; Kneser, U

    2016-02-01

    Long-term function following severe burns to the hand may be poor secondary to scar adhesions to the underlying tendons, webspaces, and joints. In this pilot study, we report the feasibility of applying a pasty dermal matrix combined with percutaneous cannula teno- and adhesiolysis. In this 6 month follow-up pilot study, we included eight hands in five patients with hand burns undergoing minimal-invasive, percutaneous cannula adhesiolysis and injection of INTEGRA™ Flowable Wound Matrix for a pilot study of this new concept. The flowable collagen-glycosaminoglycan wound matrix (FCGWM) was applied with a buttoned 2mm cannula to induce formation of a neo-gliding plane. Post treatment follow-up was performed to assess active range of motion (AROM), grip strength, Disabilities of the Arm, Shoulder and Hand (DASH) score, Vancouver Scar Scale (VSS) and quality of life Short-Form (SF)-36 questionnaire. No complications were detected associated with the treatment of FCGWM injection. The mean improvement (AROM) at 6 months was 30.6° for digits 2-5. The improvement in the DASH score was a mean of 9 points out of 100. The VSS improved by a mean of 2 points out of 14. The study demonstrates the feasibility and safety of percutaneous FCGWM for dermal augmentation after burn. Results from this pilot study show improvements in AROM for digits 2-5, functional scores from the patient's perspective (DASH) and scar quality (VSS). The flowable form of established INTEGRA™ wound matrix offers the advantage of minimal-invasive injection after scar release in the post-burned hand with a reduction in the risk of postsurgical re-scarring. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

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

    Science.gov (United States)

    Lombardi, Giuseppina; Garofoli, Francesca; Stronati, Mauro

    2010-10-01

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

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

    Science.gov (United States)

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

    1997-03-01

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

  9. Diagnostics, treatment, and follow-up in craniopharyngioma

    Directory of Open Access Journals (Sweden)

    Hermann L. Müller

    2011-11-01

    Full Text Available Craniopharyngiomas (CP are partly cystic embryogenic malformations of the sellar and parasellar region. With an overall incidence of 0.5 to 2.0 new cases / million population / year, approximately 30 to 50% of all cases represent childhood CP. Typical manifestations at diagnosis are headache, visual impairment, polyuria/polydypsia, growth retardation, and significant weight gain. Therapy of choice in patients with favorable tumor localization is complete resection with the intention to maintain optical nerve and hypothalamic-pituitary functions. In patients with unfavorable tumor localization (hypothalamic involvement, a limited resection followed by local irradiation is recommended. The overall survival rates are high (92%. Recurrences after complete resection and progressions of residual tumor after incomplete resection are frequent post-surgical events. Accordingly, the appropriate time point of irradiation after incomplete resection is currently under investigation in a randomized multinational trial (KRANIOPHARYNGEOM 2007. Quality of life is substantially reduced in approximately 50% of long-term survivors due to sequelae, notably morbid hypothalamic obesity. Both, childhood CP and adult onset CP should be recognized as chronic diseases requiring constant monitoring of the consequences and appropriate medical resources for treatment in order to provide optimal quality of survival for patients.

  10. Twelve month follow-up on a randomised controlled trial of relaxation training for post-stroke anxiety.

    Science.gov (United States)

    Golding, Katherine; Fife-Schaw, Chris; Kneebone, Ian

    2017-09-01

    To follow up participants in a randomised controlled trial of relaxation training for anxiety after stroke at 12 months. Twelve month follow-up to a randomised controlled trial, in which the control group also received treatment. Community. Fifteen of twenty one original participants with post-stroke anxiety participated in a one year follow-up study. A self-help autogenic relaxation CD listened to five times a week for one month, immediately in the intervention group and after three months in the control group. Hospital Anxiety and Depression Scale-Anxiety subscale and the Telephone Interview of Cognitive Status for inclusion. Hospital Anxiety and Depression Scale-Anxiety subscale for outcome. All measures were administered by phone. Anxiety ratings reduced significantly between pre and post-intervention, and between pre-intervention and one year follow-up ( χ 2 (2) = 22.29, p autogenic relaxation CD appear to be maintained after one year.

  11. Recovery, relapse, or else? Treatment outcomes in gambling disorder from a multicenter follow-up study.

    Science.gov (United States)

    Müller, K W; Wölfling, K; Dickenhorst, U; Beutel, M E; Medenwaldt, J; Koch, A

    2017-06-01

    Gambling disorder is associated with various adverse effects. While data on the immediate effectiveness of treatment programs are available, follow-up studies examining long-term effects are scarce and factors contributing to a stable therapy outcome versus relapse are under-researched. Patients (n=270) finishing inpatient treatment for gambling disorder regularly participated in a prospective multicenter follow-up study (pre-treatment, post-treatment, 12-month follow-up). Criteria for gambling disorder, psychopathology, functional impairment were defined as endpoints. Changes in personality were defined as an additional parameter. At follow-up, three groups were identified: subjects maintaining full abstinence (41.6%), patients still meeting criteria for gambling disorder (29.2%), and subjects still participating in gambling without meeting the diagnostic criteria for gambling disorder (29.2%). Every group had improvements in functional impairment, abstinent subjects showed the lowest psychopathology. Significant decreases in neuroticism and increases in both extraversion and conscientiousness were found among abstinent subjects but not in patients still meeting criteria for gambling disorder. One year after treatment, a considerable percentage of patients kept on gambling but not all of them were classified with gambling disorder leading to the question if abstinence is a necessary goal for every patient. The changes of personality in abstinent patients indicate that after surmounting gambling disorder a subsequent maturing of personality might be a protective factor against relapse. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

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

    DEFF Research Database (Denmark)

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

    BACKGROUND: The post-treatment follow-up is well-integrated in the oncologic care tradition, based on the risk of developing recurrent disease or new primary tumors in treated patients. Furthermore, follow-up serves as an opportunity to monitor treatment effects and to provide clinical care of side...... effects. In this study we measured the activity and effectiveness of routine follow-up in head and neck cancer and assessed the value of follow-up from the perspectives of both physicians and the patients. PATIENTS AND METHODS: During a period of six weeks a prospective national cross section cohort...

  13. The value of routine follow-up after treatment for head and neck cancer. A National Survey from DAHANCA

    DEFF Research Database (Denmark)

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

    2013-01-01

    The post-treatment follow-up is well-integrated in the oncologic care tradition, based on the risk of developing recurrent disease or new primary tumors in treated patients. Furthermore, follow-up serves as an opportunity to monitor treatment effects and to provide clinical care of side effects....... In this study we measured the activity and effectiveness of routine follow-up in head and neck cancer and assessed the value of follow-up from the perspectives of both physicians and the patients....

  14. [Cardiac sarcoidosis: diagnostics, treatment and follow-up].

    Science.gov (United States)

    Dudziak, Maria; Jankowska, Hanna; Dorniak, Karolina

    2018-03-27

    Sarcoidosis is a generalised granulomatous disorder of unknown aetiology. Cardiac involvement may affect conduction system, myocardium, valvular apparatus and pericardium. Clinical spectrum ranges from asymptomatic involvement to sudden cardiac death. Patients with biopsy-proven extracardiac sarcoidosis should be screened for cardiac involvement (standard ECG, 24-hour Holter ECG, echocardiography) and in case of any abnormalities found on these tests, more advanced diagnostic methods should be used. Steroid treatment is still the mainstay of therapy in cardiac sarcoidosis. Several immunosuppresive agents are also effective and used in different combinations with steroids, as well as heart failure treatment (including ACE inhibitors, angiotensin receptor blockers, beta-blockers and diuretics). Advanced heart block requires pacemaker implantation, and implantable cardioverterdefibrillator is an effective treatment in primary and secondary prophylaxis of sudden cardiac death. Heart transplantation is considered in advanced, drug-resistant heart failure or incessant ventricular arrhythmias unresponsive to other forms of therapy. © 2018 MEDPRESS.

  15. Use of mobile phones to improve post-hospitalisation follow-up of ...

    African Journals Online (AJOL)

    Use of mobile phones to improve post-hospitalisation follow-up of children in rural Kenya. ... Log in or Register to get access to full text downloads. ... however, have slanted towards adults, in the form of reminders or instructions of some sort. ... suitability, and utilisation of the message, and immunisation status of the child.

  16. Treatment of rheumatoid arthritis with 90yttrium. Follow up studies

    International Nuclear Information System (INIS)

    Teuber, J.; Baenkler, H.W.; Regler, G.; Erlangen-Nuernberg Univ., Erlangen

    1978-01-01

    90 Yttrium-silicate was injected into 131 knee-joints from patients with rheumatoid arthritis with stadium II-IV according to Steinbrocker. The observation period lasted until two years. After three months about 80% and after 24 months still more than 50% of the patients treated showed complete or partial remission. Side-effects as formerly observed with 198 -goldpreparations did not occur. Therefore the treatment with 90 Yttrium-silicate offers an alternative to surgical synovectomy. (orig.) [de

  17. Long-Term Follow-Up after Treatment of Cryptorchidism

    DEFF Research Database (Denmark)

    Thorup, Jorgen; Cortes, Dina

    2016-01-01

    -known knowledge on the field is presented.To some extent a smaller testis in a higher scrotal position than normal must be accepted as a fair cosmetic result after orchidopexy in childhood. The smaller testis size is related to the impaired fertility potential of the testis. In cases with atrophy, testicular......When considering long-term prognosis and results in adult age following treatment of cryptorchidism in childhood there are three main issues to be discussed: cosmetics, fertility, and malignancy. In the present review, the most recent research on the topics related to summaries of well...

  18. Surgical treatment and follow up on undescended testis

    DEFF Research Database (Denmark)

    Thorup, Jørgen Mogens; Cortes, D.

    2009-01-01

    With skill and ability to control a variety of operative techniques, undescended testes can be placed in the scrotum with 90% success rate in palpable testes and 85% in abdominal testes. Long term results are related also to the variability of the disease. A hypothesis that in cryptorchid testes...... number at birth in some cryptorchid testes and Intratubular Germ Cell Neoplasia seen in early childhood. The hypothesis that the abnormal location of the testis exposes the testis to infertility and malignant transformation is supported by the findings of early treatment lowering the risk of both...

  19. Diagnostics, Treatment, and Follow-Up in Craniopharyngioma

    Science.gov (United States)

    Müller, Hermann L.

    2011-01-01

    Craniopharyngiomas are partly cystic embryogenic malformations of the sellar and parasellar region, with up to half the 0.5–2.0 new cases per million population per year occur in children and adolescents. Diagnosis profile for pediatric and adult craniopharyngioma is characterized by a combination of headache, visual impairment, and polyuria/polydipsia, which can also include significant weight gain. In children, growth retardation, and/or premature puberty often occur later or postoperatively. Recommended therapy with favorable tumor localization is complete resection; with unfavorable tumor localization (optic nerve and/or hypothalamic involvement), consensus is still pending whether a limited resection followed by local irradiation is more prudent. Even though overall survival rates are high (92%), recurrences after complete resection and progressions after incomplete resection can be expected. Accordingly, a randomized multinational trial (KRANIOPHARYNGEOM 2007) has been established to identify optimal diagnosis, treatment (particularly the ideal time point of irradiation after incomplete resection), and quality of life strategies of this chronic disease – most notably the morbid hypothalamic obesity in ∼50% of long-term survivors. We report on craniopharyngioma origins, its pathological manifestations, and specific challenges these sequelae pose regarding diagnosis, treatment, and life-long multi-discipline quality of life management for both adult and childhood craniopharyngioma patients. PMID:22654824

  20. Adherence to vaccination guidelines post splenectomy: A five year follow up study.

    Science.gov (United States)

    Boam, Tristan; Sellars, Peter; Isherwood, John; Hollobone, Chloe; Pollard, Cristina; Lloyd, David M; Dennison, Ashley R; Garcea, Giuseppe

    Following a splenectomy patients are at increased risk of significant infections. In its most severe form, overwhelming post-splenectomy infection (OPSI) has a mortality rate of up to 80%. In this study we aim to establish the adherence to vaccination and antibiotic national guidelines in splenectomised patients. A retrospective study of 100 patients who underwent splenectomy (21 emergency, 79 elective), in two teaching hospitals was undertaken over a five-year period. Patients were followed up for five years. Hospital and GP records were reviewed for adherence to pre, intra and postoperative vaccination, thromboprophylaxis and antibiotic guidance. Eighty-six eligible patients (91.5%) received their Haemophilus influenzae B, meningococcal C and pneumococcus vaccinations peri-operatively. Eighty-one (86%) received post-operative antibiotics. Ninety-nine percent of patients received thromboprophylaxis treatment. Eighty-nine (95%) were treated with long-term antibiotic prophylaxis. Only 20 patients (23%) had an emergency supply of antibiotics. Ninety-five percent of patients were administered an annual influenza vaccination and 84% of eligible patients received a five-year pneumococcal booster vaccination. Improvement in the management of this patient cohort can be achieved by a multidisciplinary approach involving adherence to national guidelines, standardised trust protocols, patient information leaflets and advice detailing risk of infection, standardised GP letters and a splenectomy register to monitor and manage this vulnerable group of patients. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Post-operative megavoltage irradiation of minor salivary gland malignancies - 30 year follow-up

    International Nuclear Information System (INIS)

    Birdwell, Sandra H.; Terris, David J.; Fee, Willard E.; Goffinet, Don R.

    1996-01-01

    Purpose/Objective: To describe the clinical presentation, treatment techniques, outcome, and complications of a large single institutional experience with long-term follow-up after surgery and post-operative radiation therapy for the treatment of minor salivary gland malignancies. Materials and Methods: Fifty-five patients with minor salivary gland tumors were treated definitively between 1966 and 1995. Patients were staged using the 1992 AJCC staging system according to the anatomic site of origin. Follow-up averaged 7.2 years. The mean age at treatment was 54 years. There were 35 men and 20 women. Thirty patients had involved surgical margins and 25 had negative surgical margins. All patients were treated with 4-6 MeV linear accelerators. Radiation techniques included 3 field isocentric or opposed lateral pair techniques depending on the site of origin. The mean radiation dose was 60 Gy (range 50-70 Gy). Survival, both actuarial and relapse free, was determined from the treatment completion date using the method of Kaplan and Meier. Standard statistical tests (Gehan, Cox) were used to calculate the significance of covariates. Results: Minor salivary gland histologic diagnoses included 32 cases of adenoid cystic carcinoma, 15 adenocarcinomas, 7 mucoepidermoid carcinomas, and 1 pleomorphic adenoma. Eight patients had Stage I tumors, 13 had Stage II, another 13 had Stage III lesions, while 21 had Stage IV tumors (locally advanced but non-metastatic). Twenty-five tumors involved the nasal cavity-paranasal sinuses, 23 arose from the oral cavity, 5 from the oropharynx, and 2 from the glottis. Patients with adenoid cystic carcinomas had improved local control and overall survival compared with those with adenocarcinomas (p = 0.03, 0.02, respectively). Malignancies arising from the palate had improved local control rates compared with tumors arising from other anatomic sites (p = 0.04). Patients with Stage I and II disease had improved freedom from relapse compared with

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

    NARCIS (Netherlands)

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

    2017-01-01

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

  3. Effectiveness and Persistence of Liraglutide Treatment Among Patients with Type 2 Diabetes Treated in Primary Care and Specialist Settings: A Subgroup Analysis from the EVIDENCE Study, a Prospective, 2-Year Follow-up, Observational, Post-Marketing Study.

    Science.gov (United States)

    Martinez, Luc; Penfornis, Alfred; Gautier, Jean-Francois; Eschwège, Eveline; Charpentier, Guillaume; Bouzidi, Amira; Gourdy, Pierre

    2017-03-01

    The objective of this subgroup analysis is to investigate the effectiveness of liraglutide in people with type 2 diabetes (T2D) treated within the primary care physician (PCP) and specialist care settings. EVIDENCE is a prospective, observational study of 3152 adults with T2D recently starting or about to start liraglutide treatment in France. We followed patients in the PCP and specialist settings for 2 years to evaluate the effectiveness of liraglutide in glycemic control and body weight reduction. Furthermore, we evaluated the changes in combined antihyperglycemic treatments, the reasons for prescribing liraglutide, patient satisfaction, and safety of liraglutide in these two treatment settings. After 2 years of follow-up, 477 out of 1209 (39.0%) of PCP and 297 out of 1398 (21.2%) of specialist-treated patients still used liraglutide and maintained the glycated hemoglobin (HbA 1c ) target of <7.0%. Significant reductions from baseline were observed in both PCP- and specialist-treated cohorts in mean HbA 1c (-1.22% and -0.8%, respectively), fasting plasma glucose (FPG) concentration (-39 and -23 mg/dL), body weight (-4.4 and -3.8 kg), and body mass index (BMI) (-1.5 and -1.4 kg/m 2 ), all p < 0.0001. Reductions in HbA 1c and FPG were significantly greater among PCP- compared with specialist-treated patients, p < 0.0001 for both. Patient treatment satisfaction was also significantly increased in both cohorts. Reported gastrointestinal adverse events were less frequent among PCP-treated patients compared with specialist-treated patients (4.5% vs. 16.1%). Despite differences in demography and clinical characteristics of patients treated for T2D in PCP and specialty care, greater reduction in HbA 1c and increased glycemic control durability were observed with liraglutide in primary care, compared with specialist care. These data suggest that liraglutide treatment could benefit patients in primary care by delaying the need for further treatment

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2004-01-01

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

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

    NARCIS (Netherlands)

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

    2002-01-01

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

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

    NARCIS (Netherlands)

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

    2002-01-01

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

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

    NARCIS (Netherlands)

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

    2002-01-01

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

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

    Science.gov (United States)

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

    2016-07-13

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

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

    Science.gov (United States)

    Kock, M; Berntsson, C; Bengtsson, A

    2014-08-01

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

  11. A Long-Term Follow-Up of Treatment for Severe Self-Injury.

    Science.gov (United States)

    Williams, Don E.; And Others

    1994-01-01

    Treatment of a woman with severe mental retardation with the Self-Injurious Behavior Inhibiting System (SIBIS) resulted in significant reductions in SIB behavior which generalized to the natural environment and the brief follow-up sessions. (Author/DB)

  12. Orthodontic treatment in periodontal patients: a case report with 7 years follow-up.

    Science.gov (United States)

    Derton, Nicola; Derton, Roberto; Perini, Alessandro; Gracco, Antonio; Fornaciari, Paolo Andrea

    2011-03-01

    Tooth flaring of the anterior segment is often unesthetic and therefore a primary reason for combined orthodontic and periodontal treatment in adult patients with periodontal disease. Thus, a multidisciplinary approach is frequently chosen for these patients by a qualified dental team. A clinical case of an adult patient suffering from chronic periodontitis with horizontal bone loss in the anterior segment and consequent flaring of the anterior teeth is described. A combined approach was chosen, initially to improve and stabilize the periodontal situation via multiple scaling and root planning sessions with additional pharmacological therapy and, finally by orthodontic treatment, to resolve the malocclusion. At the end of treatment, bone resorbtion was stabilized, the vertical bone defect was improved and incisor flaring was absent. Follow-up at 7 years post-treatment confirmed the stability of the orthodontic and esthetic results. The correct combination of orthodontic and periodontal treatment may contribute efficaciously to eliminate the effects of chronic periodontitis in adult patients, as well as improving esthetic parameters. Copyright © 2011 CEO. Published by Elsevier Masson SAS. All rights reserved.

  13. Long-term adherence to follow-up after treatment of cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Barken, Sidsel S; Lynge, Elsebeth; Andersen, Erik S.

    2013-01-01

    OBJECTIVE: To measure adherence to annual follow-up among women treated for cervical intraepithelial neoplasia. DESIGN: Prospective, population-based, register study. SETTING: Denmark, 1996-2007. POPULATION: All women treated for cervical intraepithelial neoplasia with conization. METHODS: Treated...... was poor in Denmark. Our findings suggest that because of this poor adherence, recommendations for long-term annual follow-up after treatment of cervical intraepithelial neoplasia may not be highly effective. Shorter follow-up schedules using highly sensitive tests appear attractive....

  14. [Gender dysphoria in children and adolescents - treatment guidelines and follow-up study].

    Science.gov (United States)

    Meyenburg, Bernd; Kröger, Anne; Neugebauer, Rebecca

    2015-01-01

    Treatment guidelines for transidentity in children and adolescents are presently under discussion. We present an overview of the various treatment modalities. Further, follow-up data on children and adolescents referred for gender-identity problems are presented. Of the 84 patients seen for the first time more than 3 years before follow-up, 37 mailed in the completed questionnaires. In addition, 33 patients agreed to answer some short follow-up questions. We assessed steps of treatment, gender role, psychopathology, and psychotherapy. We compared differences in psychopathology in patients with vs. without gender role change and in patients with intense vs. less intense psychotherapy. A total of 22 patients had completely changed gender role, and some had started hormonal treatment und sex reassignment surgery. Most patients were satisfied with the treatment results. All patients showed less psychopathology on follow-up, independent of role change or intensity of psychotherapy. In general, the patients reported little psychopathology. Our follow-up results support the present treatment approach. In patients with little psychopathology, low-frequency supportive treatment appears sufficient to obtain safe judgement on hormonal of surgical treatment.

  15. A post-earthquake psychopathological investigation in Armenia: methodology, summary of findings, and follow-up.

    Science.gov (United States)

    Khachadourian, Vahe; Armenian, Haroutune; Demirchyan, Anahit; Melkonian, Arthur; Hovanesian, Ashot

    2016-07-01

    The post-earthquake psychopathological investigation (PEPSI) was designed to probe the short-and long-term effects of the earthquake in northern Armenia on 7 December 1988 on survivors' mental and physical health. Four phases of this study have been conducted to date, and, overall, more than 80 per cent of a sub-sample of 1,773 drawn from an initial cohort of 32,743 was successfully followed during 2012. This paper describes the methodology employed in the evaluation, summarises previous findings, details the current objectives, and examines the general characteristics of the sample based on the most recent follow-up phase outcomes. Despite a significant decrease in psychopathology rates between 1990 and 2012, prevalence rates of post-traumatic stress disorder and depression among study participants in 2012 were greater than 15 and 26 per cent, respectively. The paper also notes the strengths and limitations of the study vis-à-vis future research and highlights the importance and potential practical implications of similar assessments and their outcomes. © 2016 The Author(s). Disasters © Overseas Development Institute, 2016.

  16. Class II young adult treatment with Twin Force Bite corrector: 10-year follow-up

    Directory of Open Access Journals (Sweden)

    Ozge Uslu-Akcam

    2017-01-01

    Full Text Available One of the most preferred compliance free fixed functional appliances in nongrowing patients is Twin Force Bite corrector (TFBC. The aim of this case report is to evaluate the effectiveness of TFBC in the treatment of an adult Class II case. A 16-year 1-month-old boy having skeletal and dental Class II relationship was selected. Roth 0.018 × 0.025 inch slots brackets were attached; a fixed lingual arch in the mandibular dental arch and a Nance appliance in the maxillary dental arch were used to increase anchorage. The TFBC therapy used for sagittal activation and stimulation of forward mandibular growth lasted for 3 months. The post-TFBC treatment lasted 6 months and the total treatment time was 9 months. Treatment of a young adult Class II malocclusion with TFBC resulted in a Class I molar occlusion, an ideal overjet, overbite, and incisor angulation in a short time and maintained in the 10-year follow-up.

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

    Science.gov (United States)

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

    2017-03-01

    Classical galactosemia (CG) is an inborn error of galactose metabolism. Evidence-based guidelines for the treatment and follow-up of CG are currently lacking, and treatment and follow-up have been demonstrated to vary worldwide. To provide patients around the world the same state-of-the-art in care, members of The Galactosemia Network (GalNet) developed an evidence-based and internationally applicable guideline for the diagnosis, treatment, and follow-up of CG. The guideline was developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. A systematic review of the literature was performed, after key questions were formulated during an initial GalNet meeting. The first author and one of the working group experts conducted data-extraction. All experts were involved in data-extraction. Quality of the body of evidence was evaluated and recommendations were formulated. Whenever possible recommendations were evidence-based, if not they were based on expert opinion. Consensus was reached by multiple conference calls, consensus rounds via e-mail and a final consensus meeting. Recommendations addressing diagnosis, dietary treatment, biochemical monitoring, and follow-up of clinical complications were formulated. For all recommendations but one, full consensus was reached. A 93 % consensus was reached on the recommendation addressing age at start of bone density screening. During the development of this guideline, gaps of knowledge were identified in most fields of interest, foremost in the fields of treatment and follow-up.

  18. 12-month follow-up study of drug treatment in pathological gamblers: a primary outcome study.

    Science.gov (United States)

    Dannon, Pinhas N; Lowengrub, Katherine; Musin, Ernest; Gonopolsky, Yehudit; Kotler, Moshe

    2007-12-01

    Pathological gambling (PG) is a relatively common and highly disabling impulse control disorder. A range of psychotherapeutic agents including selective serotonin reuptake inhibitors, antiepileptic drugs, and opioid antagonists are shown to be effective in the short-term treatment of PG. The use of a wide range of pharmacological treatments for PG is consistent with the observation that PG shares features of obsessive-compulsive spectrum disorders, impulse control disorders, and addictive disorders. The aim of the study is to assess the rate of relapse in treatment-responder pathological gamblers after discontinuation of the active treatment. Our study sample was composed of 43 male pathological gamblers who had been full responders to 1 of 4 drug treatment regimens (fluvoxamine, topiramate, bupropion SR, or naltrexone) from several previous acute open-label (12-week) comparison studies. Full response was defined as the absence of gambling for a 1-month duration together with improvement on the Clinical Global Improvement scale. The 43 full responders were then followed prospectively for an additional 9 months, which included a 3-month open-label continuation phase and a 6-month medication-free follow-up phase. Follow-up visits were performed on a monthly basis throughout the duration of study. At every follow-up visit, a comprehensive psychiatric diagnostic evaluation was performed on all patients, and patients were assessed for symptoms of gambling using a self-report instrument and collateral family reports. The Clinical Global Impression Improvement scale was also administered at every follow-up visit. Raters were blind to the previous drug treatment. Most patients did not relapse during the 6-month medication-free follow-up phase. Three of 6 patients with fluvoxamine, 3 of 9 with topiramate, 7 of 18 with bupropion SR, and 4 of 10 with naltrexone relapsed. Relapse was strictly defined as gambling behavior at any time during the 6-month medication-free follow-up

  19. Treatment of hyperthyroidism with radioactive iodine. Methodological changes and follow-up problems

    International Nuclear Information System (INIS)

    Gibold, C.; Delisle, M.J.; Maes, B.; Vaudrey, C.; Pochard, J.M.

    1988-01-01

    The experience of treatment of hyperthyroidism with radioactive iodine in the Nuclear Medicine department of the J. Godinot Institute, Rheims, from 1967 till 1987, is described. One thousand one hundred and fifty patients (723 with diffuse and 427 with nodular hyperthyroidism) received a total of 1 565 doses. The dosage calculation method was considerably simplified, enabling a patient to be treated in 24 hours. Thyroid gland mass evaluation, initially based on the scintigraphic projection area, is now performed by ultrasonography. The mean total radioactivity administered is 370 ± 320 MBq per patient. All patients are seen on the 8th post-treatment week for clinical examination and hormone control. Seven out of 10 patients are cured with a single dose. Long-term follow-up, based on a computer file, is effected by means of an annual letter sent to patient and to his family doctor, but in spite fo sustained efforts 36 per cent of the patients are lost sight of. The diagnosis of iodine 131-induced hypothyroidism is based on plasma levels of TSH which, since 1984, are measured by the ultrasensitive method. The overall incidence of hypothyroidism is 6.6 per cent in the first year and 3 per cent thereafter. Despite a simplified procedure, the results obtained by the authors are similar to those found in the literature, and the cost-efficiency ratio is excellent [fr

  20. Loss-to-follow-up and delay to treatment initiation in Pakistan's national tuberculosis control programme.

    Science.gov (United States)

    Ali, Syed Mustafa; Naureen, Farah; Noor, Arif; Fatima, Irum; Viney, Kerri; Ishaq, Muhammad; Anjum, Naveed; Rashid, Aamna; Haider, Ghulam Rasool; Khan, Muhammad Aamir; Aamir, Javariya

    2018-03-09

    Researchers and policy-makers have identified loss to follow-up as a major programmatic problem. Therefore, the objective of this study is to quantify TB related pre-treatment loss to follow up and treatment delay in private sector health care facilities in Pakistan. This was a retrospective, descriptive cohort study using routinely collected programmatic data from TB referral, diagnosis and treatment registers. Data from 48 private healthcare facilities were collected using an online questionnaire prepared in ODK Collect, for the period October 2015 to March 2016. Data were analysed using SPSS. We calculated the: (1) number and proportion of patients who were lost to follow-up during the diagnostic period, (2) number and proportion of patients with pre-treatment loss to follow-up, and (3) the number of days between diagnosis and initiation of treatment. One thousand five hundred ninety-six persons with presumptive TB were referred to the laboratory. Of these, 96% (n = 1538) submitted an on-the-spot sputum sample. Of the 1538 people, 1462 (95%) people subsequently visited the laboratory to submit the early morning (i.e. the second) sample. Hence, loss to follow-up during the diagnostic process was 8% overall (n = 134). Of the 1462 people who submitted both sputum samples, 243 (17%) were diagnosed with sputum smear-positive pulmonary TB and 231 were registered for anti-TB treatment, hence, loss in the pre-treatment phase was 4.9% (n = 12). 152 persons with TB (66%) initiated TB treatment either on the day of TB diagnosis or the next day. A further 79 persons with TB (34%) commenced TB treatment within a mean time of 7 days (range 2 to 64 days). Concentrated efforts should be made by the National TB Control Programme to retain TB patients and innovative methods such as text reminders and behavior change communication may need to be used and tested.

  1. Congenital arterioportal fistulas: radiological treatment and color Doppler US follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Teplisky, Dario; Tincani, Eliana Uruena; Lipsich, Jose; Sierre, Sergio [Department of Interventional Radiology, Pichincha 1890, Buenos Aires (Argentina)

    2012-11-15

    Congenital intrahepatic arterioportal fistulas (APFs) are a rare cause of portal hypertension in children. Doppler US is a useful diagnostic imaging modality. Transarterial embolization is a minimally invasive and effective therapy allowing occlusion of the fistula and restoration of liver hemodynamics. To describe the clinical and radiologic findings, percutaneous treatment and role of D-US in the postembolization follow-up of children with APF. Between 2002 and 2011, four children with APF were treated. Initial diagnosis and follow-up was performed with D-US and confirmed by arteriography, followed by endovascular embolization in all patients. D-US demonstrated abnormal arterioportal communications in all patients. Six endovascular procedures were performed in these four children. In two children, no residual fistula was seen on D-US after the first procedure and symptoms resolved. In the other two children, D-US demonstrated residual flow through the fistula, with resolution of pathological D-US findings and symptoms after the second endovascular procedure. All four children were successfully treated and asymptomatic at the end of follow-up. The mean follow-up was 24 months. Interventional radiology has a key role in the treatment of congenital APF. D-US is a noninvasive and effective tool for the diagnosis and follow-up of these patients. (orig.)

  2. Short-tem Post Renal Trasplant Follow-up at Madinah Al Munawarah

    Directory of Open Access Journals (Sweden)

    Bernieh Bassam

    1999-01-01

    Full Text Available We reviewed the records of the renal transplant patients followed at our hospital to determine short-term outcome and complications. Sixty-five renal transplant patients, follow-up for two years were included in this study. Of these patients 40 (61.5% were males, 33 (50.7% were Saudis with mean age of 37.2 ± 11.7 years. Donors were living related (LRD in 23 (35%, living non-related (LNRD in 27 (42% and cadaveric (CAD in 15 (23%. Thirty-two transplants were carried out at Medinah, 21 in India and the rest in other centers inside Saudi Arabia. Immunosuppression was based on a triple therapy (Cyclosporin, Azathioprine, and Prednisone. At two years, 52 (80% patients were alive, with functioning graft in 31 (58%. Causes of death among 13 patients (11 LNRD & 2 CAD were infections in 7 (54%, immediate post transplant in three (22.7%, acute myocardial infarction in two (15.7%, CVA in one (7.6%. Complications encountered were acute rejection (23 episodes in 18 923.6% patients, infections in 19 (25%, chronic rejection in 16 (21.5%, surgical in 13 917.1%, diabetes mellitus in 5 (6.5% primary non-function in three (3.8% and Kaposi Sarcoma in two (2.4%. Twenty-six (81.25% out of 32 transplants performed in Madinah were functioning, four (12.5% patients returned to dialysis and two (6.25% patients died. Among the 21 transplants done in India 11 (52% patients died, six (28.6% returned to dialysis, and four (19.4% had function deteriorated in all patients. We conclude that despite limitations, results of renal transplantation carried out at Madinah are encouraging on short-term basis. Live related transplant has a very good outcome, while commercial transplantation carries poor prognosis.

  3. Familial hypercholesterolemia: Screening, treatment and follow-up from pregnancy into young adulthood

    NARCIS (Netherlands)

    Kusters, D.M.

    2016-01-01

    In part 1, the consequences of familial hypercholesterolemia (FH) during pregnancy for the unborn child are explored. Part II comprises several studies on the screening, diagnosis and follow-up of children with FH. The treatment of children with FH is studied in part III, with the most important

  4. Treatment and follow-up of children with common chronic liver diseases in children

    Directory of Open Access Journals (Sweden)

    LYU Xintong

    2017-10-01

    Full Text Available Chronic liver diseases in children greatly affect their growth and development and quality of life in future. There are many causes of chronic liver diseases in children, and such causes, diet, and treatment guidance are closely associated with prognosis. This article discusses the guidance and follow-up of common chronic liver diseases in children, such as infantile cholestatic liver disease, chronic hepatitis B, hepatolenticular degeneration, and nonalcoholic fatter liver disease, in order to deepen the understanding of these diseases among patients, raise the awareness of follow-up in medical staff, and improve the cure rate of liver diseases with different causes and children’s quality of life.

  5. Clinical value of FDG-PET in the follow up of post-operative patients with endometrial cancer

    International Nuclear Information System (INIS)

    Saga, Tsuneo; Higashi, Tatsuya; Ishimori, Takayoshi

    2003-01-01

    The clinical usefulness of FDG-PET in the follow up of post-operative patients with endometrial cancer was retrospectively evaluated. Twenty-one post-operative patients with endometrial cancer received 30 FDG-PET examinations to evaluate recurrence or response to treatment. The findings of FDG-PET were compared with their serum levels of tumor markers, CT and/or MRI findings, and the final outcome. Results of FDG-PET were also correlated with the clinical course of each patient. In detecting recurrent lesions and evaluating treatment responses, FDG-PET, with the help in anatomic information by CT/MRI, showed better diagnostic ability (sensitivity 100.0%, specificity 88.2%, accuracy 93.3%) compared with combined conventional imaging (sensitivity 84.6%, specificity 85.7%, accuracy 85.0%) and tumor markers (sensitivity 100.0%, specificity 70.6%, accuracy 83.3%). FDG-PET had no false-negative results, suggesting the possibility of its use as the first-line examination in a patient's follow-up. FDG-PET could detect unknown lesions in 4 cases, and, as reported for other malignancies, FDG-PET affected the patient management in one-third of the cases. Furthermore, the results of FDG-PET correlated well with the clinical outcome of the patients, with patients with negative PET results tending to show disease-free courses. These results suggest that, despite the limited number of patients studied, FDG-PET was accurate in detecting recurrence and evaluating therapeutic response, and could afford important information in the management of post-operative patients with endometrial cancer. FDG-PET also appeared to have a possibility to predict the outcome of each patient. (author)

  6. Functional evaluation of patients treated with osteochondral allograft transplantation for post-traumatic ankle arthritis: one year follow-up.

    Science.gov (United States)

    Berti, L; Vannini, F; Lullini, G; Caravaggi, P; Leardini, A; Giannini, S

    2013-09-01

    Severe post-traumatic ankle arthritis poses a reconstructive challenge in active patients. Whereas traditional surgical treatments, i.e. arthrodesis and arthroplasty, provide good pain relief, arthrodesis is associated to functional and psychological limitations, and arthroplasty is prone to failure in the active patient. More recently the use of bipolar fresh osteochondral allografts transplantation has been proposed as a promising alternative to the traditional treatments. Preliminary short- and long-term clinical outcomes for this procedure have been reported, but no functional evaluations have been performed to date. The clinical and functional outcomes of a series of 10 patients who underwent allograft transplantation at a mean follow-up of 14 months are reported. Clinical evaluation was performed with the AOFAS score, functional assessment by state-of-the-art gait analysis. The clinical score significantly improved from a median of 54 (range 12-65) pre-op to 76.5 (range 61-86) post-op (p=0.002). No significant changes were observed for the spatial-temporal parameters, but motion at the hip and knee joints during early stance, and the range of motion of the ankle joint in the frontal plane (control: 13.8°±2.9°; pre-op: 10.4°±3.1°, post-op: 12.9°±4.2°; p=0.02) showed significant improvements. EMG signals revealed a good recovery in activation of the biceps femoris. This study showed that osteochondral allograft transplantation improves gait patterns. Although re-evaluation at longer follow-ups is required, this technique may represent the right choice for patients who want to delay the need for more invasive joint reconstruction procedures. Copyright © 2013 Elsevier B.V. All rights reserved.

  7. Adherence to Follow-up Recommendations Among Individuals in the Philadelphia Glaucoma Detection and Treatment Project.

    Science.gov (United States)

    Hark, Lisa A; Leiby, Benjamin E; Waisbourd, Michael; Myers, Jonathan S; Fudemberg, Scott J; Mantravadi, Anand V; Dai, Yang; Gilligan, John P; Resende, Arthur F; Katz, L Jay

    2017-08-01

    To evaluate rates of adherence to free follow-up eye exam appointments among participants in the Philadelphia Glaucoma Detection and Treatment Project. Ophthalmologists and testing equipment were brought directly to participants at risk for glaucoma at 43 community sites in Philadelphia. Those diagnosed with glaucoma-related pathology were recommended to return for follow-up to be reexamined on site. Rates of adherence and clinical and demographic risk factors for adherence were evaluated. Five hundred thirty-one participants were diagnosed with glaucoma-related conditions and recommended to attend community-based follow-up exams. Follow-up adherence rate was 61.2% (n=325/531). Significant factors associated with greater eye exam appointment adherence, based on our univariable analysis, included final diagnosis of glaucoma (risk ratio [RR]=1.33; 95% confidence interval [CI], 1.13-1.57), male sex (RR=1.19; 95% CI, 1.04-1.36), white race (RR=1.26; 95% CI, 1.08-1.48), age (RR=1.17; 95% CI, 1.00-1.37) recommendation for glaucoma medication (RR=1.52; 95% CI, 1.35-1.71), recommendation for laser peripheral iridotomy (RR=1.18; 95% CI, 1.02-1.35), diagnosis of age-related macular degeneration (RR=1.42; 95% CI, 1.13-1.77) and an increased intraocular pressure (>22 mm Hg in the worse eye) (RR=1.23; 95% CI, 1.06-1.42). On the basis of our multivariable model, diagnosis, sex, and recommended glaucoma medications were significantly associated with follow-up adherence. This study demonstrates that individuals living in underserved urban communities would take advantage of free eye exams in community sites and return for follow-up eye exams in these same settings. Future studies could investigate interventions to improve eye exam appointment adherence in community-based settings to detect glaucoma-eye conditions.

  8. Follow-up studies on children and adolescents with Graves' disease after 131I treatment

    International Nuclear Information System (INIS)

    Chen Danyun; Chen Tanghua

    2006-01-01

    Objective: To observe relative long-term radioactive therapy effects, clinical follow-up after 131 I treatment was conducted in children and adolescent patients with Graves' disease (GD). Methods: In 161 GD patients, aged from 8 to 17 years, m I was given at a dosage of 1.85 to 3.70 MBq per gram of thyroid tissue and a maximum dose ranging from 74 to 1221 MBq per patient. The patients were then followed up for 24 to 104 months [averagely (62±22) months]. Results: After 131 I treatment, ninety-eight (60.87%) patients were found to be euthyroid. Nine (5.59%) patients remained hyperthyroid and another three (1.86%) had recurrence of hyperthyroidism. Thirty-seven (22.98%) patients turned to be hypothyroid. Fourteen patients lost in follow-up. During the follow-up period, no thyroid cancer or genetic abnormalities were ever found in the group of patients, neither in their offsprings. Conclusion: 131 I may well be considered as an effective and safe method for treating children and adolescents with GD. . (authors)

  9. Three-Year Follow-Up of Insomnia and Hypnotics after Controlled Internet Treatment for Insomnia.

    Science.gov (United States)

    Blom, Kerstin; Jernelöv, Susanna; Rück, Christian; Lindefors, Nils; Kaldo, Viktor

    2016-06-01

    To investigate the long-term effects of therapist-guided Internet-based insomnia treatment on insomnia severity and sleep medication use, compared with active control. This study was an 8 week randomized controlled trial with follow-up posttreatment and at 6, 12, and 36 months, set at the Internet Psychiatry Clinic, Stockholm, Sweden. Participants were 148 media-recruited nondepressed adults with insomnia. Interventions were Guided Internet-based cognitive behavioral therapy for insomnia (ICBT-i) or active control treatment (ICBT-ctrl). Primary outcome was insomnia severity, measured with the Insomnia Severity Index. Secondary outcomes were sleep medication use and use of other treatments. The large pretreatment to posttreatment improvements in insomnia severity of the ICBT-i group were maintained during follow-up. ICBT-ctrl exhibited significantly less improvement posttreatment (between-Cohen d = 0.85), but after 12 and 36 months, there was no longer a significant difference. The within-group effect sizes from pretreatment to the 36-months follow-up were 1.6 (ICBT-i) and 1.7 (ICBT-ctrl), and 74% of the interviewed participants no longer had insomnia diagnosis after 36 mo. ICBT-ctrl used significantly more sleep medication (P = 0.017) and underwent significantly more other insomnia treatments (P insomnia has long-term effects. After 36 months, the groups did not differ in insomnia severity, but ICBT-ctrl had used more sleep medication and undergone more other additional insomnia treatments during the follow-up period. The trial was registered, together with a parallel trial, at Clinicaltrials.gov as "Internet-CBT for Insomnia" registration ID: NCT01256099. © 2016 Associated Professional Sleep Societies, LLC.

  10. Error-related brain activity predicts cocaine use after treatment at 3-month follow-up.

    Science.gov (United States)

    Marhe, Reshmi; van de Wetering, Ben J M; Franken, Ingmar H A

    2013-04-15

    Relapse after treatment is one of the most important problems in drug dependency. Several studies suggest that lack of cognitive control is one of the causes of relapse. In this study, a relative new electrophysiologic index of cognitive control, the error-related negativity, is investigated to examine its suitability as a predictor of relapse. The error-related negativity was measured in 57 cocaine-dependent patients during their first week in detoxification treatment. Data from 49 participants were used to predict cocaine use at 3-month follow-up. Cocaine use at follow-up was measured by means of self-reported days of cocaine use in the last month verified by urine screening. A multiple hierarchical regression model was used to examine the predictive value of the error-related negativity while controlling for addiction severity and self-reported craving in the week before treatment. The error-related negativity was the only significant predictor in the model and added 7.4% of explained variance to the control variables, resulting in a total of 33.4% explained variance in the prediction of days of cocaine use at follow-up. A reduced error-related negativity measured during the first week of treatment was associated with more days of cocaine use at 3-month follow-up. Moreover, the error-related negativity was a stronger predictor of recent cocaine use than addiction severity and craving. These results suggest that underactive error-related brain activity might help to identify patients who are at risk of relapse as early as in the first week of detoxification treatment. Copyright © 2013 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2015-01-01

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

  12. One year follow-up of post-partum-onset depression: the role of depressive symptom severity and personality disorders.

    Science.gov (United States)

    Uguz, Faruk; Akman, Cemal; Sahingoz, Mine; Kaya, Nazmiye; Kucur, Rahim

    2009-06-01

    Long-term follow-up and risk factors of persistent post-partum depression (PPD) are fairly unknown compared with its prevalence in the developing countries. In this study, we did a follow-up measure of PPD and examined the factors, which were associated with PPD 1-year post-partum. Our sample comprised of 34 women. Depressive symptoms were assessed by the Edinburgh post-natal depression scale (EPDS) 6 weeks post-partum, and women with scores >12 on this scale was categorised as depressed. Personality disorders were determined at the same occasion by means of the Structured Clinical Interview for DSM-III-R personality disorders (SCID-II). One year post-partum EPDS was completed. The rate of PPD 1-year post-partum was 32.4%, and it was unrelated to age at assessment, primiparity, number of children, employment status, economical status and educational level. Women depressed 1-year post-partum had significantly higher basal scores of EPDS and more often also a diagnosis of any axis II disorder; and specifically dependent and obsessive-compulsive personality disorders. In our sample, the predictors of 1-year post-partum PPD were having higher basal score of EPDS and the existence of a personality disorder. This study suggests that women with PPD, scoring high in the EPDS scale 6 weeks post-partum and having a personality disorder, run a higher risk for depression at 1-year follow-up.

  13. Current aspects of the diagnosis, treatment, and follow-up of children with type I galactosemia

    Directory of Open Access Journals (Sweden)

    S. Ya. Volgina

    2015-01-01

    Full Text Available The paper considers the topical problems arising in children with the most severe form of type I galactosemia. It describes the specific features of neonatal screening for galactosemia. Diagnostic criteria for the classic, clinical, and biochemical variants of galactosemia are presented. The basic characteristics of the clinical picture and late sequels of the disease are identified. Particular emphasis is placed on management tactics for ill children via dietary correction, complication treatments, preventive measures, and a follow-up.

  14. Orthodontic Treatment of Binder Syndrome: A Case Report With 5 Years of Follow-up.

    Science.gov (United States)

    Cossellu, Gianguido; Biagi, Roberto; Faggioni, Giulia; Farronato, Giampietro

    2015-07-01

    We report here the case of orthodontic nonsurgical treatment in a patient with Binder syndrome. This rare syndrome (orthodontic-surgical protocol, which includes several invasive interventions such as LeFort I or II. In this patient and early diagnosis made it possible to intervene on an orthodontic level only, thus avoiding highly invasive surgical procedures (as of a 5-year follow-up).

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

    Science.gov (United States)

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

    2016-07-01

    The follow-up after intestinal transplantation (ITX) is complex and limited to specialized centers. ITX recipients often travel all over the country to be seen in the outpatient clinic of specialized centers which is costly and time-consuming. Videoconferences through Skype have been implemented to eliminate travel time, costs, and to improve patient compliance without jeopardizing safety. Eighteen of 19 patients followed up after ITX or modified multivisceral transplantation (MMVTX) in conventional outpatient clinics in Oxford agreed to attend additional Skype clinics. All patients who were followed up through Skype clinics after ITX/MMVTX received a questionnaire to measure their satisfaction with methods and technical aspects of videoconferencing as well as time/mode of traveling, travel expenses/costs, waiting time in outpatient clinic and patients' satisfaction. Mean travel distance to Oxford was 236 ± 168 miles, mean travel time was 277 ± 175 min, and mean travel cost was 200 ± 56 Great Britain Pounds. A total of 56% had to take time off work and/or find child/family care for the time spent in travel. These patients reported a satisfaction score of 4.38 ± 0.77 of 5 points as opposed to 2.88 ± 0.90 for attending the conventional outpatient clinic. Skype clinics have been proven successful and feasible in highly specialized fields like ITX in eligible patients. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Multimodal treatment in children and adolescents with attention-deficit/hyperactivity disorder: a 6-month follow-up.

    Science.gov (United States)

    Duric, Nezla S; Assmus, Jørg; Gundersen, Doris; Duric Golos, Alisa; Elgen, Irene B

    2017-07-01

    Different treatment approaches aimed at reducing attention-deficit/hyperactivity disorder (ADHD) core symptoms are available. However, factors such as intolerance, side-effects, lack of efficacy, high new technology costs, and placebo effect have spurred on an increasing interest in alternative or complementary treatment. The aim of this study is to explore efficacy of multimodal treatment consisting of standard stimulant medication (methylphenidate) and neurofeedback (NF) in combination, and to compare it with the single treatment in 6-month follow-up in ADHD children and adolescents. This randomized controlled trial with 6-month follow-up comprised three treatment arms: multimodal treatment (NF + MED), MED alone, and NF alone. A total of 130 ADHD children/adolescents participated, and 62% completed the study. ADHD core symptoms were recorded pre-/post-treatment, using parents' and teachers' forms taken from Barkley's Defiant Children: A Clinician's Manual for Assessment and Parent Training, and a self-report questionnaire. Significant ADHD core symptom improvements were reported 6 months after treatment completion by parents, teachers, and participants in all three groups, with marked improvement in inattention in all groups. However, no significant improvements in hyperactivity or academic performance were reported by teachers or self-reported by children/adolescents, respectively, in the three groups. Changes obtained with multimodal treatment at 6-month follow-up were comparable to those with single medication treatment, as reported by all participants. Multimodal treatment using combined stimulant medication and NF showed 6-month efficacy in ADHD treatment. More research is needed to explore whether multimodal treatment is suitable for ADHD children and adolescents who showed a poor response to single medication treatment, and for those who want to reduce the use of stimulant medication.

  17. Selective mutism: follow-up study 1 year after end of treatment.

    Science.gov (United States)

    Oerbeck, Beate; Stein, Murray B; Pripp, Are H; Kristensen, Hanne

    2015-07-01

    Cognitive behavioral therapy (CBT) is generally considered the recommended approach for selective mutism (SM). Prospective follow-up studies of treated SM and predictors of outcome are scarce. We have developed a CBT home and school-based intervention for children with SM previously found to increase speech in a pilot efficacy study and in a randomized controlled treatment study. In the present report we provide outcome data 1 year after having completed the 6-month course of CBT for 24 children with SM, aged 3-9 years (mean age 6.5 years, 16 girls). Primary outcome measures were the teacher rated School Speech Questionnaire (SSQ) and diagnostic status. At follow-up, no significant decline was found on the SSQ scores. Age and severity of SM had a significant effect upon outcome, as measured by the SSQ. Eight children still fulfilled diagnostic criteria for SM, four were in remission, and 12 children were without diagnosis. Younger children improved more, as 78% of the children aged 3-5 years did not have SM, compared with 33% of children aged 6-9 years. Treatment gain was upheld at follow-up. Greater improvement in the younger children highlights the importance of an early intervention.

  18. Long-term follow-up after cervical cancer treatment and subsequent successful surrogate pregnancy.

    Science.gov (United States)

    Agorastos, T; Zafrakas, M; Mastrominas, M

    2009-08-01

    Preservation of fertility is a major concern for premenopausal women after diagnosis of cervical cancer. Successful surrogate pregnancy after treatment for cervical cancer has very rarely been reported. In the present report, a case of successful surrogate pregnancy after radical hysterectomy, lymphadenectomy and ovarian transposition for cervical cancer, followed by radiation therapy, is presented. After stimulation of the transposed ovaries using the short gonadotrophin-releasing hormone (GnRH) analogue protocol, four oocytes were retrieved transabdominally from the genetic mother. IVF followed and two embryos were transferred to the surrogate mother, leading to an uneventful singleton pregnancy, and ultimately normal vaginal delivery of a healthy female infant at term. The unique aspect in this case is the long-lasting favourable outcome for both genetic mother and child, observed during 8.5 years of follow-up, the longest follow-up period reported to date in such cases.

  19. Long-Term Follow-up of Recurrence and Patient Satisfaction After Surgical Treatment of Gynecomastia.

    Science.gov (United States)

    Fricke, A; Lehner, G M; Stark, G B; Penna, V

    2017-06-01

    "Gynecomastia" is an enlargement of the male breast. Our study aims to assess patient satisfaction as well as evaluate differences in recurrence rates in lipomatous and glandular gynecomastia 10-19 years postoperatively. Forty-one gynecomastia patients undergoing surgical treatment from 1997 to 2005 were invited for a follow-up examination 10-19 years postoperatively. Of these, 16 patients presented for a clinical examination. Patient satisfaction was measured with a validated questionnaire [consultation satisfaction questionnaire (CSQ)-9]. Furthermore, photo-material and patient charts were evaluated concerning preoperative macroscopical type of gynecomastia, BMI, and operative technique. Mean follow-up time was 13.8 years (range: 10.5-19 years). Eight patients (50%) had presented with lipomatous and eight patients (50%) with glandular gynecomastia prior to surgery. One of the patients with glandular gynecomastia (12.5%) presented with recurrence at the time of follow-up, while five of the eight patients showing lipomatous gynecomastia (62.5%) presented with recurrence. Interestingly, younger patient groups tend to be more satisfied with the operative treatment of gynecomastia than older patient groups, especially regarding the improvement of self-esteem. Long-term follow-up results showed that recurrence rates are significantly higher in patients with lipomatous gynecomastia than in patients with glandular gynecomastia, with BMI increase in patients with glandular and lipomatous gynecomastia showing no statistically significant differences. Furthermore, general patient satisfaction and improvement of self-esteem was higher in younger patient groups than older patient groups. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . DRKS00009630.

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

    Science.gov (United States)

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

    2011-12-01

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

  1. Follow-up at a Dutch addiction hospital and effectiveness of therapeutic community treatment.

    Science.gov (United States)

    van de Velde, J C; Schaap, G E; Land, H

    1998-06-01

    This paper reports on inpatient treatment of addicts. Attention is paid to the Therapeutic Community (TC) model employed with alcoholics. A sample of 881 patients was assessed at intake and was followed up. The results demonstrate that the patients improved on a variety of outcome measures. Some associations were found between patient variables and improvement. Treatment variables predicting a positive outcome were sustained treatment in a TC and attending AA meetings. The relative efficacy of TCs, originally created by drug users, holds for alcoholics as well. It is concluded that an important precondition to a positive treatment outcome is the continuity of the treatment process. Pursuing that continuity seems to be an excellent mediate goal for both addicts and treatment personnel.

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

    Science.gov (United States)

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

    2015-10-01

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

  3. Multidrug-resistant tuberculosis patients’ views of interventions to reduce treatment loss to follow-up

    Science.gov (United States)

    Tupasi, T.; Garfin, A. M. C. G.; Mangan, J. M.; Orillaza-Chi, R.; Naval, L. C.; Balane, G. I.; Basilio, R.; Golubkov, A.; Joson, E. S.; Lew, W-J.; Lofranco, V.; Mantala, M.; Pancho, S.; Sarol, J. N.; Blumberg, A.; Burt, D.; Kurbatova, E. V.

    2017-01-01

    SUMMARY SETTING Patients who initiated treatment for multi-drug-resistant tuberculosis (MDR-TB) at 15 Programmatic Management of Drug-resistant Tuberculosis (PMDT) health facilities in the Philippines between July and December 2012. OBJECTIVES To describe patients’ views of current interventions, and suggest changes likely to reduce MDR-TB loss to follow-up. METHODS In-depth interviews were conducted between April and July 2014 with MDR-TB patients who were undergoing treatment, had finished treatment at the time of the interview (controls), or had been lost to follow-up (LTFU). Responses were thematically analyzed. RESULTS Interviews were conducted with 182 patients who were undergoing or had completed treatment and 91 LTFU patients. Views and suggestions could be thematically categorized as approaches to facilitate adherence or address barriers to adherence. The top themes were the need for transportation assistance or improvements to the current transportation assistance program, food assistance, and difficulties patients encountered related to their medications. These themes were addressed by respectively 63%, 60%, and 32% of the participants. CONCLUSIONS A more patient-centered approach is needed to improve MDR-TB treatment adherence. Programs should strive to provide assistance that considers patient preferences, is adequate to cover actual costs or needs, and is delivered in a timely, uninterrupted manner. PMID:28157461

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

    Directory of Open Access Journals (Sweden)

    Fabrizio Bassi

    2015-01-01

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

  5. Phosphorus-32 in polycythemia vera with and without maintenance treatment. Intermediate follow-up results

    International Nuclear Information System (INIS)

    Najean, Y.; Rain, J.D.

    1995-01-01

    Three-hundred and seventy-two patients with polycythemia vera, aged 65 years or more or with a high risk of vascular complications, were openly treated between 1979 and 1994 with 32 P or a combination of 32 P plus a small maintenance dose (7,5 mg/kg/day) of hydroxy urea. Although only a small number of patients was followed long enough to allow definite conclusions, some results are already significant in this intermediary study performed in November 1994. Maintenance treatment with hydroxy urea led to a significant prolongation of the intervals between 32 P administrations and to a decreased annual mean dose of radiophosphorus. Median survival does not differ between to the two treatment groups, 10,7 years compared to 10,0 years. The rate of vascular complications did not differ between groups. At 10 years follow-up, the risk of developing (epithelial) cancer was increased in the group of patients who received maintenance treatment, 30% compared to 10%. Similarly, development of myelodysplasia, acute leukemia or lymphoma was more common in patients receiving hydroxy urea, 25% compared to 12%. Myeloid transformation of the spleen occurred with the same frequency. Our intermediate follow-up results show that addition of hydroxy urea to 32 P treatment does not change survival or vascular complications in polycythemia vera patients, but probably increases the risk of developing cancer or leukemia. (authors). 2 refs., 4 figs

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

    Directory of Open Access Journals (Sweden)

    Gülsün Yildirim

    2010-07-01

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

  7. Long-term follow-up results of 131I treatment of recurrent hyperthyroidism previously treated by subtotal thyroidectomy

    International Nuclear Information System (INIS)

    Bal, C.S.; Padhy, A.K.; Nair, P.G.

    1998-01-01

    Full text: In patients with recurrent hyperthyroidism following previous subtotal thyroidectomy for Graves' disease or toxic MNG, radioiodine therapy is often recommended. However, our knowledge of the long-term effect of 131 I in this subset of patient is limited. 47 patients presented with post surgery recurrence at thyroid clinic of Nuclear Medicine Department from 1972 to 1996. Mean age of patients at presentation was 43 years (range 23-67 years), 10 were males and 28 had Graves' and rest toxic-MNG. Time of recurrence following surgery varied widely from 6 months to 32 years, 21% recurrent within a year and 75% before tenth year. However, 15% recurred beyond 20 years. 11 patients (23.4%) were aged more than 50 years at the time of recurrence. 34 patients (72%) needed single dose of 131 I (mean dose 288 MBq and range 107 - 740 MBq) and remaining 13 patients multiple doses of 131 I, to be free of thyrotoxicosis (7 patients: 2 doses, 3 patients: 3 doses, 2 patients: 4 doses and the last one 5 doses). 38 patients required ≤370 MBq for this purpose. One individual needed the maximum which was 1480 MBq in divided doses to be euthyroid. The maximum duration of follow-up was 26 years with mean follow up of 10 years. 5 patients were lost to follow-up after their 131 I therapy. The end point considered was confirmed hypothyroidism or euthyroidism in the last visit. 26 patients (62%) were euthyroid and 16 (38%) were hypothyroid after 10 years of mean follow-up period. However, hypothyroidism at the end of one year was in eleven patients (26%). Comparing age, sex, type of gland, time of 131 I treatment and RAIU matched non-operated thyrotoxic patients revealed hypothyroidism rate at first year was 9% and cumulative hypothyroidism after 9.8 years of follow-up (ranging 1-26 years) 36%. This study reveals 15% of patients recur even after 20 years, indicating life-long follow-up after thyroidectomy. The 131 I treatment in these patients shows high initial hypothyroidism rate

  8. Long-term follow-up of treatment for synthetic mesh complications.

    Science.gov (United States)

    Hansen, Brooke L; Dunn, Guinn Ellen; Norton, Peggy; Hsu, Yvonne; Nygaard, Ingrid

    2014-01-01

    The objectives of this study are (1) to describe the presenting symptoms, findings, and treatment and (2) to describe the self-reported improvement and function at least 6 months after presentation in women presenting to 1 urogynecology division for complications associated with synthetic vaginal mesh. Women evaluated between 2006 and 2011 were identified by diagnostic codes. We abstracted information from the medical record and attempted to contact all women to complete a follow-up telephone survey questionnaire consisting of several validated instruments. A total of 111 women were evaluated for complications associated with synthetic vaginal mesh. The mean interval from index surgery was 2.4 years. Of these, 84% were referred from outside hospitals. Index surgeries included vaginal mesh kits/vaginally placed mesh (47%), midurethral mesh slings (37%), abdominally placed vaginal mesh (11%), and vaginal mesh kit with concomitantly placed mesh sling (5%). The most common complications were extrusion (65%), contraction (17%), and chronic pelvic pain (16%). A total of 98 women underwent some type of treatment (85 surgical) by urogynecologists, pelvic pain specialists, or physical therapists. Eighty-four (76%) provided follow-up information at mean interval since presentation of 2.3 years. At follow-up, the mean (SD) Pelvic Floor Distress Inventory score was 98 (67), the mean (SD) EQ-5D index score was 0.69 (0.23), and 22% reported vaginal discharge, 15% vaginal bleeding or spotting, and 45% sexual abstinence due to problems related to mesh. A total of 71% reported being overall better, whereas 29% were the same or worse. Two years after tertiary care level multidisciplinary treatment of vaginal mesh complications, many women still report symptoms that negatively impact their quality of life.

  9. Treatment and follow-up of a locked posterior shoulder dislocation

    DEFF Research Database (Denmark)

    Schmal, Hagen; Klemt, Christof; Südkamp, Norbert P.

    2004-01-01

    Posterior shoulder dislocation appears to be a rare event and is a frequently overlooked problem in traumatology. Once the diagnosis is made, usually by clinical examination and use of conventional radiography, head damage should be evaluated by an arthro-CT of the shoulder. In case of severe...... humeral head damage and advanced age, arthroplasty of the shoulder seems to provide a reliable treatment method. Implantation of a new-generation prosthesis in a female patient and follow-up by assessment using the Constant-Murley score are described. © Urban & Vogel....

  10. Treatment of Odontogenic Myxoma: A Multidisciplinary Approach—6-Year Follow-Up Case

    Directory of Open Access Journals (Sweden)

    João Gustavo Oliveira de Souza

    2014-01-01

    Full Text Available The most aggressive diseases that affect the oral environment are considered tumors of the jaw. The surgical treatment is preferably done by surgical resection of the lesion, resulting in a great loss of tissue and esthetics. Multidisciplinary planning is required for the rehabilitation of these cases. Autogenous grafting techniques or vascularized flaps allow ridge reconstruction for implant placement, restoring function, and esthetics. This paper reports a 6-year follow-up case of an odontogenic myxoma treated with wide resection and mandibular bone reconstruction for posterior rehabilitation with dental implants.

  11. Ten-Year Follow-Up of Endovascular Aneurysm Treatment with Talent Stent-Grafts

    International Nuclear Information System (INIS)

    Pitton, Michael B.; Scheschkowski, Tobias; Ring, Markus; Herber, Sascha; Oberholzer, Katja; Leicher-Dueber, Annegret; Neufang, Achim; Schmiedt, Walther; Dueber, Christoph

    2009-01-01

    The purpose of this study was to evaluate the clinical results, complications, and secondary interventions during long-term follow-up after endovascular aneurysm repair (EVAR) and to investigate the impact of endoleak sizes on aneurysm shrinkage. From 1997 to March 2007, 127 patients (12 female, 115 male; age, 73.0 ± 7.2 years) with abdominal aortic aneurysms were treated with Talent stent-grafts. Follow-up included clinical visits, contrast-enhanced MDCT, and radiographs at 3, 6, and 12 months and then annually. Results were analyzed with respect to clinical outcome, secondary interventions, endoleak rate and management, and change in aneurysm size. There was no need for primary conversion surgery. Thirty-day mortality was 1.6% (two myocardial infarctions). Procedure-related morbidity was 2.4% (paraplegia, partial infarction of one kidney, and inguinal bleeding requiring surgery). Mean follow-up was 47.7 ± 34.2 months (range, 0-123 months). Thirty-nine patients died during follow-up; three of the deaths were related to aneurysm (aneurysm rupture due to endoleak, n = 1; secondary surgical reintervention n = 2). During follow-up, a total of 29 secondary procedures were performed in 19 patients, including 14 percutaneous procedures (10 patients) and 15 surgical procedures (12 patients), including 4 cases with late conversion to open aortic repair (stent-graft infection, n = 1; migration, endoleak, or endotension, n = 3). Overall mean survival was 84.5 ± 4.7 months. Mean survival and freedom from any event was 66.7 ± 4.5 months. MRI depicted significantly more endoleaks compared to MDCT (23.5% vs. 14.3%; P 10% of the aneurysm area were associated with reduced aneurysm shrinkage compared to no endoleaks or <10% endoleaks (Δ at 3 years, -1.8% vs. -12.0%; P < 0.05). In conclusion, endovascular aneurysm treatment with Talent stent-grafts demonstrated encouraging long-term results with moderate secondary intervention rates. Primary occlusion of all aortic side

  12. Evaluating adherence to the Dutch guideline for diagnosis, treatment and follow-up of laryngeal carcinomas

    International Nuclear Information System (INIS)

    Agthoven, Michel van; Heule-Dieleman, Helene A.G.; Boer, Maarten F. de; Kaanders, Johannes H.A.M.; Baatenburg de Jong, Robert J.; Kremer, Bernd; Rene Leemans, C.; Marres, Henri A.M.; Manni, Johannes J.; Langendijk, Johannes A.; Levendag, Peter C.; Tjho-Heslinga, Reina E.; Jong, Joseph M.A. de; Uyl-de Groot, Carin A.; Knegt, Paul P.

    2005-01-01

    Background and purpose: An evidence-based clinical practice guideline for laryngeal carcinomas was introduced in the Netherlands late 1999. The objective of this guideline was to ensure uniformity in the diagnosis, treatment, and follow-up. We retrospectively evaluated whether clinical practice changed according to the recommendations of this guideline and whether it succeeded in its aim. Material and methods: In five out of eight Dutch university hospitals, chart data of 459 patients treated before the guideline introduction were compared to data of 363 patients treated after the guideline introduction. Results: Patient and tumour characteristics were comparable among both groups. In general, the guideline recommendations were properly complied with. The patients treated before the guideline introduction were actually also for a large part already treated according to the guideline's recommendations. After its introduction, several changes according to the guideline were observed: increased rates of reassessment of biopsy samples taken in local hospitals, psychological screening (although still only performed in 10.5% of patients), application of accelerated radiotherapy schedules, clinical trial treatments, function-preserving treatments, and decreased rates of total laryngectomy, and annual chest X-rays during follow-up. Conclusions: Although a causal relationship cannot be established in this kind of observational studies, several positive changes were observed after the introduction of the guideline, and therefore the guideline seems to have contributed to more uniformity. The largest changes were seen for the guideline recommendations based on the highest levels of evidence

  13. Treatment adherence in heart failure patients followed up by nurses in two specialized clinics

    Science.gov (United States)

    da Silva, Andressa Freitas; Cavalcanti, Ana Carla Dantas; Malta, Mauricio; Arruda, Cristina Silva; Gandin, Thamires; da Fé, Adriana; Rabelo-Silva, Eneida Rejane

    2015-01-01

    Objectives: to analyze treatment adherence in heart failure (HF) patients followed up by the nursing staff at specialized clinics and its association with patients' characteristics such as number of previous appointments, family structure, and comorbidities. Methods: a cross-sectional study was conducted at two reference clinics for the treatment of HF patients (center 1 and center 2). Data were obtained using a 10-item questionnaire with scores ranging from 0 to 26 points; adherence was considered adequate if the score was ≥ 18 points, or 70% of adherence. Results: a total of 340 patients were included. Mean adherence score was 16 (±4) points. Additionally, 124 (36.5%) patients showed an adherence rate ≥ 70%. It was demonstrated that patients who lived with their family had higher adherence scores, that three or more previous nursing appointments was significantly associated with higher adherence (p<0.001), and that hypertension was associated with low adherence (p=0.023). Conclusions: treatment adherence was considered satisfactory in less than a half of the patients followed up at the two clinics specialized in HF. Living with the family and attending to a great number of nursing appointments improved adherence, while the presence of hypertension led to worse adherence. PMID:26487139

  14. Follow-up of neurocysticercosis patients after treatment using an antigen detection ELISA

    Directory of Open Access Journals (Sweden)

    Nguekam

    2003-03-01

    Full Text Available Seven patients with active neurocysticercosis (NCC received an eight days treatment with albendazole and were followed up using computed tomography (CT-scan and a monoclonal antibody based ELISA for the detection of circulating antigen (Ag-ELISA. Only three patients were cured as was shown by CT-scan and by the disappearance of circulating antigens one month after treatment. After a second course of albendazole therapy, two other patients became seronegative. CT-scan showed the disappearance of viable cysts in all persons who became seronegative whereas patients who were not cured remained seropositive. These preliminary results show that this Ag-ELISA is a promising technique for monitoring the success of treatment of NCC patients because of the excellent correlation between the presence of circulating antigens and of viable brain cysts.

  15. Surgical treatment of Bertolotti's syndrome. Follow-up of 16 patients.

    Science.gov (United States)

    Santavirta, S; Tallroth, K; Ylinen, P; Suoranta, H

    1993-01-01

    We surgically treated 16 patients with Bertolotti's syndrome (chronic, persistent low back pain and radiographically diagnosed transitional lumbar vertebra). Eight had posterolateral fusion and another eight resection of the transitional articulation. Thirteen patients had in addition to the chronic low back pain, suffered from repeated episodes or chronic sciatica. In six cases with resection treatment, local injections were administered at the transitional articulation before deciding for resection of the transitional joint; each patient reported transient relief of pain, while this preoperative test did not correlate with successful outcome of treatment. Six patients had to be treated with second operations. Ten of the 16 operatively treated patients showed improvement of the low back pain, and this result was similar in the group treated with fusion and in that treated with resection. Seven had no low back pain at follow-up, and the improvement according to the Oswestry pain scale was similar in the two groups, and statistically significant. Eleven patients still had persisting episodes of sciatica (versus 13 preoperatively). The average disability according to the Oswestry total disability scale was 30%, corresponding with moderate outcome, and both operatively treated groups did equally well. At follow-up the first disc above the fused segments was found to be degenerated in seven out of eight cases, and in the group treated with resection the first disc above the transitional vertebra was degenerated in five cases.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. [Post-gastrectomy reconstruction versus enteral alimentation--a one year follow-up study].

    Science.gov (United States)

    Kostov, D; Balabanova, G; Vasilev, B; Plachkov, I; Ignatov, G

    2000-01-01

    This is a report on various post-gastrectomy reconstructive procedures, proceeding from personal experience had with 14 patients undergoing gastrectomy for carcinoma of the stomach and five patients with operations of esophagus and stomach for various pathological conditions. An assessment is done of the reconstructive methods used on the ground of objective indicators. All patients are subjected to enteral alimentation through nutritive jejunostomy. In the pre- and postoperatived periods, the trophic state of patients is evaluated on basis of biochemical, anthropometric and immunologic study data. Postoperatively, in those with small-intestinal reservoir a lower degree negative symptomatology is established, along with life style improvement. Post-gastrectomy patients presenting I-II (UICC) stage of the oncological disease are indicated for small-intestinal reservoir formation. In the overall therapeutic approach to post-gastrectomy patients adequate clinical therapeutic feeding proves absolutely indispensable.

  17. Stability of orthodontic treatment outcome in relation to retention status: An 8-year follow-up.

    Science.gov (United States)

    Steinnes, Jeanett; Johnsen, Gunn; Kerosuo, Heidi

    2017-06-01

    Our aim was to evaluate the stability of orthodontic treatment outcome and retention status 7 or more years after active treatment in relation to posttreatment or postretention time, type of retention appliance, and duration of retainer use. The subjects were former patients who completed orthodontic treatment with fixed appliances from 2000 to 2007. The pretreatment eligibility criteria were anterior crowding of 4 mm or more in the maxilla or the mandible and Angle Class I or Class II sagittal molar relationship. Acceptable pretreatment and posttreatment dental casts were required. A total of 67 patients participated, 24 men and 43 women, with a mean age of 24.7 years (range, 20.0-50.0 years). All participants had a follow-up clinical examination, which included impressions for follow-up casts, and each completed a questionnaire. Data were obtained from pretreatment, posttreatment, and follow-up (T2) casts as well as from the patients' dental records. Treatment stability was evaluated with the peer assessment rating (PAR) index and Little's irregularity index. The participation rate was 64%. The average posttreatment time was 8.5 years (range, 7.0-11.0). All participants had received a retainer in the mandible, maxilla, or both after active treatment. At T2, the PAR score showed a mean relapse of 14%. The majority (78%) of participants still had a fixed retainer at T2 (retainer group), and 22% had been out of retention for at least 1 year (postretention group). The relapse according to the PAR did not differ significantly between participants with and without a retainer at T2. From posttreatment to T2, the irregularity of the mandibular incisors increased almost 3 times more in participants with no retainer in the mandible compared with those with an intact retainer at T2 (P = 0.001). In the maxilla, no corresponding difference was found. Our results suggest that occlusal relapse can be expected after active orthodontic treatment irrespective of long

  18. Post-stroke epilepsy in young adults: a long-term follow-up study

    NARCIS (Netherlands)

    Arntz, R.M.; Rutten-Jacobs, L.C.A.; Maaijwee, N.A.M.M.; Schoonderwaldt, H.C.; Dorresteijn, L.D.A.; Dijk, E.J. van; Leeuw, F.E. de

    2013-01-01

    BACKGROUND: Little is known about the incidence and risk of seizures after stroke in young adults. Especially in the young seizures might dramatically influence prognosis and quality of life. We therefore investigated the long-term incidence and risk of post-stroke epilepsy in young adults with a

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

    DEFF Research Database (Denmark)

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

    1987-01-01

    The effect of intranasal LH-RH on cryptorchidism was investigated in 45 prepubertal boys with 68 undescended testes. A daily dose of 1.2 mg LH-RH was given for 4 weeks. A total of 16 testes (24%) descended. Follow-up examination 5 years later showed that relapse had occurred in two cases. Fifty......-two testes did not descend during the LH-RH treatment. However, seven of these testes descended spontaneously during puberty. So far surgical treatment has been carried out in 39 of the remaining 45 testes. Anatomical anomalies (ectopic position of the testis, open processus vaginalis, abnormal epididymis......) explained the failure of LH-RH to cause descent in the majority of the surgically treated cases....

  20. Four-year follow-up study of pharmacological treatment in pathological gamblers.

    Science.gov (United States)

    Rosenberg, Oded; Dinur, Limor Klein; Dannon, Pinhas N

    2013-01-01

    In the past decade, we have witnessed the emergence of pharmacological treatments for pathological gambling with some success but many question marks. We aimed to explore pharmacological treatments that have been previously explored with some success, with the intent of comparing their efficacy and pave the way to larger placebo-controlled trials. In this study, we allocated 78 patients to 4 different types of psychotropic medications: naltrexone, topiramate, bupropion, and escitalopram. We treated patients for more than 2 years, with additional 2-year follow-ups without medication. The sample was evaluated using the 21-item Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Global Assessment of Functioning, and the Visual Analog Scale to measure general well-being before enrollment as well as at 1 month, 6 months, 24 months, and 48 months after beginning medication treatment. During the first 2 years of treatment, 34 patients dropped out, with one more dropping out during the additional 2 years of follow-up. Significant improvement on all rating scales was seen in all groups after 2 years, except HAMD in the group that received topiramate. We found the naltrexone-treated group of patients to have a statistically significant lower dropout rate compared with other groups, statistically significant lower HAMD scores in comparison to the group treated with bupropion, statistically significant lower Hamilton Anxiety Rating Scale score compared to the groups treated with escitalopram and topiramate, and significantly higher Visual Analog Scale scores compared to the groups treated with bupropion and topiramate. Pathological gambling is essentially a biopsychological disorder that may be attenuated provided that patients adhere to medication. In our study, among 4 medications with different mechanisms of action, naltrexone was found to be the most effective. Placebo-controlled studies involving large numbers of subjects are required before

  1. A multidisciplinary treatment of congenitally missing maxillary lateral incisors: a 14-year follow-up case report

    Science.gov (United States)

    de ALMEIDA, Renato Rodrigues; MORANDINI, Ana Carolina Faria; de ALMEIDA-PEDRIN, Renata Rodrigues; de ALMEIDA, Marcio Rodrigues; CASTRO, Renata Cristina Faria Ribeiro; INSABRALDE, Natalia Martins

    2014-01-01

    Absence of the maxillary lateral incisor creates an aesthetic problem which can be managed in various ways. The condition requires careful treatment planning and consideration of the options and outcomes following either space closure or prosthetic replacement. Recent developments in restorative dentistry have warranted a re-evaluation of the approach to this clinical situation. Factors relating both to the patient and the teeth, including the presentation of malocclusion and the effect on the occlusion must be considered. The objective of this study was to describe the etiology, prevalence and alternative treatment modalities for dental agenesis and to present a clinical case of agenesis of the maxillary lateral incisors treated by the closure of excessive spaces and canine re-anatomization. A clinical case is presented to illustrate the interdisciplinary approach between orthodontics and restorative dentistry for improved esthetic results. In this report, the treatment of a girl with a Class II malocclusion of molars and canines with missing maxillary lateral incisors and convex facial profile is shown. Treatment was successfully achieved and included the space closure of the areas corresponding to the missing upper lateral incisors, through movement of the canines and the posterior teeth to mesial by fixed appliances as well as the canines transformation in the maxillary lateral incisors. This is a 14-year follow-up case report involving orthodontics and restorative dentistry in which pretreatment, post-treatment, and long-term follow-up records for the patient are presented. PMID:25466480

  2. Treatment of the Mal de Debarquement Syndrome: A 1-Year Follow-up

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    Mingjia Dai

    2017-05-01

    Full Text Available The mal de debarquement syndrome (MdDS is a movement disorder, occurring predominantly in women, is most often induced by passive transport on water or in the air (classic MdDS, or can occur spontaneously. MdDS likely originates in the vestibular system and is unfamiliar to many physicians. The first successful treatment was devised by Dai et al. (1, and over 330 MdDS patients have now been treated. Here, we report the outcomes of 141 patients (122 females and 19 males treated 1 year or more ago. We examine the patient’s rocking frequency, body drifting, and nystagmus. The patients are then treated according to these findings for 4–5 days. During treatment, patients’ heads were rolled while watching a rotating full-field visual surround (1. Their symptom severity after the initial treatment and at the follow-up was assessed using a subjective 10-point scale. Objective measures, taken before and at the end of the week of treatment, included static posturography. Significant improvement was a reduction in symptom severity by more than 50%. Objective measures were not possible during the follow-up because of the wide geographic distribution of the patients. The treatment group consisted of 120 classic and 21 spontaneous MdDS patients. The initial rate of significant improvement after a week of treatment was 78% in classic and 48% in spontaneous patients. One year later, significant improvement was maintained in 52% of classic and 48% of spontaneous subjects. There was complete remission of symptoms in 27% (32 of classic and 19% (4 of spontaneous patients. Although about half of them did not achieve a 50% improvement, most reported fewer and milder symptoms than before. The success of the treatment was generally inversely correlated with the duration of the MdDS symptoms and with the patients’ ages. Prolonged travel by air or car on the way home most likely contributed to the symptomatic reversion from the initial successful treatment

  3. Treatment of selective mutism: a 5-year follow-up study.

    Science.gov (United States)

    Oerbeck, Beate; Overgaard, Kristin Romvig; Stein, Murray B; Pripp, Are Hugo; Kristensen, Hanne

    2018-01-22

    Selective mutism (SM) has been defined as an anxiety disorder in the diagnostic and statistical manual of mental disorders (DSM-5). Cognitive behavioral therapy (CBT) is the recommended approach for SM, but prospective long-term outcome studies are lacking. Reports from the children themselves, and the use of more global quality of life measures, are also missing in the literature. We have developed a school-based CBT intervention previously found to increase speech in a pilot efficacy study and a randomized controlled treatment study. Continued progress was found in our 1-year follow-up studies, where older age and more severe SM had a significant negative effect upon outcome. In the present study, we provide 5-year outcome data for 30 of these 32 children with SM who completed the same CBT for mean 21 weeks (sd 5, range 8-24) at mean age 6 years (10 boys). Mean age at the 5-year follow-up was 11 years (range 8-14). Outcome measures were diagnostic status, the teacher- and parent-rated selective mutism questionnaires, and child rated quality of life and speaking behavior. At the 5-year follow-up, 21 children were in full remission, five were in partial remission and four fulfilled diagnostic criteria for SM. Seven children (23%) fulfilled criteria for social phobia, and separation anxiety disorder, specific phobia and/or enuresis nocturna were found in a total of five children (17%). Older age and severity at baseline and familial SM were significant negative predictors of outcome. Treatment gains were maintained on the teacher- and parent questionnaires. The children rated their overall quality of life as good. Although most of them talked outside of home, 50% still experienced it as somewhat challenging. These results point to the long-term effectiveness of CBT for SM, but also highlight the need to develop more effective interventions for the subset of children with persistent symptoms.Clinical trials registration NCT01002196.

  4. Risk-adapted treatment and follow-up management in childhood-onset craniopharyngioma.

    Science.gov (United States)

    Müller, Hermann L

    2016-05-01

    Craniopharyngiomas are rare embryonic malformations of the sellar/parasellar region with low histological grade. Here, we review findings on the diagnosis, treatment, clinical course, follow-up, and prognosis of craniopharyngioma patients. Clinical manifestations develop from increased intracranial pressure, anterior visual pathway damage, and hypothalamic/pituitary deficiencies. If the tumor is favorably localized (no anatomical involvement with the hypothalamic and optical structures) therapy of choice is complete resection, meticulously performed to preserve hypothalamic and optic functions. In patients with unfavorable tumor involvement, optimal therapy is limited hypothalamus-sparing surgical strategy, followed by judicious irradiation dosage to minimize recurrences and progression. Surgical lesions and/or anatomical involvement of posterior hypothalamic areas result in serious sequelae, mainly hypothalamic syndrome. Craniopharyngioma is a chronic disease and must be managed as such, providing ongoing care of pediatric and adult patients by experienced multidisciplinary teams in the context of multicenter trials.

  5. Treatment and follow-up of a case of bleeding duodenal varix

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    Viveksandeep Thoguluva Chandrasekar

    2013-01-01

    Full Text Available Duodenal varices (DV are rare in patients with portal hypertension secondary to liver disease. Their tendency to bleed is less common than in gastroesophageal varices, but can sometimes produce a life-threatening bleed. They are often difficult to diagnose and treat. We present a case of a 35-year-old man with parenchymal liver disease admitted with complaints of hematemesis and melena. Upper gastrointestinal endoscopy was performed and a duodenal varix, with stigmata of a recent bleed, was noted in the second part of the duodenum. Five milliliters of N-butyl-2-cyanoacrylate glue was injected into the varix leading to obliteration. A follow-up study with an endoscopic ultrasound and repeat endoscopy showed near total obturation of the varix and success of the therapy. This report concludes that glue injection can effectively be used as a first-line treatment for bleeding duodenal varices.

  6. The standard diagnosis, treatment, and follow-up of gastrointestinal stromal tumors based on guidelines.

    Science.gov (United States)

    Nishida, Toshirou; Blay, Jean-Yves; Hirota, Seiichi; Kitagawa, Yuko; Kang, Yoon-Koo

    2016-01-01

    Although gastrointestinal stromal tumors (GISTs) are a rare type of cancer, they are the commonest sarcoma in the gastrointestinal tract. Molecularly targeted therapy, such as imatinib therapy, has revolutionized the treatment of advanced GIST and facilitates scientific research on GIST. Nevertheless, surgery remains a mainstay of treatment to obtain a permanent cure for GIST even in the era of targeted therapy. Many GIST guidelines have been published to guide the diagnosis and treatment of the disease. We review current versions of GIST guidelines published by the National Comprehensive Cancer Network, by the European Society for Medical Oncology, and in Japan. All clinical practice guidelines for GIST include recommendations based on evidence as well as on expert consensus. Most of the content is very similar, as represented by the following examples: GIST is a heterogeneous disease that may have mutations in KIT, PDGFRA, HRAS, NRAS, BRAF, NF1, or the succinate dehydrogenase complex, and these subsets of tumors have several distinctive features. Although there are some minor differences among the guidelines--for example, in the dose of imatinib recommended for exon 9-mutated GIST or the efficacy of antigen retrieval via immunohistochemistry--their common objectives regarding diagnosis and treatment are not only to improve the diagnosis of GIST and the prognosis of patients but also to control medical costs. This review describes the current standard diagnosis, treatment, and follow-up of GISTs based on the recommendations of several guidelines and expert consensus.

  7. Analysis and Long-Term Follow-Up of the Surgical Treatment of Children With Craniopharyngioma.

    Science.gov (United States)

    Cheng, Jing; Shao, Qiang; Pan, Zhiyong; You, Jin

    2016-11-01

    To investigate the relationship between the operative approach, clinical pathological factors, and curative effect of the surgical treatment in the patients with craniopharyngioma; to provide a theoretical basis for determining the prognosis and reducing the recurrence rate during the long-term postoperative follow-up in children. This was a retrospective analysis of the clinical data of 92 children who underwent surgical treatment in our department from May 2011 to January 2005. Long-term follow-up was performed from 12 months to 8 years. The pterional approach was used in 49 patients, the interhemispheric approach in 20 patients, the corpus callosum approach in 16 patients, and the butterfly approach in 7 patients. Pathological classification was performed by hematoxylin and eosin stain staining of the pathological tissues and evaluated according to the different surgical approaches, MRI calcification status, calcification type, pathological type, whether radiotherapy was performed, postoperative recurrence, and death. For the pterion approach resection, there was near total resection in 46 patients (93.9%) with the lowest recurrence rate. The operative approach and postoperative recurrence rates were compared; the difference was statistically significant (P 0.05). There was not a significant difference between the MRI classification and postoperative recurrence rate (P >0.05). Comparing the degree of tumor calcification with the recurrence rate after operation and the mortality rate, the difference was statistically significant (P craniopharyngioma and squamous papillary craniopharyngioma in 2 groups following operation were compared, and the differences were statistically significant (P craniopharyngioma relapse rate is higher, which could be because invasion of craniopharyngioma only occurs with adamantimous craniopharyngioma. Postoperative radiotherapy can significantly prolong the recurrence time and reduce the mortality rate of patients with

  8. Long-Term Follow-Up After Endovascular Treatment of Acute Aortic Emergencies

    International Nuclear Information System (INIS)

    Pitton, M. B.; Herber, S.; Schmiedt, W.; Neufang, A.; Dorweiler, B.; Dueber, C.

    2008-01-01

    Purpose. To investigate the long-term outcome and efficacy of emergency treatment of acute aortic diseases with endovascular stent-grafts. Methods. From September 1995 to April 2007, 37 patients (21 men, 16 women; age 53.9 ± 19.2 years, range 18-85 years) with acute complications of diseases of the descending thoracic aorta were treated by endovascular stent-grafts: traumatic aortic ruptures (n = 9), aortobronchial fistulas due to penetrating ulcer or hematothorax (n = 6), acute type B dissections with aortic wall hematoma, penetration, or ischemia (n = 13), and symptomatic aneurysm of the thoracic aorta (n = 9) with pain, penetration, or rupture. Diagnosis was confirmed by contrast-enhanced CT. Multiplanar reformations were used for measurement of the landing zones of the stent-grafts. Stent-grafts were inserted via femoral or iliac cut-down. Two procedures required aortofemoral bypass grafting prior to stent-grafting due to extensive arteriosclerotic stenosis of the iliac arteries. In this case the bypass graft was used for introduction of the stent-graft. Results. A total of 46 stent-grafts were implanted: Vanguard/Stentor (n = 4), Talent (n = 31), and Valiant (n = 11). Stent-graft extension was necessary in 7 cases. In 3 cases primary graft extension was done during the initial procedure (in 1 case due to distal migration of the graft during stent release, in 2 cases due to the total length of the aortic aneurysm). In 4 cases secondary graft extensions were performed-for new aortic ulcers at the proximal stent struts (after 5 days) and distal to the graft (after 8 months) and recurrent aortobronchial fistulas 5 months and 9 years after the initial procedure-resulting in a total of 41 endovascular procedures. The 30-day mortality rate was 8% (3 of 37) and the overall follow-up was 29.9 ± 36.6 months (range 0-139 months). All patients with traumatic ruptures demonstrated an immediate sealing of bleeding. Patients with aortobronchial fistulas also demonstrated a

  9. Clinical Simulation in Psychiatric-Mental Health Nursing: Post-Graduation Follow Up.

    Science.gov (United States)

    Lilly, Mary LuAnne; Hermanns, Melinda; Crawley, Bill

    2016-10-01

    In psychiatric-mental health, creating an innovative strategy to help students learn content that may not be frequently seen in a clinical setting is challenging. Thus, simulation helps narrow this gap. Using Kirkpatrick and Kirkpatrick's model of evaluation to guide the current study, faculty contacted baccalaureate nursing program graduates who completed a psychiatric-mental health clinical simulation scenario featuring a hanging suicide and wrist cutting suicide attempt scenario in the "Behind the Door" series as part of the clinical component of their undergraduate psychiatric-mental health course. Eleven nurses responded to a survey regarding their post-graduate encounters with these types of clinical situations, and their perception of recall and application of knowledge and skills acquired during the simulation experience to the clinical situation. Nursing graduates' responses are expressed through three major themes: emotional, contextual/behavioral, and assessment outcomes. Data from the survey indicate that nursing graduates perceived the "Behind the Door" simulations as beneficial to nursing practice. This perception is important in evaluating knowledge transfer from a simulation experience as a student into application in nursing practice. [Journal of Psychosocial Nursing and Mental Health Services, 54(10), 40-45.]. Copyright 2016, SLACK Incorporated.

  10. Measures and time points relevant for post-surgical follow-up in patients with inflammatory arthritis: a pilot study

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    Tägil Magnus

    2009-05-01

    Full Text Available Abstract Background Rheumatic diseases commonly affect joints and other structures in the hand. Surgery is a traditional way to treat hand problems in inflammatory rheumatic diseases with the purposes of pain relief, restore function and prevent progression. There are numerous measures to choose from, and a combination of outcome measures is recommended. This study evaluated if instruments commonly used in rheumatologic clinical practice are suitable to measure outcome of hand surgery and to identify time points relevant for follow-up. Methods Thirty-one patients (median age 56 years, median disease duration 15 years with inflammatory rheumatic disease and need for post-surgical occupational therapy intervention formed this pilot study group. Hand function was assessed regarding grip strength (Grippit, pain (VAS, range of motion (ROM (Signals of Functional Impairment (SOFI and grip ability (Grip Ability Test (GAT. Activities of daily life (ADL were assessed by means of Disabilities of the Arm, Shoulder and Hand Outcome (DASH and Canadian Occupational Performance Measure (COPM. The instruments were evaluated by responsiveness and feasibility; follow-up points were 0, 3, 6 and 12 months. Results All instruments showed significant change at one or more follow-up points. Satisfaction with activities (COPM showed the best responsiveness (SMR>0.8, while ROM measured with SOFI had low responsiveness at most follow-up time points. The responsiveness of the instruments was stable between 6 and 12 month follow-up which imply that 6 month is an appropriate time for evaluating short-term effect of hand surgery in rheumatic diseases. Conclusion We suggest a core set of instruments measuring pain, grip strength, grip ability, perceived symptoms and self-defined daily activities. This study has shown that VAS pain, the Grippit instrument, GAT, DASH symptom scale and COPM are suitable outcome instruments for hand surgery, while SOFI may be a more insensitive

  11. Psilocybin with psychological support for treatment-resistant depression: six-month follow-up.

    Science.gov (United States)

    Carhart-Harris, R L; Bolstridge, M; Day, C M J; Rucker, J; Watts, R; Erritzoe, D E; Kaelen, M; Giribaldi, B; Bloomfield, M; Pilling, S; Rickard, J A; Forbes, B; Feilding, A; Taylor, D; Curran, H V; Nutt, D J

    2018-02-01

    Recent clinical trials are reporting marked improvements in mental health outcomes with psychedelic drug-assisted psychotherapy. Here, we report on safety and efficacy outcomes for up to 6 months in an open-label trial of psilocybin for treatment-resistant depression. Twenty patients (six females) with (mostly) severe, unipolar, treatment-resistant major depression received two oral doses of psilocybin (10 and 25 mg, 7 days apart) in a supportive setting. Depressive symptoms were assessed from 1 week to 6 months post-treatment, with the self-rated QIDS-SR16 as the primary outcome measure. Treatment was generally well tolerated. Relative to baseline, marked reductions in depressive symptoms were observed for the first 5 weeks post-treatment (Cohen's d = 2.2 at week 1 and 2.3 at week 5, both p psilocybin. Reductions in depressive symptoms at 5 weeks were predicted by the quality of the acute psychedelic experience. Although limited conclusions can be drawn about treatment efficacy from open-label trials, tolerability was good, effect sizes large and symptom improvements appeared rapidly after just two psilocybin treatment sessions and remained significant 6 months post-treatment in a treatment-resistant cohort. Psilocybin represents a promising paradigm for unresponsive depression that warrants further research in double-blind randomised control trials.

  12. Constipation in early childhood: patient characteristics, treatment, and longterm follow up.

    Science.gov (United States)

    Loening-Baucke, V

    1993-10-01

    Little is known about chronic constipation in infants, toddlers, and preschool children and longterm outcome after treatment. The symptoms of 174 children milk of magnesia, and finally toilet training of the preschool child. Longterm outcome could be evaluated in 90 patients (52%) (mean (SD) 6.9 (2.7)) years after initial evaluation. Fifty seven children (63%) had recovered, defined as no soiling with > or = 3 bowel movements per week, while not receiving treatment. The recovery rate of children 2 to 4 years of age. Thirty three children (37%) had not recovered. Constipation recurred as soon as laxatives were discontinued in 31 (94%) of them. Laxatives were still used by 33% of the children who had not recovered, 39% had < 3 bowel movements per week, 48% had faecal soiling, 45% had stool withholding, 27% complained of abdominal pain, 73% passed large stools, and 45% still on occasions clogged the toilet with their large stools. Symptoms of chronic constipation persisted in one third of our patients, 3-12 years after initial evaluation and treatment. Children who had not recovered deserve continued follow up, to reinforce and adjust treatment and to prevent faecal soiling.

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

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    Lina Bollani

    2014-01-01

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

  14. Long term follow-up observation of /sup 131/Iodine treatment of hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Kao, Y.; Liu, Y.; Ch' en, C.

    1977-07-20

    This paper reports the 5 to 13 years follow-up conditions of 241 cases of hyperthyroidism treated with /sup 131/iodine, with emphasis on the side-effect of incidence of hypothyroidism. Of the group, 192 cases were cured; 25 cases were improved; there were 3 cases of recurrence and 5 cases remained the same as before the treatment. Hypothyroidism yroidism occurred to the remaining 16 cases. The rate of incidence of hypothyroidism at the end of one year after treatment was 3.3%; at the end of 9 years 9.5%, with an average yearly increase of 0.8%. In foreign countries, the reported yearly increase rate of hypothyroidism has been reported to be 1 to 6%, and the ten-year aggregate may be as high as 30.2 to 70%, much higher than the observed data here reported. There was no incidence of thyroid nodules, cancer, or leukemia among the group of 241 cases treated with /sup 131/iodine, and the reproductive capacity was not observed to be affected by the treatment.

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

    NARCIS (Netherlands)

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

    2006-01-01

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

  16. Sequential treatment for proctalgia fugax. Mid-term follow-up.

    Science.gov (United States)

    Gracia Solanas, J A; Ramírez Rodríguez, J M; Elía Guedea, M; Aguilella Diago, V; Martínez Díez, M

    2005-07-01

    Proctalgia fugax (PF) is a benign, self-limiting disease characterized by episodes of intense anorectal pain at frequent intervals in the absence of organic proctological disease. Even though PF was described more than a century ago, its etiology remains unclear. Currently there is no information available. Few papers quoting many ways of management have been published. The aim of this study was to investigate patients complaining of this condition and to treat them with sequential therapy. We devised a descriptive, prospective study of patients complaining of acute perianal pain--duration less than 30 minutes--without organic disease or previous perianal surgery since 1996 to 2002 in our Department. We treated these patients using a three-step treatment (1: information, hip bath, benzodiazepines; 2: sublingual nifedipine 10 mg, or topic 0.1% nitroglycerin on demand; 3: internal anal sphincterotomy if hypertrophy of the internal anal sphincter was demonstrated by anal ultrasonography and no improvement was confirmed with the previous steps of treatment). We defined remarkable improvement as a decrease in the number of episodes by half or in pain intensity by 50%. Fifteen patients with an average follow-up of 4 years. Anal endosonography confirmed a grossly thickened internal anal sphincter (IAS) in 5 cases. After the first step of treatment 7 patients improved and 1 patient was cured; after the second step of treatment 3 patients improved and 1 was cured; the third step was applied to 3 patients with a thickened IAS; 1 patient improved and 1 patient was cured. A total resolution of PF is not always possible, but we may improve symptoms and their frequency. Almost 50% of patients in our series improved with the first step of treatment; 30% of our patients had IAS hypertrophy. Anal endosonography can help in the diagnosis of organic diseases or IAS hypertrophy, for which we can perform an internal anal sphincter myectomy.

  17. Nucleoplasty in the Treatment of Lumbar Diskogenic Back Pain: One Year Follow-Up

    International Nuclear Information System (INIS)

    Masala, Salvatore; Massari, Francesco; Fabiano, Sebastiano; Ursone, Antonio; Fiori, Roberto; Pastore, Francesco; Simonetti, Giovanni

    2007-01-01

    Purpose. The spine is an important source of pain and disability, affecting two thirds of adults at some time in their lives. Treatment in these patients is mainly conservative medical management, based on medication, physical therapy, behavioral management, and psychotherapy, surgery being limited to elective cases with neurologic deficits. This study was carried out to evaluate the efficacy of percutaneous nucleoplasty in patients affected by painful diskal protrusions and contained herniations. Methods. From February 2004 to October 2005, 72 patients (48 men, 24 women; mean age 48 years) affected by lumbar disk herniation were treated with nucleoplasty coblation. All patients were evaluated clinically and with radiography and MRI in order to confirm the presence of lumbalgic and/or sciatalgic pain, in the absence of major neurologic deficit and with lack of response after 6 weeks of conservative management. Results. Average preprocedural pain level for all patients was 8.2 (on a visual analog scale of 1 to 10), while the average pain level at 12 months follow-up was 4.1. At the 1 year evaluation, 79% of patients demonstrated a statistically significant improvement in numeric pain scores (p < 0.01): 17% (12 patients) were completely satisfied with complete resolution of symptoms, and 62% (43 patients) obtained a good result. Conclusion. Our data indicate that nucleoplasty coblation is a promising treatment option for patients with symptomatic disk protrusion and herniation who present with lumbalgic and/or sciatalgic pain, have failed conservative therapies, and are not considered candidates for open surgery

  18. Long Term Follow-Up of Sulfur Mustard Related Bronchiolitis Obliterans Treatment

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    Hamidreza Abtahi

    2016-10-01

    Full Text Available Bronchiolitis obliterans (BO is the most remarkable pulmonary sequels of war-related sulfur mustard inhalation. There is little if any data about long-term efficacy of associated BO treatment. Five years spirometric records of three groups of patients with obstructive pulmonary diseases (asthma, COPD, BO and documented sulfur mustard inhalation were evaluated. The BO patients were treated with inhaled Seretide 125-250/25 (2 puffs BID, azithromycin (250 mg, three times/week and N-acetylcysteine (1200-1800/day. Asthma and COPD patients were treated according to existing guidelines. Seventy-three (38 asthma, 16 COPD and 19 BO patients completed the 5 years follow-up. Basal and final FEV1 in BO patients (2.69±0.81 and 2.39±0.65 respectively were not significantly different from COPD patients (2.46±0.56 and 1.96±0.76 respectively. There was also no significant difference between the yearly FEV1 decline in BO patients compared to COPD patients (60±84 cc vs. 99±79 cc respectively, P=0.163. The non-significant difference of FEV1 decline in BO compared to COPD patients suggests the effectiveness of azithromycin, inhaled steroid and N-acetyl cysteine in BO patients. Considering safety and possible effectiveness, this treatment is recommended until more data is available from controlled clinical studies.

  19. Treatment of fibromyalgia at the Maharishi Ayurveda Health Centre in Norway. A six-month follow-up study.

    Science.gov (United States)

    Rasmussen, L B; Mikkelsen, K; Haugen, M; Pripp, A H; Førre, Ø T

    2009-01-01

    Treatments offered at the Maharishi Ayurveda Health Centre in Norway are based on Maharishi Vedic medicine, which is also known as Maharishi Ayurveda. It is a consciousness based revival of the ancient Ayurvedic medicine tradition in India and is established by Maharishi Mahesh Yogi, the founder of the Transcendental Meditation (TM) technique. To conduct a pilot study of the effect of the treatment program at the Health Centre on fibromyalgia patients. Thirty-one women with diagnosed fibromyalgia received an individually designed Maharishi Vedic physiological purification therapy. All subjects received personal advice on diet based on Ayurvedic principles, including a novel approach to food into-lerance, and daily routines. In addition they were offered instruction in TM (for stress and pain management and personal development) (four subjects started), and recommended Ayurvedic herbal food products for home treatment. A modified Fibromyalgia Impact Questionnaire included a visual analogue scale for each of the seven outcomes: working ability, generalised pain, tiredness, stiffness, tiredness on arising, anxiety and depression. Pre-treatment scores were compared with scores at six-month follow-up for levels of statistical significance. Twenty-eight subjects (90%) completed the follow-up. The outcome measures were reduced by 25 to 46% by the study's endpoint: working ability (pmeditating control group the TM-subgroup showed statistically significant improvements for all outcome measures except depression. In this pilot study fibromyalgia patients undergoing treatment at Maharishi Ayurveda Health Centre in Norway showed significant improvements six months post treatment. Because fibromyalgia is considered a treatment-resistant condition, these encouraging results warrant further research.

  20. Evaluation of a follow-up protocol for patients on chloroquine and hydroxychloroquine treatment.

    Science.gov (United States)

    Sanabria, M R; Toledo-Lucho, S C

    2016-01-01

    To review the problems found after a new follow-up protocol for patients on chloroquine and hydroxychloroquine treatment. Retrospective study was conducted between May 2012 and January 2013 on the clinical files, retinographies, fundus auto-fluorescence (FAF) images, and central-10 degree visual fields (VF) of patients who were referred to the Ophthalmology Department as they had started treatment with hydroxychloroquine. One hundred twenty-six patients were included; 94.4% were referred from the Rheumatology Department and 5.6% from Dermatology. Mean age was 59.7 years, and 73.8% were women. All of them were on hydroxychloroquine treatment, and 300mg was the most frequent daily dose. Rheumatoid arthritis was the most common diagnosis (40.5%), followed by systemic lupus erythematosus (15.9%). The mean Snellen visual acuity was 0.76, and 26 patients had lens opacities. The VF were normal in 97 patients, 8 had mild to moderate defects with no definite pattern, and in 9 the results were unreliable. Of the 51 patients older than 65years, 16 (31.4%) had altered or unreliable VF. The FAF was normal in 104 patients (82.5%), and abnormal, but consistent with ophthalmoscopic features, in 12 patients (pathological myopia, age related changes, early, middle or late age-related macular degeneration). Visual fields as a reference test for the diagnosis of AP toxicity are not quite reliable for patients over 65. Therefore, the FAF is recommended as primary test, perhaps combined with another objective test, such as SD-OCT instead of VF. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  1. Splenomegaly in sarcoidosis: Frequency, treatment, prognosis and long-term follow-up

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    Pavlović-Popović Zora

    2015-01-01

    Full Text Available Introduction. The splenic involvement is common in sarcoidosis, but its real frequency is still obscure, depending doubtless on the method of splenomegaly detection. Splenomegaly may be accompanied with pain or anemia, leucopenia and thrombocytopenia. Objective. The aim of this study was to investigate the frequency of splenomegaly related to clinical characteristics of sarcoidosis and to solve the dilemma - whether to introduce medicaments, and when to perform splenectomy. Methods. The method of the study is a retrospective and prospective analysis of the patients’ material. Results. The study included 540 patients with sarcoidosis in a 20-year period. Of them, 26% had splenomegaly detected by computerized tomography screening. Splenomegaly was more frequently registered in the patients with a longer history of sarcoidosis (38%, as compared to those with a shorter history of the disease (23% (p<0.05. Splenomegaly was more frequently registered in the patients with other extrapulmonary lesions detected (33% than in those who had no extrapulmonary manifestations of sarcoidosis (17% (p<0.01. Indications, possible benefits and complications of splenectomy were analysed in 11 sarcoidosis patients undergoing this intervention for various reasons, of which the follow-up period ranged from one to 20 years. Conclusion. Splenomegaly was more frequent in chronic cases or in the patients with established sarcoid lesions of other extrapulmonary organs. The primary treatment of uncomplicated symptomatic splenic sarcoidosis includes medicamentous therapy. Occasionally, splenectomy is required. Prognostically, splenomegaly indicates an unfavorable course of the disease.

  2. Follow-up of Thalidomide treatment in patients with Hereditary Haemorrhagic Telangiectasia.

    Science.gov (United States)

    Hosman, A; Westermann, C J J; Snijder, R; Disch, F; Mummery, C L; Mager, J J

    2015-12-01

    Patients with a hereditary vascular disorder called Rendu-Osler-Weber syndrome (Hereditary Haemorrhagic Telangiectasia, HHT) haemorrhage easily due to weak-walled vessels. Haemorrhage in lungs or brain can be fatal but patients suffer most from chronic and prolonged nosebleeds (epistaxis), the frequency and intensity of which increases with age. Several years ago, it was discovered serendipitously that the drug Thalidomide had beneficial effects on the disease symptoms in several of a small group of HHT patients: epistaxis and the incidence of anaemia were reduced and patients required fewer blood transfusions. In addition, they reported a better quality of life. However, Thalidomide has significant negative side effects, including neuropathy and fatigue. We followed up all HHT patients in the Netherlands who had been taking Thalidomide at the time the original study was completed to find out (i) how many had continued taking Thalidomide and for how long (ii) the nature and severity of any side-effects and (iii) whether side-effects had influenced their decision to continue taking Thalidomide. Only a minority of patients had continued taking the drug despite its beneficial effects on their symptoms and that the side effects were the primary reason to stop. Despite symptom reduction, alternative treatments are still necessary for epistaxis in HHT patients and a large-scale clinical trial is not justified although incidental use in the most severely affected patients can be considered.

  3. Treatment of early breast cancer, a long-term follow-up study: the GOCS experience.

    Science.gov (United States)

    Iturbe, Julián; Zwenger, Ariel; Leone, José Pablo; Verdera, Palmira Perez; Vallejo, Carlos; Romero, Alberto; Perez, Juán; Machiavelli, Mario; Leone, Bernardo

    2011-01-01

    Most cases of breast cancer are diagnosed at early stage of disease; therefore, treatment is oriented to increase the disease-free interval (DFI) and overall survival (OS). The prognosis, in comparison with other malignancies, has improved in the last decades as a result of mammographic screening. The aim of the study was to report the incidence of local and distant recurrence, DFI and OS in patients (pts) with stage I and stage II breast cancer over a period of 26 years divided into three groups. From January 1978 to December 2004, 927 women with early breast cancer (EBC) were included, 350 were stage I and 577 Stage II (AJCC 2002). Patients were divided according to the year of diagnosis into three periods of 10 years: Group A (1978-1987) 135 pts, Group B (1988-1997) 412 pts, and Group C (1998-2004) 380 pts. DFI was analyzed from the date of initial diagnosis to the date of local or distant recurrence. OS was estimated from the date of initial diagnosis to the last follow-up or date of death. Median age was 51 years (28-92). Conservative surgery was performed in 69% of pts, adjuvant radiation therapy in 78%, adjuvant chemotherapy in 29%, and adjuvant hormone therapy in 18%. The median follow-up was 8.4 years (0.3-30). The mean tumor size in Group A was 2.7 cm, in Group B 2.2 cm, and in Group C 1.94 cm (p = 0.0001). The percentage of pts with stage I increased from 13% in Group A to 38% in Group B and to 47% in Group C (p = 0.0001). Local recurrence was documented in 5% of all pts, whereas 28% developed metastatic disease. The DFI and OS showed a statistically significant difference among the three groups (p = 0.005). DFI rate at 5, 10, 15, 20, and 25 years was 71%, 67%, 65%, 65%, and 64%, respectively. OS at 5, 10, 15, 20, and 25 years was 82%, 62%, 49%, 39%, and 28%, respectively. Factors that had an effect in OS demonstrated by the multivariate regression analysis were: Tumor size, ER status, and nodal involvement (p < 0.001). Clinical outcomes in EBC in our

  4. Comprehensive treatment in a case with advanced chronic periodontitis: a 15-year follow-up.

    Science.gov (United States)

    Zafiropoulos, Gregory-George; Rebbe, Jochen

    2010-01-01

    This case report describes the comprehensive treatment of generalized, advanced periodontal disease and full-mouth rehabilitation in an adult patient. Given the extensive periodontal tissue destruction, a systematic approach was needed to determine restoration possibilities and patient expectations. Subsequent oral rehabilitation was accomplished with fixed dentures in the mandible and a removable denture in the maxilla. In the maxilla, strategically important anchor teeth were replaced with implants and a palate-free horseshoe-shaped removable denture was fabricated, using telescopic crowns as abutments. This case indicates that long-term post-treatment periodontal stability can be ensured only by full patient cooperation and consistent periodontal maintenance.

  5. Change in contrast enhancement of HCC on 1-month follow-up CT after local radiotherapy: An early predictor of final treatment response

    International Nuclear Information System (INIS)

    Kim, Eun Young; Choi, Dongil; Lim, Do Hoon; Lee, Won Jae; Yoo, Byung Chul; Paik, Seung Woon

    2009-01-01

    Background: The purpose of this study was to evaluate the change in contrast enhancement of HCC on 1-month follow-up CT after local radiotherapy (RT) as an early predictor of final treatment response. Materials: Fifty patients who underwent local RT for HCCs had both pre-RT and post-RT CT scans including 1-month follow-up CT. We assessed the final treatment response by using the change in maximal tumor size on 6-12-month follow-up CT scan after RT. We also evaluated the change in tumor enhancement between pre-RT and 1-month follow-up CT scans. Results: A final treatment response was achieved in 27 (54%) of 50 patients, who showed either a complete response (n = 11) or a partial response (n = 16). Compared with non-responsive patients (n = 23), responsive patients showed a significant decrease in tumor enhancement on 1-month follow-up CT after RT in both objective and subjective analyses (each P < 0.001). Conclusion: The change in contrast enhancement of HCC seen on the 1-month follow-up CT in patients after local RT may be used as an early predictor of final treatment response.

  6. Slow-growing labyrinthine masses: contribution of MRI to diagnosis, follow-up and treatment

    International Nuclear Information System (INIS)

    Deux, J.F.; Marsot-Dupuch, K.; Tubiana, J.M.; Tran Ba Huy, P.; Sterkers, J.M.

    1998-01-01

    We report the use of MRI in the diagnosis, follow-up and therapeutic management of three cases of intralabyrinthine Schwannoma. The diagnosis was based on the history and initial and follow-up MRI findings. The main feature suggesting the diagnosis was a nodular intralabyrinthine mass of low signal intensity on T2-weighted images, and high or isointense signal on T1-weighted images (relative to cerebrospinal fluid), which showed contrast enhancement. Follow-up imaging showed growth of the tumour in one patient. One patient underwent surgery for severe tinnitus. To detect these lesions, MRI should be focussed on the inner ear, using thin-section T2-weighted and T1-weighted images before and after contrast medium. MRI allowed informed surgical planning. (orig.) (orig.)

  7. Slow-growing labyrinthine masses: contribution of MRI to diagnosis, follow-up and treatment

    Energy Technology Data Exchange (ETDEWEB)

    Deux, J F; Marsot-Dupuch, K; Tubiana, J M [Hopital Saint-Antoine, Paris (France). Service de Radiology; Ouayoun, M; Meyer, B [Service d` ORL, Hopital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, F-75012 Paris (France); Tran Ba Huy, P [Service d` ORL, Hopital Lariboisiere, 2 rue Ambroise Pare, F-75010 Paris (France); Sterkers, J M

    1998-10-01

    We report the use of MRI in the diagnosis, follow-up and therapeutic management of three cases of intralabyrinthine Schwannoma. The diagnosis was based on the history and initial and follow-up MRI findings. The main feature suggesting the diagnosis was a nodular intralabyrinthine mass of low signal intensity on T2-weighted images, and high or isointense signal on T1-weighted images (relative to cerebrospinal fluid), which showed contrast enhancement. Follow-up imaging showed growth of the tumour in one patient. One patient underwent surgery for severe tinnitus. To detect these lesions, MRI should be focussed on the inner ear, using thin-section T2-weighted and T1-weighted images before and after contrast medium. MRI allowed informed surgical planning. (orig.) (orig.) With 3 figs., 1 tab., 21 refs.

  8. Follow-up treatment effects of contingency management and motivational interviewing on substance use: A meta-analysis.

    Science.gov (United States)

    Sayegh, Caitlin S; Huey, Stanley J; Zara, Erica J; Jhaveri, Kinnari

    2017-06-01

    Motivation is an integral factor in substance use treatment and long-term recovery. However, it is unclear what role intrinsic and extrinsic motivation play across different treatment modalities. A meta-analysis (N = 84) was performed to estimate the pooled effect size of Motivational Interviewing (MI; primarily targeting intrinsic motivation) and contingency management (CM; primarily targeting extrinsic motivation) at different follow-up periods. Collapsed across all substance types, CM had a significant effect at 3-month follow-up, only. In contrast, MI had a significant effect at 6-month follow-up, only. CM had small and medium effects on multiple substances at 3-month follow-up (i.e., tobacco, marijuana, stimulants, polysubstances), but not at 6-month follow-up. MI had 1 significant medium effect at 3-month follow-up (i.e., marijuana), but several significant small effects at 6-month follow-up (i.e., alcohol, tobacco, polysubstances). This meta-analysis suggests that both CM and MI promote reductions in a range of substances, even several months after the intervention concludes. Further, these results provide some evidence that extrinsically focused CM may produce medium follow-up effects in the short run, but intrinsically focused MI may produce small but durable follow-up effects. However, this interpretation is complicated by the differences between the MI and CM studies that preclude statistical tests comparing effect sizes, and few studies assessed motivation itself. Future researchers should investigate how motivational dynamics impact lasting outcomes in substance use treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  9. Left Ventricular Deformation by Speckle Tracking Echocardiography at 2-year Follow-up in Treatment Naive Rheumatoid Arthritis Patients

    DEFF Research Database (Denmark)

    Løgstrup, Brian Bridal; Masic, D; Laurberg, Trine Bay

    2015-01-01

    -CCP titers were evaluated by standardized techniques at baseline and 2-year follow-up. We performed a novel advanced echocardiography by speckle tracking in means of global LV systolic deformation (GLS) imaging. One experienced senior rheumatologist and one experienced cardiologist performed all the clinical...... assessments as well as all the echocardiography including the LV deformation analysis at baseline and by 2-year follow-up. Results: Disease activity scores before treatment at baseline and at 2-year follow-up were respectively: number of swollen joints (28): 7.1+/-2.9 (SD) and 0.4+/-0.3, number of tender...

  10. Successful treatment for carriage of methicillin-resistant Staphylococcus aureus and importance of follow-up

    NARCIS (Netherlands)

    F.P.N. Mollema (Femke); J.A. Severin (Juliëtte); J.L. Nouwen (Jan); A. Ott (Alewijn); H.A. Verbrugh (Henri); A. Voss (Andreas)

    2010-01-01

    textabstractWith this prospective observational follow-up study of 165 methicillin-resistant Staphylococcus aureus (MRSA)-positive individuals (23 health care workers and 142 patients), we determined that our MRSA eradication therapy protocol results in a high success rate (81%). Five or more

  11. New outlook on the diagnosis, treatment and follow-up of childhood-onset craniopharyngioma.

    Science.gov (United States)

    Müller, Hermann L; Merchant, Thomas E; Puget, Stephanie; Martinez-Barbera, Juan-Pedro

    2017-05-01

    Childhood-onset craniopharyngiomas are rare embryonic tumours of low-grade histological malignancy. Novel insights into the molecular pathogenesis of human adamantinomatous craniopharyngioma have started to unveil the possibility of testing novel treatments targeting pathogenic pathways. Hypothalamic involvement and/or treatment-related lesions result in impaired physical and social functionality and in severe neuroendocrine sequelae. Quality of survival in patients with craniopharyngioma with hypothalamic involvement is impaired by severe obesity, physical fatigue and non-optimal psychosocial development. Patients with craniopharyngioma involving hypothalamic structures have reduced 20-year overall survival, but overall and progression-free survival are not related to the degree of surgical resection. Irradiation is effective in the prevention of tumour progression and recurrence. For favourably localized craniopharyngiomas, the preferred treatment of choice is to attempt complete resection with preservation of visual, hypothalamic and pituitary function. For unfavourably localized tumours in close proximity to optic and/or hypothalamic structures, a radical neurosurgical strategy attempting complete resection is not recommended owing to potential severe sequelae. As expertise has been shown to have an impact on post-treatment morbidity, medical societies should establish criteria for adequate professional expertise for the treatment of craniopharyngioma. On the basis of these criteria, health authorities should organize the certification of centres of excellence that are authorized to treat and care for patients with this chronic disease.

  12. Treatment and violent behavior in persons with first episode psychosis during a 10-year prospective follow-up study

    DEFF Research Database (Denmark)

    Langeveld, Johannes; Bjørkly, Stål; Auestad, Bjørn

    2014-01-01

    BACKGROUND: First episode psychosis (FEP) patients have an increased risk for violence and criminal activity prior to initial treatment. However, little is known about the prevalence of criminality and acts of violence many years after implementation of treatment for a first episode psychosis. AIM......: To assess the prevalence of criminal and violent behaviors during a 10-year follow-up period after the debut of a first psychosis episode, and to identify early predictors and concomitant risk factors of violent behavior. METHOD: A prospective design was used with comprehensive assessments of criminal...... follow-up period, 20% of subjects had been apprehended or incarcerated. At 10-year follow-up, 15% of subjects had exposed others to threats or violence during the year before assessment. Illegal drug use at baseline and five-year follow-up, and a longer duration of psychotic symptoms were found...

  13. Radiological evaluation of cartilage after microfracture treatment: A long-term follow-up study

    International Nuclear Information System (INIS)

    Von Keudell, A.; Atzwanger, J.; Forstner, R.; Resch, H.; Hoffelner, T.; Mayer, M.

    2012-01-01

    Introduction: Recent literature revealed good short-term results after microfracturing (MFX) of isolated focal cartilage defects in the knee joint. Study purpose was a long-term evaluation of patients who received MFX through a multimodal approach, correlating clinical scores and morphological pre- and postoperative MRI-scans. Materials and methods: Between 2000 and 2007 158 patients were treated with MFX for focal femoral or tibial defects at our department. Patients with instabilities, secondary surgical intervention, patellofemoral lesions, a plica mediopatellaris or more than one cartilage defect site and age >55 were excluded. 15 patients were included. Minimum postoperative follow-up (FU) was 18 months (18–78 m). Mean age at surgery was 45 years (27–54), mean FU-interval 48 months (18–78 m). Male to female ratio was 9:6. For clinical assessment the Knee Osteoarthritis Outcome Score (KOOS) and Lysholm Score were used, radiological evaluation was performed with radiographs and 3Tesla-MRI. Results: Clinical knee function was rated good to excellent in 1 patient, fair in 2 and poor in 10 patients. 2/15 patients received full knee replacement due to insufficient cartilage repair through MFX during FU period. Evaluation of pre- and postoperative MRI showed good cartilage repair tissue in 1 (7.7%), moderate repair in 2 (15.4%) and poor fill in 10 patients (76.9%). In these 10 patients the defect size increased. Average defect size preoperatively was 187 mm 2 (range 12–800 mm 2 ) and postoperatively 294 mm 2 (40–800 mm 2 ). The KOOS-Pain averaged 60 (39–94), KOOS-Symptoms 60.6 (21–100), KOOS-ADL 69 (21–91), KOOS-Sports 35.7 (5–60) and KOOS-QUL 37.2 (6–81). The average Lysholm Score was 73.9 (58–94). 10 patients showed a varus leg axis deviation (Ø 5.9°), 3 had a neutral alignment. The alignment correlated positively with KOOS and especially with the Lysholm Score. Conclusion: Our study demonstrated that MFX as a treatment option for cartilage

  14. Follow-up of Long-term Treatment with Clean Intermittent Catheterization for Neurogenic Bladder in Children

    Directory of Open Access Journals (Sweden)

    Panuwat Lertsithichai

    2004-04-01

    Conclusions: For most patients and with close long-term follow-up, early treatment of neurogenic bladder using CIC in children born with myelomeningocele yields better results than late treatment. In our experience, treatment is recommended as soon as possible, especially during the first year of life.

  15. Treatment of bisphosphonate related osteonecrosis following root canal therapy at the 1-year follow-up: report of two cases.

    Science.gov (United States)

    Kaptan, Figen; Kazandag, Meric Karapinar; Iseri, Ufuk

    2013-01-01

    The objective of this report was to use topical gaseous ozone as an adjunct to conventional treatment methods and to describe the multidisciplinary management of bisphosphonate associated bone necrosis, which developed following endodontic treatment. No complaints were noted by the patients at their 1-year follow-up and the treatment showed favorable prognosis.

  16. Impact of comprehensive insurance parity on follow-up care after psychiatric inpatient treatment in Oregon.

    Science.gov (United States)

    Wallace, Neal T; McConnell, K John

    2013-10-01

    This study assessed the impact of Oregon's 2007 parity law, which required behavioral health insurance parity, on rates of follow-up care provided within 30 days of psychiatric inpatient care. Data sources were claims (2005-2008) for 737 individuals with inpatient stays for a mental disorder who were continuously enrolled in insurance plans affected by the parity law (intervention group) or in commercial, self-insured plans that were not affected by the law (control group). A difference-in-difference analysis was used to compare rates of follow-up care before and after the parity law between discharges of individuals in the intervention group and the control group and between discharges of individuals in the intervention group who had or had not met preparity quantitative coverage limits during a coverage year. Estimates of the marginal effects of the parity law were adjusted for gender, discharge diagnosis, relationship to policy holder, and calendar quarter of discharge. The study included 353 discharges in the intervention group and 535 discharges in the control group. After the parity law, follow-up rates increased by 11% (p=.042) overall and by 20% for discharges of individuals who had met coverage limits (p=.028). The Oregon parity law was associated with a large increase in the rate of follow-up care, predominantly for discharges of individuals who had met preparity quantitative coverage limits. Given similarities between the law and the 2008 Mental Health Parity and Addiction Equity Act, the results may portend a national effect of more comprehensive parity laws.

  17. HPV E6/E7 mRNA Testing Is More Specific than Cytology in Post-Colposcopy Follow-Up of Women with Negative Cervical Biopsy

    Science.gov (United States)

    Sørbye, Sveinung Wergeland; Arbyn, Marc; Fismen, Silje; Gutteberg, Tore Jarl; Mortensen, Elin Synnøve

    2011-01-01

    Background In Norway, women with negative or low-grade cervical biopsies (normal/CIN1) are followed up after six months in order to decide on further follow-up or recall for screening at three-year intervals. A high specificity and positive predictive value (PPV) of the triage test is important to avoid unnecessary diagnostic and therapeutic procedures whereas a low risk of high-grade disease among triage negative women assures safety. Materials and Methods At the University Hospital of North Norway, cytology and the HPV mRNA test PreTect HPV-Proofer, detecting E6/E7 mRNA from HPV types 16, 18, 31, 33 and 45, are used in post-colposcopy follow-up of women with negative or low-grade biopsy. In this study, women with negative biopsy after high grade cytology (ASC-H/HSIL) and/or positive HPV mRNA test in the period 2005–2009 were included (n = 520). Histologically confirmed cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) was used as study endpoint. Results Of 520 women with negative or low-grade biopsy, 124 women (23.8%) had CIN2+ in follow-up biopsy. The sensitivity and specificity of the HPV mRNA test were 89.1% (95% CI, 80.1–98.1) and 92.5% (95% CI, 88.2–96.7), respectively. The ratios of sensitivity, specificity and PPV of HPV mRNA testing compared to repeat cytology for finding CIN2+ was 1.05 (95% CI: 0.92–1.21), 1.21 (95% CI: 1.12–1.32), and 1.49 (95% CI: 1.20–1.86), respectively. The PPV of mRNA was 77.3% (95% CI, 59.8–94.8) in women aged 40 or older. Conclusion Women with negative cervical biopsy require follow-up before resumption of routine screening. Post-colposcopy HPV mRNA testing was as sensitive but more specific than post-colposcopy cytology. In addition, the HPV mRNA test showed higher PPV. A positive mRNA test post-colposcopy could justify treatment in women above 40 years. PMID:21998748

  18. Long-term outcomes of Botulinum toxin in the treatment of chronic anal fissure: 5 years of follow-up.

    Science.gov (United States)

    Barbeiro, Sandra; Atalaia-Martins, Catarina; Marcos, Pedro; Gonçalves, Cláudia; Canhoto, Manuela; Arroja, Bruno; Silva, Filipe; Cotrim, Isabel; Eliseu, Liliana; Santos, Antonieta; Vasconcelos, Helena

    2017-03-01

    Chronic anal fissure is a frequent and disabling disease, often affecting young adults. Botulinum toxin and lateral internal sphincterotomy are the main therapeutic options for refractory cases. Botulinum toxin is minimally invasive and safer compared with surgery, which carries a difficult post-operative recovery and fecal incontinence risk. The long-term efficacy of Botulinum toxin is not well known. The aim of this study was to evaluate the long-term efficacy and safety of Botulinum toxin in the treatment of chronic anal fissure. This was a retrospective study at a single center, including patients treated with Botulinum toxin from 2005 to 2010, followed over at least a period of 5 years. All patients were treated with injection of 25U of Botulinum toxin in the intersphincteric groove. The response was registered as complete, partial, refractory and relapse. Botulinum toxin was administered to 126 patients, 69.8% ( n  = 88) were followed over a period of 5 years. After 3 months, 46.6% ( n  = 41) had complete response, 23.9% ( n  = 21) had partial response and 29.5% ( n  = 26) were refractory. Relapse was observed in 1.2% ( n  = 1) at 6 months, 11.4% ( n  = 10) at 1 year, 2.3% ( n  = 2) at 3 years; no relapse at 5 years. The overall success rate was 64.8% at 5 years of follow-up. Botulinum toxin was well tolerated by all patients and there were no complications. The use of Botulinum toxin to treat patients with chronic anal fissure was safe and effective in long-term follow-up.

  19. A follow-up study on post myocardial infarction depression in a tertiary healthcare centre of Assam

    Directory of Open Access Journals (Sweden)

    Hemanta Dutta

    2016-01-01

    Full Text Available Background: Major depressive disorder is widely prevalent in post myocardial infarction (MI period. Various studies have reported a significant relationship between these two major disease states. Aim: To examine depression after MI and its socio-demographic variation. Methods: The study was a follow up study on patients of acute MI (n=50 attending cardiology outpatient department of the Assam Medical College Hospital in four to six weeks after the index event. Screening was done by the Primary Care Evaluation of Mental Disorders and diagnoses of major depressive disorder were established according to the text revision of the fourth edition of the Diagnostic and Statistical Manual for Mental Disorders criteria. Severity of the depression was assessed by the Beck Depression Inventory. Study populations were again reassessed after eight weeks from the index event. Statistical software packages like SPSS-20, XLSTAT, and Microsoft Office Access were used for analysis. Results: Twenty eight and 32% of the study subjects were depressed on their first and second visit respectively. Conclusion: Similar pattern of post MI depression is found in our state likewise in correlation to western and Indian studies which were conducted in different states. So we recommend vigilance from the clinician’s side while handling cases of MI.

  20. [Long term follow up of medical treatment of differentiated thyroid cancer].

    Science.gov (United States)

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

    1995-01-01

    106 patients, 114 W, 27 M, were thyroidectomized for differentiated thyroid cancer (follicular 29.3%-papillary 54.3%) with different stages of gravity (NO: 48.2% - N1: 32.8% - N2: 19%). Neck dissection was used in cases of involved nodes. One or several doses of 131 I were given to 126 subjects, 106 patients were treated with LT4 (mean daily dose: 2.5 micrograms/kg BW). 23 patients presenting intolerance to LT4 with non suppressed TSH for 13 of them were treated by an association of TRIAC + LT4. The follow up included a yearly check up involving clinical examination, plasma Tg and TSH assessment, neck ultrasonography and X-ray of the chest. Therapy was stopped for 4 weeks in cases with Tg above its detectable value and a total body scan performed with Tg and TSH controls. The mean duration of follow up was 94.5 +/- 67.7 months and extended to more than 5 years for 61% of the patients. We observed 22 relapses of the tumor with 4 deaths. Age less then 45 years, appears as the best factor of prognosis. 2 groups of patients were compared to evaluate the incidence of TSH suppression on the relapse free survival (group 1 n = 30 with a TSH 1 mU/l during the follow up). The relapse free survival was shorter in group 2 (p = 0.01). Association of TRIAC with LT4 leads to a reduction of the daily dose of LT4 (m = 25 micrograms/day) with a significant improvement of TSH suppression and clinical tolerance.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Diagnosis, Treatment and Follow-Up in Four Children with Biotinidase Deficiency from Pakistan

    International Nuclear Information System (INIS)

    Afroze, B.; Wasay, M.

    2013-01-01

    Biotinidase deficiency is an inherited disorder in which the vitamin biotin is not recycled. If untreated, affected individuals develop neurological and cutaneous symptoms. Untreated individuals with biotinidase deficiency either succumb to disease or are left with significant morbidity. We describe clinical course and follow-up of 4 children from Pakistan. All 4 presented with classical symptoms of biotinidase deficiency and responded dramatically to oral biotin within days to weeks. Biotinidase deficiency is reported in Pakistani children from different part of world, however; there is no such report from Pakistan. This highlights lack of awareness of biotinidase deficiency among physicians in Pakistan. (author)

  2. Treatment and long-term follow-up of distichiasis, with special reference to the Friesian horse: a case series

    NARCIS (Netherlands)

    Hermans, Hanneke; Ensink, Jos

    Reasons for performing study: Distichiasis is very uncommon in horses and treatment options and outcome remain unknown. Objectives: To describe treatment and long-term follow-up of distichiasis in the horse. Study design: Retrospective clinical study. Methods: Case records of horses admitted for

  3. Fecal Transplantation Treatment of Antibiotic-Induced, Noninfectious Colitis and Long-Term Microbiota Follow-Up

    NARCIS (Netherlands)

    Satokari, R.; Fuentes, S.; Mattila, E.; Jalanka, J.; Vos, de W.M.; Arkkila, P.

    2014-01-01

    Fecal microbiota transplantation (FMT) is an effective treatment for recurrent Clostridium difficile infection (CDI) and is considered as a treatment for other gastrointestinal (GI) diseases. We followed up the relief of symptoms and long-term, over-a-year microbiota stabilization in a 46-year-old

  4. Follow-up of Temporary Implantable Nitinol Device (TIND) Implantation for the Treatment of BPH: a Systematic Review.

    Science.gov (United States)

    Bertolo, Riccardo; Fiori, Cristian; Amparore, Daniele; Porpiglia, Francesco

    2018-04-26

    The purpose of the present systematic review is to offer a narrative synthesis of the available literature regarding the role of the temporary implantable nitinol device (TIND) (Medi-Tate®; Medi-Tate Ltd., Or Akiva, Israel) for the treatment of benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms (LUTS), specifically focusing on the follow-up data. Current available evidences are limited in this topic. Sample size of patients available for analysis is small. Moreover, the duration of follow-up period is intermediate and longer follow-up is required. At the available 3 years follow-up, the TIND implantation is safe, effective, and well tolerated. The extended follow-up of the first and only available cohort of patients who underwent TIND for LUTS related to BPH corroborated previous literature findings. Further studies are required in order to assess the durability of TIND outcomes over a longer follow-up, to better define the indications of this approach, and to demonstrate the advantages of second-generation device over the first.

  5. 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.

  6. Parents report on stimulant-treated children in the Netherlands: initiation of treatment and follow-up care.

    Science.gov (United States)

    Faber, Adrianne; Kalverdijk, Luuk J; de Jong-van den Berg, Lolkje T W; Hugtenburg, Jacqueline G; Minderaa, Ruud B; Tobi, Hilde

    2006-08-01

    The aim of this study was to describe current practices around initiation and follow-up care of stimulant treatment among stimulant-treated children in a nationwide survey among parents. A total of 115 pharmacies detected current stimulant users parents a questionnaire regarding their child's stimulant treatment. Parents returned 924 of 1,307 questionnaires (71%). The median age of the stimulant users was 10 years and 85% were boys. In all, 91% were diagnosed with attention-deficit/hyperactivity disorder (ADHD). In 77% of the cases, the child or parents received other therapies besides stimulants-21% received psychotropic co-medication, with melatonin (11%) and antipsychotics (7%) being mentioned most frequently. Stimulant use was primarily initiated by child psychiatrists (51%) and pediatricians (32%), but most children received repeat prescriptions from general practitioners (61%). Of these 924 children, 19% did not receive any follow-up care, and transfer of prescribing responsibility increased the risk of not receiving follow-up care. The 732 children (79%) who were monitored visited a physician approximately twice a year. During follow-up visits, pediatricians performed physical check ups significantly more often. Stimulant treatment in The Netherlands is initiated mainly by specialists such as child psychiatrists and pediatricians. In the current study, follow-up care for stimulant-treated children in The Netherlands appeared to be poor, suggesting an urgent need for improvement.

  7. Treatment of Class II Division 2 Malocclusion Using the Forsus Fatigue Resistance Device and 5-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Ezgi Atik

    2016-01-01

    Full Text Available This case report presents the treatment of a 14-year-and-8-month-old boy with Class II division 2 mandibular retrusion, severe deep bite, and concave profile. The Forsus fatigue resistance device (FRD was effective in correcting both skeletal and dental parameters. At 5-year posttreatment follow-up, the teeth were well aligned and the occlusion was stable. FRD application with appropriate treatment time can result with prominent changes in the facial profile and dentition, and the outcomes can be maintained at the long-term follow-up periods.

  8. Correcting Mortality for Loss to Follow-Up: A Nomogram Applied to Antiretroviral Treatment Programmes in Sub-Saharan Africa

    Science.gov (United States)

    Egger, Matthias; Spycher, Ben D.; Sidle, John; Weigel, Ralf; Geng, Elvin H.; Fox, Matthew P.; MacPhail, Patrick; van Cutsem, Gilles; Messou, Eugène; Wood, Robin; Nash, Denis; Pascoe, Margaret; Dickinson, Diana; Etard, Jean-François; McIntyre, James A.; Brinkhof, Martin W. G.

    2011-01-01

    Background The World Health Organization estimates that in sub-Saharan Africa about 4 million HIV-infected patients had started antiretroviral therapy (ART) by the end of 2008. Loss of patients to follow-up and care is an important problem for treatment programmes in this region. As mortality is high in these patients compared to patients remaining in care, ART programmes with high rates of loss to follow-up may substantially underestimate mortality of all patients starting ART. Methods and Findings We developed a nomogram to correct mortality estimates for loss to follow-up, based on the fact that mortality of all patients starting ART in a treatment programme is a weighted average of mortality among patients lost to follow-up and patients remaining in care. The nomogram gives a correction factor based on the percentage of patients lost to follow-up at a given point in time, and the estimated ratio of mortality between patients lost and not lost to follow-up. The mortality observed among patients retained in care is then multiplied by the correction factor to obtain an estimate of programme-level mortality that takes all deaths into account. A web calculator directly calculates the corrected, programme-level mortality with 95% confidence intervals (CIs). We applied the method to 11 ART programmes in sub-Saharan Africa. Patients retained in care had a mortality at 1 year of 1.4% to 12.0%; loss to follow-up ranged from 2.8% to 28.7%; and the correction factor from 1.2 to 8.0. The absolute difference between uncorrected and corrected mortality at 1 year ranged from 1.6% to 9.8%, and was above 5% in four programmes. The largest difference in mortality was in a programme with 28.7% of patients lost to follow-up at 1 year. Conclusions The amount of bias in mortality estimates can be large in ART programmes with substantial loss to follow-up. Programmes should routinely report mortality among patients retained in care and the proportion of patients lost. A simple

  9. The relationship between post-stent strut apposition and follow-up strut coverage assessed by a contour plot optical coherence tomography analysis.

    Science.gov (United States)

    Kim, Jung-Sun; Ha, Jinyong; Kim, Byeong-Keuk; Shin, Dong-Ho; Ko, Young-Guk; Choi, Donghoon; Jang, Yangsoo; Hong, Myeong-Ki

    2014-06-01

    This study sought to evaluate the relationship between post-stent strut apposition and follow-up strut coverage using contour plot optical coherence tomographic analysis. Tracking the fate of interested regions of struts at different time points has not been investigated. Post-intervention and 6-month follow-up optical coherence tomographic evaluations were performed in 82 patients treated with biolimus- (n = 37) or sirolimus-eluting stents (n = 45). Post-stent apposition was classified as embedded, apposed, or malapposed. For volumetric stent evaluation, the post-intervention strut-artery distance and the neointimal thickness at follow-up were measured as a function of the circumferential arc length and longitudinal stent length. Computer-generated contour plots of the strut-artery distance and neointimal thickness were compared. The percentages of embedded and malapposed struts after intervention were 1.8% (Interquartile range [IQR]: 0.6% to 6.2%) and 2.3% (IQR: 0.5% to 5.2%), respectively. The percentages of uncovered and malapposed struts at 6 months were 16.0% (IQR: 7.4% to 33.3%) and 0% (IQR: 0% to 0.7%), respectively. The percentage of uncovered struts at 6 months varied significantly with post-stent strut apposition (0% [IQR: 0% to 11.4%] in embedded, 16.3% [IQR: 8.1% to 31.3%] in apposed, and 26.8% [IQR: 0% to 56.3%] in malapposed, p < 0.001 for all pairwise comparisons). In lesions without tissue prolapse, embedded struts were all covered (100% covered struts) compared with those with tissue prolapse (76.8% covered, p < 0.001). The optical coherence tomography-guided optimization of stent strut apposition enhances strut coverage at follow-up. This comprehensive method for evaluating strut apposition may provide more useful information to understanding the serial changes in strut coverage. (Neointimal Coverage After Implantation of Biolimus Eluting Stent With Biodegradable Polymer: Optical Coherence Tomographic Assessment According to the Treatment of

  10. Cannabis Abstinence During Treatment and One-Year Follow-Up: Relationship to Neural Activity in Men

    OpenAIRE

    Kober, Hedy; DeVito, Elise E; DeLeone, Cameron M; Carroll, Kathleen M; Potenza, Marc N

    2014-01-01

    Cannabis is among the most frequently abused substances in the United States. Cognitive control is a contributory factor in the maintenance of substance-use disorders and may relate to treatment response. Therefore, we assessed whether cognitive-control-related neural activity before treatment differs between treatment-seeking cannabis-dependent and healthy individuals and relates to cannabis-abstinence measures during treatment and 1-year follow-up. Cannabis-dependent males (N=20) completed ...

  11. [Treatment of Fallot tetralogy with a transannular patch. Six years follow-up].

    Science.gov (United States)

    Galicia-Tornell, Myriam; Reyes-López, Alfonso; Ruíz-González, Sergio; Bolio-Cerdán, Alejandro; González-Ojeda, Alejandro; Fuentes-Orozco, Clotilde

    2015-01-01

    Primary repair of Fallot tetralogy has been performed successfully for the last 45 years. It has low surgical mortality (Fallot tetralogy is the most common form of cyanotic congenital heart disease (including transannular patch) and accounts for 7.5% of all cardiovascular surgical procedures. The mid-term follow-up results are reported. Case series. The study included patients who had complete repair of Fallot tetralogy with transannular patch from January 2000 to December 2009. An analysis was performed on the clinical variables, morbidity and mortality. There were 52 patients in the study, with mean age 4 ± 2 years. Perioperative mortality in 6 patients, with 5 associated with residual right ventricular obstruction and, 1 associated with further surgery. The survival rate was 88% (46) patients, with a follow-up 75 ± 26 months. Late morbidity occurred in 14, due to right ventricular dysfunction in 11, recurrent distal obstruction in 2, and residual ventricular septal defect in 1. Associated risk factors were severe pulmonary insufficiency (p=0.001); QRS > 160 ms, p=0.001); cardiothoracic > 0.60 index, (p=0.048), and tricuspid regurgitation (p=0.001). There was reasonable long-term survival and excellent quality of life after total correction of Fallot tetralogy; however, progressive right ventricular dysfunction requires continuous monitoring, as well as the choice of optimal timing of pulmonary valve replacement. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  12. The importance of adequate follow-up in defining treatment success after external beam irradiation for prostate cancer

    International Nuclear Information System (INIS)

    Vicini, Frank A.; Kestin, Larry L.; Martinez, Alvaro A.

    1999-01-01

    Purpose: We reviewed our institution's experience treating patients with localized prostate cancer with external beam radiation therapy (RT) to determine how differences in the length of follow-up affect the determination of treatment outcome using the American Society for Therapeutic Radiology and Oncology (ASTRO) Consensus Panel Definition of biochemical failure (BF). Methods and Materials: From January 1987 through December 1997, 1109 patients with localized prostate cancer were treated with definitive external beam RT at William Beaumont Hospital, Royal Oak, Michigan. All patients received external beam RT to a median total prostate dose of 66.6 Gy (range: 59.4-70.4 Gy). A total of 1096 patients (99%) had sufficient prostate-specific antigen (PSA) follow-up to determine their biochemical status. To test the impact of differences in follow-up on the calculation of BF, 389 patients with at least 5 years of PSA follow-up were selected as the reference group for the initial analysis. BF was then retrospectively determined using the Consensus Panel definition at yearly intervals, ignoring the remainder of each patient's follow-up. The median follow-up for this group of patients was 6.6 years (range: 5.0-11.6 years). In a second analysis, patient cohorts were randomly selected with varying median PSA follow-up intervals in order to more accurately represent a population whose follow-up is distributed continuously over a defined range. Seven cohorts were randomly selected with 200 patients in each cohort. Cohorts were individually identified such that half of the patients (100) had 2 years or less follow-up than the stated time point for analysis and half (100) had up to 2 years more follow-up than the time point chosen for analysis. For example, in the cohort with a median follow-up of 3 years, 100 patients with a PSA follow-up from 1 to 3 years were randomly selected, and 100 patients with a follow-up from 3 to 5 years were randomly selected, thus generating a

  13. Cardiac myxoma: diagnostic approach, surgical treatment and follow-up. A twenty years experience.

    Science.gov (United States)

    Jelic, J; Milicić, D; Alfirević, I; Anić, D; Baudoin, Z; Bulat, C; Corić, V; Dadić, D; Husar, J; Ivanćan, V; Korda, Z; Letica, D; Predrijevac, M; Ugljen, R; Vućemilo, I

    1996-12-01

    years after the operation. Among them there was no evidence of the tumour recurrence, 15 pts were asymptomatic and 7 had NYHA II class symptoms. For 17 pts with a left atrial myxoma preoperative and postoperative echocardiographic data were available for comparison, showing a significant reduction of the left atrial diameter (p<0.001) during the postoperative follow-up. Our data, presenting one of the biggest reports concerning cardiac myxomas, showed a broad spectrum of their clinical presentation, importance of echocardiography in diagnosing and postoperative follow-up and efficacy of a proper surgical intervention as a definite, curative therapy since there were no deaths and no significant cardiac dysfunction neither tumour reccurrence as well.

  14. Efficacy of three treatment protocols for adolescents with social anxiety disorder: a 5-year follow-up assessment.

    Science.gov (United States)

    Garcia-Lopez, Luis-Joaquin; Olivares, Jose; Beidel, Deborah; Albano, Anne-Marie; Turner, Samuel; Rosa, Ana I

    2006-01-01

    Few studies have reported long-term follow-up data in adults and even fewer in adolescents. The purpose of this work is to report on the longest follow-up assessment in the literature on treatments for adolescents with social phobia. A 5-year follow-up assessment was conducted with subjects who originally received either Cognitive Behavioral Group Therapy for Adolescents (CBGT-A), Social Effectiveness Therapy for Adolescents--Spanish version (SET-Asv), or Intervención en Adolescentes con Fobia Social--Treatment for Adolescents with Social Phobia (IAFS) in a controlled clinical trial. Twenty-three subjects completing the treatment conditions were available for the 5-year follow-up. Results demonstrate that subjects treated either with CBGT-A, SET-Asv and IAFS continued to maintain their gains after treatments were terminated. Either the CBGT-A, SET-Asv and IAFS can provide lasting effects to the majority of adolescents with social anxiety. Issues that may contribute to future research and clinical implications are discussed.

  15. Parents report on stimulant-treated children in the Netherlands : Initiation of treatment and follow-up care

    NARCIS (Netherlands)

    Faber, Adrianne; Kalverdijk, Luuk J.; de Jong-van den Berg, Lolkje T. W.; Hugtenburg, Jacqueline G.; Minderaa, Ruud B.; Tobi, Hilde

    Objectives: The aim of this study was to describe current practices around initiation and follow-up care of stimulant treatment among stimulant-treated children in a nationwide survey among parents. Methods: A total of 115 pharmacies detected current stimulant users <16 years old in their pharmacy

  16. The role of CT in follow-up treatment of patients after proctectomy due to a carcinoma

    International Nuclear Information System (INIS)

    Oellinger, R.

    1986-01-01

    The results of the thesis explain the unquestionable value of computed tomography as a method for follow-up treatment. Given a suitable timing of CT examinations, and due consideration of additional information obtained e.g. by CEA assays, early detection of local recurrences is possible. (MBC) [de

  17. A follow-up urine sample has limited value after treatment for urinary tract infection in children

    DEFF Research Database (Denmark)

    Lytzen, Rebekka; Kaalund-Jørgensen, Kristine; Ahmed, Akhlaq

    2015-01-01

    INTRODUCTION: A routine follow-up urine sample (FUS) in the form of a midstream urine sample (MSU) is recommended after treatment for urinary tract infection (UTI) according to the Danish Paediatric Society (DPS) and "Lægehåndbogen" published by Danish Regions. We studied the effect of FUS...

  18. Risk factors associated with loss to follow-up from tuberculosis treatment in Tajikistan: A case-control study

    NARCIS (Netherlands)

    J. Wohlleben (Jessica); M. Makhmudova (Mavluda); F. Saidova (Firuza); S. Azamova (Shahnoza); C. Mergenthaler (Christina); S. Verver (Suzanne)

    2017-01-01

    markdownabstract_Background:_ There are very few studies on reasons for loss to follow-up from TB treatment in Central Asia. This study assessed risk factors for LTFU and compared their occurrence with successfully treated (ST) patients in Tajikistan. _Methods:_ This study took place in all TB

  19. Diagnostic and interventional radiology in the post-operative period and follow-up of patients after rectal resection with coloanal anastomosis

    International Nuclear Information System (INIS)

    Severini, A.; Civelli, E.M.; Uslenghi, E.; Cozzi, G.; Salvetti, M.; Milella, M.; Gallino, G.; Bonfanti, G.; Belli, F.; Leo, E.

    2000-01-01

    Surgical treatment of carcinoma of the distal third of the rectum with anal sphincter preservation is increasingly used in accredited cancer centers. This study aimed to evaluate the diagnostic usefulness of radiological investigations in the management of patients who had undergone resection with coloanal anastomosis for carcinoma of the rectum, in the immediate post-operative period, during closure of the protective colostomy and in the follow-up of symptomatic recanalized patients. A total of 175 patients who had undergone total rectal resection with end-to-side anastomosis for carcinoma of the distal third of the rectal ampulla, most of whom had received postoperative radiotherapy, were evaluated radiologically. In the postoperative period radiological investigation was ordered only for symptomatic patients to detect pathology of the anastomosis and the pouch sutures and was used direct film abdominal radiography and contrast-enhanced radiography of the rectal stump with a water-soluble radio-opaque agent. Before closure of the colostomy, 2 months after rectal excision or approximately 4 months after if postoperative radiotherapy was given, the anastomosis and pouch of all patients, even asymptomatic ones, were studied with water-soluble contrast enema to check for normal canalization. In the follow-up after recanalization radiological examinations were done to complete the study of the large intestine if the endoscopist was not able to examine it up to the cecum. Of the 175 patients examined radiologically during the postoperative period and/or subsequent follow-up, 95 showed no pathological findings. Seventy-nine patients had fistulas of the coloanal anastomosis or the pouch, 23 of which supplied a presacral collection. In the absence of severe sepsis, the only therapeutic measures were systemic antibiotics and washing of the surgical catheters to maintain efficient operation. In 2 patients in whom transanal drainage was performed radiologically the fistula

  20. Diagnostic and interventional radiology in the post-operative period and follow-up of patients after rectal resection with coloanal anastomosis

    Energy Technology Data Exchange (ETDEWEB)

    Severini, A.; Civelli, E.M.; Uslenghi, E.; Cozzi, G.; Salvetti, M.; Milella, M. [Department of Radiology, National Cancer Institute of Milan, via Venezian 1, I-23100 Milan (Italy); Gallino, G.; Bonfanti, G.; Belli, F.; Leo, E. [Department of Surgery, National Cancer Institute of Milan, via Venezian 1, I-23100 Milan (Italy)

    2000-07-01

    Surgical treatment of carcinoma of the distal third of the rectum with anal sphincter preservation is increasingly used in accredited cancer centers. This study aimed to evaluate the diagnostic usefulness of radiological investigations in the management of patients who had undergone resection with coloanal anastomosis for carcinoma of the rectum, in the immediate post-operative period, during closure of the protective colostomy and in the follow-up of symptomatic recanalized patients. A total of 175 patients who had undergone total rectal resection with end-to-side anastomosis for carcinoma of the distal third of the rectal ampulla, most of whom had received postoperative radiotherapy, were evaluated radiologically. In the postoperative period radiological investigation was ordered only for symptomatic patients to detect pathology of the anastomosis and the pouch sutures and was used direct film abdominal radiography and contrast-enhanced radiography of the rectal stump with a water-soluble radio-opaque agent. Before closure of the colostomy, 2 months after rectal excision or approximately 4 months after if postoperative radiotherapy was given, the anastomosis and pouch of all patients, even asymptomatic ones, were studied with water-soluble contrast enema to check for normal canalization. In the follow-up after recanalization radiological examinations were done to complete the study of the large intestine if the endoscopist was not able to examine it up to the cecum. Of the 175 patients examined radiologically during the postoperative period and/or subsequent follow-up, 95 showed no pathological findings. Seventy-nine patients had fistulas of the coloanal anastomosis or the pouch, 23 of which supplied a presacral collection. In the absence of severe sepsis, the only therapeutic measures were systemic antibiotics and washing of the surgical catheters to maintain efficient operation. In 2 patients in whom transanal drainage was performed radiologically the fistula

  1. Surgical treatment of iris and ciliary body melanoma: follow-up of a 25-year series of patients

    DEFF Research Database (Denmark)

    Klauber, Stefan; Jensen, Peter K; Prause, Jan U

    2010-01-01

    Purpose: To evaluate outcome of surgical resection of iris and irido-ciliary melanomas. Method: Retrospective analysis of all cases treated in Denmark 1975-1999 with clinical follow-up in 2002 and death certificate analysis in 2008. A quality of life questionnaire was completed at follow-up. Resu......Purpose: To evaluate outcome of surgical resection of iris and irido-ciliary melanomas. Method: Retrospective analysis of all cases treated in Denmark 1975-1999 with clinical follow-up in 2002 and death certificate analysis in 2008. A quality of life questionnaire was completed at follow...... time. However, none had changed job as a consequence of the surgical treatment. Only two patients were emotionally affected by the diagnosis of iris melanoma. Conclusion: Resection of small iris and irido-ciliary melanomas is a safe and efficient procedure, provided that strict diagnostic and surgical...

  2. Treatment of active duty military with PTSD in primary care: A follow-up report.

    Science.gov (United States)

    Cigrang, Jeffrey A; Rauch, Sheila A M; Mintz, Jim; Brundige, Antoinette; Avila, Laura L; Bryan, Craig J; Goodie, Jeffrey L; Peterson, Alan L

    2015-12-01

    First-line trauma-focused therapies offered in specialty mental health clinics do not reach many veterans and active duty service members with posttraumatic stress disorder (PTSD). Primary care is an ideal environment to expand access to mental health care. Several promising clinical case series reports of brief PTSD therapies adapted for primary care have shown positive results, but the long-term effectiveness with military members is unknown. The purpose of this study was to determine the long-term outcome of an open trial of a brief cognitive-behavioral primary care-delivered protocol developed specifically for deployment-related PTSD in a sample of 24 active duty military (15 men, 9 women). Measures of PTSD symptom severity showed statistically and clinically significant reductions from baseline to posttreatment that were maintained at the 6-month and 1-year follow-up assessments. Similar reductions were maintained in depressive symptoms and ratings of global mental health functioning. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Oral health-related quality of life after dental general anaesthesia treatment among children: a follow-up study.

    Science.gov (United States)

    Jankauskiene, Birute; Virtanen, Jorma I; Kubilius, Ricardas; Narbutaite, Julija

    2014-07-01

    Many young paediatric patients with severe dental caries receive dental treatment under general anaesthesia. Oral health-related quality of life (OHRQoL) can be evaluated to assess the outcome of dental general anaesthesia (DGA) treatment. The aim of our study was to examine the OHRQoL of young Lithuanian children in need of DGA treatment and analyse the impact of DGA treatment on children's OHRQoL. We carried out a prospective clinical follow-up study on OHRQoL among all young Lithuanian child patients who received DGA treatment at the Lithuanian University of Health Sciences Hospital during 2010-2012. The study consisted of clinical dental examinations of patients younger than six years, data collected from their patient files, and an OHRQoL survey completed by their parents prior to the child's dental treatment. We conducted a follow-up OHRQoL survey one month after the DGA treatment. The Early Childhood Oral Health Impact Scale (ECOHIS) and its effect size (ES) served to evaluate children's OHRQoL, and the Wilcoxon signed-rank test served for statistical analyses. We obtained complete baseline and follow-up data for 140 and 122 participants, respectively (84.7% follow-up rate). Pain and eating problems among children and parents feeling upset and guilty were the most frequently reported impacts at baseline. The parents reported greater impacts on boys than on girls. The ECOHIS score decreased significantly (69.5%, p family (2.4) sections of the ECOHIS. The OHRQoL of young Lithuanian children requiring DGA treatment is seriously impaired. Dental general anaesthesia treatment results in significant improvement of the children's OHRQoL. The children's parents also greatly appreciate this treatment modality for its positive impact on the family's quality of life.

  4. Pharmacotherapy and group cognitive behavioral therapy enhance follow-up treatment duration in gambling disorder patients.

    Science.gov (United States)

    Choi, Sam-Wook; Shin, Young-Chul; Youn, HyunChul; Lim, Se-Won; Ha, Juwon

    2016-01-01

    Longer treatment duration is important for the successful treatment of gambling disorder (GD). This retrospective study investigated the factors and interventions that might enhance treatment duration in GD patients in South Korea. A total of 758 outpatients with a primary diagnosis of GD, who were treated in a clinical practice from 2002 to 2011, were assessed by retrospective chart review. We compared the treatment duration according to pharmacotherapy and group cognitive behavioral therapy (CBT). Pharmacotherapy contributed to a longer duration of treatment maintenance, despite the patients' gambling severity (p gambling severity. The treatment maintenance duration was the longest in those receiving combined antidepressant pharmacotherapy and group CBT (F = 35.79, p prevention and treatment strategies.

  5. Cognitive–Behavioral Therapy Plus Contingency Management for Cocaine Use: Findings During Treatment and Across 12-Month Follow-Up

    OpenAIRE

    Epstein, David H; Hawkins, Wesley E; Covi, Lino; Umbricht, Annie; Preston, Kenzie L

    2003-01-01

    Contingency management (CM) rapidly reduces cocaine use, but its effects subside after treatment. Cognitive–behavioral therapy (CBT) produces reductions months after treatment. Combined, the 2 might be complementary. One hundred ninety-three cocaine-using methadone-maintained outpatients were randomly assigned to 12 weeks of group therapy (CBT or a control condition) and voucher availability (CM contingent on cocaine-negative urine or noncontingent). Follow-ups occurred 3, 6, and 12 months po...

  6. Prospective clinical study of prosthetic treatment outcome of implantretained-removable-partial-denture during 5 year-follow-ups

    OpenAIRE

    Mehran Bahrami; Mohammed Hussein Mahmood Alsharbaty

    2017-01-01

    Background IRRPD offers patients the ability to upgrade their treatment planning to implant-supported-overdentures (ISOs) or implant-supported-fixed-prostheses (ISFPs) through insertion of more implants in the future after the loss of the remaining natural teeth. Aims The purpose of this prospective-clinical-study was to evaluate the success rate and treatment outcome of IRRPD for 15 patients, during at least 5-year-follow-ups after prosthetic rehabilitation with respect to implant ...

  7. Treatment of traumatic internal carotid artery pseudoaneurysms with willis covered stents: a midterm follow-up result

    International Nuclear Information System (INIS)

    Wang Wu; Li Minghua; Li Yongdong; Gu Binxian; Fang Chun; Tan Huaqiao; Wang Ju; Zhang Peilei

    2010-01-01

    Objective: To evaluate the efficacy and mid-term follow-up results of endovascular treatment with Willis covered stent for traumatic pseudoaneurysms located in the internal carotid artery (ICA). Methods: ICA angiography was performed in 38 patients with traumatic brain and neck injury. Of the 38 patients, 13 delayed traumatic pseudoaneurysms were found. All the pseudoaneurysms were treated with Willis covered stents. Follow-up angiography was performed at 1, 3, 6 and 12 months after the procedure, and the results were categorized as complete or incomplete occlusion. Clinical manifestations were graded as full recovery, improvement, unchanged and aggravation. Results: Willis covered stent placement was technically successful in all traumatic pseudoaneurysms. No procedure-related complications occurred. The initial angiographic results showed a complete occlusion in 9 patients, and an incomplete occlusion in 4. The angiographic follow-up within 3-12 months exhibited a complete occlusion in 12 patients and the parent arteries remained patency in all patients. The clinical follow-up observation demonstrated that full recovery was obtained in 11 patients, clinical improvement in one, and unchanged condition in one. No morbidity or mortality occurred. Conclusion: Willis covered stent implantation is a feasible and practical treatment for traumatic pseudoaneurysms located in the ICA. This technique can well preserve the parent artery with excellent therapeutic results. (authors)

  8. Male anorexia and bulimia nervosa: Disorder symptoms and impulsive behaviour during hospital treatment and one year follow-up period.

    Science.gov (United States)

    Sernec, Karin; Mrevlje, Gorazd V; Čarapič, Jadranka; Weber, Urška; Zalar, Bojan

    2015-09-01

    The study aimed to evaluate treatment efficacy in male patients with anorexia (AN) and bulimia nervosa (BN) treated at the Eating Disorder Unit, University Psychiatric Clinic Ljubljana, Slovenia (EDU UPCL), using longitudinal assessments of eating disorder (ED) symptoms and selected impulsive behaviours highly correlated with these entities from hospital admission till twelve months after. 35 male AN and 35 male BN patients were included. Participants were aged 17 or more and somatically stable with the BMI>12 kg/m(2). Patients with psychiatric comorbidity, mental disorder due to a general medical condition, or serious somatic or neurological disease were excluded. Intensity of ED symptoms and presence of selected impulsive behaviours were evaluated at hospital admission and discharge, and three, six and twelve months after, using an internal Eating Disorder Unit Questionnaire. For statistical analysis multivariate analysis of variance was used. Throughout the research period the appropriate changes in BMI were observed in both patient groups. In both, AN and BN patient groups, the evaluation of longitudinal differences regarding the intensity of all ED symptoms and the presence of studied impulsive behaviours showed a significant decline at discharge and all subsequent assessments compared to the results obtained upon admission to the hospital. The re-hospitalization rates of patients with AN and BN in the first year after discharge from the hospital were 3.84% vs. 3.7% respectively. In male patients with AN and BN treated at the EDU UPCL, ED symptoms, BMI, and studied impulsive behaviours show a substantial improvement during hospital treatment. These changes seem to be long lasting, still being effective through one-year post-hospitalization follow-up.

  9. The sodium pentothal hypnosis interview with follow-up treatment for complex regional pain syndrome.

    Science.gov (United States)

    Simon, E P; Dahl, L F

    1999-08-01

    A patient who was unresponsive to multiple conservative medical treatments for complex regional pain syndrome was assessed using a novel approach--the sodium pentothal hypnosis interview. The interview suggested that his pain was centrally generated. The patient's pain symptoms resolved with hypnotherapeutic treatment. Indications for this procedure and implications for assessment and treatment are discussed. This case raises more questions than it answers, and leaves the reader to struggle with current difficulties in diagnostic decision-making.

  10. Heterogeneity of treatment changes after psychodynamic therapy within a one year follow-up

    DEFF Research Database (Denmark)

    Jensen, Hans Henrik; Mortensen, Erik Lykke; Lotz, Martin

    2014-01-01

    Naturalistic psychotherapy effect studies commonly report effect sizes for the total sample. However, a previous study of SCL-90 Global Severity Index (GSI) improvement in a large outpatient sample used a cluster analytic strategy and reported clinical relevant outcome trajectories that could...... and agoraphobic symptoms may be less optimally treated in short-term time limited psychodynamic groups. There is an obvious need for diversity of treatment offers, better integration of psycho-social treatment components, and long-term open ended treatment....

  11. Clinical and endoscopic findings in the mucosae of the upper respiratory and digestive tracts in post-treatment follow-up of paracoccidioidomycosis patients Achados clínicos e endoscópicos na mucosa das vias aéreas e digestivas superiores no segmento pós-terapêutico de pacientes com paracoccidioidomicose

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Francesconi do Valle

    1995-10-01

    Full Text Available Systematic examination of the upper respiratory and digestive tracts (URDT was performed in a group of 80 paracoccidioidomycosis (PCM patients submitted to post-treatment follow-up ranging from 8 months to 17 years. Mucosae of the URDT had been involved prior to specific treatment in 74 patients, distributed as follows: oropharynx, 50 (41 alone, 7 in association with the larynx, and 2 with the nasal mucosa; larynx, 30 (23 alone and 7 in association; and nasal mucosa, 3(1 alone and 2 in association. Inactive lesions were observed in all the 50 patients with lesions of the oropharynx, 3 of whom with deforming scars (1 with retraction of the tongue and 2 with narrowing of the oral orifice. One case presented a destructive lesion, with perfuration of the palate. Of the other 46 cases, examination showed nacreous white striated scars which were nearly imperceptible in some cases and in others displayed partial retraction of anatomical structures without any alteration of their features. Patients presented a high rate of missing teeth. In 3 patients with involvement of the nasal mucosa, none of whom presented active PCM lesions, 2 still had nasal voices. In 30 patients with lesions of the larynx, 1 suffered a relapse of PCM and 2 developed epidermoid carcinoma. Of the other 27 cases, none of whom had active PCM lesions, 15 presented dysphonia, 3 were tracheotomized, and 9 were asymptomatic.Foi realizado sistematicamente o exame das vias aero-digestivas superiores (VADS em grupo de 80 pacientes de paracoccidioidomicose (PCM acompanhados após o tratamento específico por período que variou de 8 meses a 17 anos. A mucosa das VADS estava comprometida antes do tratamento específico em 74 pacientes, assim distribuídos: orofaringe, 50 (41 isoladamente, 7 em associação com o laringe e 2 com a mucosa nasal; laringe, 30 (23 isoladamente e 7 em associação e nasal, 3 (1 isoladamente e 2 em associação. Em todos os 50 que apresentavam lesões no

  12. Treatment of primary axillary hyperhidrosis by fractional microneedle radiofrequency: Is it still effective after long-term follow-up?

    Directory of Open Access Journals (Sweden)

    Bahareh Abtahi-Naeini

    2016-01-01

    Full Text Available Background: Primary axillary hyperhidrosis (PAH is a chronic idiopathic disorder causing major stress in patients. Among the common therapies for PAH, only surgical interventions have proven feasible as a permanent solution. Objective and Aim: The aim of this study was to evaluate the efficacy and safety of fractional microneedle radiofrequency (FMR as an alternative permanent treatment for PAH with long-term follow-up. Materials and Methods: This was a single-blind, sham-controlled comparative study. Twenty-five patients with severe PAH were provided three treatments of FMR at 3-week intervals (the treatment group, and a control group was provided the sham treatment. Clinical efficacy was evaluated using the hyperhidrosis disease severity scale (HDSS at baseline and the end of the study, as well as during the 1 year follow-up phase. Results: HDSS demonstrated significant improvement after treatment in the treatment group compared to the sham control. The mean (±standard deviation of HDSS in the group being treated with radiofrequency was 2.50 (±0.88 after 1 year follow-up, and that of the control group was 3.38 (±0.49; P < 0.001. Follow-up results show that there were 10 patients (41.6% with no relapse and 11 patients (45.9% with relapse after 1 year. There was a significant correlation between HDSS changes in relapse and body mass index (BMI (P = 0.03. Conclusion: Treatment of PAH with FMR is a safe and noninvasive procedure with a positive therapeutic effect on HDSS. It is recommended, however, that sessions of FMR be repeated after 1 year, particularly in overweight patients with high BMIs. Clinical Trial Registration: IRCT2013111915455N1. Level of Evidences: Level II-1.

  13. A randomized controlled study of early headgear treatment on occlusal stability--a 13 year follow-up.

    Science.gov (United States)

    Krusinskiene, Viktorija; Kiuttu, Päivi; Julku, Johanna; Silvola, Anna-Sofia; Kantomaa, Tuomo; Pirttiniemi, Pertti

    2008-08-01

    The purpose of this investigation was to assess the long-term occlusal stability in a group treated early with headgear (HG) compared with a control group. The total study group comprised 68 children (40 males and 28 females) aged 7.6 years (standard deviation 0.3), randomly divided into two groups of equal size. In the first group, HG treatment was initiated immediately, while in the control group only minor interceptive procedures were performed during the follow-up period. Fixed appliance treatment, if needed, including extraction of permanent teeth due to crowding, was undertaken after the completion of early treatment. The records were available from the start of the early treatment and at follow-up after 2, 4, 8, and 13 years. The US-weighted Peer Assessment Rating (PAR) Index, graded according to the severity of malocclusion, was used to evaluate occlusal stability. Little's Irregularity Index (LII)and intercanine distance in the lower arch were measured at all time periods. The Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) scores was used for evaluation of dental aesthetics at the last follow-up. Parametric tests were applied for statistical analyses, except for the evaluation of aesthetics, where a non-parametric test was used. No significant differences were found when long-term stability between the HG and control groups was evaluated at the 13 year follow-up. Lower PAR scores were observed in patients treated without extraction of teeth. A greater irregularity in lower incisor alignment before treatment was found in subjects later treated with extractions. The findings of this study seem to suggest that treatment timing has only a minor influence on stability.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    PURPOSE: To describe change in mental health after treatment with antidepressants and trauma-focused cognitive behavioral therapy. METHODS: Patients receiving treatment at the Psychiatric Trauma Clinic for Refugees in Copenhagen completed self-ratings of level of functioning, quality of life...... and effect size were observed on all rating scales (p-value

  15. Maxillary first molar extraction in Class II malocclusion : Follow-up studies on treatment effects

    NARCIS (Netherlands)

    Livas, Christos

    2015-01-01

    This PhD research investigated treatment effects of extraction of one and two maxillary first molars in Class II subdivision and Class II/1 malocclusion cases respectively from a longer time perspective. Private practice records were scrutinized to evaluate aspects of a treatment technique combining

  16. 'Lost to follow up': rethinking delayed and interrupted HIV treatment among married Swazi women.

    Science.gov (United States)

    Dlamini-Simelane, Thandeka T T; Moyer, Eileen

    2017-03-01

    Through various campaigns and strategies, more women are being tested for HIV in countries with a high prevalence of the virus. Despite the ready availability of treatment at government clinics in sub-Saharan African countries like Swaziland, women consistently report difficulty in maintaining access to treatment. Drawing on two individual case studies selected from a larger study of the so-called leaky cascade in Swaziland, we illustrate the protracted journeys married women undertake to initiate treatment. We demonstrate how women manoeuvre tactically after diagnosis, highlight factors that influence their decisions related to initiating treatment, and detail the actors involved in the decision-making process. Our research shows the persistence of structural factors that inhibit access, including economic constraints, gender inequality and patriarchal social norms. Patients referred as ‘lost to follow up’ are in many cases actively pursuing treatment within a context that includes the biomedical health system, but also extends well beyond it. We argue that the phrase ‘lost to follow up’ conceals the complex social navigation required by women to initiate and maintain access to treatment. Further, we suggest that many of the logistical challenges of monitoring and tracking people with HIV can be better addressed by taking into account the structural and social aspects of delayed treatment initiative.

  17. MR angiography in diagnosing and following up the treatment result: arteria lusoria

    International Nuclear Information System (INIS)

    Vogl, T.J.; Juergens, M.; Harms, J.; Pegios, W.; Zimmermann, A.; Hetzer, R.; Felix, R.

    1994-01-01

    Diagnostic and therapeutic procedures are presented in a 29-year-old female patient who suffered from severe dysphagia and rapid loss in weight. In the conventional X-ray examination and barium swallow an aberrant right subclavian artery was suspected. MR imaging (MRI) and MR angiography (MRA) were done to plan the surgical correction. Post-operative MRA documented exactly the complex topography after surgical correction and the flow pattern in the implanted Gore-Tex stretch graft prosthesis. Non-invasive MR angiography renders possible the concrete planning of complex corrections of thoracic vessels replacing invasive catheter angiography. (orig.) [de

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

    Science.gov (United States)

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

    2016-01-01

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

  19. Postsurgical Orthodontic Treatment Planning: a Case Report with 20 Years Follow-up.

    Science.gov (United States)

    Farronato, Giampietro; Garagiola, Umberto; Carletti, Vera; Cressoni, Paolo; Mortellaro, Carmen

    2011-01-01

    Traditionally, maxillofacial deformities are corrected surgically after an initial orthodontic treatment phase. However in, this article, the authors emphasize the postsurgical therapeutic protocol which is extremely important for determining the final and permanent retention of the corrected occlusion. A 55 year old female with severe skeletal Class II malocclusion is presented. Combined surgical and orthodontic correction of the malocclusion was used. : The step-by-step procedure the authors followed for the postsurgical therapy is described. The goals of the postoperative therapy were to restore and rehabilitate neuromuscular function, obtain occlusal stabilization, grind teeth selectively, and final occlusion retention. The importance of a surgical occlusal splint for rehabilitating stomatognathic neuromuscular function postoperatively was demonstrated. Furthermore, the orthodontic-prosthodontic treatment ensured occlusion stability after the surgical correction. The long-term results confirmed the efficacy of the treatment protocol presented here from both functional and aesthetical perspectives. Postsurgical orthodontic treatment is an important step in the surgical and orthodontic therapy of maxillofacial deformities.

  20. DIAGNOSTICS, TREATMENT AND FOLLOW-UP OF AN ADULT PATIENT WITH INTERMEDIATE UVEITIS

    Directory of Open Access Journals (Sweden)

    Saša Počkar

    2016-07-01

    Full Text Available Intermediate uveitis is a chronic inflammatory eye disease where the vitreous is the major site of the inflammation. It mostly affects younger patients. The inflammation can be idiopathic or related to either infectious or autoimmune systemic disease. The leading cause of visual deterioration in intermediate uveitis is cystoid macular edema and cataract is the most common complication.Criteria for treating intermediate uveitis depend on the cause of the disease. We consider the presence of cystoid macular edema, vitreous haze 2+ or more, retinal neovascularization or vasculitis. We decide to treat the patient early, because it is easier to preserve visual function and ocular structures. The basic approach to treatment is a »step approach«. We start the treatment  with periocular, intraocular or systemic corticosteroids. If the treatment is ineffective we use immunosuppressants/immunomodulators. Prognosis is improved with  early control of inflammation and early treatment of the complications.

  1. Assessing methods for dealing with treatment crossover in clinical trials: A follow-up simulation study

    OpenAIRE

    Latimer, N.R.; Abrams, K.R.; Lambert, P.C.; Crowther, M.J.; Morden, J.P.

    2014-01-01

    Background: Treatment switching commonly occurs in clinical trials of novel interventions, particularly in the advanced or metastatic cancer setting, which causes important problems for health technology assessment. Previous research has demonstrated which adjustment methods are suitable in specific scenarios, but scenarios considered have been limited. \\ud Objectives: We aimed to assess statistical approaches for adjusting survival estimates in the presence of treatment switching in order to...

  2. Constipation in early childhood: patient characteristics, treatment, and longterm follow up.

    OpenAIRE

    Loening-Baucke, V

    1993-01-01

    Little is known about chronic constipation in infants, toddlers, and preschool children and longterm outcome after treatment. The symptoms of 174 children < or = 4 years of age, who were evaluated for chronic constipation, are reported in this study together with the long-term outcome in 90 of them. Initial symptoms were infrequent bowel movements in 58%, painful bowel movements in 77% often with screaming, and severe stool withholding manoeuvres in 97%. The treatment of chronic idiopathic co...

  3. Spasmodic dysphonia follow-up with videolaryngoscopy and voice spectrography during treatment with botulinum toxin.

    Science.gov (United States)

    Esposito, Marcello; Dubbioso, R; Apisa, P; Allocca, R; Santoro, L; Cesari, U

    2015-09-01

    Spasmodic dysphonia (SD) is a focal dystonia of laryngeal muscles seriously impairing quality of voice. Adductor SD (ADSD) is the most common presentation of this disorder that can be identified by specialized phoniatricians and neurologists firstly on a clinical evaluation and then confirmed by videolaryngoscopy (VL). Botulinum toxin (BTX) injection with electromyographic guidance in muscles around vocal cords is the most effective treatment. Voice Handicap Index (VHI) questionnaire is the main tool to assess dysphonia and response to treatment. Objective of this study is to perform VL and voice spectrography (VS) to confirm the efficacy of BTX injections over time. 13 patients with ADSD were studied with VHI, VL and VS before and after 4 consecutive treatment with onobotulinumtoxin-A. For each treatment vocal improvement was proved by a significant reduction of VHI score and increase of maximum time phonation and harmonic-to-noise ratio while VL showed the absence of spasm in most of patients. No change of the response to BTX was found between injections. This study supports the efficacy of the treatment of SD with BTX with objective measurements and suggests that the efficacy of recurring treatments is stable over time.

  4. Orthodontic treatment and follow-up of a patient with cerebral palsy and spastic quadriplegia.

    Science.gov (United States)

    Çifter, Muhsin; Cura, Nil

    2016-10-01

    This report describes the clinical orthodontic management of a patient with spastic quadriplegia and cerebral palsy. Guidelines to overcome difficulties encountered during the treatment period are suggested. A 13-year-old boy with cerebral palsy and spastic quadriplegia complained of an undesirable oral appearance because of his malocclusion. He had a Class II molar relationship, with severe maxillary and moderate mandibular anterior crowding. Enamel hypoplasia was apparent on all teeth. He had losses of body function and upper extremity function of 70% and 39%, respectively. His physical limitations necessitated a treatment approach that did not rely on patient-dependent appliances. The treatment plan called for maxillary first premolar extractions, mandibular incisor protrusion, and air rotor stripping. The patient's oral function and esthetic appearance were significantly improved. Aligned dental arches with good occlusion were obtained. The patient's self-confidence improved during the treatment period. Physical appearance can influence personality and social acceptability. Corrective orthodontic treatment for patients with physical handicaps can improve not only oral function, but also self-confidence and self-esteem. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  5. [Treatment and follow up protocol in differentiated thyroid carcinomas of follicular origin].

    Science.gov (United States)

    Rodrigues, Fernando; Limbert, Edward; Marques, Ana Paula; Santos, Ana Paula; Lopes, Carlos; Rodrigues, Elizabete; Borges, Fátima; Carrilho, Francisco; Castro, João Jácome de; Neto, João; Salgado, Lucília; Oliveira, Maria João

    2005-01-01

    Differentiated thyroid carcinoma of follicular origin (DTCFO), although not very frequent, has registered a raising incidence in the last decades. In the majority of the cases, DTCFO is a curable disease when treated and monitored by experienced, multidisciplinary teams. These factors contribute to an increasing number of DTCFO survivors requiring life-long monitoring, due to the possibility of occurrence of recurrences many years after the initial treatment. Several aspects of the treatment and management of these patients are still controversial. The present protocol represents the consensus of the members of the Grupo de Estudo da Tiróide of the Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo. It aims to define guidelines, in agreement with the current state of the art and contemplating the necessary adaptations to local constrains, that ensure decreased mortality and protection of patients' quality of life, avoiding unnecessarily aggressive or ineffective treatments, optimizing the use of the available resources.

  6. [Operative treatment of traumatic fractures of the thoracic and lumbar spinal column: Part III: Follow up data].

    Science.gov (United States)

    Reinhold, M; Knop, C; Beisse, R; Audigé, L; Kandziora, F; Pizanis, A; Pranzl, R; Gercek, E; Schultheiss, M; Weckbach, A; Bühren, V; Blauth, M

    2009-03-01

    In this third and final part, the Spine Study Group (AG WS) of the German Trauma Association (DGU) presents the follow-up (NU) data of its second, prospective, internet-based multicenter study (MCS II) for the treatment of thoracic and lumbar spinal injuries including 865 patients from 8 trauma centers. Part I described in detail the epidemiologic data of the patient collective and the subgroups, whereas part II analyzed the different methods of treatment and radiologic findings. The study period covered the years 2002 to 2006 including a 30-month follow-up period from 01.01.2004 until 31.05.2006. Follow-up data of 638 (74%) patients were collected with a new internet-based database system and analyzed. Results in part III will be presented on the basis of the same characteristic treatment subgroups (OP, KONS, PLASTIE) and surgical treatment subgroups (Dorsal, Ventral, Kombi) in consideration of the level of injury (thoracic spine, thoracolumbar junction, lumbar spine). After the initial treatment and discharge from hospital, the average duration of subsequent inpatient rehabilitation was 4 weeks, which lasted significantly longer in patients with persistent neurologic deficits (mean 10.9 weeks) or polytraumatized patients (mean 8.6 weeks). Following rehabilitation on an inpatient basis, subsequent outpatient rehabilitation lasted on average 4 months. Physical therapy was administered significantly longer to patients with neurologic deficits (mean 8.7 months) or type C injuries (mean 8.6 months). The level of injury had no influence of the duration of the inpatient or outpatient rehabilitation. A total of 382 (72.2%) patients who were either operated from posterior approach only or in a combined postero-anterior approach had an implant removal after an average 12 months. During the follow-up period 56 (8.8%) patients with complications were registered and of these 18 (2.8%) had to have surgical revision. The most common complications reported were infection, loss

  7. Long-term follow-up of behavioural treatment for primary encopresis in people with intellectual disability in the community.

    Science.gov (United States)

    Huntley, E; Smith, L

    1999-12-01

    Encopresis is a major problem in high-dependency fields such as intellectual disability. Little information is available with respect to either the prevalence or aetiology of encopresis, probably because it is widely regarded as part and parcel of the handicapping condition. Consequently, treatment reports are rare and confined to a small number of case studies. There is a dearth of long-term follow-up on the behavioural treatment of encopresis in the general population, and no long-term follow-up studies are available for the treatment of encopresis in intellectual disability. The present report provides follow-up data for nine out of 10 people with mainly severe intellectual disability who had received behavioural treatment for primary retentive or non-retentive encopresis between 5 and 17 years previously. Six out of the nine subjects for whom data were available were accident-free and a further two clients were very substantially improved. Interestingly, those whose former encopresis was retentive in nature maintained more successfully, despite the severity of their original impaction. The limitations of the present study are discussed.

  8. Clinical role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in post-operative follow up of gastric cancer: Initial results

    Institute of Scientific and Technical Information of China (English)

    Long Sun; Xin-Hui Su; Yong-Song Guan; Wei-Ming Pan; Zuo-Ming Luo; Ji-Hong Wei; Hua Wu

    2008-01-01

    AIM: To evaluate the clinical role of 18F-fluorodeo-xyglucose positron emission and computed tomography(18F-FDG PET/CT) in detection of gastric cancer recur rence after initial surgical resection.METHODS: In the period from January 2007 to May 2008, 23 patients who had previous surgical resection of histopathologically diagnosed gastric cancer underwent a total of 25 18F-FDG PET/CT scans as follow-up visits in our center. The standard of reference for tumor recurrence consisted of histopathologic confirmation or clinical follow-up information for at least 5 mo after PET/CT examinations.RESULTS: PET/Cr was positive in 14 patients (61%)and negative in 9 (39%). When correlated with final diagnosis, which was confirmed by histopathologic evidence of tumor recurrence in 8 of the 23 patients(35%) and by clinical follow-up in 15 (65%), PET/CT was true positive in 12 patients, false positive in 2,true negative in 8 and false negative in 2. Overall,the accuracy of PET/CT was 82.6%, the negative predictive value (NPV) was 77.7%, and the positive predictive value (PPV) was 85.7%. The 2 false positive PET/CT findings were actually chronic inflammatory tissue lesions. For the two patients with false negative PET/CT, the final diagnosis was recurrence of mucinous adenocarcinoma in the anastomosis in one patient and abdominal wall metastasis in the other. Importantly,PET/CT revealed true-positive findings in 11 (47.8%)patients who had negative or no definite findings by CT. PET/CT revealed extra-abdominal metastases in 7 patients and additional esophageal carcinoma in onepatient. Clinical treatment decisions were changed in 7 (30.4%) patients after introducing PET/CT into theirconventional post-operative follow-up program.CONCLUSION: Whole body 18F-FDG PET/CT was highly effective in discriminating true recurrence in post-operative patients with gastric cancer and had important impacts on clinical decisions in a considerable portion of patients.

  9. Four-year follow-up of endoscopic gastroplication for the treatment of gastroesophageal reflux disease

    NARCIS (Netherlands)

    Schwartz, Matthijs P.; Schreinemakers, J. Rieneke C.; Smout, André J. P. M.

    2013-01-01

    To evaluate the long-term effect of Endocinch treatment for gastroesophageal reflux disease (GERD). After unblinding and crossover, 50 patients (32 males, 18 females; mean age 46 years) with pH-proven chronic GERD were recruited from an initial randomized, placebo-controlled, single-center study,

  10. Postsurgical Orthodontic Treatment Planning: a Case Report with 20 Years Follow-up

    Directory of Open Access Journals (Sweden)

    Giampietro Farronato

    2011-04-01

    Full Text Available Background: Traditionally, maxillofacial deformities are corrected surgically after an initial orthodontic treatment phase. However in, this article, the authors emphasize the postsurgical therapeutic protocol which is extremely important for determining the final and permanent retention of the corrected occlusion.Methods: A 55 year old female with severe skeletal Class II malocclusion is presented. Combined surgical and orthodontic correction of the malocclusion was used.Results: The step-by-step procedure the authors followed for the postsurgical therapy is described. The goals of the postoperative therapy were to restore and rehabilitate neuromuscular function, obtain occlusal stabilization, grind teeth selectively, and final occlusion retention. The importance of a surgical occlusal splint for rehabilitating stomatognathic neuromuscular function postoperatively was demonstrated. Furthermore, the orthodontic-prosthodontic treatment ensured occlusion stability after the surgical correction. The long-term results confirmed the efficacy of the treatment protocol presented here from both functional and aesthetical perspectives.Conclusions: Postsurgical orthodontic treatment is an important step in the surgical and orthodontic therapy of maxillofacial deformities.

  11. Inpatient Treatment for Early Sexually Abused Adults: A Naturalistic 12-Month Follow-Up Study

    NARCIS (Netherlands)

    Jepsen, E.K.K.; Langeland, W.; Sexton, H.; Heir, T.

    2014-01-01

    To date, most of the inpatient outcome studies among early traumatized individuals lack data on dissociative disorders. More research is needed to evaluate whether severely dissociative patients can improve following specialized inpatient treatment for chronic childhood abuse. The objectives of this

  12. Long-term treatment of nocturnal enuresis with desmopressin. A follow-up study

    DEFF Research Database (Denmark)

    Knudsen, U B; Rittig, Søren; Nørgaard, J P

    1991-01-01

    Eight patients with monosymptomatic nocturnal enuresis (age 11-24 years) were investigated prior to and after 24 weeks of desmopressin treatment in order to evaluate the impact on the endogenous vasopressin secretion and urinary output. No effect on plasma vasopressin, diurnal urinary volume, and...

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

    International Nuclear Information System (INIS)

    Glynne-Jones, Robert; Nilsson, Per J.; Aschele, Carlo; Goh, Vicky; Peiffert, Didier; Cervantes, Andrés; Arnold, Dirk

    2014-01-01

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

  14. Ultrasound guided percutaneous treatment and follow-up of Baker's cyst in knee osteoarthritis

    International Nuclear Information System (INIS)

    Köroğlu, Mert; Çallıoğlu, Mehmet; Eriş, Hüseyin Naim; Kayan, Mustafa; Çetin, Meltem; Yener, Mahmut; Gürses, Cemil; Erol, Bekir; Türkbey, Barış; Parlak, Ayşe Eda; Akhan, Okan

    2012-01-01

    Objective: Purpose of this study is to assess sonographic changes and clinical response in different subgroups of Baker's cyst patients with knee osteoarthritis after a single session of ultrasound-guided percutaneous aspiration and corticosteroid injection. Materials and methods: Thirty-two knee osteoarthritis patients (46–85 years, mean 58.97 ± 9.88) with symptomatic Baker's cyst diagnosed at ultrasonography were included in the study. To determine the grade of the symptoms, Visual Analogue Scale was applied. The patients were grouped in two, as simple (n = 24) and complex (n = 8) Baker's cyst. Thirty-two ultrasound-guided cyst aspirations concomitant 1 ml betamethasone injection (24 simple, 8 complex subgroups) were performed. Patients were followed clinically as well as via ultrasonography for 6 months after procedures. Results: A significant decrease in volume of the Baker's cysts after percutaneous treatment was accompanied by a significant clinical improvement. Moreover, the volume reduction of Baker's cyst after the treatment was significantly correlated with the clinical improvement (Pearson correlation coefficient = 0.542, p = 0.001). All 6 Baker's cysts relapsed at ultrasonography were complex type. Furthermore, a comparison of patients with simple Baker's cysts and those with complex Baker's cysts demonstrated no significant change in Visual Analogue Scale scores between two groups (p = 0.061, Mann–Whitney U). No complications (minor or major) occurred secondary to percutaneous treatment. Conclusion: Baker's cysts can be grouped as simple and complex groups via ultrasonography prior to the treatment. Cyst aspiration with ultrasound-guided corticosteroid injection yields clinical improvement and cyst volume reduction in all subgroups of patients with Baker's cyst secondary to knee osteoarthritis.

  15. [Alcoholism: definition, diagnosis, illness concept, follow-up, results and costs of treatment].

    Science.gov (United States)

    Feuerlein, W

    1991-02-01

    The article starts with a review on the definition of alcoholism stressing the useful differentiation between alcohol abuse and alcohol dependence. On the basis of this definition the principles of the diagnosis of alcoholism are demonstrated. The disease concept of alcoholism is discussed in detail. Then the aims, the structure and the results of the therapy for alcoholics are briefly described. The article concludes with a short cost-benefit analysis of the alcoholism treatment.

  16. Nerve Ultrasound Predicts Treatment Response in Chronic Inflammatory Demyelinating Polyradiculoneuropathy-a Prospective Follow-Up.

    Science.gov (United States)

    Härtig, Florian; Ross, Marlene; Dammeier, Nele Maria; Fedtke, Nadin; Heiling, Bianka; Axer, Hubertus; Décard, Bernhard F; Auffenberg, Eva; Koch, Marilin; Rattay, Tim W; Krumbholz, Markus; Bornemann, Antje; Lerche, Holger; Winter, Natalie; Grimm, Alexander

    2018-04-01

    As reliable biomarkers of disease activity are lacking, monitoring of therapeutic response in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) remains a challenge. We sought to determine whether nerve ultrasound and electrophysiology scoring could close this gap. In CIDP patients (fulfilling EFNS/PNS criteria), we performed high-resolution nerve ultrasound to determine ultrasound pattern sum scores (UPSS) and predominant echotexture nerve conduction study scores (NCSS) as well as Medical Research Council sum scores (MRCSS) and inflammatory neuropathy cause and treatment disability scores (INCAT) at baseline and after 12 months of standard treatment. We retrospectively correlated ultrasound morphology with nerve histology when available. 72/80 CIDP patients featured multifocal nerve enlargement, and 35/80 were therapy-naïve. At baseline, clinical scores correlated with NCSS (r 2  = 0.397 and r 2  = 0.443, p  50% of measured segments, possibly reflecting axonal degeneration; and 3) almost no enlargement, reflecting "burned-out" or "cured" disease without active inflammation. Clinical improvement after 12 months was best in patients with pattern 1 (up to 75% vs up to 43% in pattern 2/3, Fisher's exact test p < 0.05). Nerve ultrasound has additional value not only for diagnosis, but also for classification of disease state and may predict treatment response.

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

    Science.gov (United States)

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

    2010-12-01

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

  18. Treatment and follow-up of patients suffering from the cutaneous radiation syndrome

    International Nuclear Information System (INIS)

    Peter, R.U.; Gottloeber, P.; Heckmann, M.; Braun-FaIco, O.; Plewig, G.

    1996-01-01

    The hazards of acute radiation exposure are commonly addressed with respect to total body gamma or neutron irradiation, resulting primarily in bone marrow failure as the main clinically relevant aspect of the acute radiation disease. Under conditions of inhomogeneous exposure, as they are characteristic for many accident scenarios, other organ systems, such as the skin may become more important in determining clinical prognosis. This became especially obvious in the two worst radiation accidents since 1945, the Chernobyl accident in April 1986 and the Goiania accident in September 1987. The characteristic chronic sequelae of accidental cutaneous radiation exposure and therapeutic results have been described based on own clinical experience with treating patients with acute and late cutaneous effects after therapeutic irradiation, and a distinct group of patients having survived the Chernobyl nuclear power plant accident of April 26, 1986. Apart from clinical examination, histological analysis and high-frequency (20 MHz) ultrasound as well as a variety of functional tests have been used to determine the extent of radiation fibrosis and to exclude malignant transformation of keratoses and ulcers. Treatment included, apart from dermatosurgical procedures and plastic surgery for disabling contractures or ulcers, argon laser treatment of telangiectasias, topical tretinoin 0,005% (Epi-Aberel R , Cilag, Frankfurt), etretinate and acitretin (Tigason R , Neotigason R , Hoffmann LaRoche, Grenzach) for radiation keratoses, partly combined with a novel, nonatrophogenic steroid, Mometasonefuroate (Elocon R , Schering-Plough, New Jersey) to antagonize inflammatory reactions, and low-dose interferon-gamma (Polyferon R , Rentschler, Laupheim) for extensive radiation fibrosis. Basic dermatotherapy was performed with an ointment containing linoleic acid (Linola R , Wolff, Bielefeld). With this combination treatment, transepidermal water loss could be sustained, progression of

  19. Long time follow up of implant therapy and treatment of peri-implantitis.

    Science.gov (United States)

    Roos-Jansåker, Ann-Marie

    2007-01-01

    Dental implants have become an often used alternative to replace missing teeth, resulting in an increasing percentage of the adult population with implant supported prosthesis. Although favourable long-term results of implant therapy have been reported, infections occur. Until recently few reports included data on peri-implant infections, possibly underestimating this complication of implant treatment. It is possible that some infections around implants develop slowly and that with time peri-implantitis will be a common complication to implant therapy as an increasing number of patients have had their implants for a long time (>10 years). Data on treatment of peri-implant lesions are scarce leaving the clinician with limited guidance regarding choice of treatment. The aim of this thesis was to study the frequency of implant loss and presence of peri-implant lesions in a group of patients supplied with Brånemark implants 9-14 years ago, and to relate these events to patient and site specific characteristics. Moreover three surgical treatment modalities for peri-implantitis were evaluated. The thesis is based on six studies; Studies I-III included 218 patients and 1057 implants followed for 9-14 years evaluating prevalence of, and factors related to implant loss (Paper I) and prevalence of peri-implant infections and related factors (Paper I-III). Study IV is a review describing different treatment modalities of peri-implant infections. Study V is a prospective cohort study involving 36 patients and 65 implants, evaluating the use of a bone substitute with or without the use of a resorbable membrane. Study VI is a case series with 12 patients and 16 implants, evaluating a bone substitute in combination with a resorbable membrane and submerged healing. This thesis demonstrated that: After 9-14 years the survival rates of dental implants are high (95.7%). Implant loss seems to cluster within patients and are related to periodontitis evidenced as bone loss on

  20. Consensus on the diagnosis, treatment and follow-up of patients with Duchenne muscular dystrophy.

    Science.gov (United States)

    Nascimento Osorio, A; Medina Cantillo, J; Camacho Salas, A; Madruga Garrido, M; Vilchez Padilla, J J

    2018-03-09

    Duchenne muscular dystrophy (DMD) is the most common myopathy in children, with a worldwide prevalence of approximately 0.5 cases per 10,000 male births. It is characterised by a progressive muscular weakness manifesting in early childhood, with the subsequent appearance of musculoskeletal, respiratory, and cardiac complications, causing disability, dependence, and premature death. Currently, DMD is mainly managed with multidisciplinary symptomatic treatment, with favourable results in terms of the progression of the disease. It is therefore crucial to establish clear, up-to-date guidelines enabling early detection, appropriate treatment, and monitoring of possible complications. We performed a literature search of the main biomedical databases for articles published in the last 10years in order to obtain an overview of the issues addressed by current guidelines and to identify relevant issues for which no consensus has yet been established. The degree of evidence and level of recommendation of the information obtained were classified and ordered according to the criteria of the American Academy of Neurology. DMD management should be multidisciplinary and adapted to the patient's profile and the stage of clinical progression. In addition to corticotherapy, treatment targeting gastrointestinal, respiratory, cardiac, and orthopaedic problems, as well as physiotherapy, should be provided with a view to improving patients' quality of life. Genetic studies play a key role in the management of the disease, both in detecting cases and potential carriers and in characterising the mutation involved and developing new therapies. Copyright © 2018 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Prospective follow-up of nebivolol in the treatment of arterial hypertension

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    Despotović Nebojša

    2012-01-01

    Full Text Available Introduction. Nebivolol, a third-generation beta-blocker (BB shows a highly selective beta-blockade and specific vasodilating effects due to getting free nitro-oxide from the dysfunctional endothelium. Objective. The aim of the study was to investigate the antihypertensive effect of nebivolol in patients with arterial hypertension (AH of both sexes. Methods. Systolic and diastolic blood pressure (BP, heart rate and serum glycemia, creatinin, cholesterol and trygliceride were measured after a 6-week treatment with a single 5 mg dose of nebivolol once daily so as to assess its efficacy and metabolic effects, as well as its tolerance by using a questionnaire answered by physicians and patients. Results. Out of 520 patients with mild or moderate AH, 430 (82.7% were treated with nebivolol as monotherapy. After a 6-week treatment with nebivolol, with very good tolerability and neutral metabolic effects, systolic BP was significantly decreased (in male from initial 165±19 to 129±12 mm Hg, and female from initial 169±22 to 132±15 mm Hg at the end of the study; average decrease 22.3%, p<0.001 and as well as diastolic BP (male from initial 103±12 to 79±6 mm Hg and female from initial 100±9 to 82±7 mm Hg, average decrease 22.6%; p<0.001. Conclusion. After a 6-week treatment nebivolol significantly decreased systolic and diastolic BP in patients with mild and moderate AH, independently of the sex.

  2. Estramustine phosphate in the treatment of hormone escape prostatic carcinoma - a 3 year follow-up

    Directory of Open Access Journals (Sweden)

    Altaf H Syed

    2003-01-01

    Full Text Available Objective: A recent literature review has shown rekin-dled interest in the use of estramustine phosphate (EMP inpatients with advanced prostatic cancer. This led us to assess prostate specific antigen (PSA response and drug tolerability following EMP therapy inpatients with hor-mone refractory prostate cancer Patients and Methods: Twenty-five patients with a mean age of 73.5 years (range 49 to 85 years received EMP for hormone insensitive prostate cancer from January 1996 onwards. They were received at 6 weeks initially followed by 3 monthly intervals to monitor further progression of disease. At each visit clinical examination and blood chem-istry (PSA, etc was done and further investigations, i.e., bone scan, CT scan, etc. were requested if thought neces-sary. Results: According to the WHO score of pain 71 %found immediate symptomatic relief following EMP treatment but only 29% were pain free after one year PSA level showed a persistent decline of> 50% of pre-treatment value in 16 patients (64% at 6 weeks. However, at 1 year 22% had either a still declining PSA or had reached a stable nadir PSA level while the rest showed rising PSA suggesting in-sensitivity to EMP. Three out of 5 patients (excluding I patient with intolerance at 2 months with> 80% decrease in PSA at 6 weeks had longer period of progression free interval (1 year in 2 and 2 years in 1 patient. The treat-ment was generally well tolerated (72% as only 7 patients had to discontinue EMP because of severe side ef-fects. Conclusions: EMP treatment in patients with hormone escaped prostatic cancer does produce immediate PSA response which is reflected simultaneously in pain improve-ment in the majority of cases but overall the benefit is shortlived. Patients who have> 80% reduction in pre-treat-ment PSA value at 6 weeks may have longer period of pro-gressionfree intervals. However EMP was generally well tolerated.

  3. The clinical features, laboratory findings, treatment and follow-up results of patients with morphea

    Directory of Open Access Journals (Sweden)

    Nehir Parlak

    2013-12-01

    Full Text Available Objective: Morphea, also known as localized scleroderma, is a rare skin disease of unknown pathogenesis, characterized by fibrosis in the skin and subcutaneous tissue. In this study, we aim to evaluate the demographic features, clinical characteristics, laboratory findings, and response to treatment in patients diagnosed with morphea. Materials and Methods: The findings of fifty eight patients diagnosed with morphea were retrospectively evaluated between 1995-2011. All patients' clinical symptoms, concomitant diseases, symptoms, immunological features and presence of peripheral eosinophilia were investigated. Treatment methods, response to therapy of 40 patients whose treatment continued for 2-12 months were examined. Fourty nine patients (84.5% were female and 9 patients (15.5% were male of 58 patients who were diagnosed with morphea. The mean age of patients was 42.33±18.44 years (range: 7-75 years. Diagnosis was made histopathologically in all cases. Borrelia antibodies were negative in all patients enrolling the study. Thirty six patients (62.1% had plaque type, 17 patients (29.3% had generalized type, 3 patients (5.2% had mixed type (linear + plaque and 2 patients (3.4% had linear type of morphea. ANA was found to be positive in 12 (26.2% of 46 patients. Considering the relationship between the clinical types of morphea with ANA, 38.5% of plaque type, 53.8% of generalized type, 7.7% of mixed type patients showed ANA positivity. ANA positivity was statistically significant in patients with generalized morphea (p=0.027. Peripheral eosinophilia was detected in one case in whom lesions were generalized (2.1%. Colchicine therapy was given to 23 cases. Complete and partial response rates are 47.8% and 26.1%, respectively. However, 17.4% of patients remained stable and progression was noted in 8.7% of the cases. Conclusion: In conclusion, plaque type morphea is the most common type of morphea. ANA positivity was statistically significant in

  4. Prevalence and predictors of post-traumatic stress symptoms in adolescent and young adult cancer survivors: a 1-year follow-up study.

    Science.gov (United States)

    Kwak, Minyoung; Zebrack, Brad J; Meeske, Kathleen A; Embry, Leanne; Aguilar, Christine; Block, Rebecca; Hayes-Lattin, Brandon; Li, Yun; Butler, Melissa; Cole, Steven

    2013-08-01

    Post-traumatic stress symptoms (PTSS) have been identified as a meaningful indicator of distress in cancer survivors. Distinct from young adult survivors of childhood cancer, young people diagnosed with cancer as adolescents and young adults (AYAs) face unique psychosocial issues; however, there is little published research of PTSS in the AYA population. This study examines prevalence and predictors of PTSS among AYAs with cancer. As part of a longitudinal study of AYAs with cancer, 151 patients aged 15-39 years completed mailed surveys at 6 and 12 months post-diagnosis. Severity of PTSS was estimated at 6 and 12 months post-diagnosis. Multiple regression analyses were conducted to investigate the predictive effects of socio-demographic and clinical characteristics on changes in PTSS over time. At 6 and 12 months, respectively, 39% and 44% of participants reported moderate to severe levels of PTSS; 29% had PTSS levels suggestive of post-traumatic stress disorder. No significant differences in severity of PTSS between 6 and 12 months were observed. Regression analyses suggested that a greater number of side effects were associated with higher levels of PTSS at 6 months. Currently receiving treatment, having surgical treatment, diagnosis of a cancer type with a 90-100% survival rate, remaining unemployed/not in school, and greater PTSS at 6 months were associated with higher levels of PTSS at 12 months. Post-traumatic stress symptoms were observed as early as 6 months following diagnosis and remained stable at 12-month follow-up. The development of early interventions for reducing distress among AYA patients in treatment is recommended. Copyright © 2012 John Wiley & Sons, Ltd.

  5. Treatment of bisphosphonate related osteonecrosis following root canal therapy at the 1-year follow-up: report of two cases

    Directory of Open Access Journals (Sweden)

    Kaptan F

    2013-12-01

    Full Text Available Figen Kaptan,1 Meric Karapinar Kazandag,1 Ufuk Iseri21Yeditepe University, Faculty of Dentistry, Department of Endodontics, 2Department of Prosthodontics, Istanbul, TurkeyAbstract: The objective of this report was to use topical gaseous ozone as an adjunct to conventional treatment methods and to describe the multidisciplinary management of bisphosphonate associated bone necrosis, which developed following endodontic treatment. No complaints were noted by the patients at their 1-year follow-up and the treatment showed favorable prognosis.Keywords: bisphosphonate, osteonecrosis, BRONJ, endodontics, oxygen, ozone

  6. [Effectiveness of an integrated treatment for severe personality disorders. A 36-month pragmatic follow-up].

    Science.gov (United States)

    Lana, Fernando; Sánchez-Gil, Carmen; Ferrer, Laia; López-Patón, Nuria; Litvan, Lia; Marcos, Susana; Sierra, Ana C; Soldevilla, Joan M; Feixas, Guillem; Pérez, Víctor

    2015-01-01

    Over the past 25 years, several studies have shown the efficacy of a number of psychological interventions for severe personality disorders. However, the generalizability of these positive results from long traditional research settings to more ordinary ones has been questioned, requiring a need for replication in pragmatic studies. This pragmatic study compares hospitalizations and Emergency Room visits before and during a 6-month therapeutic program for severe personality disorders, and at 36 months after starting it. The therapeutic program, which integrates several specific interventions within a coherent framework, was carried out in an ordinary clinical setting. Fifty-one patients, evaluated according DSM-IV criteria by using the Spanish version of the Structured Clinical Interview for Personality Disorders (SCID-II), were included. The clinical characteristics showed a group of severely disturbed patients, of which 78.4% met criteria for borderline personality disorder. The percentage of patients hospitalized and visiting the Emergency Room, as well as the number of days of hospitalization and Emergency Room visits was significantly reduced during the treatment, and this improvement was maintained throughout. An integrated treatment for severe personality disorders could be effective in preventing reliance on readmissions, or prolonged hospital stays, when it is implemented by clinicians in ordinary clinical settings. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.

  7. Cardiac damage after treatment of childhood cancer: A long-term follow-up

    International Nuclear Information System (INIS)

    Velensek, Veronika; Mazic, Uros; Krzisnik, Ciril; Demšar, Damjan; Jazbec, Janez; Jereb, Berta

    2008-01-01

    With improved childhood cancer cure rate, long term sequelae are becoming an important factor of quality of life. Signs of cardiovascular disease are frequently found in long term survivors of cancer. Cardiac damage may be related to irradiation and chemotherapy. We have evaluated simultaneous influence of a series of independent variables on the late cardiac damage in childhood cancer survivors in Slovenia and identified groups at the highest risk. 211 long-term survivors of different childhood cancers, at least five years after treatment were included in the study. The evaluation included history, physical examination, electrocardiograpy, exercise testing and echocardiograpy. For analysis of risk factors, beside univariate analysis, multivariate classification tree analysis statistical method was used. Patients treated latest, from 1989–98 are at highest risk for any injury to the heart (73%). Among those treated earlier are at the highest risk those with Hodgkin's disease treated with irradiation above 30 Gy and those treated for sarcoma. Among specific forms of injury, patients treated with radiation to the heart area are at highest risk of injury to the valves. Patients treated with large doses of anthracyclines or concomitantly with anthracyclines and alkylating agents are at highest risk of systolic function defect and enlarged heart chambers. Those treated with anthracyclines are at highest risk of diastolic function defect. The time period of the patient's treatment is emerged as an important risk factor for injury of the heart

  8. Long-term follow-up and treatment of congenital alveolar proteinosis

    Directory of Open Access Journals (Sweden)

    Muensterer Oliver J

    2011-08-01

    Full Text Available Abstract Background Clinical presentation, diagnosis, management and outcome of molecularly defined congenital pulmonary alveolar proteinosis (PAP due to mutations in the GM-CSF receptor are not well known. Case presentation A 2 1/2 years old girl was diagnosed as having alveolar proteinosis. Whole lung lavages were performed with a new catheter balloon technique, feasible in small sized airways. Because of some interstitial inflammation in the lung biopsy and to further improve the condition, empirical therapy with systemic steroids and azathioprin, and inhaled and subcutaneous GMCSF, were used. Based on clinical measures, total protein and lipid recovered by whole lung lavages, all these treatments were without benefit. Conversely, severe respiratory viral infections and an invasive aspergillosis with aspergilloma formation occurred. Recently the novel homozygous stop mutation p.Ser25X of the GMCSF receptor alpha chain was identified in the patient. This mutation leads to a lack of functional GMCSF receptor and a reduced response to GMCSF stimulation of CD11b expression of mononuclear cells of the patient. Subsequently a very intense treatment with monthly lavages was initiated, resulting for the first time in complete resolution of partial respiratory insufficiency and a significant improvement of the overall somato-psychosocial condition of the child. Conclusions The long term management from early childhood into young adolescence of severe alveolar proteinosis due to GMCSF receptor deficiency requires a dedicated specialized team to perform technically demanding whole lung lavages and cope with complications.

  9. Treatment side effects and follow-up of malignant melanoma; Therapienebenwirkungen und Nachsorge bei malignem Melanom

    Energy Technology Data Exchange (ETDEWEB)

    Stahl, T. [Klinikum der Stadt Ludwigshafen gGmbH, Zentralinstitut fuer diagnostische und interventionelle Radiologie, Ludwigshafen (Germany); Loquai, C. [Universitaetsmedizin der Johannes-Gutenberg Universitaet Mainz, Hautklinik und Poliklinik, Mainz (Germany)

    2015-01-30

    Side effects in the therapy of malignant melanoma are primarily of importance for radiologists in advanced tumor stages. The available treatment options and their respective side effect profiles have undergone a profound change in recent years after the introduction of modern oncological therapies (e.g. immunotherapy and targeted therapy) with an increasing focus on individual tumor biology and differ significantly from those of classical chemotherapy. The immunotherapeutic agents, in particular ipilimumab, take on a special position because of their specific immune-mediated mechanisms of action and the associated side effects, so-called immune-related adverse events (irAE). The majority of the treatment effects are manifested on the skin (> 50 %) and are generally not detectable by diagnostic radiology. Only a comparatively small proportion of treatment side effects is detectable with diagnostic imaging (15-20 %) but as in the example of therapy-induced colitis with ipilimumab, may be rapidly fatal. In addition to colitis (10-20 %) further therapy side effects apparent in diagnostic imaging are hypophysitis (1.8-17 %), thyroiditis (0.8 %), myositis (1.7 %), fasciitis and sarcoid-like lymph node alterations (6.8 %). To detect radiologically detectable side effects early on and to delineate them especially from tumor progression and (opportunistic) infections, detailed knowledge of the therapeutic methods for melanoma, the mechanisms of action and in particular the sometimes very specific side effects is imperative for radiologists. (orig.) [German] Nebenwirkungen der Therapie des malignen Melanoms sind fuer den Radiologen primaer in fortgeschrittenen Tumorstadien von Bedeutung. Die zur Verfuegung stehenden Therapieoptionen und ihre jeweiligen Nebenwirkungsprofile haben sich in den letzten Jahren nach Einfuehrung moderner onkologischer Therapieoptionen, die sich zunehmend an der individuellen Tumorbiologie orientieren (zielgerichtete Therapie, Immuntherapie), einem

  10. Neurotoxicity and LSD treatment: a follow-up study of 151 patients in Denmark.

    Science.gov (United States)

    Larsen, Jens Knud

    2016-06-01

    LSD was introduced in psychiatry in the 1950s. Between 1960 and 1973, nearly 400 patients were treated with LSD in Denmark. By 1964, one homicide, two suicides and four suicide attempts had been reported. In 1986 the Danish LSD Damages Law was passed after complaints by only one patient. According to the Law, all 154 applicants received financial compensation for LSD-inflicted harm. The Danish State Archives has preserved the case material of 151 of the 154 applicants. Most of the patients suffered from severe side effects of the LSD treatment many years afterwards. In particular, two-thirds of the patients had flashbacks. With the recent interest in LSD therapy, we should consider the neurotoxic potential of LSD. © The Author(s) 2016.

  11. A case of localized juvenile periodontitis: treatment and 3 years follow-up with superimposable radiographs.

    Science.gov (United States)

    Dubrez, B; Baehni, P; Cimasoni, G

    1996-06-01

    A 17-year-old male patient with localized juvenile periodontitis was treated by subgingival instrumentation with full thickness flap on the lower molars, combined with a 3-week course of systemic tetracycline, and a programme of supervised oral hygiene. The treatment was rapidly followed by dramatic clinical and microbiological improvement. However, despite good oral hygiene, gingival inflammation recurred at regular intervals. It was necessary to maintain the clinical results by periodic subgingival instrumentation with an ultrasonic scaler. Healing of alveolar bone was monitored in the lower 1st molar regions over 3 years by using superimposable radiographs. Quantitative analysis of bone density performed with a high-resolution digitalisation technique showed a considerable improvement 1 year after therapy. However, continuous remodelling, probably related to variations in inflammation, occurred during the 3 postoperative years.

  12. Merkel Cell Carcinoma: An Update of Key Imaging Techniques, Prognostic Factors, Treatment, and Follow-up.

    Science.gov (United States)

    Llombart, B; Kindem, S; Chust, M

    2017-03-01

    Merkel cell carcinoma, though rare, is one of the most aggressive tumors a dermatologist faces. More than a third of patients with this diagnosis die from the disease. Numerous researchers have attempted to identify clinical and pathologic predictors to guide prognosis, but their studies have produced inconsistent results. Because the incidence of Merkel cell carcinoma is low and it appears in patients of advanced age, prospective studies have not been done and no clear treatment algorithm has been developed. This review aims to provide an exhaustive, up-to-date account of Merkel cell carcinoma for the dermatologist. We describe prognostic factors and the imaging techniques that are most appropriate for evaluating disease spread. We also discuss current debates on treating Merkel cell carcinoma. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Treatment and Follow Up Outcomes of Patients with Peroneal Nerve Injury: A Single Center Experience

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    Yasar Dagistan

    2017-01-01

    Full Text Available Aim: Trap neuropathy is characterized by compression of the peripheral nerve into fibro osseous channels in trespassing areas of body segments. Peroneal nerve is the most frequently injured nerve in traumatic injuries of the lower extremities. In the present study, we investigated functional results of surgical treatment of patients with peroneal nerve injury who delayed visiting our clinics after the damage; we also aimed to observe the effects of this delay on prognosis. We interpreted postoperative results of the patients with EMG and physical examination findings. Material and Method: Subjects with peroneal nerve damage who visited our clinics between 2012 and 2015 were included in the present study. EMG and muscle motor strength tests were conducted pre and postoperatively for clinical assessment. Results: Of the 16 patients in the study population, 7 were men and 9 were women. The median age of the subjects was 49.6 years (14-77 years. Admission time was 9 months after injury. Causes of the peroneal nerve damage were as follows: prosthesis surgery in 4 (25%, ankle damage in 2 (12.5%, excessive squatting by agriculture workers in 4 (25%, aggressive exercise in 2 (12.5%, bone fracture in 2 (12.5%, and unknown origin in 2 (12.5%. Discussion: Peroneal nerve injury usually occurs by compression of the nerve at the head or neck of the fibula. Results of decompression surgery are usually compromising in non-traumatic nerve palsies. Period of duration between injury and diagnosis and muscular atrophy are main factors associated with success of treatment.

  14. Plantar Pressures After Nonoperative Treatment for Clubfoot: Intermediate Follow-up at Age 5 Years.

    Science.gov (United States)

    Jeans, Kelly A; Erdman, Ashley L; Karol, Lori A

    2017-01-01

    Worldwide, a nonoperative approach in the treatment of idiopathic clubfoot has been taken in an attempt to reduce the incidence of surgical outcomes. Although both the Ponseti casting (Ponseti) and the French physiotherapy (PT) methods have shown gait and pedobarograph differences at age 2 years, improved gait results have been reported by age 5 years. The purpose of this study was to assess plantar pressures in feet treated with the Ponseti versus the PT methods at this intermediate stage. Clubfoot patients treated nonoperatively (Ponseti or PT) underwent pedobarograph data collection at age 5 years. The foot was subdivided into the medial/lateral hindfoot, midfoot, and forefoot regions. Variables included Peak Pressure, Maximum Force, Contact Area%, Contact Time%, Pressure Time Integral, the hindfoot-forefoot angle, and displacement of the center of pressure (COP) line. Twenty controls were used for comparison. Pedobarograph data from 164 patients (238 feet; 122 Ponseti and 116 PT) showed no significant differences between the Ponseti and the PT feet, except the PT feet had a significantly less medial movement of the COP than the Ponseti feet (P=0.0379). Compared with controls, both groups had decreased plantar pressures in the hindfoot and first metatarsal regions, whereas the midfoot and lateral forefoot experienced significant increases compared with controls. This lateralization was also reflected in the hindfoot-forefoot angle and the COP. Feet that remain nonoperative and avoid surgical intervention are considered a good clinical result. However, pedobarograph results indicate mild residual deformity in these feet despite clinically successful outcomes. Level II-therapeutic.

  15. Cannabis abstinence during treatment and one-year follow-up: relationship to neural activity in men.

    Science.gov (United States)

    Kober, Hedy; DeVito, Elise E; DeLeone, Cameron M; Carroll, Kathleen M; Potenza, Marc N

    2014-09-01

    Cannabis is among the most frequently abused substances in the United States. Cognitive control is a contributory factor in the maintenance of substance-use disorders and may relate to treatment response. Therefore, we assessed whether cognitive-control-related neural activity before treatment differs between treatment-seeking cannabis-dependent and healthy individuals and relates to cannabis-abstinence measures during treatment and 1-year follow-up. Cannabis-dependent males (N=20) completed a functional magnetic resonance imaging (fMRI) cognitive-control (Stroop) task before a 12-week randomized controlled trial of cognitive-behavioral therapy and/or contingency management. A healthy-comparison group (N=20) also completed the fMRI task. Cannabis use was assessed by urine toxicology and self-report during treatment, and by self-report across a 1-year follow-up period (N=18). The cannabis-dependent group displayed diminished Stroop-related neural activity relative to the healthy-comparison group in multiple regions, including those strongly implicated in cognitive-control and addiction-related processes (eg, dorsolateral prefrontal cortex and ventral striatum). The groups did not differ significantly in response times (cannabis-dependent, N=12; healthy-comparison, N=14). Within the cannabis-dependent group, greater Stroop-related activity in regions including the dorsal anterior cingulate cortex was associated with less cannabis use during treatment. Greater activity in regions including the ventral striatum was associated with less cannabis use during 1-year posttreatment follow-up. These data suggest that lower cognitive-control-related neural activity in classic 'control' regions (eg, dorsolateral prefrontal cortex and dorsal anterior cingulate) and classic 'salience/reward/learning' regions (eg, ventral striatum) differentiates cannabis-dependent individuals from healthy individuals and relates to less abstinence within-treatment and during long-term follow-up

  16. Attainment of LDL Cholesterol Treatment Goals in Children and Adolescents With Familial Hypercholesterolemia. The SAFEHEART Follow-up Registry.

    Science.gov (United States)

    Saltijeral, Adriana; Pérez de Isla, Leopoldo; Alonso, Rodrigo; Muñiz, Ovidio; Díaz-Díaz, José Luis; Fuentes, Francisco; Mata, Nelva; de Andrés, Raimundo; Díaz-Soto, Gonzalo; Pastor, José; Pinilla, José Miguel; Zambón, Daniel; Pinto, Xavier; Badimón, Lina; Mata, Pedro

    2017-06-01

    Little is known about the characteristics of persons with familial hypercholesterolemia (FH) younger than 18 years, the lipid-lowering therapy used in these patients, and the lipid goals reached in real life. Our aim was to evaluate the achievement of low-density lipoprotein cholesterol (LDL-C) treatment goals in FH patients younger than 18 years enrolled in a large national registry. We analyzed patients younger than 18 years enrolled in a large ongoing registry of molecularly-defined patients with FH in Spain. The attainment of guideline-recommended plasma LDL-C goals at entry and follow-up was analyzed in relation to the use of lipid-lowering therapy. We enrolled 392 individuals younger than 18 years. Of these, 217 were molecularly-diagnosed FH patients and had a complete follow-up. The median follow-up time was 4.69 years (interquartile range, 2.48-6.38 years), 68.2% of FH patients were on statins, and 41.5% patients had LDL-C < 130mg/dL. Statin use was the only predictor of LDL-C goal attainment. This study shows that a high proportion of FH patients younger than 18 years have high LDL-C levels and fail to achieve recommended LDL-C targets. Statin use was the only independent predictor of LDL-C goal achievement. No safety concerns were detected during follow-up. These results indicate that many FH patients are not adequately controlled and that there is still room for treatment improvement. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  17. Spas for gynaecological complaints in the follow-up treatment of women operated and irradiated for cancer

    International Nuclear Information System (INIS)

    Baatz, H.; Verband Deutscher Badeaerzte e.V., Bad Pyrmont

    1980-01-01

    The therapeutical value of the two main fields of gynaecological balneotherapy, and treatment and brine treatment, is about equal, so that the therapy of choice depends mostly on the 12 possible indications. Mud therapy is never indicated for the post-operative treatment of woman who have undergone primary cancer therapy. It is contra-indicated during cancer treatment as well as afterwards. Brine therapy is the method of choice for post-operative treatment. (orig./MG) [de

  18. Arthroscopic Treatment of 2 Consecutive Cases of Dysplasia Epiphysealis Hemimelica of the Ankle: A 5-Year Follow-Up Report

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    Cosma Calderaro

    2017-01-01

    Full Text Available The dysplasia epiphysealis hemimelica (DEH is a rare disease of unknown etiology consisting in an abnormal osteocartilaginous growth at the epiphysis, usually hemimelic with histological findings similar to benign osteochondroma. In this case series, we described the results of the arthroscopic treatment of 2 consecutive cases of intra-articular ankle localization of DEH in 2 patients aged 9 and 10 years. The good result obtained, persistent at the 5-year follow-up, leads us to consider the arthroscopic approach as a reliable treatment in patient affected by intra-articular ankle DEH.

  19. Prospective clinical study of prosthetic treatment outcome of implantretained-removable-partial-denture during 5 year-follow-ups

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    Mehran Bahrami

    2017-11-01

    Full Text Available Background IRRPD offers patients the ability to upgrade their treatment planning to implant-supported-overdentures (ISOs or implant-supported-fixed-prostheses (ISFPs through insertion of more implants in the future after the loss of the remaining natural teeth. Aims The purpose of this prospective-clinical-study was to evaluate the success rate and treatment outcome of IRRPD for 15 patients, during at least 5-year-follow-ups after prosthetic rehabilitation with respect to implant mobility, peri-implant-marginal-bone-levels, and prosthetic complications. Methods 15 successive patients were attended the Department of Implantology and Prosthodontics in TUMS, and received Implant-Retained-Removable-Partial-Dentures (IRRPDs. Two standard-size-dental-implants (Implantium/Dentium system, internal hexagon, Seoul, South Korea were placed in distal-extension-areas for each patient. After the osseointegration period, all patients received IRRPDs using two Ball attachments. All the participated patients were followed-up at least for 5 years, and the survival rate of 30 implants was evaluated. The patients’ satisfaction of function, phonetics, and aesthetics was assessed by means of questionnaire. Results None of the studied patients reported any prosthetic complications during the follow-up-periods such as attachment loosening, metal housing loosening, or denture fracture. No implants failure was recorded, so that the cumulative-implant-survival rate was 100 per cent. The mean marginal-bone-resorption (MBR around the two implants was 0.9mm with a range of 0.5–1.4mm. Teeth aesthetics was judged as excellent or very good by 86.7 per cent of the patients, while phonetics and mastication were considered excellent or very good by 66.7 per cent and 73.3 per cent of the patients, respectively. Conclusion 15 patients received 30 implants for the fabrication of IRRPDs in the posterior-edentulous-sites. The IRRPDs were delivered to the patients by the same

  20. Characteristics Associated With Antihypertensive Treatment and Blood Pressure Control: A Population-Based Follow-Up Study in Peru.

    Science.gov (United States)

    Zavala-Loayza, J Alfredo; Benziger, Catherine Pastorius; Cárdenas, María Kathia; Carrillo-Larco, Rodrigo M; Bernabé-Ortiz, Antonio; Gilman, Robert H; Checkley, William; Miranda, J Jaime

    2016-03-01

    Over one-quarter of the world's adult population has hypertension, yet achieving adequate treatment or control targets remains a challenge. This study sought to identify, longitudinally, characteristics associated with antihypertensive treatment and blood pressure (BP) control among individuals with hypertension. Data from individuals enrolled in the population-based CRONICAS Cohort Study (adults ≥35 years, living in 4 different rural/urban and coastal/high-altitude Peruvian settings) with hypertension at baseline were used. Antihypertensive treatment and BP control were assessed at baseline and at 15 months. Multinomial logistic regressions were used to estimate relative risk ratios (RRR) and 95% confidence intervals (95% CI) of factors associated with antihypertensive treatment and BP control at follow-up. At baseline, among 717 individuals with hypertension (53% women, mean age 61.5 ± 12.4 years), 28% were unaware of their hypertension status, 30% were aware but untreated, 16% were treated but uncontrolled, and 26% were treated and controlled. At follow-up, 89% of unaware and 82% of untreated individuals persisted untreated, and only 58% of controlled individuals remained controlled. Positive predictors of receiving treatment and being controlled at follow-up included age (RRR: 0.81; 95% CI: 0.73 to 0.91 for every 5 years) and family history of a chronic disease (RRR: 0.53; 95% CI: 0.31 to 0.92 vs. no history); whereas Puno rural site (RRR: 16.51; 95% CI: 1.90 to 143.56 vs. Lima) and male sex (RRR: 2.59; 95% CI: 1.54 to 4.36) were risk factors. Systolic BP at baseline (RRR: 1.27; 95% CI: 1.16 to 1.39 for every 5 mm Hg) and male sex (RRR: 1.75, 95% CI: 1.02 to 2.98) were risk factors for being treated but uncontrolled at follow-up. Large gaps in treatment of hypertension were observed. Targeting specific populations such as men, younger individuals, or those without family history of disease may increase coverage of antihypertensive treatment. Also, targeting

  1. MR angiography in the follow-up of coiled cerebral aneurysms after treatment with Guglielmi detachable coils

    International Nuclear Information System (INIS)

    Nome, T.; Bakke, S. J.; Nakstad, P. H.

    2002-01-01

    Purpose: Intra-arterial digital subtraction angiography (DSA) has been considered the gold standard examination in the follow-up of patients treated with Guglielmi detachable coils (GDCs). However, DSA is an invasive and expensive investigation and results in exposure to ionising radiation to both patient and operator. The aim of this study was to compare MR angiography (MRA) with DSA with regard to patency of the occlusion of aneurysms following GDC treatment. Material and Methods: We performed 75 MRA and DSA examinations on 51 patients treated with GDCs. The examinations were performed 3-36 months after embolisation and the interval between MRA and DSA was less than 1 week. Hard copies of both studies were interpreted retrospectively and independently for residual flow within the aneurysm, residual aneurysmal neck, and parent and branch vessel flow. Results: Patency status of parent and branch vessel flow was correctly identified with MRA in all patients except 1. The sensitivity of MRA in revealing residual flow within the aneurysm was 97%. The specificity in ruling out residual flow within the aneurysm was 91%. Conclusion: MRA may replace DSA in the long-term follow-up of coiled cerebral aneurysms. The initial follow-up examination should, however, include both modalities

  2. Kidney function and specific mortality in 60-80 years old post-myocardial infarction patients: A 10-year follow-up study.

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    Ellen K Hoogeveen

    Full Text Available Chronic kidney disease (CKD is highly prevalent among older post-myocardial infarction (MI patients. It is not known whether CKD is an independent risk factor for mortality in older post-MI patients with optimal cardiovascular drug-treatment. Therefore, we studied the relation between kidney function and all-cause and specific mortality among older post-MI patients, without severe heart failure, who are treated with state-of-the-art pharmacotherapy. From 2002-2006, 4,561 Dutch post-MI patients were enrolled and followed until death or January 2012. We estimated Glomerular Filtration Rate (eGFR with cystatin C (cysC and creatinine (cr using the CKD-EPI equations and analyzed the relation with any and major causes of death using Cox models and restricted cubic splines. Mean (SD for age was 69 years (5.6, 79% were men, 17% smoked, 21% had diabetes, 90% used antihypertensive drugs, 98% used antithrombotic drugs and 85% used statins. Patients were divided into four categories of baseline eGFRcysC: ≥90 (33%; reference, 60-89 (47%, 30-59 (18%, and <30 (2% ml/min/1.73m2. Median follow-up was 6.4 years. During follow-up, 873 (19% patients died: 370 (42% from cardiovascular causes, 309 (35% from cancer, and 194 (22% from other causes. After adjustment for age, sex and classic cardiovascular risk factor, hazard ratios (95%-confidence intervals for any death according to the four eGFRcysC categories were: 1 (reference, 1.4 (1.1-1.7, 2.9 (2.3-3.6 and 4.4 (3.0-6.4. The hazard ratios of all-cause and cause-specific mortality increased linearly below kidney functions of 80 ml/min/1.73 m2. Weaker results were obtained for eGFRcr. To conclude, we found in optimal cardiovascular drug-treated post-MI patients an inverse graded relation between kidney function and mortality for both cardiovascular as well as non-cardiovascular causes. Risk of mortality increased linearly below kidney function of about 80 ml/min/1.73 m2.

  3. A multidisciplinary treatment of congenitally missing maxillary lateral incisors: a 14-year follow-up case report

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    Renato Rodrigues de ALMEIDA

    2014-10-01

    Full Text Available Absence of the maxillary lateral incisor creates an aesthetic problem which can be managed in various ways. The condition requires careful treatment planning and consideration of the options and outcomes following either space closure or prosthetic replacement. Recent developments in restorative dentistry have warranted a re-evaluation of the approach to this clinical situation. Factors relating both to the patient and the teeth, including the presentation of malocclusion and the effect on the occlusion must be considered. The objective of this study was to describe the etiology, prevalence and alternative treatment modalities for dental agenesis and to present a clinical case of agenesis of the maxillary lateral incisors treated by the closure of excessive spaces and canine re-anatomization. A clinical case is presented to illustrate the interdisciplinary approach between orthodontics and restorative dentistry for improved esthetic results. In this report, the treatment of a girl with a Class II malocclusion of molars and canines with missing maxillary lateral incisors and convex facial profile is shown. Treatment was successfully achieved and included the space closure of the areas corresponding to the missing upper lateral incisors, through movement of the canines and the posterior teeth to mesial by fixed appliances as well as the canines transformation in the maxillary lateral incisors. This is a 14-year follow-up case report involving orthodontics and restorative dentistry in which pretreatment, posttreatment, and long-term follow-up records for the patient are presented.

  4. Iliococcygeus fixation for the treatment of apical vaginal prolapse: efficacy and safety at 5 years of follow-up.

    Science.gov (United States)

    Serati, Maurizio; Braga, Andrea; Bogani, Giorgio; Leone Roberti Maggiore, Umberto; Sorice, Paola; Ghezzi, Fabio; Salvatore, Stefano

    2015-07-01

    Sacrocolpopexy is considered the gold standard treatment for vaginal vault prolapse. However, the vaginal approach is very common, with 80-90 % of procedures being performed via this route. The aim of this study was to evaluate the safety and efficacy of iliococcygeus (ICG) fixation in the treatment of vaginal vault prolapse, with a minimum follow-up of 5 years. We prospectively enrolled women with symptomatic vaginal vault prolapse (Pelvic Organ Prolapse Quantification [POP-Q] stage ≥2) who were treated with ICG fixation. Subjective success was defined in the case of Patient Global Impression of Improvement ≤ 2 and an absence of bulging symptoms. Objective success was defined as stage of prolapse < 2 in all compartments. Overall success rate was defined as women without prolapse symptoms, PGI-I ≤ 2, stage of prolapse < 2, and no need for other surgery. All women filled in the Prolapse Quality of Life (P-QOL) questionnaire both at the preoperative visit and at every follow-up visit. Multiple logistic regression was performed to identify factors involved in the risk of recurrent POP. After a median (range) follow-up of 68.8 (60-92) months the subjective, objective, and overall cure rates were 88.6 % (39 out of 44), 84.1 % (37 out of 44), and 84.1 % (37 out of 44) respectively. Only preoperative stage IV vault descensus independently predicted POP recurrence after iliococcygeus fixation (OR: 8.78 [95 % CI: 1.31-9.42]; p < 0.001). Iliococcygeus fixation is a safe and effective surgical technique for the treatment of vaginal vault prolapse with long-lasting effectiveness.

  5. A Spiderless Arachnophobia Therapy: Comparison between Placebo and Treatment Groups and Six-Month Follow-Up Study

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    Laura Carmilo Granado

    2007-01-01

    Full Text Available We describe a new arachnophobia therapy that is specially suited for those individuals with severe arachnophobia who are reluctant to undergo direct or even virtual exposure treatments. In this therapy, patients attend a computer presentation of images that, while not being spiders, have a subset of the characteristics of spiders. The Atomium of Brussels is an example of such an image. The treatment group (n=13 exhibited a significant improvement (time × group interaction: P=.0026 when compared to the placebo group (n=12 in a repeated measures multivariate ANOVA. A k-means clustering algorithm revealed that, after 4 weeks of treatment, 42% of the patients moved from the arachnophobic to the nonarachnophobic cluster. Six months after concluding the treatment, a follow-up study showed a substantial consolidation of the recovery process where 92% of the arachnophobic patients moved to the nonarachnophobic cluster.

  6. A Retrospective Review of Outcomes of Dental Treatment Performed for Special Needs Patients under General Anaesthesia: 2-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Sreekanth Kumar Mallineni

    2014-01-01

    Full Text Available Objective. The purpose of the study was to evaluate the follow-up pattern of special needs patients (SNP treated under general anaesthesia (GA and the failure rates of different treatment procedures and restorative materials. Study Design. The treatment records of the patients who received dental treatment under GA during 2005 to 2009 were reviewed. The duration of follow-up periods, the outcomes of different treatment procedures, and the quality of different restorative materials were recorded and evaluated. Statistics were used for the comparison (SPSS 20.0. Pearson’s chi-square test and post hoc analysis were used to evaluate the attendance of postoperative appointments and the associations of failure rates of different treatment procedures and restorative materials. Cohen kappa statistics was used for intraexaminer reliability. Results. A total of 177 patients were included in the study. The attendance of postoperative appointments showed a gradual decrease from 96% to 36% within 24 months (P<0.05. Restorative procedures had the highest failure rates among all treatment procedures (P<0.05. Stainless steel crowns showed higher survival rates among different restorative materials (P<0.05. Pulp treatment in primary molars has higher success rate than primary incisors and canines. Composite restorations placed in primary canines have low survival rates. The intraexaminer reliability was good (k=0.94. Conclusion. The attendance for postoperative follow-up appointments declined within two years. Restorative treatment was less successful when compared to preventive and pulp treatments. Stainless steel crowns were more reliable restorations with higher survival rates and composite restorations were less durable.

  7. Preschool-based social communication treatment for children with autism: 12-month follow-up of a randomized trial.

    Science.gov (United States)

    Kaale, Anett; Fagerland, Morten W; Martinsen, Egil W; Smith, Lars

    2014-02-01

    This study reports 12-month follow-up data from a randomized controlled trial of preschool-based social communication treatment for young children with autism. A total of 61 children (48 males) with autism, 29 to 60 months of age, had earlier been randomized either to 8 weeks of preschool-based social communication treatment in addition to standard preschool program (n = 34) or to standard preschool program only (n = 27). Significant short-term effects on targeted social communication skills have previously been published. Long-term gains in social communication, language and global social functioning and communication were assessed from video-taped preschool teacher-child and mother-child interactions, Early Social Communication Scales, Reynell Developmental Language Scale, and Social Communication Questionnaire. Compared with those in the control group, the treated children achieved significantly larger improvements in joint attention and joint engagement from baseline to 12-month follow-up. However, no effects were detected on language and global ratings of social functioning and communication. The treatment effect on child initiation of joint attention increased with increasing level of sociability at baseline, whereas nonverbal IQ and expressive language had no moderating effect. This study is the first to show that, similar to specialist-delivered treatment, preschool-based treatment may produce small but possibly clinically important long-term changes in social communication in young children with autism. The treatment did not affect language and global ratings of social functioning and communication. More studies are needed to better understand whether treatment effects may be improved by increasing the intensity and duration of the treatment. Clinical trial registration information--Joint Attention Intervention and Young Children With Autism; http://clinicaltrials.gov/; NCT00378157. Copyright © 2014 American Academy of Child and Adolescent Psychiatry

  8. Clinical research and long-term follow-up of early hypothyroidism after 131I treatment for hyperthyroidism

    International Nuclear Information System (INIS)

    Liu Jianfeng; Zhang Youren; Xing Jialiu; Ye Genyao

    2004-01-01

    Objective: To evaluate the clinical research and long-term follow-up results of early hypothyroidism after 131 I treatment for hyperthyroidism. Methods: One hundred and forty-five patients with hyperthyroidism who developed hypothyroidism within 12 months after 131 I therapy were evaluated by clinical symptoms and plasma T 3 , T 4 , thyroid-stimulating hormone (TSH). One year after treatment, 121 of 145 patients were divided into two groups according to the occurrence of hypothyroidism. Results: 1) Group 1: transient hypothyroidism (n=33), 64%(21/33) of the patients developed euthyroidism and 36%(12/33) patients had recurrent hyperthyroidism within 1 year after being diagnosed with hypothyroidism after 131 I treatment. The long-term follow-up showed 2 patients were with euthyroidism and 2 patients who were previously with hyperthyroidism developed permanent hypothyroidism after 3 months ∼6 years. Three patients who were previously with hyperthyroidism developed euthyroidism after 3 months ∼5 years. Group 2: permanent hypothyroidism (n=88), 82.95% (73/88) patients of group 2 were treated with low-dose 131 I, 86.36% (76/88) cases of this group were found with clinical hypothyroidism. Conclusions: 72.73% (88/121) patients of early hypothyroidism after 131 I therapy developed permanent hypothyroidism. The incidence of permanent hypothyroidism in the patients treated with low-dose 131 I was higher. Recovery of transient hypothyroidism after 131 I therapy did not predict future thyroid function. (authors)

  9. Dissociations of the Fluocinolone Acetonide Implant: The Multicenter Uveitis Steroid Treatment (MUST) Trial and Follow-up Study.

    Science.gov (United States)

    Holbrook, Janet T; Sugar, Elizabeth A; Burke, Alyce E; Vitale, Albert T; Thorne, Jennifer E; Davis, Janet L; Jabs, Douglas A

    2016-04-01

    To describe fluocinolone acetonide implant dissociations in the Multicenter Uveitis Steroid Treatment (MUST) Trial. Randomized clinical trial with extended follow-up. Review of data collected on the first implant in the eye(s) of participants. Dissociation was defined as the drug pellet no longer being affixed to the strut and categorized as spontaneous or surgically related. A total of 250 eyes (146 patients) had at least 1 implant placed. Median follow-up time after implant placement was 6 years (range 0.5-9.2 years). Thirty-four dissociations were reported in 30 participants. There were 22 spontaneous events in 22 participants; 6-year cumulative risk of a spontaneous dissociation was 4.8% (95% confidence interval [CI]: 2.4%-9.1%). The earliest event occurred 4.8 years after placement. Nine of 22 eyes with data had a decline in visual acuity ≥5 letters temporally related to the dissociation. Thirty-nine implant removal surgeries were performed, 33 with replacement. Twelve dissociations were noted during implant removal surgeries in 10 participants (26%, 95% CI 15%-48%); 5 of these eyes had a decline in visual acuity ≥5 letters after surgery. The time from implant placement to removal surgery was longer for the surgeries at which dissociated implants were identified than for those without one (5.7 vs 3.7 years, P uveitis or its treatment. There is an increasing risk of dissociation of Retisert implants during follow-up; the risk is greater with removal/exchange surgeries, but the risk of both spontaneous and surgically related events increases with longevity of the implants. In 22% of affected eyes visual acuity declined by 15 letters. In the context of eyes with moderate to severe uveitis for years, this rate is not unexpected. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Antipsychotic treatment, psychoeducation & regular follow up as a public health strategy for schizophrenia: Results from a prospective study.

    Science.gov (United States)

    Kumar, Channaveerachari Naveen; Thirthalli, Jagadisha; Suresha, Kudumallige K; Venkatesh, Basappa K; Arunachala, Udupi; Gangadhar, Bangalore N

    2017-07-01

    In low- and middle-income countries such as India, a feasible public health strategy could be to ensure continuous antipsychotics and psychoeducation for those with schizophrenia. Whether such a strategy favourably influences its course and outcome is not well-studied. The objectives of this study were to examine these issues in a cohort of patients with schizophrenia in a rural south Indian taluk (an administrative block). This cohort was part of a community intervention programme running in the place since the past one decade. A total of 201 patients were assessed after an average of four years of follow up. Psychopathology, disability and course of illness were assessed using Positive and Negative Syndrome Scale (PANSS), Indian Disability Evaluation and Assessment Scale (IDEAS) and Psychiatric and Personal History Schedule (PPHS), respectively. Interventions included ensuring continuous antipsychotic treatment and low-intensity psychoeducation. One hundred and forty two [70.6%; 95% confidence interval (CI): 64.35-76.95] of the 201 patients achieved clinical remission by the end of follow up period (four years); 140 (69.6%; 95% CI: 63.29-76.07) had satisfactory outcome (42.3% best outcome and 27.4% intermediate outcome). There was a significant reduction in the proportion of patients with disability [134/201 (66.7%) at baseline; 55/201 (27.3%) at follow up; PInterpretation & conclusions: Treatment with antipsychotics and psychoeducation can favourably influence the course of schizophrenia and reduce disability in a substantial proportion of patients. Structured psychosocial interventions may be indicated in the significant minority who show suboptimal outcome with this strategy.

  11. Durability of improvement in post-traumatic stress disorder symptoms and absence of harmful effects or drug dependency after 3,4-methylenedioxymethamphetamine-assisted psychotherapy: a prospective long-term follow-up study

    OpenAIRE

    Mithoefer, Michael C; Wagner, Mark T; Mithoefer, Ann T; Jerome, Lisa; Martin, Scott F; Yazar-Klosinski, Berra; Michel, Yvonne; Brewerton, Timothy D; Doblin, Rick

    2013-01-01

    We report follow-up data evaluating the long-term outcomes for the first completed trial of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for chronic, treatment-resistant post-traumatic stress disorder (PTSD) (Mithoefer et al., 2011). All of the 19 subjects who received MDMA-assisted treatment in the original trial participated in the long-term follow-up (LTFU), with 16 out of 19 completing all of the long-term outcome measures, which were administered from 17 to 74 months a...

  12. Step-down versus outpatient psychotherapeutic treatment for personality disorders: 6-year follow-up of the Ullevål personality project

    Science.gov (United States)

    2014-01-01

    Background Although psychotherapy is considered the treatment of choice for patients with personality disorders (PDs), there is no consensus about the optimal level of care for this group of patients. This study reports the results from the 6-year follow-up of the Ullevål Personality Project (UPP), a randomized clinical trial comparing outpatient individual psychotherapy with a long-term step-down treatment program that included a short-term day hospital treatment followed by combined group and individual psychotherapy. Methods The UPP included 113 patients with PDs. Outcome was evaluated after 8 months, 18 months, 3 years and 6 years and was based on a wide range of clinical measures, such as psychosocial functioning, interpersonal problems, symptom severity, and axis I and II diagnoses. Results At the 6-year follow-up, there were no statistically significant differences in outcome between the treatment groups. Effect sizes ranged from medium to large for all outcome variables in both treatment arms. However, patients in the outpatient group had a marked decline in psychosocial functioning during the period between the 3- and 6-year follow-ups; while psychosocial functioning continued to improve in the step-down group during the same period. This difference between groups was statistically significant. Conclusions The findings suggest that both hospital-based long-term step-down treatment and long-term outpatient individual psychotherapy may improve symptoms and psychosocial functioning in poorly functioning PD patients. Social and interpersonal functioning continued to improve in the step-down group during the post-treatment phase, indicating that longer-term changes were stimulated during treatment. Trial registration NCT00378248. PMID:24758722

  13. Asymptomatic significant bacteriuria in the non-pregnant woman. II. Response to treatment and follow-up.

    Science.gov (United States)

    Asscher, A W; Sussman, M; Waters, W E; Evans, J A; Campbell, H; Evans, K T; Williams, J E

    1969-03-29

    Short courses of nitrofurantoin and ampicillin produced an immediate cure in 80% of adult non-pregnant bacteriuric women. Of the subjects so treated, 55% remained cured at the end of one year. Over the same follow-up period 36% of untreated bacteriuric women developed a spontaneous remission of bacteriuria. Treatment failed to prevent the development of symptomatic infection, and the reinfections which followed successful treatment were more commonly associated with the development of symptoms than the persistent or relapsing infections in untreated or unsuccessfully treated subjects.It is concluded that a search for bacteriuria in non-pregnant women is unlikely to be of value as a preventive measure, since in many instances it fails to detect urinary tract infection at an early stage and since treatment by methods suitable for large-scale use is ineffective.

  14. Two-phase orthodontic treatment in a unilateral cleft lip and palate patient with 1-year follow-up results

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    Prashant M Dhole

    2017-01-01

    Full Text Available Treatment of a patient with cleft lip and palate can be challenging. A 10-year and 10-month-old girl presented with uneven and crowded teeth. She had unilateral cleft lip and palate on left side for which she had undergone primary lip repair and palatoplasty when she was younger. On examination, she had concave facial appearance, crossbite of upper arch with reverse overjet of 2 mm, wits appraisal of 6 mm and impacted 23. She was treated with two-phase orthodontic treatment; growth modification appliances followed by fixed mechanotherapy. Total treatment time was 5 years. 1-year follow-up shows that results have been stable with good facial aesthetics and functional occlusion.

  15. Do Increasing Rates of Loss to Follow-up in Antiretroviral Treatment Programs Imply Deteriorating Patient Retention?

    Science.gov (United States)

    Johnson, Leigh F.; Estill, Janne; Keiser, Olivia; Cornell, Morna; Moolla, Haroon; Schomaker, Michael; Grimsrud, Anna; Davies, Mary-Ann; Boulle, Andrew

    2014-01-01

    In several studies of antiretroviral treatment (ART) programs for persons with human immunodeficiency virus infection, investigators have reported that there has been a higher rate of loss to follow-up (LTFU) among patients initiating ART in recent years than among patients who initiated ART during earlier time periods. This finding is frequently interpreted as reflecting deterioration of patient retention in the face of increasing patient loads. However, in this paper we demonstrate by simulation that transient gaps in follow-up could lead to bias when standard survival analysis techniques are applied. We created a simulated cohort of patients with different dates of ART initiation. Rates of ART interruption, ART resumption, and mortality were assumed to remain constant over time, but when we applied a standard definition of LTFU, the simulated probability of being classified LTFU at a particular ART duration was substantially higher in recently enrolled cohorts. This suggests that much of the apparent trend towards increased LTFU may be attributed to bias caused by transient interruptions in care. Alternative statistical techniques need to be used when analyzing predictors of LTFU—for example, using “prospective” definitions of LTFU in place of “retrospective” definitions. Similar considerations may apply when analyzing predictors of LTFU from treatment programs for other chronic diseases. PMID:25399412

  16. [A long-term follow-up of treatment of adult unicameral bone cysts with allograft of lyophilized cancellous bone].

    Science.gov (United States)

    Zhang, Yonggang; Wang, Yan; Cheng, Jiying

    2005-08-01

    To investigate the long-term clinical results of treatment of adult unicameral bone cyst with cancellous allograft. From 1993 to 1998, 15 patients with unicameral bone cyst were treated by allograft with lyophilized cancellous bone. Among 15 patients, there were 5 males and 10 females, aging 19-41 years with an average of 27 years. The average follow-up time was 7.5 years (6-11 years). The X-ray films were taken and the CT scanning were carried out. The X-ray films showed that the allograft particles became vague 2-3 months after operation, that the allograft particles fused and began to form new bone and the bone density increased 5 months after operation, and that new bone formation completed after 7 months of operation. At the end of follow-up, remodelling in new bone occurred. Recurrence was not found in all patients. The symptom of pain disappeared or relieved obviously. Allograft of lyophilized cancellous bone is an effective treatment for adult unicameral bone cysts.

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

    Directory of Open Access Journals (Sweden)

    Jetha, Eunice Abdul Remane

    2011-07-01

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

  18. The gambling follow-up scale: development and reliability testing of a scale for pathological gamblers under treatment.

    Science.gov (United States)

    de Castro, Viviane; Fuentes, Daniel; Tavares, Hermano

    2005-02-01

    To provide preliminary data on the Gambling Follow-Up Scale (GFS), a new scale assessing recovering gamblers. Secondary goals included assessing the impact of "work status," "family relationship," "leisure," and "enrolment in Gamblers Anonymous (GA)" on gambling (all items from the scale), together with the impact of treatment. Using the GFS, 3 independent raters interviewed gamblers under treatment. The sample was collected in 2 university centres in the city of São Paulo, Brazil. Patients attended psychotherapy coupled with psychiatric follow-up, participation in GA, or both. We interviewed 47 pathological gamblers; 13 were interviewed twice, with a minimum interval of 6 months, for a total of 60 GFS interviews. Interviews took on average 6.0 minutes, SD 2.7. Interrater concordance ranged from 82% to 95% (intraclass correlation coefficient range 0.85 to 0.99, P < 0.001). A factorial analysis showed a 1-factor solution (Eigenvalue = 2.4, 47.6% of total variance accounted). "Leisure," "frequency and time gambling," and "family relationship" showed considerable loadings (0.84; 0.71; 0.71),whereas "enrolment in GA" and "work status" showed moderate loadings (0.59; 0.56). A linear regression model significantly correlated gambling (R2 = 0.356; P < 0.001) with "leisure" and length of treatment. Treatment modalities affected "leisure" (F2,43 = 5.00, P = 0.011), with GA attendees reporting more regular and gratifying activities. The GFS showed interrater reliability and construct validity. More leisure and lengthier treatment were significantly relAted to less gambling. GA enrolment seemed to particularly benefit the quality of leisure. Future studies could profit from the quickness and simple structure of the GFS in providing shareable outcome measures.

  19. Clinical follow-up of responses to treatment with benznidazol in Amazon: a cohort study of acute Chagas disease.

    Directory of Open Access Journals (Sweden)

    Ana Yecê das Neves Pinto

    Full Text Available A total of 179 individuals with acute Chagas disease mainly transmitted by oral source, from Pará and Amapá State, Amazonian, Brazil were included during the period from 1988 to 2005. Blood samples were used to survey peripheral blood for T. cruzi hemoparasites by quantitative buffy coat (QBC, indirect xenodiagnosis, blood culture and serology to detection of total IgM and anti-T. cruzi IgG antibodies by indirect immunofluorescence assay (IFA and indirect hemagglutination assay (HA. All assays were performed pre-treatment (0 days and repeated 35 (±7 and 68 (±6 days after the initiation of treatment with benznidazol and every 6 months while remained seropositive. The endpoint of collection was performed in 2005. Total medium period of follow-up per person was 5.6 years. Also, a blood sample was collected from 72 randomly chosen treated patients to perform polimerase chain reaction (PCR method. Proportions of subjects with negative or positive serology according to the number of years after treatment were compared. In the endpoint of follow-up we found 47 patients (26.7% serologically negative, therefore considered cured and 5 (2.7% exhibited mild cardiac Chagas disease. Other 132 patients had persistent positive serologic tests. The PCR carried out in 72 individuals was positive in 9.8%. Added, there was evidence of therapeutic failure immediately following treatment, as demonstrated by xenodiagnosis and blood culture methods in 2.3% and 3.5% of cases, respectively. There was a strong evidence of antibody clearing in the fourth year after treatment and continuous decrease of antibody titers. Authors suggest that control programs should apply operational researches with new drug interventions four years after the acute phase for those treated patients with persistently positive serology.

  20. Clinical Follow-Up of Responses to Treatment with Benznidazol in Amazon: A Cohort Study of Acute Chagas Disease

    Science.gov (United States)

    Pinto, Ana Yecê das Neves; Valente, Vera da Costa; Coura, José Rodrigues; Valente, Sebastião Aldo da Silva; Junqueira, Angela Cristina Veríssimo; Santos, Laura Cristina; Ferreira, Alberto Gomes; de Macedo, Roberto Cavalleiro

    2013-01-01

    A total of 179 individuals with acute Chagas disease mainly transmitted by oral source, from Pará and Amapá State, Amazonian, Brazil were included during the period from 1988 to 2005. Blood samples were used to survey peripheral blood for T. cruzi hemoparasites by quantitative buffy coat (QBC), indirect xenodiagnosis, blood culture and serology to detection of total IgM and anti-T. cruzi IgG antibodies by indirect immunofluorescence assay (IFA) and indirect hemagglutination assay (HA). All assays were performed pre-treatment (0 days) and repeated 35 (±7) and 68 (±6) days after the initiation of treatment with benznidazol and every 6 months while remained seropositive. The endpoint of collection was performed in 2005. Total medium period of follow-up per person was 5.6 years. Also, a blood sample was collected from 72 randomly chosen treated patients to perform polimerase chain reaction (PCR) method. Proportions of subjects with negative or positive serology according to the number of years after treatment were compared. In the endpoint of follow-up we found 47 patients (26.7%) serologically negative, therefore considered cured and 5 (2.7%) exhibited mild cardiac Chagas disease. Other 132 patients had persistent positive serologic tests. The PCR carried out in 72 individuals was positive in 9.8%. Added, there was evidence of therapeutic failure immediately following treatment, as demonstrated by xenodiagnosis and blood culture methods in 2.3% and 3.5% of cases, respectively. There was a strong evidence of antibody clearing in the fourth year after treatment and continuous decrease of antibody titers. Authors suggest that control programs should apply operational researches with new drug interventions four years after the acute phase for those treated patients with persistently positive serology. PMID:23724050

  1. Post-trauma ratings of pre-collision pain and psychological distress predict poor outcome following acute whiplash trauma: A 12-month follow-up study

    DEFF Research Database (Denmark)

    Carstensen, Tina; Frostholm, Lisbeth; Ørnbøl, Eva

    2008-01-01

    emergency departments or primary care after car accidents in four counties in Denmark. After the collision patients received a questionnaire on psychological distress, unspecified pain and socio-demographics and 12 months later a follow-up on work capability and neck pain was performed. Risk factors were......Patients with acute whiplash trauma were followed to examine if post-trauma ratings of pre-collision pain and psychological distress were associated with reduced work capability and neck pain at 12 months follow-up. The study included 740 consecutive patients (474 females, 266 males) referred from...... identified by multiple logistic regression analysis. Factors associated with affected work capacity at the 12-month follow-up were pre-collision unspecified pain condition (OR = 2.4, p = 0.002) and socio-demographic characteristics: female gender, low educational level, unemployment and blue collar worker...

  2. Type of Preadmission Antidiabetic Treatment and Outcome among Patients with Ischemic Stroke: A Nationwide Follow-up Study

    DEFF Research Database (Denmark)

    Horsdal, Henriette Thisted; Mehnert, Frank; Rungby, Jørgen

    2012-01-01

    BACKGROUND: We examined whether the preadmission use of sulfonylureas is associated with improved clinical outcome compared with other antidiabetic treatments after hospitalization with ischemic stroke. METHODS: We conducted a nationwide population-based follow-up study among all Danish patients...... computed mortality rates and rates of readmission recurrent ischemic stroke or myocardial infarction according to type of treatment and used the Cox proportional hazards regression analysis to compute hazard ratios (HRs). RESULTS: We identified 4817 stroke patients with type 2 diabetes mellitus. We found...... lower 30-day mortality rates among users of metformin (adjusted HR 0.32; 95% confidence interval [CI] 0.15-0.68), insulin (adjusted HR 0.47; 95% CI 0.27-0.81), and patients without antidiabetic pharmacotherapy (adjusted HR 0.58; 95% CI 0.36-0.93) compared with users of sulfonylureas. Users of any...

  3. Preliminary and intermediate follow-up outcomes for cervical disc replacement in the treatment of cervical spondylopathy in 12 cases

    International Nuclear Information System (INIS)

    Qian Zhonglai; Yang Huilin; Jiang Weimin; Li Xigong; Li Xuefeng; Tang Tiansi

    2010-01-01

    Objective: To observe the short and intermediate-term clinical outcomes of porous coated motion (PCM) cervical prosthesis in the treatment of cervical spondylosis. Methods: The 12 (13 levels) patients who were suffered spondylotic myelopathy with PCM cervical prosthesis were treated. Evaluate the clinical outcome by comparing the JOA scores, the position of prosthesis,rotation of motion, the heterotopic ossification and Odom's scales. Results: After the average 6.5 months(3 ∼ 12 months) follow-up, the JOA scales raised from 8.35 ± 1.10 preoperatively to 15.88 ± 0.73 postoperatively (P 0.05). There was no occurrence of failures of prosthesis such as subsidence, loosening, or excursion. Heterotopic ossification was also absent. Conclusion: The clinical outcomes for cervical disc replacement in the treatment of cervical spondylopathy are satisfied. (authors)

  4. Prophylactic treatment uptake and compliance with recommended follow up among HIV exposed infants: a retrospective study in Addis Ababa, Ethiopia

    Directory of Open Access Journals (Sweden)

    Shargie Mulatu

    2011-12-01

    Full Text Available Abstract Background Children are being infected by HIV/AIDS mainly through mother-to-child transmission. In Ethiopia currently more than 135,000 children are living with HIV/AIDS. The aim of this study was to describe the pattern of ARV uptake after birth, co-trimoxazole prophylaxis and follow up compliance, and to examine which factors are associated with the intervention outcome. Methods A retrospective quantitative study design was used for data collection through two hospitals. All infants who were delivered by HIV infected mothers between October 2008 and August 2009 were included and information regarding treatment adherence during their first 6 months of age was collected. Findings 118 HIV exposed infant-mother pairs were included in the study. 107 (90.7% infants received ARV prophylaxis at birth. Sixty six (56% of the infants were found to be adherent to co-trimoxazole prophylactic treatment. The majority (n = 110(93.2% of infants were tested HIV negative with DNA/PCR HIV test at the age of sixth weeks. Infants who took ARV prophylaxis at birth were found to be more likely to adhere with co-trimoxazole treatment: [OR = 9.43(95% CI: 1.22, 72.9]. Similarly, infants whose mothers had been enrolled for HIV/ART care in the same facility [OR = 14(95% CI: 2.6, 75.4], and children whose fathers were tested and known to be HIV positive [OR = 3.0(95% CI: 1.0, 9.0] were more likely to adhere than their counterparts. Infants feeding practice was also significantly associated with adherence χ2 -test, p Conclusion The proportion of ARV uptake at birth among HIV exposed infants were found to be high compared to other similar settings. Mother-infant pair enrolment in the same facility and the infant's father being tested and knew their HIV result were major predictors of infants adhering to treatment and follow up. However, large numbers of infants were lost to follow up.

  5. Treatment of Angio-Seal-Related Femoral Artery Occlusion Using Directional Atherectomy-Primary Results and Midterm Follow-Up.

    Science.gov (United States)

    Babaev, Anvar; Gokhale, Rohit; Zavlunova, Susanna; Attubato, Michael

    2016-11-01

    We describe a novel approach for the endovascular treatment of femoral artery occlusion as a result of Angio-Seal closure device deployment. Angio-Seal is the most commonly used vascular closure device following percutaneous coronary and peripheral catheterizations worldwide. A rare complication of Angio-Seal deployment is an occlusion of the femoral artery leading to limb ischemia requiring revascularization. Given its unique ability to cut both atherosclerotic plaque and the Angio-Seal anchor with a collagen plug at operator-directed planes, TurboHawk/HawkOne atherectomy device can be a fast and effective approach to treat Angio-Seal-associated femoral artery occlusions. We studied 13 consecutive patients who developed Angio-Seal-associated femoral artery occlusions that occurred from 3 hours to several weeks after catheterization. These patients were successfully treated with TurboHawk/HawkOne directional atherectomy followed by balloon angioplasty with no complications. During a mean follow-up period of 20.4 ± 17.3 months, 12 patients remained claudication free with no evidence of obstructive arterial disease of the treated segment on imaging studies. One patient developed restenosis that was treated with repeat atherectomy and balloon angioplasty following which he was asymptomatic at follow-up. The use of directional atherectomy followed by balloon angioplasty is a quick, safe, and effective endovascular approach to treating Angio-Seal-associated femoral artery occlusions. It is associated with an excellent success rate, no complications, and good midterm outcomes.

  6. Surgical treatment is effective in severe cases of exercise-induced laryngeal obstruction: A follow-up study.

    Science.gov (United States)

    Norlander, Katarina; Johansson, Henrik; Jansson, Christer; Nordvall, Lennart; Nordang, Leif

    2015-01-01

    Surgery is an effective treatment in severe cases of supraglottic exercise-induced laryngeal obstruction (E-ILO). Conservatively treated subjects and subjects tested negative for E-ILO, who still experience breathing problems 1-3 years after diagnosis, tend to adjust their physical activity to a greater extent than surgically treated subjects. To investigate how symptoms and level of physical activity change over time in patients with E-ILO who have undergone surgery, patients with E-ILO treated conservatively and patients who tested negative for laryngeal obstruction at continuous laryngoscopy exercise-test (CLE-test). Patients referred for exercise-induced breathing difficulties answered questionnaires at diagnostic CLE-test and at follow-up. Questions regarded exercise-induced breathing problems, current physical activity level, and medical history of asthma and perennial allergy. Out of 84 invited subjects, 59 (70%) answered both questionnaires. Surgically treated subjects had less breathing problems at follow-up compared with conservatively treated subjects and subjects who tested negative (p < 0.001). None of the surgically treated subjects were less physically active or had changed sport due to exercise-induced dyspnoea, whereas 41.7% of the conservatively treated subjects had made such adjustments (p < 0.001).

  7. TVT-ABBREVO: efficacy and two years follow-up for the treatment of stress urinary incontinence.

    Science.gov (United States)

    Capobianco, G; Dessole, M; Lutzoni, R; Surico, D; Ambrosini, G; Dessole, S

    2014-01-01

    To assess the effectiveness of inside-out TVT-ABBREVO in the surgical treatment of female stress urinary incontinence (SUI) with mean two-year follow-up. Fifty-six women underwent surgery for moderate-severe SUI. The technology used was the TVT-ABBREVO inside-out. Each woman at 12 and 24 months underwent postoperative evaluation by means of urodynamics, Q-tip test, CST, transperineal ultrasonography, and administration of "King's Health Questionnaire" (KHQ). The mean age of the women was 57.03 +/- 11.1 years (range 42-75). Postoperative urodynamics (12 months follow-up) resulted to be normal in 43/56 patients (76.79%), in 10/56 (17.86%) cases resulted in a considerable improvement of the symptomatology, and only 1/56 (1.78%) case had de novo overactive bladder (OAB), in 2/56 (3.57%) symptomatology unchanged. After administration of the KHQ 43/56 cases (76.79%) had resolution of the symptomatology, 10/56 cases (17.86%) improvement of the symptomatology, and no change in 3/56 cases (5.36%). In the authors' experience, the TVT-ABBREVO resulted technically simple. The TVT-ABBREVO procedure provides high objective and subjective long-term efficacy, a clinically meaningful improvement in patient quality of life, and an excellent safety profile.

  8. Dental anxiety reduction and dental attendance after treatment in a dental fear clinic: A follow-up study.

    NARCIS (Netherlands)

    Aartman, I.H.A.; de Jongh, A.; Makkes, P.C.; Hoogstraten, J.

    2000-01-01

    The aim of the present study was to assess treatment outcome in terms of dental anxiety reduction at a post-treatment assessment and dental anxiety reduction and dental attendance one year later. Furthermore, it was determined to what extent psychopathological characteristics were related to

  9. Rib Tuberculosis Treatment By Steel Greft which has Fractured after a Thoracic Trauma: 10-year Follow up Case

    Directory of Open Access Journals (Sweden)

    Murat Oncel

    2013-04-01

    Full Text Available Rib tuberculosis is an uncommon form of osteoarticular tuberculosis. The physical and radiological examination can often mimic other conditions ,including primary and metastatic chest wall tumors . A 60 year-old male patient had a mass in the chest wall. Surgery aiming diagnosis and treatment based on physical and radiological findings were performed. Histopathological examination of the mass specimen revealed tuberculosis. The chest wall defect was supported with a stell greft after the six month . The patient had fallen from stairs and hit his chest six year after . The case had a significant fracture in the steel graft . This is unusual manifestation of chest wall grefts . This, chest wall, showing a softer steel materials should be used in grafts that would break a long-term follow-up is presented [Cukurova Med J 2013; 38(2.000: 295-298

  10. The maintenance effect of cognitive-behavioural treatment groups for the Chinese parents of children with intellectual disabilities in Melbourne, Australia: a 6-month follow-up study.

    Science.gov (United States)

    Wong, D F K; Poon, A; Kwok, Y C Lai

    2011-11-01

    Caring for a child with intellectual disability can be stressful. No data on the longer-term effects of cognitive-behavioural treatment (CBT) on parents from a Chinese-speaking background who have children with intellectual disabilities are available in the literature. This study attempted to fill this research gap by examining the maintenance effect of CBT among the Chinese parents of such children in Melbourne, Australia. Thirty-nine participants took part in our CBT groups and attended follow-up meetings. A questionnaire comprising four instruments, the Parenting Stress Index (PS) - Parent Domain, General Health Questionnaire-12 (GHQ-12), Abbreviated Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-18) and Dysfunctional Attitude Scale (DAS), was administered to the participants at the pre- and post-test stage and at the 6-month follow-up. One-way repeated-measures analyses of variance revealed significant time and group effects in the PS (F(2,27) = 16.93, P times. The participants continued to maintain significant improvements in mental health and quality of life and declines in the severity of parenting stress and dysfunctional attitudes at the 6-month follow-up. Effect size analyses revealed mostly large differences in the foregoing measurements (Cohen's d = 0.76-2.18) between the pre-test and 6-month follow-up. Employing a cut-off score of 3/4 in the GHQ-12 to identify at-risk and not-at-risk cases, approximately 90.5% of the participants could be classified as not-at-risk at the follow-up. Lastly, regression analyses showed that changes in DAS scores significantly predicted changes in the GHQ-12 and Q-LES-Q-18 scores at the follow-up. This study provides preliminary evidence of the 6-month maintenance effect of CBT groups for the Melbourne-resident Chinese parents of children with intellectual disabilities. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.

  11. Comparison of Intravitreal Bevacizumab and Intravitreal Diclofenac in the Treatment of Diabetic Macular Edema: a 6-month Follow-up.

    Science.gov (United States)

    Faghihi, Hooshang; Yahyapour, Hanif; Mahmoudzadeh, Raziyeh; Faghihi, Shahin

    2017-01-01

    The aim of this study was to compare the effect of intravitreal diclofenac, a non-steroidal anti-inflammatory drug (NSAID), with that of bevacizumab, a well-known anti-vascular endothelial growth factor (VEGF) drug, in the treatment of diabetic macular edema (DME). Diclofenac was chosen in this study because it has both features of NSAIDs and corticosteroids by inhibiting the cyclooxygenase (COX) and lipoxygenase pathways, respectively. In this non-randomized comparative interventional case series, 64 eyes from 32 patients with bilateral naïve DME were selected and every eye was randomly assigned to intravitreal injection of bevacizumab (IVB) or diclofenac (IVD). After exclusion of some patients because of short follow-up duration or less than two intravitreal injections, finally, 52 eyes from 26 patients were analyzed. Of those, 26 eyes received 500 µg/0.1 mL IVD and 26 eyes received 1.25 mg IVB. After 6 months of follow-up, the results indicated that visual acuity was significantly improved from 0.50 ± 0.13 in IVB and 0.52 ± 0.12 LogMAR in IVD at baseline to 0.2 ± 0.1 and 0.29 ± 0.07, respectively. Central macular thickness (CMT) and macular volume were measured based on spectral-domain optical coherence tomography (OCT) at month 1, 3, and 6. Both groups showed a significant reduction in CMT and macular volume from baseline but there was no significant difference between the IVB and IVD groups. Interestingly, IVD, but not IVB, decreased intraocular pressure (IOP), which is a desirable effect. There was no serious complication due to injections. This study sheds light into the long-term effects of NSAIDs and may support the idea that inflammation suppression by NSAIDs may have the same results as anti-VEGF administration.

  12. Patterns of Failure Following Multimodal Treatment for Medulloblastoma: Long-Term Follow-up Results at a Single Institution.

    Science.gov (United States)

    Lee, Dong Soo; Cho, Jaeho; Kim, Se Hoon; Kim, Dong-Seok; Shim, Kyu Won; Lyu, Chuhl Joo; Han, Jung Woo; Suh, Chang-Ok

    2015-10-01

    The purpose of this study is to investigate the long-term results and appropriateness of radiation therapy (RT) for medulloblastoma (MB) at a single institution. We analyzed the clinical outcomes of 106 patients with MB who received RT between January 1992 and October 2009. The median age was 7 years (range, 0 to 50 years), and the proportion of M0, M1, M2, and M3 stages was 60.4%, 8.5%, 4.7%, and 22.6%, respectively. The median total craniospinal irradiation (CSI) and posterior fossa tumor bed dose in 102 patients (96.2%) treated with CSI was 36 Gy and 54 Gy, respectively. The median follow-up period in survivors was 132 months (range, 31 to 248 months). A gradual improvement in survival outcomes was observed, with 5-year overall survival rates of 61.5% in 1990s increasing to 73.6% in 2000s. A total of 29 recurrences (27.4%) developed at the following sites: five (17.2%) in the tumor bed; five (17.2%) in the posterior fossa other than the tumor bed; nine (31%) in the supratentorium; and six (20.7%) in the spinal subarachnoid space only. The four remaining patients showed multiple site recurrences. Among 12 supratentorial recurrences, five cases recurred in the subfrontal areas. Although the frequency of posterior fossa/tumor bed recurrences was significantly high among patients treated with subtotal resection, other site (other intracranial/spinal) recurrences were more common among patients treated with gross tumor removal (p=0.016). There was no case of spinal subarachnoid space relapse from desmoplastic/extensive nodular histological subtypes. Long-term follow-up results and patterns of failure confirmed the importance of optimal RT dose and field arrangement. More tailored multimodal strategies and proper CSI technique may be the cornerstones for improving treatment outcomes in MB patients.

  13. A follow-up urine sample has limited value after treatment for urinary tract infection in children.

    Science.gov (United States)

    Lytzen, Rebekka; Kaalund-Jørgensen, Kristine; Ahmed, Akhlaq; Abd-El-Redda, Haidar Karim; Thorup, Jørgen; Knudsen, Jenny Dahl; Cortes, Dina

    2015-01-01

    A routine follow-up urine sample (FUS) in the form of a midstream urine sample (MSU) is recommended after treatment for urinary tract infection (UTI) according to the Danish Paediatric Society (DPS) and "Lægehåndbogen" published by Danish Regions. We studied the effect of FUS with a focus on patients without symptoms at the time of FUS. Consecutive patients below 16.0 years treated for upper or lower UTI from 1 January 2009 to 31 December 2009 at Hvidovre Hospital in accordance with the guidelines of the department and the DPS. All patients were asked to provide a FUS within 21 days. A total of 87 patients were treated for upper UTI: 59 girls and 28 boys, the median age was 1.1 year (range: 0.1-15.6 years); and 42 girls were treated for lower UTI, their median age was 8.2 years (range: 2.5-15.3 years). After treatment, the risk of a UTI was 0% (0/87) after upper UTI versus 19% (8/42) after lower UTI (Fisher's exact test (FE), p UTI was 0% (0/75) (95% confidence interval (CI): 0-4.9%) after upper UTI versus 4% (1/26) (95% CI: 0.1-19.6%) after lower UTI (FE, p = 0.2754). The cost of requesting a FUS in patients without symptoms was 166 euro after treatment for upper UTI and 66 euro after treatment of lower UTI. We do not recommend a FUS after treatment for UTI as the 95% CI of risk of missing UTI after treatment for upper UTI was below 5%. This strategy will save the patients/families and the health-care system. However, if a child has symptoms after treatment for UTI, it must be examined. not relevant. The study was approved by the Danish Data Protection Agency (J. no. 2007-58-0015).

  14. Long-term follow-up for efficacy and safety of treatment of retinitis pigmentosa with valproic acid.

    Science.gov (United States)

    Bhalla, Sheena; Joshi, Deval; Bhullar, Shaminder; Kasuga, Daniel; Park, Yeonhee; Kay, Christine N

    2013-07-01

    The purpose of this study was to determine the long-term efficacy and safety of valproic acid (VPA) treatment in patients with pigmentary retinal dystrophies. A retrospective chart review was conducted on 31 patients with a diagnosis of pigmentary retinal dystrophy prescribed VPA at a single centre. Visual field (VF), visual acuity (VA), length of treatment, liver enzymes and side effects were analysed. VF areas were defined using Goldmann VF (GVF) tracings recorded before, during and after VPA treatment using the V4e isopter for each eye. Using custom software, planimetric areas of VF were calculated. Five of the patients (10 eyes) had two Goldmann VF tracings, allowing comparison between baseline and follow-up VF. After 9.8 months of VPA, VF decreased by 0.145 cm(2) (26.478%) (p=0.432). For 22 of the patients (41 eyes), VA data was available, and logarithm of the minimum angle of resolution (logMAR) score changed by 0.056 log units (representing a decline in VA) after 14.9 months on VPA (p=0.002). Twelve patients (38.7%) reported negative side effects related to VPA use. VPA plays a complex role in patients with pigmentary retinal dystrophies and may be associated with VA and field decline as well as adverse side effects. Physicians should use caution with using VPA for pigmentary retinal dystrophies.

  15. Long-Term Follow-Up of Patients with Spasmodic Dysphonia and Improved Voice despite Discontinuation of Treatment.

    Science.gov (United States)

    Geneid, Ahmed; Lindestad, Per-Åke; Granqvist, Svante; Möller, Riitta; Södersten, Maria

    2016-01-01

    To evaluate voice function in patients with adductor spasmodic dysphonia (AdSD) who discontinued botulinum toxin (BTX) treatment because they felt that their voice had improved sufficiently. Twenty-eight patients quit treatment in 2004, of whom 20 fulfilled the inclusion criteria for the study, with 3 subsequently excluded because of return of symptoms, leaving 17 patients (11 males, 6 females) included in this follow-up study. A questionnaire concerning current voice function and the Voice Handicap Index were completed. Audio-perceptual voice assessments were done by 3 listeners. The inter- and intrarater reliabilities were r > 0.80. All patients had a subjectively good stable voice, but with differences in their audio-perceptual voice assessment scores. Based on the pre-/posttreatment auditory scores on the overall degree of AdSD, patients were divided into 2 subgroups showing more and less improvement, with 10 and 7 patients, respectively. The subgroup with more improvement had shorter duration from the onset of symptoms until the start of BTX treatment, and included 7 males compared to only 4 males in the subgroup with less improvement. It seems plausible that the symptoms of spasmodic dysphonia may decrease over time. Early intervention and male gender seem to be important factors for long-term reduction of the voice symptoms of AdSD. © 2016 S. Karger AG, Basel.

  16. Psychological effects of the intensified follow-up of the CEAwatch trial after treatment for colorectal cancer

    NARCIS (Netherlands)

    Zhan, Zhuozhao; Verberne, Charlotte J.; van den Heuvel, Edwin R.; Grossmann, Irene; Ranchor, Adelita V.; Wiggers, Theo; de Bock, Geertruida H.

    2017-01-01

    Background: The aim of the study was to evaluate psychological effects of the state-of-art intensified follow-up protocol for colorectal cancer patients in the CEAwatch trial. Method: At two time points during the CEAwatch trial questionnaires regarding patients' attitude towards follow-up,

  17. Requests for post-registration studies (PRS), patients follow-up in actual practice: Changes in the role of databases.

    Science.gov (United States)

    Berdaï, Driss; Thomas-Delecourt, Florence; Szwarcensztein, Karine; d'Andon, Anne; Collignon, Cécile; Comet, Denis; Déal, Cécile; Dervaux, Benoît; Gaudin, Anne-Françoise; Lamarque-Garnier, Véronique; Lechat, Philippe; Marque, Sébastien; Maugendre, Philippe; Méchin, Hubert; Moore, Nicholas; Nachbaur, Gaëlle; Robain, Mathieu; Roussel, Christophe; Tanti, André; Thiessard, Frantz

    2018-02-01

    Early market access of health products is associated with a larger number of requests for information by the health authorities. Compared with these expectations, the growing expansion of health databases represents an opportunity for responding to questions raised by the authorities. The computerised nature of the health system provides numerous sources of data, and first and foremost medical/administrative databases such as the French National Inter-Scheme Health Insurance Information System (SNIIRAM) database. These databases, although developed for other purposes, have already been used for many years with regard to post-registration studies (PRS). The use thereof will continue to increase with the recent creation of the French National Health Data System (SNDS [2016 health system reform law]). At the same time, other databases are available in France, offering an illustration of "product use under actual practice conditions" by patients and health professionals (cohorts, specific registries, data warehouses, etc.). Based on a preliminary analysis of requests for PRS, approximately two-thirds appeared to have found at least a partial response in existing databases. Using these databases has a number of disadvantages, but also numerous advantages, which are listed. In order to facilitate access and optimise their use, it seemed important to draw up recommendations aiming to facilitate these developments and guarantee the conditions for their technical validity. The recommendations drawn up notably include the need for measures aiming to promote the visibility of research conducted on databases in the field of PRS. Moreover, it seemed worthwhile to promote the interoperability of health data warehouses, to make it possible to match information originating from field studies with information originating from databases, and to develop and share algorithms aiming to identify criteria of interest (proxies). Methodological documents, such as the French National

  18. [Adherence to treatment after kidney transplantation as quality indicator of the information received: Longitudinal study of 2 years follow-up].

    Science.gov (United States)

    Costa-Requena, G; Cantarell, M C; Moreso, F; Parramon, G; Seron, D

    Transplantation is an optimal form of treatment for end-stage renal disease, but requires lifelong adherence to immunosuppressive therapy. The aim of this study was to longitudinally assess the adherence to treatment after kidney transplant, as well as to compare the amount of information about the treatment received at one month and 18 months post-transplantation, and its influence on adherence to treatment. The Self-Reported Measure of Medication Adherence was administered at month (T1), 6 months (T2), 12 months (T3), 18 months (T4), and 24 months (T5) post-transplantation. Survey about aspects of knowledge and attitudes about medication, was administered at one month and 18 months post-transplant. Measures of central tendency and non-parametric tests were used to compare the data. The study included a total of 73 patients with a median age of 57 years. The percentage of patients non-adherent to medication was 9.6% (T1), 22.5% (T2), 29.2% (T3), 29.8% (T4), and 28.1% (T5). One month after transplantation "not consulting with the doctor on forgetting to take medication (P=.034) significantly influenced the non-adherence to treatment. At 18 months post- transplantation, none of the issues raised on medication knowledge had an influence on non-adherence to treatment. Longer times since transplantation increased the non-adherence to treatment. Some issues regarding the information of treatment influenced the non-adherence in the immediate transplant period, but not in the follow-up. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Infective endocarditis: long-term reversibility of kidney function impairment. A 1-y post-discharge follow-up study

    DEFF Research Database (Denmark)

    Buchholtz, Kristine; Larsen, Carsten T; Hassager, Christian

    2010-01-01

    The aim of this study was to quantify the long-term reversibility of kidney function decrease occurring during hospitalization and treatment for infective endocarditis (IE). A prospective observational cohort study was performed at a tertiary university hospital in Copenhagen from October 2002...

  20. Quality of life impact of treatments for localized prostate cancer: Cohort study with a 5 year follow-up

    International Nuclear Information System (INIS)

    Ferrer, Montse; Guedea, Ferran; Suárez, José Francisco; Paula, Belén de; Macías, Víctor; Mariño, Alfonso; Hervás, Asunción; Herruzo, Ismael

    2013-01-01

    Purpose: To assess long-term quality of life (QoL) impact of treatments in localized prostate cancer patients treated with radical prostatectomy, external beam radiotherapy or brachytherapy. Material and methods: Observational, prospective cohort study with pre-treatment QoL evaluation and follow-up until five years after treatment. 704 patients with low or intermediate risk localized prostate cancer were consecutively recruited in 2003–2005. QoL was measured by the EPIC questionnaire, with urinary irritative–obstructive, incontinence, bowel, sexual, and hormonal scores (ranging 0–100). Results: Brachytherapy’s QoL impact was restricted to the urinary domain, Generalized Estimating Equation models showed score changes at five years of −12.0 (95% CI = −15.0, −9.0) in incontinence and −5.3 (95% CI = −7.5, −3.1) in irritative–obstructive scales. Compared to brachytherapy, radical prostatectomy fared +3.3 (95% CI = +0.0, +6.5) points better in irritative–obstructive but −17.1 (95% CI = −22.7, −11.5) worse in incontinence. Sexual deterioration was observed in radical prostatectomy (−19.1; 95% CI = −25.1, −13.1) and external radiotherapy groups (−7.5; 95% CI = −12.5, −2.5). Conclusions: Brachytherapy is the treatment causing the least impact on QoL except for moderate urinary irritative–obstructive symptoms. Our study provides novel long-term valuable information for clinical decision making, supporting brachytherapy as a possible alternative to radical prostatectomy for patients seeking an attempted curative treatment, while limiting the risk for urinary incontinence and sexual impact on QoL

  1. Long-Term Impact of Cyclosporin Reduction with MMF Treatment in Chronic Allograft Dysfunction: REFERENECE Study 3-Year Follow Up

    Directory of Open Access Journals (Sweden)

    L. Frimat

    2010-01-01

    Full Text Available Calcineurin inhibitor (CNI toxicity contributes to chronic allograft nephropathy (CAN. In the 2-year, randomized, study, we showed that 50% cyclosporin (CsA reduction in combination with mycophenolate mofetil (MMF treatment improves kidney function without increasing the risk for graft rejection/loss. To investigate the long-term effect of this regimen, we conducted a follow up study in 70 kidney transplant patients until 5 years after REFERENCE initiation. The improvement of kidney function was confirmed in the MMF group but not in the control group (CsA group. Four graft losses occurred, 2 in each group (graft survival in the MMF group 95.8% and 90.9% in control group. One death occurred in the control group. There was no statistically significant difference in the occurrence of serious adverse events or acute graft rejections. A limitation is the weak proportion of patient still remaining within the control group. On the other hand, REFERENCE focuses on the CsA regimen while opinions about the tacrolimus ones are still debated. In conclusion, CsA reduction in the presence of MMF treatment seems to maintain kidney function and is well tolerated in the long term.

  2. THE USE OF NITINOL RODS IN SURGICAL TREATMENT OF DEGENERATIVE SCOLIOSIS. 2.5-YEAR FOLLOW-UP

    Directory of Open Access Journals (Sweden)

    Natalia Sergeyevna Morozova

    2016-03-01

    Full Text Available ABSTRACT Objectives: To compare the outcomes of surgical treatment with lumbar fixation using nitinol rods without fusion and with standard lumbar fixation with titanium rods and interbody fusion. Methods: Treatment results of 70 patients with degenerative lumbar scoliosis aged 40 to 82 were analyzed. In all cases pedicle screws and nitinol rods with a diameter of 5.5 mm were used. Thirty patients underwent fixation at L1-S1 and 40 patients underwent fixation at L1-L5. Spinal fusion was not performed. All patients had radiography, CT and MRI performed. The results were assessed according to the Oswestry scale, SRS 22, SF 36 and VAS. The minimum follow-up period for all patients was 2.5 years. For the control group, consisting of 72 patients, pedicle fixation with titanium rods and interbody fusion in the lumbosacral region were performed. Results: The average level of deformity correction equaled 25° (10° - 38°. The analysis of X-ray and CT-scans revealed a single patient with implant instability, two patients with bone resorption around the screws and one patient with rod fractures. Functional radiography 2.5 years after surgery showed an average mobility of the lumbar spine of 21° (15° - 30°. There were no problems at the adjacent levels. Conclusions: The use of nitinol rods in spinal deformity surgery is promising. This technology is an alternative to rigid fixation. Continued gathering of clinical data and its further evaluation is necessary.

  3. Positive practice routines in overcoming resistance to the treatment of school phobia: a case study with follow-up.

    Science.gov (United States)

    Kolko, D J; Ayllon, T; Torrence, C

    1987-09-01

    The treatment is described of a 6-year-old first grade girl who refused to attend her classroom without adult accompaniment. For eight weeks an attempt was made, using different adult escorts, to prompt/shape classroom attendence through classroom exposure. However, the outcome was the development of an unwavering preference to remain in the principal's office after the child would not tolerate separation from these adults. Rather then continue to take her to the classroom, an intervention was initiated designed to structure her daily experiences and provide instruction. In this she was expected to practice several educational activities at designated times in the principal's office. This intervention resulted in a complete elimination of the child's classroom avoidance within five weeks and concomitant improvements in both social and academic functioning. Although the child's mother suddenly died during intervention, follow-up at one and 12 months in a different school indicated the maintenance of all therapeutic gains. Unique aspects of the procedures pertaining to refractory problems and some tentative behavioral guidelines to overcoming resistance to treatment are discussed.

  4. A follow-up urine sample has limited value after treatment for urinary tract infection in children

    DEFF Research Database (Denmark)

    Lytzen, Rebekka; Kaalund-Jørgensen, Kristine; Ahmed, Akhlaq

    2015-01-01

    INTRODUCTION: A routine follow-up urine sample (FUS) in the form of a midstream urine sample (MSU) is recommended after treatment for urinary tract infection (UTI) according to the Danish Paediatric Society (DPS) and "Lægehåndbogen" published by Danish Regions. We studied the effect of FUS...... with a focus on patients without symptoms at the time of FUS. METHODS: Consecutive patients below 16.0 years treated for upper or lower UTI from 1 January 2009 to 31 December 2009 at Hvidovre Hospital in accordance with the guidelines of the department and the DPS. All patients were asked to provide a FUS...... within 21 days. RESULTS: A total of 87 patients were treated for upper UTI: 59 girls and 28 boys, the median age was 1.1 year (range: 0.1-15.6 years); and 42 girls were treated for lower UTI, their median age was 8.2 years (range: 2.5-15.3 years). After treatment, the risk of a UTI was 0% (0/87) after...

  5. Wolfe Island Ecopower Centre post construction follow-up plan bird and bat resources monitoring report no. 2 : executive summary

    International Nuclear Information System (INIS)

    2010-05-01

    The 197.8 MW Wolfe Island EcoPower Centre consists of 86 wind turbine generators (WTGs), each with a capacity of 2.3 MW, plus ancillary facilities and supporting electrical infrastructure on the Kingston mainland. This report presented the results of a post-construction monitoring program for the period between July 1 and December 31, 2009. Field surveys included bird and bat mortality monitoring; disturbance effects monitoring of foraging migratory waterfowl; and disturbance effects monitoring of wintering raptors. During the mortality monitoring reporting period, 100 carcasses of 33 bird species were collected along with 180 carcasses of 5 bat species. This report concluded that mortality and disturbance effects monitoring should proceed in 2010, but with some modifications to the current method of alternating once-weekly/twice-weekly carcass search schedule for each turbine. It was suggested that in order to reduce uncertainty surrounding the scavenger correction factor, half of the WTGs should be the subject of once-weekly carcass searches, and the other half should be searched twice-weekly. Mortality rates would be calculated separately.

  6. Wolfe Island Ecopower Centre post construction follow-up plan bird and bat resources monitoring report no. 2 : executive summary

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-05-15

    The 197.8 MW Wolfe Island EcoPower Centre consists of 86 wind turbine generators (WTGs), each with a capacity of 2.3 MW, plus ancillary facilities and supporting electrical infrastructure on the Kingston mainland. This report presented the results of a post-construction monitoring program for the period between July 1 and December 31, 2009. Field surveys included bird and bat mortality monitoring; disturbance effects monitoring of foraging migratory waterfowl; and disturbance effects monitoring of wintering raptors. During the mortality monitoring reporting period, 100 carcasses of 33 bird species were collected along with 180 carcasses of 5 bat species. This report concluded that mortality and disturbance effects monitoring should proceed in 2010, but with some modifications to the current method of alternating once-weekly/twice-weekly carcass search schedule for each turbine. It was suggested that in order to reduce uncertainty surrounding the scavenger correction factor, half of the WTGs should be the subject of once-weekly carcass searches, and the other half should be searched twice-weekly. Mortality rates would be calculated separately.

  7. Effectiveness of a simple lymphoedema treatment regimen in podoconiosis management in southern ethiopia: one year follow-up.

    Directory of Open Access Journals (Sweden)

    Catherine Sikorski

    2010-11-01

    Full Text Available Podoconiosis is a non-filarial elephantiasis caused by long-term barefoot exposure to volcanic soils in endemic areas. Irritant silicate particles penetrate the skin, causing a progressive, debilitating lymphoedema of the lower leg, often starting in the second decade of life. A simple patient-led treatment approach appropriate for resource poor settings has been developed, comprising (1 education on aetiology and prevention of podoconiosis, (2 foot hygiene (daily washing with soap, water and an antiseptic, (3 the regular use of emollient, (4 elevation of the limb at night, and (5 emphasis on the consistent use of shoes and socks.We did a 12-month, non-comparative, longitudinal evaluation of 33 patients newly presenting to one clinic site of a non-government organization (the Mossy Foot Treatment & Prevention Association, MFTPA in southern Ethiopia. Outcome measures used for the monitoring of disease progress were (1 the clinical staging system for podoconiosis, and (2 the Amharic Dermatology Life Quality Index (DLQI, both of which have been recently validated for use in this setting. Digital photographs were also taken at each visit. Twenty-seven patients completed follow up. Characteristics of patients completing follow-up were not significantly different to those not. Mean clinical stage and lower leg circumference decreased significantly (mean difference -0.67 (95% CI -0.38 to -0.96 and -2.00 (95% CI -1.26 to -2.74, respectively, p<0.001 for both changes. Mean DLQI diminished from 21 (out of a maximum of 30 to 6 (p<0.001. There was a non-significant change in proportion of patients with mossy lesions (p = 0.375.This simple, resource-appropriate regimen has a considerable impact both on clinical progression and self-reported quality of life of affected individuals. The regimen appears ideal for scaling up to other endemic regions in Ethiopia and internationally. We recommend that further research in the area include analysis of cost

  8. Vertebroplasty as treatment of aggressive and symptomatic vertebral hemangiomas: up to 4 years of follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Guarnieri, G.; Ambrosanio, G.; Vassallo, P.; Galasso, R.; Lavanga, A.; Izzo, R.; Muto, M. [AORNA Cardarelli, Neuroradiology Service, Naples (Italy); Pezzullo, M.G. [Seconda Universita degli studi di Napoli - SUN, Radiology Service, Naples (Italy)

    2009-07-15

    This study aimed to illustrate the validity of the treatment with vertebroplasty (VP) in patients with aggressive or symptomatic vertebral hemangioma (VH) with or without epidural extension. From January 2003 to December 2007, 24 consecutive patients have been treated with VP, for a total of 36 vertebral bodies affected by VH: two cervical, ten dorsal, 24 lumbar. All the patients complained of a pain syndrome resistant to continuous medical medication; four of 24 patients also presented aggressive magnetic resonance features of the vertebral lesion and two patients showed also epidural extension. A unipedicular approach has been performed in 16 patients; a bipedicular approach has been performed in six, while for the cervical spine an anterior-lateral approach with manual dislocation of the carotid axis has always been performed. Bone biopsy was never done. All procedures have been carried out with local anesthesia, except for the treatment of the cervical hemangiomas which has always been performed under general anesthesia. Four vertebral bodies in the same session have been treated in one case. Results have been evaluated with the visual analog scale and the Oswestry Disability Index methods. In all the patients, in the following 24-72 h, a successful outcome has been observed with a complete resolution of pain symptom. Extravertebral vascular or discal cement leakage has been observed in four patients, without any onset of clinical radicular syndrome due to epidural diffusion. Clinical and radiological follow-up until 4 years has been performed in 12 patients and it showed stability of the treatment and absence of pain. Percutaneous treatment with VP for aggressive and symptomatic vertebral hemangiomas even with epidural extension is a valuable, mini-invasive, and quick method that allows a complete and enduring resolution of the painful vertebral symptoms without findings of fracture of a vertebral body adjacent or distant to the one treated. (orig.)

  9. [Preventive treatment of retinal detachment of the contralateral eye. Results of 5 years follow-up of 109 eyes].

    Science.gov (United States)

    Haut, J; Ladjimi, A; Van Effenterre, G; Monin, C; Moulin, F; Le Mer, Y

    1991-01-01

    In 1987, we presented a study of 141 eyes treated prophylactically following retinal detachment in the fellow eye. A hundred and nine of these patients are reviewed with a minimum follow-up of five years. Only the evolution was studied, whether a peripheral retinal lesion was present or not at the time of prophylactic treatment. The examiner noted if new lesions had occurred, or if lesions present at the time of the first examination had developed: lattice degeneration or snail track developing into a retinal tear, hole or tear causing a retinal detachment, contained or not by laser treatment. Our study contained sixty two myopes. Fifty eyes had visible, dangerous lesions, and fifty nine a normal retina. Forty five circular barrages with four anterior radial rows returning to the ora serrata were performed, and sixty four barrages with tight anterior grids and a localised barrage of visible lesions. The results were judged on one criterion only: retinal detachment requiring emergency surgery. Only one retinal detachment occurred behind the barrage, caused by proliferative vitreoretinopathy due to multiple tears, and surgical results were good. Eight tears appeared in front of the barrage, five of these in healthy retina. Two very posterior tears behind the barrage were blocked with no problem by laser treatment. Four localised detachments occurred in front of the barrage, three of these without anterior grid treatment. The advantage of this is undeniable since out of sixty three cases treated in this way, only three tears were seen to be blocked by the laser shots, and one anterior localised detachment where the anterior grid was insufficient.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Vertebroplasty as treatment of aggressive and symptomatic vertebral hemangiomas: up to 4 years of follow-up

    International Nuclear Information System (INIS)

    Guarnieri, G.; Ambrosanio, G.; Vassallo, P.; Galasso, R.; Lavanga, A.; Izzo, R.; Muto, M.; Pezzullo, M.G.

    2009-01-01

    This study aimed to illustrate the validity of the treatment with vertebroplasty (VP) in patients with aggressive or symptomatic vertebral hemangioma (VH) with or without epidural extension. From January 2003 to December 2007, 24 consecutive patients have been treated with VP, for a total of 36 vertebral bodies affected by VH: two cervical, ten dorsal, 24 lumbar. All the patients complained of a pain syndrome resistant to continuous medical medication; four of 24 patients also presented aggressive magnetic resonance features of the vertebral lesion and two patients showed also epidural extension. A unipedicular approach has been performed in 16 patients; a bipedicular approach has been performed in six, while for the cervical spine an anterior-lateral approach with manual dislocation of the carotid axis has always been performed. Bone biopsy was never done. All procedures have been carried out with local anesthesia, except for the treatment of the cervical hemangiomas which has always been performed under general anesthesia. Four vertebral bodies in the same session have been treated in one case. Results have been evaluated with the visual analog scale and the Oswestry Disability Index methods. In all the patients, in the following 24-72 h, a successful outcome has been observed with a complete resolution of pain symptom. Extravertebral vascular or discal cement leakage has been observed in four patients, without any onset of clinical radicular syndrome due to epidural diffusion. Clinical and radiological follow-up until 4 years has been performed in 12 patients and it showed stability of the treatment and absence of pain. Percutaneous treatment with VP for aggressive and symptomatic vertebral hemangiomas even with epidural extension is a valuable, mini-invasive, and quick method that allows a complete and enduring resolution of the painful vertebral symptoms without findings of fracture of a vertebral body adjacent or distant to the one treated. (orig.)

  11. Orthodontic treatment in a patient with unilateral open-bite and Becker muscular dystrophy. A 5-year follow-up

    Directory of Open Access Journals (Sweden)

    Juan Fernando Aristizabal

    2014-12-01

    Full Text Available INTRODUCTION: Becker muscular dystrophy is an X-chromosomal linked anomaly characterized by progressive muscle wear and weakness. This case report shows the orthodontic treatment of a Becker muscular dystrophy patient with unilateral open bite.METHODS: To correct patient's malocclusion, general anesthesia and orthognathic surgery were not considered as an option. Conventional orthodontic treatment with intermaxillary elastics and muscular functional therapy were employed instead.RESULTS: After 36 months, open bite was corrected. The case remains stable after a 5-year post-treatment retention period.

  12. Lack of evidence for post-vaccine onset of autoimmune/lymphoproliferative disorders, during a nine-month follow-up in multiply vaccinated Italian military personnel.

    Science.gov (United States)

    Ferlito, Claudia; Barnaba, Vincenzo; Abrignani, Sergio; Bombaci, Mauro; Sette, Alessandro; Sidney, John; Biselli, Roberto; Tomao, Enrico; Cattaruzza, Maria Sofia; Germano, Valentina; Biondo, Michela Ileen; Salerno, Gerardo; Lulli, Patrizia; Caporuscio, Sara; Picchianti Diamanti, Andrea; Falco, Mirella; Biselli, Valentina; Cardelli, Patrizia; Autore, Alberto; Lucertini, Elena; De Cesare, Donato Pompeo; Peragallo, Mario Stefano; Lista, Florigio; Martire, Carmela; Salemi, Simonetta; Nisini, Roberto; D'Amelio, Raffaele

    2017-08-01

    Anecdotal case reports, amplified by mass media and internet-based opinion groups, have recently indicated vaccinations as possibly responsible for autoimmunity/lymphoproliferation development. Multiply vaccinated Italian military personnel (group 1, operating in Italy, group 2, operating in Lebanon) were followed-up for nine months to monitor possible post-vaccine autoimmunity/lymphoproliferation onset. No serious adverse event was noticed in both groups. Multivariate analysis of intergroup differences only showed a significant association between lymphocyte increase and tetanus/diphtheria vaccine administration. A significant post-vaccine decrease in autoantibody positivity was observed. Autoantibodies were also studied by microarray analysis of self-proteins in subjects exposed to ≥4 concurrent vaccinations, without observing significant difference among baseline and one and nine months post-vaccine. Moreover, HLA-A2 subjects have been analyzed for the possible CD8T-cell response to apoptotic self-epitopes, without observing significant difference between baseline and one month post-vaccine. Multiple vaccinations in young adults are safe and not associated to autoimmunity/lymphoproliferation onset during a nine-month-long follow-up. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Management of chronic anterior uveitis relapses: efficacy of oral phospholipidic curcumin treatment. Long-term follow-up

    Directory of Open Access Journals (Sweden)

    Pia Allegri

    2010-10-01

    Full Text Available Pia Allegri1, Antonio Mastromarino1, Piergiorgio Neri21Uveitis Center, Ophthalmological Department of Lavagna Hospital, Genova, Italy; 2Uveitis Unit, The Eye Clinic, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Ancona, Ancona, ItalyAbstract: Curcumin has been successfully applied to treat inflammatory conditions in experimental research and in clinical trials. The purpose of our study is to evaluate the efficacy of an adjunctive-to-traditional treatment with Norflo tablets (curcumin-phosphatidylcholine complex; Meriva administered twice a day in recurrent anterior uveitis of different etiologies. The study group consisted of 106 patients who completed a 12-month follow-up therapeutic period. We divided the patients into three main groups of different uveitis origin: group 1 (autoimmune uveitis, group 2 (herpetic uveitis, and group 3 (different etiologies of uveitis. The primary end point of our work was the evaluation of relapses frequency in all treated patients, before and after Norflo treatment, followed by the number of relapse in the three etiological groups. Wilcoxon signed-rank test showed a P < 0.001 in all groups. The secondary end points were the evaluation of relapse severity and of the overall quality of life. The results showed that Norflo was well tolerated and could reduce eye discomfort symptoms and signs after a few weeks of treatment in more than 80% of patients. In conclusion, our study is the first to report the potential therapeutic role of curcumin and its efficacy in eye relapsing diseases, such as anterior uveitis, and points out other promising curcumin-related benefits in eye inflammatory and degenerative conditions, such as dry eye, maculopathy, glaucoma, and diabetic retinopathy.Keywords: curcumin, anterior recurrent uveitis, phosphatidylcholine-bound-curcumin (Meriva

  14. Diagnosis, Treatment and Long-Term Follow Up of Patients with ADA Deficiency: a Single-Center Experience.

    Science.gov (United States)

    Baffelli, Renata; Notarangelo, Lucia D; Imberti, Luisa; Hershfield, Michael S; Serana, Federico; Santisteban, Ines; Bolda, Federica; Porta, Fulvio; Lanfranchi, Arnalda

    2015-10-01

    We carried out a retrospective analysis of 27 patients with Adenosine Deaminase (ADA) deficiency diagnosed in a single center from 1997 to the 2013, for evaluating whether data regarding types of disease-inducing mutations, biochemical and immunological features as well as clinical outcomes of patients treated with enzyme replacement or transplantation, were comparable to those obtained in multicenter studies. The ADA deficiency diagnosis was performed with biochemical, immunological and molecular techniques. Ten patients treated with hematopoietic stem cell transplantation and three in treatment with enzyme replacement were followed up in our center. Twenty-four different mutations were identified and five were not previously reported. Identical mutations were found among patients from the same Romani ethnic group or from the same geographical region. A more rapid recovery was observed in enzyme replacement treated patients in comparison with those transplanted that, however, showed a continuous and long-lasting improvement both in terms of immune and metabolic recovery. The data obtained in our single center are comparable with those that have been reported in multicenter surveys.

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

    OpenAIRE

    Endres, Stefan; Wilke, Axel

    2011-01-01

    Abstract Background A retrospective study concerning patients presenting with patella instability, treated using a Roux-Elmslie-Trillat reconstruction operation and followed up for 10 years following surgery, is presented. Methods Pre-operative and follow-up radiographic evaluation included the weight-bearing anteroposterior and merchant views. Evaluation was carried out using the Insall-Salvati index, sulcus and congruence angle. The Roux-Elmslie-Trillat reconstruction operation was performe...

  16. Ascending colonic variceal bleeding: utility of phase-contrast MR portography in diagnosis and follow-up after treatment with TIPS and variceal embolization

    International Nuclear Information System (INIS)

    Chevallier, P.; Motamedi, J.P.; Oddo, F.; Padovani, B.; Demuth, N.; Caroli-Bosc, F.X.

    2000-01-01

    The authors describe the discovery of ascending colonic variceal veins via celiomesenteric diagnostic angiography following a bout of melena in a 44-year-old woman. Magnetic resonance imaging, including phase-contrast MR venography, allowed visualization of the portal and systemic veins immediately after the initial angiograms. The hemorrhagic episode did not resolve until after transjugular intrahepatic shunt insertion and selective variceal embolization through the shunt. At 1 week-, 3 months-, and 6 months post treatment, follow-up MR venography no longer revealed the presence of colonic varices. Colonoscopy at 6 months was normal and the patient did not have any further episodes of bleeding until a liver transplantation was performed after 9 months. (orig.)

  17. Outcome at 2 Years after Dextrose Gel Treatment for Neonatal Hypoglycemia: Follow-Up of a Randomized Trial.

    Science.gov (United States)

    Harris, Deborah L; Alsweiler, Jane M; Ansell, Judith M; Gamble, Gregory D; Thompson, Benjamin; Wouldes, Trecia A; Yu, Tzu-Ying; Harding, Jane E

    2016-03-01

    To determine neurodevelopmental outcome at 2 years' corrected age in children randomized to treatment with dextrose gel or placebo for hypoglycemia soon after birth (The Sugar Babies Study). This was a follow-up study of 184 children with hypoglycemia (dextrose (90/118, 76%) or placebo gel (94/119, 79%). Assessments were performed at Kahikatea House, Hamilton, New Zealand, and included neurologic function and general health (pediatrician assessed), cognitive, language, behavior, and motor skills (Bayley Scales of Infant and Toddler Development, Third Edition), executive function (clinical assessment and Behaviour Rating Inventory of Executive Function-Preschool Edition), and vision (clinical examination and global motion perception). Coprimary outcomes were neurosensory impairment (cognitive, language or motor score below -1 SD or cerebral palsy or blind or deaf) and processing difficulty (executive function or global motion perception worse than 1.5 SD from the mean). Statistical tests were two sided with 5% significance level. Mean (± SD) birth weight was 3093 ± 803 g and mean gestation was 37.7 ± 1.6 weeks. Sixty-six children (36%) had neurosensory impairment (1 severe, 6 moderate, 59 mild) with similar rates in both groups (dextrose 38% vs placebo 34%, relative risk 1.11, 95% CI 0.75-1.63). Processing difficulty also was similar between groups (dextrose 10% vs placebo 18%, relative risk 0.52, 95% CI 0.23-1.15). Dextrose gel is safe for the treatment of neonatal hypoglycemia, but neurosensory impairment is common among these children. Australian New Zealand Clinical Trials Registry: ACTRN 12608000623392. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Outcome at two years after dextrose gel treatment for neonatal hypoglycemia; Follow up of a randomized trial

    Science.gov (United States)

    Harris, Deborah L; Alsweiler, Jane M; Ansell, Judith M; Gamble, Greg D; Thompson, Ben; Wouldes, Trecia A; Yu, Tzu-Ying; Harding, Jane E

    2015-01-01

    Objective To determine neurodevelopmental outcome at two years’ corrected age in children randomized to treatment with dextrose gel or placebo for hypoglycemia soon after birth (The Sugar Babies Study). Study design This was a follow-up study of 184 children who had been hypoglycemic (dextrose (90/118, 76%) or placebo gel (94/119, 79%). Assessments were performed at Kahikatea House, Hamilton, New Zealand, and included neurological function and general health (Pediatrician assessed), cognitive, language, behaviour and motor skills (Bayley-III), executive function (clinical assessment and BRIEF-P), and vision (clinical examination and global motion perception). Co-primary outcomes were neurosensory impairment (cognitive, language or motor score below −1 SD or cerebral palsy or blind or deaf) and processing difficulty (executive function or global motion perception worse than 1.5 SD from the mean). Statistical tests were two sided with 5% significance level. Results Mean (±SD) birth weight was 3093 ± 803 g and mean gestation was 37.7 ±1.6 weeks. Sixty-six children (36%) had neurosensory impairment (1 severe, 6 moderate, 59 mild) with similar rates in both groups (dextrose 38% vs. placebo 34%, RR 1.11, 95% CI 0.75–1.63). Processing difficulty was also similar between groups (dextrose 10% vs. placebo 18%, RR 0.52, 95% CI 0.23–1.15). Conclusions Dextrose gel is safe for treatment of neonatal hypoglycemia, but neurosensory impairment is common amongst these children. PMID:26613985

  19. A 6-month follow-up of imaginal desensitization plus motivational interviewing in the treatment of pathological gambling.

    Science.gov (United States)

    Grant, Jon E; Donahue, Christopher B; Odlaug, Brian L; Kim, Suck Won

    2011-02-01

    Pathological gambling (PG), a disabling disorder experienced by approximately 1% of adults, has few empirically validated treatments. A recent study demonstrated that 6 sessions of imaginal desensitization plus motivational interviewing (IDMI) was effective in achieving abstinence for a majority of individuals with PG. This study sought to examine whether those benefits were maintained 6 months post-treatment. Sixty-eight individuals who met DSM-IV criteria for PG were randomly assigned to 6 sessions of IDMI or Gamblers Anonymous (GA) referral over an 8-week period. Participants who failed to respond to GA were offered IDMI after the 8-week acute treatment period. All individuals who responded to IDMI were contacted after 6 months and assessed with measures of gambling severity and psychosocial functioning. Forty-four participants completed 6 sessions of IDMI (25 initially assigned to IDMI and 19 to GA). Thirty-five of the 44 (79.5%) responded during acute treatment, and all 35 were available for a 6-month evaluation. All gambling severity scales maintained statistically significant gains from baseline, although some measures showed significant worsening compared with post-IDMI treatment. Six sessions of IDMI resulted in statistically significant reductions in PG urges and behavior, which were largely maintained for 6 months.

  20. Occlusal stability in Class II, Division 1, deep bite cases followed up for many years after orthodontic treatment.

    Science.gov (United States)

    Kondo, E

    1998-12-01

    This case report analyzes long-term occlusal stability that can be achieved in Class II, Division 1, deep bite cases with active treatment finished during the period of maxillomandibular growth. The analysis was designed to identify occlusal features common to two cases at the end of active treatment and to study how the occlusion changed with growth and jaw movement to achieve stability. The following occlusal features were shared by the two cases at the end of active treatment: (1) AB plane and axes of the maxillary and mandibular posterior teeth were perpendicular to functional occlusal plane; (2) the axis of the lower incisor was almost perpendicular to DC-L1i line; (3) the anterior occlusion was overcorrected to or near an edge-to-edge relationship. Items 1 and 2 remained unchanged throughout the follow-up periods, regardless of growth status, and the overjet and overbite increased during maxillomandibular growth after treatment. During the period of mandibular growth alone, after the end of retention, the axes of maxillary incisors tipped labially; as a result, F line became parallel to CDM line by the end of growth. The labial tipping of maxillary incisors brought the lower incisal edge into contact with or extremely near the inflection point (Bp).1 By the end of growth, the tangent of Bp became parallel to or coincident with DC-L1i line and perpendicular to the axis of the lower incisor, and the DC-L1i lines at various times posttreatment were almost parallel to each other in the two cases. Overjet increased as the maxillary incisors tipped labially, providing proper protrusive and retrusive paths for mandibular guidance. The angle between the functional occlusal plane and CDM line stayed almost the same as at the end of active treatment in the two cases, suggesting a possible change in the angle of eminence in harmony with the functional occlusal plane. These factors apparently contributed to the long-term occlusal stability in the two cases.

  1. Can a more detailed evaluation of excision margins refine cytologic follow-up of women post-LLETZ for high-grade dysplasia?

    LENUS (Irish Health Repository)

    Treacy, Ann

    2010-09-01

    The relationship between dysplastic changes in the cervical epithelium and progression to in situ carcinoma and invasive carcinoma has been extensively studied. The removal of dysplastic epithelium through the long loop excision of the transformation zone (LLETZ) in 95% of the cases is curative. About 18% to 37% of LLETZ specimens with dysplasia at the margins have recurrent\\/residual disease. Earlier small studies suggest that the degree of dysplasia at the margins could predict for recurrence and allow a risk-based stratification of follow-up. We tested this hypothesis in a large group of women post-LLETZ for high-grade dysplasia with follow-up histology and cytology over a 12-year period. The cases were divided according to the excision margin status for dysplasia and if positive, low-grade or high-grade dysplasia. The groups were compared to assess whether the LLETZ specimens\\' margin status had an impact on the subsequent cytology or histology results. Positive follow-up results were defined as any grade of dysplasia in cytology or histology. Two thousand three hundred twenty-one women had LLETZs containing high-grade dysplasia over the 12-year period. One thousand five hundred thirty-four (66.1%) women had full histology and cytology follow-up available. Eight hundred twenty (53.4%) LLETZ specimens had positive margins and 714 (46.6%) had negative margins. The grade of dysplasia at the margins was available in 796 cases (97%) with 115 (15%) showing low-grade dysplasia and 680 (85%) high-grade dysplasia. One hundred seventy (20.7%) of the specimens with positive margins had positive follow-up results compared with 105 (14.7%) of the specimens with negative margins. The presence of dysplasia at an LLETZ margin is associated with dysplasia on follow-up cytology and histology (P=0.0021); however, the grade of dysplasia at the excision margin is not predictive of recurrent\\/residual dysplasia.

  2. Twelve-Month Follow-Up of a Randomized Controlled Trial of Internet-Based Guided Self-Help for Parents of Children on Cancer Treatment.

    Science.gov (United States)

    Cernvall, Martin; Carlbring, Per; Wikman, Anna; Ljungman, Lisa; Ljungman, Gustaf; von Essen, Louise

    2017-07-27

    A substantial proportion of parents of children on cancer treatment report psychological distress such as symptoms of post-traumatic stress (PTSS), depression, and anxiety. During their child's treatment many parents also experience an economic burden. The aim of this study was to evaluate the long-term efficacy of Internet-based guided self-help for parents of children on cancer treatment. This study was a parallel randomized controlled trial comparing a 10-week Internet-based guided self-help program, including weekly support from a therapist via encrypted email, with a wait-list control condition. The intervention was based on cognitive behavior therapy (CBT) and focused on psychoeducation and skills to cope with difficult thoughts and feelings. Primary outcome was self-reported PTSS. Secondary outcomes were self-reported symptoms of depression, anxiety, health care consumption, and sick leave during the past month. Outcomes were assessed pre- and postintervention and at 12-month follow-up. Parents of children on cancer treatment were invited by health care personnel at pediatric oncology centers, and parents meeting the modified symptom criteria on the PCL-C were included in the study. Self-report assessments were provided on the Web. A total of 58 parents of children on cancer treatment (median months since diagnosis=3) were included in the study (intervention n=31 and control n=27). A total of 18 participants completed the intervention, and 16 participants in each group participated in the 12-month follow-up. Intention-to-treat analyses revealed significant effects in favor of the intervention on the primary outcome PTSS, with large between-group effect sizes at postassessment (d=0.89; 95% CI 0.35-1.43) and at 12-month follow-up (d=0.78; 95% CI 0.25-1.32). Significant effects in favor of the intervention on the secondary outcomes depression and anxiety were also observed. However, there was no evidence for intervention efficacy on health care consumption or

  3. Retrospective 25-year follow-up of treatment outcomes in Angle Class III patients : Success versus failure.

    Science.gov (United States)

    Wendl, Brigitte; Kamenica, A; Droschl, H; Jakse, N; Weiland, F; Wendl, T; Wendl, M

    2017-03-01

    Despite recommendations for early treatment of hereditary Angle Class III syndrome, late pubertal growth may cause a relapse requiring surgical intervention. This study was performed to identify predictors of successful Class III treatment. Thirty-eight Class III patients treated with a chincup were retrospectively analyzed. Data were collected from the data archive, cephalograms, and casts, including pretreatment (T0) and posttreatment (T1) data, as well as long-term follow-up data collected approximately 25 years after treatment (T2). Each patient was assigned to a success or a failure group. Data were analyzed based on time (T0, T1, T2), deviations from normal (Class I), and prognathism types (true mandibular prognathism, maxillary retrognathism, combined pro- and retrognathism). Compared to Class I normal values, the data obtained in both groups yielded 11 significant parameters. The success group showed values closer to normal at all times (T0, T1, T2) and vertical parameters decreased from T0 to T2. The failure group showed higher values for vertical and horizontal mandibular growth, as well as dentally more protrusion of the lower anterior teeth and more negative overjet at all times. In adittion, total gonial and upper gonial angle were higher at T0 and T1. A prognostic score-yet to be evaluated in clinical practice-was developed from the results. The failure group showed greater amounts of horizontal development during the years between T1 and T2. Treatment of true mandibular prognathism achieved better outcomes in female patients. Cases of maxillary retrognathism were treated very successfully without gender difference. Failure was clearly more prevalent, again without gender difference, among the patients with combined mandibular prognathism and maxillary retrognathism. Crossbite situations were observed in 44% of cases at T0. Even though this finding had been resolved by T1, it relapsed in 16% of the cases by T2. The failure rate increased in cases of

  4. Group therapy for somatization disorders in primary care: maintenance of treatment goals of short cognitive-behavioural treatment one-and-a-half-year follow-up.

    Science.gov (United States)

    Lidbeck, J

    2003-06-01

    The objective of this study was to evaluate the maintenance of treatment goals of a short cognitive-behavioural group treatment programme for the management of somatization disorders in primary care. In a previous controlled 6-month follow-up study, patients with somatization disorders (n=32) improved with respect to illness and somatic preoccupation, hypochondriasis, and medication usage. In the present report the same group of patients were also investigated one-and-a-half year after initial treatment. The long-term follow-up manifested maintained improvement with respect to hypochondriasis. There was additional reduction of anxiety and psychosocial preoccupation, whereas somatization and depression-anxiety scores improved progressively. A short cognitive-behavioural group treatment of psychosomatic patients can be useful in primary care and may manifest maintained or progressive beneficial outcome.

  5. Back and neck pain and function in females with adolescent idiopathic scoliosis: A follow-up at least 23 years after conservative treatment with a Milwaukee brace

    Science.gov (United States)

    2017-01-01

    We aimed to explore the long-term outcomes of back and neck pain and functionality in adult females with adolescent idiopathic scoliosis (AIS), who had been treated with a Milwaukee brace, in a follow-up study a minimum of 23 years after the completion of the treatment, using radiological, clinical and socio-demographical data. Thirty AIS patients (scoliosis group–SG), were included in the study based on an extensive search of Pediatric Orthopedics and Traumatology Clinic charts. All treatments were successfully completed between 1974 and 1990. In all cases, scoliosis had not been detected before the age of 10 and was not combined with any major spinal deformities at the time when the brace treatment was implemented. In those patients, the Risser sign 4 and minimum two years post-menarche was defined as a maturity, after that time the brace treatment was completed. Patients were excluded from the study if they, at the time of the follow-up examinations, suffered from any other disease leading to trunk deformity. Forty patients met the criteria for inclusion, but due to change some personal details, not all of them were contacted. Finally, 30 women returned for a follow-up evaluation. Patients’ follow-up period was mean 27.77 yrs. ± SD 3.30 (range 23–35). Curvature change from the end of the treatment until the present day was mean 9.1 degrees ± SD 7.64 (range 0–27). A control group of 42 healthy females (healthy controls group—HG) matching the age profile of the patient group was randomly selected for comparative purposes.Both SG and HG completed the Polish versions of the Revised Oswestry Lower Back Pain Disability Index (RODI), the Rolland-Morris Questionnaire (RMQ), the Quebec Back Pain Disability Scale (QDS), the Neck Disability Index (NDI) and the Copenhagen Neck Functional Disability Scale (CNFDS). Descriptive statistics were calculated for demographics and baseline questionnaire scores. To determine if the investigated sample sizes are equivalent

  6. Evaluating outcomes of patients lost to follow-up in a large comprehensive care treatment program in western Kenya

    Science.gov (United States)

    Rachlis, B; Ochieng, D; Geng, E; Rotich, E; Ochieng, V; Maritim, B; Ndege, S; Naanyu, V; Martin, J; Keter, A; Ayuo, P; Diero, L; Nyambura, M; Braitstein, P

    2014-01-01

    Background The Academic Model Providing Access To Healthcare (AMPATH) program provides comprehensive HIV care and treatment services. Approximately 30% of patients have become lost to follow-up (LTFU). We sought to actively trace and identify outcomes for a sample of these patients. Methods LTFU was defined as missing a scheduled visit by ≥ 3 months. A randomly selected sample of 17% of patients identified as LTFU between January 2009 and June 2011 was generated, with sample stratification on age, antiretroviral therapy (ART) status at last visit, and facility. Chart reviews were conducted followed by active tracing. Tracing was completed by trained HIV-positive outreach workers July 2011 to February 2012. Outcomes were compared between adults and children and by ART status. Results Of 14,811 LTFU patients, 2,540 were randomly selected for tracing (2,179 adults, 1,071 on ART). The chart reviews indicated that 326 (12.8%) patients were not actually LTFU. Outcomes for 71% of sampled patients were determined including 85% of those physically traced. Of those with known outcomes, 21% had died while 29% had disengaged from care for various reasons. The remaining patients had moved away (n=458, 25%) or were still receiving HIV care (n=443 total, 25%). Conclusions Our findings demonstrate the feasibility of a large scale sampling-based approach. A significant proportion of patients were found not to be LTFU and further, high numbers of patients who were LTFU could not be located. Over a quarter of patients disengaged from care for various reasons including access challenges and familial influences. PMID:25692336

  7. Combined endoscopic treatment in the patient with inoperable middle third esophageal cancer (4-year clinical follow-up

    Directory of Open Access Journals (Sweden)

    E. V. Filonenko

    2015-01-01

    Full Text Available The results of 4-year clinical follow-up in the patient with obstructive inoperable retropericardial esophageal cancer are represented. According to cardiac co-morbidity (myocardial infarction, postinfarction cardiosclerosis the palliative care for patient was managed. To preserve patency of esophagus multiple courses of endoscopic photodynamic therapy by means of the approach developed in P.A. Herzen MCRI were performed. From 2011 to 2014 thirteen courses of photodynamic therapy with photosens were conducted. The patient was under follow-up for 4 years and 3 months to his death in 2015. For follow-up period the patient had oral feeding with no signs of dysphagia, not significant weight loss and with good quality of life. 

  8. Effect of post-discharge follow-up care on re-admissions among US veterans with congestive heart failure: a rural-urban comparison.

    Science.gov (United States)

    Muus, Kyle J; Knudson, Alana; Klug, Marilyn G; Gokun, Jane; Sarrazin, Mary; Kaboli, Peter

    2010-01-01

    Hospital re-admissions for patients with congestive heart failure (CHF) are relatively common and costly occurrences within the US health infrastructure, including the Veterans Affairs (VA) healthcare system. Little is known about CHF re-admissions among rural veteran patients, including the effects of socio-demographics and follow-up outpatient visits on these re-admissions. To examine socio-demographics of US veterans with CHF who had 30 day potentially preventable re-admissions and compare the effect of 30 day VA post-discharge service use on these re-admissions for rural- and urban-dwelling veterans. The 2005-2007 VA data were analyzed to examine patient characteristics and hospital admissions for 36 566 veterans with CHF. The CHF patients who were and were not re-admitted to a VA hospital within 30 days of discharge were identified. Logistic regression was used to examine and compare the effect of VA post-acute service use on re-admissions between rural- and urban-dwelling veterans. Re-admitted veterans tended to be older (p=.002), had disability status (p=.024) and had longer hospital stays (precovery and good health among hospitalized veterans with CHF, regardless of their rural or urban residence. Older, rural veterans with CHF are in need of special attention for VA discharge planning and follow up with primary care providers.

  9. Treatment of malreduced pilon fracture: A case report and the result in the long-term follow-up

    OpenAIRE

    Balio?lu, Mehmet Bulent; Akman, Yunus Emre; Bahar, Hakan; Albayrak, Akif

    2015-01-01

    Introduction The risk for post-traumatic osteoarthritis (POA) following tibial plafond joint trauma has been reported to be as high as 70?75%. In the treatment of more severe joint pathologies, with incongruity and intra-articular defects, internal or external fixations techniques may be required. Presentation of case We report the orthopedic management of a pilon fracture in a 30-year-old male with malunion and implant failure after initial mal-reduction of the fracture 9-months earlier. Tri...

  10. In-Hospital Management and Follow-Up Treatment of Venous Thromboembolism: Focus on New and Emerging Treatments.

    Science.gov (United States)

    Lenchus, Joshua D; Biehl, Michelle; Cabrera, Jorge; Moraes, Alice Gallo de; Dezfulian, Cameron

    2017-06-01

    Venous thromboembolism (VTE), encompassing pulmonary embolism (PE) and deep venous thrombosis (DVT), is a major cause of morbidity and mortality of particular relevance for intensivists and hospitalists. Acute VTE is usually managed with parenteral unfractionated heparin or low-molecular-weight heparin, followed by an oral vitamin K antagonist. Data are lacking for optimal treatment of less common occurrences, such as upper extremity DVT, and for approaches such as thrombolysis for PE associated with early signs of hemodynamic compromise or inferior vena cava filters when anticoagulation is contraindicated. Direct oral anticoagulants (DOACs) including apixaban, dabigatran, edoxaban, and rivaroxaban are now added to the armamentarium of agents available for acute management of VTE and/or reducing the risk of recurrence. This review outlines an algorithmic approach to acute VTE treatment: from aggressive therapies when anticoagulation may be inadequate, to alternative choices when anticoagulation is contraindicated, to anticoagulant options in the majority of patients in whom anticoagulation is appropriate. Evidence-based guidelines and the most recent DOAC clinical trial data are discussed in the context of the standard of care. Situations and treatment approaches for which data are unavailable or insufficient are identified. VTE therapy in care transitions is discussed, as are choices for secondary prevention.

  11. Left ventricular deformation at 2-year follow-up in treatment-naive rheumatoid arthritis patients is associated with high inflammation parameters

    DEFF Research Database (Denmark)

    Logstrup, B. B.; Masic, D.; Laurbjerg, T. B.

    2015-01-01

    : To assess LV function by speckle-tracking echocardiography and the amount of coronary calcium by coronary computer tomography (CCT) in relation to anti-cyclic citrullinated peptide antibody (anti-CCP) status during a 2-year follow-up period in a open cohort of treatment-naive RA patients. Methods: Thirty...... we measured global longitudinal systolic strain (GLS) and coronary calcium score (Agatston's score) by coronary computer tomography (CCT) at time of diagnosis and at 2-year follow-up. Results: We found GLS similar at baseline and after 2-year follow-up (GLSBASELINE: -16.56+/-3.1% vs. GLS2-YEAR: -16...

  12. Treatment of Visceral Aneurysm Using Multilayer Stent: Two-Year Follow-Up Results in Five Consecutive Patients

    Energy Technology Data Exchange (ETDEWEB)

    Balderi, Alberto, E-mail: balders@libero.it; Antonietti, Alberto, E-mail: antonietti.a@ospedale.cuneo.it; Pedrazzini, Fulvio, E-mail: pedrazzini.f@ospedale.cuneo.it; Sortino, Davide, E-mail: davide.sortino@hotmail.it; Vinay, Claudia, E-mail: claudia.vinay@gmail.com; Grosso, Maurizio, E-mail: grosso.m@ospedale.cuneo.it [AO Santa Croce e Carle Hospital, Department of Radiology (Italy)

    2013-10-15

    Purpose: The present study was performed to analyze the midterm results (five consecutive patients, 2-year follow-up) of the endovascular management of visceral artery aneurysms using the Cardiatis Multilayer Flow Modulator (CMFM) (Cardiatis, Isnes, Belgium), a self-expandable stent. Materials and Methods: From August 2009 to January 2011, we implanted five CMFMs in five patients (all men; mean age 73 years) to treat two common hepatic artery aneurysms, one celiac trunk aneurysm, one splenic artery aneurysm, and one superior mesenteric artery aneurysm (diameter 25-81 mm). The primary end point was technical success. The secondary end point was stent patency, absence of aneurysm rupture or reperfusion, and shrinking of the sac at 6-, 12-, and 24-month follow-up using computed tomography angiography. Follow-up ranged from 24 to 48 months (mean 31.2). Results: Technical success was achieved in all patients. Complete exclusion of the aneurysm with sac shrinking was achieved in two patients. Two stents became occluded at 6- and 24-month follow-up, respectively; both patients were asymptomatic and were not retreated. One patient developed sac reperfusion due to incomplete aneurysm exclusion. Conclusion: Long-term results in a wider population are needed to validate the effectiveness of the CMFM.

  13. A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones

    NARCIS (Netherlands)

    Asscheman, H.; Giltay, E.J.; Megens, J.A.J.; de Ronde, W.; van Trotsenburg, M.A.A.; Gooren, L.J.G.

    2011-01-01

    Objective: Adverse effects of long-term cross-sex hormone administration to transsexuals are not well documented. We assessed mortality rates in transsexual subjects receiving long-term cross-sex hormones. Design: A cohort study with a median follow-up of 18.5 years at a university gender clinic.

  14. Two Studies of the Long-Term Follow-up of Minimal Therapist Contact Treatments of Vascular and Tension Headache.

    Science.gov (United States)

    Blanchard, Edward B.; And Others

    1988-01-01

    Followed up on tension and vascular headache patients, intially treated with biofeedback and/or relaxation training in either a minimal therapist contact or an intensive individual protocol, where one-half of patients continued keeping headache diaries and were seen monthly; others had minimal contact. Demonstrated equally good maintenance from…

  15. Two-, Three-, and Four-Year Follow-Up on the Self-Regulatory Treatment of Chronic Headache.

    Science.gov (United States)

    Blanchard, Edward B.; And Others

    1987-01-01

    Chronic tension and vascular headache patients, initially treated with relaxation and biofeedback, were followed-up on an annual basis at two-, three-, and four-years posttreatment. Tension headache patients generally showed good maintenance of initial headache reduction at Year Four. Vascular patients showed a nonsignificant trend for gradual…

  16. A Short-Term Follow-Up Of Tension-Free Vaginal Tape For Surgical Treatment Of Stress Urinary Incontinence

    Directory of Open Access Journals (Sweden)

    A.S. Moosavi

    2006-05-01

    Full Text Available Background and Aim: This study was conducted to evaluate the safety and efficacy of Tension-free Tape for the surgical treatment of female stress urinary incontinence. Materials and Methods: In a prospective open study for pre and post operative, we followed 36 patients at least 1.5 years after surgery (18-28 months; all patients underwent the operation under local anesthesia, allowing the surgeon to check intra-operatively that continence has been obtained. Results: Mean operation time was 36 minutes (range 20-45 minutes. 32(89% of the patients was cured according to the protocol, another 3(8.3% were significantly improved and there was 1(2.7% failure. Mast of patients (about 91% were operated on a one day-care basis, which implies that they were released from the hospital the day after the procedure, and no post operative catheterization, defect healing and tape rejection occurred. Pain free recovery time without any analgesic was another benefit. Five patients needed an indwelling catheter for 3 days and two uncomplicated hematoma occurred. Conclusion: Based on the results, we conclude that Tension-free Vaginal Tape is a safe and effective ambulatory procedure for surgical treatment of genuine stress urinary incontinence, which allows the majority of the women to be discharged from the clinic the day after the procedure and start their works in the second week.

  17. TVT for the treatment of urodynamic stress incontinence: Efficacy and adverse effects at 13-year follow-up.

    Science.gov (United States)

    Serati, Maurizio; Sorice, Paola; Bogani, Giorgio; Braga, Andrea; Cantaluppi, Simona; Uccella, Stefano; Caccia, Giorgio; Salvatore, Stefano; Ghezzi, Fabio

    2017-01-01

    To assess long-term subjective, objective, and urodynamic outcomes of retropubic mid-urethral slings at 13-year follow-up. This was a prospective observational study. Consecutive women with proven urodynamic stress incontinence were treated with standard retropubic tension free vaginal tape (TVT). Patients with mixed incontinence and/or anatomic evidence of pelvic organ prolapse were excluded. All the included patients underwent preoperative clinical and urodynamic evaluations. During follow-up examinations, women were assessed for subjective satisfaction and objective cure rates. The Cox model was used in order to investigate factors predicting the risk of recurrent stress urinary incontinence (SUI), over the study period. Overall, 55 patients were suitable for the analysis. At 13-year follow-up, 47 out of 55 (85.5%) patients declared themselves cured (p-for-trend 0.02) and 48 out of 58 (87.2%) were at least improved (p-for-trend 0.07). No significant deterioration of objective cure rates was observed over time (P = 0.29). At the time of the last evaluation, 50 out of 55 (90.9%) women were objectively cured; urodynamic evaluation confirmed this finding in 49 (89.1%) patients. Considering factors predictive of SUI recurrence, we observed that, via multivariate analysis, obesity (HR 7.2; P = 0.01) and maximum detrusor pressure during the voiding phase ≤29 cmH 2 O (HR 8.0; P = 0.01) were the only independent predictors of recurrent SUI. Our data confirmed that TVT is a highly effective and safe procedure also at 13-year follow-up. Interestingly, we observed a significant decrease of subjective satisfaction over time. Neurourol. Urodynam. 36:192-197, 2017. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  18. Arterio-venous malformations in childhood: clinical presentation, results after operative treatment and long-term follow-up.

    Science.gov (United States)

    Kahl, W; Kessel, G; Schwarz, M; Voth, D

    1989-01-01

    In a series of 182 arterio-venous malformations (AVM) recently published we found 33 children aged 1 to 16 years. In 28 cases, the admitting condition was hemorrhage. For 31 AVMs total excision was possible. We observed one postoperative death accounting for a mortality of 3%. All children but two were followed-up by personal examination. Two were not able to work due to severe neurological deficits and seven had not been able to get into their intended occupation.

  19. Serial follow up V/P scanning in assessment of treatment response in high probability scans for pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Moustafa, H; Elhaddad, SH; Wagih, SH; Ziada, G; Samy, A; Saber, R [Department of nuclear medicine and radiology, faculty of medicine, Cairo university, Cairo, (Egypt)

    1995-10-01

    138 patients proved with V/P scan to have different probabilities of pulmonary emboli event. Serial follow up scanning after 3 days, 2 weeks, 1 month and 3 months was done, with anticoagulant therapy. Out of the remaining 10 patients, 6 patients died with documented P.E. by P.M. study and lost follow up recorded in 4 patients. Complete response with disappearance of all perfusion defects after 2 weeks was detected in 37 patients (49.3%), partial improvement of lesions after 3 months was elicited in 32%. The overall incidence of response was (81.3%) such response was complete in low probability group (100%), (84.2%) in intermediate group and (79.3%) in high probability group with partial response in 45.3%. New lesions were evident in 18.7% of this series. To conclude that serial follow up V/P scan is mandatory for evaluation of response to anticoagulant therapy specially in first 3 months. 2 figs., 3 tabs.

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

    Science.gov (United States)

    Endres, Stefan; Wilke, Axel

    2011-02-18

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

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

    Directory of Open Access Journals (Sweden)

    Wilke Axel

    2011-02-01

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

  2. Post-procedural Care in Interventional Radiology: What Every Interventional Radiologist Should Know—Part I: Standard Post-procedural Instructions and Follow-Up Care

    Energy Technology Data Exchange (ETDEWEB)

    Taslakian, Bedros, E-mail: Bedros.Taslakian@nyumc.org; Sridhar, Divya [NYU Langone Medical Center, Department of Radiology, Interventional Radiology Section (United States)

    2017-04-15

    Interventional radiology (IR) has evolved into a full-fledged clinical specialty with attendant patient care responsibilities. Success in IR now requires development of a full clinical practice, including consultations, inpatient admitting privileges, and an outpatient clinic. In addition to technical excellence and innovation, maintaining a comprehensive practice is imperative for interventional radiologists to compete successfully for patients and referral bases. A structured approach to periprocedural care, including routine follow-up and early identification and management of complications, facilitates efficient and thorough management with an emphasis on quality and patient safety.

  3. Risk factors for 90-day readmission in veterans with inflammatory bowel disease-Does post-discharge follow-up matter?

    Science.gov (United States)

    Malhotra, Ashish; Phatharacharukul, Parkpoom; Thongprayoon, Charat

    2018-02-08

    Repeat hospitalizations in veterans with inflammatory bowel disease (IBD) are understudied. The early readmission rate and potentially modifiable risk-factors for 90-day readmission in veterans with IBD were studied to avert avoidable readmissions. A retrospective cohort study was conducted using the data from veterans who were admitted to the Minneapolis VA Medical Center (MVMC) between January 1, 2007, and December 31, 2013, for an IBD-related problem. All-cause readmissions within 30 and 90 days were recorded to calculate early readmission rates. The multivariate logistic regression was used to identify the potential risk factors for 90-day readmission. There were 130 unique patients (56.9% with Crohn's disease and 43.1% with ulcerative colitis) with 202 IBD-related index admissions. The mean age at the time of index admission was 59.8 ± 15.2 years. The median time to re-hospitalization was 26 days (IQR 10-49), with 30- and 90-day readmission rates of 17.3% (35/202) and 29.2% (59/202), respectively. Reasons for all-cause readmission were IBD-related (71.2%), scheduled surgery (3.4%) and non-gastrointestinal causes (25.4%). The following reasons were independently associated with 90-day readmission: Crohn's disease (OR 3.90; 95% CI 1.82-8.90), use of antidepressants (OR 2.19; 95% CI 1.12-4.32), and lack of follow-up within 90 days with a primary care physician (PCP) (OR 2.63; 95% CI 1.32-5.26) or a gastroenterologist (GI) (OR 2.44; 95% CI 1.20-5.00). 51.0% and 49.0% of patients had documentation of a recommended outpatient follow-up with PCP and/or GI, respectively. Early readmission in IBD is common. Independent risk factors for 90-day readmission included Crohn's disease, use of antidepressants and lack of follow-up visit with PCP or GI. Further research is required to determine if the appropriate timing of post-discharge follow-up can reduce IBD readmissions.

  4. Treatment of malreduced pilon fracture: A case report and the result in the long-term follow-up.

    Science.gov (United States)

    Balioğlu, Mehmet Bulent; Akman, Yunus Emre; Bahar, Hakan; Albayrak, Akif

    2016-01-01

    The risk for post-traumatic osteoarthritis (POA) following tibial plafond joint trauma has been reported to be as high as 70-75%. In the treatment of more severe joint pathologies, with incongruity and intra-articular defects, internal or external fixations techniques may be required. We report the orthopedic management of a pilon fracture in a 30-year-old male with malunion and implant failure after initial mal-reduction of the fracture 9-months earlier. Tricortical iliac crest autologous bone grafting (TCG) was used in combination with internal fixation to restore distal tibial articular. The procedure resulted in a pain free ankle, sufficient range of motion for function and patient satisfaction. Early surgical intervention and anatomical reduction with appropriate fixation are recommended for intra-articular tibial pilon fractures. Autogenous bone grafting is a reliable treatment option to augment structural stability, bone defects and bone-healing. Indications for bone grafting include delayed union or nonunion, malunion, arthrodesis, limb salvage, and reconstruction of bone voids or defects. The application of TCG in the management of a malreduced tibial plafond fracture has not been described before. We performed TCG with internal fixation in order to restore stability, congruency and alignment in a young patient in whom a biological restoration was feasible due to good bone quality. In suitable cases, TCG might provide an alternative to arthrodesis or arthroplasty. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Coaching in self-efficacy improves care responses, health and well-being in dementia carers: a pre/post-test/follow-up study.

    Science.gov (United States)

    Chenoweth, Lynn; Stein-Parbury, Jane; White, Danielle; McNeill, Georgene; Jeon, Yun-Hee; Zaratan, Beverley

    2016-05-04

    Maintaining the health and well-being of family carers of people with dementia is vital, given their potential for experiencing burden associated with the role. The study aimed to help dementia carers develop self-efficacy, be less hassled by the caring role and improve their health and well-being with goal-directed behaviour, by participating in an eight module carer coaching program. The study used mixed methods in a pre/post-test/follow-up design over 24 months, with assignment of consented dementia carers to either individualised (n = 16) or group coaching (n = 32), or usual carer support services (n = 43), depending on preference. Care-giving self-efficacy and hassles, carer health, well-being and goal-directed behaviours were assessed over time. Analysis of Variance (ANOVA) was used to compare changes over time and the effects of coaching on carer self-efficacy, hassles and health, using the Univariate General Linear Model (GLM). All carers were hassled by many aspects of caring at baseline. Participants receiving coaching reported non-significant improvements in most areas of self-efficacy for caring, hassles associated with caring and self-reported health at post-test and follow-up, than did carers receiving usual carer support. Group coaching had greater success in helping carers to achieve their goals and to seek help from informal and formal support networks and services. The study outcomes were generally positive, but need to be interpreted cautiously, given some methodological limitations. It has been shown, however, that health staff can assist dementia carers to develop self-efficacy in better managing their family member's limitations and behaviour, seek help from others and attend to their health. Teaching carers to use goal-directed behaviour may help them achieve these outcomes.

  6. Follow-up survey of the prevalence, diagnosis, clinical manifestations and treatment of Spirocerca lupi in South Africa

    Directory of Open Access Journals (Sweden)

    Remo Lobetti

    2014-11-01

    Full Text Available Spirocercosis is an important disease in South Africa. The object of this study was to determine if there had been a change in the prevalence, clinical manifestations and treatment of Spirocerca lupi over a 14-year period. A questionnaire was sent to 577 veterinary practices throughout South Africa in 2012. Of responders, 76% indicated that S. lupi occurred in their area, whilst 24% indicated that it did not; 84% considered S. lupi not to be a new phenomenon, whereas 16% considered it to be new. Monthly or seasonal distribution of the disease was not reported, and 76% of responders reported it to occur in no specific breed of dog, whereas 24% reported a breed risk, most considering large breeds to be at greater risk. No specific age or sex was identified as at higher risk. Common owner complaints were vomiting, weight loss, cough, or regurgitation. Reported clinical findings tended to mirror the clinical signs reported by owners. Most common diagnostic methods used were radiology, endoscopy, faecal flotation, and post mortem examination. Forty-four percent did not report seeing asymptomatic cases, 40% reported asymptomatic cases and 16% did not know. Associated complications were reported by 85% of responders, and included oesophageal neoplasia, hypertrophic osteopathy and acute haemothorax. Four different drugs were used as therapy: doramectin, ivermectin, milbemycin and Advocate®, with 9% of the responders using a combination of these four; 85% considered treatment to be effective and 15% ineffective. Treatment was considered more effective if the disease was diagnosed early and there were no complications. Two important conclusions were that more cases are being seen and that efficacy of therapy has increased, with a decrease in the mortality rate.

  7. Follow-Up Testing

    Science.gov (United States)

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

  8. [Midterm follow-up results on Asian femoral intramedullary nail for the treatment of segmental and comminuted femoral fractures].

    Science.gov (United States)

    Li, Lang; Gao, Feng; Huang, Qi; Li, Qiang; Xie, Lin; Zhang, Bin

    2016-06-01

    To investigate midterm follow-up results on Asian femoral intramedullary nail in treating segmental and comminuted femoral fractures. Between June 2011 and October 2012,16 patients with segmental and comminuted femoral fractures were treated with minimally invasive reset and Asian femoral intramedullary nail under extension table. Among them, there were 10 males and 6 females aged from 21 to 49 years old with an average of 34.5 years old; the time from injury to operation ranged from 3 to 24 d with an average of 9.1 d. There were 6 cases were type C1,2 cases were type C2 and 8 cases were type C3 according to AO classification. X-ray of femoral segment at 3,6 and 12 months after operation were applied for evaluating fracture healing. Harris score of hip joint and HSS score of knee joint were used to evaluate postoperative function. All patients were followed up from 24 to 36 months with an average of 28.4 months. Operative time was from 88 to 112 min with an average of 90.7 min; blood loss ranged from 150 to 200 ml with an average of 188.75 ml; the time of fracture healing was from 5 to 9 months with an average of 5.4 months. All incision were healed at stage I. No loosening, breakage of internal fixation and displacement of fracture were occurred. There were no significant differences in Harris score of hip joint at 3, 6 and 12 months after operation (F = 0.07, P = 0.893 > 0.05), 10 cases obtained excellent results, 5 good and 1 moderate. There was no obvious meaning in HSS score of knee joint (F = 0.08,P = 0.876 > 0.05), 9 cases obtained excellent results, 6 good and 1 poor. Asian femoral intramedullary nail could treat segmental and comminuted femoral fractures by using variety of less invasive ways,which has advantages of less trauma, quick recovery of function and satisfied midterm following-up results. But long term following-up effects remains to be seen.

  9. Bidirectional Relations between Parenting Practices and Child Externalizing Behavior: A Cross-Lagged Panel Analysis in the Context of a Psychosocial Treatment and 3-Year Follow-up

    Science.gov (United States)

    Shaffer, Anne; Lindhiem, Oliver; Kolko, David J.; Trentacosta, Christopher J.

    2013-01-01

    In the current study, we examined longitudinal changes in, and bidirectional effects between, parenting practices and child behavior problems in the context of a psychosocial treatment and 3-year follow-up period. The sample comprised 139 parent-child dyads (child ages 6-11) who participated in a modular treatment protocol for early-onset ODD or…

  10. Kidney function and specific mortality in 60-80 years old post-myocardial infarction patients : A 10-year follow-up study

    NARCIS (Netherlands)

    Hoogeveen, Ellen K.; Geleijnse, Johanna M.; Giltay, Erik J.; Soedamah-Muthu, S.S.; De Goede, Janette; Oude Griep, Linda M.; Stijnen, Theo; Kromhout, Daan; Shimosawa, Tatsuo

    2017-01-01

    Chronic kidney disease (CKD) is highly prevalent among older post-myocardial infarction (MI) patients. It is not known whether CKD is an independent risk factor for mortality in older post-MI patients with optimal cardiovascular drug-treatment. Therefore, we studied the relation between kidney

  11. Denervation of nerve terminals in renal arteries: one-year follow-up of interventional treatment of arterial hypertension.

    Science.gov (United States)

    Bartuś, Krzysztof; Sadowski, Jerzy; Kapelak, Bogusław; Litwinowicz, Radosław; Zajdel, Wojciech; Godlewski, Jacek; Bartuś, Magdalena; Zmudka, Krzysztof; Chrapusta, Anna; Konstanty-Kalandyk, Janusz; Węgrzyn, Piotr; Sobotka, Paul A

    2014-01-01

    Arterial hypertension is the most common cardiovascular system disease, affecting nearly one billion people worldwide. Despite the widespread use of antihypertensive medications, in some groups of patients an optimal blood pressure (BP) cannot be achieved. To assess BP reduction in patients with resistant hypertension after a catheter-based renal sympathetic denervation procedure and to report vascular and kidney safety in one-year follow-up. Twenty eight patients with diagnosed resistant hypertension (median age 52.02 years, range 42-72) underwent percutaneous catheter-based renal denervation of nerve terminals in renal arteries. Arterial angiography and procedure of ablation was performed by Symplicity catheters and generator provided by Ardian (currently Medtronic Inc., USA). Mean BP value before ablation was [mm Hg]: systolic 176.6, diastolic 100.28 and pulse pressure 73.4. After the procedure, reductions in the value of BP were reported [mm Hg]: systolic 154.8/152.54; diastolic 90.2/89.8, pulse pressure 64.66/62.73, respectively in nine-month and one-year follow-up. All results were statistically significant. No complications during one year observation were observed. Percutaneous renal artery ablation procedure effectively reduces systolic BP, diastolic BP, and pulse pressure. No vascular or renal complications in any of the patients were observed. The results of a Polish research group showed no significant differences compared to the results obtained in the international studies Symplicity I and Symplicity II.

  12. Treatment of active acne with an Er:Glass (1.54 microm) laser: a 2-year follow-up study.

    Science.gov (United States)

    Angel, Sylvie; Boineau, Dominique; Dahan, Serge; Mordon, Serge

    2006-12-01

    To investigate the effects of the 1.54 microm wavelength on active lesions of the face and of the back at the 2-year follow-up. A 1.54 microm erbium:glass laser (Aramis, Quantel Medical, France) was used in combination with contact cooling set at +5 degrees C to treat acne on the face with the following parameters (3 ms, four pulses, 10 J/cm2, 2 Hz, cumulative fluence: 40 J/cm2). The laser spots were adjacent (maximum overlap: 20%) and delivered in rows in order to cover the entire area. Four treatments were performed at 4-week intervals in 25 patients with acne severity greater than 3 on the Burton scale. Acne lesion counts (papules, pustules, nodules, comedones) were performed prior to each treatment, and at 2, 4, 12, 18 and 24 months after the final treatment. Among the 25 patients, three were lost to follow-up, four were retreated. So, 18 patients had acne lesions counts 2 years after the fourth treatment. The mean percent reduction was 71% at the 6-month follow-up, 79% at the 1-year follow-up and 73% at the 2-year follow-up. No side effects were reported. All patients commented that their skin was less prone to oiliness. Biopsies taken after treatment showed progressive rarefaction and miniaturization of sebaceous glands and pilosebaceous follicles without morphologic damage to epidermal and dermal structures. Active acne can be successfully treated by selective dermal heating with a 1.54 microm erbium:glass laser coupled to contact cooling, with no related side effects. Furthermore, this longer follow-up study demonstrates long-term acne clearing. Combined treatments with medications (oral or topical) or light (targeting Propionibacterium acnes) may also improve acne clearance.

  13. Evaluation of the relationship between compliance with the follow-up and treatment protocol and health literacy in bladder tumor patients.

    Science.gov (United States)

    Turkoglu, Ali Riza; Demirci, Hakan; Coban, Soner; Guzelsoy, Muhammet; Toprak, Erdem; Aydos, Mustafa Murat; Ture, Deniz Azkan; Ustundag, Yasemin

    2018-03-07

    To investigate the relationship between the compliance of bladder cancer patients with cystoscopic follow-up and the treatment protocol, and their health literacy. Patients who underwent transurethral resection surgery for bladder tumor were found to have non-muscular invasive bladder carcinoma on pathology examination and then underwent cystoscopic follow-up for 1 year or more were included in the study. Cystoscopic follow-up was recommended to the low- and high-risk groups in terms of progression and recurrence. The patients were evaluated with the Health Literacy Survey-European Union scale. The mean age of the patients was 67.13 ± 10.77 years. The treatment continuity rate was 80.50% (n = 33) in the adequate health literacy group (n = 41) and significantly higher than the 56.50% (n = 48) rate in the inadequate health literacy group (n = 85) (p = .008). The health literacy results revealed that the health promotion and general index score was higher in the group of patients under the age of 65. Adequate health literacy in bladder cancer patients is associated with better compliance with the treatment protocol. Young patients show better compliance with the follow-up protocol recommended by the physician. Increasing the follow-up protocol compliance of elderly patients with inadequate health literacy is necessary.

  14. Comparison of titanium and polyetheretherketone (PEEK) cages in the surgical treatment of multilevel cervical spondylotic myelopathy: a prospective, randomized, control study with over 7-year follow-up.

    Science.gov (United States)

    Chen, Yu; Wang, Xinwei; Lu, Xuhua; Yang, Lili; Yang, Haisong; Yuan, Wen; Chen, Deyu

    2013-07-01

    Anterior cervical discectomy and fusion (ACDF) with titanium- or polyetheretherketone (PEEK)-cage reconstruction is widely used in the treatment of cervical spondylotic myelopathy (CSM). This study was to compare outcomes of titanium and PEEK cages in the treatment of multilevel CSM. Between November 2002 and December 2004, a total of 80 patients with 3-level CSM were randomized in a 1:1 ratio to titanium group and PEEK group. The overall follow-up period of the patients ranged from 86 to 116 months (average 99.7 months). Clinical and radiological results were compared between titanium group and PEEK group. At the final follow-up, the clinical outcomes including JOA score, NDI score, and the excellent and good rates of clinical outcomes in the PEEK group were better than those in the titanium group. More loss of the Cobb angles and the intervertebral height was observed in the titanium group, resulting in the radiological parameters in the titanium group becoming inferior to the PEEK group at the final follow-up. Cage subsidence rates were 34.5 and 5.4% in the titanium and PEEK groups, respectively. Fusion was observed in all patients of two groups at the final follow-up. Two patients presented with cage dislocation without clinical symptoms in the titanium group. In surgical treatment of multilevel CSM, PEEK cage is superior to titanium cage in maintenance of intervertebral height and cervical lordosis, resulting in better clinical outcomes in the long-term follow-up.

  15. Biochemical failure as single abnormality in patients with prostate cancer following radical treatment with external radiotherapy: follow-up without immediate treatment

    Directory of Open Access Journals (Sweden)

    Sergio L. Faria

    2004-08-01

    Full Text Available INTRODUCTION: Biochemical failure has been defined as 3 consecutive increases in PSA following curative treatment of prostate cancer. The appropriate management in such cases is controversial. The most usual treatment has been early introduction of hormones. Such patients will live for many years and hormone therapy causes important secondary effects and increases costs. The guideline in our Department of Radiotherapy has been to follow up, with no initial therapy, cases with low PSA and short PSA doubling time. The present study reports this experience. MATERIALS AND METHODS: 528 patients with localized prostate cancer were treated by radical approach between 1992 and 1999, with external radiotherapy, with or without adjuvant hormone therapy. After a median follow-up of 77 months, there were 207 (39% cases with biochemical failure, 78 of which were followed without therapy after the identification of biochemical failure. All of them were asymptomatic patients and had negative radiographic examinations or did not have imaging exams requested since they presented a favorable outcome. The follow-up included at least 2 annual visits with physical examination and PSA. RESULTS: Of the 78 patients with biochemical failure followed without initial therapy, 7 died from other causes than prostate cancer and the remaining 71 cases were alive and asymptomatic in the last follow-up. Prognostic factors previous to radiotherapy such as stage and Gleason score were not considered when deciding for follow-up without initial therapy in these cases. The most significant aspects considered for this decision were low PSA value (median PSA on the last visit for the 78 cases was only 3.9 ng/mL and a slow PSA doubling time (in the present experience the median PSA doubling time was 22.5 months. CONCLUSION: There seems to be space for expectant management, without initial hormone therapy, in patients with prostate cancer who present biochemical failure and are

  16. Effect of Yoga in the Treatment of Eating Disorders: A Single-blinded Randomized Controlled Trial with 6-Months Follow-up.

    Science.gov (United States)

    Karlsen, Kari Ebbesen; Vrabel, Karianne; Bratland-Sanda, Solfrid; Ulleberg, Pål; Benum, Kirsten

    2018-01-01

    The aim of this study is to examine the effect of yoga treatment of eating disorders (EDs). Adult females meeting the Diagnostic and Statistical Manual-IV criteria for bulimia nervosa or ED not otherwise specified ( n = 30) were randomized to 11-week yoga intervention group (2 × 90 min/week) or a control group. Outcome measures, the Eating Disorder Examination (EDE)-Interview and Eating Disorders Inventory-2 (EDI-2) scores, were administered at baseline, posttest, and at 6-month follow-up. There was a dropout rate of 30% (posttest) and 37% (6-month follow-up). The intervention group showed reductions in EDE global score ( P control group. The differences between the groups increased at 6-month follow-up. There were no differences between the groups in the EDI-2 score. The results indicate that yoga could be effective in the treatment of ED.

  17. Transcatheter arterial embolization of abnormal vessels as a treatment for lateral epicondylitis refractory to conservative treatment: a pilot study with a 2-year follow-up.

    Science.gov (United States)

    Iwamoto, Wataru; Okuno, Yuji; Matsumura, Noboru; Kaneko, Takao; Ikegami, Hiroyasu

    2017-08-01

    Abnormal vessels and accompanying nerves are possible sources of pain with lateral epicondylitis. The purpose of this study was to describe the safety and efficacy of transcatheter arterial embolization (TAE) for lateral epicondylitis resistant to conservative treatment. This prospective study was conducted in 24 patients with lateral epicondylitis resistant to conservative treatments for more than 3 months, with a symptom duration longer than 6 months, and with moderate to severe pain who were treated with TAE between March 2013 and October 2014. Two patients were lost to follow-up, and the remaining 22 patients were followed up for 2 years after TAE. Abnormal vessels were identified in all of the patients. No major adverse events were observed. The Quick Disabilities of the Arm, Shoulder and Hand scores at baseline significantly decreased at 1, 3, 6, and 24 months after treatment (50.8 vs 23.4, 8.3, 5.3, and 2.7, respectively; all P lateral epicondylitis that fails to improve with conservative treatments. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  18. Pre-treatment and follow-up examinations of carcinoid metastases using indium-111-octreotide - rational application of Sandostatin

    International Nuclear Information System (INIS)

    Lipp, R.W.; Hammer, H.F.; Passath, A.; Dobnig, H.; Ramschak-Schwarzer, S.; Stiegler, C.; Leb, G.; Krejs, G.J.

    1993-01-01

    Carcinoids may express somatostatin receptors. Therefore, a somatostatin-analogue, In-111 octreotide (OctreoScan), was used for their demonstration. A total of 6 patients who presented radiologically verified carcinoid-metastases was examined. In order to control tumor progress, 4 of these patients were reexamined within a period of 3 to 11 months. All of the radiological findings were confirmed scintigraphically, except some small retroperitoneally located lymph nodes. The follow-up examinations of 2 patients revealed additional metastases by scintigraphy only. There were no false positive results. These results of OctreoScan-scintigraphy may be used for predicting the success of receptor-specific therapies and therefore, permit the rational and efficient application of Sandostatin. Note: Sandostatin and OctreoScan are registered trademarks. (authors)

  19. Autotransplantation and Orthodontic Treatment after Maxillary Central Incisor Region Trauma: A 13-Year Follow-Up Case Report Study.

    Science.gov (United States)

    Piroozmand, Farzad; Hessari, Hossein; Shirazi, Mohsen; Khazaei, Pegah

    2018-01-01

    The anterior maxilla is the most prone region to the trauma during childhood, and tooth loss sometimes happens due to trauma. Replacing the missing teeth has always been one of the dentists' challenges in children and adolescents, since their dentofacial growth is not complete. Autotransplantation of mandibular premolars with two-thirds or three-quarters of root formation provides the best prognosis for the tooth survival. This case report describes the management of a 10-year-old boy suffering a severe dental injury who received the autotransplantation of the premolars from mandible to restore the space caused by trauma in maxillary central incisor region and a 13-year follow-up of the autotransplantation.

  20. Transforaminal Anterior Release for the Treatment of Fixed Sagittal Imbalance and Segmental Kyphosis, Minimum 2-Year Follow-Up Study.

    Science.gov (United States)

    Sweet, Fred A; Sweet, Andrea

    2015-09-01

    Retrospective review of prospectively accrued patient cohort. To report minimum 2 years' follow-up after a single-surgeon series of 47 consecutive patients in whom fixed sagittal imbalance or segmental kyphosis was treated with a novel unilateral transforaminal annular release. Fixed sagittal imbalance has been treated most recently with pedicle subtraction osteotomy with great success but is associated with significant blood loss and neurologic risk. Forty-seven consecutive patients with fixed sagittal imbalance (n = 29) or segmental kyphosis (n = 18) were treated by a single surgeon with a single-level transforaminal anterior release (TFAR) to effect an opening wedge correction. Sagittal and coronal correction was performed with in situ rod contouring. An interbody cage was captured in the disc space with rod compression. Radiographic and clinical outcome analysis was performed with a minimum 2-year follow-up (range 2-7.8 years). The average increase in lordosis was 36° (range 24°-56°) in the fixed sagittal deformity group. Coronal corrections averaged 34° (range 18°-48°). The average improvement in plumb line was 13.6 cm. There were four pseudarthroses, one at the TFAR. Average blood loss was 578 mL (range 200-1,200). One patient had a transient grade 4/5 anterior tibialis weakness. There were no vascular injuries or permanent neurologic deficits. There were significant improvements in the Oswestry Disability Index (p imbalance with relatively low blood loss and was found to be neurologically safe in this single-surgeon series. Therapeutic study, Level IV (case series, no control group). Copyright © 2015 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

  1. CONTRACT FOLLOW UP TRAINING

    CERN Multimedia

    Technical Training; Tel. 74460

    2001-01-01

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

  2. Resilience, post-traumatic growth, and work engagement among health care professionals after the Great East Japan Earthquake: A 4-year prospective follow-up study.

    Science.gov (United States)

    Nishi, Daisuke; Kawashima, Yuzuru; Noguchi, Hiroko; Usuki, Masato; Yamashita, Akihiro; Koido, Yuichi; Matsuoka, Yutaka J

    2016-07-22

    Although attention has been paid to post-traumatic stress disorder (PTSD) among health care professionals after disasters, the impact of traumatic events on their work has not been elucidated. The aim of this study was to examine whether disaster-related distress, resilience, and post-traumatic growth (PTG) affect work engagement among health care professionals who had been deployed to the areas affected by the Great East Japan Earthquake that occurred on March 11, 2011. We recruited disaster medical assistance team members who were engaged in rescue activities after the earthquake. The short version of the Resilience Scale (RS-14) and Peritraumatic Distress Inventory (PDI) were administered one month after the earthquake, and the short form of Posttraumatic Growth Inventory (SF-PTGI) and Utrecht Work Engagement Scale (UWES) were administered four years after the earthquake. Work engagement is composed of vigor, dedication, and absorption. Regression analyses were used to examine the relationship of UWES with RS-14, PDI, and SF-PTGI. We obtained baseline data of 254 participants in April 2011, and 191 (75.2%) completed the follow-up assessment between December 2014 and March 2015. The results showed that RS-14 predicted vigor, dedication, and absorption; in addition, SF-PTGI was positively related with these three parameters (pwork engagement among health care professionals after disasters. These findings could be useful for establishing a support system after rescue activities during a large-scale disaster and for managing work-related stress among health care professionals.

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

    Science.gov (United States)

    Solberg, Cathrine; Larsson, Bo; Jozefiak, Thomas

    2015-04-01

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

  4. A Randomised Controlled Treatment Trial of Two Forms of Family Therapy in Adolescent Anorexia Nervosa: A Five-Year Follow-Up

    Science.gov (United States)

    Eisler, Ivan; Simic, Mima; Russell, Gerald F. M.; Dare, Christopher

    2007-01-01

    Background: There is growing evidence that family therapy is an effective treatment for adolescent anorexia nervosa. This study aimed to ascertain the long-term impact of two forms of outpatient family intervention previously evaluated in a randomised controlled trial (RCT). Method: A five-year follow-up was conducted on a cohort of 40 patients…

  5. Multidimensional Treatment Foster Care for Girls in the Juvenile Justice System: 2-Year Follow-Up of a Randomized Clinical Trial

    Science.gov (United States)

    Chamberlain, Patricia; Leve, Leslie D.; DeGarmo, David S.

    2007-01-01

    This study is a 2-year follow-up of girls with serious and chronic delinquency who were enrolled in a randomized clinical trial conducted from 1997 to 2002 comparing multidimensional treatment foster care (MTFC) and group care (N = 81). Girls were referred by juvenile court judges and had an average of over 11 criminal referrals when they entered…

  6. Humoral immune response against proteins E6 and E7 in cervical carcinoma patients positive for human papilloma virus type 16 during treatment and follow-up

    NARCIS (Netherlands)

    Baay, M. F.; Duk, J. M.; Burger, M. P.; de Bruijn, H. W.; Stolz, E.; Herbrink, P.

    1999-01-01

    To investigate the humoral immune response to transforming proteins E6 and E7 of human papillomavirus type 16 before and after treatment and during follow-up, consecutive serum samples from 36 cervical cancer patients whose tumours were found to contain human papillomavirus type 16 DNA by use of the

  7. Humoral immune response against proteins E6 and E7 in cervical carcinoma patients positive for human papilloma virus type 16 during treatment and follow-up

    NARCIS (Netherlands)

    Baay, MFD; Duk, JM; Burger, MPM; de Bruijn, HWA; Stolz, E; Herbrink, P

    To investigate the humoral immune response to transforming proteins E6 and E7 of human papillomavirus type 16 before and after treatment and during follow-up, consecutive serum samples from 36 cervical cancer patients whose tumours were found to contain human papillomavirus type 16 DNA by use of the

  8. Adalimumab for treatment of severe Behçet's uveitis: a retrospective long-term follow-up study.

    Science.gov (United States)

    Interlandi, Emanuela; Leccese, Pietro; Olivieri, Ignazio; Latanza, Loredana

    2014-01-01

    Behçet's disease (BD) is a chronic multisystem inflammatory disorder associated to uveitis that may represent a serious sight-threatening condition. The purpose of the present study is to assess the effectiveness of adalimumab as new strategic therapeutic approach in patients affected by severe Behçet's uveitis. Clinical data from twelve selected patients (22 eyes) were retrospectively analysed. All patients received 40 mg of adalimumab subcutaneously, once every 2 weeks, in addition to traditional immunosuppressive on-going therapy and eight of them were switched to adalimumab after failure of infliximab therapy. Primary outcome measures included ocular inflammatory activity, frequency of uveitis attacks and steroid-sparing effect. Secondary outcomes were changes of best-corrected visual acuity (BCVA), impact on traditional immunosuppressive therapy and occurrence of adalimumab-related side effects. Mean age of patients (11 males and 1 female) at the onset of disease was 24.34 years (±8.62 SD). Ocular involvement resulted bilateral in 83% of cases and mainly consisted in panuveitis (68% of eyes). After mean follow-up of 21 months (±9.63 SD) all patients but one (92%) achieved uveitis remission with BCVA improvement at least in one eye. Average uveitis attacks decreased from 2 to 0,42 during adalimumab (ptreatment of patients with severe and resistant Behçet's uveitis, providing an appropriate and long-term control of ocular inflammation.

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

    Energy Technology Data Exchange (ETDEWEB)

    Fujimoto, Y.; Obara, T.; Ito, Y.; Kodama, T.; Aiba, M.; Yamaguchi, K. (Tokyo Women' s Medical College (Japan))

    1990-12-01

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

  10. Back and neck pain and function in females with adolescent idiopathic scoliosis: A follow-up at least 23 years after conservative treatment with a Milwaukee brace.

    Directory of Open Access Journals (Sweden)

    Ewa Misterska

    Full Text Available We aimed to explore the long-term outcomes of back and neck pain and functionality in adult females with adolescent idiopathic scoliosis (AIS, who had been treated with a Milwaukee brace, in a follow-up study a minimum of 23 years after the completion of the treatment, using radiological, clinical and socio-demographical data. Thirty AIS patients (scoliosis group-SG, were included in the study based on an extensive search of Pediatric Orthopedics and Traumatology Clinic charts. All treatments were successfully completed between 1974 and 1990. In all cases, scoliosis had not been detected before the age of 10 and was not combined with any major spinal deformities at the time when the brace treatment was implemented. In those patients, the Risser sign 4 and minimum two years post-menarche was defined as a maturity, after that time the brace treatment was completed. Patients were excluded from the study if they, at the time of the follow-up examinations, suffered from any other disease leading to trunk deformity. Forty patients met the criteria for inclusion, but due to change some personal details, not all of them were contacted. Finally, 30 women returned for a follow-up evaluation. Patients' follow-up period was mean 27.77 yrs. ± SD 3.30 (range 23-35. Curvature change from the end of the treatment until the present day was mean 9.1 degrees ± SD 7.64 (range 0-27. A control group of 42 healthy females (healthy controls group-HG matching the age profile of the patient group was randomly selected for comparative purposes.Both SG and HG completed the Polish versions of the Revised Oswestry Lower Back Pain Disability Index (RODI, the Rolland-Morris Questionnaire (RMQ, the Quebec Back Pain Disability Scale (QDS, the Neck Disability Index (NDI and the Copenhagen Neck Functional Disability Scale (CNFDS. Descriptive statistics were calculated for demographics and baseline questionnaire scores. To determine if the investigated sample sizes are equivalent

  11. Is drug treatment for dementia followed up in primary care? A Swedish study of dementia clinics and referring primary care centres.

    Directory of Open Access Journals (Sweden)

    Lars Sonde

    Full Text Available PURPOSE: It is largely unknown how the medical treatment of patients diagnosed with dementia is followed up in primary care. Therefore, we studied patient medical records from two dementia clinics and from the referring primary care centres. METHODS: A retrospective study of 241 patients was conducted from April to October 2011 in north west Stockholm, Sweden. Over half (51.5% of the patients had Alzheimer's disease (AD, the remainder had mixed AD/vascular dementia (VaD. Eighty-four medical reports from primary care (35% of the study group were analysed at follow-up 18 months after diagnosis. RESULTS: All four dementia drugs available on the Swedish market (three cholinesterase inhibitors [donepezil, rivastigmine and galantamine] and memantine were prescribed at the two dementia clinics. The most commonly used dementia drug was galantamine. There were differences between the two dementia clinics in preference and combination of drugs and of treatment given to male and female patients. At follow-up, 84% were still on dementia medication. Drug use was followed up by the general practitioners (GPs in two-thirds of the cases. Eighteen per cent of the GPs' medical records made no reference to the patient's dementia or treatment even though dementia drugs were included in the list of medications prescribed. CONCLUSIONS: The results indicate that the Swedish guidelines for treatment of cognitive symptoms in AD are being followed in primary care. However, documentation of follow-up of drug treatment was sometimes insufficient, which calls for development of guidelines for complete medical records and medication lists.

  12. Retinal screening acceptance, laser treatment uptake and follow-up response in diabetics requiring laser therapy in an urban diabetes care centre

    International Nuclear Information System (INIS)

    Memon, S.

    2015-01-01

    To determine the acceptance of retinal screening, Laser uptake and subsequent follow-up in diabetic patients attending the Diabetes Centre of Diabetic Association of Pakistan (DAP), Karachi. Study Design: Observational case series. Place and Duration of Study: Diabetic Centre of Diabetic Association of Pakistan (DAP), Karachi, from January 2011 to December 2012. Methodology: All the diabetic patients were screened for Diabetic Retinopathy (DR) with non-Mydriatic Fundus Camera (NMFC). Patients with DR were examined by the ophthalmologist using fundus lens and slit lamp. DR was graded for severity on the basis of modified Airlie House Classification. Patients with Sight Threatening Diabetic Retinopathy (STDR) were advised Laser treatment. Each patient was followed-up for at least 6 months. The records of patients recommended Laser were retrieved, and called for re-examination. Results: Retinal screening was accepted by all of the 8368 registered diabetics attending DAP Centre. On fundus photography, 21.2% (1777) individuals were found to have DR. Seven hundred and five (39.5%) patients were found to have STDR. Laser was advised to 96.4% (680) of STDR patients; amongst whom 70.5% (480) accepted Laser treatment. Out of 480 patients who had Laser treatment, 21.2% (107) turned out for follow-up after 6 months. Conclusion: Acceptance of retinal screening and Laser application was good; but follow-up was suboptional. (author)

  13. Treatment of Neuropathic Pain and Functional Limitations Associated With Multiple Sclerosis Using an MRI-Compatible Spinal Cord Stimulator: A Case Report With Two Year Follow-Up and Literature Review.

    Science.gov (United States)

    Provenzano, David A; Williams, Joseph R; Jarzabek, Gaye; DeRiggi, Leonard A; Scott, Thomas F

    2016-06-01

    To report a case with two years follow-up of neuropathic pain and functional limitations associated with multiple sclerosis (MS) effectively treated with an MRI conditional spinal cord stimulator (SCS) system that allowed for spinal imaging. To present a comprehensive literature review of spinal cord stimulator utilization in the treatment of multiple sclerosis. Case report and literature review. Treatment was a spinal cord stimulation implant after successful trial. Pain scores, medication utilization, and functional outcomes were reviewed. Pre- and post-SCS implant MRI spine images were obtained. At 24 months follow-up, the patient has had a 77% reduction in pain and a 99% reduction in opioid use. Furthermore, he had improvement in reported tactile sensation, spasticity levels, and ambulation. Post-SCS implant, MRI images at 18 months follow-up provided the ability to review the spinal cord with minimal artifact. No new MS documented plaques occurred during this time period. A literature review demonstrated 33 published reports including a total of 496 trialed and 744 implanted patients. Only 3 of the reports occurred after the year 2000. We report the successful treatment of MS-associated pain and functional limitations with an MRI conditional spinal cord stimulator system. The ability to obtain post-implant MRI imaging of not only the brain but also the spinal cord in MS patients allows for the continued need to document and follow disease progression, especially with the advancements in pharmacological therapy. © 2016 International Neuromodulation Society.

  14. Essure Removal for the Treatment of Device-Attributed Symptoms: An Expanded Case Series and Follow-up Survey.

    Science.gov (United States)

    Clark, Nisse V; Rademaker, Doortje; Mushinski, Avery A; Ajao, Mobolaji O; Cohen, Sarah L; Einarsson, Jon I

    To evaluate perioperative outcomes and symptom resolution in women undergoing removal of the Essure device for device-attributed symptoms. Retrospective case series and follow-up patient survey (Canadian Task Force classification III). Large academic medical center. Fifty-two women who underwent laparoscopic or hysteroscopic Essure removal between 2012 and 2016. Women underwent one of four procedures: laparoscopic hysterectomy (LH) and bilateral salpingectomy (BS), laparoscopic BS and cornuectomy, laparoscopic Essure removal and BS, or hysteroscopic Essure removal and laparoscopic BS. Fifty-two women who underwent Essure removal were asked to complete a survey regarding symptom resolution and quality of life following the procedure. Thirty-two women (61.5%) responded to the survey. Seventy-five percent (24/32) reported almost total or total improvement in quality of life, 56.3% (18/32) for sex life, 53.1% (17/32) for pelvic pain, and 65.6% (21/32) for daily activities. The majority of women reported some degree of improvement in all four domains queried (87.5%, 28/32). When asked about their symptoms in general, 31.3% (10/32) of women reported ongoing or worse symptoms after Essure removal. All procedures took approximately one hour (mean 65 min, SD 33 min), were associated with minimal blood loss (mean 31 mL, SD 17), and had no perioperative complications. Essure removal is a procedure that may be effective for treating most women with symptoms attributed to the device. Patients should be counseled that some symptoms may persist or even worsen following surgery. Copyright © 2017 AAGL. Published by Elsevier Inc. All rights reserved.

  15. Treatment and follow-up results of children with electrical burn who observed in burn intensive care unit

    Directory of Open Access Journals (Sweden)

    Çiğdem Aliosmanoğlu

    2011-06-01

    Full Text Available Electrical burns are infrequent relative to other injuries, but they are associated with high morbidity and mortality. The aim of this study was to assess management and follow-up results of pediatric patients’ who observed in intensive care unit and also review the precautions for preventing electrical burns.Materials and methods: Totally 22 patients aged under 17 years who were observed in the burn intensive care unit of Şanlıurfa Education and Research Hospital during the period between July 2009-October 2010. Cases were investigated retrospectively. The patients’ age, gender, total burn surface area, length of stay in hospital, musculo-skeletal system complication, cardiovascular system complication, kidney damage and attempts were recorded.Results: Of the 22 cases, 19 (86.3% were male and 3 (13.7% were female. The mean age of the patients was 11.5 years. In 10 (45.4% children burns were occurred in workplace and working area and 12 (54.6% were occurred in the home environment. Depth of burns were third degree in 10 (45.4% children and second degree in 12 (54.6%. The mean percentage of burn surface area was 25.9%. The mean length of stay in hospital was 17 days. Debridement and grafting were performed to 12 (54.6% cases and 10 (45.4% children were treated with dressings. No patient had increased creatinine kinase levels, oliguria, myoglobuinuria and arrhythmia. The mean hospitalization time was 17 days.Conclusion: Nearly half of patients underwent debridement plus grafting. None of our patients developed renal failure other severe system dysfunction.

  16. Regenerative Endodontic Treatment with Orthodontic Treatment in a Tooth with Dens Evaginatus: A Case Report with a 4-year Follow-up.

    Science.gov (United States)

    Natera, Marianella; Mukherjee, Padma M

    2018-06-01

    Dens evaginatus is a developmental tooth anomaly in which an extra cusp or tubercle protrudes on the occlusal surface of the tooth along with some pulpal tissue. Because of the fragile nature of the protrusion, these teeth are often at risk of pulpal exposure. When this occurs in an immature tooth, regenerative endodontic treatment may be a good treatment approach to promote root formation. There is limited literature that documents the occurrence of orthodontic treatment in teeth that have undergone regenerative endodontic therapy using triple antibiotic paste. Here we present a case of an immature premolar tooth with dens evaginatus that was diagnosed with pulp necrosis and chronic apical abscess. The tooth was treated with regenerative endodontic treatment; after which, the patient received orthodontic treatment with fixed appliances for 2 years. The tooth responded favorably to the regenerative endodontic treatment and orthodontic tooth movement. Clinically and radiographically, all the follow-up examinations revealed an asymptomatic tooth with evidence of periapical healing with stunted root development. The tooth remained asymptomatic even after 4 years. The regenerative endodontic procedure (REP) was successful in treating an immature permanent premolar with pulp necrosis and apical periodontitis with dens evaginatus. In this case, the tooth treated with an REP responded to orthodontic treatment similar to the nonendodontically treated teeth. Further studies are recommended to clarify the precise effects of orthodontic treatment on teeth treated with an REP. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  17. A long-term controlled follow-up study of objective treatment need on young adults treated with functional appliances.

    Science.gov (United States)

    Faxén Sepanian, Varoojan; Paulsson-Björnsson, Liselotte; Kjellberg, Heidrun

    2014-01-01

    The aims of this study were to 1) evaluate the objective success rate of Class II malocclusion treatment with functional appliances five years after completion of treatment and 2) to compare the remaining objective treatment need with an untreated control group. Records of all listed patients between 18-20 years (n=1054) treated in a general practice were reviewed for the purpose of finding treatments with removable functional appliances. Among all subjects (n=61) who previously had been treated, 58 accepted to participate in the study.The test group was matched with an orthodontically untreated group with no history of objective treatment need. Clinical examination was performed and study casts and photos were taken from both groups.The objective treatment need was evaluated through clinical examination and study cast analysis with weighted Peer Assessment Rating index (wPAR). Twenty patients, (34.5%) (mean wPAR 13.8), succeeded with the functional appliance treatment.The wPAR score (mean 15.0) of the entire test group was significantly higher than the one of the control group (mean 7.3).The group that was treated exclusively with functional appliances had a mean wPAR score of 17.4. Eighteen patients (31.0%) who received retreatment with fixed appliances had a slightly higher mean wPAR (8.6) than the control group. Treatments with functional appliances in a general practice showed a high failure rate and a remaining treatment need. It is the treating dentist's responsibility to motivate the patient to cooperate to the treatment, because as it previously has been shown the treatment with functional appliances is a well-functioning treatment alternative with the cooperation of the patient being sufficient. It is also of importance, already before starting treatment, to estimate the child's cooperation ability and to avoid treatment with removable appliances if the child or parents are reluctant about such a treatment.

  18. Sixteen multidetector row computed tomography of pulmonary veins: 3-months' follow-up after treatment of paroxysmal atrial fibrillation with cryothermal ablation

    International Nuclear Information System (INIS)

    Maksimovic, Ruzica; Cademartiri, Filippo; Pattynama, Peter M.T.; Scholten, Marcoen F.; Jordaens, Luc J.

    2005-01-01

    The aim of the study was to assess pulmonary veins (PVs) for the presence of stenosis 3 months after cryothermal ablation (CA) with a new method of electrical isolation of PVs using contrast-enhanced 16 multidetector row computed tomography (MDCT). Twenty four patients with symptomatic atrial fibrillation underwent CA in 46 PVs. MDCT of PVs was performed before the treatment and after 3-months' follow-up. Following cryoablation, 13/24 (54%) patients showed clinical improvement and had reduced attacks of atrial fibrillation. The dimensions of the treated PVs remained unchanged: the coronal ostial diameter was 19.1±2.4 preprocedural versus 18.6±2.4 mm at follow-up, p>0.05; the ratio of the coronal and axial diameters at the ostium was 1.2±0.2 versus 1.2±0.1, p>0.05, respectively, and the coronal diameter of the proximal 10 mm was 17.1±2.5 mm versus 16.5±2.2 mm, p>0.05, respectively. CA is a promising technique for electrical isolation of PVs that has not been associated with stenosis at the orifice and the proximal 10 mm of the PVs after 3-months' follow-up. MDCT is a noninvasive, fast and comfortable method for assessment of PVs in a three-dimensional manner prior to ablative treatment and during the follow-up. (orig.)

  19. Sixteen multidetector row computed tomography of pulmonary veins: 3-months' follow-up after treatment of paroxysmal atrial fibrillation with cryothermal ablation

    Energy Technology Data Exchange (ETDEWEB)

    Maksimovic, Ruzica; Cademartiri, Filippo; Pattynama, Peter M.T. [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Scholten, Marcoen F.; Jordaens, Luc J. [Erasmus Medical Center, Department of Cardiology, Rotterdam (Netherlands)

    2005-06-01

    The aim of the study was to assess pulmonary veins (PVs) for the presence of stenosis 3 months after cryothermal ablation (CA) with a new method of electrical isolation of PVs using contrast-enhanced 16 multidetector row computed tomography (MDCT). Twenty four patients with symptomatic atrial fibrillation underwent CA in 46 PVs. MDCT of PVs was performed before the treatment and after 3-months' follow-up. Following cryoablation, 13/24 (54%) patients showed clinical improvement and had reduced attacks of atrial fibrillation. The dimensions of the treated PVs remained unchanged: the coronal ostial diameter was 19.1{+-}2.4 preprocedural versus 18.6{+-}2.4 mm at follow-up, p>0.05; the ratio of the coronal and axial diameters at the ostium was 1.2{+-}0.2 versus 1.2{+-}0.1, p>0.05, respectively, and the coronal diameter of the proximal 10 mm was 17.1{+-}2.5 mm versus 16.5{+-}2.2 mm, p>0.05, respectively. CA is a promising technique for electrical isolation of PVs that has not been associated with stenosis at the orifice and the proximal 10 mm of the PVs after 3-months' follow-up. MDCT is a noninvasive, fast and comfortable method for assessment of PVs in a three-dimensional manner prior to ablative treatment and during the follow-up. (orig.)

  20. Nephrotoxicity during tenofovir treatment: a three-year follow-up study in a Brazilian reference clinic

    Directory of Open Access Journals (Sweden)

    Lauro Ferreira da Silva Pinto Neto

    2016-01-01

    Full Text Available In this study, 275 patients in use of tenofovir were retrospectively followed-up for three years to evaluate risk factors involved in impaired renal function. Analysis of variance (ANOVA and Tukey's test were used to verify any differences in creatinine levels and estimated clearance at 0, 6, 12, 24 and 36 months, adjusting for the co-variables sex, skin color, age >50 years, arterial hypertension, diabetes and the use of the ritonavir-boosted protease inhibitors (PI/r lopinavir/r or atazanavir/r. The software package STATISTICA 10® was used for statistical analysis. The patients’ mean age was 43.2 ± 10.7 years. Systemic arterial hypertension (SAH and diabetes were found in 20.4% and 8.7% of the patients, respectively. Overall, 96.7% were on tenofovir associated with lamivudine (TDF + 3TC, 39.3% on lopinavir/r, 29.8% on efavirenz, and 17.6% on atazanavir/r. There was a statistically significant difference in estimated creatinine clearance at 24 months, when the co-variables male (F = 3.95; p = 0.048, SAH (F = 6.964; p = 0.009, and age over 50 years (F = 45.81; p < 0.001 were taken into consideration. Analysis of the co-variable use of atazanavir/r showed a tendency toward an increased risk over time (F = 2.437; p = 0.063; however, no significant time interaction was seen. At 36-month, a statistically significant difference was found for age over 50 years, (F = 32.02; p < 0.05 and there was a significant time-by-sex interaction (F = 3.117; p = 0.0149. TDF was discontinued in 12 patients, one because of a femoral neck fracture (0.7% and 11 due to nephrotoxicity (4%. Of these latter cases, 9/11 patients were also using protease inhibitors. These data strongly alert that tenofovir use should be individualized with careful attention to renal function especially in male patients, over 50 years, with SAH, and probably those on ATV/r.

  1. Investigation of the treatment results of advanced squamous cell carcinoma of the oral cavity and clinical necessity of long-term follow-up

    International Nuclear Information System (INIS)

    Yamakawa, Nobuhiro; Kirita, Tadaaki; Imai, Yuichiro; Yamanaka, Yasutsugu; Aoki, Kumiko

    2011-01-01

    It has been considered that oral cancer is cured if more than five years pass without recurrence or metastasis after the initial treatment. Treatment results are usually evaluated as a 5-year survival rate, but we sometimes find recurrence more than five years after the initial treatment. We retrospectively investigated treatment results by long-term follow-up of advanced squamous cell carcinoma of the oral cavity after radical surgery, and analyzed the relation between the period of follow-up and the time to recurrence. One hundred and sixteen patients with advanced squamous cell carcinoma of the oral cavity were enrolled between November 1994 and October 2004 in this study. Seventy-six patients were Stage III and 40 were stage IV, and the mean age of this cohort was 63.0 years. All patients received radical surgery with or without preoperative chemoradiotherapy and were followed for a minimum of 5 years. Overall actuarial survival of all patients was 77.8% at 10 years. The 10-year cumulative local and regional recurrence rates were 20.1% and 12.9%, respectively. The actuarial loco-regional recurrence rate was the highest within 2 years after initial treatment at 19.0%, and was seen in 3.4% even after 5 years. These results showed that it is necessary to follow-up patients with advanced oral cancer even beyond 5 years after the initial treatment because there was delayed loco-regional recurrence in 3.4%. (author)

  2. 1-year follow-up of neurofeedback treatment in adolescents with attention-deficit hyperactivity disorder : Randomised controlled trial

    NARCIS (Netherlands)

    Bink, M.; Bongers, I.L.; Popma, A.; Janssen, T.W.P.; van Nieuwenhuizen, Ch.

    2016-01-01

    Background Estimates of the effectiveness of neurofeedback as a treatment for attention-deficit hyperactivity disorder (ADHD) are mixed. Aims To investigate the long-term additional effects of neurofeedback (NFB) compared with treatment as usual (TAU) for adolescents with ADHD. Method Using a

  3. A daily SMS reminder increases adherence to asthma treatment: a three-month follow-up study

    DEFF Research Database (Denmark)

    Strandbygaard, Ulla; Thomsen, Simon Francis; Backer, Vibeke

    2010-01-01

    Poor adherence to asthma treatment is a well-recognised challenge and is associated with increased morbidity, mortality and consumption of health care resources. This study examined the impact of receiving a daily text message reminder on one's cell phone on adherence to asthma treatment....

  4. Periodontal treatment in a generalized severe chronic periodontitis patient: A case report with 7-year follow-up.

    Science.gov (United States)

    Agrali, Omer Birkan; Kuru, Bahar Eren

    2015-01-01

    The aim of the periodontal treatment is to provide healthy and functional dentition all through a lifetime. In this report, periodontal treatment of a 42-year-old male patient with generalized severe chronic periodontitis is presented. He received initial periodontal treatment together with adjunctive antimicrobials. The devital teeth were endodontically treated, and free gingival grafts were placed at the inadequate keratinized tissue zones before regenerative surgery. Following the surgical treatment using enamel matrix derivatives and xenogenic bone graft combination, the patient was put on a strict recall program. After 12 months, favorable clinical and radiographical improvements were obtained. The 7-year maintenance of the present case with several initially hopeless teeth has been shown and discussed in this report. It can be concluded that optimum oral hygiene level as well as the positive cooperation of the patient enhanced the success of periodontal treatment results even in extremely severe periodontal destruction.

  5. Dialectical behaviour therapy and an added cognitive behavioural treatment module for eating disorders in women with borderline personality disorder and anorexia nervosa or bulimia nervosa who failed to respond to previous treatments. An open trial with a 15-month follow-up.

    Science.gov (United States)

    Kröger, Christoph; Schweiger, Ulrich; Sipos, Valerija; Kliem, Sören; Arnold, Ruediger; Schunert, Tanja; Reinecker, Hans

    2010-12-01

    There is evidence from case studies suggesting that adapted dialectical behavior therapy (DBT) for borderline personality disorder (BPD) and eating disorders (ED) might improve disorder related complaints. Twenty-four women with BPD (9 with comorbid anorexia nervosa [AN] and 15 with bulimia nervosa [BN]), who already had failed to respond to previous eating-disorder related inpatient treatments were consecutively admitted to an adapted inpatient DBT program. Assessment points were at pre-treatment, post-treatment, and 15-month follow-up. At follow-up, the remission rate was 54% for BN, and 33% for AN. Yet 44% of women with AN crossed over to BN and one woman additionally met the criteria of AN. For women with AN, the mean weight was not significantly increased at post-treatment, but had improved at follow-up. For women with BN, the frequency of binge-eating episodes was reduced at post-treatment as well as at follow-up. Self-rated eating-related complaints and general psychopathology, as well as ratings on global psychosocial functioning, were significantly improved at post-treatment and at follow-up. Although these findings support the assumption that the adapted DBT inpatient program is a potentially efficacious treatment for those who failed to respond to previous eating-disorder related inpatient treatments, remission rates and maintained eating-related psychopathology also suggest that this treatment needs further improvement. 2010 Elsevier Ltd. All rights reserved.

  6. Healthcare utilization in general practice before and after psychological treatment: a follow-up data linkage study in primary care.

    Science.gov (United States)

    Prins, Marijn A; Verhaak, Peter F M; Smit, Dineke; Verheij, Robert A

    2014-09-01

    Literature suggests that serious mental health problems increase the use of health services and psychological interventions can reduce this effect. This study investigates whether this effect is also found in primary care patients with less serious mental health problems. Routine electronic health records (EHR) from a representative sample of 128 general practices were linked to patient files from 150 primary care psychologists participating in the NIVEL Primary Care Database, using a trusted third party. Data were linked using the date of birth, gender, and postcode. This yielded 503 unique data pairs that were listed in one of the participating GP practices in 2008-2010, for people who had psychological treatment from a psychologist that ended in 2009. The number of contacts, health problems presented, and prescribed medication in general practice were analysed before and after the psychological treatment. Nearly all 503 patients consulted their GP during the six months preceding the psychological treatment (90.9%) and also in the six months after this treatment had ended (83.7%). The frequency of contacts was significantly higher before than after the psychological treatment (6.1 vs. 4.8). Fewer patients contacted their GPs specifically for psychological or social problems (46.3% vs. 38.8%) and fewer patients had anxiolytic drug prescriptions (15.5% vs. 7.6%) after psychological treatment. After psychological treatment, patients contact their GPs less often and present fewer psychological or social problems. Although contact rates seem to decrease, clients of psychologists are still frequent GP attenders.

  7. Burst fractures of the thoracolumbar spine : changes of the spinal canal during operative treatment and follow-up

    NARCIS (Netherlands)

    Leferink, VJM; Nijboer, JMM; Zimmerman, KW; Veldhuis, EFM; ten Vergert, EM; ten Duis, HJ

    Although multiple studies have concluded operative decompression of a traumatically narrowed spinal canal is not indicated because of spontaneous remodeling, instrumental decompression is frequently used as part of the operative treatment of spinal fractures. To investigate the process of

  8. Antipsychotic treatment, psychoeducation & regular follow up as a public health strategy for schizophrenia: Results from a prospective study

    Directory of Open Access Journals (Sweden)

    Channaveerachari Naveen Kumar

    2017-01-01

    Interpretation & conclusions: Treatment with antipsychotics and psychoeducation can favourably influence the course of schizophrenia and reduce disability in a substantial proportion of patients. Structured psychosocial interventions may be indicated in the significant minority who show suboptimal outcome with this strategy.

  9. Treatment of bisphosphonate related osteonecrosis following root canal therapy at the 1-year follow-up: report of two cases

    OpenAIRE

    Kaptan, Figen; Kazandag, Meric Karapinar; Iseri, Ufuk

    2013-01-01

    Figen Kaptan,1 Meric Karapinar Kazandag,1 Ufuk Iseri21Yeditepe University, Faculty of Dentistry, Department of Endodontics, 2Department of Prosthodontics, Istanbul, TurkeyAbstract: The objective of this report was to use topical gaseous ozone as an adjunct to conventional treatment methods and to describe the multidisciplinary management of bisphosphonate associated bone necrosis, which developed following endodontic treatment. No complaints were noted by the patients at their 1-year follow-u...

  10. Long-term efficacy of ultrasound-guided low power microwave ablation for the treatment of primary papillary thyroid microcarcinoma: a 3-year follow-up study.

    Science.gov (United States)

    Teng, Dengke; Sui, Guoqing; Liu, Caimei; Wang, Yu; Xia, Yongxu; Wang, Hui

    2018-04-01

    To evaluate the safety and efficacy of ultrasound-guided low-power microwave ablation (MWA) for the treatment of papillary thyroid microcarcinoma (PTMC) with a 3-year follow-up. A total of 21 nodules diagnosed as PTMC from the 15 patients were performed with MWA at a power of 20 W. The images of the nodules were recorded by ultrasound before MWA and 1, 3, 6, 12 months after MWA, and every 6 months thereafter, respectively. The volumes of the nodules were compared before MWA and at each follow-up point after MWA. The volume reduction rate (VRR) of nodules was also calculated. The mean volume of the nodules was 134.3 ± 129.8 mm 3 initially (the range was 7.4-423.8 mm 3 ), which decreased significantly to 2.3 ± 10.5 mm 3 (the range was 0-48.1 mm 3 ) of the ablation area (P = 0.000) at the follow-up point of 36 months with a mean VRR as 98.78 ± 5.61% (the range was 74.28-100%). During the follow-up period (the range was 36-48 months), 20 of the 21 nodules were completely absorbed and no recurrent nodule was found. After a long-term follow-up of 3 years, the low power MWA showed a good safety and efficacy for the treatment of PTMC. In addition to surgery and active surveillance, MWA might be another alternative for patients with PTMC.

  11. Reverse Shoulder Arthroplasty for the Treatment of Rotator Cuff Deficiency: A Concise Follow-up, at a Minimum of 10 Years, of Previous Reports.

    Science.gov (United States)

    Cuff, Derek J; Pupello, Derek R; Santoni, Brandon G; Clark, Rachel E; Frankle, Mark A

    2017-11-15

    We previously evaluated 94 patients (96 shoulders) who underwent reverse shoulder arthroplasty using a central compressive screw with 5.0-mm peripheral locking screws for baseplate fixation and a center of rotation lateral to the glenoid as treatment for end-stage rotator cuff deficiency. The purpose of this study was to report updated results at a minimum follow-up of 10 years. Forty patients (42 shoulders) were available for clinical follow-up. In the patients available for study, implant survivorship, with the end point being revision for any reason, was 90.7%. Since our 5-year report, 2 patients underwent revision surgery; 1 patient sustained a periprosthetic fracture 7 years postoperatively and 1 patient had a dislocation because of chronic shoulder instability at 8 years postoperatively. At a minimum follow-up of 10 years, the patients continued to maintain their improved outcome scores and range of motion, which were comparable with earlier follow-up evaluations. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

  12. Durability of improvement in post-traumatic stress disorder symptoms and absence of harmful effects or drug dependency after 3,4-methylenedioxymethamphetamine-assisted psychotherapy: a prospective long-term follow-up study.

    Science.gov (United States)

    Mithoefer, Michael C; Wagner, Mark T; Mithoefer, Ann T; Jerome, Lisa; Martin, Scott F; Yazar-Klosinski, Berra; Michel, Yvonne; Brewerton, Timothy D; Doblin, Rick

    2013-01-01

    We report follow-up data evaluating the long-term outcomes for the first completed trial of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for chronic, treatment-resistant post-traumatic stress disorder (PTSD) (Mithoefer et al., 2011). All of the 19 subjects who received MDMA-assisted treatment in the original trial participated in the long-term follow-up (LTFU), with 16 out of 19 completing all of the long-term outcome measures, which were administered from 17 to 74 months after the original study's final MDMA session (mean = 45.4; SD = 17.3). Our primary outcome measure used was the Clinician-Administered PTSD Scale (CAPS). Secondary outcome measures were the Impact of Events Scale-Revised (IES-R) and the Neuroticism Extroversion Oppenness Personality Inventory-Revised (NEO PI-R) Personality Inventory. We also collected a long-term follow-up questionnaire. Results for the 16 CAPS completers showed there were no statistical differences between mean CAPS score at LTFU (mean = 23.7; SD = 22.8) (t (matched) = 0.1; df = 15, p = 0.91) and the mean CAPS score previously obtained at Study Exit (mean = 24.6, SD = 18.6). On average, subjects maintained statistically and clinically-significant gains in symptom relief, although two of these subjects did relapse. It was promising that we found the majority of these subjects with previously severe PTSD who were unresponsive to existing treatments had symptomatic relief provided by MDMA-assisted psychotherapy that persisted over time, with no subjects reporting harm from participation in the study.

  13. Chair time saving method for treatment of an impacted maxillary central incisor with 15-month follow-up

    Directory of Open Access Journals (Sweden)

    Saeed Noorollahian

    2018-01-01

    Full Text Available Maxillary permanent incisors have a major role in facial esthetics. Impaction of them has great adverse effect on smile and causes serious concerns in patient and parents. Physical barriers (e.g., overretained primary teeth, supernumerary teeth, and pathologic lesions, space problems, developmental abnormalities, altered eruption sequence, trauma, palatal clefts, and genetics can act as etiologic factors. Currently, the conventional technique to treatment of impacted teeth consists of a combined orthodontic and surgical approach, to guide the impacted teeth in a constant position and surrounded by normal hard and soft tissues. Treatment is challenging because of some limitations such as patient's age, cooperation, anchorage, and mechanotherapy possibilities. Hence, sophisticated treatment planning is crucial. A 9-year-old girl with horizontally impacted maxillary left central incisor treated with surgical exposure and closed orthodontic forced eruption with 2 × 4 partial setup fixed appliances. Force was applied with 0.014 inch nickel–titanium wire as elastic overlay and handmade ligated bracket. To save chair time in each appointment, the overlay was activated by twisting of ligature wire extensions around it. After 16-month treatment, impacted incisor emerged in oral cavity, with accepted alignment and inclination. Handmade ligated bracket with ligature wire extensions is useful for the treatment of impacted teeth. Due to easy activation of overlay in this method, chair time become short in each appointment.

  14. The shorter the better? A follow-up analysis of 10-session psychiatric treatment including the motive-oriented therapeutic relationship for borderline personality disorder.

    Science.gov (United States)

    Kramer, Ueli; Stulz, Niklaus; Berthoud, Laurent; Caspar, Franz; Marquet, Pierre; Kolly, Stéphane; De Roten, Yves; Despland, Jean-Nicolas

    2017-05-01

    There is little research on short-term treatments for borderline personality disorder (BPD). While the core changes may occur only in long-term treatments, short-term treatments may enable the study of early generic processes of engagement in therapy and thus inform about effective treatment components. It was shown that a 10-session version of a psychiatric treatment was effective in reducing borderline symptoms at the end of this treatment [Kramer, U., Kolly, S., Berthoud, L., Keller, S., Preisig, M., Caspar, F., … Despland, J.-N. (2014). Effects of motive-oriented therapeutic relationship in a ten-session general psychiatric treatment for borderline personality disorder: A randomized controlled trial. Psychotherapy and Psychosomatics, 83, 176-186.]. Also, it was demonstrated in a randomized design that adding the motive-oriented therapeutic relationship (MOTR), following an individualized case formulation based on Plan Analysis, further increased general outcome after session 10 and had a positive effect on the early changes in self-esteem and alliance. The present study focuses on the follow-up period after this initial treatment, examining treatment density and outcomes after 6 months and service utilization after 12 months. Outcome was measured using the OQ-45. Results on a sub-sample of N = 40 patients with available OQ-45 data at follow-up (n = 21 for MOTR-treatment, n = 19 for comparison treatment) showed maintenance of gains over the follow-up period, which did not differ between both conditions. It appeared for this sample that MOTR treatments, while using the same number of sessions, lasted more weeks (i.e., lower treatment density, defined as the number of sessions per week), when compared to the treatments without MOTR. Density marginally predicted symptom reduction at follow-up. Patients in MOTR treatments had a greater likelihood of entering structured psychotherapy after the initial sessions than patients in the comparison

  15. Surgical treatment of multiple rib fractures and flail chest in trauma: a one-year follow-up study.

    Science.gov (United States)

    Caragounis, Eva-Corina; Fagevik Olsén, Monika; Pazooki, David; Granhed, Hans

    2016-01-01

    Multiple rib fractures and unstable thoracic cage injuries are common in blunt trauma. Surgical management of rib fractures has received increasing attention in recent years and the aim of this 1-year, prospective study was to assess the long-term effects of surgery. Fifty-four trauma patients with median Injury Severity Score 20 (9-66) and median New Injury Severity Score 34 (16-66) who presented with multiple rib fractures and flail chest, and underwent surgical stabilization with plate fixation were recruited. Patients responded to a standardized questionnaire concerning pain, local discomfort, breathlessness and use of analgesics and health-related quality of life (EQ-5D-3 L) questionnaire at 6 weeks, 3 months, 6 months and 1 year. Lung function, breathing movements, range of motion and physical function were measured at 3 months, 6 months and 1 year. Symptoms associated with pain, breathlessness and use of analgesics significantly decreased from 6 weeks to 1 year following surgery. After 1 year, 13 % of patients complained of pain at rest, 47 % had local discomfort and 9 % used analgesics. The EQ-5D-3 L index increased from 0.78 to 0.93 and perceived overall health state increased from 60 to 90 % (p rib fractures and flail chest show a gradual improvement in symptoms associated with pain, quality of life, mobility, disability and lung function over 1 year post surgery. Therefore, the final outcome of surgery cannot be assessed before 1 year post-operatively.

  16. Good outcome of adolescent onset anorexia nervosa after systematic treatment. Intermediate to long-term follow-up of a representative county-sample.

    Science.gov (United States)

    Halvorsen, Inger; Andersen, Anne; Heyerdahl, Sonja

    2004-10-01

    We studied the intermediate to long-term outcome of childhood and adolescent onset anorexia nervosa (AN), in a sample that had received systematic treatment based on close cooperation between parents, paediatric department and child and adolescent psychiatry. Of 55 female AN-patients, 51 were examined 3.5-14.5 years after treatment start. The material includes all AN-patients under 18 years in one county that received inpatient treatment and almost all that received outpatient treatment, during the time period 1986-1998. Forty-two (82%) subjects had no eating disorder (ED) at follow-up, one (2%) had AN, one (2%) bulimia nervosa (BN) and seven (14%) had less severe ED (EDNOS). Except the one with BN, none had bulimic symptoms. There was no mortality. Twenty (41%) had one or more other axis-1 psychiatric diagnoses at follow-up. Depression and anxiety disorders were most frequent. Psychosocial functioning assessed by Global Assessment of Functioning (GAF) was fairly good; mean 73+/-SD14 for symptoms and mean 77+/-SD13 for functioning. Only 48% were satisfied with life, compared to 83% in a normal population sample. Our conclusion is that the eating disorder outcome was good. However, in accordance with other studies, many subjects had other psychiatric problems at follow-up.

  17. Long-term follow-up after neoplastic seeding complicating percutaneous ethanol injection for treatment of hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Arrive, L.; Vurgait, A.; Monnier-Cholley, L.; Lewin, M.; Tubiana, J.M.; Balladur, P.; Poupon, R.

    2002-01-01

    We describe a case of subcutaneous metastasis along the needle track after percutaneous ethanol injection (PEI) for treatment of hepatocellular carcinoma. After surgical resection and extrabeam radiation therapy the patient is alive without evidence of recurrence five years after PEI. One should pay attention to the abdominal wall around the needle track in interpreting CT or MR images of patients with previous PEI. (orig.)

  18. Prediction of Response to Treatment in a Randomized Clinical Trial of Couple Therapy: A 2-Year Follow-Up

    Science.gov (United States)

    Baucom, Brian R.; Atkins, David C.; Simpson, Lorelei E.; Christensen, Andrew

    2009-01-01

    Many studies have examined pretreatment predictors of immediate posttreatment outcome, but few studies have examined prediction of long-term treatment response to couple therapies. Four groups of predictors (demographic, intrapersonal, communication, and other interpersonal) and 2 moderators (pretreatment severity and type of therapy) were…

  19. Cryotherapy for renal-cell cancer: diagnosis, treatment, and contrast-enhanced ultrasonography for follow-up

    NARCIS (Netherlands)

    Wink, M. H.; Lagerveld, B. W.; Laguna, M. P.; de la Rosette, J. J. M. C. H.; Wijkstra, H.

    2006-01-01

    Cryotherapy is a curative treatment option for patients with small ( <4 cm) renal-cell cancers. For the followup of ablated lesions, imaging is the only available method, but the best tool has not yet been determined. The method selected should be able to determine the presence or absence of

  20. Treatment of Chagas' disease with itraconazole: electrocardiographic and parasitological conditions after 20 years of follow-up.

    Science.gov (United States)

    Apt, Werner; Arribada, Arturo; Zulantay, Inés; Rodríguez, Jorge; Saavedra, Miguel; Muñoz, Andrea

    2013-09-01

    To evaluate cases of chronic Chagas' disease for the long-term effects of treatment with itraconazole on Trypanosoma cruzi infections and the regression or development of ECG abnormalities. In March 1992, we treated 46 patients with chronic Chagas' disease with 6 mg/kg/day of itraconazole for 120 days in a blind evaluation. The patients came from an area of Chile where the disease was endemic and were checked for ECG abnormalities and with xenodiagnosis (XD) or real-time XD-quantitative PCR (XD-qPCR) for Trypanosoma cruzi infection before treatment and once a year for 20 years. Twenty-one patients proved to be uninfected after 20 years and 15 of the patients had a normal ECG. Of the latter cases, 32.6% could be considered cured, although all of them had positive serology. Itraconazole prevents the development of ECG abnormalities, because after 20 years of treatment only 10.86% of patients developed ECG abnormalities (Z = 1.70, P = 0.046). XD-qPCR performed on 16 patients demonstrated 10 cases with XD; these cases correspond to therapy failure, since re-infection was ruled out. In one case, XD-qPCR did not present amplification. Itraconazole is useful in the treatment of chronic Chagas' disease as it prevented the development of ECG abnormalities and cured 32.6% of patients.

  1. The use of non-medical/alternative treatment in multiple sclerosis. A 5 year follow-up study

    DEFF Research Database (Denmark)

    Stenager, Egon; Stenager, E N; Knudsen, Lone

    1995-01-01

    Forty-nine patients (22 males, 27 females) were examined and interviewed with 5 years interval in order to determine the extent of the use of non-medical (alternative) treatment and whether the use influenced the natural course of multiple sclerosis (MS). Using clinical course, Kurtzke Disability...

  2. Follow-up of 13 patients with surgical treatment of cerebral cavernous malformations: effect on epilepsy and patient disability

    NARCIS (Netherlands)

    Folkersma, H.; Mooij, J. J.

    2001-01-01

    We report a series of 13 patients with surgical treatment of cerebral cavernous malformation (CM). The aim of this study was to investigate postoperative patient disability and seizure control in patients with CM in order to clarify indications for neurosurgical removal. In our series we emphasize

  3. Follow-up of 13 patients with surgical treatment of cerebral cavernous malformations : effect on epilepsy and patient disability

    NARCIS (Netherlands)

    Folkersma, H; Mooij, JJA

    Objective: We report a series of 13 patients with surgical treatment of cerebral cavernous malformation (CM). The aim of this study was to investigate postoperative patient disability and seizure control in patients with CM in order to clarify indications for neurosurgical removal. In our series we

  4. Successful treatment of neuro-Behçet’s disease with infliximab: four years follow-up

    Directory of Open Access Journals (Sweden)

    Manjinder Kaur

    2015-10-01

    Full Text Available Neuro-Behçet’s disease (NBD is a rare but severe manifestation of Behçet’s disease. Patients with NBD tend to have high morbidity and mortality. Some patients do not respond adequately to conventional therapy (corticosteroids and immunosuppressants. This has led to treatment gaps in the therapy of NBD. There are reports in the literature of patients with Behçet’s disease responding to anti-TNF therapy. We present a case of a male patient with biopsy proven cerebral vasculitis presenting as NBD who has been in remission with near resolution of cerebral magnetic resonance imaging lesions for 4 years following treatment with infliximab and azathioprine.

  5. Naturalistic follow-up of subjects affected with anorexia nervosa 8 years after multimodal treatment: Personality and psychopathology changes and predictors of outcome.

    Science.gov (United States)

    Amianto, F; Spalatro, A; Ottone, L; Abbate Daga, G; Fassino, S

    2017-09-01

    Eating disorders (EDs) are serious mental illnesses of growing clinical and social impact. Despite their severity, there is still no satisfactory evidence-based treatment. Follow-up investigations are the most reliable studies to enlighten long-term outcome predictors and modifiers. In total, 59 subjects affected with anorexia nervosa were assessed 8 years after their admission into an outpatient multimodal treatment program for eating disorders. The follow-up changes in diagnostic criteria were compared with Chi-square test. Improved and not-improved subjects were compared. Clinical, personality and psychopathology features between T0 and T1 were compared with t-test for repeated measures. Correlation between T0 features and changes at T1 in personality and psychopathology features were assessed. The rate of complete remission was 42%, an overall rate of 67.8% improved, a rate of 18.6% worsened. Concerning personality, a significant decrease of harm avoidance and increase in self-directedness were evidenced. Interoceptive awareness, drive for thinness, bulimia were significantly reduced at follow-up. Many T0 personality facets were related to personality and psychopathology improvement at follow-up. Multimodal treatment encompassing psychiatric, nutritional and psychological approaches is at the moment the most reliable approach for the treatment of moderate to severe anorexia nervosa with a discrete rate of improvement. Some personality and psychopathology characteristics may represent specific factors which favor resistance and impair improvement. Future approaches should consider the personalization of therapeutic approach according to these features. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  6. Percutaneous radiofrequency ablation with transarterial embolization is useful for treatment of stage 1 renal cell carcinoma with surgical risk. Results at 2-year mean follow up

    International Nuclear Information System (INIS)

    Arima, Kiminobu; Yamakado, Kouichirou; Kinbara, Hiroyuki; Nakatsuka, Atsuhiro; Takeda, Kan; Sugimura, Yoshiki

    2007-01-01

    Despite laparoscopic partial nephrectomy and laparoscopic cryotherapy being performed lately, an even less invasive treatment would be desirable in high-risk patients. Under local anesthesia with intravenous (i.v.) sedation, we were able to perform percutaneous radiofrequency ablation (RFA) combined with renal arterial embolization for unresectable stage 1 (T1NoMo) renal cell carcinoma (RCC). We evaluated the feasibility, safety and therapeutic effects of this technique after a 2-year mean follow up. Thirty-one patients who were not candidates for surgery underwent RFA for 36 stage 1 RCC. Twenty-eight tumors were percutaneously ablated 6 days after the tumor vessels were embolized. Dynamic contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) were performed to evaluate treatment at completion. Tumor enhancement was eliminated after two RFA sessions in all tumors. Thirty tumors remained free of enhancement during a mean follow-up period of 24.3 months. There were no major complications related to the procedures though one instance of pyonephrosis, two of subcapsular hematomas, one of retroperitoneal hemorrhage and one of nausea were seen after RFA. Two patients died of other diseases (id est (i.e.) colon cancer and cerebral bleeding) 20 and 26 months after RFA treatment. One patient had a local recurrence of tumor and underwent re-RFA. The recurrence rate of RCC after successful RFA was 2.8%. There was no recurrence in patients who had tumors of less than 4 cm after RFA at a mean follow-up period of 24.3 months. Local control was achieved in 100% of T1NoMo tumors including the recurrence case that underwent re-RFA. The result of the present study at 2-year mean follow up showed percutaneous RFA was a feasible, safe and promising therapy for the treatment of unresectable stage 1 RCC, especially those smaller than 4 cm. (author)

  7. Sublingual Buprenorphine and Methadone Maintenance Treatment: A Three-Year Follow-Up of Quality of Life Assessment

    Directory of Open Access Journals (Sweden)

    Salvatore M. Giacomuzzi

    2005-01-01

    Full Text Available This study was conducted to compare long-term outcome effects on the quality of life (QOL of oral methadone with sublingual buprenorphine maintenance treatment. The QOL status of opioid-dependent patients was assessed using the German version (“Berlin Quality of Life Profile” of the Lancashire Quality of Life Profile. Physical symptoms were measured using the Opiate Withdrawal Scale (OWS. Urine tests were carried out randomly to detect additional consumption. In the first study period, 53 opioid-dependent subjects were enrolled and 25 could be reached after 3 years. The retention rate was 50% for methadone and 45% for buprenorphine (p = 0.786. Baseline values of the total sample (completers and noncompleters QOL and somatic complaints did not show significant differences between the two treatment groups. QOL characteristics at 6 months of treatment of the buprenorphine completer and noncompleter groups differed significantly regarding job (p = 0.013, family, and total score of physical symptoms (p = 0.002, in which the completer group showed the more favorable values. Concerning physical symptoms at 36 months, logistic regression revealed significantly less stomach cramps (p = 0.037 and fatigue and tiredness (p = 0.034 in buprenorphine compared to the methadone. Moreover, the buprenorphine-maintained group showed significantly less additional consumption of benzodiazepines (p = 0.015 compared with methadone participants. It is concluded that opioid addicts improved their QOL and health status when treated with methadone or buprenorphine. In summary, regarding QOL and health status, the present data indicate that buprenorphine is also a useful long-term alternative for maintenance treatment of opioid-dependent patients.

  8. Ultrasound guided percutaneous treatment and follow-up of Baker's cyst in knee osteoarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Koeroglu, Mert, E-mail: mertkoroglu@hotmail.com [Antalya Education and Research Hospital, Department of Radiology, Antalya (Turkey); Call Latin-Small-Letter-Dotless-I oglu, Mehmet, E-mail: mehmetcallioglu@hotmail.com [Sueleyman Demirel University, Faculty of Medicine, Department of Radiology, Isparta (Turkey); Eris, Hueseyin Naim, E-mail: drhneris@hotmail.com [Sueleyman Demirel University, Faculty of Medicine, Department of Radiology, Isparta (Turkey); Kayan, Mustafa, E-mail: drkayan32@hotmail.com [Sueleyman Demirel University, Faculty of Medicine, Department of Radiology, Isparta (Turkey); Cetin, Meltem, E-mail: meltemcetin2011@yahoo.com [Sueleyman Demirel University, Faculty of Medicine, Department of Radiology, Isparta (Turkey); Yener, Mahmut, E-mail: bahtiyaryener@yahoo.com [Sueleyman Demirel University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Isparta (Turkey); Guerses, Cemil, E-mail: cemilgurses@gmail.com [Antalya Education and Research Hospital, Department of Radiology, Antalya (Turkey); Erol, Bekir, E-mail: mertkoroglu@hotmail.com [Antalya Education and Research Hospital, Department of Radiology, Antalya (Turkey); Tuerkbey, Bar Latin-Small-Letter-Dotless-I s, E-mail: bturkbey@yahoo.com [Hacettepe University, Faculty of Medicine, Department of Radiology, Ankara (Turkey); Parlak, Ayse Eda, E-mail: drteda@yahoo.com [Antalya Education and Research Hospital, Department of Radiology, Antalya (Turkey); Akhan, Okan, E-mail: akhano@tr.net [Hacettepe University, Faculty of Medicine, Department of Radiology, Ankara (Turkey)

    2012-11-15

    Objective: Purpose of this study is to assess sonographic changes and clinical response in different subgroups of Baker's cyst patients with knee osteoarthritis after a single session of ultrasound-guided percutaneous aspiration and corticosteroid injection. Materials and methods: Thirty-two knee osteoarthritis patients (46-85 years, mean 58.97 {+-} 9.88) with symptomatic Baker's cyst diagnosed at ultrasonography were included in the study. To determine the grade of the symptoms, Visual Analogue Scale was applied. The patients were grouped in two, as simple (n = 24) and complex (n = 8) Baker's cyst. Thirty-two ultrasound-guided cyst aspirations concomitant 1 ml betamethasone injection (24 simple, 8 complex subgroups) were performed. Patients were followed clinically as well as via ultrasonography for 6 months after procedures. Results: A significant decrease in volume of the Baker's cysts after percutaneous treatment was accompanied by a significant clinical improvement. Moreover, the volume reduction of Baker's cyst after the treatment was significantly correlated with the clinical improvement (Pearson correlation coefficient = 0.542, p = 0.001). All 6 Baker's cysts relapsed at ultrasonography were complex type. Furthermore, a comparison of patients with simple Baker's cysts and those with complex Baker's cysts demonstrated no significant change in Visual Analogue Scale scores between two groups (p = 0.061, Mann-Whitney U). No complications (minor or major) occurred secondary to percutaneous treatment. Conclusion: Baker's cysts can be grouped as simple and complex groups via ultrasonography prior to the treatment. Cyst aspiration with ultrasound-guided corticosteroid injection yields clinical improvement and cyst volume reduction in all subgroups of patients with Baker's cyst secondary to knee osteoarthritis.

  9. Assess results of PET/CT in cancer diagnosis, follow up treatment and simulation for radiation therapy

    International Nuclear Information System (INIS)

    Mai Trong Khoa; Tran Dinh Ha; Tran Hai Binh

    2015-01-01

    PET/CT (Positron Emission Computed Tomography) has been studied and established as routine at the Nuclear Medicine and Oncology Center, Bach Mai hospital. From 8/2009 to 5/2015, 6223 patients have been undergone PET/CT scan. Among them, diagnostic and simulation PET/CT scan for cancer patients accounted to 5833 (93.8%). Researches about value of PET/CT for most common cancers have been done. Results: PET/CT can help the primary tumor diagnosis, metastases detection, staging, simulation for radiation therapy, response to treatment assessment, and relapses after treatment identification. Percentage accordance between PET / CT and histopathology was 96% (esophagus cancer), 94.7% (lung cancer). Average maxSUV value of primary tumor of the esophagus cancer, colorectal cancer, nasopharynx cancer, lung cancer, and NHL respectively 9.50, 9.78, 11.08, 9.17, 10.21. MaxSUV value increased with histological grade and tumor size. After undergone PET / CT, stage of disease changed in 28% esophagus cancer; 22.7% colorectal cancer; stage of disease increased in 23.5% of NHL, 32.0% of lung cancer, and 25.0% of nasopharynx cancer. PET / CT simulation for radiation therapy target volume reduced in 28% of nasopharynx cancer, which helped the radioactive dose concentrate exactly in the target lesions, minimize effect to healthy tissues, improved the effectiveness of treatment and reduced complications. (author)

  10. MINIMAL INVASIVE PLATE OSTEOSYNTHESIS- AN EFFECTIVE TREATMENT METHOD FOR DISTAL TIBIA INTRAARTICULAR (PILON FRACTURES- AN 18 MONTHS FOLLOW UP

    Directory of Open Access Journals (Sweden)

    Saket Jati

    2016-12-01

    Full Text Available BACKGROUND Tibial pilon fracture though requires operative treatment is difficult to manage. Conventional osteosynthesis is not suitable, because distal tibia is subcutaneous bone with poor vascularity. Closed reduction and Minimally Invasive Plate Osteosynthesis (MIPO for distal tibia has emerged as an alternative treatment option because it respects fracture biology and haematoma and also provides biomechanically stable construct. The aim of the study is to evaluate the results of minimally invasive plate osteosynthesis using locking plates in treating tibial pilon fractures in terms of fracture union, restoration of ankle function and complications. MATERIALS AND METHODS 30 patients with closed tibial pilon fractures (Ruedi and Allgower type I (14, type II (13, type III (3 treated with MIPO with Locking Compression Plates (LCP were prospectively followed for average duration of 18 months. RESULTS Average duration of injury-hospital and injury-surgery interval was as 12.05 hrs. and 3.50 days, respectively. All fractures got united with an average duration of 20.8 weeks (range 14-28 weeks. Olerud and Molander score was used for evaluation at 3 months, 6 months and 18 months. One patient had union with valgus angulation of 15 degrees, but no nonunion was found. CONCLUSION The present study shows that MIPO with LCP is an effective treatment method in terms of union time and complications rate for tibial pilon fracture promoting early union and early weight bearing.

  11. Caries risk assessment/treatment programs in U.S. dental schools: an eleven-year follow-up.

    Science.gov (United States)

    Yorty, Jack S; Walls, Allan Todd; Wearden, Stanley

    2011-01-01

    The purpose of this survey was to identify the number and characteristics of caries risk assessment/treatment (CRA/ Tx) programs in U.S. dental schools in 2009 and compare the results to those of the 1998 survey. A survey of U.S. dental schools was conducted in 2009 using the same eleven-question survey instrument as in 1998. Results were analyzed using stratified random sampling and chi-square tests for six of the questions. Additionally, data from the other questions were directly compared. Two questions showed a statistically significant difference: an increase in programs supervised by one school department and the number of schools using CRA as a graduation requirement. Positive changes are occurring in the development of CRA/Tx programs in U.S. dental schools. A wide variety of approaches to teaching this subject, including use of terminology and treatment philosophies, is evident. The evolution of this subject has been slow and varied over the past eleven years. Changing from a mainly surgical approach model to a medical model is occurring, but a more integrated method is needed to clarify terminology, diagnosis, treatment, and communications with researchers, clinicians, teachers, patients, and third-party payers.

  12. Comparative evaluation of long pulse Alexandrite laser and intense pulsed light systems for pseudofolliculitis barbae treatment with one year of follow up.

    Science.gov (United States)

    Leheta, Tahra M

    2009-01-01

    Existing remedies for controlling pseudofolliculitis barbae (PFB) are sometimes helpful; however the positive effects are often short lived. The only definitive cure for PFB is permanent removal of the hair follicle. Our aim was to compare the efficacy of the Alexandrite laser with the intense pulsed light system in the treatment of PFB and to follow up the recurrence. Twenty male patients seeking laser hair removal for the treatment of PFB were enrolled in this study. One half of the face was treated with the long-pulse Alexandrite laser and the other half was treated with the IPL system randomly. The treatment outcome and any complications were observed and followed up for one year. All patients exhibited a statistically significant decrease in the numbers of papules. Our results showed that the Alexandrite-treated side needed seven sessions to reach about 80% improvement, while the IPL-treated side needed 10-12 sessions to reach about 50% improvement. During the one year follow up period, the Alexandrite-treated side showed recurrence in very minimal areas, while the IPL-treated side showed recurrence in bigger areas. Our results showed that both systems might improve PFB but Alexandrite laser was more effective at reducing PFB than IPL.

  13. The Relevance of Osteoclastic and Osteoblastic Activity Markers Follow-Up in Patients on Antiresorptive Osteoporosis Treatment.

    Science.gov (United States)

    Smilic, Tanja N; Novakovic, Tatjana R; Markovic-Jovanovic, Snezana R; Smilic, Ljiljana L J; Mitic, Javorka S; Radunovic, Miodrag L

    2017-11-02

    In general, markers of bone formation and markers of bone resorption are changing synergistically, so the monitoring of any osteoclastic and any osteoblastic marker should reflect the rate of bone transformation. The aim of the study is to monitor the bone metabolism markers in postmenopausal women with osteoporosis and osteopenia along with the variations caused by the effects of bisphosphonate therapy. The study involved 55 women of average age of 57.95 years, with osteopenia or osteoporosis. The patients with osteoporosis were treated with bisphosphonates (75 mg once a week); the laboratory tests were performed before the treatment and 6 months later. Patients with osteopenia were evaluated at the first assessment and 6 months later. The tests included bone densitometry, dual-energy X-ray absorptiometry, osteocalcin, alkaline phosphatase, collagen 1 N-terminal pro-peptide (P1NP), and beta C telopeptide of type I collagen (CTX). The mean T-score was -2.80 ± 0.63 before therapy and -2.64 ± 0.45 6 months later (p < 0.001). Women with osteoporosis had elevated levels of osteocalcin and P1NP at the first assessment, whereas the alkaline phosphatase level did not change with the treatment. After the introduction of antiresorptive therapy, the levels of osteocalcin and P1NP significantly decreased (p < 0.001). In the group with osteopenia, the biochemical markers activity were increased in both assessments. In patients with osteoporosis, Beta-CTX was increased in the first evaluation, and decreased after treatment (p = 0.001). The results indicate that the assessment of biochemical markers of bone metabolism show excellent results in the assessment of prognosis, monitoring the course and the response to various treatment regimens of osteoporosis and evince strong correlation with standard densitometry and dual-energy X-ray absorptiometry procedures. P1NP and CTX show better diagnostic applicability compared with osteocalcin and alkaline phosphatase

  14. [Six-month follow-up study of drug treatment for cannabis addiction: comparison study of four drugs].

    Science.gov (United States)

    Shoenfeld, Netta; Bodnik, Dana; Rosenberg, Oded; Kotler, Moshe; Dannon, Pinhas

    2011-12-01

    Marijuana addiction is one of the most common forms of addiction worldwide. A variety of reasons for use exist, however, there are only a few tested treatments with frequent relapses. In this study, we examined the efficacy of four pharmacotherapy agents for the treatment of marijuana addiction: naltrexone, bupropion, escitalopram and bromazepam. A total of 59 patients were randomly assigned into four groups. Each group received one of the pharmacological agents for 120 days. Four types of questionnaires were employed: The Hamilton Rating Scale for Depression--21 items, the Hamilton Rating Scale for Anxiety, the Global Assessment of Functioning and a Visual Analogue Scale for perceived need of the drug. In addition, random urine tests were performed to detect tetrahydrocannabinol [THC). Naltrexone proved to be the most efficacious of the four agents, with only four dropouts. Other agents proved less efficacious with six, seven and eights dropouts for bupropion, bromazepam and escitalopram, respectively. In addition, naltrexone was most efficacious in reducing anxiety and depression rates, and increasing functioning and perceived need for drug use. Out of four pharmacological agents, naltrexone proved to be most efficacious in treating marijuana addiction and related disorders. Further studies are needed to confirm our results.

  15. Post-treatment CIN

    DEFF Research Database (Denmark)

    Bais, Aagje G; Eijkemans, Marinus J C; Rebolj, Mateja

    2009-01-01

    We investigated in a randomised clinical trial whether addition of hrHPV testing (high-risk human papillomavirus) to cytological follow-up after treatment for high-grade CIN (cervical intraepithelial neoplasia 2/3) can lead to a better selection of women at risk for residual/recurrent CIN. We...

  16. A case of parafalx subdural abscess with conservative treatment and follow-up by cranial CT scanning

    International Nuclear Information System (INIS)

    Watanabe, Saburo; Iwata, Kinjiro; Kato, Kyoji.

    1983-01-01

    A parafalx subdural abscess, which was not accompanied by abscess formation in other place, was diagnosed by carotid angiography and computerized tomography in a 20-year-old female. She presented with left hemiparesis and intracranial hypertension. Examination of the eyegrounds showed bilateral choked discs. Right carotid angiography revealed the callosomarginal artry was displaced from the midline parallel to the distal pericallosal artery and a small avascular area of 8 mm width between the callosomarginal and pericallosal arteries. Comuterized tomography demonstrated a narrow area of low density alongside the falx posteriorly on 2nd day, and this altered into a large lucent parafalx mass with enhanced margins on 21th day. Antibiotic treatment and hyperosmotic agent without surgery brought complete clinical and radiological cure. The usefulness of the compurterized tomography for earlier and more precise initial diagnosis and management of intracranial abscess is stressed and now a nonsurgical approach can be considered in certain cases of intracranial abscess. (author)

  17. Rigiflex Balloon dilation without fluoroscopy for treatment of Achalasia: A long-term follow-up of 99 patients

    Directory of Open Access Journals (Sweden)

    "Mikaeli J

    2002-06-01

    Full Text Available Achalasia is a well- defined esophageal motor disorder. Graded pneumatic dilation using Rigiflex ballon is one of the therapeutic modalities that had not been evaluated in a large long-term study. We aimed at evaluating long-term efficacy of graded Rigiflex pneumatic dilation in the treatment of achalasia. Symptomatic patients with achalasia who had been referred to our center were consecutively enrolled. The diagnosis was established by clinical, radiographic and endoscopic criteria. Exclusion criteria included pregnancy, coagulopathy, serious medical illness or malignancy. Initially all patients were clinically scored based on the severity of five main symptoms and then underwent pneumatic dilation wit at 3 cm ballon. Symptom scores were evaluated at 1, 6, 12 .. months. Clinical recurrence was defined as an increase of symptom with 3.5 cm balloon dilation. If recurrence occurred again, third dilation was done with a 4 cm ballon. Over a five-year period, 99 patients [mean age: 35.6 (3.0-72 years.] were followed to an average length of 47.4 (18-20 months. 35 patients needed- retreatment, only 6 of them required third dilation. After third dilation two patients did not reveal improvement and underwent cardiomyotomy. Over this time period, cumulative remission rate was 65% without redilation and 94% with redilation. The mean remission period was 44.7 months (95% CI, 43.52-51.27 for single pneumatic dilation by use of Kaplan- Meier survival analysis. There was no significant predictive value for age, gender, previous treatment and severity of initial score to outcome (P>0.4 by use of Cox regression analysis. Pneumatic dilation by a Rigiflex balloon using a graded approach is effective long-term therapy for achalasia in majority of patients.

  18. A retrospective analysis of the characteristics, treatment and follow-up of 26 odontomas in Greek children

    International Nuclear Information System (INIS)

    Iatrou, I.; Vardas, E.; Theologie-Lygidakis, N.; Leventis, M.

    2010-01-01

    Odontomas represent the most common type of odontogenic jaw tumors among patients younger than 20 years of age. Clinically, they are often associated with eruption failure of adjacent permanent teeth, and are classified as compound and complex. The aim of the present retrospective study was to present the characteristics, treatment approach and outcome of odontomas in Greek children, over a ten-year period. Twenty six patients, 2 to 14 years of age (mean 9.3 years), with odontomas treated during the years 1999-2008 at the Department of Oral and Maxillofacial Surgery of a Children's Hospital, were included in the study. Data from patients' files were retrieved and they were recalled for review. Odontomas were equally distributed in the maxilla and mandible and 42.3% of them were located in the anterior maxilla. Of the odontomas, 80.7% were related to disturbances in tooth eruption. Bone expansion was observed in 65.3% of the cases. All odontomas were surgically removed, and related impacted permanent teeth were either left to erupt spontaneously, orthodontically guided into occlusion or were removed. Orthodontic intervention appeared to be necessary in older children, while in younger children spontaneous eruption was frequent. In the present study, odontomas were associated with unerupted or impacted teeth. Radiographic examination was essential to verify the presence of the tumor and early removal prevented tooth eruption failure and disturbances in a majority of the cases. (author)

  19. Effect of yoga in the treatment of eating disorders: A single-blinded randomized controlled trial with 6-months follow-up

    Directory of Open Access Journals (Sweden)

    Kari Ebbesen Karlsen

    2018-01-01

    Full Text Available Aim of the Study: The aim of this study is to examine the effect of yoga treatment of eating disorders (EDs. Methods: Adult females meeting the Diagnostic and Statistical Manual-IV criteria for bulimia nervosa or ED not otherwise specified (n = 30 were randomized to 11-week yoga intervention group (2 × 90 min/week or a control group. Outcome measures, the Eating Disorder Examination (EDE-Interview and Eating Disorders Inventory-2 (EDI-2 scores, were administered at baseline, posttest, and at 6-month follow-up. There was a dropout rate of 30% (posttest and 37% (6-month follow-up. Results: The intervention group showed reductions in EDE global score (P < 0.01, the EDE subscale restraint (P < 0.05, and eating concern (P < 0.01 compared to the control group. The differences between the groups increased at 6-month follow-up. There were no differences between the groups in the EDI-2 score. Conclusion: The results indicate that yoga could be effective in the treatment of ED.

  20. Open versus arthroscopic approach in the treatment of femoroacetabular impingement: a case–control study with two-years follow up

    Directory of Open Access Journals (Sweden)

    Bruno Dutra Roos

    Full Text Available Abstract Objective To compare clinical and imaging results and complications between patients treated for femoroacetabular impingement (FAI who underwent either anterior open surgery or an arthroscopic approach, with a minimum follow-up of two years. Methods This retrospective case–control study included patients submitted to FAI surgical treatment between November 2007 and March 2012. Patients treated with open surgery were compared with those treated with arthroscopy. Patients were clinically assessed by the modified Harris Hip Score, Non-Arthritic Hip Score, and internal hip rotation. Patients were radiographically assessed by the center-edge angle, joint space width, alpha angle, neck-head index, degree of arthrosis, and presence of heterotopic ossification of the hip. Results In the study period, 56 patients (58 hips with FAI were included; 16 underwent open surgery and 40 underwent arthroscopy. The 40 patients treated by the arthroscopic route had a mean follow-up of 29.1 months, and 75.6% presented good or excellent clinical results. The radiographic evaluation parameters progressed to normal levels. The 16 patients who underwent open surgery had a mean follow-up of 52 months, and 70.58% presented good or excellent clinical results. The radiographic evaluation parameters progressed to normal levels. Postoperative clinical and radiographic results were considered similar in both groups. Conclusions Arthroscopy and open surgery treatments for FAI provided comparable clinical and radiographic results. However, a higher rate of complications was observed in the open surgery group.

  1. Antiretroviral treatment interruption and loss to follow-up in two HIV cohorts in Australia and Asia: implications for 'test and treat' prevention strategy.

    Science.gov (United States)

    Guy, Rebecca; Wand, Handan; McManus, Hamish; Vonthanak, Saphonn; Woolley, Ian; Honda, Miwako; Read, Tim; Sirisanthana, Thira; Zhou, Julian; Carr, Andrew

    2013-12-01

    Both antiretroviral treatment interruption (TI) and cessation have been strongly discouraged since 2006. We describe the incidence, duration, and risk factors for TI and loss-to-follow-up (LTFU) rates across 13 countries. All 4689 adults (76% men) in two large HIV cohorts in Australia and Asia commencing combination antiretroviral therapy (ART) to March 2010 were included. TI was defined by ART cessation >30 days, then recommencement, and loss to follow-up (LTFU) by no visit since 31 March 2009 and no record of death. Survival analysis and Poisson regression methods were used. With median follow-up of 4.4 years [interquartile range (IQR):2.1-6.5], TI incidence was 6.7 per 100 person years (PY) (95% CI:6.1-7.3) pre-2006, falling to 2.0 (95% CI:1.7-2.2) from 2006 (pfood restrictions (fasting or with food). In conclusion, since 2006, 7.8% of patients had significant time off treatment, which has the potential to compromise any 'test and treat' policy as during the interruption viral load will rebound and increase the risk of transmission.

  2. Prevalence and correlates of serostatus disclosure in HIV-infected adults attending the follow up and treatment clinic in Barbados.

    Directory of Open Access Journals (Sweden)

    Sheila Forde

    2007-04-01

    Full Text Available Objective: To determine the extent of disclosure and factors associated with disclosure of HIV status to sexual partners, we interviewed HIV infected adults attending the centralized HIV clinics seeking medical care for HIV. Methods: The subjects were patients who attended the LRU for primary care and treatment of their HIV infection during the three months period of this study enrolment. Patients were asked to participate in this study after initial clinical care was performed, in a 30-minute standardized interview concerning behavioral, medical, and social history. Results: The study patients had the following characteristics: female, 42.7%; male, 57.3%; singles, 84.5%; married, 11.8%. The median age of respondents was 35 years, and 66.4% were employed. Seventy nine percent were sexually active, and of these 72% had a steady sex partner and 61% had one or more casual partners. Over all 64 (58.2% of those interviewed, had disclosed their HIV status to significant others. Of the sixty three persons who had a steady partner 71.4% had self disclosed their HIV status to one or more steady partners. Of the fifty three persons who had one or more casual partners, 26.4% had self-disclosed their status to one or more casual partners. The most common reasons listed for nondisclosure to spouse or significant other were stigma/discrimination, fear of spread of information, rejection. Conclusion: Our findings suggest that both the knowing and unknowing sexual partners of HIV-infected persons continue to be at risk for HIV transmission.

  3. TVT-O for the treatment of pure urodynamic stress incontinence: efficacy, adverse effects, and prognostic factors at 5-year follow-up.

    Science.gov (United States)

    Serati, Maurizio; Bauer, Ricarda; Cornu, Jean Nicolas; Cattoni, Elena; Braga, Andrea; Siesto, Gabriele; Lizée, Daphné; Haab, François; Torella, Marco; Salvatore, Stefano

    2013-05-01

    Inside-out tension-free vaginal transobturator tape (TVT-O) is currently one of the most effective and popular procedures for the surgical treatment of female stress urinary incontinence (SUI), but data reporting long-term outcomes are scarce. To evaluate the efficacy and safety of TVT-O 5-yr implantation for management of pure SUI in women. A prospective observational study was conducted in four tertiary reference centers. Consecutive women presenting with urodynamically proven, pure SUI treated by TVT-O were included. Patients with mixed incontinence and/or anatomic evidence of pelvic organ prolapse were excluded. TVT-O implantation without any associated procedure. Data regarding subjective outcomes (International Consultation on Incontinence-Short Form [ICIQ-SF], Patient Global Impression of Improvement, patient satisfaction scores), objective cure (stress test) rates, and adverse events were collected during follow-up. Multivariable analyses were performed to investigate outcomes. Of the 191 women included, 21 (11.0%) had previously undergone a failed anti-incontinence surgical procedure. Six (3.1%) patients were lost to follow-up. The 5-yr subjective and objective cure rates were 90.3% and 90.8%, respectively. De novo overactive bladder (OAB) was reported by 24.3% of patients at 5-yr follow-up. Median ICIQ-SF score significantly improved from 17 (interquartile range [IQR]:16-17) preoperatively to 0 (IQR: 0-2) (pTVT-O implantation is a highly effective option for the treatment of women with pure SUI, showing a very high cure rate and a low incidence of complications after 5-yr follow-up. Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  4. Not all are lost: interrupted laboratory monitoring, early death, and loss to follow-up (LTFU in a large South African treatment program.

    Directory of Open Access Journals (Sweden)

    Aima A Ahonkhai

    Full Text Available Many HIV treatment programs in resource-limited settings are plagued by high rates of loss to follow-up (LTFU. Most studies have not distinguished between those who briefly interrupt, but return to care, and those more chronically lost to follow-up.We conducted a retrospective cohort study of 11,397 adults initiating antiretroviral therapy (ART in 71 Southern African Catholic Bishops Conference/Catholic Relief Services HIV treatment clinics between January 2004 and December 2008. We distinguished among patients with early death, within the first 7 months on ART; patients with interruptions in laboratory monitoring (ILM, defined as missing visits in the first 7 months on ART, but returning to care by 12 months; and those LTFU, defined as missing all follow-up visits in the first 12 months on ART. We used multilevel logistic regression models to determine patient and clinic-level characteristics associated with these outcomes.In the first year on ART, 60% of patients remained in care, 30% missed laboratory visits, and 10% suffered early death. Of the 3,194 patients who missed laboratory visits, 40% had ILM, resuming care by 12 months. After 12 months on ART, patients with ILM had a 30% increase in detectable viremia compared to those who remained in care. Risk of LTFU decreased with increasing enrollment year, and was lowest for patients who enrolled in 2008 compared to 2004 [OR 0.49, 95%CI 0.39-0.62].In a large community-based cohort in South Africa, nearly 30% of patients miss follow-up visits for CD4 monitoring in the first year after starting ART. Of those, 40% have ILM but return to clinic with worse virologic outcomes than those who remain in care. The risk of chronic LTFU decreased with enrollment year. As ART availability increases, interruptions in care may become more common, and should be accounted for in addressing program LTFU.

  5. Why do Patients undergoing Chronic Obstructive Pulmonary Disease Treatment Turn Defaulters? A Follow up Study in a Tertiary Care Hospital in Jamnagar, India.

    Science.gov (United States)

    Sarkar, Amrita; Javia, Abhay; Pithadia, Pradeep; Parmar, Dipesh

    2017-07-01

    Chronic Obstructive Pulmonary Disease (COPD), a progressive respiratory illness requiring long-term treatment, is a significant cause of morbidity, mortality and economic burden on the family as well as the country. In the tertiary health care facility where the study was carried out, it was observed that many COPD patients did not come for regular follow up. In these patients, treatment interruption may lead to increased morbidity and mortality. This study aimed to find out the reasons for defaulting follow up and treatment in COPD patients. All patients of COPD, attending TB Chest outpatient department during the study period (September 2012 to February 2013), were classified into Group A, B, C, and D according to latest Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Data was collected on patient's sociodemographic profile, severity of disease and reasons for defaulting follow up and treatment using pre-tested semi-structured questionnaires, patient history and clinical examination. Data obtained were entered in Microsoft Office Excel 2007 and analysed using Chi-square test. The mean age of the 200 patients recruited was 59.3 years. A total of 87% patients were male. Patients belonging to Group A, B, C and D were 11%, 25.5%, 41.5% and 22% respectively. Overall, 32% patients were defaulters. Three main reasons for default were non-affordability for treatment expenses (39.07%), resolution of symptoms (26.56%), and too ill to come (18.75%). The associations between default rate and demographic variables like age and gender were found statistically significant. Default rate among COPD patients is significantly associated with GOLD Group A and D, patient's income and patient literacy level. Main reasons for default were non-affordability of treatment expenses, too ill to come and resolution of symptoms.

  6. Treatment of fibromyalgia at the Maharishi Ayurveda Health Centre in Norway II--a 24-month follow-up pilot study.

    Science.gov (United States)

    Rasmussen, Lars Bjørn; Mikkelsen, Knut; Haugen, Margaretha; Pripp, Are H; Fields, Jeremy Z; Førre, Øystein T

    2012-05-01

    Treatments offered at the Maharishi Ayurveda Health Centre in Norway are based on Maharishi Vedic Medicine (MVM). MVM is a consciousness-based revival by Maharishi Mahesh Yogi, the founder of the Transcendental Meditation (TM) program of the ancient Ayurvedic medicine tradition in India. To extend from 6 to 24 months, a pilot study of the effects of the treatment program at the Health Centre on fibromyalgia. Retesting 2 years after a clinical trial. In this intention to treat study, 31 women with a diagnosis of fibromyalgia received an individually tailored program of (1) physiological purification therapy (Maharishi Panchakarma) and (2) Ayurvedic recommendations regarding daily routine and diet including a novel approach to food intolerance. Five subjects chose to learn TM for stress reduction, pain management and personal development. All were recommended Ayurvedic herbal products for follow-up treatment. A modified Fibromyalgia Impact Questionnaire (FIQ) that included seven dimensions. Scores at 24 months follow-up were compared with pre-treatment scores. At 24-months follow-up, there were significant reductions (26% to 44%) in six of the seven fibromyalgia dimensions: impairment of working ability, pain, tiredness, morning tiredness, stiffness and anxiety. The 7th, depression, decreased 32% (borderline significant). At 24 months, the four subjects who continued practising TM, had almost no symptoms and significantly lower FIQ change scores (-92% to 97%) than the non-meditators on all outcomes. This pilot study suggests that the treatments and health promotion programs offered at the Maharishi Ayurveda Health Centre in Norway lead to long-term reductions in symptoms of fibromyalgia, which is considered a treatment-resistant condition, and further studies are warranted.

  7. Stability of interceptive/corrective orthodontic treatment for tooth ankylosis and Class II mandibular deficiency: A case report with 10 years follow-up

    OpenAIRE

    Carlos Henrique Guimarães; José Fernando Castanha Henriques; Guilherme Janson; Wilana S Moura

    2015-01-01

    The purpose of this article is to present the treatment of a 8-year-old boy with tooth ankylosis in teeth 85 and Class II division 1 malocclusion and to report a 10-year follow-up result. The patient was initially treated with a sagittal removable appliance, followed by an eruption guidance appliance and braces. The interceptive orthodontic treatment performed to recover the space lost by ankylosis of a deciduous tooth allowed a spontaneous eruption and prevented progression of the problem. T...

  8. Development and validation of the Gambling Follow-up Scale, Self-Report version: an outcome measure in the treatment of pathological gambling

    Directory of Open Access Journals (Sweden)

    Ana M. Galetti

    Full Text Available Objective: To validate the Gambling Follow-up Scale, Self-Report version (GFS-SR, a 10-item scale designed to assess gambling frequency, time and money spent on gambling, gambling craving, debts, emotional distress, family relationships, autonomy, and frequency of and satisfaction with leisure activities in individuals diagnosed with gambling disorder according to the DSM-5 criteria. Methods: One hundred and twenty treatment-seeking gamblers were evaluated, 84 of whom proceeded to treatment. Fifty-two relatives provided collateral informant reports at baseline. Six months later, the 50 patients who completed the program were reassessed. Results: The GFS-SR showed good inter-rater agreement and internal consistency. Factor analysis presented a three-factor solution: gambling behavior (factor 1; social life (factor 2; and personal hardship (factor 3. There was a high degree of convergence between GFS-SR scores and those of reference scales. The GFS-SR scores showed excellent sensitivity to change (factor 1, predictive validity for treatment response (factor 2, and ability to distinguish recovered from unrecovered patients after treatment (factor 3. A cutoff score of 33 was found to have 87% sensitivity and 80% specificity for gambling recovery. Conclusion: The GFS-SR is well suited to providing reliable follow-up of gamblers under treatment and assessing the efficacy of their treatment.

  9. Sick leave and disability pension in Hodgkin lymphoma survivors by stage, treatment, and follow-up time--a population-based comparative study.

    Science.gov (United States)

    Glimelius, I; Ekberg, S; Linderoth, J; Jerkeman, M; Chang, E T; Neovius, M; Smedby, K E

    2015-12-01

    This study seeks to investigate the long-term public health burden of Hodgkin lymphoma (HL) in terms of work loss following contemporary treatment protocols and associations with established treatment complications and lymphoma relapse. We identified 1,989 Swedish HL patients (1,082 with clinical information) aged 18-60 (median 33) years at diagnosis 1992-2009, and matched 1:4 to population comparators. Sick leave, disability pension (work loss), and comorbidity were retrieved through September 2013. Relative risks (RR) with 95% confidence intervals (CI) were calculated using Poisson regression, and mean lost work days were estimated yearly during follow-up. The risk of annual work loss was elevated in HL survivors versus comparators up to the 15th year post-diagnosis (RR(5th year) 1.64, 95% CI 1.46-1.84; RR(10th year) 1.33, 95% CI 1.15-1.34; and RR(15th year) 1.30, 95% CI 1.04-1.62). The risk remained elevated up to the 10th year after adjustment for secondary malignancies and cardiovascular disease (RR(10th year) 1.31, 95% CI 1.13-1.52). Advanced-stage patients had more lost days than comparators (mean number(5th year) 66 versus 33, mean difference 34, 95% CI 20-48) as did patients receiving 6-8 chemotherapy courses (62 versus 33, mean difference(5th year) 30, 95 % CI 17-43). Among patients in the first complete remission, a difference was still observed for advanced-stage (51 versus 33, mean difference(5th year) 19, 95% CI 5-34) but not early-stage disease. Advanced-stage HL survivors treated with full-dose chemotherapy were at increased risk of work loss, not only explained by relapse, secondary malignancies, or cardiovascular disease. The results call for increased awareness and evaluation of reasons for long-term work disability following intensive chemotherapy among young HL survivors.

  10. Quality of life changes following inpatient and outpatient treatment in obsessive-compulsive disorder: a study with 12 months follow-up

    Directory of Open Access Journals (Sweden)

    Hertenstein Elisabeth

    2013-02-01

    Full Text Available Abstract Background Quality of life (QoL is increasingly recognized as a critical outcome parameter in mental health studies. The aim of this study was to investigate different domains of the QoL in persons with obsessive-compulsive disorder (OCD before and after a multimodal, disorder-specific in- and outpatient treatment. Methods Data of 73 persons with OCD treated in an inpatient setting followed by outpatient treatment were analyzed. The World Health Organization Quality of Life abbreviated (a multidimensional measure of the QoL and the Beck Depression Inventory were administered prior to (baseline and 12 months after the inpatient treatment (follow-up. Results At baseline, participants reported a significantly diminished psychological, social, physical, and global QoL compared to the German general population. Environmental QoL was not impaired in the present sample. The QoL was significantly improved at follow-up, except for social QoL, but remained below norm values. The QoL improvement was predicted by improvements of depressive symptoms. Conclusions The results indicate that persons with OCD suffer from a very low QoL. The QoL was significantly improved after 12 months of intensive state-of-the-art treatment. However, the QoL indices remained considerably lower than population norm values, indicating the need for additional research into novel treatment options for persons with OCD.

  11. Three-year follow-up of treatment-naïve and previously treated patients with CLL and SLL receiving single-agent ibrutinib.

    Science.gov (United States)

    Byrd, John C; Furman, Richard R; Coutre, Steven E; Burger, Jan A; Blum, Kristie A; Coleman, Morton; Wierda, William G; Jones, Jeffrey A; Zhao, Weiqiang; Heerema, Nyla A; Johnson, Amy J; Shaw, Yun; Bilotti, Elizabeth; Zhou, Cathy; James, Danelle F; O'Brien, Susan

    2015-04-16

    Ibrutinib is an orally administered inhibitor of Bruton tyrosine kinase that antagonizes B-cell receptor, chemokine, and integrin-mediated signaling. In early-phase studies, ibrutinib demonstrated high response rates and prolonged progression-free survival (PFS) in chronic lymphocytic leukemia (CLL). The durable responses observed with ibrutinib relate in part to a modest toxicity profile that allows the majority of patients to receive continuous therapy for an extended period. We report on median 3-year follow-up of 132 patients with symptomatic treatment-naïve and relapsed/refractory CLL or small lymphocytic lymphoma. Longer treatment with ibrutinib was associated with improvement in response quality over time and durable remissions. Toxicity with longer follow-up diminished with respect to occurrence of grade 3 or greater cytopenias, fatigue, and infections. Progression remains uncommon, occurring primarily in some patients with relapsed del(17)(p13.1) and/or del(11)(q22.3) disease. Treatment-related lymphocytosis remains largely asymptomatic even when persisting >1 year and does not appear to alter longer-term PFS and overall survival compared with patients with partial response or better. Collectively, these data provide evidence that ibrutinib controls CLL disease manifestations and is well tolerated for an extended period; this information can help direct potential treatment options for different subgroups to diminish the long-term risk of relapse. © 2015 by The American Society of Hematology.

  12. A five-year follow-up of two different 131I treatment methods for Graves' disease and the factors affecting the outcome

    International Nuclear Information System (INIS)

    Yoshimoto, Midori; Iino, Shiro; Yoshimura, Hiroshi; Ishikawa, Naofumi; Momotani, Naoko; Hamada, Noboru; Ito, Kunihiko.

    1994-01-01

    We employed two different methods of 131 I treatment for Graves' disease in 285 patients and compared the results between the two. (We also analyzed the factors affecting the treatment outcome.) A single dose of 131 I adjusted to the patients' thyroid weight was administered to 180 patients in group 1, while a relatively lower dose of 131 I (approximately 30 Gy) was given repeatedly to 105 patients in group 2. A 5-year follow-up showed that in group 1, 34% of the patients were euthyroid, 11% hypothyroid, 11% subclinical hypothyroid and 44% still remained hyperthyroid. In group 2, 43% of the patients were euthyroid, 5% hypothyroid, 35% subclinical hypothyroid and 17% hyperthyroid. The factors affecting the outcome of the treatment in group 1 patients were their thyroid weight, the duration of the disease and TRAb levels. No significant correlation was observed between the efficacy of 131 I treatment and the patients' sex, age, 24 hr 131 I-uptake, effective half life of administered 131 I or titers of antithyorid antibodies. We conclude that the repeated low dose administration of 131 I provides the best outcome in a 5-year follow-up. However, we suggest that an adjusted dose of 131 I in relation to the patients' thyroid weight should be employed to obtain a faster therapeutic response. (author)

  13. Effective Treatment of Manganese-Induced Occupational Parkinsonism With p-Aminosalicylic Acid: A Case of 17-Year Follow-Up Study

    Science.gov (United States)

    Jiang, Yue-Ming; Mo, Xue-An; Du, Feng-Qi; Fu, Xue; Zhu, Xia-Yan; Gao, Hong-Yu; Xie, Jin-Lan; Liao, Feng-Ling; Pira, Enrico; Zheng, Wei

    2014-01-01

    Objective Chronic manganese (Mn) intoxication induces syndromes resembling Parkinson disease. The clinical intervention has largely been unsuccessful. We report a 17-year follow-up study of effective treatment of occupational Mn parkinsonism with sodium para-aminosalicylic acid (PAS). Methods The patient, female and aged 50 at the time of treatment, was exposed to airborne Mn for 21 years (1963–1984). The patient had palpitations, hand tremor, lower limb myalgia, hypermyotonia, and a distinct festinating gait. She received 6 g PAS per day through an intravenous drip infusion for 4 days and rested for 3 days as one therapeutic course. Fifteen such courses were carried out between March and June 1987. Results At the end of PAS treatment, her symptoms were significantly alleviated, and handwriting recovered to normal. Recent follow-up examination at age 67 years (in 2004) showed a general normal presentation in clinical, neurologic, brain magnetic resonance imaging, and handwriting examinations with a minor yet passable gait. Conclusions This case study suggests that PAS appears to be an effective drug for treatment of severe chronic Mn poisoning with a promising prognosis. PMID:16766929

  14. Two-year follow-up of the MOSAIC trial: A multicenter randomized controlled trial comparing two psychological treatments in adult outpatients with broadly defined anorexia nervosa.

    Science.gov (United States)

    Schmidt, Ulrike; Ryan, Elizabeth G; Bartholdy, Savani; Renwick, Bethany; Keyes, Alexandra; O'Hara, Caitlin; McClelland, Jessica; Lose, Anna; Kenyon, Martha; Dejong, Hannah; Broadbent, Hannah; Loomes, Rachel; Serpell, Lucy; Richards, Lorna; Johnson-Sabine, Eric; Boughton, Nicky; Whitehead, Linette; Bonin, Eva; Beecham, Jennifer; Landau, Sabine; Treasure, Janet

    2016-08-01

    This study reports follow-up data from a multicenter randomized controlled trial (n = 142) comparing the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) with Specialist Supportive Clinical Management (SSCM) in outpatients with broadly defined anorexia nervosa (AN). At 12 months postrandomization, all patients had statistically significant improvements in body mass index (BMI), eating disorder (ED) symptomatology and other outcomes with no differences between groups. MANTRA was more acceptable to patients. The present study assessed whether gains were maintained at 24 months postrandomization. Follow-up data at 24 months were obtained from 73.2% of participants. Outcome measures included BMI, ED symptomatology, distress, impairment, and additional service utilization during the study period. Outcomes were analyzed using linear mixed models. There were few differences between groups. In both treatment groups, improvements in BMI, ED symptomatology, distress levels, and clinical impairment were maintained or increased further. Estimated mean BMI change from baseline to 24 months was 2.16 kg/m(2) for SSCM and 2.25 kg/m(2) for MANTRA (effect sizes of 1.75 and 1.83, respectively). Most participants (83%) did not require any additional intensive treatments (e.g., hospitalization). Two SSCM patients became overweight through binge-eating. Both treatments have value as outpatient interventions for patients with AN. © 2016 Crown copyright. International Journal of Eating Disorders. (Int J Eat Disord 2016; 49:793-800). © 2016 Crown copyright. International Journal of Eating Disorders.

  15. Efficacy of integrated school based de-worming and prompt malaria treatment on helminths -Plasmodium falciparum co-infections: A 33 months follow up study

    Directory of Open Access Journals (Sweden)

    Chadukura Vivian

    2011-06-01

    Full Text Available Abstract Background The geographical congruency in distribution of helminths and Plasmodium falciparum makes polyparasitism a common phenomenon in Sub Saharan Africa. The devastating effects of helminths-Plasmodium co-infections on primary school health have raised global interest for integrated control. However little is known on the feasibility, timing and efficacy of integrated helminths-Plasmodium control strategies. A study was conducted in Zimbabwe to evaluate the efficacy of repeated combined school based antihelminthic and prompt malaria treatment. Methods A cohort of primary schoolchildren (5-17 years received combined Praziquantel, albendazole treatment at baseline, and again during 6, 12 and 33 months follow up surveys and sustained prompt malaria treatment. Sustained prompt malaria treatment was carried out throughout the study period. Children's infection status with helminths, Plasmodium and helminths-Plasmodium co-infections was determined by parasitological examinations at baseline and at each treatment point. The prevalence of S. haematobium, S. mansoni, STH, malaria, helminths-Plasmodium co-infections and helminths infection intensities before and after treatment were analysed. Results Longitudinal data showed that two rounds of combined Praziquantel and albendazole treatment for schistosomiasis and STHs at 6 monthly intervals and sustained prompt malaria treatment significantly reduced the overall prevalence of S. haematobium, S. mansoni, hookworms and P. falciparum infection in primary schoolchildren by 73.5%, 70.8%, 67.3% and 58.8% respectively (p P. f + schistosomes, and P. f + STHs + schistosomes co-infections were reduced by 68.0%, 84.2%, and 90.7%, respectively. The absence of anti-helminthic treatment between the 12 mth and 33 mth follow-up surveys resulted in the sharp increase in STHs + schistosomes co-infection from 3.3% at 12 months follow up survey to 10.7%, slightly more than the baseline level (10.3% while other

  16. How home HIV testing and counselling with follow-up support achieves high testing coverage and linkage to treatment and prevention: a qualitative analysis from Uganda.

    Science.gov (United States)

    Ware, Norma C; Wyatt, Monique A; Asiimwe, Stephen; Turyamureeba, Bosco; Tumwesigye, Elioda; van Rooyen, Heidi; Barnabas, Ruanne V; Celum, Connie L

    2016-01-01

    The successes of HIV treatment scale-up and the availability of new prevention tools have raised hopes that the epidemic can finally be controlled and ended. Reduction in HIV incidence and control of the epidemic requires high testing rates at population levels, followed by linkage to treatment or prevention. As effective linkage strategies are identified, it becomes important to understand how these strategies work. We use qualitative data from The Linkages Study, a recent community intervention trial of community-based testing with linkage interventions in sub-Saharan Africa, to show how lay counsellor home HIV testing and counselling (home HTC) with follow-up support leads to linkage to clinic-based HIV treatment and medical male circumcision services. We conducted 99 semi-structured individual interviews with study participants and three focus groups with 16 lay counsellors in Kabwohe, Sheema District, Uganda. The participant sample included both HIV+ men and women (N=47) and HIV-uncircumcised men (N=52). Interview and focus group audio-recordings were translated and transcribed. Each transcript was summarized. The summaries were analyzed inductively to identify emergent themes. Thematic concepts were grouped to develop general constructs and framing propositional statements. Trial participants expressed interest in linking to clinic-based services at testing, but faced obstacles that eroded their initial enthusiasm. Follow-up support by lay counsellors intervened to restore interest and inspire action. Together, home HTC and follow-up support improved morale, created a desire to reciprocate, and provided reassurance that services were trustworthy. In different ways, these functions built links to the health service system. They worked to strengthen individuals' general sense of capability, while making the idea of accessing services more manageable and familiar, thus reducing linkage barriers. Home HTC with follow-up support leads to linkage by building

  17. Multidisciplinary therapy for the treatment of malocclusion in a patient with chronic periodontitis with a five-year follow-up: A case report.

    Science.gov (United States)

    Zhang, Dongmei; Lin, Li; Tang, Xiaoling; Li, Chen; Liu, Jingbo; Wang, Hongyang; Pan, Yaping

    2017-10-01

    Multidisciplinary therapy is essential in dental practice to achieve optimized outcomes. The present case report describes the application of periodontal surgery with a five-year follow-up in a patient with malocclusion and chronic periodontitis. In the presence of periodontal inflammation, orthodontic therapy may result in further periodontal breakdown due to plaque accumulation. In order to prevent this progression, scaling and root planning with a periodontal endoscope was applied, and continuous clinical monitoring and risk assessment was performed every 3 months using a Florida Probe. This combined treatment supports the long-term maintenance of periodontal conditions, functional occlusion and harmony of the facial profile.

  18. Post-trauma ratings of pre-collision pain and psychological distress predict poor outcome following acute whiplash trauma: A 12-month follow-up study

    DEFF Research Database (Denmark)

    Carstensen, Tina

    2008-01-01

    emergency departments or primary care after car accidents in four counties in Denmark. After the collision patients received a questionnaire on psychological distress, unspecified pain and socio-demographics and 12months later a follow-up on work capability and neck pain was performed. Risk factors were...... were not associated with poor outcome. In conclusion unspecified as opposed to specified pain (neck pain) before the collision is associated with poor recovery and high accumulation of pre-collision psychological distress is associated with considerable neck pain at follow-up. However, no conclusions...... on causality can be drawn. Personal characteristics before the collision are important for recovery and attention to pre-collision characteristics may contribute to the prevention of poor recovery after acute whiplash trauma....

  19. Post-trauma ratings of pre-collision pain and psychological distress predict poor outcome following acute whiplash trauma: A 12-month follow-up study

    DEFF Research Database (Denmark)

    Carstensen, Tina; Frostholm, Lisbeth; Ørnbøl, Eva

    2008-01-01

    emergency departments or primary care after car accidents in four counties in Denmark. After the collision patients received a questionnaire on psychological distress, unspecified pain and socio-demographics and 12 months later a follow-up on work capability and neck pain was performed. Risk factors were...... of accident were not associated with poor outcome. In conclusion unspecified as opposed to specified pain (neck pain) before the collision is associated with poor recovery and high accumulation of pre-collision psychological distress is associated with considerable neck pain at follow-up. However......, no conclusions on causality can be drawn. Personal characteristics before the collision are important for recovery and attention to pre-collision characteristics may contribute to the prevention of poor recovery after acute whiplash trauma....

  20. Steroid injections in the treatment of humeral unicameral bone cysts: long-term follow-up and review of the literature.

    Science.gov (United States)

    Pavone, V; Caff, G; Di Silvestri, C; Avondo, S; Sessa, G

    2014-05-01

    Retrospective evaluation of long-term effectiveness of the steroid injections treatment in patients with unicameral bone cysts (UBC). From January 1993 to April 2005, 23 children affected by proximal humeral UBC were evaluated according to the Neer-Cole classification system and treated with serial methylprednisolone acetate's injections. The patients were followed up at 1, 3, 6 and 12 months and then every year until the adolescence. After treatment, in 15 out of 23 patients (65.2%), the humeral cysts were referred, respectively, as Grade 1 and in four as Grade 2. In 4 patients, a refracture occurred. Statistical analysis showed an overall good response in 82.6% of patients at the end of the follow-up. Minor complication including skin discoloration accounted for 13.04%. The steroid injections showed to be an alternative excellent treatment for UBC, with complete healing of the lesions in the majority of cases. This procedure is not expensive, mini-invasive, with low surgical risk and short hospitalization.

  1. A hospitalização por asma e a carência de acompanhamento ambulatorial Asthma-related hospitalizations and lack of outpatient follow-up treatment

    Directory of Open Access Journals (Sweden)

    Emanuel Sarinho

    2007-08-01

    Full Text Available OBJETIVO: Verificar se as crianças e os adolescentes internados por crise aguda de asma em duas unidades de saúde da cidade do Recife faziam acompanhamento ambulatorial preventivo para controle da asma. MÉTODOS: Estudo prospectivo de uma série de casos de pacientes internados por asma aos quais foi aplicado um questionário no momento da internação para verificar a freqüência de acompanhamento ambulatorial para tratamento profilático. Foi considerado asmático aquele paciente que apresentou duas ou mais crises de broncoespasmo com boa resposta aos broncodilatadores. RESULTADOS: Do total de 169 pacientes internados por asma, 67% (112/167 - dados referentes a 2 pacientes não foram fornecidos foram atendidos exclusivamente em serviços de urgência no período intercrise. Apesar de haver encaminhamento médico para atendimento ambulatorial em 53,3% (89/167 - dados referentes a 2 pacientes não foram fornecidos dos casos, apenas 16% (27/169 dos pacientes efetivamente freqüentavam um ambulatório específico de asma para tratamento preventivo e somente 13% (22/169 usavam medicação profilática. CONCLUSÃO: A maioria das crianças e dos adolescentes internados por asma não fazia acompanhamento ambulatorial preventivo. Uma série de problemas, tais como a não referência para acompanhamento ambulatorial após a alta hospitalar, a dificuldade de acesso ao ambulatório e a impossibilidade de se obter a medicação profilática gratuitamente, entre outros fatores relacionados ao sistema de saúde, podem ter contribuído para esta baixa taxa de procura por atendimento ambulatorial. Recomenda-se a implementação de uma política de saúde que possibilite o efetivo funcionamento do programa de controle da asma.OBJECTIVE: To determine whether the children and adolescents with acute asthma attacks admitted to two public hospitals in the city of Recife, Brazil underwent outpatient follow-up treatment for the prevention and control of asthma

  2. A 2-year follow-up study of patients participating in our transcranial pulsating electromagnetic fields augmentation in treatment-resistant depression

    DEFF Research Database (Denmark)

    Bech, Per; Lindberg, Lone; Straasø, Birgit

    2015-01-01

    OBJECTIVE: We have made a 2-year follow-up study to evaluate the effect of repeated transcranial pulsating electromagnetic fields (T-PEMF) augmentation in patients who had achieved remission but later on relapsed, as well as to identify factors contributing to treatment-resistant depression......: In group A, comprising 27 patients, 13 had relapsed; they obtained a clear remission after a repeated course of T-PEMF augmentation. In group D, comprising 16 patients, we identified misdiagnostic factors both concerning the event of remission after the previous T-PEMF augmentation and concerning...... with the first series of T-PEMF. Treatment-resistant depression is a condition that has a high degree of multivariate problems. Misuse of alcohol or drugs, severe somatic disorders and other psychosocial problems may need other kinds of treatment before T-PEMF augmentation....

  3. Stability of interceptive/corrective orthodontic treatment for tooth ankylosis and Class II mandibular deficiency: A case report with 10 years follow-up.

    Science.gov (United States)

    Guimarães, Carlos Henrique; Henriques, José Fernando Castanha; Janson, Guilherme; Moura, Wilana S

    2015-01-01

    The purpose of this article is to present the treatment of a 8-year-old boy with tooth ankylosis in teeth 85 and Class II division 1 malocclusion and to report a 10-year follow-up result. The patient was initially treated with a sagittal removable appliance, followed by an eruption guidance appliance and braces. The interceptive orthodontic treatment performed to recover the space lost by ankylosis of a deciduous tooth allowed a spontaneous eruption and prevented progression of the problem. The use of an eruption-guidance appliance corrected the dentoskeletal Class II, thus improving the patient's appearance. Besides the treatment producing a good occlusal relationship with the Class I molar, the correction of the overjet and overbite was stable over a ten-year period.

  4. Stability of interceptive/corrective orthodontic treatment for tooth ankylosis and Class II mandibular deficiency: A case report with 10 years follow-up

    Directory of Open Access Journals (Sweden)

    Carlos Henrique Guimarães

    2015-01-01

    Full Text Available The purpose of this article is to present the treatment of a 8-year-old boy with tooth ankylosis in teeth 85 and Class II division 1 malocclusion and to report a 10-year follow-up result. The patient was initially treated with a sagittal removable appliance, followed by an eruption guidance appliance and braces. The interceptive orthodontic treatment performed to recover the space lost by ankylosis of a deciduous tooth allowed a spontaneous eruption and prevented progression of the problem. The use of an eruption-guidance appliance corrected the dentoskeletal Class II, thus improving the patient's appearance. Besides the treatment producing a good occlusal relationship with the Class I molar, the correction of the overjet and overbite was stable over a ten-year period.

  5. A randomized prospective clinical trial on the effectiveness of three treatment modalities for patients with lower denture problems - A 10 year follow-up study on patient satisfaction : a 10 year follow-up study on patient satisfaction

    NARCIS (Netherlands)

    Raghoebar, GM; Meijer, HJA; van 't Hof, M; Stegenga, B; Vissink, A

    2003-01-01

    Treatment of lower denture complaints of patients with an edentulous mandible with a height of at least 15 mm can consist of meticulous construction of a new set of dentures (CD), construction of a new set of dentures following preprosthetic surgery to enlarge the denture-bearing area (PPS), or

  6. Follow-up in Childhood Functional Constipation

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  7. Surgical treatment of anterior instability in rugby union players: clinical and radiographic results of the Latarjet-Patte procedure with minimum 5-year follow-up.

    Science.gov (United States)

    Neyton, Lionel; Young, Allan; Dawidziak, Bérangère; Visona, Enrico; Hager, Jean-Philippe; Fournier, Yann; Walch, Gilles

    2012-12-01

    Anterior instability in rugby players is characterized by the common finding of a bony lesion, which has been identified as a potential cause of recurrence after soft-tissue reconstruction. The Latarjet-Patte procedure is effective in the treatment of recurrent anterior instability in collision sports such as rugby union. We retrospectively assessed 34 rugby players (37 shoulders) stabilized with the Latarjet-Patte procedure. The mean follow-up was 12 years. All patients underwent clinical and radiographic assessment preoperatively and at final follow-up. Functional evaluation was performed with the Walch-Duplay and Rowe scores. A visual analog scale score for the evaluation of pain and the subjective shoulder value were recorded. In addition, all patients completed a questionnaire regarding the return to playing rugby. No recurrence of either dislocation or subluxation occurred. Persistent apprehension on clinical examination was present in 5 patients (14%). A bony lesion of the glenoid was present in 73% and a Hill-Sachs lesion in 68%. Sixty-five percent of the patients returned to playing rugby; only 1 patient did not return to playing rugby because of his shoulder. The mean Walch-Duplay and Rowe scores were 86 and 93 points, respectively. The mean subjective shoulder value was 90%. Radiographic healing of the bone block was observed in 89% of cases. At final follow-up, 11 patients (30%) had minor arthritic changes, with no cases of moderate or severe arthritis. The Latarjet-Patte procedure provides a reliable method for stabilizing the shoulder, resulting in a return to playing rugby in a high number of cases without increasing the risk of long-term arthritic degradation. Copyright © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  8. Does behaviour modification affect post-stroke risk factor control? Three-year follow-up of a randomized controlled trial.

    Science.gov (United States)

    McManus, Julie Ann; Craig, Alison; McAlpine, Christine; Langhorne, Peter; Ellis, Graham

    2009-02-01

    Little is known about the long-term effectiveness after stroke of interventions for behaviour modification and ensuring concordance with therapies. We describe a follow-up study of a previous randomized controlled trial of a brief period of behaviour modification. The aim of this study was to determine outcomes three years after the initial intervention. Survivors of the original cohort were contacted and asked to attend for follow-up interview, within a geriatric day hospital. This study was carried out in the Geriatric Day Hospital at Stobhill Hospital, Balornock Road, Glasgow. Details of risk factor control, including blood pressure, cholesterol levels and diabetic control, were assessed. Questionnaires used in the initial study were repeated including the Geriatric Depression Scale score, Euroqol Perceived Health Status and Stroke Services Satisfaction Questionnaire. Primary outcome was collective risk factor control. Clinical outcomes including recurrent cerebrovascular events, medication persistence and perceived health status were also recorded. Mean length of follow-up was 3.6 years (SD 0.43). Of the 205 patients enrolled in the initial study, 102 patients attended for repeat interview(49 intervention/53 control). There were no significant differences in the percentage of controlled risk factors between groups (intervention 51.7% versus control 55.9%, P = 0.53). Similarities were observed in the number of recurrent clinical events and medication persistence between groups. No overall difference was observed in perceived health status, satisfaction with care or depression scores. Brief intervention with respect to behaviour modification and risk factor control does not appear to have any long-term benefit. These results must be cautiously interpreted in light of the small study number and further research is required.

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

    Science.gov (United States)

    McFarland, Brian R; Klein, Daniel N

    2005-01-01

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

  10. Virtual reality for enhancing the cognitive behavioral treatment of obesity with binge eating disorder: randomized controlled study with one-year follow-up.

    Science.gov (United States)

    Cesa, Gian Luca; Manzoni, Gian Mauro; Bacchetta, Monica; Castelnuovo, Gianluca; Conti, Sara; Gaggioli, Andrea; Mantovani, Fabrizia; Molinari, Enrico; Cárdenas-López, Georgina; Riva, Giuseppe

    2013-06-12

    Recent research identifies unhealthful weight-control behaviors (fasting, vomiting, or laxative abuse) induced by a negative experience of the body, as the common antecedents of both obesity and eating disorders. In particular, according to the allocentric lock hypothesis, individuals with obesity may be locked to an allocentric (observer view) negative memory of the body that is no longer updated by contrasting egocentric representations driven by perception. In other words, these patients may be locked to an allocentric negative representation of their body that their sensory inputs are no longer able to update even after a demanding diet and a significant weight loss. To test the brief and long-term clinical efficacy of an enhanced cognitive-behavioral therapy including a virtual reality protocol aimed at unlocking the negative memory of the body (ECT) in morbidly obese patients with binge eating disorders (BED) compared with standard cognitive behavior therapy (CBT) and an inpatient multimodal treatment (IP) on weight loss, weight loss maintenance, BED remission, and body satisfaction improvement, including psychonutritional groups, a low-calorie diet (1200 kcal/day), and physical training. 90 obese (BMI>40) female patients with BED upon referral to an obesity rehabilitation center were randomly assigned to conditions (31 to ECT, 30 to CBT, and 29 to IP). Before treatment completion, 24 patients discharged themselves from hospital (4 in ECT, 10 in CBT, and 10 in IP). The remaining 66 inpatients received either 15 sessions of ECT, 15 sessions of CBT, or no additional treatment over a 5-week usual care inpatient regimen (IP). ECT and CBT treatments were administered by 3 licensed psychotherapists, and patients were blinded to conditions. At start, upon completion of the inpatient treatment, and at 1-year follow-up, patients' weight, number of binge eating episodes during the previous month, and body satisfaction were assessed by self-report questionnaires and

  11. Rational emotive behavior therapy, cognitive therapy, and medication in the treatment of major depressive disorder: a randomized clinical trial, posttreatment outcomes, and six-month follow-up.

    Science.gov (United States)

    David, Daniel; Szentagotai, Aurora; Lupu, Viorel; Cosman, Doina

    2008-06-01

    A randomized clinical trial was undertaken to investigate the relative efficacy of rational-emotive behavior therapy (REBT), cognitive therapy (CT), and pharmacotherapy in the treatment of 170 outpatients with nonpsychotic major depressive disorder. The patients were randomly assigned to one of the following: 14 weeks of REBT, 14 weeks of CT, or 14 weeks of pharmacotherapy (fluoxetine). The outcome measures used were the Hamilton Rating Scale for Depression and the Beck Depression Inventory. No differences among treatment conditions at posttest were observed. A larger effect of REBT (significant) and CT (nonsignificant) over pharmacotherapy at 6 months follow-up was noted on the Hamilton Rating Scale for Depression only. (c) 2008 Wiley Periodicals, Inc.

  12. Elastic stable intramedullary nailing is the best treatment of unicameral bone cysts of the long bones in children?: Prospective long-term follow-up study.

    Science.gov (United States)

    de Sanctis, Nando; Andreacchio, Antonio

    2006-01-01

    Since Virchow first described the unicameral bone cyst (UBC) in 1876, several methods for management were proposed. Currently performed surgical procedures include curettage combined with bone grafting, allografting with freeze-dried crushed cortical bone, use of homologous cancellous bone chips, the application of high-porosity hydroxyapatite, and cryosurgery. Decompression with multiple drill holes and intralesional injections of either steroids or bone marrow have also been used to treat UBC, with variable success rates. Elastic stable intramedullary nailing for the treatment of UBC in long bones has been rapidly gaining popularity. Elastic stable intramedullary nailing for the treatment of a UBC was performed in 56 patients between 1994 and 2003. The follow-up is between 2.1 and 11 years. Nine children were excluded because of short period of follow-up or were lost. The study population consisted of 47 children. The cyst was located in the humerus in 36 patients, in the femur in 11. The mean age of the patients at the time of surgery was 8.9 years. Results were evaluated on plain radiographs according to the classification system of Capanna et al. In our study population of 47 UBCs, 31 (65.9 %) were classified as completely healed, and 16 (34.1%) were healed with residual radiolucency. No recurrence or no response was observed. Each lesion responded to treatment after the nailing. This method can solve in time the pathology, and we feel that, with skilled hands, this method is the best one for UBC treatment in the long bones of the children.

  13. Evaluation of shoulder and elbow functions after treatment of humeral shaft fractures: a 20-132-month follow-up study.

    Science.gov (United States)

    Fırat, Ahmet; Deveci, Alper; Güler, Ferhat; Oçgüder, Ali; Oğuz, Temel; Bozkurt, Murat

    2012-01-01

    The aim of this study was to evaluate the long-term results of shoulder and elbow functions in humeral shaft fractures treated with functional brace, plate and screw osteosynthesis or intramedullary nailing. The study included 128 patients treated for humeral shaft fracture. The patients were divided into three groups according to treatment method: Group 1 (n=62) received functional brace, Group 2 (n=36) plate and screw osteosynthesis and Group 3 (n=30) intramedullary nailing. Coronal and sagittal humeral angulations were measured radiologically during the final follow-up. Shoulder and elbow functions were evaluated using the Constant shoulder score, the Mayo Elbow Performance Scoring and range of movement measurements. The mean follow-up time was 74 (range: 20 to 132) months. Mean Constant shoulder scores were 92.4 in Group 1, 85.6 in Group 2 and 74 in Group 3. A statistically significant difference was detected between the Constant shoulder scores of Groups 2 and 3 (p0.05). In the statistical evaluation of the Constant shoulder scores, a statistically significant difference was detected between the Constant scores of patients with a varus angulation greater than 20° and those with neutral alignment. Functional results of humeral shaft fractures treated with functional brace appear to be satisfactory. Varus and antecurvatum may affect shoulder and elbow function. In the presence of surgical indications, plate and screw fixation technique is the most effective method in terms of shoulder and elbow functions.

  14. Quality of life after surgical treatment of coarctation in long-term follow-up (CoAFU): Predictive value of clinical variables.

    Science.gov (United States)

    Bambul Heck, Pinar; Pabst von Ohain, Jelena; Kaemmerer, Harald; Ewert, Peter; Hager, Alfred

    2018-01-01

    We sought to analyze the quality of life and the predictive value of clinical variables from previous follow-up study in patients late after surgical treatment of aortic coarctation on the quality of life. All patients, who have participated in the prospective cross-sectional COALA Study in 2000 with a structural clinical investigation including blood pressure measurement and symptom-limited exercise test were contacted for the health-related quality of life questionnaire SF-36 from January 2013 through December 2014. From 273 eligible patients, we received data from 135 patients, 9 of them died during the follow-up time at the median age of 46years (range 30-64years). Seventy-four patients did not participate in the study, other 64 patients moved to remote or unknown areas and could not be contacted. Quality of life was good in the fields of physical role and pain. However, patients reported a significant impairment in general health and in health transition, depending on the age. Arterial hypertension and variables from echocardiography or exercise testing from the COALA study were not predictive on functional health status. Quality of life in patients late after aortic coarctation repair is fairly good compared with healthy controls. Impairments in general health and health transition depend mainly on age, can be explained due to numerous comorbidities and reinterventions in long-term. The predictive value of the commonly assessed clinical variables on quality of life is limited. Copyright © 2017. Published by Elsevier B.V.

  15. Women with provoked vestibulodynia experience clinically significant reductions in pain regardless of treatment: results from a 2-year follow-up study.

    Science.gov (United States)

    Davis, Seth N P; Bergeron, Sophie; Binik, Yitzchak M; Lambert, Bernard

    2013-12-01

    Provoked vestibulodynia (PVD) is a prevalent genital pain syndrome that has been assumed to be chronic, with little spontaneous remission. Despite this assumption, there is a dearth of empirical evidence regarding the progression of PVD in a natural setting. Although many treatments are available, there is no single treatment that has demonstrated efficacy above others. The aims of this secondary analysis of a prospective study were to (i) assess changes over a 2-year period in pain, depressive symptoms, and sexual outcomes in women with PVD; and (ii) examine changes based on treatment(s) type. Participants completed questionnaire packages at Time 1 and a follow-up package 2 years later. Visual analog scale of genital pain, Global Measure of Sexual Satisfaction, Female Sexual Function Index, Beck Depression Inventory, Dyadic Adjustment Scale, and sexual intercourse attempts over the past month. Two hundred thirty-nine women with PVD completed both time one and two questionnaires. For the sample as a whole, there was significant improvement over 2 years on pain ratings, sexual satisfaction, sexual function, and depressive symptoms. The most commonly received treatments were physical therapy, sex/psychotherapy, and medical treatment, although 41.0% did not undergo any treatment. Women receiving no treatment also improved significantly on pain ratings. No single treatment type predicted better outcome for any variable except depressive symptoms, in which women who underwent surgery were more likely to improve. These results suggest that PVD may significantly reduce in severity over time. Participants demonstrated clinically significant pain improvement, even when they did not receive treatment. Furthermore, the only single treatment type predicting better outcomes was surgery, and only for depressive symptoms, accounting for only 2.3% of the variance. These data do not demonstrate the superiority of any one treatment and underscore the need to have control groups in

  16. The Impeding Role of Self-Critical Perfectionism on Therapeutic Alliance During Treatment and Eating Disorder Symptoms at Follow-up in Patients with an Eating Disorder

    Directory of Open Access Journals (Sweden)

    Jolene van der Kaap-Deeder

    2016-04-01

    Full Text Available This study examines the impeding role of self-critical perfectionism at onset of treatment on therapeutic alliance during treatment and eating disorder symptoms at follow-up in patients with an eating disorder. Participants were 53 female patients with a mean age of 21.1 years treated for an eating disorder in a specialized inpatient treatment unit. Self-critical perfectionism was assessed at admission, therapeutic alliance was assessed during treatment (after three months of treatment, and eating disorder symptoms were assessed at admission, after three months and one year later. Self-critical perfectionism negatively related to treatment alliance with the therapist. Although self-critical perfectionism was not directly predictive of subsequent changes in eating disorder symptoms, it was indirectly related to less reduction in body dissatisfaction through the therapeutic alliance. These results point to the importance of self-critical perfectionism in the therapeutic alliance and in changes in body image problems. Treatment implications are discussed.

  17. Young adult outcomes in the follow-up of the multimodal treatment study of attention-deficit/hyperactivity disorder: symptom persistence, source discrepancy, and height suppression.

    Science.gov (United States)

    Swanson, James M; Arnold, L Eugene; Molina, Brooke S G; Sibley, Margaret H; Hechtman, Lily T; Hinshaw, Stephen P; Abikoff, Howard B; Stehli, Annamarie; Owens, Elizabeth B; Mitchell, John T; Nichols, Quyen; Howard, Andrea; Greenhill, Laurence L; Hoza, Betsy; Newcorn, Jeffrey H; Jensen, Peter S; Vitiello, Benedetto; Wigal, Timothy; Epstein, Jeffery N; Tamm, Leanne; Lakes, Kimberly D; Waxmonsky, James; Lerner, Marc; Etcovitch, Joy; Murray, Desiree W; Muenke, Maximilian; Acosta, Maria T; Arcos-Burgos, Mauricio; Pelham, William E; Kraemer, Helena C

    2017-06-01

    The Multimodal Treatment Study (MTA) began as a 14-month randomized clinical trial of behavioral and pharmacological treatments of 579 children (7-10 years of age) diagnosed with attention-deficit/hyperactivity disorder (ADHD)-combined type. It transitioned into an observational long-term follow-up of 515 cases consented for continuation and 289 classmates (258 without ADHD) added as a local normative comparison group (LNCG), with assessments 2-16 years after baseline. Primary (symptom severity) and secondary (adult height) outcomes in adulthood were specified. Treatment was monitored to age 18, and naturalistic subgroups were formed based on three patterns of long-term use of stimulant medication (Consistent, Inconsistent, and Negligible). For the follow-up, hypothesis-generating analyses were performed on outcomes in early adulthood (at 25 years of age). Planned comparisons were used to estimate ADHD-LNCG differences reflecting persistence of symptoms and naturalistic subgroup differences reflecting benefit (symptom reduction) and cost (height suppression) associated with extended use of medication. For ratings of symptom severity, the ADHD-LNCG comparison was statistically significant for the parent/self-report average (0.51 ± 0.04, p ADHD group was 1.29 ± 0.55 cm shorter than the LNCG (p ADHD group showed symptom persistence compared to local norms from the LNCG. Within naturalistic subgroups of ADHD cases, extended use of medication was associated with suppression of adult height but not with reduction of symptom severity. © 2017 Association for Child and Adolescent Mental Health.

  18. Survivorship and the chronic cancer patient: Patterns in treatment-related effects, follow-up care, and use of survivorship care plans.

    Science.gov (United States)

    Frick, Melissa A; Vachani, Carolyn C; Bach, Christina; Hampshire, Margaret K; Arnold-Korzeniowski, Karen; Metz, James M; Hill-Kayser, Christine E

    2017-11-01

    The survivorship needs of patients living with chronic cancer (CC) and their use of survivorship care plans (SCPs) have been overlooked and underappreciated. A convenience sample of 39,088 SCPs completed for cancer survivors with an Internet-based SCP tool was examined; it included 5847 CC survivors (15%; CC was defined as chronic leukemia and/or recurrent/metastatic cancer of another nature). Patient-reported treatment effects and follow-up care patterns were compared between CC survivors and survivors treated with curative intent (CI). Responses from a follow-up survey regarding SCP satisfaction and use were reviewed. CC survivors had greater odds of experiencing multiple treatment-related effects than survivors treated with CI; these effects included fatigue, cognitive changes, dyspnea, peripheral neuropathy, lymphedema, and erectile dysfunction. Nearly half of CC survivors were managed by an oncologist alone, and they were less likely than CI patients to be comanaged by a primary care provider and an oncologist. Fewer SCPs were generated by health care providers (HCPs) for CC survivors versus CI survivors. A smaller proportion of CC users versus CI users rated their experience and satisfaction with the SCP tool as very good or excellent, and CC users were less likely to share the HCP summary with their health care team. A substantial number of CC survivors, often considered incurable but treatable, seek survivorship support. Tools to facilitate participation, communication, and coordination of care are valuable for these patients, and future iterations of SCPs should be designed to address the particular circumstances of living with CC. Cancer 2017;123:4268-4276. © 2017 American Cancer Society. © 2017 American Cancer Society.

  19. Long-term follow-up studies on iodine-131 treatment of hyperthyroid Graves' disease based on the measurement of thyroid volume by ultrasonography

    International Nuclear Information System (INIS)

    Tsuruta, Masako; Nagayama, Yuji; Yokoyama, Naokata; Izumi, Motomori; Nagataki, Shigenobu

    1993-01-01

    In the present series of studies, the long-term (four year) effect of 80 Gy of 131 I treatment was evaluated in patients with hyperthyroid Graves' disease whose thyroid volumes have been accurately estimated with a high resolution ultrasound scanner. One year after 131 I treatment, 23.1% (3 out of 13 patients) remained hyperthyroid, 69.2% (9 out of 13) became euthyroid, and 7.7% (1 out of 13) were in a hypothyroid state. Since three patients in a hyperthyroid state one year after treatment were subsequently treated with either antithyroid drugs or additional 131 I treatment, the remaining ten patients (9 euthyroid and 1 hypothyroid patients) have been followed up for three more years. Two patients developed a hypothyroid state three years after treatment and one patient four years after treatment. Overall, 60% (6 out of 10 patients) were in a euthyroid state and 40% (4 out of 10) in a hypothyroid state, four years after 80 Gy 131 I treatment. There was no significant difference between eu- and hypo-thyroid groups in the sex ratio, age, radiation doses, therapeutic dose, thyroid gland volume, 24-hr 131 I uptake, the effective half-life of 131 I in the thyroid or the duration of hyperthyroidism. In our preliminary studies, the incidence of late hypothyroidism in our 131 I treatment is similar to those previously reported. These suggest that uncertain factor(s), such as inhomogeneity of iodine distribution in the thyroid, unequal sensitivity of the thyroid cells to the radiation, and/or persistent destructive effects of the autoimmune process may influence the long-term effect of 131 I treatment of Graves' disease. (author)

  20. Long-term follow-up studies on iodine-131 treatment of hyperthyroid Graves' disease based on the measurement of thyroid volume by ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Tsuruta, Masako; Nagayama, Yuji; Yokoyama, Naokata; Izumi, Motomori; Nagataki, Shigenobu (Nagasaki Univ. (Japan). School of Medicine)

    1993-08-01

    In the present series of studies, the long-term (four year) effect of 80 Gy of [sup 131]I treatment was evaluated in patients with hyperthyroid Graves' disease whose thyroid volumes have been accurately estimated with a high resolution ultrasound scanner. One year after [sup 131]I treatment, 23.1% (3 out of 13 patients) remained hyperthyroid, 69.2% (9 out of 13) became euthyroid, and 7.7% (1 out of 13) were in a hypothyroid state. Since three patients in a hyperthyroid state one year after treatment were subsequently treated with either antithyroid drugs or additional [sup 131]I treatment, the remaining ten patients (9 euthyroid and 1 hypothyroid patients) have been followed up for three more years. Two patients developed a hypothyroid state three years after treatment and one patient four years after treatment. Overall, 60% (6 out of 10 patients) were in a euthyroid state and 40% (4 out of 10) in a hypothyroid state, four years after 80 Gy [sup 131]I treatment. There was no significant difference between eu- and hypo-thyroid groups in the sex ratio, age, radiation doses, therapeutic dose, thyroid gland volume, 24-hr [sup 131]I uptake, the effective half-life of [sup 131]I in the thyroid or the duration of hyperthyroidism. In our preliminary studies, the incidence of late hypothyroidism in our [sup 131]I treatment is similar to those previously reported. These suggest that uncertain factor(s), such as inhomogeneity of iodine distribution in the thyroid, unequal sensitivity of the thyroid cells to the radiation, and/or persistent destructive effects of the autoimmune process may influence the long-term effect of [sup 131]I treatment of Graves' disease. (author).

  1. Evaluating the Measurement Properties of the Self-Assessment of Treatment Version II, Follow-Up Version, in Patients with Painful Diabetic Peripheral Neuropathy

    Directory of Open Access Journals (Sweden)

    Floortje van Nooten

    2017-01-01

    Full Text Available Background. The Self-Assessment of Treatment version II (SAT II measures treatment-related improvements in pain and impacts and impressions of treatment in neuropathic pain patients. The measure has baseline and follow-up versions. This study assesses the measurement properties of the SAT II. Methods. Data from 369 painful diabetic peripheral neuropathy (PDPN patients from a phase III trial assessing capsaicin 8% patch (Qutenza® efficacy and safety were used in these analyses. Reliability, convergent validity, known-groups validity, and responsiveness (using the Brief Pain Inventory-Diabetic Neuropathy [BPI-DN] and Patient Global Impression of Change [PGIC] analyses were conducted, and minimally important differences (MID were estimated. Results. Exploratory factor analysis supported a one-factor solution for the six impact items. The SAT II has good internal consistency (Cronbach’s alpha: 0.96 and test-retest reliability (intraclass correlation coefficients: 0.62–0.88. Assessment of convergent validity showed moderate to strong correlations with change in other study endpoints. Scores varied significantly by level of pain intensity and sleep interference (p<0.05 defined by the BPI-DN. Responsiveness was shown based on the PGIC. MID estimates ranged from 1.2 to 2.4 (pain improvement and 1.0 to 2.0 (impact scores. Conclusions. The SAT II is a reliable and valid measure for assessing treatment improvement in PDPN patients.

  2. Endovascular stent-graft placement for the treatment of acute onset and chronic aortic dissections of the descending aorta (Short-term follow-up)

    International Nuclear Information System (INIS)

    Petrov, I; Jorgova, J.; Trendafilova, D.

    2004-01-01

    The leading cause of death for patients with surgically untreated thoracic aortic aneurysms is the rupture of the aneurysm. Almost one half of these patients are left to medical treatment assuming the risk of late rupture and aneurysm sac enlargement - the late surgical treatment of these patients is too risky and with poor results. On the other hand the emergent surgical treatment of these cases is related with relatively high mortality rate. Recently, thoracic aortic stent-grafting has emerged as a less traumatic alternative therapeutic modality for patients with thoracic aortic aneurysms and aortic dissections. The first case of stent implantation in a dissected descending aorta was performed in Bulgaria at 09.04.2003. Since then we implanted in 8 patients thoracic stent grafts, The mean age of the patients was 67.5 years. The primary success was 100%. One died on the second postoperative day by abdominal aorta rupture. No other complications were registered. The mean follow-up of 5 months proved to be uneventful and the control CT revealed efficacious sealing of the entry and false lumen thrombosis in all except one cases. We report our initial clinical experience of endovascular stent-graft repair for dissection of the descending aorta that is encouraging. These preliminary data suggest that endovascular stent-grafting is a viable treatment for acute onset and chronic aortic dissection type B

  3. Bidirectional relations between parenting practices and child externalizing behavior: a cross-lagged panel analysis in the context of a psychosocial treatment and 3-year follow-up.

    Science.gov (United States)

    Shaffer, Anne; Lindhiem, Oliver; Kolko, David J; Trentacosta, Christopher J

    2013-02-01

    In the current study, we examined longitudinal changes in, and bidirectional effects between, parenting practices and child behavior problems in the context of a psychosocial treatment and 3-year follow-up period. The sample comprised 139 parent-child dyads (child ages 6-11) who participated in a modular treatment protocol for early-onset ODD or CD. Parenting practices and child behavior problems were assessed at six time-points using multiple measures and multiple reporters. The data were analyzed using cross-lagged panel analyses. Results indicated robust temporal stabilities of parenting practices and child behavior problems, in the context of treatment-related improvements, but bidirectional effects between parenting practices and child behavior were less frequently detected. Our findings suggest that bidirectional effects are relatively smaller than the temporal stability of each construct for school-age children with ODD/CD and their parents, following a multi-modal clinical intervention that is directed at both parents and children. Implications for treatment and intervention are discussed.

  4. Echinococcus P29 Antigen: Molecular Characterization and Implication on Post-Surgery Follow-Up of CE Patients Infected with Different Species of the Echinococcus granulosus Complex

    Science.gov (United States)

    Boubaker, Ghalia; Gottstein, Bruno; Hemphill, Andrew; Babba, Hamouda; Spiliotis, Markus

    2014-01-01

    The protein P29 is a potential serological marker for post-treatment monitoring of cystic echinococcosis (CE) especially in young patients. We now have demonstrated that P29 is encoded in the Echinococcus genus by a single gene consisting of 7 exons spanning 1.2 kb of DNA. Variability of the p29 gene at inter- and intra-species level was assessed with 50 cDNA and 280 genomic DNA clones isolated from different E. granulosus s.l. isolates (E. granulosus sensu stricto (G1), E. equinus (G4), E. ortleppi (G5), E. canadensis (G6), E. canadensis (G7) and E. canadensis (G10)) as well as four E. multilocularis isolates. Scarce interspecies polymorphism at the p29 locus was observed and affected predominantly E. granulosus s.s. (G1), where we identified two alleles (A1 and A2) coding for identical P29 proteins and yielding in three genotypes (A1/A1, A2/A2 and A1/A2). Genotypic frequencies expected under Hardy-Weinberg equilibrium revealed a high rate of heterozygosity (47%) that strongly supports the hypothesis that E. granulosus s.s. (G1) is predominantly outbreeding. Comparative sequence analyses of the complete p29 gene showed that phylogenetic relationships within the genus Echinococcus were in agreement with those of previous nuclear gene studies. At the protein level, the deduced P29 amino acid (AA) sequences exhibited a high level of conservation, ranging from 97.9% AA sequence identity among the whole E. granulosus s.l. group to 99.58% identity among E. multilocularis isolates. We showed that P29 proteins of these two species differ by three AA substitutions without implication for antigenicity. In Western-blot analyses, serum antibodies from a human CE patient infected with E. canadensis (G6) strongly reacted with recombinant P29 from E. granulosus s.s. (G1) (recEg(G1)P29). In the same line, human anti-Eg(G1)P29 antibodies bound to recEcnd(G6)P29. Thus, minor AA sequence variations appear not to impair the prognostic serological use of P29. PMID:24851904

  5. Echinococcus P29 antigen: molecular characterization and implication on post-surgery follow-up of CE patients infected with different species of the Echinococcus granulosus complex.

    Science.gov (United States)

    Boubaker, Ghalia; Gottstein, Bruno; Hemphill, Andrew; Babba, Hamouda; Spiliotis, Markus

    2014-01-01

    The protein P29 is a potential serological marker for post-treatment monitoring of cystic echinococcosis (CE) especially in young patients. We now have demonstrated that P29 is encoded in the Echinococcus genus by a single gene consisting of 7 exons spanning 1.2 kb of DNA. Variability of the p29 gene at inter- and intra-species level was assessed with 50 cDNA and 280 genomic DNA clones isolated from different E. granulosus s.l. isolates (E. granulosus sensu stricto (G1), E. equinus (G4), E. ortleppi (G5), E. canadensis (G6), E. canadensis (G7) and E. canadensis (G10)) as well as four E. multilocularis isolates. Scarce interspecies polymorphism at the p29 locus was observed and affected predominantly E. granulosus s.s. (G1), where we identified two alleles (A1 and A2) coding for identical P29 proteins and yielding in three genotypes (A1/A1, A2/A2 and A1/A2). Genotypic frequencies expected under Hardy-Weinberg equilibrium revealed a high rate of heterozygosity (47%) that strongly supports the hypothesis that E. granulosus s.s. (G1) is predominantly outbreeding. Comparative sequence analyses of the complete p29 gene showed that phylogenetic relationships within the genus Echinococcus were in agreement with those of previous nuclear gene studies. At the protein level, the deduced P29 amino acid (AA) sequences exhibited a high level of conservation, ranging from 97.9% AA sequence identity among the whole E. granulosus s.l. group to 99.58% identity among E. multilocularis isolates. We showed that P29 proteins of these two species differ by three AA substitutions without implication for antigenicity. In Western-blot analyses, serum antibodies from a human CE patient infected with E. canadensis (G6) strongly reacted with recombinant P29 from E. granulosus s.s. (G1) (recEg(G1)P29). In the same line, human anti-Eg(G1)P29 antibodies bound to recEcnd(G6)P29. Thus, minor AA sequence variations appear not to impair the prognostic serological use of P29.

  6. [Role of long-term follow-up in management of late-onset post-hematopoietic stem cell transplant complications].

    Science.gov (United States)

    Asano-Mori, Yuki

    As the number of long-term survivors after allogeneic hematopoietic stem cell transplantation (HSCT) has increased owing to advances in transplantation and supportive care techniques, the health and welfare of these survivors have come into focus. However, they are still at risks for various complications, including chronic graft-versus-host disease, infectious diseases, and secondary cancers even in the late period, which can not only interfere with the patient's quality of life (QOL) but also lead to death. The importance of long-term follow-up (LTFU) and management have been recently recognized, and nationwide systems to promote LTFU care in patients receiving HSCT, such as medical fee revision, publication of a LTFU guideline unique to Japan, and preparation of patient pocketbook, is under consideration. The number of medical facilities at LTFU outpatient clinic is also increasing; therefore, an optimal comprehensive support system may be established sooner or later. However, self-management by patients is essential to overcome late complications as well as to improve QOL after HSCT. Healthcare professionals should collaborate and continue to make the greatest possible efforts to educate patients regarding the risks of late complications and their prevention.

  7. Oral administration of a curcumin-phospholipid delivery system for the treatment of central serous chorioretinopathy: a 12-month follow-up study

    Directory of Open Access Journals (Sweden)

    Mazzolani F

    2013-05-01

    Full Text Available Fabio Mazzolani,1 Stefano Togni21Private Ophthalmology Practice, 2Indena SpA, Milan, ItalyBackground: The therapeutic effects of Meriva®, a curcumin-phospholipid (lecithin delivery system (formulated as Norflo® tablets, on visual acuity and retinal thickness in patients with acute and chronic central serous chorioretinopathy was previously investigated in a six-month open-label study.Methods: In this follow-up study, visual acuity was again assessed by ophthalmologic evaluation and retinal thickness by optical coherence tomography (OCT. Norflo tablets were administered twice daily to patients with central serous chorioretinopathy. The study group consisted of 12 patients (total 18 eyes who completed 12 months of follow-up. The primary endpoint was change in visual acuity before and after treatment with Norflo, and change in neuroretinal or retinal pigment epithelium detachment on OCT was the secondary endpoint.Results: After 12 months of therapy, no eyes showed further reduction in visual acuity, 39% showed stabilization, and 61% showed statistically significant improvement (P = 0.0001 by Student’s t-test and P = 0.0005 by Wilcoxon signed rank test. Ninety-five percent of eyes showed a reduction in neuroretinal or retinal pigment epithelium detachment and 5% showed stabilization. The difference in retinal thickness after 12 months was statistically significant (P = 0.0001 by Student’s t-test and P = 0.0004 by Wilcoxon signed rank test.Conclusion: These results, albeit preliminary, confirm our previous finding that this curcumin delivery system is effective in the management of central serous chorioretinopathy. When administered in a bioavailable formulation, curcumin is worth considering as a therapeutic agent for the management of inflammatory and degenerative eye conditions involving activation of retinal microglial cells.Keywords: curcumin, central serous chorioretinopathy, retinal pigment epithelium detachment, Norflo®, Meriva®

  8. Effectiveness of peroral endoscopic myotomy in the treatment of achalasia: a pilot trial in Chinese Han population with a minimum of one-year follow-up.

    Science.gov (United States)

    Ling, Ting Sheng; Guo, Hui Min; Yang, Tian; Peng, Chun Yan; Zou, Xiao Ping; Shi, Rui Hua

    2014-07-01

    To investigate the outcomes of Chinese Han patients who underwent peroral endoscopic myotomy (POEM) for achalasia. Patients undergoing POEM for achalasia at the Affiliated Drum Tower Hospital of Nanjing University Medical School were prospectively enrolled in this study, with a follow-up duration of at least one year. Their outcomes were evaluated by analyzing esophageal manometry, timed barium esophagogram and 36-Item Short Form Health Survey (SF-36), which were performed before surgery, 5 days after surgery and at the last follow-up. Patients' symptom relief was considered the primary outcome. Secondary outcomes included lower esophageal sphincter (LES) pressure, esophageal emptying, patients' quality of life (QoL) and procedure-related complications. Eighty-seven patients were included in the study. Eckardt score after POEM was remarkably lower than the preoperative score (0.4 ± 0.7 vs 7.1 ± 2.1, P = 0.001). The preoperative LES pressure was 32.4 ± 15.3 mmHg, which was decreased to 3.8 ± 3.9 mmHg immediately after surgery. The height of the barium column at 1 min after barium swallow was significantly reduced after treatment (11.7 ± 1.2 cm vs 3.2 ± 1.6 cm, P achalasia, which can relieve the symptoms of achalasia by improving esophageal emptying and lowering LES pressure. © 2014 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  9. Percutaneous Transforaminal Endoscopic Discectomy for the Treatment of Lumbar Disc Herniation in Obese Patients: Health-Related Quality of Life Assessment in a 2-Year Follow-Up.

    Science.gov (United States)

    Kapetanakis, Stylianos; Gkantsinikoudis, Nikolaos; Chaniotakis, Constantinos; Charitoudis, Georgios; Givissis, Panagiotis

    2018-05-01

    Percutaneous transforaminal endoscopic discectomy (PTED) is a minimally invasive surgical technique used principally for the treatment of lumbar disc herniation (LDH). LDH is a frequent spinal ailment in obese individuals. The aim of this prospectively designed study was to assess for the first time in the literature the impact of PTED in postoperative parameters of health-related quality of life (HRQoL) in obese patients with LDH within a 2-year follow-up period, to further evaluate the effectiveness of PTED. Patients with surgically treatable LDH were divided into 2 groups. Group A constituted 20 obese patients, and group B was composed of 10 patients with normal body mass index (BMI). A visual analog scale was used for pain evaluation, and the Short Form SF-36 Medical Survey Questionnaire contributed to HRQoL assessment. Follow-up was conducted preoperatively and at 6 weeks and 3, 6, 12, and 24 months postoperatively. Two of the 20 patients (10%) presented with severe postoperative pain, necessitating conventional microdiscectomy. All studied parameters exhibited maximal improvement at 6 months in group A and at 6 weeks in group B, with subsequent stabilization. Obese patients scored lower in all parameters compared with their healthy counterparts with normal BMI, acquiring a less favorable clinical benefit. PTED appears to be a generally safe and effective method for treating obese patients with LDH. However, major technical challenges that lead to a higher frequency of complications, as well as the lesser acquired clinical benefit, in obese patients may contribute to the further consideration for PTED in specific obese patients, especially on the grounds of low surgical experience. Copyright © 2018 Elsevier Inc. All rights reserved.

  10. Mediastinal radiotherapy after multidrug chemotherapy and prophylactic cranial irradiation in patients with SCLC - treatment results after long-term follow-up and literature overview

    International Nuclear Information System (INIS)

    Herrmann, M.K.A.; Bloch, E.; Overbeck, T.; Wolff, H.A.; Hille, A.; Hess, C.F.; Christiansen, H.; Koerber, W.; Vorwerk, H.; Muller, M.; Pradier, O.

    2011-01-01

    Introduction. - Curative therapy for patients with small-cell lung cancer (SCLC) is based on multidrug chemotherapy combinations and radiotherapy. After a long time follow-up, the aim of the study was to evaluate the efficacy and toxicity of sequential chemo-radiotherapy and the effect of prophylactic cranial irradiation (PCI). Methods. - From 1995-2005, 96 patients with SCLC (64 limited-disease [LD], 32 extensive-disease [ED]; median age 61 years [range 39-79]) were treated at our department with varying chemotherapy regimens and sequential mediastinal radiotherapy (50 Gy + 10 Gy boost in case of residual disease after chemotherapy). Afterwards, 15 patients with LD, good general condition and at least partial response after local treatment received PCI (30 Gy). Results. - After a median follow-up of 78.6 months, 20 patients remained alive (20.8%, median survival time 18.2 months). The 2-/5-year overall survival rates were 33.8% and 12.6%, the 2-/5-year loco-regional control rates were 30.3% and 24.5%, respectively. Distant metastases occurred in 43 patients (24 cerebral). Cerebral metastasis occurred in 6.7% and 27.2% of the patients with PCI and without PCI respectively. Only tumor stage showed a statistically significant impact on overall survival and loco-regional control in multivariate analysis. Radiotherapy was well tolerated. Grade 3/4 toxicity occurred in seven patients. Prognosis of patients with SCLC remains poor. Administration of PCI in selected patients bears a decrease in the incidence of cerebral metastases. Alternative chemotherapy schemes as well as irradiation schemes and techniques should be the substance of future randomized trials. (authors)

  11. Noninvasive monopolar capacitive-coupled radiofrequency for the treatment of pain associated with lateral elbow tendinopathies: 1-year follow-up.

    Science.gov (United States)

    Weber, Tobias; Kabelka, Bernd

    2012-03-01

    To evaluate noninvasive monopolar capacitive-coupled radiofrequency (mcRF) for the treatment of pain associated with lateral elbow tendinopathies. Prospective, single-center, single-arm, 1-year follow-up. Private sports medicine practice. Thirty-nine consecutive patients with diagnosis of lateral elbow tendinopathy (including 3 bilateral cases, for a total of 42 elbows) participated in the study. All patients had been unsuccessfully treated with a variety of nonoperative therapies (eg, nonsteroidal anti-inflammatory drugs, corticosteroid injections, and braces) for at least 3 months before they were enrolled in the study. Patients were treated with mcRF technology in the office without local anesthetic or any particular preparation. Anatomic landmarks and careful determination of the most tender point defined the area treated; rapid and precise mcRF pulses were delivered covering the area in a staggered fashion; and 10 additional pulses were delivered directly to the point of maximum tenderness (total of 100 pulses). Patients returned to activities of daily living without restriction and were instructed to avoid nonsteroidal anti-inflammatory drugs and/or ice over the treated area. Physical therapy or other treatment modalities were disallowed. The presence of pain before enrollment ranged from 15 weeks to 2 years (average, 32 weeks). Visual analog scores at rest, with regular activity, and with triggering events were gathered at 3, 6, and 12 months. The Nirschl Tennis Elbow Questionnaire and patient satisfaction also were used to evaluate study outcomes. Follow-up average was 423 days (range, 330-487 days). On the basis of the study's multifactorial success criteria, 81% of participants had successful outcomes. Furthermore, 89% of the patients who completed the study were completely or moderately satisfied with the outcome. Outcomes of this study suggest that noninvasive mcRF may have a role in the treatment of pain associated with lateral elbow tendinopathies

  12. Evaluating PET-CT in routine surveillance and follow-up after treatment for cervical cancer: a cost-effectiveness analysis.

    Science.gov (United States)

    Auguste, P; Barton, P; Meads, C; Davenport, C; Małysiak, S; Kowalska, M; Zapalska, A; Guest, P; Martin-Hirsch, P; Borowiack, E; Khan, K; Sundar, S; Roberts, T

    2014-03-01

    To undertake a cost-effectiveness analysis that compares positron emission tomography - computed tomography (PET-CT) imaging plus standard practice with standard practice alone in the diagnosis of recurrent or persistent cervical cancer during routine surveillance and follow-up of women who have previously been diagnosed and treated. Model-based economic evaluation using data from a systematic review, supplemented with data from other sources, and taking a UK National Health Service (NHS) perspective. Secondary Care in England. Women at least 3 months after the completion of treatment, with either recurrent or persistent cervical cancer. A state transition (Markov) model was developed using TreeAge Pro 2011. The structure of the model was informed by the reviews of the trials and clinical input. In the model, two diagnostic strategies were examined. A one-way sensitivity analysis, probabilistic sensitivity analysis, and a value of information analysis were also carried out. Cost-effectiveness based on incremental cost per quality-adjusted life year (QALY). Adding PET-CT to the current treatment strategy of clinical examination and scanning [magnetic resonance imaging (MRI) and/or CT scan] during the routine surveillance and follow-up of women with recurrent or persistent cervical cancer is significantly more costly, with only a minimal increase in effectiveness. The incremental cost-effectiveness ratio (ICER) for the strategy of PET-CT as an adjunct to the standard treatment strategy that included clinical examination, MRI, and/or CT scan, compared with the usual treatment alone, was over £1 million per QALY. The results of the current analysis suggest that use of PET-CT in the diagnosis of recurrent or persistent cervical cancer is not cost-effective. Current guidelines recommending imaging using PET-CT as a diagnostic or surveillance tool need to be reconsidered in light of these results. This study did not specifically investigate the use of PET-CT in women

  13. Botulinum toxin, a new treatment modality for chronic idiopathic constipation in children: long-term follow-up of a double-blind randomized trial.

    Science.gov (United States)

    Keshtgar, Alireza S; Ward, Harry C; Sanei, Ahmad; Clayden, Graham S

    2007-04-01

    Myectomy of the internal anal sphincter (IAS) has been performed on some children after failure of medical treatment to treat idiopathic constipation. The aim of this study was to compare botulinum toxin injection with myectomy of the IAS in the treatment of chronic idiopathic constipation and soiling in children. This was a double-blind randomized trial. Patients between 4 and 16 years old were included in the study if they had failed to respond to laxative treatment and anal dilatation for chronic idiopathic constipation. All study patients had anorectal manometry and anal endosonography under ketamine anesthesia. Outcome was measured using a validated symptom severity (SS) scoring system, with scores ranging from 0 to 65. Of 42 children, 21 were randomized to the botulinum group and 21 were randomized to the myectomy group. At the 3-month follow-up, the median preoperative SS score improved from 34 (range = 19-47) to 20 (range = 2-43) in the botulinum group (P 41) for the botulinum group and the myectomy group, respectively (P IAS for chronic idiopathic constipation and fecal incontinence in children.

  14. Splenectomy as a curative treatment for immune thrombocytopenia: a retrospective analysis of 233 patients with a minimum follow up of 10 years

    Science.gov (United States)

    Vianelli, Nicola; Palandri, Francesca; Polverelli, Nicola; Stasi, Roberto; Joelsson, Joel; Johansson, Eva; Ruggeri, Marco; Zaja, Francesco; Cantoni, Silvia; Catucci, Angelo Emanuele; Candoni, Anna; Morra, Enrica; Björkholm, Magnus; Baccarani, Michele; Rodeghiero, Francesco

    2013-01-01

    The treatment of choice in steroid-resistant immune thrombocytopenia is still controversial due to the recent advent of new drugs (anti-CD20 antibodies and thrombopoietin mimetics) that have encouraged a generalized tendency to delay splenectomy. Consequently, it is extremely importance to define the efficacy and safety of splenectomy in the long term. We retrospectively analyzed the data of 233 patients affected by immune thrombocytopenia who underwent splenectomy between 1959 and 2001 in 6 European hematologic institutions and who have now a minimum follow up of ten years from surgery. Of the 233 patients, 180 (77%) achieved a complete response and 26 (11%) a response. Sixty-eight of 206 (33%) responsive patients relapsed, mostly (75%) within four years from first response. In 92 patients (39.5%), further treatment was required after splenectomy that was effective in 76 cases (83%). In 138 patients (59%), response was maintained free of any treatment at last contact. No significant association between baseline characteristics and likelihood of stable response was found. Overall, 73 (31%) and 58 (25%) patients experienced at least one infectious or hemorrhagic complication, which was fatal in 2 and 3 patients, respectively. A stable response to splenectomy was associated with a lower rate of infections (P=0.004) and hemorrhages (PSplenectomy achieved a long-term stable response in approximately 60% of cases. Complications mainly affected non-responding patients and were fatal in a minority. PMID:23144195

  15. Do retreatment tuberculosis patients need special treatment response follow-up beyond the standard regimen? Finding of five-year retrospective study in pastoralist setting.

    Science.gov (United States)

    Getnet, Fentabil; Sileshi, Henok; Seifu, Wubareg; Yirga, Selam; Alemu, Abere Shiferaw

    2017-12-12

    execute DOTS should be strengthened and special follow-up mechanism should be in place to monitor treatment response of retreatment cases.

  16. The influence of computertomography on treatment strategies and follow-up in tumors of the nasopharynx and the paranasal sinuses. A retrospective study on 104 patients

    International Nuclear Information System (INIS)

    Reisner, K.; Uhlig, U.

    1996-01-01

    We performed a retrospective study on 104 treated patients with malignant tumors of the nasopharynx (n=54) and the paranasal sinuses (n=50). Tumors of the nasopharynx: The value of CT for tumor staging was 76% but there was no influence on treatment decision. Radiotherapy planning was influenced in 37% of cases, CT for follow-up was done in 22% of cases. Most relapses occurred within the first 2 years. Paranasal sinus tumors: There was no influence of CT on primary diagnosis of the tumor. Tumor staging was influenced by CT in 94%, treatment decision in 44% and radiotherapy planning in 60%. CT-control immediately after therapy was of value in 40%. The re-treatment of recurrences detected by CT showed poor results. Late recurrences seem to have better prognosis. We recommend therefore routinely 1 basic CT 6 months after primary treatment followed by 1 CT yearly from the 3rd to 5th year. MRT might offer more diagnostic details than CT. However, at present therapy is not influenced much by this. Since CT is cheaper and faster, MRT could be discussed as additional procedure when CT presents equivocal findings and this fact could be decisive for therapy planning. Paranasal sinus tumors: The influence of CT on tumor-staging and treatment decision is high and convincing. CT helps also at radiotherapy planning and control of tumor response after therapy. CT has high value in detecting recurrences. Re-treatment could control disease in some of our patients for 3 to 9 years. Better results could be achieved possibly with earlier diagnosis of recurrence. (orig./MG) [de

  17. Avaliação e acompanhamento audiológico após meningite bacteriana Audiological assessment and follow-up post bacterial meningitis

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    MARIA INÊS VIEIRA COUTO

    1999-09-01

    Full Text Available A deficiência auditiva é uma das sequelas da meningite bacteriana que ocorre com maior frequência em crianças. Este estudo descreve o perfil audiológico (periférico e central de crianças internadas com diagnóstico de meningite bacteriana. Nas 89 crianças que compareceram ao seguimento audiológico após a alta hospitalar e foram submetidas aos testes audiológicos, os resultados evidenciaram que 85,4% apresentaram acuidade auditiva normal em ambas orelhas, 10,1% apresentaram deficiência auditiva neurossensorial bilateral e 4,5% apresentaram deficiência auditiva neurossensorial unilateral. Nos testes que avaliaram as habilidades de processamento auditivo, os resultados mostraram que 10% dessas crianças apresentaram alteração no desempenho de localização auditiva e de reconhecimento de sentenças com mensagem competitiva ipsilateral.Hearing loss is the more frequent sequel of bacterial meningitis in children. This study describes the audiological profile (peripheric and central of 89 children admitted to the hospital wards with the diagnosis of bacterial meningitis. Those children attended audiological follow up, after their hospital descharge, and were submitted to audiological tests. The results showed that 85.4% among them presented normal hearing in both ears 10.1% presented bilateral neurosensorial hearing loss and 4.5% presented unilateral neurosensorial hearing loss. The results from the auditory processing skills assessment showed that 10% of those children presented auditory localization and recognition of sentences with competitive messages (Paediatric Sentences Identification - ipsilateral disorders.

  18. Prognostic factors and outcome of treatment in Perthes' disease: a prospective study of 368 patients with five-year follow-up.

    Science.gov (United States)

    Wiig, O; Terjesen, T; Svenningsen, S

    2008-10-01

    This nationwide prospective study was designed to determine prognostic factors and evaluate the outcome of different treatments of Perthes' disease. A total of 28 hospitals in Norway were instructed to report all new cases of Perthes' disease over a period of five years and 425 patients were reported and followed for five years. Of these, 368 with unilateral disease were included in the present study. The hips were classified radiologically according to a modified two-group Catterall classification and the lateral pillar classification. A total of 358 patients (97%) attended the five-year follow-up, when a modified three-group Stulberg classification was used as a radiological outcome measure. For patients over six years of age at diagnosis and with more than 50% necrosis of the femoral head (152 patients), the surgeons at the different hospitals had chosen one of three methods of treatment: physiotherapy (55 patients), the Scottish Rite abduction orthosis (26), and proximal femoral varus osteotomy (71). Of these hips, 146 (96%) were available for the five-year follow-up. The strongest predictor of outcome was femoral head involvement of more or less than 50% (odds ratio (OR) = 7.76, 95% confidence interval (CI) 2.82 to 21.37), followed by age at diagnosis (OR = 0.98, 95% CI 0.92 to 0.99) and the lateral pillar classification (OR = 0.62, 95% CI 0.40 to 0.98). In children over six years at diagnosis with more than 50% of femoral head necrosis, proximal femoral varus osteotomy gave a significantly better outcome than orthosis (p = 0.001) or physiotherapy (p = 0.001). There was no significant difference between the physiotherapy and orthosis groups (p = 0.36), and we found no difference in outcome after any of the treatments in children under six years (p = 0.73). We recommend proximal femoral varus osteotomy in children aged six years and over at the time of diagnosis with hips having more than 50% femoral head necrosis. The abduction orthosis should be abandoned in

  19. Long-term follow-up with Granulocyte and Monocyte Apheresis re-treatment in patients with chronically active inflammatory bowel disease

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    Karlsson Mats

    2010-07-01

    Full Text Available Abstract Background Patients with IBD and chronic inflammation refractory to conventional therapy often demonstrate higher risk of serious complications. Combinations of immunosuppression and biological treatment as well as surgical intervention are often used in this patient group. Hence, there is need for additional treatment options. In this observational study, focused on re-treatment and long-term results, Granulocyte/Monocyte Adsorption (GMA, Adacolumn® treatment has been investigated to study efficacy, safety and quality of life in IBD-patients with chronic activity. Methods Fifteen patients with ulcerative colitis and 25 patients with Crohn's disease, both groups with chronically active inflammation refractory to conventional medication were included in this observational study. The patients received 5-10 GMA sessions, and the clinical activity was assessed at baseline, after each completed course, and at week 10 and 20 by disease activity index, endoscopy and quality of life evaluation. Relapsed patients were re-treated by GMA in this follow-up study up to 58 months. Results Clinical response was seen in 85% and complete remission in 65% of the patients. Ten patients in the UC-group (66% and 16 patients in the CD-group (64% maintained clinical and endoscopic remission for an average of 14 months. Fourteen patients who relapsed after showing initial remission were re-treated with GMA and 13 (93% went into a second remission. Following further relapses, all of seven patients were successfully re-treated for the third time, all of three patients for the fourth time and one for a fifth time. Conclusions IBD-patients with chronic inflammation despite conventional therapy seem to benefit from GMA. Re-treatment of relapsing remission patients seems to be effective.

  20. Thoracic Malignancies and Pulmonary Nodules in Patients under Evaluation for Transcatheter Aortic Valve Implantation (TAVI): Incidence, Follow Up and Possible Impact on Treatment Decision

    Science.gov (United States)

    Kaleschke, Gerrit; Schülke, Christoph; Görlich, Dennis; Schliemann, Christoph; Kessler, Torsten; Schulze, Arik Bernard; Buerke, Boris; Kuemmel, Andreas; Thrull, Michael; Wiewrodt, Rainer; Baumgartner, Helmut; Berdel, Wolfgang E.; Mohr, Michael

    2016-01-01

    Background Transcatheter aortic valve implantation (TAVI) has become the treatment of choice in patients with severe aortic valve stenosis who are not eligible for operative replacement and an alternative for those with high surgical risk. Due to high age and smoking history in a high proportion of TAVI patients, suspicious findings are frequently observed in pre-procedural chest computer tomography (CCT). Methods CCT scans of 484 consecutive patients undergoing TAVI were evaluated for incidentally discovered solitary pulmonary nodules (SPN). Results In the entire study population, SPN ≥ 5 mm were found in 87 patients (18%). These patients were compared to 150 patients who were incidentally collected from the 397 patients without SPN or with SPN 8 mm (p = 0.328) were significant predictors of overall survival. Conclusions Despite the high prevalence of SPNs in this single center TAVI cohort lung cancer incidence at midterm follow-up seems to be low. Thus, aggressive diagnostic approaches for incidentally discovered SPN during TAVI evaluation should not delay the treatment of aortic stenosis. Unless advanced thoracic malignancy is obvious, the well documented reduction of morbidity and mortality by TAVI outweighs potentially harmful delays regarding further diagnostics. Standard guideline-approved procedure for SPN can be safely performed after TAVI. PMID:27171441

  1. Kerathocyst odontogenic tumor: Importance of selection the best treatment modality and a periodical follow-up to prevent from recurrence: A case report and literature review

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    Nasim Jafaripozve

    2013-01-01

    Full Text Available The keratocystic odontogenic tumor (KCOT is a relatively common oral and maxillofacial lesion with specific characteristics such us rapid growth, extension into the surrounding tissues and high rates of recurrence. Various treatment modalities have been reported. Due to the very thin and friable lining characteristic of the tumor, enucleation can be difficult undertaken and for this reason it is associated with the highest recurrence rates. A 22-year-old male referred to our clinic due to a slight expansion in the right mandible from 2 years ago. He has a history of occurrence of KCOT in this region that was treated surgically by enucleation and curettage 5 years ago. Cone beam computed tomography showed a multilocular radiolucent lesion that extended from the angle of the mandible to the symphysis. Incisional biopsy showed a KCOT recurrence that surgically treated with resection of the right mandible by continuity preservation. Selection of the best treatment modality and also a periodical lifelong follow-up is very important to reduce the rate of recurrence and morbidity of the patient.

  2. Higher percentage of in vitro apoptotic cells at time of diagnosis in patients with chronic lymphocytic leukemia indicate earlier treatment requirement: Ten years follow up

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    Kravić-Stevović Tamara

    2014-01-01

    Full Text Available Introduction. Chronic lymphocytic leukemia (CLL has an extremely variable clinical course. Biological reasons for that wide variation in clinical course and survival rates in CLL patients are not fully understood. Objective. The aim of the study was to evaluate the value of spontaneous apoptosis of CLL cells in vitro determined at presentation of disease, in prediction of treatment requirements and evolution of the CLL. Methods. Malignant B cells were isolated from the whole blood of 30 newly diagnosed CLL patients and cultured for 24 hours in RPMI-1640 medium supplemented with 10% of serum obtained from the same CLL patient. Cells were later fixed and processed for embedding in Epon, or cell smears were prepared and stained with TUNEL technique. Results. Ten-year follow-up revealed that patients with lower percentage of cells in apoptosis at presentation of disease had significant longer time treatment initiation (log rank test p0.05. Conclusion. The results of this study emphasize the importance of apoptosis of CLL cells at the time of the initial diagnosis in pathobiology of this disease. [Projekat Ministarstva nauke Republike Srbije, br. 41025

  3. Single Sitting Surgical Treatment of Generalized Aggressive Periodontitis Using GTR Technique and Immediate Implant Placement with 10-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Fatme Mouchref Hamasni

    2018-01-01

    Full Text Available This case report exhibits a patient with generalized aggressive periodontitis who has been under maintenance for the past 12 years after being surgically treated in a single sitting and restored with dental implants. A 41-year-old systemically healthy male patient presented complaining of lower anterior teeth mobility and pain in the upper right quadrant. After clinical and radiographic examination, the upper right molars and lower anterior incisors were deemed unrestorable. Covered by doxycycline, the patient received a nonsurgical periodontal treatment. Three weeks later, teeth extraction, immediate implant placement, immediate nonloading provisional prosthesis, and a guided tissue regeneration were performed at indicated areas in a single sitting. The clinical decisions were based on patient compliance, the status of the existing periodontal tissues, and the prognosis of the remaining teeth. During the 12-year follow-up period, no residual pockets were observed and there was no exacerbation of the inflammatory condition. Marginal bone stability is present on all implants. For aggressive periodontal disease, a high risk of relapse as well as limited success and survival of dental implants should be considered. This case shows proper containment of the disease based on appropriate treatment planning and a strict maintenance program.

  4. [Value of quantitative iodine-based material decomposition images with gemstone spectral CT imaging in the follow-up of patients with hepatocellular carcinoma after TACE treatment].

    Science.gov (United States)

    Xing, Gusheng; Wang, Shuang; Li, Chenrui; Zhao, Xinming; Zhou, Chunwu

    2015-03-01

    To investigate the value of quantitative iodine-based material decomposition images with gemstone spectral CT imaging in the follow-up of patients with hepatocellular carcinoma (HCC) after transcatheter arterial chemoebolization (TACE). Consecutive 32 HCC patients with previous TACE treatment were included in this study. For the follow-up, arterial phase (AP) and venous phase (VP) dual-phase CT scans were performed with a single-source dual-energy CT scanner (Discovery CT 750HD, GE Healthcare). Iodine concentrations were derived from iodine-based material-decomposition images in the liver parenchyma, tumors and coagulation necrosis (CN) areas. The iodine concentration difference (ICD) between the arterial-phase (AP) and venal-phase (VP) were quantitatively evaluated in different tissues.The lesion-to-normal parenchyma iodine concentration ratio (LNR) was calculated. ROC analysis was performed for the qualitative evaluation, and the area under ROC (Az) was calculated to represent the diagnostic ability of ICD and LNR. In all the 32 HCC patients, the region of interesting (ROI) for iodine concentrations included liver parenchyma (n=42), tumors (n=28) and coagulation necrosis (n=24). During the AP the iodine concentration of CNs (median value 0.088 µg/mm(3)) appeared significantly higher than that of the tumors (0.064 µg/mm(3), P=0.022) and liver parenchyma (0.048 µg/mm(3), P=0.005). But it showed no significant difference between liver parenchyma and tumors (P=0.454). During the VP the iodine concentration in hepatic parenchyma (median value 0.181 µg/mm(3)) was significantly higher than that in CNs (0.140 µg/mm(3), P=0.042). There was no significant difference between liver parenchyma and tumors, CNs and tumors (both P>0.05). The median value of ICD in CNs was 0.006 µg/mm(3), significantly lower than that of the HCC (0.201 µg/mm(3), Piodine-based material decomposition images with gemstone spectral CT imaging can improve the diagnostic efficacy of CT imaging

  5. Implication of Integrative Treatment Strategies for Real-Life Geriatric Patients with Multiple, Chronic Illnesses: A 60-Month Follow-Up of a Naturalistic Study

    Directory of Open Access Journals (Sweden)

    Gjumrakch Aliev

    2015-03-01

    Full Text Available Neurodegeneration [Stroke and Alzheimer disease (AD] is fastly becoming one of the leading causes of age-associated disability, dementia, and death. In addition, the Centers for Disease Control and Prevention (CDC and the National Center for Health Statistics recently reported that AD has surpassed diabetes as a leading cause of death and is now considered the sixth-leading cause of death in the United States. Unfortunately, currently no effective treatments are available against this devastating disease. In the past we have shown the preservation and improvement of cognitive tasks in depressed and demented patients after 24 and 36 months of combined pharmacological and non- pharmacological treatment. Here we present the results of our ongoing, naturalistic study, in the same outpatient setting, at the 60 month follow up. The study group consisted of 156 medically ill, physically-disabled patients with mild to moderate dementia and depression. Patients were treated with antidepressants, cholinesterase inhibitors, and NMDA antagonists, along with their regular medication regimen. Non-pharmacological intervention was centered on a home-based program of physical and cognitive exercises as well as with vitamins and supplements (multivitamins, vitamin E, L-methylfolate, alpha-lipoic acid, acetyl-l-carnitine, omega-3, and coenzyme Q-10 and diet modification. Cognitive assessments were performed yearly. After 60 months of treatment, performance of all tasks remained at or above baseline. The MMSE, Cognistat–Attention, Cognistat–Judgment, and RFFT - Total Unique Designs demonstrated significant improvement. Our results, for the first time, demonstrate arrest in cognitive decline in demented/depressed patients with multiple medical co-morbidities for 60 months. Future investigations addressing the application of a combined, integrative treatment models in clinical practices are warranted.

  6. Long-term Follow-up of Treatment with Ibrutinib and Rituximab in Patients with High-Risk Chronic Lymphocytic Leukemia.

    Science.gov (United States)

    Jain, Preetesh; Keating, Michael J; Wierda, William G; Sivina, Mariela; Thompson, Philip A; Ferrajoli, Alessandra; Estrov, Zeev; Kantarjian, Hagop; O'Brien, Susan; Burger, Jan A

    2017-05-01

    Background: Ibrutinib is an active therapy with an acceptable safety profile for patients with chronic lymphocytic leukemia (CLL), including high-risk patients with del17p or with TP53 mutations. Ibrutinib is broadly indicated for the treatment of patients with CLL and specifically including those with 17p deletion. The optimal use of ibrutinib in combination with other agents remains controversial. Experimental Design: We report the long-term outcome [median follow-up of 47 months (range, 36-51 months)] of 40 patients with high-risk CLL, treated on the first ibrutinib combination trial with rituximab (IR). The majority of patients (36/40) were previously treated. Results: Median age was 65 years, and 21 patients (52%) had 17p deletion. Median duration on treatment was 41 months (range, 2-51 months), and median number of treatment cycles was 42 (range, 2-49). Overall response rate was 95%, and 9 patients (23%) attained a complete remission. Twenty-one patients discontinued treatment, 10 due to disease progression, 9 for other causes, and 2 due to stem cell transplantation; the remaining 19 patients continue on ibrutinib. Median progression-free survival for all patients was 45 months, which was significantly shorter in the subgroup of patients with del17p ( n = 21, 32.3 months, P = 0.02). Fourteen patients (35%) died, five from progressive disease, five from infections, and four from other causes. Median overall survival has not been reached. Conclusions: IR combination therapy leads to durable remissions in high-risk CLL; the possible benefit from the addition of rituximab is currently explored in a randomized trial. Clin Cancer Res; 23(9); 2154-8. ©2016 AACR . ©2016 American Association for Cancer Research.

  7. Epidemiology, Treatment Efficacy, and Anxiety Aspects of Music Students Affected by Playing-Related Pain: A Retrospective Evaluation with Follow-up.

    Science.gov (United States)

    Ioannou, Christos I; Hafer, Julia; Lee, André; Altenmüller, Eckart

    2018-03-01

    Playing-related pain (PRP) is a common problem among music students. We retrospectively assessed epidemiological factors that contributed to the manifestation of PRP and evaluated the efficacy of treatment methods used by affected music students. The long-term course of PRP symptoms was also examined, along with current (today) levels of trait anxieties. Demographic and epidemiological data of 186 music students who visited the musicians' outpatient clinic over a 5-year period were retrieved. Of these students, 122 had been diagnosed with PRP and were invited to participate (response rate 61.5%) in a follow-up online survey to: a) estimate the long-term course of their PRP symptoms, b) assess the efficacy of treatment methods they used, and c) assess their current trait anxiety (general and performance-related) using two standardized psychodiagnostic questionnaires. Two-thirds of music students who sought medical care were affected by PRP, with most being affected during their first year of studies, and with 69% having acute rather than chronic pain. The sudden increase in practice time was the main triggering factor for PRP (but not for non-PRP-related problems). Concerning the course of PRP, almost all students recovered or improved significantly. Students reported that "active" treatment methods (e.g., physical activities) were more effective than "passive" methods (e.g., oral medications). Psychodiagnostic questionnaires indicated that about 40% of PRP-affected students currently had increased levels of trait anxieties (music and non-music related), possibly warranting further medical assistance. PRP in music students occurs mainly at the beginning of their studies and has a good prognosis, although recovery may be lengthy. It is necessary to provide students with early information about PRP and about the multidimensional treatment framework that allows for individualized care of PRP in affected music students.

  8. Short- to mid-term follow-up effectiveness of US-guided focal extracorporeal shock wave therapy in the treatment of elbow lateral epicondylitis.

    Science.gov (United States)

    Trentini, R; Mangano, T; Repetto, I; Cerruti, P; Kuqi, E; Trompetto, C; Franchin, F

    2015-09-01

    Lateral epicondylitis of the elbow is a common and disabling overuse syndrome. Several treatment modalities are currently available for this condition, but the optimal treatment method remains undefined. Extracorporeal shock wave therapy (ESWT) has been widely used in the last 10 years, although conflicting results are present in the literature. In this study, we evaluated 36 patients (37 elbows), with a mean follow-up time of 24.8 months. Focal ESWT was administered by means of an electromagnetic generator equipped with in-line ultrasound guidance, during one or more cycles of 3-4 weekly sessions. In the setting of the study, patients were clinically evaluated and subjective satisfaction and rate of relapse were investigated. A positive response was described in 75.7 % of the patients after treatment. Mean quickDASH score and VAS attested at 5.5 and 1.1, respectively. Roles and Maudsley score was rated as I or II in 33 cases. Four patients resulted not responders to the therapy, while 5 patients complained one or more episodes of symptoms relapse. No influence on the final outcome was evident with respect to demographic features and previous therapies as well. Response rate to further ESWT cycles in patients refractory to the first cycle of ESWT was 33.3 %. Focal ESWT represents a valuable and safe solution in case of elbow lateral epicondylitis, both in newly diagnosed and previously treated cases, representing a definitive treatment in the majority of patients. Patients refractory to a 3- to 4-session ESWT cycle have lower chances of positive response after further ESWT cycles.

  9. Bridging the osteoarthritis treatment gap with the KineSpring Knee Implant System: early evidence in 100 patients with 1-year minimum follow-up

    Directory of Open Access Journals (Sweden)

    London NJ

    2013-09-01

    Full Text Available Nicholas J London,1 Jon Smith,2 Larry E Miller,3,4 Jon E Block4 1Department of Orthopaedic Surgery, Harrogate District Foundation Trust, Harrogate, UK; 2The Mid Yorkshire Hospitals NHS Trust, Yorkshire, UK; 3Miller Scientific Consulting, Arden, NC, USA; 4The Jon Block Group, San Francisco, CA, USA Abstract: Almost 4 million Americans are within the knee osteoarthritis (OA treatment gap, the period from unsuccessful exhaustion of conservative treatment to major surgical intervention. New treatment alternatives for symptomatic knee OA are greatly needed. The purpose of this report was to assess outcomes of a joint-unloading implant (KineSpring® Knee Implant System in patients with symptomatic medial knee OA. A total of 100 patients enrolled in three clinical trials were treated with the KineSpring System and followed for a minimum of 1 year. All devices were successfully implanted and activated, with no operative complications. Knee pain severity improved 60% (P < 0.001 at 1 year, with 76% of patients reporting a minimum 30% improvement in pain severity. All Western Ontario and McMaster Universities Arthritis Index (WOMAC subscores significantly improved at 1 year, with a 56% improvement in pain, 57% improvement in function, and a 39% improvement in stiffness (all P < 0.001. The percentage of patients experiencing a minimum 20% improvement in WOMAC subscores was 74% for pain, 83% for function, and 67% for stiffness. During follow-up, six (6% patients required additional surgery, including four total knee arthroplasties and two high tibial osteotomies. The KineSpring System effectively bridges the treatment gap between failed conservative care and surgical joint-modifying procedures. Keywords: implant, KineSpring, knee, medial, osteoarthritis, unloading

  10. Effect of a low glycaemic index diet in gestational diabetes mellitus on post-natal outcomes after 3 months of birth: a pilot follow-up study.

    Science.gov (United States)

    Louie, Jimmy Chun Yu; Markovic, Tania P; Ross, Glynis P; Foote, Deborah; Brand-Miller, Jennie C

    2015-07-01

    A low glycaemic index (LGI) diet during pregnancy complicated by gestational diabetes mellitus (GDM) may offer benefits to the mother and infant pair beyond those during pregnancy. We aimed to investigate the effect of an LGI diet during pregnancy complicated with GDM on early post-natal outcomes. Fifty-eight women (age: 23-41 years; mean ± SD pre-pregnancy body mass index: 24.5 ± 5.6 kg m(-2) ) who had GDM and followed either an LGI diet (n = 33) or a conventional high-fibre diet (HF; n = 25) during pregnancy had a 75-g oral glucose tolerance test and blood lipid tests at 3 months post-partum. Anthropometric assessments were conducted for 55 mother-infant pairs. The glycaemic index of the antenatal diets differed modestly (mean ± SD: 46.8 ± 5.4 vs. 52.4 ± 4.4; P diet during pregnancy complicated by GDM has outcomes similar to those of a conventional healthy diet. Adequately powered studies should explore the potential beneficial effects of LGI diet on risk factors for chronic disease. © 2013 John Wiley & Sons Ltd.

  11. Real versus virtual phenotype to guide treatment in heavily pretreated patients: 48-week follow-up of the Genotipo-Fenotipo di Resistenza (GenPheRex) trial.

    Science.gov (United States)

    Mazzotta, Francesco; Lo Caputo, Sergio; Torti, Carlo; Tinelli, Carmine; Pierotti, Piera; Castelli, Francesco; Lazzarin, Adriano; Angarano, Gioacchino; Maserati, Renato; Gianotti, Nicola; Ladisa, Nicoletta; Quiros-Roldan, Eugenia; Rinehart, Alex R; Carosi, Giampiero

    2003-03-01

    We compared viroimmunologic response after real phenotype (r-PHT) versus virtual phenotype (v-PHT) in patients failing highly active antiretroviral therapy (HAART). A total of 201 patients with >2 years of exposure, more than six experienced drugs, >1000 HIV RNA copies/mL, and on stable HAART for >6 months were randomized to the r-PHT or v-PHT arm. The primary end point was the proportion of HIV plasma viral load (pVL) 0.5 log(10) copies/mL, and absolute CD4 cell change. In the intention-to-treat-last observation carried forward analysis, study outcomes were not significantly different between arms over 48 weeks of follow-up: 20% and 24% pVL 0.5 log(10) copies/mL; -0.92 and -0.94(10) log copies/mL mean pVL decrease; and +41.6 and +94.4 cells/mm(3) mean absolute CD4 increase in the r-PHT and v-PHT arms, respectively. On-treatment analyses gave similar results. In the multivariate analysis of pVL <400 copies/mL, the following covariates were independent predictors at week 48: adherence (OR p= 0.25; p=.002), baseline CD4 (OR = 4.39; p=.007), intravenous drug use as risk factor for HIV acquisition (OR = 0.33; p=.024), and sensitivity score of the new regimens by biologic cut-offs (OR = 1.84; p=.029). Prescribed drugs for which patients were naive resulted in marginal prediction (OR = 1.93; p=.054). In conclusion, virologic and immunologic outcomes did not differ when r-PHT or v-PHT was used in this cohort of heavily pretreated patients. Several factors should be considered to take better advantage of resistance testing, including treatment history, clinical status, and patients' ability to adhere to treatment.

  12. A 6-year follow-up of a randomized prospective trial comparing methimazole treatment with or without exogenous L-thyroxine in Chinese patients with Graves' disease.

    Science.gov (United States)

    Liu, X; Qiang, W; Liu, X; Liu, L; Liu, S; Gao, A; Gao, S; Shi, B

    2014-11-01

    Antithyroid drug therapy is one of the main medical treatments for Graves' disease. There have been conflicting reports as to whether the addition of exogenous L-thyroxine improves remission rates more than antithyroid drugs alone. This randomized, controlled and prospective clinical trial was undertaken to investigate the long-term outcome of methimazole treatment with or without exogenous L-thyroxine in Chinese patients. 145 patients with Graves' disease were randomly divided into 3 groups and all patients initially received 30 mg of methimazole daily for at least 1 month and then followed the titration -regimen with or without L-thyroxine: group 1 (30 mg→20 mg→15 mg→10 mg→5 mg); group 2 (30 mg→20 mg→15 mg→10 mg+L-thyroxine→5 mg+L-thyroxine); group 3 (30 mg→20 mg→15 mg→10 mg+L-thyroxine→5 mg+L-thyroxine→2.5 mg+L-thyroxine). The drug therapy was discontinued after 5 months of the final dose. 16 out of 46 patients in group 1 (34.8%), 12 out of 47 in group 2 (25.5%) and 16 out of 52 in group 3 (30.8%) had a recurrence of Graves' disease within 6-year follow-up after drug withdrawal. Survival Analysis showed no significant differences in the remission rates between any 2 groups, despite the remission rates in group 2 and 3 were slightly higher than that in group 1. The addition of L-thyroxine to methimazole treatment in patients with Graves' disease neither improves nor prevents the remission or recurrence of Graves' disease in China. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

  13. A 10-year follow-up study of completers versus dropouts following treatment with an integrated cognitive-behavioral group therapy for eating disorders.

    Science.gov (United States)

    Okamoto, Yuri; Miyake, Yoshie; Nagasawa, Ichie; Shishida, Kazuhiro

    2017-01-01

    Cognitive-behavioral therapy (CBT) has been recommended for the treatment of eating disorders, and group therapy is known to have certain advantages over individual therapy. The aim of the current study was to compare the 10-year prognosis of patients who completed integrated group CBT with those who dropped out and to examine the effect of completion of group CBT on the prognosis. The participants were 65 adult patients with eating disorders. All patients were women and Japanese. The average age (19-37) of the patients was 25.1 ± 3.8 years, and the average body mass index (BMI) was 17.7 ± 2.0. We conducted integrated group CBT with the patients and compared eating disorder symptoms, mood states, coping styles, and self-esteem before and after therapy. Furthermore, we compared clinical features and the 10-year prognosis of patients who completed the treatment and those who dropped out. After 10 sessions of group therapy, Eating Attitudes Test scores, Profile of Mood States depression scores, and Coping Inventory for Stressful Situations emotion-oriented scores decreased, while Rosenberg's Self-Esteem Scale scores increased. Regarding the results of the 10-year follow up, the completer group had more patients with a good prognosis. In contrast, the dropout group had more patients with a poor prognosis. Those who completed the integrated group CBT had a good prognosis. Group therapy gives the patients an opportunity to form peer relationships, and helps them to develop communication and socialization skills. Furthermore, in the group therapy sessions, the patients develop self-awareness by listening to other members of the group and they also develop interpersonal relationships. This effect may be temporary, but experience of group therapy may provide hope for the patient and increase the chance of the patient continuing treatment. Retrospectively registered in University Hospital Medical Information Network in Japan: No. 000028868 (May 19th, 2017).

  14. The experience of patients with early-stage testicular cancer during the transition from active treatment to follow-up surveillance.

    Science.gov (United States)

    Shen, Abra H; Howell, Doris; Edwards, Elizabeth; Warde, Padraig; Matthew, Andrew; Jones, Jennifer M

    2016-04-01

    To gain a better understanding of the experiences of patients with early-stage testicular cancer during the transition from active cancer treatment to follow-up care. Cross-sectional multimethod study (questionnaires, focus groups, and telephone interviews) to describe experiences of patients with testicular cancer transitioning to survivorship. Questionnaire package included standardized measures of survivorship knowledge, feeling of preparedness, health-related distress, and perspectives on care coordination. Standard descriptive statistics and Mann-Whitney tests to examine associations between all outcomes based on demographic and clinical variables were performed. Qualitative results (focus groups and interviews) were analyzed with qualitative content analysis. Based on quantitative data (n = 90) and qualitative analyses (n = 13), participants had relatively high survivorship knowledge, most testicular cancer survivors were not provided with any formal transition planning or documentation, and a substantial minority felt unprepared to cope with the aftereffects of testicular cancer and the posttreatment survivorship phase. Younger men had lower survivorship knowledge, feelings of preparedness, and continuity of care scores and were less likely to report having received any self-management tools and education or information of patient resources. Participants reported that they did not know what to expect physically or emotionally after treatment ended and many continued to be frustrated and worried about their health problems. They expressed the need for reliable and personalized resources on what to expect after treatment and more formal transition care planning. Patients with testicular cancer continue to struggle in their transition to posttreatment survivorship. Quality of care must emphasize a shift from a purely disease-focused approach to a wellness-centered approach that provides coordinated, patient-centered, and comprehensive care to optimize quality

  15. [Effectiveness of dialectical behavior therapy for patients with borderline personality disorder in the long-term course--a 30-month-follow-up after inpatient treatment].

    Science.gov (United States)

    Fassbinder, Eva; Rudolf, Sebastian; Bussiek, Anke; Kröger, Christoph; Arnold, Rüdiger; Greggersen, Wiebke; Hüppe, Michael; Sipos, Valerija; Schweiger, Ulrich

    2007-01-01

    The beneficial effects of Dialectical Behavior Therapy (DBT) for patients with borderline personality disorder (BPD) are well established. However, it is not well known whether this type of treatment relieves symptoms and signs of BPD in the long-term course thereafter and whether the results of DBT are transferable for patients with high comorbidity. We conducted a follow-up examination of 50 consecutive inpatients with BPD as defined by DSM-IV. The patients were examined at admission, at discharge and 15 and 30 months after discharge. For the clinical diagnosis and to survey psychopathology we used the Structured Clinical Interview for DSM-IV (SCID), the Global Assessment of Functioning (GAF) and several self-rating-instruments. Compared to admission 30 months after discharge we observed the following results: A significant number of patients did not meet the DSM-IV criteria for BPD anymore, comorbidity (particularly mood disorders, drug or alcohol abuse/dependence and eating disorders) was reduced, psychosocial functioning was improved and general and BPD-typical symptoms were relieved. Our findings support the efficacy of DBT in an inpatient setting and show that the achieved success of therapy is stable for a prolonged period of time. Patients with high comorbidity seem to profit from DBT as well.

  16. Implementation and operational research: evaluating outcomes of patients lost to follow-up in a large comprehensive care treatment program in western Kenya.

    Science.gov (United States)

    Rachlis, Beth; Ochieng, Daniel; Geng, Elvin; Rotich, Elyne; Ochieng, Vincent; Maritim, Beryl; Ndege, Samson; Naanyu, Violet; Martin, Jeffrey N; Keter, Alfred; Ayuo, Paul; Diero, Lameck; Nyambura, Monicah; Braitstein, Paula

    2015-04-01

    Academic Model Providing Access To Healthcare (AMPATH) program provides comprehensive HIV care and treatment services. Approximately, 30% of patients have become lost to follow-up (LTFU). We sought to actively trace and identify outcomes for a sample of these patients. LTFU was defined as missing a scheduled visit by ≥3 months. A randomly selected sample of 17% of patients identified as LTFU between January 2009 and June 2011 was generated, with sample stratification on age, antiretroviral therapy (ART) status at last visit, and facility. Chart reviews were conducted followed by active tracing. Tracing was completed by trained HIV-positive outreach workers July 2011 to February 2012. Outcomes were compared between adults and children and by ART status. Of 14,811 LTFU patients, 2540 were randomly selected for tracing (2179 adults, 1071 on ART). The chart reviews indicated that 326 (12.8%) patients were not actually LTFU. Outcomes for 71% of sampled patients were determined including 85% of those physically traced. Of those with known outcomes, 21% had died, whereas 29% had disengaged from care for various reasons. The remaining patients had moved away (n = 458, 25%) or were still receiving HIV care (n = 443 total, 25%). Our findings demonstrate the feasibility of a large-scale sampling-based approach. A significant proportion of patients were found not to be LTFU, and further, high numbers of patients who were LTFU could not be located. Over a quarter of patients disengaged from care for various reasons including access challenges and familial influences.

  17. Comparison of polypropylene and silicone Ahmed® glaucoma valves in the treatment of neovascular glaucoma: A 2-year follow-up.

    Science.gov (United States)

    Lubiński, Wojciech; Krzystolik, Karol; Gosławski, Wojciech; Kuprjanowicz, Leszek; Mularczyk, Maciej

    2018-01-01

    Inflammation associated with biomaterials of Ahmed® glaucoma drainage devices may cause the formation of a capsule around the device and can thus have a significant influence on the level of intraocular pressure reduction. The objective of this study was to compare the clinical outcomes after the implantation of a polypropylene or silicone Ahmed® glaucoma valve in patients with neovascular glaucoma. In the study, 27 eyes with neovascular glaucoma (group 1) received silicon Ahmed® valves and 23 eyes (group 2) received polypropylene valves. The best corrected distance visual acuity (BCDVA), intraocular pressure (IOP) and number of anti-glaucomatous drugs were recorded preoperatively and during a follow-up period of 24 months after surgery. Success was defined by the following criteria: 1) intraocular pressure in the rage of 6-21 mm Hg; 2) IOP reduction of at least 30% relative to preoperative values. All complications were registered. One month postoperatively, the mean BCDVA increased significantly in both groups compared to preoperative values (p glaucoma, the implantation of a silicone valve is associated with a significantly higher probability of long-term reduction of IOP below 21 mm Hg and with a lower risk of valve encapsulation in comparison to polypropylene valves. The obtained results suggest that silicone Ahmed® valves are more effective in the treatment of patients with neovascular glaucoma.

  18. Comparison of structural outcome between intravitreal bevacizumab and laser treatment for type 1 retinopathy of prematurity after long-term follow-up

    Institute of Scientific and Technical Information of China (English)

    Yen-Yi Chen; Yun-Ju Chen; Yung-Ray Hsu; Fang-Ting Chen; Jia-Kang Wang

    2016-01-01

    Background:To compare the structural outcome of intravitreal bevacizumab (IVB) and laser treatment for type 1 retinopathy of prematurity (ROP). Methods: This is a retrospective comparative study. From December 2002 to April 2009, patients with type 1 ROP according to criteria of Early Treatment of Retinopathy of Prematurity (ETROP) study were treated by peripheral retinal diode laser photocoagulation in nearly confluent pattern. From May 2009 to January 2015, we performed IVB for patients with type 1 ROP. The patients were closely followed until disappearance of retinal neovascularization in the laser group and regression of avascular zone in the bevacizumab group. The demographical data, postmenstrual age (PMA) for treatment, and fundus ifndings were recorded by chart review. The difference between laser and bevacizumab groups was compared by Studentt-test and Fisher exact test. Results: We collected 43 patients (86 eyes) with type 1 ROP, including 30 male and 13 female infants. Their mean gestation age and birth body weight (BBW) were 27.5 weeks and 1,034 gm. Zone I and zone II disease were found in 8 and 35 patients. The mean PMA for treatment was 37.3 weeks. The mean follow-up period was 54.4 months. Laser treatment was administered in 26 patients, and bevacizumab injection for 17 infants. Single session of laser was performed in all patients of laser group without recurrence of retinal neovascularization. Complete regression of ROP was found in 15 infants of bevacizumab group following the ifrst IVB. Four eyes in two patients (2/17, 11.7%) had recurrence of ROP and received additional injections and adjuvant laser treatment. There was no unfavorable anatomical results such as retinal detachment or macular ectopia or complications such as cataract or endophthalmitis in either bevacizumab or laser management. Conclusions: Laser therapy and IVB were both effective treatments for type 1 ROP to cause favorable anatomical outcomes. Single session of laser ablation

  19. [Revival after Ebola: multidisciplinary assessment at 1 year, prospect and follow-up study of surviving patients from Ebola in Guinea (PostEboGui cohort)].

    Science.gov (United States)

    Msellati, P; Touré, A; Sow, M S; Cécé, K; Taverne, B; Desclaux, A; Barry, M; Etard, J-F; Delaporte, E

    2016-10-01

    Ebola virus disease (EVD) epidemic that spread in West Africa from the end of 2013 to early 2016 has reached more people than all past epidemics. Beyond care management of acute phase ill patients and measures for the control of the epidemic, the outcome of Ebola survivors became an important question as their number increased and raised new issues. A multidisciplinary prospective cohort of survivors in Guinea has been launched by IRD UMI 233 and Donka National Hospital, Conakry, Guinea, to assess the long-term clinical, psychological, sociological, immunological, and viral outcomes potentially related to EVD. This paper describes PostEboGui Programme, constraints and changes to the initial proposal, participants, first results, and new issues, 1 year after its start, in a descriptive and critical view. We started also to work on ethical aspects in the context of epidemics and of mass interventions with a risk of overinvestigation of patients.

  20. Comparison of treatment outcomes in severe personality disorder patients with or without substance use disorders: a 36-month prospective pragmatic follow-up study

    Directory of Open Access Journals (Sweden)

    Lana F

    2016-06-01

    psychiatric inpatient admissions, the number of days hospitalized, and the proportion and the number of psychiatric ER visits – improved significantly during the treatment period, and this improvement was maintained throughout the follow-up period. Although PD-SUD patients had more psychiatric hospitalizations and ER visits than PD-nSUD patients during follow-up, the differences between these two groups remained stable over the study period indicating that the treatment was equally effective in both groups.Conclusion: Specialized psychotherapy for severe PD can be effectively applied in patients with concurrent PD-SUD under usual practice conditions. These findings suggest that exclusion of patients with dual disorders from specialized treatments is unjustified. Keywords: personality disorder, substance use disorder, borderline personality disorder, dual disorders, psychotherapy, pragmatic clinical study