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Sample records for six-month follow-up review

  1. The outcome of stroke: A six month follow-up study

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    Kameran Hassan Ismail

    2018-04-01

    Full Text Available Background and objective: Stroke is an increasing problem in developing countries and is the principal cause of disability and dependency in the western world. This study aimed to find out the one- and six-month case fatality, dependency and recurrence rates of stroke in Erbil teaching hospitals. Methods: This hospital-based prospective study included 293 stroke patients hospitalized in Erbil teaching hospitals from January 1st, 2015 through December 31st, 2015. Stroke was diagnosed by a consultant internist or neurologist and confirmed by brain CT-scan and/or MRI. Patients were followed-up for six months, then one- and six-month outcomes were measured including case-fatality, dependency and recurrences rates. Results: The one and six month case fatality rates were 28.3% and 37.5%, respectively. The rates in females (33.3%, 42.6%, respectively were higher than that in males (23.7%, 32.9%, respectively, but there was no significant association between case-fatality rate and gender. A total of 74.3% and 45.4% of patients at one- and six-month were functionally dependent. The majority (88.9% of diabetic patients were functionally dependent. Also, the one and six month recurrence rates of stroke patients were 15.7% and 23.2%, respectively. For both one and six month post stroke more recurrence occurred from ischemic (16.2%, 14.3%, respectively than from hemorrhagic (24.5%, 19.5%, respectively strokes, but there was no significant association between the recurrence and stroke subtype (P = 0.691, P = 0.367, respectively. Conclusion: The reported outcomes are relatively comparable to that reported in other developing countries, although it is still more than the rates of developed countries. Outcome measures can help to give information and develop guidelines for clinical practice and research. Keywords: Stroke; Case fatality; Recurrence; Functional outcome.

  2. The Nottingham Fatigue After Stroke (NotFAST) study: results from follow-up six months after stroke.

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    Hawkins, Louise; Lincoln, Nadina B; Sprigg, Nikola; Ward, Nick S; Mistri, Amit; Tyrrell, Pippa; Worthington, Esme; Drummond, Avril

    2017-12-01

    Background Post-stroke fatigue is common and disabling. Objectives The aim of NotFAST was to examine factors associated with fatigue in stroke survivors without depression, six months after stroke. Methods Participants were recruited from four UK stroke units. Those with high levels of depressive symptoms (score ≥7 on Brief Assessment Schedule Depression Cards) or aphasia were excluded. Follow-up assessment was conducted at six months after stroke. They were assessed on the Fatigue Severity Scale, Rivermead Mobility Index, Nottingham Extended Activities of Daily Living scale, Barthel Index, Beck Anxiety Index, Brief Assessment Schedule Depression Cards, Impact of Event Scale-Revised, and Sleep Hygiene Index. Results Of the 371 participants recruited, 263 (71%) were contacted at six months after stroke and 213 (57%) returned questionnaires. Approximately half (n = 109, 51%) reported fatigue at six months. Of those reporting fatigue initially (n = 88), 61 (69%) continued to report fatigue. 'De novo' (new) fatigue was reported by 48 (38%) of those not fatigued initially. Lower Nottingham Extended Activities of Daily Living scores and higher Beck Anxiety Index scores were independently associated with fatigue at six months. Conclusions Half the stroke survivors reported fatigue at six months post-stroke. Reduced independence in activities of daily living and higher anxiety levels were associated with the level of fatigue. Persistent and delayed onset fatigue may affect independence and participation in rehabilitation, and these findings should be used to inform the development of appropriate interventions.

  3. Persistent benefits of slow titration of paroxetine in a six-month follow-up.

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    Olgiati, Paolo; Serretti, Alessandro

    2015-09-01

    Paroxetine titration may be difficult in older individuals as they are more sensitive to side effects. The current study extends to 6 months our previously published report in which paroxetine was started at 2.5 mg/day and slowly increased by 2.5 mg on alternate days (slow titration) or rapidly titrated to target dose from 10 mg/day (standard titration) in a naturalistic setting. Here, the follow-up period was extended to 26 weeks. We performed an intent-to-treat analysis of 47 subjects from the original sample (major depressive disorder and/or generalized anxiety disorder (GAD); >60 years of age). Missing evaluations were replaced by last observations carried forward. GAD was included as a stratification factor. Patients in whom paroxetine was slowly up-titrated were more likely to remit (84.0% vs 54.5%; p = 0.028) and had lower core depression (p = 0.0015) and psychic anxiety levels (p = 0.006) after 26 weeks. Dropout rate was 20% in the slow titration group compared with 77.3% in the standard titration arm (p titration groups in the subsample without GAD. Despite some limitations, these findings suggest that paroxetine treatment should be started at lower doses in older depressed patients and slowly up-titrated. This strategy would allow to increase antidepressant response and the likelihood of completing treatment cycle in patients with high anxiety levels and GAD comorbidity. Copyright © 2015 John Wiley & Sons, Ltd.

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

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    Larsson Bo

    2009-02-01

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

  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. Emotional experiences predict the conversion of individuals with Attenuated Psychosis Syndrome to psychosis: A six-month follow up study

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    Fa Zhan Chen

    2016-06-01

    Full Text Available The present study explored the conversion rate in individuals with Attenuated Psychosis Syndrome (APS and potential predictor for transition in China. Sixty-three participants were identified as APS were followed up six months later. The results showed that 17% of individuals with APS converted to psychosis. The converters exhibited poorer emotional experience and expression than the non-converters at baseline. A further binary logistic regression analysis showed that emotional experience could predict the transition (Wald = 4.18, p = 0.041, 95% CI = 1.04~6.82. The current study suggested an important role of emotional processing in the prediction of the development of full-blown psychosis.

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

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    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.

  8. How needs and preferences of employees influence participation in health promotion programs: a six-month follow-up study.

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    Rongen, Anne; Robroek, Suzan J W; van Ginkel, Wouter; Lindeboom, Dennis; Pet, Martin; Burdorf, Alex

    2014-12-15

    Low participation in health promotion programs (HPPs) might hamper their effectiveness. A potential reason for low participation is disagreement between needs and preferences of potential participants and the actual HPPs offered. This study aimed to investigate employees' need and preferences for HPPs, whether these are matched by what their employers provide, and whether a higher agreement enhanced participation. Employees of two organizations participated in a six-month follow-up study (n = 738). At baseline, information was collected on employees' needs and preferences for the topic of the HPP (i.e. physical activity, healthy nutrition, smoking cessation, stress management, general health), whether they favored a HPP via their employer or at their own discretion, and their preferred HPP regarding three components with each two alternatives: mode of delivery (individual vs. group), intensity (single vs. multiple meetings), and content (assignments vs. information). Participation in HPPs was assessed at six-month follow-up. In consultation with occupational health managers (n = 2), information was gathered on the HPPs the employers provided. The level of agreement between preferred and provided HPPs was calculated (range: 0-1) and its influence on participation was studied using logistic regression analyses. Most employees reported needing a HPP addressing physical activity (55%) and most employees preferred HPPs organized via their employer. The mean level of agreement between the preferred and offered HPPs ranged from 0.71 for mode of delivery to 0.84 for intensity, and was 0.47 for all three HPP components within a topic combined. Employees with a higher agreement on mode of delivery (OR: 1.72, 95% CI: 0.87-3.39) and all HPP components combined (OR: 2.36, 95% CI: 0.68-8.17) seemed to be more likely to participate in HPPs, but due to low participation these associations were not statistically significant. HPPs aimed at physical activity were most needed by

  9. Personality disorder and substance related disorders: a six-month follow-up study with a Brazilian sample

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    Débora M. Krieger

    2016-06-01

    Full Text Available ABSTRACT Objectives A few Brazilian researches correlate personality disorders (PD and substance related disorders (SRD. The aim of the present study is to investigate the association between them, to evaluate the PD frequency among chemical dependents inpatients, this comorbidity association with social and demographic characteristics, used drug of choice, its impact on clinical evolution until the moment of their committal, the frequency of relapse, self-help group – and psychotherapic adherence among SRD patients six months following committal. Methods A 101 inpatients sample of chemical dependents was enrolled in 2 hospitals. The following instruments were applied: a questionnaire for social and demographic characteristics identification and drug use pattern, some questions from the sixth version of the Addiction Severity Index (ASI-6, the SCID-II questionnaire and specific questions concerning psychotherapic and self-help groups participation, and medication use. Results From these 101 patients, 55.4% were diagnosed with PD, being avoidant (14.9%, borderline (11.9% and antisocial (8.9% the more frequent ones found. PD patients had an earlier crack use in life (p = 0.038 and had also more previous treatments than the ones without PD (p = 0.005. Borderline PD patients were less worried to substance use problem (p = 0.003. After 6-months follow-up, no statistical significance was found between patients with and without PD regarding drug use or treatment adherence. Conclusion A high PD diagnosis was found in drug use inpatients. Patients diagnosed with SRD and PD need the identification of this comorbidity and of their personality characteristics in order to plan a more comprehensive and effective treatment.

  10. Oral Hygiene and Gingival Health in Patients with Fixed Prosthodontic Appliances - A Six Month Follow-up.

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    Kc Basnyat, S; Sapkota, B; Shrestha, S

    2015-01-01

    Background Gingival inflammation and periodontal disease are the common complications of fixed dental prosthesis. They can be overcome by good oral hygiene maintenance. Objective The objective of this study was to assess the oral hygiene and gingival condition in patients after placement of fixed dental prosthesis for a period of six months. It was also analyzed how factors like type of fixed dental prosthesis (Single crown, fixed partial denture) and material (Metal, Porcelain fused to metal) are statistically associated with oral hygiene and gingival health. Method The sample consisted of 50 patients visiting the Dental Outpatient Department of Dhulikhel Hospital. The oral examinations were conducted using basic diagnostic tools (Mouth mirror, periodontal probe and explorer). Teeth and gingiva were examined using the Plaque and Gingiva Index by Silness and Löe. The examinations were conducted after 14 days and six months after placement of fixed dental prosthesis along with the oral hygiene instructions. Paired sample t-test were done to find statistical association using SPSS 16.0. Result Our results revealed no significant difference in plaque index among patients with single crown whereas fixed partial denture showed statistical significance. No significant differences were found for type of material. The statistical analysis showed similar results for gingival index. Conclusion Our research showed that single crown had no significant difference on Plaque index and Gingival index of the patient after 14 days and six months, whereas, Fixed partial denture showed significant difference. Both metal and porcelain fused to metal crown revealed no statistically significant difference on Plaque index and Gingival index.

  11. Predictors of Better Self-Care in Patients with Heart Failure after Six Months of Follow-Up Home Visits

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    Trojahn, Melina Maria; Ruschel, Karen Brasil; Nogueira de Souza, Emiliane; Mussi, Cláudia Motta; Naomi Hirakata, Vânia; Nogueira Mello Lopes, Alexandra; Rabelo-Silva, Eneida Rejane

    2013-01-01

    This study aimed to examine the predictors of better self-care behavior in patients with heart failure (HF) in a home visiting program. This is a longitudinal study nested in a randomized controlled trial (ISRCTN01213862) in which the home-based educational intervention consisted of a six-month followup that included four home visits by a nurse, interspersed with four telephone calls. The self-care score was measured at baseline and at six months using the Brazilian version of the European Heart Failure Self-Care Behaviour Scale. The associations included eight variables: age, sex, schooling, having received the intervention, social support, income, comorbidities, and symptom severity. A simple linear regression model was developed using significant variables (P ≤ 0.20), followed by a multivariate model to determine the predictors of better self-care. One hundred eighty-eight patients completed the study. A better self-care behavior was associated with patients who received intervention (P < 0.001), had more years of schooling (P = 0.016), and had more comorbidities (P = 0.008). Having received the intervention (P < 0.001) and having a greater number of comorbidities (P = 0.038) were predictors of better self-care. In the multivariate regression model, being in the intervention group and having more comorbidities were a predictor of better self-care. PMID:24083023

  12. EuReCa Serbia one 2014 - Research center Subotica: Sudden cardiac arrest: Six month follow up

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    Budimski Mihaela

    2015-01-01

    Full Text Available INTRODUCTION: Cardiovascular diseases are the leading cause of death in Europe and they account for 40% of all fatal cases among patients under 75 years. The incidence of out-of-hospital cardiac arrests (OHCA that were managed by EMS in Europe, including all rhythmes, varies between 38 and 86 per 100 000 people. Epidemiological data on sudden cardiac arrest in Republic of Serbia were not known before Eureca ONE study. AIM: The aim of this paper is to point out the importance of researching cardiac arrest, and the first results of EURECA SERBIA programme 2014. will enable comparison of resuscitation procedures quality and survival rate, both within our country, and relative to European participants. MATERIALS AND METHODS: Prospective study. Data were gathered through specific questionnaire during the period of six months, from October 1, 2014 to April 1, 2015. This qustionnaire covered all patients that have had OHCA on the territory of Subotica, and were treated by the EMS. In cases with achieved ROSC, survival was monitored after a month. RESULTS: Emergency medical service of Subotica covers the territory with 141 554 citizens. Cardiac arrest was recorded in 46 patients that EMS treated. The incidence of OHCA during six month period was 32,5/100 000. Number of initiated resuscitations is 44, i.e. 31,08/100 000. The most often place of OHCA event was patient's home (27 61%, or 19, 07/100 000. Heart condition was the cause of OHCA in 100% of all cases (44, that is 31, 08/100 000. 15 patients (34,09% or 10,6/100 000 achieved ROSC, and 12 (27%, that is 8,47/100 000 had pulse and measurable blood pressure at hospital door. 6 patients of all hospitalized were discharged (4,23/100 000, and the incidence of survival after 30 days was 4,23/100 0. ' CONCLUSION: EuReCa One 2014 programme enables inclusion into European register of out-of-hospital cardiac arrest. There are differences in observed variables that cannot be explained by precise definition of

  13. Six-month follow-up of in-patient experiential cognitive therapy for binge eating disorders.

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    Riva, G; Bacchetta, M; Cesa, G; Conti, S; Molinari, E

    2003-06-01

    Treating binge eating disorders is not easy: the disordered eating is usually combined with a patient who is overweight and often obese. As underlined by the current literature, treatment outcome must focus, at a minimum, on the binge eating characterizing this disorder, on weight changes, and preferably also changes in co-morbid psychopathology. To address these issues, cognitive behavioral therapy (CBT) is still considered the best approach. However, if we check the results of follow-up studies, different authors reported some relapse in the frequency of binge eating and small weight gains over the follow-up period. This paper describes the 6-month follow-up outcome of the Experiential Cognitive Therapy (ECT), a multi factorial treatment for binge eating disorders, including virtual reality therapy. These results are compared in a randomized controlled trial (n = 36) with the ones obtained by CBT and nutritional groups only. The results showed that 77% of the ECT group quit binging after 6 months versus 56% for the CBT sample and 22% for the nutritional group sample. Moreover, the ECT sample reported better scores in most psychometric tests including EDI-2 and body image scores.

  14. A six month randomized school intervention and an 18-month follow-up intervention to prevent childhood obesity in Mexican elementary schools

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    Bacardí-Gascon, M.; Pérez-Morales, M.ª E.; Jiménez-Cruz, A.

    2012-01-01

    Background: The objective of this study, focused on parents and children to reduce sedentary behavior, consumption of soft drinks and high-fat and salt containing snacks, and increase the consumption of fruits and vegetables, was to assess the effect of a six month intervention and an 18 month follow-up intervention on the body mass index, food consumption and physical activity of 2nd and 3rd grade elementary school children. Methods: This was a randomized cluster controlled trial. School chi...

  15. Six-month open-label follow-up of risperidone long-acting injection use in pediatric bipolar disorder.

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    Boarati, Miguel A; Wang, Yuan-Pang; Ferreira-Maia, Ana Paula; Cavalcanti, Ana Rosa S; Fu-I, Lee

    2013-01-01

    Recent studies suggest that risperidone long-acting injection (RLAI) may be considered for controlling mood episodes in bipolar disorder patients who have relapsed due to medication nonadherence or failure to respond to standard therapies. Currently, no study has reported the usefulness of RLAI in youths with bipolar disorder. The aim of this study was to evaluate short-term effects of RLAI in the naturalistic treatment of early-onset bipolar disorder and its role in symptomatic remission and adherence to treatment. Nineteen early-onset bipolar disorder outpatients receiving RLAI were observed in a 6-month naturalistic study at the outpatient clinic of the Child and Adolescent Affective Disorders Program at the Institute of Psychiatry of the University of São Paulo, São Paulo, Brazil. All patients met DSM-IV criteria for bipolar disorder. Clinical response to RLAI was evaluated using the Children's Global Assessment Scale (CGAS) and Clinical Global Impressions scale (CGI) across 3 time periods: index time (T0), 8 weeks after (T1), and 24 weeks after (T2). These subjects were recruited from May 2008 to December 2009. Patients receiving RLAI presented considerable improvement in global functioning (CGAS: T0 = 20.6; T1 = 42.9; and T2 = 49.2) and clinical severity (CGI: T0 = 5.9; T1 = 3.9; and T2 = 3.4). Global CGI mean scores of clinical improvement were 2.2 at T1 and 2.4 at T2. There were no significant changes in laboratory measurements and weight throughout follow-up. RLAI was shown to be an alternative treatment for youths with bipolar disorder failing to respond to prior medication trials or with adherence problems. Further blind, randomized controlled studies are necessary to confirm these initial findings. Sistema Nacional de Informaçōes Sobre Ética em Pesquisa Envolvendo Seres Humanos-Commisão Nacional de Ética em Pesquisa identifier: CAAE 0709.0.015.000-06.

  16. Enhanced external counterpulsation in patients with refractory angina pectoris: a pilot study with six months follow-up regarding physical capacity and health-related quality of life.

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    Wu, Eline; Mårtensson, Jan; Broström, Anders

    2013-10-01

    Refractory angina pectoris (AP) is a persistent, painful condition characterized by angina caused by coronary insufficiency in the presence of coronary artery disease. It has been emphasized that there are possible underlying neuropathophysiological mechanisms for refractory AP but chronic ischemia is still considered to be the main problem. These patients suffer from severe AP and cannot be controlled by a combination of pharmacological therapies, angioplasty or coronary bypass surgery. AP has a negative impact on quality of life and daily life. Enhanced external counterpulsation (EECP) is a therapeutic option for these patients. The aim of this study was to evaluate EECP after six months regarding physical capacity and health-related quality of life (HRQoL) in patients with refractory AP. This was a study with single case research experimental design involving 34 patients treated with EECP. Six minute walk test (6MWT), functional class with Canadian Cardiological Society (CCS) classification and self-reported HRQoL questionnaires as Short Form 36 (SF-36) were collected at baseline and after treatment. CCS class and SF-36 were repeated at six months follow-up. Patients enhanced walk distance on average by 29 m after EECP (p<0.01). CCS class also improved (p<0.001) and persisted at six months follow-up (p<0.001). HRQoL improved significantly and the effects were maintained at follow-up after the treatment. Patients with refractory AP receive beneficial effects from EECP both in physical capacity and HRQoL. As other treatment options for this patient group are scarce, EECP should be offered to improve physical health and HRQoL in these patients.

  17. Enduring Effects of a Computer-Assisted Training Program For Cognitive Behavioral Therapy: A six-month follow-up of CBT4CBT*

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    Carroll, Kathleen M.; Ball, Samuel A.; Martino, Steve; Nich, Charla; Babuscio, Theresa A.; Rounsaville, Bruce J.

    2009-01-01

    Objectives To evaluate the durability of effects of a computer assisted version of cognitive behavioral therapy (CBT) as treatment for substance dependence through a 6 month follow-up. Methods Following a randomized clinical trial in which 73 individuals seeking outpatient treatment for substance dependence in an outpatient community setting were randomized to either standard treatment-as-usual (TAU) or TAU with 8 weeks of biweekly access to computer-based training for CBT (CBT4CBT), participants were interviewed one, three, and six months after the termination of study treatments. Results Sixty of the 73 participants were reached for follow-up (82%); follow up rates and availability of data were comparable across treatment conditions. Random regression analyses of use across time indicated significant differences between groups, such that those assigned to TAU increased their drug use across time while those assigned to CBT4CBT tended to improve slightly. The durability of the CBT4CBT effect remained even after controlling for treatment retention, treatment substance use outcomes, and exposure to other treatment during the follow-up period. Conclusions Computerized CBT4CBT appears to have both short-term and enduring effects on drug use. PMID:19041197

  18. [Treatment of temporo-mandibular joint closed-lock using intra-articular injection of mepivacaine with immediate resolution durable in time (six months follow-up)].

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    Guarda Nardini, L; Tito, R; Beltrame, A

    2002-01-01

    The purpose of this study was to assess the value of intra-articular fluid injection under pressure, as a technique suggested for temporo-mandibular joint (TMJ) closed-lock treatment, and to determine if there is a persisting lock resolution in time. Twelve patients were studied at our centre, with a diagnosis of TMJ closed-lock, not amenable with conventional therapies. All patients underwent a MRI scan, confirming the presence of anteriorly displaced disk. This technique is based on intra-articular injection of anaesthetic (mepivacaine cloridrate) under pressure, using the so called pumping technique, that allows an inferior distraction of the condyle. The study has a six months follow-up. After closed-lock resolution all patients underwent physiotherapy with guided mouth opening, for one month. Mandibular function (maximal mouth opening) increased on average of 20.2 mm after treatment, and of 21.1 mm six months later (p=0.00000; with p<0.005). Pain decreased on average from VAS=6.75 to VAS=0.3 (p=0.00001; with p<0.005). The masticatory efficiency improved from VAS=5.25 to VAS=8.75 (p=0.002; p<0.005). Functional TMJ limitation level is significantly increased (p=0.002; p<0.005). Also, patient's efficacy judgement (mean value 3.58= good) and tolerability judgement (mean value 2.92=good) indicate that this therapy is well accepted. This technique is easy to perform, well tolerated and does not need specific instruments: it permits the resolution of TMJ closed-lock, decreases the pain and improves masticatory efficiency. All these effects persist in time. Subjects with recent closed-lock have an immediate and complete functional recovery while patients with chronic closed-lock do not.

  19. Prediction of posttraumatic stress in fathers of children with chronic diseases or unintentional injuries: a six-months follow-up study

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    Sennhauser Felix H

    2007-12-01

    Full Text Available Abstract Background While fathers were neglected for a long time in research investigating families of pediatric patients, there are now a few studies available on fathers' posttraumatic stress symptoms (PTSS and posttraumatic stress disorder (PTSD. However, little is known about the course of PTSS and PTSD in fathers of pediatric patients. The present study aimed to compare the prevalence and course of PTSS and PTSD in fathers of children with different chronic and acute conditions and to identify factors that contribute to fathers' PTSS. Methods Sixty-nine fathers of children newly diagnosed with either cancer, type I diabetes mellitus, or epilepsy and 70 fathers of children suffering from an unintentional injury completed questionnaires at 4–6 weeks (Time 1 and six months (Time 2 after diagnosis or injury. Results Noticeable PTSD rates were found in fathers of children with a chronic disease (26% at Time 1 and 21% at Time 2, respectively. These rates were significantly higher than rates found in fathers of children with unintentional injuries (12% at Time 1 and 6% at Time 2, respectively. Within six months after the child's diagnosis or accident a decrease in severity of PTSS was observed in both groups. Significant predictors of PTSS at Time 2 were the father's initial level of PTSS, the child's medical condition (injuries vs. chronic diseases and functional status, the father's use of dysfunctional coping strategies, and father's level of neuroticism. Conclusion Our findings suggest that fathers with initially high PTSS levels are at greater risk to experience PTSS at follow-up, particularly fathers of children with a chronic disease. Sensitizing health care professionals to the identification of PTSS symptoms but also to indicators of neuroticism and the use of specific coping strategies early in the treatment course is essential for the planning and implementation of adequate intervention strategies.

  20. Six-month follow-up of patient-rated outcomes in a randomized controlled trial of exercise training during breast cancer chemotherapy.

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    Courneya, Kerry S; Segal, Roanne J; Gelmon, Karen; Reid, Robert D; Mackey, John R; Friedenreich, Christine M; Proulx, Caroline; Lane, Kirstin; Ladha, Aliya B; Vallance, Jeffrey K; Liu, Qi; Yasui, Yutaka; McKenzie, Donald C

    2007-12-01

    Few exercise trials in cancer patients have reported longer-term follow-up. Here, we report a 6-month follow-up of exercise behavior and patient-rated outcomes from an exercise trial in breast cancer patients. Breast cancer patients initiating adjuvant chemotherapy (n = 242) were randomly assigned to usual care (n = 82), resistance exercise training (RET; n = 82), or aerobic exercise training (AET; n = 78) for the duration of their chemotherapy. At 6-month follow-up, participants were mailed a questionnaire that assessed quality of life, self-esteem, fatigue, anxiety, depression, and exercise behavior. Two hundred one (83.1%) participants provided 6-month follow-up data. Adjusted linear mixed-model analyses showed that, at 6-month follow-up, the RET group reported higher self-esteem [adjusted mean difference, 1.6; 95% confidence interval (95% CI), 0.1-3.2; P = 0.032] and the AET group reported lower anxiety (adjusted mean difference, -4.7; 95% CI, -0.0 to -9.3; P = 0.049) compared with the usual care group. Moreover, compared with participants reporting no regular exercise during the follow-up period, those reporting regular aerobic and resistance exercise also reported better patient-rated outcomes, including quality of life (adjusted mean difference, 9.5; 95% CI, 1.2-17.8; P = 0.025). Improvements in self-esteem observed with RET during breast cancer chemotherapy were maintained at 6-month follow-up whereas reductions in anxiety not observed with AET during breast cancer chemotherapy emerged at 6-month follow-up. Moreover, adopting a combined aerobic and resistance exercise program after breast cancer chemotherapy was associated with further improvements in patient-rated outcomes. Exercise training during breast cancer chemotherapy may result in some longer-term and late effects for selected patient-rated outcomes.

  1. Moclobemide and Cognitive Behavioral Therapy in the Treatment of Social Phobia. A Six-Month Controlled Study and 24 Months Follow Up

    Czech Academy of Sciences Publication Activity Database

    Praško, J.; Dockery, C.; Horáček, J.; Houbová, P.; Kosová, J.; Klaschka, Jan; Pašková, B.; Prašková, H.; Seifertová, D.; Záleský, R.; Höschl, C.

    2006-01-01

    Roč. 27, č. 4 (2006), s. 473-481 ISSN 0172-780X Source of funding: V - iné verejné zdroje Keywords : social phobia * moclobemide * cognitive behavioural therapy * placebo * controlled study * 6-months efficacy * 24-months follow up Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 0.924, year: 2006

  2. Effectiveness of mental health first aid training in Sweden. A randomized controlled trial with a six-month and two-year follow-up.

    Science.gov (United States)

    Svensson, Bengt; Hansson, Lars

    2014-01-01

    According to a recent report from the European Brain Council and the European Colleague of Neuropsychopharmacology the one year prevalence of some kind of mental disorder is around 27% among the adult population in Europe. Research has shown a lack of mental health literacy in the population in general and it is thus important to find ways to improve the public's knowledge and skills to provide first hand support to people with mental disorders. Mental Health First Aid (MHFA) is a training program that has shown positive changes in knowledge and helping behavior. This study investigates if MHFA training in a Swedish context provides a sustained improvement in knowledge about mental disorders, a better ability to be helpful in contacts with people who are ill and if it changes attitudes in a positive direction. The introduction of the training program was made in accordance with the constructor's instructions. Participants were mainly public sector employees from a county in the west of Sweden. The study was a randomized controlled trial with an experiment group (n = 199) and a control group (n = 207) placed on a waiting list during a 6-month follow-up. A two-year follow-up was conducted for participants (n = 155) from both the intervention and waiting list group who had completed the training and during the follow-up been in contact with persons with mental disorders. The intervention group improved in knowledge as well as in confidence in providing help for someone in need. The two-year follow-up showed that the improvements were to a great extent maintained. Mental Health First Aid might raise the level of awareness of mental disorders and have an influence on the number of people who can receive professional treatment for their problems.

  3. Effectiveness of mental health first aid training in Sweden. A randomized controlled trial with a six-month and two-year follow-up.

    Directory of Open Access Journals (Sweden)

    Bengt Svensson

    Full Text Available According to a recent report from the European Brain Council and the European Colleague of Neuropsychopharmacology the one year prevalence of some kind of mental disorder is around 27% among the adult population in Europe. Research has shown a lack of mental health literacy in the population in general and it is thus important to find ways to improve the public's knowledge and skills to provide first hand support to people with mental disorders. Mental Health First Aid (MHFA is a training program that has shown positive changes in knowledge and helping behavior. This study investigates if MHFA training in a Swedish context provides a sustained improvement in knowledge about mental disorders, a better ability to be helpful in contacts with people who are ill and if it changes attitudes in a positive direction.The introduction of the training program was made in accordance with the constructor's instructions. Participants were mainly public sector employees from a county in the west of Sweden. The study was a randomized controlled trial with an experiment group (n = 199 and a control group (n = 207 placed on a waiting list during a 6-month follow-up. A two-year follow-up was conducted for participants (n = 155 from both the intervention and waiting list group who had completed the training and during the follow-up been in contact with persons with mental disorders. The intervention group improved in knowledge as well as in confidence in providing help for someone in need. The two-year follow-up showed that the improvements were to a great extent maintained.Mental Health First Aid might raise the level of awareness of mental disorders and have an influence on the number of people who can receive professional treatment for their problems.

  4. A six months' prospective follow-up of 65+-y-old patients from general practice classified according to nutritional risk by the Mini Nutritional Assessment

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Ovesen, Lars; Schroll, M.

    2001-01-01

    Objective: To assess the prevalence of old people at risk of undernutrition according to the Mini Nutritional Assessment (MNA), characterise the at risk group with regard to nutritional state, energy intake, and physical and mental functioning, and to assess the consequences of the MNA score over...... a 6 month period. Design: A cross-sectional prospective study. Setting: The clinic of a general practitioner. Subjects: Ninety-four patients 65 + -y-old with no acute illness contacted at the clinic. Sixty-one subjects (65%) agreed to participate at baseline and 34 (56%) showed up at the follow-up 6...

  5. 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.

  6. Effectiveness of the Electronic Cigarette: An Eight-Week Flemish Study with Six-Month Follow-up on Smoking Reduction, Craving and Experienced Benefits and Complaints

    Directory of Open Access Journals (Sweden)

    Karolien Adriaens

    2014-10-01

    Full Text Available Background: Smoking reduction remains a pivotal issue in public health policy, but quit rates obtained with traditional quit-smoking therapies remain disappointingly low. Tobacco Harm Reduction (THR, aiming at less harmful ways of consuming nicotine, may provide a more effective alternative. One promising candidate for THR are electronic cigarettes (e-cigs. The aim of this study was to investigate the efficacy of second-generation e-cigs both in terms of acute craving-reduction in the lab and in terms of smoking reduction and experienced benefits/complaints in an eight-month Randomized Controlled Trial (RCT. Design: RCT with three arms. Methods: Participants (N = 48 unwilling to quit smoking were randomized into two e-cig groups and one control group. During three lab sessions (over two months participants, who had been abstinent for four hours, vaped/smoked for five minutes, after which we monitored the effect on craving and withdrawal symptoms. eCO and saliva cotinine levels were also measured. In between lab sessions, participants in the e-cig groups could use e-cigs or smoke ad libitum, whereas the control group could only smoke. After the lab sessions, the control group also received an e-cig. The RCT included several questionnaires, which repeatedly monitored the effect of ad libitum e-cig use on the use of tobacco cigarettes and the experienced benefits/complaints up to six months after the last lab session. Results: From the first lab session on, e-cig use after four hours of abstinence resulted in a reduction in cigarette craving which was of the same magnitude as when a cigarette was smoked, while eCO was unaffected. After two months, we observed that 34% of the e-cig groups had stopped smoking tobacco cigarettes, versus 0% of the control group (difference p < 0.01. After five months, the e-cig groups demonstrated a total quit-rate of 37%, whereas the control group showed a quit rate of 38% three months after initiating e-cig use. At

  7. Type D Personality Predicts Poor Medication Adherence in Chinese Patients with Type 2 Diabetes Mellitus: A Six-Month Follow-Up Study.

    Directory of Open Access Journals (Sweden)

    Xuemei Li

    Full Text Available Type D personality and medication nonadherence have been shown to be associated with poor health outcomes. Type D personality is associated with poor medication adherence in patients with coronary artery disease, myocardial infarction, and heart failure. However, the relationship between type D personality and medication adherence in patients with Type 2 Diabetes Mellitus (T2DM remains unknown. This study aims to examine whether type D personality was associated with medication adherence in patients with T2DM.A follow-up study was conducted in general hospital of the People's Liberation Army in Beijing.412 T2DM patients (205 females, who were recruited by circular systematic random sampling, provided demographic and baseline data about medical information and completed measures of Type D personality. Then, 330 patients went on to complete a self-report measure of medication adherence at the sixth month after baseline data collection. Chi-square test, t tests, and hierarchical multiple regression analyses were conducted, as needed.Patients with type D personality were significantly more likely to have poor medication adherence (p<0.001. Type D personality predicts poor medication adherence before and after controlling for covariates when it was analyzed as a categorical variable. However, the dimensional construct of type D personality was not associated with medication adherence when analyzed as a continuous variable.Although, as a dimensional construct, type D personality may not reflect the components of the personality associated with poor medication adherence in patients with T2DM, screening for type D personality may help to identify those who are at higher risk of poor medication adherence. Interventions, aiming to improve medication adherence, should be launched for these high-risk patients.

  8. Domestic Rhodnius ecuadoriensis (Hemiptera, Reduviidae) infestation in Northern Peru: a comparative trial of detection methods during a six-month follow-up.

    Science.gov (United States)

    Cuba Cuba, César Augusto; Vargas, Franklin; Roldan, Judith; Ampuero, Cynthia

    2003-01-01

    Two passive methods in the assessment of intradomiciliary infestation by Rhodnius ecuadoriensis were tested: (i) the Gomes Nu ez sensor box (GN), (ii) sheets of white typing paper and (iii) one active timed manual method. The study was carried out in the Alto Chicama River Valley, Province of Gran Chim , Department of La Libertad. The study design consisted of an initial searching of triatomines inside of the domestic environment by the manual capture active procedure (man/hour) covering all the studied houses. Then, matched pairs of GN boxes and paper sheets were simultaneously installed in the bedrooms of 207 households distributed in 19 localities. A comparative prospective trial of these passive detection devices were monitored at 2, 4 and, finally 6 months follow-up. Parasitological Trypanosoma rangeli and/or T. cruzi infections were investigated in two houses with high level of infestation by R. ecuadoriensis. 16.9% of the 207 households investigated by an initial active manual method were infested with R. ecuadoriensis. The proportion of infested houses fluctuated from 6.2 to 55.5% amongst the 19 localities investigated. T. rangeli natural infection was detected in R. ecuadoriensis specimens collected in two households. Parasite rates in the bugs ranged from 16.6 to 21.7% respectively. The most striking fact was an average rate of salivary gland infection ranging from 7.4 to 8.3%. At the end of the sixth month period, a cumulative incidence of 31.4% of positive GN boxes against 15.9% for paper sheets was recorded. All three methods combined detected domestic infestation in 129 (62.3%) of the 207 houses studied in the 19 localities. The range of houses infested varies from 6.7% to 92.9%. In areas with low bug density infestation rates, the methodology experienced in our studies, seems to be the best choice for investigations on domestic R. ecuadoriensis populations.

  9. Anxiety symptoms are linked to new-onset suicidal ideation after six months of follow-up in outpatients with major depressive disorder.

    Science.gov (United States)

    Baek, Ji Hyun; Heo, Jung Yoon; Fava, Maurizio; Mischoulon, David; Nierenberg, Andrew; Hong, Jin Pyo; Roh, Sungwon; Jeon, Hong Jin

    2015-11-15

    Suicide risk evaluation is one of the most challenging assessments of patients with major depressive disorder (MDD). Initial risk evaluation might be insufficient in predicting emergence of suicidal ideation during the maintenance period. We aimed to elucidate factors associated with emergence or persistence of suicidal ideation 6 months after initiation of outpatient treatment in patients with MDD. A total of 300 participants with MDD defined by DSM-IV-TR criteria underwent face-to-face interview at baseline and follow-up phone interview at 6 months later. Severity of depression, suicidal ideation, and anxiety were evaluated. Among participants who did not report any suicidal idea at baseline, 10.9% reported suicidal ideation during the 6-month phone interview, while 28.4% of participants who reported suicidal ideation at baseline reported suicidal ideation during the phone interview. No significant difference in remission rate of depression was observed between the groups, but subjects without suicidal ideation at baseline had a higher rate of symptom improvement at the 6-month phone interview. After controlling for age, sex, baseline severity of suicide risk and depression and lifetime history of suicide attempts, emergence of suicidal ideation was significantly associated with anxiety level at baseline (t=2.127, p=0.039) and severity of depression symptoms at 6 month (t=-3.028, p=0.004); persistence of suicidal ideation was associated with severity of depression symptoms at 6 month (t=-4.962, psuicide risk of patients with MDD. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Breakfast and Energy Drink Consumption in Secondary School Children: Breakfast Omission, in Isolation or in Combination with Frequent Energy Drink Use, is Associated with Stress, Anxiety, and Depression Cross-Sectionally, but not at Six-Month Follow-Up

    Directory of Open Access Journals (Sweden)

    Gareth eRichards

    2016-02-01

    Full Text Available A considerable amount of research suggests that breakfast omission and the frequent use of caffeinated energy drinks may be associated with undesirable effects, and particularly so in children and adolescents. The current paper presents cross-sectional and longitudinal data from the Cornish Academies Project to investigate the effects of consuming energy drinks and missing breakfast on stress, anxiety, and depression in a cohort of secondary school children from the South West of England. Questionnaires were administered at two time-points (spaced six months apart to collect information relating to diet and lifestyle over the previous six months, demographic and school data were acquired through the School Information Management System, and single-item measures of stress, anxiety, and depression were administered at the second time-point only. Associations between breakfast and energy drink consumption and stress, anxiety, and depression were investigated, and a multivariate approach was taken so that additional variance from diet, demography, and lifestyle could be controlled for statistically. Cross-sectional analyses showed that breakfast omission was consistently associated with negative outcomes, and that this was largely observed for both those who frequently consumed energy drinks and those who did not. However, cross-lag analyses showed that neither breakfast omission or energy drink consumption, alone or in combination, was predictive of stress, anxiety, or depression at six-month follow-up. This suggests that associations between breakfast and mental health may be bi-directional rather than breakfast being the causal factor.

  11. Health literacy of primiparae in the first six months of maternity: review

    Directory of Open Access Journals (Sweden)

    Ivana Olecká

    2016-08-01

    Full Text Available Aim: The aim of this study was to find out how the health literacy of primiparae in the first six months of motherhood is examined. The following research questions were raised: What methods are used to examine maternal health literacy? What aspects of maternal health literacy are investigated? Do the results prove any link between maternal health literacy and child health? Design: Review. Methods: The search for primary research studies was based on a combination of the following keywords: health literacy, mother*, maternity*, information, and knowledge in the Scopus and Web of Science databases. Exclusion criteria: not a primary study, does not concern research on primiparae of children under six months, unrelated to health literacy research or obtaining of information and acquiring of knowledge, not available in full-text, or clear research methodology description not available. The data were processed using thematic analysis based on the sorting method. Results: 31 studies were found, 17 of which were analysed. The majority of studies used quantitative methods of research with standardized tools. The key categories of health literacy related to obtaining, understanding and use of health information. No direct correlation was clearly demonstrated between level of maternal health literacy and child health. Conclusion: The trend in terms of the focus and goals of professional studies, regardless of cultural or national context, is a shift away from examining the way information is acquired to how it is understood by mothers.

  12. Petroleum products price regulation in Nov Scotia : a six-month review

    International Nuclear Information System (INIS)

    2007-03-01

    Gasoline pricing regulation was introduced in July 2006 in order to achieve the following 3 main objectives: (1) stabilize prices by reducing the frequency of price changes and creating more uniform pricing across the province, (2) maintain industry infrastructure by slowing or halting the decline in the dealer network, particularly in rural areas, by improving viability through regulated margins, and (3) minimize the cost to consumers since higher prices are expected to result from the actions needed to maintain price stability and the higher margins needed to maintain industry infrastructure. This report examined the extent to which these objectives were achieved and contained the findings and recommendations of a review of the first six months of gasoline price regulation in Nova Scotia. The report discussed the rationale for regulation, study objectives, approach, and warning signs. It also discussed gasoline regulation in Nova Scotia including how regulation works and implementing regulation. The Nova Scotia gasoline market was presented with reference to industry structure; pre-regulation competition and pricing; and how regulation may affect structure and competition. Last, the report discussed whether regulation was meeting the objectives and perspectives on regulation. Several recommendations were presented, such as reducing the benchmark price adjustment period from two weeks to one week; removing the price cap on full-serve gasoline; adopting a fixed and transparent formula for forward averaging and applying it at each adjustment; and considering a framework for regulatory review. 12 refs., 15 figs

  13. Effect of Probiotic Containing Ice-cream on Salivary Mutans Streptococci (SMS) Levels in Children of 6-12 Years of Age: A Randomized Controlled Double Blind Study with Six-months Follow Up.

    Science.gov (United States)

    Ashwin, Devasya; Ke, Vijayaprasad; Taranath, Mahanthesh; Ramagoni, Naveen Kumar; Nara, Asha; Sarpangala, Mythri

    2015-02-01

    To evaluate the caries risk based on the salivary levels of streptococcus mutans in children of 6-12 years of age group before and after consuming probiotic ice-cream containing Bifidobacterium lactis Bb-12 and Lactobacillus acidophilus La-5. A double blind, placebo controlled trial was carried out in 60 children aged between 6 to 12 years with zero decayed, missing, and filled teeth (DMFT). They were randomly divided into two equal groups. Saliva sample were collected before the consumption of ice-cream and Streptococcus mutans count was calculated and recorded as baseline data. For the next seven days both the groups were given ice creams marked as A and B. Saliva samples were collected after ice-cream consumption at the end of study period and also after a washout period of 30 days and again after six months. Samples were inoculated and colonies were counted. On statistical evaluation by students paired t-test, probiotic ice-cream brought significant reduction in the Streptococcus mutans count after seven days of ice-cream ingestion (pice-cream consumption. After six months of the study period in both the groups the salivary levels of Streptococcus mutans was similar to the baseline. Probiotic ice-cream containing Bifidobacterium lactis Bb-12 and Lactobacillus acidophilus La-5 can cause reduction in caries causative organism. The dosage of the probiotic organisms for the long term or synergetic effect on the oral health are still needed to be explored.

  14. Somatic symptoms: an important index in predicting the outcome of depression at six-month and two-year follow-up points among outpatients with major depressive disorder.

    Science.gov (United States)

    Hung, Ching-I; Liu, Chia-Yih; Wang, Shuu-Jiun; Juang, Yeong-Yuh; Yang, Ching-Hui

    2010-09-01

    Few studies have simultaneously compared the ability of depression, anxiety, and somatic symptoms to predict the outcome of major depressive disorder (MDD). This study aimed to compare the MDD outcome predictive ability of depression, anxiety, and somatic severity at 6-month and 2-year follow-ups. One-hundred and thirty-five outpatients (men/women=34/101) with MDD were enrolled. Depression and anxiety were evaluated by the Hamilton Depression Rating Scale, Hospital Anxiety and Depression Scale, and depression subscale of the Depression and Somatic Symptoms Scale (DSSS). Somatic severity was evaluated by the somatic subscale of the DSSS. Subjects undergoing pharmacotherapy in the follow-up month were categorized into the treatment group; the others were categorized into the no-treatment group. Multiple linear regressions were used to identify the scales most powerful in predicting MDD outcome. Among the 135 subjects, 119 and 106 completed the 6-month and 2-year follow-ups, respectively. Somatic severity at baseline was correlated with the outcomes of the three scales at the two follow-ups. After controlling for demographic variables, somatic severity independently predicted most outcomes of the three scales at the two follow-ups in the no-treatment group and the cost of pharmacotherapy and DSSS score at the 6-month follow-up in the treatment group. Division of the subjects into treatment and no-treatment groups was not based on randomization and bias might have been introduced. Somatic severity was the most powerful index in predicting MDD outcome. Psychometric scales with appropriate somatic symptom items may be more accurate in predicting MDD outcome. 2010 Elsevier B.V. All rights reserved.

  15. A pilot study of randomized clinical controlled trial of gait training in subacute stroke patients with partial body-weight support electromechanical gait trainer and functional electrical stimulation: six-month follow-up.

    Science.gov (United States)

    Ng, Maple F W; Tong, Raymond K Y; Li, Leonard S W

    2008-01-01

    This study aimed to assess the effectiveness of gait training using an electromechanical gait trainer with or without functional electrical stimulation for people with subacute stroke. This was a nonblinded randomized controlled trial with a 6-month follow-up. Fifty-four subjects were recruited within 6 weeks after stroke onset and were randomly assigned to 1 of 3 gait intervention groups: conventional overground gait training treatment (CT, n=21), electromechanical gait trainer (GT, n=17) and, electromechanical gait trainer with functional electrical stimulation (GT-FES, n=16). All subjects were to undergo an assigned intervention program comprising a 20-minute session every weekday for 4 weeks. The outcome measures were Functional Independence Measure, Barthel Index, Motricity Index leg subscale, Elderly Mobility Scale (EMS), Berg Balance Scale, Functional Ambulatory Category (FAC), and 5-meter walking speed test. Assessments were made at baseline, at the end of the 4-week intervention program, and 6 months after the program ended. By intention-to-treat and multivariate analysis, statistically significant differences showed up in EMS (Wilks' lambda=0.743, P=0.005), FAC (Wilks' lambda=0.744, P=0.005) and gait speed (Wilks' lambda=0.658, Pgait training that used an electromechanical gait trainer compared with conventional overground gait training. The training effect was sustained through to the 6-month follow-up after the intervention.

  16. A six month randomized school intervention and an 18-month follow-up intervention to prevent childhood obesity in Mexican elementary schools Intervención aleatorizada de seis meses en las escuelas, con un seguimiento de 18 meses para la prevención de obesidad infantil en escuelas primarias de México

    OpenAIRE

    M. Bacardí-Gascon; M.ª E. Pérez-Morales; A. Jiménez-Cruz

    2012-01-01

    Background: The objective of this study, focused on parents and children to reduce sedentary behavior, consumption of soft drinks and high-fat and salt containing snacks, and increase the consumption of fruits and vegetables, was to assess the effect of a six month intervention and an 18 month follow-up intervention on the body mass index, food consumption and physical activity of 2nd and 3rd grade elementary school children. Methods: This was a randomized cluster controlled trial. School chi...

  17. Follow-up analyses for the ANTT review

    International Nuclear Information System (INIS)

    Stillman, J. A.; Bauer, T. H.; Hill, R. N.; Wigeland, R. A.; Nuclear Engineering Division

    2006-01-01

    Early in FY04, the Advanced Nuclear Transformation Technology (ANTT) subcommittee of the Nuclear Energy Research Advisory Committee (NERAC) requested a report on repository benefits for recycling of key transuranics in existing light water-cooled reactors (LWRs). The ANTT reviewers specifically requested a quantification of how such a campaign would impact (improve) the achievable loading of nuclear waste in the Yucca Mountain facility. The request stipulated that the transuranics be separated from commercial spent nuclear fuel (CSNF) and recycled a finite number of times in LWR-compatible fuel forms. The spent fuel remaining at the end of the recycling campaign, as well as all other nuclear waste generated by spent fuel reprocessing, would be permanently disposed in a geologic repository. In response, two reports have been prepared and distributed as deliverables for the AFCI program. Reference 1 provides the final report which addresses the original ANTT sub-committee request. Plutonium, neptunium, and americium recycling strategies in assemblies fabricated from mixed-oxide (MOX), CORAIL (heterogeneous UO 2 and MOX), and inert-matrix fuel (IMF) forms were evaluated; the focus of the report is the time-dependent thermal response of the repository to a given loading of nuclear waste in the storage tunnels (drifts), as well as a quantification of how the loading could be increased relative to the reference direct disposal of CSNF. Reference 2 provides a more complete description of the neutronics and mass flow analyses which were completed as part of the study. That report also provides an analysis of the differences between the various recycling strategies and the underlying reactor physics

  18. Atendimento de emergência a mulheres que sofreram violência sexual: características das mulheres e resultados até seis meses pós-agressão Emergency care for women following sexual assault: characteristics of women and six-month post-aggression follow-up

    Directory of Open Access Journals (Sweden)

    Carlos Tadayuki Oshikata

    2005-02-01

    Full Text Available Avaliou-se o processo e os resultados do tratamento a mulheres vítimas de violência sexual em Hospital Universitário. Estudo prospectivo para avaliar o atendimento de emergência e o seguimento ambulatorial por seis meses de 166 mulheres, pós-púberes, atendidas no Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas, entre outubro de 1999 e fevereiro de 2002. Metade era menor de vinte anos, duas não eram alfabetizadas, 70,0% eram solteiras, 20,0% usavam anticoncepcionais, 80,1% foram atendidas até 24 horas pós-agressão. Os agressores eram desconhecidos em 80,0% dos casos e 95,0% tiveram relação vaginal. Anticoncepção de emergência foi administrada a 76,0% das mulheres, antibióticos a 98,0%, imunoglobulina para hepatite B a 95,0% e anti-retrovirais a 90,0%. Retornaram aos 14 dias 137 mulheres, 37,0% não retornaram aos 45 dias e 29,0% completaram seis meses de seguimento. Foi diagnosticado hepatite B e HPV em 2,6%, doença inflamatória pélvica e tricomoníase em 2,1%, sífilis 1,3%, além de três gestações entre 127 que receberam anticoncepção de emergência (2,6%. Não houve infecção pelo HIV. O atendimento de emergência a vítimas de violência sexual é eficiente em reduzir o número de gestações indesejadas e das DST.This study evaluated the process and results of treatment for women at a university hospital after sexual violence. A prospective study of 166 women (> 12 years of age treated from October 1999 to February 2002 included six months follow-up after aggression. Half of the women were under 20 years of age, two were illiterate, 70.0% unmarried, 20.0% used contraceptives, and 80.0% received treatment within the first 24 hours post-aggression. Nearly 80.0% of aggressors were unknown to victims and 95.0% of the cases involved vaginal penetration. Emergency contraception was administered to 76.0%, antibiotics to 98.0%, hepatitis B immunoglobulin to 95.0%, and HIV anti

  19. Efeito da duração da amamentação exclusiva e mista sobre os níveis de hemoglobina nos primeiros seis meses de vida: um estudo de seguimento Effect of length of exclusive breastfeeding and mixed feeding on hemoglobin levels in the first six months of life: a follow-up study

    Directory of Open Access Journals (Sweden)

    Andréa Silva de Oliveira

    2010-02-01

    Full Text Available O objetivo deste estudo foi avaliar o efeito da duração da amamentação exclusiva e mista sobre os níveis de hemoglobina de lactentes. Trata-se de um estudo de seguimento com seis meses de duração, envolvendo 150 crianças nascidas na maternidade de Mutuípe, Bahia, Brasil. Mensalmente, as crianças eram submetidas ao exame de sangue para avaliação dos níveis de hemoglobina e realizava-se coleta de dados de consumo alimentar. Foram obtidos, ainda, dados obstétricos e sócio-econômicos. Utilizou-se o modelo linear de efeitos mistos para investigar as associações de interesse. Ao final do seguimento, a perda amostral foi de 15,3%, e detectou-se uma prevalência de 71,7% de anemia. Constatou-se um incremento de 0,091g/dL nos níveis de hemoglobina a cada mês de duração de aleitamento materno exclusivo (p = 0,031, enquanto, a cada mês de duração de aleitamento materno misto, os níveis de hemoglobina declinaram em 0,097g/dL (p = 0,017. Concluiu-se que as práticas alimentares inadequadas parecem estar diretamente envolvidas na etiologia da deficiência nutricional de ferro nesse período da vida.This six-month follow-up study aimed to assessing the effect of length of both exclusive breastfeeding and mixed feeding on hemoglobin levels in 150 infants born at the Mutuípe maternity facility in Bahia State, Brazil. Blood tests were performed monthly to assess the hemoglobin levels, at which time data were gathered on food intake. Obstetric and socioeconomic data were also collected. The linear mixed effects model was used to investigate the target associations. Loss to follow-up was 15.3%, and anemia prevalence was 71.7%. An increase of 0.091g/dL (p = 0.031 in hemoglobin levels was found for each month of exclusive breastfeeding, while a decrease of 0.097g/dL (p = 0.017 was shown for each month of mixed feeding. In conclusion, inadequate food practices appear to be directly involved in the etiology of iron deficiency anemia during

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

    Science.gov (United States)

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

    2016-01-01

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

  1. Genealogical databases as a tool for extending follow-up in clinical reviews.

    Science.gov (United States)

    Ho, Thuy-Van; Chowdhury, Naweed; Kandl, Christopher; Hoover, Cindy; Robinson, Ann; Hoover, Larry

    2016-08-01

    Long-term follow-up in clinical reviews often presents significant difficulty with conventional medical records alone. Publicly accessible genealogical databases such as Ancestry.com provide another avenue for obtaining extended follow-up and added outcome information. No previous studies have described the use of genealogical databases in the follow-up of individual patients. Ancestry.com, the largest genealogical database in the United States, houses extensive demographic data on an increasing number of Americans. In a recent retrospective review of esthesioneuroblastoma patients treated at our institution, we used this resource to ascertain the outcomes of patients otherwise lost to follow-up. Additional information such as quality of life and supplemental treatments the patient may have received at home was obtained through direct contact with living relatives. The use of Ancestry.com resulted in a 25% increase (20 months) in follow-up duration as well as incorporation of an additional 7 patients in our study (18%) who would otherwise not have had adequate hospital chart data for inclusion. Many patients within this subset had more advanced disease or were remotely located from our institution. As such, exclusion of these outliers can impact the quality of subsequent outcome analysis. Online genealogical databases provide a unique resource of public information that is acceptable to institutional review boards for patient follow-up in clinical reviews. Utilization of Ancestry.com data led to significant improvement in follow-up duration and increased the number of patients with sufficient data that could be included in our retrospective study. © 2016 ARS-AAOA, LLC.

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

    DEFF Research Database (Denmark)

    Hagen, Knut; Jensen, Rigmor; Bøe, Magne Geir

    2010-01-01

    in headache index at the end of follow-up were reported in only one and two of nine studies, respectively. The present review demonstrated a lack of uniform end points used in recently published follow-up studies. Guidelines for presenting follow-up data on MOH are needed and we propose end points......No guidelines for performing and presenting the results of studies on patients with medication overuse headache (MOH) exist. The aim of this study was to review long-term outcome measures in follow-up studies published in 2006 or later. We included MOH studies with >6 months duration presenting...... a minimum of one predefined end point. In total, nine studies were identified. The 1,589 MOH patients (22% men) had an overall mean frequency of 25.3 headache days/month at baseline. Headache days/month at the end of follow-up was reported in six studies (mean 13.8 days/month). The decrease was more...

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

    Science.gov (United States)

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

    2007-12-01

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

  4. Interventions to Improve Follow-Up of Laboratory Test Results Pending at Discharge: A Systematic Review.

    Science.gov (United States)

    Whitehead, Nedra S; Williams, Laurina; Meleth, Sreelatha; Kennedy, Sara; Epner, Paul; Singh, Hardeep; Wooldridge, Kathleene; Dalal, Anuj K; Walz, Stacy E; Lorey, Tom; Graber, Mark L

    2018-02-28

    Failure to follow up test results pending at discharge (TPAD) from hospitals or emergency departments is a major patient safety concern. The purpose of this review is to systematically evaluate the effectiveness of interventions to improve follow-up of laboratory TPAD. We conducted literature searches in PubMed, CINAHL, Cochrane, and EMBASE using search terms for relevant health care settings, transition of patient care, laboratory tests, communication, and pending or missed tests. We solicited unpublished studies from the clinical laboratory community and excluded articles that did not address transitions between settings, did not include an intervention, or were not related to laboratory TPAD. We also excluded letters, editorials, commentaries, abstracts, case reports, and case series. Of the 9,592 abstracts retrieved, 8 met the inclusion criteria and reported the successful communication of TPAD. A team member abstracted predetermined data elements from each study, and a senior scientist reviewed the abstraction. Two experienced reviewers independently appraised the quality of each study using published LMBP™ A-6 scoring criteria. We assessed the body of evidence using the A-6 methodology, and the evidence suggested that electronic tools or one-on-one education increased documentation of pending tests in discharge summaries. We also found that automated notifications improved awareness of TPAD. The interventions were supported by suggestive evidence; this type of evidence is below the level of evidence required for LMBP™ recommendations. We encourage additional research into the impact of these interventions on key processes and health outcomes. © 2018 Society of Hospital Medicine.

  5. A Systematic Review of Interventions to Follow-Up Test Results Pending at Discharge.

    Science.gov (United States)

    Darragh, Patrick J; Bodley, T; Orchanian-Cheff, A; Shojania, K G; Kwan, J L; Cram, P

    2018-05-01

    Patients are frequently discharged from the hospital before all test results have been finalized. Thirty to 40% of tests pending at discharge (TPADs) return potentially actionable results that could necessitate change in the patients' management, often unbeknownst to their physicians. Delayed follow-up of TPADs can lead to patient harm. We sought to synthesize the existing literature on interventions intended to improve the management of TPADs, including interventions designed to enhance documentation of TPADs, increase physician awareness when TPAD results finalize post-discharge, decrease adverse events related to missed TPADs, and increase physician satisfaction with TPAD management. We searched Medline, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Database of Controlled Clinical Trials and Medline (January 1, 2000-November 10, 2016) for randomized controlled trials and prospective, controlled observational studies that evaluated interventions to improve follow-up of TPADs for adult patients discharged from acute care hospitals or emergency department settings. From each study we extracted characteristics of the intervention being evaluated and its impact on TPAD management. Nine studies met the criteria for inclusion. Six studies evaluated electronic discharge summary templates with a designated field for documenting TPADs, and three of six of these studies reported a significant improvement in documentation of TPADs in discharge summaries in pre- and post-intervention analysis. One study reported that auditing discharge summaries and providing feedback to physicians were associated with improved TPAD documentation in discharge summaries. Two studies found that email alerts when TPADs were finalized improved physicians' awareness of the results and documentation of their follow-up actions. Of the four studies that assessed patient morbidity, two showed a positive effect; however, none specifically measured the impact of their interventions

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

    International Nuclear Information System (INIS)

    2011-01-01

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

  7. Seguimento ambulatorial de um grupo de prematuros e a prevalência do aleitamento na alta hospitalar e ao sexto mês de vida: contribuições da fonoaudiologia Outpatient follow-up of a group of premature infants and the prevalence of breastfeeding at discharge and at six months: speech-language pathology contributions

    Directory of Open Access Journals (Sweden)

    Aliana Eduarda Czechowski

    2010-12-01

    Full Text Available OBJETIVO: Verificar a prevalência do aleitamento materno em prematuros com peso acima de 1500 g, na alta hospitalar e até o 6º mês de vida. MÉTODOS: Trata-se de um estudo descritivo observacional, retrospectivo, de caráter quantitativo, baseado na análise de prontuários de bebês nascidos entre janeiro de 2006 e dezembro de 2007, que foram assistidos pelo serviço de Fonoaudiologia na unidade pediátrica e ambulatório de Fonoaudiologia de um Hospital de Base. Foram incluídos recém-nascidos pré-termo de baixo peso, com ausência de doenças congênitas cardíacas, pulmonares ou síndromes genéticas e índice de APGAR maior que três no 1º minuto e cinco no 5º minuto. RESULTADOS: Dos 156 prontuários estudados, constatou-se que a prevalência de aleitamento materno exclusivo na alta hospitalar foi de 58,3%. Aos seis meses de vida do bebê foi observado uma prevalência de 22,2% em aleitamento materno exclusivo. CONCLUSÃO: A prevalência do aleitamento materno exclusivo mostrou-se bastante aquém do valor recomendado pela Organização Mundial de Saúde, que é de aleitamento materno exclusivo até o sexto mês de vida.PURPOSE: To verify the prevalence of breastfeeding in preterm infants weighting over 1500 g at hospital discharge and until six months of life. METHODS: This is a quantitative descriptive observational retrospective study, based on the analysis of records of infants born between January 2006 and December 2007, which were assisted by the Speech-Language Pathology department in the pediatric unit and the Speech-Language Pathology outpatient clinic of a hospital. The inclusion criteria were: low birth weight preterm infants, with no congenital heart or pulmonary diseases, no genetic syndromes, and APGAR score higher than three at one minute and five at five minutes. RESULTS: The results from the 156 records studied showed that the prevalence of exclusive breastfeeding at hospital discharge was 58.3%. At six months it was

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

    International Nuclear Information System (INIS)

    2011-01-01

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

  9. IAEA Concludes Follow-up Review of Malaysia Rare Earth Plant IAEA Concludes Follow-up Review of Malaysia Rare Earth Plant

    International Nuclear Information System (INIS)

    2014-01-01

    In its preliminary observations, the follow-up mission found that good progress had been made in implementing the recommendations of the 2011 mission, and noted that the radiological risks of the Lynas plant are low because of the very low level of radioactivity of the materials handled. The team also noted that Malaysia is actively updating its regulations in accordance with the most recent IAEA safety standards. The IAEA team gave some advice for further progress in specific areas. For example: The waste management plan should be based on realistic scenarios including, if considered appropriate, the identification of a final disposal site. Environmental monitoring activities should be optimised to ensure resources are focused on the most important areas, including enhancing monitoring of liquid discharges. The basis of the financial fund to be paid by Lynas for long-term waste management and decommissioning should be communicated more clearly. The AELB and Lynas are encouraged to maintain a proactive approach to relations with the media, public and other stakeholders, on an ongoing basis, to address continuing widespread misconceptions about the plant and radiation issues in general. Rare earths are elements used in many high-technology applications, from mobile phones to wind turbines. Since the ore from which they are refined also usually contains naturally occurring radioactive materials such as thorium or uranium, the process results in very low-level radioactive waste that must be managed safely. The IAEA mission's final report will be submitted to the Malaysian government at the end of October, and will be made public

  10. Oral Anticoagulation: the impact of the therapy in health-related quality of life at six-month follow-up Anticoagulación oral: impacto de la terapia en la calidad de vida relacionada a la salud a lo largo de seis meses Anticoagulação oral: impacto da terapia na qualidade de vida relacionada à saúde ao longo de seis meses

    Directory of Open Access Journals (Sweden)

    Ariana Rodrigues da Silva Carvalho

    2013-02-01

    Full Text Available OBJECTIVE: to study the changes in health-related quality of life from beginning of anticoagulation therapy to six-month follow-up, and to study associations of sociodemographic and clinical characteristics with measures of quality of life and general health status at six-month follow-up, in individuals using oral anticoagulation due to various medical indications for the therapy. METHOD: prospective study performed at a city in the state of Paraná, Brazil, composed of 78 patients. Measures included the Duke Anticoagulation Satisfaction Scale and the Medical Outcomes Survey Short Form SF-36. RESULTS: mean age was 57 years (S.D.= 16 and 54% were women. Compared to the beginning of therapy, there was a statistically significant improvement in health-related quality of life at six-month follow-up. Linear regression analyses explained 32% and 30%, respectively, of the variance of the Duke Anticoagulation Satisfaction Scale and of the general health status. There was improvement in all components of the SF-36, except Mental Health. CONCLUSION: The use of oral anticoagulation therapy was associated with improvement in health-related quality of life in the first six months of therapy. This study is longitudinal and therefore, has fewer limitations than cross-sectional studies published to date in the Nursing literature in Brazil.OBJETIVO: Estudiar los cambios en la calidad de vida relacionada con la salud desde el inicio de la anticoagulación oral y al final de seis meses de tratamiento, y estudiar las asociaciones de las características sociodemográficas y clínicas con las medidas de calidad de vida y salud general seis meses después de iniciar la terapia, en pacientes con diversas indicaciones clínicas de anticoagulación oral. MÉTODO: Se realizó un estudio prospectivo en una ciudad de Paraná, Brasil, evaluando 78 pacientes. Las herramientas aplicadas fueron la Duke Anticoagulation Satisfaction Scale y el Medical Outcomes Survey Short Form

  11. The laboratory diagnosis and follow up of strongyloidiasis: a systematic review.

    Directory of Open Access Journals (Sweden)

    Ana Requena-Méndez

    treatment which can cause a substantial loss to follow-up in a clinical trial.

  12. Nuclear Experts Complete IAEA Follow-up Review of German Regulatory System

    International Nuclear Information System (INIS)

    2011-01-01

    Full text: Nuclear safety experts concluded a seven-day mission to review the German Regulatory System, conducted from 4-10 September in Bonn, Stuttgart and Berlin. At the request of the Government of the Federal Republic of Germany, the International Atomic Energy Agency assembled a peer-review team of six high-level regulatory experts from six nations (Finland, France, the Netherlands, Switzerland, the UK, the US and three IAEA senior staff members) to conduct a follow-up assessment of an Integrated Regulatory Review Service (IRRS) mission conducted in 2008. This follow-up IRRS mission examined the progress in acting upon the recommendations and suggestions made during the 2008 IRRS mission and reviewed the areas of significant regulatory changes since that review at both the Federal Ministry of Environment, Nature Conservation and Nuclear Safety (BMU) and the Ministry of Environment of the federal state of Baden-Wurttemberg (UM BW). The first mission reviewed Germany's regulatory framework against IAEA Safety Standards and fostered the exchange of information and experience on safety regulation. This is a peer review based on IAEA Standards. It is not an inspection, nor an audit. The scope of the mission was limited to the safety regulation of nuclear power plants. IRRS team leader, Mr. McCree, of the US Nuclear Safety Commission (USNRC), said, ''This was an important IRRS mission, particularly given the recent Fukushima Daiichi Nuclear Power Plant accident and the related insights which underscore the importance of having an independent, credible nuclear safety regulator.'' ''The IRRS team identified several strengths of the German nuclear safety regulators, including the prompt and coordinated incident response activities of BMU and UM BW to the Fukushima accident. Some suggestions were also made to further strengthen nuclear safety regulations concerning the future work of BMU,'' he said. The review team found that important progress has been made toward

  13. Survival benefits from follow-up of patients with lung cancer: a systematic review and meta-analysis.

    Science.gov (United States)

    Calman, Lynn; Beaver, Kinta; Hind, Daniel; Lorigan, Paul; Roberts, Chris; Lloyd-Jones, Myfanwy

    2011-12-01

    The burden of lung cancer is high for patients and carers. Care after treatment may have the potential to impact on this. We reviewed the published literature on follow-up strategies intended to improve survival and quality of life. We systematically reviewed studies comparing follow-up regimes in lung cancer. Primary outcomes were overall survival (comparing more intensive versus less intensive follow-up) and survival comparing symptomatic with asymptomatic recurrence. Quality of life was identified as a secondary outcome measure. Hazard ratios (HRs) and 95% confidence intervals from eligible studies were synthesized. Nine studies that examined the role of more intensive follow-up for patients with lung cancer were included (eight observational studies and one randomized controlled trial). The studies of curative resection included patients with non-small cell lung cancer Stages I to III disease, and studies of palliative treatment follow-up included limited and extensive stage patients with small cell lung cancer. A total of 1669 patients were included in the studies. Follow-up programs were heterogeneous and multifaceted. A nonsignificant trend for intensive follow-up to improve survival was identified, for the curative intent treatment subgroup (HR: 0.83; 95% confidence interval: 0.66-1.05). Asymptomatic recurrence was associated with increased survival, which was statistically significant HR: 0.61 (0.50-0.74) (p impact of follow-up regimes on living with lung cancer and psychosocial well-being.

  14. Nourodevelopmental follow-up in high-risk infants: review article

    Directory of Open Access Journals (Sweden)

    Farin Soleimani

    2015-02-01

    for it. The present review article aims to introduce the care process and tools that is used for following-up these babies, also introduces the application of screening tools for neuro-developmental care.

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

    Science.gov (United States)

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

    2017-08-01

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

  16. 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.

  17. Marketing Violent Entertainment to Children: A Six-Month Follow-Up Review of Industry Practices in the Motion Picture, Music Recording & Electronic Game Industries. A Report to Congress.

    Science.gov (United States)

    Federal Trade Commission, Washington, DC.

    In September 2000, the Federal Trade Commission issued a report on marketing violent entertainment to children. The Commission found that all three segments of the entertainment industry intentionally promoted products to children that warranted parental cautions. This report provides a look at the advertising practices to see if the industries…

  18. Training new operators - the first six months

    Energy Technology Data Exchange (ETDEWEB)

    Worthel, B.; /Fermilab

    2010-04-01

    The Fermilab Operations Department takes about two years to train a new Operator. The Operator's introductory (Concepts) On-the-Job-Training (OJT) gives him or her an overview of the laboratory, teaches the basic facts about all the accelerators, and it also teaches the new operator the training process used for all the rest of their OJT training. The Concepts OJT takes about four to six months for most people to complete. This paper will explain how this first six months of training sets the new employee on their path to becoming a fully trained Operator.

  19. Training new operators - the first six months

    International Nuclear Information System (INIS)

    Worthel, B.

    2010-01-01

    The Fermilab Operations Department takes about two years to train a new Operator. The Operator's introductory (Concepts) On-the-Job-Training (OJT) gives him or her an overview of the laboratory, teaches the basic facts about all the accelerators, and it also teaches the new operator the training process used for all the rest of their OJT training. The Concepts OJT takes about four to six months for most people to complete. This paper will explain how this first six months of training sets the new employee on their path to becoming a fully trained Operator.

  20. 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.

  1. Methods and time schedule for follow-up of intracranial aneurysms treated with endovascular embolization: a systematic review.

    Science.gov (United States)

    Serafin, Zbigniew; Strześniewski, Piotr; Lasek, Władysław; Beuth, Wojciech

    2011-01-01

    To review the diagnostic value of angiographic methods and the optimal timetable for follow-up imaging of patients after endovascular treatment of intracranial aneurysms. A comprehensive computer-aided search for relevant primary papers was performed using the MEDLINE, PubMed, Embase, and Cochrane Collaboration database from January 1991 to March 2011. Original papers were included that reported either diagnostic value of angiographic modalities for follow-up vs. digital subtracted angiography (DSA) or comparison of aneurysm occlusion rate in delayed vs. early follow-up. The systematic review identified 35 relevant studies: 3 on the diagnostic value of three-dimensional (3D) DSA, 30 on the performance of magnetic resonance angiography (MRA), and 3 on time schedules for follow-up. 3D DSA had sensitivity of 100%, and specificity of 58.3-94.7%. Magnetic resonance angiography had sensitivity of 28.4-100%, and specificity of 50.0-100%. The proportion of aneurysms that recanalized between the early follow-up examination at 6 months and the delayed imaging at 1.5-6.0 years was 0-2.5%. Magnetic resonance angiography seems to be the best imaging method for the follow-up. In selected cases, when invasive angiography is necessary, 3D DSA should be considered to improve the diagnostic accuracy. Most patients who present with stable and adequate aneurysm occlusion at 6 months after coiling may not require further follow-up. Key words: intracranial aneurysm, embolization, coils, digital subtracted angiography, magnetic resonance, computed tomography.

  2. Epidemiological follow-up of nuclear fuel cycle workers in France: Review of IRSN's studies - 2017 report

    International Nuclear Information System (INIS)

    2017-10-01

    This report reviews the progresses in knowledge provided by the epidemiological research conducted by the IRSN. It concerns follow-up studies of health effects of workers employed in the nuclear fuel cycle, in link with their occupational chronic exposure to ionizing radiation, from external irradiation or internal contamination

  3. Long-term follow-up of radiation accident patients in Peru: Review of two cases

    International Nuclear Information System (INIS)

    Barriga, L. E.; Zaharia, M.; Pinillos, L.; Moscol, A.; Heredia, A.; Sarria, G.; Marquina, J.; Barriga, O.; Picon, C.

    2012-01-01

    Overexposure to radioactive sources used in radiotherapy or industrial radiography may result in severe health consequences. This report assesses the initial clinical status and the medical and psychological long-term follow-up of two radiation accident patients from Peru during the mid-to-late 1990's: one patient exposed to a radiotherapy 60 Co source in Arequipa, the other patient to a 192 Ir source in Yanango. Commonalities and differences are described. The main causes in both accidents were human error and the failure to apply appropriate safety guidelines and standard operating procedures. Education and training of the personnel working with radiation sources are essential to prevent accidents. The experience gained from the medical management of the two patients is valuable for future treatment of such patients. (authors)

  4. Incidence of chronic atrophic gastritis: systematic review and meta-analysis of follow-up studies.

    Science.gov (United States)

    Adamu, Mariam Abdullahi; Weck, Melanie Nicole; Gao, Lei; Brenner, Hermann

    2010-07-01

    Chronic atrophic gastritis (CAG) is an important precursor lesion of intestinal gastric cancer. As it is typically asymptomatic, epidemiological data on the incidence of CAG are sparse. We aimed to provide an overview of published data on CAG incidence (overall and according to risk factors) from follow-up studies. Articles with information on incidence of CAG published in English until 26th of July 2009 were identified through a systematic MEDLINE and EMBASE search. Data extracted include study characteristics and key findings regarding the incidence of CAG. A meta-analysis was performed on the association between Helicobacter pylori infection and CAG incidence. Overall, data on CAG incidence were available from 14 studies, in 7 studies incidence could be estimated according to H. pylori infection. Most studies were conducted in symptomatic or high risk populations and the maximum number of incident cases was 284. Incidence estimates ranged from 0 to 11% per year and were consistently below 1% in patients not infected with H. pylori. The highest incidence was observed in a special study conducted on ulcer patients treated by proximal gastric vagotomy. Rate ratios for the association between H. pylori infection and CAG incidence ranged from 2.4 to 7.6 with a summary estimate of 5.0 (95% confidence interval: 3.1-8.3). Incidence of CAG is very low in the absence of H. pylori infection. There is a need for more population-based studies to provide comparable estimates of incidence and the impact of risk factors in the development of CAG.

  5. Responding to Community Needs through Community Follow-Up. Junior College Resource Review.

    Science.gov (United States)

    Mehallis, Mantha Vlahos

    This literature review examines the utilization of community needs assessment data in program planning and evaluation efforts at community colleges. The review first defines and looks at the purposes of community needs assessments, noting that while such studies are purported to facilitate the planning and evaluation of credit and non-credit…

  6. Cognitive-behavioral therapy for anxiety disorders in children and adolescents: a systematic review of follow-up studies

    Directory of Open Access Journals (Sweden)

    Roberta Davis

    2014-12-01

    Full Text Available Objective To conduct a systematic review about the long-term response to cognitive-behavioral therapy (CBT for anxiety disorders (ADs in children and adolescents. Methods The PubMed and ISI Web of Science databases were consulted. Search in the databases was performed in November 2012 and included cohort studies after CBT for ADs in children and adolescents with a follow-up period over 12 months. Results A total of 10 papers met the inclusion criteria. The follow-up period ranged from 12 months to 13 years and the results generally showed maintenance of the short-term benefits with CBT. However, the studies presented limitations, especially regarding methods, such as lack of a control group and losses to follow-up. Conclusion The long-term benefits of CBT were identified, however it would be interesting to conduct other studies with more frequent assessment periods, in order to minimize losses to follow-up, in addition to evaluating children and adolescents in the various stages of their development.

  7. Follow up of MRI bone marrow edema in the treated diabetic Charcot foot – a review of patient charts

    Science.gov (United States)

    Chantelau, Ernst-A.; Zweck, Brigitte; Haage, Patrick

    2018-01-01

    ABSTRACT Background: Ill-defined areas of water-like signal on bone magnetic resonance imaging (MRI), characterized as bone marrow edema or edema-equivalent signal-changes (EESC), is a hallmark of active-stage pedal neuro-osteoarthropathy (Charcot foot) in painless diabetic neuropathy, and is accompanied by local soft-tissue edema and hyperthermia. The longitudinal effects on EESC of treating the foot in a walking cast were elucidated by reviewing consecutive cases of a diabetic foot clinic. Study design: Retrospective observational study, chart review Material and methods: Cases with active-stage Charcot foot were considered, in whom written reports on baseline and follow-up MRI studies were available for assessment. Only cases without concomitant infection or skin ulcer were chosen, in whom both was documented, onset of symptomatic foot swelling and patient compliance with cast treatment. Results: From 1994 to 2017, 45 consecutive cases in 37 patients were retrieved, with 95 MRI follow-up studies (1–6 per case, average interval between studies 13 weeks). Decreasing EESC was documented in 66/95 (69%) follow-up studies. However, 29/95 (31%) studies revealed temporarily increasing, migrating or stagnating EESC. Conclusion: EESC on MRI disappear in response to prolonged offloading and immobilizing treatment; however, physiologic as well as pathologic fluctuations of posttraumatic EESC have to be considered when interpreting the MR images. Conventional MRI is useful for surveillance of active-stage Charcot foot recovery. PMID:29713425

  8. Gliomatosis cerebri followed-up with sequential CT scans report of case and a brief review

    International Nuclear Information System (INIS)

    Shiino, Akihiko; Suda, Kinya; Matsuda, Masayuki; Handa, Jyoji; Hazama, Fumitada

    1984-01-01

    Gliomatosis cerebri is a rare condition in which the tumor cells grow infiltratively and diffusely into the central nervous system without destructing the normal architechtures of the brain to a significant degree. As no single diagnostic test is highly specific to this condition, its clinical diagnosis is often very difficult. In the present case of a 71-year-old man, we could follow the course of the disease by repeated CT scans performed in 2 and a half years, and found such sequential CT scans very useful for the diagnosis of this condition. To our knowledge, this is the first report of sequential CT studies in gliomatosis cerebri. This case is reported and the relevant literature on gliomatosis cerebri is briefly reviewed. (author)

  9. Economic evaluations of follow-up strategies for cancer survivors: a systematic review and quality appraisal of the literature.

    Science.gov (United States)

    Meregaglia, Michela; Cairns, John

    2015-01-01

    The aim of this study was to review and critically assess the health economics literature on post-treatment follow-up for adult cancer survivors. A systematic search was performed using PubMed, EMBASE and the Cochrane Library. The Consolidated Health Economic Evaluation Reporting Standards checklist was adopted to assess the quality of the included studies. Thirty-nine articles met the eligibility criteria. Around two thirds of the studies addressed the most common cancers (i.e., breast, colorectal, cervical and lung); 21 were based on a single clinical study, while the rest were modeling papers. All types of economic evaluations were represented other than cost-benefit analysis. The overall quality was generally high with an average proportion of 74% of checklist criteria fulfilled. The cost-effectiveness results supported the current trend towards less intensive, primary care-based and risk-adapted follow-up schemes.

  10. Surgical management of arrested hydrocephalus: Case report, literature review, and 18-month follow-up.

    Science.gov (United States)

    Hong, Jennifer; Barrena, Benjamin G; Lollis, S Scott; Bauer, David F

    2016-12-01

    Arrested hydrocephalus is stable ventriculomegaly without evidence of neurologic deterioration or symptoms. Management of arrested hydrocephalus in asymptomatic adults is controversial, with little clinical data. This case highlights the potential for decompensation in adults with arrested hydrocephalus and reviews the literature regarding pathophysiology and management of this clinical entity. A 39 year-old gentleman with arrested hydrocephalus incidentally found during work-up for new-onset seizure and managed conservatively for ten years presented with increasing headache, memory loss, gait instability and urinary and fecal incontinence. Stable massive triventriculomegaly was documented on serial brain imaging, and ophthalmologic exam revealed no papilledema. The patient underwent endoscopic third ventriculostomy with immediate post-operative improvement of headache, resolution of incontinence, and cessation of seizures. At 15 months after surgery, neuropsychiatric testing demonstrated improvement in visuomotor skills, problem solving, verbal fluency and cognitive flexibility compared to his pre-operative baseline. At 18 months after surgery he remained seizure free with full continence and significant improvement in headaches. Early recognition of arrested hydrocephalus and its potential for decompensation may prompt surgical treatment and prevent neurologic deterioration. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Survival of all-ceramic restorations after a minimum follow-up of five years: A systematic review.

    Science.gov (United States)

    Araujo, Nara Santos; Moda, Mariana Dias; Silva, Ebele Adaobi; Zavanelli, Adriana Cristina; Mazaro, José Vitor Quinelli; Pellizzer, Eduardo Piza

    2016-01-01

    The purpose of this systematic review was to compare the survival and complication rates of all-ceramic restorations after a minimum follow-up time of 5 years. A comprehensive search of studies published from 2005 to November 2015 and listed in the PubMed/MEDLINE, Scopus, and Cochrane Library databases was performed in accordance with the PRISMA statement. Two reviewers independently analyzed the abstracts. Relevant studies were selected according to predetermined inclusion criteria. Twenty-nine studies were selected for the final analysis from an initial yield of 514. Only four studies fulfilled the requirement of having a randomized design, and 25 studies were prospective with a mean follow-up period of 5 to 16 years. Overall, the 5-year complication rates were low. The most frequent complications were secondary caries, endodontic problems, ceramic fractures, ceramic chipping, and loss of retention. This systematic review showed that all-ceramic restorations fabricated using the correct clinical protocol have an adequate clinical survival for at least 5 years of clinical service with very low complication rates. Minor ceramic chipping and debonding did not affect the longevity of the restorations. Long-term clinical performance of all-ceramic restorations manufactured using various ceramic systems provides clinical evidence of complications and long-term management of these restorations. Available evidence indicates the effectiveness of many ceramic systems for numerous clinical applications. Correct planning and a rigorous technical execution protocol increase clinical success. Studies of ceramic prostheses indicate more problems with ceramic failure and debonding.

  12. Colorectal cancer patients in a tertiary referral centre in Malaysia: a five year follow-up review.

    Science.gov (United States)

    Rashid, Mohd Radzniwan A; Aziz, Aznida Firzah Abdul; Ahmad, Saharuddin; Shah, Shamsul Azhar; Sagap, Ismail

    2009-01-01

    Colorectal cancer (CRC) is one of the major malignancies in the world. In Malaysia, CRC is fast becoming the commonest cause of cancer death. Its etiology is complex, involving both environmental and genetic factors. This study looked at the profile and outcome of five-year follow-up of patients with CRC. Retrospective case review study done on CRC patients at University Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia. Patientsandapos; socio-demographic characteristics, modalities of treatment, cancer characteristics and outcome at 5-year follow up were extracted from the case records. A total of 107 case records of patients were analyzed. Peak age of CRC presentation was 40-69 years (71.1%). Male to female ratio was 1.2:1 with Chinese predominance (52.3%). Anaemia and its related symptoms including per rectal bleeding was the commonest clinical presentation. The median duration of clinical presentation was 13 weeks (IQR 21.8). More than two-thirds presented as non-emergency cases (69.2%). Most patients presented with Dukes C stage (40.2%). The overall 5-year survival rate was 40% with local recurrence rate of 19.6%. Metastasis after curative-intend treatment (surgery with adjuvant therapy) developed in 26% of patients. Lower recurrence (p = 0.016, OR = 0.205) and metastatic disease (p = 0.02, OR = 0.24) found among the Chinese patients. Almost half of the patients defaulted follow up care (43%), most often within the first year of treatment (22.4%) and the Chinese were the least likely to default (p= 0.04, OR = 0.45). Socio-demographic profile of CRC patients in UKMMC is comparable to Asia pacific region. Apparent delay in seeking treatment gives rise to poor overall survival and local recurrence rates.

  13. IAEA OSART/EXPERT follow-up review mission completes assessment of actions taken by Paks Nuclear Power Plant

    International Nuclear Information System (INIS)

    2004-01-01

    On 28 February 2004 the IAEA completed its follow-up review mission to assess the actions taken by Paks nuclear power plant (NPP) in response to the Agency's recommendations and suggestions made during the 2001 Operational Safety Review Team (OSART) mission and the 2003 Expert mission that investigated the fuel cleaning incident at the Paks NPP in Hungary. The mission was requested by the Hungarian Government to provide an independent assessment of the actions taken by Paks NPP. The IAEA team determined that the actions taken by Paks have resulted in tangible progress and concluded that all issues were either fully resolved or progressing satisfactorily. In a press conference, the team's conclusions in five areas were highlighted: management, Regulatory Oversight/Interface, operations and maintenance, including operating experience, radiation protection, emergency planning and preparedness, and transparency

  14. Follow-up of cerebral aneurysm embolization with hydrogel embolic system: Systematic review and meta-analysis.

    Science.gov (United States)

    Serafin, Zbigniew; Di Leo, Giovanni; Pałys, Alicja; Nowaczewska, Magdalena; Beuth, Wojciech; Sardanelli, Francesco

    2015-10-01

    Hydrogel embolic system (HES) for endovascular treatment of cerebral aneurysms was developed to reduce the risk of aneurysm recurrence and the rate of retreatment. The aim of this systematic review was to verify the efficacy of HES, also in comparison to bare platinum coils (BPC). A systematic literature search was performed by two independent reviewers for articles published until January 31st, 2013 on the follow-up recurrence rate of intracranial aneurysm embolization with hydrogel-coated coils. Thirteen articles on the use of HES for embolization of cerebral aneurysms were included in this study, for a total of 1683 embolized aneurysms. Significant heterogeneity was found regarding patient populations, methods of aneurysm coiling, follow-up schedules, and recurrence definitions. The pooled rate of initial complete aneurysm occlusion was 55% (95%CI, 38-70%); 59% (95%CI, 43-74%) in the subgroup of aneurysms treated with the use of HES. The pooled total recurrence rate was 19% (95%CI, 15-24%); 17% (95%CI, 14-22%) in the HES-treated subgroup. The pooled major recurrence rate was 12% (95%CI, 8-18%); 11% (95%CI, 7-16%) in the HES-treated subgroup. Comparing both types of coils, the pooled odds ratio for total recurrence was 0.63 (95%CI, 0.45-0.88; p=0.008) in favor of HES. Embolization of cerebral aneurysms using HES seems to result in a lower rate of recurrence than that obtained using BPC, which is in line with the only randomized controlled trial. High-quality prospective studies are needed to define specific indications for the use of hydrogel-coated coils. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Monitoring and Follow-up of Chronic Heart Failure: a Literature Review of eHealth Applications and Systems.

    Science.gov (United States)

    de la Torre Díez, Isabel; Garcia-Zapirain, Begoña; Méndez-Zorrilla, Amaia; López-Coronado, Miguel

    2016-07-01

    In developed countries heart failure is one of the most important causes of death, followed closely by strokes and other cerebrovascular diseases. It is one of the major healthcare issues in terms of increasing number of patients, rate of hospitalizations and costs. The main aim of this paper is to present telemedicine applications for monitoring and follow-up of heart failure and to show how these systems can help reduce costs of administering heart failure. The search for e-health applications and systems in the field of telemonitoring of heart failure was pursued in IEEE Xplore, Science Direct, PubMed and Scopus systems between 2005 and the present time. This search was conducted between May and June 2015, and the articles deemed to be of most interest about treatment, prevention, self-empowerment and stabilization of patients were selected. Over 100 articles about telemonitoring of heart failure have been found in the literature reviewed since 2005, although the most interesting ones have been selected from the scientific standpoint. Many of them show that telemonitoring of patients with a high risk of heart failure is a measure that might help to reduce the risk of suffering from the disease. Following the review conducted, in can be stated that via the research articles analysed that telemonitoring systems can help to reduce the costs of administering heart failure and result in less re-hospitalization of patients.

  16. Periapical cemento-osseous dysplasia: a case report with twelve-year follow-up and review of literature.

    Science.gov (United States)

    Senia, E S; Sarao, M S

    2015-11-01

    To present a case report describing the long-term behaviour of periapical cemento-osseous dysplasia by observing the radiographic changes that took place over a period of 12 years. A review of the pertinent literature is also presented. A healthy 26-year-old white female was referred to the Wilford Hall USAF Medical Center Endodontic Department for evaluation of an asymptomatic radiolucency at the apex of the right mandibular lateral incisor. Following a clinical evaluation that included pulp testing, a diagnosis of periapical cemento-osseous dysplasia (PCOD) was made. No treatment was rendered but follow-up visits were recommended. The patient was subsequently re-evaluated 8 times over a period of 12 years. During that time the lesion changed in appearance, displaying the various phases of PCOD. At the same time, lesions affecting the three adjoining incisors appeared and behaved in a similar manner. At the 12-year recall, the right lateral and both central incisors revealed no evidence of PCOD and an almost normal trabecular pattern of bone could be seen. Misdiagnosis and unnecessary treatment of PCOD may be avoided with careful pulp testing and knowledge of its most common locations of occurrence, radiographic appearances (phases) and benign behaviour. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  17. Intensive follow-up for women with breast cancer: review of clinical, economic and patient's preference domains through evidence to decision framework.

    Science.gov (United States)

    Lafranconi, Alessandra; Pylkkänen, Liisa; Deandrea, Silvia; Bramesfeld, Anke; Lerda, Donata; Neamțiu, Luciana; Saz-Parkinson, Zuleika; Posso, Margarita; Rigau, David; Sola, Ivan; Alonso-Coello, Pablo; Martinez-Zapata, Maria José

    2017-10-19

    Women treated for breast cancer are followed-up for monitoring of treatment effectiveness and for detecting recurrences at an early stage. The type of follow-up received may affect women's reassurance and impact on their quality of life. Anxiety and depression among women with breast cancer has been described, but little is known about how the intensity of the follow-up can affect women's psychological status. This study was undertaken to evaluate the effects of intensive vs. less-intensive follow-up on different health outcomes, to determine what are women's preferences and values regarding the follow-up received, and also assess the costs of these different types of follow-up. A systematic review following standard Cochrane Collaboration methods was carried out to assess the efficacy of intensive follow-up versus non-intensive follow-up in breast cancer patients. Two additional reviews on women's preferences and economic evidence were also carried out. The search was performed up to January 2016 in: MEDLINE, EMBASE, PDQ, McMaster Health Systems Evidence, CENTRAL, and NHS EED (through The Cochrane Library). The quality of evidence was assessed by GRADE (for quantitative studies) and CerQUAL (for qualitative studies). Several outcomes including mortality, breast cancer recurrences, quality of life, and patient satisfaction were evaluated. Six randomised trials (corresponding to 3534 women) were included for the evaluation of health outcomes; three studies were included for women's values and preferences and four for an economic assessment. There is moderate certainty of evidence showing that intensive follow-up, including more frequent diagnostic tests or visits, does not have effects on 5- or 10-year overall mortality and recurrences in women with breast cancer, compared with less intensive follow-up. Regarding women's preferences and values, there was important variability among studies and within studies (low confidence due to risk of bias and inconsistency

  18. EU-stress test: Swiss national action plan. Follow-up of peer review 2012 year-end status report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-12-15

    The European Union (EU) stress test is part of the review process which Switzerland initiated immediately after the reactor accident in Japan. As a direct consequence of the accident, the Swiss Federal Nuclear Safety Inspectorate (ENSI) issued three formal orders in which the operators of the Swiss nuclear power plants (NPPs) were required to implement immediate measures and to conduct additional reassessments. The immediate measures comprised the establishment of an external emergency storage facility for the Swiss NPPs, including the necessary plant-specific connections, and back-fittings to provide external injection into the spent fuel pools. The additional reassessments focused on the design of the Swiss NPPs against earthquakes, external flooding and a combination thereof. Investigations on the coolant supply for the safety systems and the spent fuel pool cooling were also requested. ENSI carried out an analysis of the events at Fukushima providing detailed descriptions of the causes, consequences and radiological impacts of the accident. The reports analyse the contributory human and organisational factors, and specify lessons that can be derived from this information. ENSI instructed the Swiss operators to take part in the EU stress test. There was to be particular examination of the robustness of the NPPs in case of impacts beyond the design basis due to earthquakes, external flooding and extreme weather conditions, with consequential loss of power supply and heat sink, and the need for severe accident management actions. ENSI requested further clarification on plant specific issues and produced the National Report which was delivered to the EU Commission. A Country Peer Review Draft Report was drawn up for each country, including a list of issues (open points) for further follow-up by the review team. Eight new open points were identified to further improve the safety of the Swiss NPPs. These open points together with the issues identified in the analysis

  19. EU-stress test: Swiss national action plan. Follow-up of peer review 2012 year-end status report

    International Nuclear Information System (INIS)

    2012-12-01

    The European Union (EU) stress test is part of the review process which Switzerland initiated immediately after the reactor accident in Japan. As a direct consequence of the accident, the Swiss Federal Nuclear Safety Inspectorate (ENSI) issued three formal orders in which the operators of the Swiss nuclear power plants (NPPs) were required to implement immediate measures and to conduct additional reassessments. The immediate measures comprised the establishment of an external emergency storage facility for the Swiss NPPs, including the necessary plant-specific connections, and back-fittings to provide external injection into the spent fuel pools. The additional reassessments focused on the design of the Swiss NPPs against earthquakes, external flooding and a combination thereof. Investigations on the coolant supply for the safety systems and the spent fuel pool cooling were also requested. ENSI carried out an analysis of the events at Fukushima providing detailed descriptions of the causes, consequences and radiological impacts of the accident. The reports analyse the contributory human and organisational factors, and specify lessons that can be derived from this information. ENSI instructed the Swiss operators to take part in the EU stress test. There was to be particular examination of the robustness of the NPPs in case of impacts beyond the design basis due to earthquakes, external flooding and extreme weather conditions, with consequential loss of power supply and heat sink, and the need for severe accident management actions. ENSI requested further clarification on plant specific issues and produced the National Report which was delivered to the EU Commission. A Country Peer Review Draft Report was drawn up for each country, including a list of issues (open points) for further follow-up by the review team. Eight new open points were identified to further improve the safety of the Swiss NPPs. These open points together with the issues identified in the analysis

  20. 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 ...

  1. Tuberculous pleural effusion – relapse or re-infection? Follow up of a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Tahziba Hussain

    2016-10-01

    This condition carries good prognosis, if promptly diagnosed and treated. A reasonable management strategy for pleural TB would be to initiate a four-drug regimen and perform a therapeutic thoracocentesis in patients with large, symptomatic effusions. Prolonged follow-up is essential in cases of pleural effusion, as in the presented case.

  2. Long term follow up of idiopathic gingival enlargement associated with chronic periodontitis: A case report and review

    Directory of Open Access Journals (Sweden)

    Girish P Nagarale

    2013-01-01

    Full Text Available Background: Idiopathic gingival enlargement is a rare condition characterized by massive enlargement of the gingiva. It may be associated with other diseases/conditions characterizing a syndrome, but rarely associated with periodontitis. Case Description: This case report describes an unusual clinical form of gingival enlargement associated with chronic periodontitis. Clinical examination revealed diffuse gingival enlargement. The lesion was asymptomatic, firm, and pinkish red. Generalized periodontal pockets were observed. Radiographic evaluation revealed generalized severe alveolar bone loss. Histopathological investigations revealed atrophic epithelium with dense fibrocollagenous tissue. Lesions healed successfully following extraction and surgical excision, and no recurrence was observed after 1 year follow-up but recurrence was observed at 3 and 5-years follow-up. Clinical Implications: Successful treatment of idiopathic gingival enlargement depends on proper identification of etiologic factors and improving esthetics and function through surgical excision of the over growth. However, there may be recurrence.

  3. Long term follow up of idiopathic gingival enlargement associated with chronic periodontitis: A case report and review.

    Science.gov (United States)

    Nagarale, Girish P; Ravindra, S; Thakur, Srinath; Setty, Swati

    2013-03-01

    Idiopathic gingival enlargement is a rare condition characterized by massive enlargement of the gingiva. It may be associated with other diseases/conditions characterizing a syndrome, but rarely associated with periodontitis. This case report describes an unusual clinical form of gingival enlargement associated with chronic periodontitis. Clinical examination revealed diffuse gingival enlargement. The lesion was asymptomatic, firm, and pinkish red. Generalized periodontal pockets were observed. Radiographic evaluation revealed generalized severe alveolar bone loss. Histopathological investigations revealed atrophic epithelium with dense fibrocollagenous tissue. Lesions healed successfully following extraction and surgical excision, and no recurrence was observed after 1 year follow-up but recurrence was observed at 3 and 5-years follow-up. Successful treatment of idiopathic gingival enlargement depends on proper identification of etiologic factors and improving esthetics and function through surgical excision of the over growth. However, there may be recurrence.

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

    Directory of Open Access Journals (Sweden)

    Hummers-Pradier Eva

    2011-06-01

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

  5. [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.

  6. How needs and preferences of employees influence participation in health promotion programs: A six-month follow-up study

    NARCIS (Netherlands)

    A. Rongen (Anne); S.J.W. Robroek (Suzan); W. van Ginkel (Wouter); D. Lindeboom; M. Pet (Martin); A. Burdorf (Alex)

    2014-01-01

    textabstractBackground: Low participation in health promotion programs (HPPs) might hamper their effectiveness. A potential reason for low participation is disagreement between needs and preferences of potential participants and the actual HPPs offered. This study aimed to investigate employees'

  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. 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...

  9. Retrospective review to determine the utility of follow-up skeletal surveys in child abuse evaluations when the initial skeletal survey is normal

    Directory of Open Access Journals (Sweden)

    Kachelmeyer Andrea

    2011-09-01

    Full Text Available Abstract Objective The AAP recommends that a follow-up skeletal survey be obtained for all children Methods A retrospective review of radiology records from September 1, 1998 - January 31, 2007 was conducted. Suspected victims of child abuse who were Results Forty-seven children had a negative initial skeletal survey and were included for analysis. The mean age was 6.9 months (SD 5.7; the mean number of days between skeletal surveys was 18.7 (SD 10.1 Four children (8.5% had signs of healing bone trauma on a follow-up skeletal survey. Three of these children (75% had healing rib fractures and one child had a healing proximal humerus fracture. The findings on the follow-up skeletal survey yielded forensically important information in all 4 cases and strengthened the diagnosis of non-accidental trauma. Conclusion 8.5 percent of children with negative initial skeletal surveys had forensically important findings on follow-up skeletal survey that increased the certainty of the diagnosis of non-accidental trauma. A follow-up skeletal survey can be useful even when the initial skeletal survey is negative.

  10. Six month suspension of Tsuruga nuclear power plant ordered

    International Nuclear Information System (INIS)

    1981-01-01

    This report first describes on brief review of the troubles at Tsuruga Nuclear Power Station. All these accidents or troubles were settled within the Tsuruga Nuclear Power Station, and none was reported either to the Agency of Natural Resources and Energy (ANRE) of Ministry of International Trade and Industry, which is responsible for the supervision of nuclear power plants, or even to the head of Japan Atomic Power Co. (JAPCO). JAPCO criticized itself for the failure to recognize the importance of proper communication. It has been decided that Mr. Suzuki, President of JAPCO, will be succeeded by Mr. Okabe, Managing Director of Tokyo Electric Power Co. It was ordered that the operation of the Tsuruga Nuclear Power Station should be suspended for six months, in accordance with the Reactor Regulation Law, because of the violation of the safety regulations. The final report of ANRE said that ANRE has determined to make maximum efforts to ensure the safety of nuclear power plants, in order to prevent the recurrence of such an accident, and to restore public confidence in nuclear power plants. Nuclear Safety Commission declared that there would be no present or future effect of the radiation leakage on the local people. Local people's organization is lodging complaint against JAPCO. It is expected that the talks between the Ministries of Home Affairs and International Trade and Industry will center on the strengthening of contacts between nuclear power plants and local self-government bodies. (Wakatsuki, Y.)

  11. Gelsemium elegans Poisoning: A Case with 8 Months of Follow-up and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Zhou Zhou

    2017-05-01

    Full Text Available BackgroundGelsemium elegans (G. elegans is a toxic plant indigenous to Southeast Asia. It is highly poisonous due to its strong respiratory depressive effect. However, G. elegans poisoning cases have not been summarized comprehensively and are rarely reported in English journals. Furthermore, none of the present reports present prognosis in detail.Case presentationA 26-year-old female was found comatose at home and brought to the hospital with deep coma, hypoxia, and acidosis. After mechanical ventilation for hours, the patient recovered from coma with sequelae of impaired short-term memory, disorientation, and childish behaviors. Brain magnetic resonance imaging (MRI showed bilateral hippocampus and basal ganglia damage due to hypoxia. During 8 months of follow-up, both her symptoms and brain MRI scan improved significantly.ConclusionG. elegans is highly toxic. Although patients may die within 30 min due to its strong respiratory depressive effect, they can survive with timely respiratory support and enjoy gradual improvement without delayed postanoxic encephalopathy.

  12. Spondylocostal Dysostosis: A Literature Review and Case Report with Long-Term Follow-Up of a Conservatively Managed Patient

    Directory of Open Access Journals (Sweden)

    Brendan R. Southam

    2018-01-01

    Full Text Available Introduction. Patients with spondylocostal dysostosis (SCD have congenital spine and rib deformities associated with frequently severe thoracic insufficiency and respiratory compromise. The literature is largely composed of case reports and small cohorts, and there is little information regarding adults with this condition. In this report, we describe the natural history of a conservatively treated patient and include quality-of-life issues such as childbearing, athletic participation, and occupational selection. Case Presentation. We present a patient with SCD who was conservatively treated by a single physician from birth for 31 years. Our patient was capable of a reasonably good quality of life through adulthood, including participation in gymnastics and employment. At age 18, she became pregnant and subsequently terminated the pregnancy due to obstetrical concerns for compromised respiration. She has had intermittent respiratory complaints and occasionally experiences dyspnea with exertion, but this only has limited her during certain activities in the past three years. Currently, she takes naproxen for chronic back pain with periodic exacerbations. Discussion. Other cases in the literature have described adult SCD patients who have received nonoperative treatment and achieved a wide range of functional outcomes. This provides some limited evidence to suggest that select patients with SCD may be treated conservatively and achieve a reasonable quality of life. However, close clinical follow-up with these patients is recommended, particularly early on, considering the high rates of infant morbidity and mortality. Chest physiotherapy and early pulmonary care have been associated with favorable outcomes in infancy. Surgery to increase thoracic volume and correct scoliosis has been shown in some cases to improve respiratory function. Treatment depends on the degree of thoracic insufficiency and quality of life. The natural history of SCD remains

  13. Long-Term Follow-Up after Phrenic Nerve Reconstruction for Diaphragmatic Paralysis: A Review of 180 Patients.

    Science.gov (United States)

    Kaufman, Matthew R; Elkwood, Andrew I; Brown, David; Cece, John; Martins, Catarina; Bauer, Thomas; Weissler, Jason; Rezzadeh, Kameron; Jarrahy, Reza

    2017-01-01

    Background  Phrenic nerve reconstruction has been evaluated as a method of restoring functional activity and may be an effective alternative to diaphragm plication. Longer follow-up and a larger cohort for analysis are necessary to confirm the efficacy of this procedure for diaphragmatic paralysis. Methods  A total of 180 patients treated with phrenic nerve reconstruction for chronic diaphragmatic paralysis were followed for a median 2.7 years. Assessment parameters included: 36-Item Short Form Health Survey (SF-36) physical functioning survey, spirometry, chest fluoroscopy, electrodiagnostic evaluation, a five-item questionnaire to assess specific functional issues, and overall patient-reported outcome. Results  Overall, 134 males and 46 females with an average age of 56 years (range: 10-79 years) were treated. Mean baseline percent predicted values for forced expiratory volume in 1 second, forced vital capacity, vital capacity, and total lung capacity, were 61, 63, 67, and 75%, respectively. The corresponding percent improvements in percent predicted values were: 11, 6, 9, and 13% ( p ≤ 0.01; ≤ 0.01; ≤ 0.05; ≤ 0.01). Mean preoperative SF-36 physical functioning survey scores were 39%, and an improvement to 65% was demonstrated following surgery ( p  ≤ 0.0001). Nerve conduction latency, improved by an average 23% ( p  ≤ 0.005), and there was a corresponding 125% increase in diaphragm motor amplitude ( p  ≤ 0.0001). A total of 89% of patients reported an overall improvement in breathing function. Conclusion  Long-term assessment of phrenic nerve reconstruction for diaphragmatic paralysis indicates functional correction and symptomatic relief. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

    Science.gov (United States)

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

    2013-11-01

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

  15. Are We Overtreating Renal Angiomyolipoma: A Review of the Literature and Assessment of Contemporary Management and Follow-Up Strategies.

    Science.gov (United States)

    Murray, Timothy E; Lee, Michael J

    2018-04-01

    Renal angiomyolipoma (AML) are benign tumours composed of fat, muscle, and disorganised blood vessels. Historic treatment algorithms for sporadic AML based on size fail to consider additional risk factors such as tumour vascularity and pseudoaneurysm formation. As AML is now predominantly incidental, rupture is rare and its mortality low. The recent publication of the largest longitudinal series to date also suggest that growth is uncommon, challenging existing surveillance paradigms. The evidence assessing treatment strategies in AML are reviewed, with particular emphasis on incidental sporadic AML. The relative merits of various AML treatments are discussed, and areas of clinical uncertainty highlighted.

  16. Ten years on: a follow-up review of ERP research in attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Johnstone, Stuart J; Barry, Robert J; Clarke, Adam R

    2013-04-01

    This article reviews the event-related potential (ERP) literature in relation to attention-deficit/hyperactivity disorder (AD/HD) over the years 2002-2012. ERP studies exploring various aspects of brain functioning in children and adolescents with AD/HD are reviewed, with a focus on group effects and interpretations in the domains of attention, inhibitory control, performance monitoring, non-pharmacological treatments, and ERP/energetics interactions. There has been a distinct shift in research intensity over the past 10 years, with a large increase in ERP studies conducted in the areas of inhibitory control and performance monitoring. Overall, the research has identified a substantial number of ERP correlates of AD/HD. Robust differences from healthy controls have been reported in early orienting, inhibitory control, and error-processing components. These data offer potential to improve our understanding of the specific brain dysfunction(s) which contribute to the disorder. The literature would benefit from a more rigorous approach to clinical group composition and consideration of age effects, as well as increased emphasis on replication and extension studies using exacting participant, task, and analysis parameters. Copyright © 2012 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  17. Quality-of-Life Impairments Persist Six Months After Treatment of Graves' Hyperthyroidism and Toxic Nodular Goiter

    DEFF Research Database (Denmark)

    Cramon, Per; Winther, Kristian Hillert; Watt, Torquil

    2016-01-01

    treated with antithyroid drugs, radioactive iodine, or surgery. Disease-specific and generic HRQoL were assessed using the thyroid-related patient-reported outcome (ThyPRO) and the Medical Outcomes Study 36-item Short Form (SF-36), respectively, evaluated at baseline and six-month follow-up. The scores...

  18. Seismic safety review mission for the follow-up of the seismic upgrading of Kozloduy NPP (Units 1-4). Sofia, Bulgaria, 16-20 November 1992

    International Nuclear Information System (INIS)

    David, M.; Shibata, H.; Stevenson, J.D.; Godoy, A.; Gurpinar, A.

    1992-11-01

    A Seismic Safety Review Mission for the follow-up of the design and implementation of the seismic upgrading of Kozloduy NPP was performed in Sofia from 16-20 November 1992. This mission continued the second task of the follow-up activities of the design and implementation of the seismic upgrading (Phases 1 and 2), which is being carried out in Units 1 and 2 of the NPP. Thus the objectives of the mission was to assist the Bulgarian authorities in the technical evaluation of the design tasks defined for Phases 1 and 2 item HB of WANO 6 Month Programme, as follows: anchorage upgrades of low seismic capacity components; list of seismic safety related systems and components; detailed walkdown to assess seismic capacity of components and define priorities for the upgrading; determination of seismic structural capacity of pump house, diesel generator building and turbine building and design of required upgrades; liquefaction potential evaluation. Tabs

  19. Six-month longitudinal patterns of mental health treatment utilization by older adults with depressive symptoms.

    Science.gov (United States)

    Gum, Amber M; Iser, Lindsay; King-Kallimanis, Bellinda L; Petkus, Andrew; DeMuth, Anne; Schonfeld, Lawrence

    2011-11-01

    Aims of the study were to describe behavioral health treatment utilization patterns of community-dwelling older adults with depressive symptoms over a six-month period and to identify factors associated with treatment use, guided by a theoretical model emphasizing the dynamic nature of treatment use patterns over time and social context. A total of 144 participants ≥65 years old with depressive symptoms completed an in-person baseline interview and six monthly telephone follow-up interviews. Outcomes at each follow-up included the use of antidepressants or counseling. Covariates included personal and social context variables. Approximately half of the participants (N=70, 48%) received no formal treatment (antidepressant prescription or counseling). Treatment use or nonuse did not change for most participants. More participants with severe symptoms received antidepressants (25%-37%) than did those with milder symptoms (10%-14%), although more participants in the latter group started (milder, 62%,versus severe, 49%) and stopped (milder, 77%, versus severe, 26%) antidepressant treatment at least once. Fewer individuals received counseling overall, with no clear patterns by symptom severity. In multivariate longitudinal analyses, treatment use at follow-up was independently associated with younger age, current major depressive episode, baseline use of antidepressant, intention to begin a new treatment at baseline, and receipt of advice to seek treatment. Over a six-month period, most older adults with depressive symptoms in this study continued their use or nonuse of mental health treatment. Demographic, need, attitudinal, and social variables were related to treatment use over time. Addressing intentions and providing advice may facilitate treatment seeking.

  20. Long-Term Clinical Outcomes and Factors That Predict Poor Prognosis in Athletes After a Diagnosis of Acute Spondylolysis: A Retrospective Review With Telephone Follow-up.

    Science.gov (United States)

    Selhorst, Mitchell; Fischer, Anastasia; Graft, Kristine; Ravindran, Reno; Peters, Eric; Rodenberg, Richard; MacDonald, James

    2016-12-01

    Study Design Retrospective review with telephone follow-up. Background Acute spondylolytic injuries have a dramatic impact on the young athlete. Excellent short-term clinical outcomes have been observed, but not enough is known about long-term clinical outcomes. Objectives (1) To report long-term clinical outcomes for patients diagnosed with acute spondylolysis, and (2) to assess the prognostic ability of retrospective variables for long-term outcomes. Methods Patients from 2010 through 2013 were retrospectively reviewed to identify patients and to obtain demographic, baseline, and short-term outcomes. Long-term follow-up data were collected by telephone from patients diagnosed with acute spondylolysis to assess recurrence rate of low back pain, perceived outcome, pain, and functional ability. Patients were categorized as having a good or poor long-term outcome based on these measures. Logistic regression analysis was performed to assess the prognostic ability of the retrospective variables for long-term outcomes 3.4 years (range, 1.5-5.6 years) after treatment. Results One hundred twenty-one (71.6%) patients completed the follow-up questionnaire (48 female; mean age at baseline, 14.4 years). At follow-up, 81 (66.9%) patients were able to maintain their same or a higher level of sport. Recurrence of significant symptoms was reported by 55 (45.5%) patients, with 41 (33.9%) requiring medical treatment. The final logistic regression model revealed that female sex, adverse reaction during care, and multilevel injury were significant predictors of poor long-term outcome (R 2 = 0.22). Conclusion Although excellent short-term outcomes were noted, 42% of patients reported a poor outcome at long-term follow-up. Female sex, multilevel injury, and experiencing an adverse reaction during care were significant predictors of poor long-term clinical outcome for patients diagnosed with acute spondylolysis. Level of Evidence Prognosis, level 4. Registered January 15, 2015 at www

  1. Low-dose radioiodine given six-monthly in Graves' disease

    International Nuclear Information System (INIS)

    Hoskin, P.J.; McCready, V.R.; Harmer, C.L.; Spathis, G.S.; Cosgrove, D.O.

    1985-01-01

    Experience using low-dose radioiodine given six-monthly instead of yearly in hyperthyroid patients with Graves' disease is reported. One hundred and thirty-five patients have been treated over a three-year period with 74 MBq (2 mCi) doses of 131 I. |Thirty-eight|percent| were controlled with a single dose. Those patients requiring more than one dose were treated with a further 74 MBq (2 mCi) 131 I at six-monthly intervals until euthyroid. Using this approach, 46% were euthyroid one year after starting treatment, and 75% were euthyroid at two years. The incidence of hypothyroidism following treatment was 2.2% at one year, with a yearly incidence thereafter of 4-6%. Six-monthly scheduling of low-dose radioiodine in Graves' disease can reduce the time taken to become euthyroid, compared with conventional yearly low-dose treatments. Further follow up is required to confirm the present low incidence of hypothyroidism following treatment. (author)

  2. Six-Month Clinical and Angiographic Results of Paclitaxel Eluting Simpax Stent

    Directory of Open Access Journals (Sweden)

    Mehmet Muhsin Türkmen

    2012-08-01

    Full Text Available Introduction: We aimed to evaluate the safety and efficacy of the simpax stent in the treatmentof different patient groups.Patients and Methods: Forty-five patients were treated with the simpax stent. Of these patients,23 patients gave consent for six months of follow-up by quantitative coronary angiography (QSAand six patients were evaluated by exercise electrocardiographic test. Only the patients havinglesions with stenosis > 50% of diameter and lengths > 16 mm with reference diameters < 2.75mm were included.Results: The device success rate was 100% and procedure success rate was 97.7%. The meanstent length was 24.6 ± 7.3 mm and stent size was 2.54 ± 0.24 mm. The overall six months incidenceof major adverse cardiac events (MACE was 8.8%. MACE was consisted of two casesof non-Q wave myocardial infarction and two cases of repeated revascularization of the targetlesion. MACE rate was higher in chronic total occlusion (CTO group than non-CTO group (respectively33.3% and 5.1. Also when compared to stent size, MACE rate was 25% in < 2.5 mm,0% ≥ 2.5 mm. The QSA results at six months showed in-stent late lumen loss witha diameter of0.25 ± 0.15 mm in 17 patients.Conclusion: The six month results in this study demonsrated excellent procedural and devicesuccess. Simpax stent was associated with a low in-stent late lumen loss. Also this study showedsimpax stent was a safe and effective device in non-CTO group with stent size ≥ 2.5 mm.

  3. Changes in marsh soils for six months after a fire

    International Nuclear Information System (INIS)

    Schmalzer, P.A.; Hinkle, C.R.; Koller, A.M. Jr.

    1991-01-01

    In this study, the authors examined changes in the soil nutrient levels in marsh systems after fire. These studies were conducted in conjunction with studies of particulates and gases generated from biomass combustion and flux measures of methane and nitric oxide before and after the fire. Here data are presented through six months postfire, past the time during which flux measurements were made. These data indicate that changes in soil properties occur at different times after the fire and persist for different intervals, indicating the need for long-term postfire observations

  4. 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.

  5. Acceptance of standardized ultrasound classification, use of albendazole, and long-term follow-up in clinical management of cystic echinococcosis: a systematic review.

    Science.gov (United States)

    Tamarozzi, Francesca; Nicoletti, Giovanni J; Neumayr, Andreas; Brunetti, Enrico

    2014-10-01

    Cystic echinococcosis is a chronic, complex, and neglected disease. The need for a simple classification of cyst morphology that would provide an accepted framework for scientific and clinical work on cystic echinococcosis has been addressed by two documents issued by the WHO Informal Working Group on Echinococcosis in 2003 (cyst classification) and in 2010 (Expert consensus for the diagnosis and treatment of echinococcosis). Here we evaluate the use of the WHO Informal Working Group on Echinococcosis classification of hepatic cystic echinococcosis, the acceptance by clinicians of recommendations regarding the use of albendazole, and the implementation of the long-term follow-up of patients with hepatic cystic echinococcosis in the scientific literature since the WHO Informal Working Group on Echinococcosis recommendations were issued. Of the publications included in our review, 71.2% did not indicate any classification, whereas 14% used the WHO Informal Working Group on Echinococcosis classification. Seventy-four percent reported the administration of peri-interventional albendazole, although less than half reported its modality, and 51% the length of patient follow-up. A joint effort is needed from the scientific community to encourage the acceptance and implementation of these three key issues in the clinical management of cystic echinococcosis.

  6. Renal denervation in patients with resistant hypertension: six-month results.

    Science.gov (United States)

    Dores, Hélder; de Sousa Almeida, Manuel; de Araújo Gonçalves, Pedro; Branco, Patrícia; Gaspar, Augusta; Sousa, Henrique; Canha Gomes, Angela; Andrade, Maria João; Carvalho, Maria Salomé; Campante Teles, Rui; Raposo, Luís; Mesquita Gabriel, Henrique; Pereira Machado, Francisco; Mendes, Miguel

    2014-04-01

    Increased activation of the sympathetic nervous system plays a central role in the pathophysiology of hypertension (HTN). Catheter-based renal denervation (RDN) was recently developed for the treatment of resistant HTN. To assess the safety and efficacy of RDN for blood pressure (BP) reduction at six months in patients with resistant HTN. In this prospective registry of patients with essential resistant HTN who underwent RDN between July 2011 and May 2013, the efficacy of RDN was defined as ≥ 10 mm Hg reduction in office systolic blood pressure (SBP) six months after the intervention. In a resistant HTN outpatient clinic, 177 consecutive patients were evaluated, of whom 34 underwent RDN (age 62.7 ± 7.6 years; 50.0% male). There were no vascular complications, either at the access site or in the renal arteries. Of the 22 patients with complete six-month follow-up, the response rate was 81.8% (n=18). The mean office SBP reduction was 22 mm Hg (174 ± 23 vs. 152 ± 22 mm Hg; p<0.001) and 9 mm Hg in diastolic BP (89 ± 16 vs. 80 ± 11 mm Hg; p=0.006). The number of antihypertensive drugs (5.5 ± 1.0 vs. 4.6 ± 1.1; p=0.010) and pharmacological classes (5.4 ± 0.7 vs. 4.6 ± 1.1; p=0.009) also decreased significantly. Of the 24-hour ambulatory BP monitoring and echocardiographic parameters analyzed, there were significant reductions in diastolic load (45 ± 29 vs. 27 ± 26%; p=0.049) and in left ventricular mass index (174 ± 56 vs. 158 ± 60 g/m(2); p=0.014). In this cohort of patients with resistant HTN, RDN was safe and effective, with a significant BP reduction at six-month follow-up. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

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

    Science.gov (United States)

    2014-01-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

  9. Patient and healthcare provider barriers to hypertension awareness, treatment and follow up: a systematic review and meta-analysis of qualitative and quantitative studies.

    Directory of Open Access Journals (Sweden)

    Rasha Khatib

    Full Text Available BACKGROUND: Although the importance of detecting, treating, and controlling hypertension has been recognized for decades, the majority of patients with hypertension remain uncontrolled. The path from evidence to practice contains many potential barriers, but their role has not been reviewed systematically. This review aimed to synthesize and identify important barriers to hypertension control as reported by patients and healthcare providers. METHODS: Electronic databases MEDLINE, EMBASE and Global Health were searched systematically up to February 2013. Two reviewers independently selected eligible studies. Two reviewers categorized barriers based on a theoretical framework of behavior change. The theoretical framework suggests that a change in behavior requires a strong commitment to change [intention], the necessary skills and abilities to adopt the behavior [capability], and an absence of health system and support constraints. FINDINGS: Twenty-five qualitative studies and 44 quantitative studies met the inclusion criteria. In qualitative studies, health system barriers were most commonly discussed in studies of patients and health care providers. Quantitative studies identified disagreement with clinical recommendations as the most common barrier among health care providers. Quantitative studies of patients yielded different results: lack of knowledge was the most common barrier to hypertension awareness. Stress, anxiety and depression were most commonly reported as barriers that hindered or delayed adoption of a healthier lifestyle. In terms of hypertension treatment adherence, patients mostly reported forgetting to take their medication. Finally, priority setting barriers were most commonly reported by patients in terms of following up with their health care providers. CONCLUSIONS: This review identified a wide range of barriers facing patients and health care providers pursuing hypertension control, indicating the need for targeted multi

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

    Science.gov (United States)

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

    2013-01-01

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

  11. Orlistat for Six Months in Overweight and Obese Patients

    Directory of Open Access Journals (Sweden)

    Alfredo Halpern

    2010-01-01

    Full Text Available Objective. To assess the efficacy and tolerability of the association sibutramine (10–20 mg/day and orlistat (120 mg 2-3 times a day in the treatment of obesity in a six-month open trial. Methods. 446 overweight and obese patients who sought treatment for obesity in a private clinic were assessed every 2 weeks during a period of 3 and 6 months. Results. After 3 months, the mean weight loss was 10.5 kg (−9.8% of the initial weight, =263, and after 6 months, the mean weight loss was 13.9 kg (−12.8% of the initial weight, =97. The tolerability of such association was quite acceptable and coherent with the action mechanism of each component. Conclusions. The association of orlistat and sibutramine is quite efficient and it seems to promote a higher rate of weight loss than that reported in clinical studies performed with each drug separately.

  12. Follow-up of pulmonary perfusion recovery after embolism

    International Nuclear Information System (INIS)

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

    1986-01-01

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

  13. Low back pain: what determines functional outcome at six months? An observational study

    Directory of Open Access Journals (Sweden)

    Peers Charles E

    2010-10-01

    Full Text Available Abstract Background The rise in disability due to back pain has been exponential with escalating medical and societal costs. The relative contribution of individual prognostic indicators to the pattern of recovery remains unclear. The objective of this study was to determine the prognostic value of demographic, psychosocial, employment and clinical factors on outcome in patients with low back pain Methods A prospective cohort study with six-month follow-up was undertaken at a multidisciplinary back pain clinic in central London employing physiotherapists, osteopaths, clinical psychologists and physicians, receiving referrals from 123 general practitioners. Over a twelve-month period, 593 consecutive patients referred from general practice with simple low back pain were recruited. A baseline questionnaire was developed to elicit information on potential prognostic variables. The primary outcome measures were change in 24-item Roland Morris disability questionnaire score at six months as a measure of low back related functional disability and the physical functioning scale of the SF-36, adjusted for baseline scores. Results Roland Morris scores improved by 3.8 index points (95% confidence interval 3.23 to 4.32 at six months and SF-36 physical functioning score by 10.7 points (95% confidence interval 8.36 to 12.95. Ten factors were linked to outcome yet in a multiple regression model only two remained predictive. Those with episodic rather than continuous pain were more likely to have recovered at six months (odds ratio 2.64 confidence interval 1.25 to 5.60, while those that classified themselves as non-white were less likely to have recovered (0.41 confidence interval 0.18 to 0.96. Conclusions Analysis controlling for confounding variables, demonstrated that participants showed greater improvement if their episodes of pain during the previous year were short-lived while those with Middle Eastern, North African and Chinese ethnicity demonstrated

  14. 259 Patients with DCIS of the breast applying USC/Van Nuys prognostic index: a retrospective review with long term follow up.

    Science.gov (United States)

    Di Saverio, Salomone; Catena, Fausto; Santini, Donatella; Ansaloni, Luca; Fogacci, Tommaso; Mignani, Stefano; Leone, Antonio; Gazzotti, Filippo; Gagliardi, Stefano; De Cataldis, Angelo; Taffurelli, Mario

    2008-06-01

    The Van Nuys Prognostic Index (VNPI) is a simple score for predicting the risk of local recurrence (LR) in patients with Ductal Carcinoma In Situ (DCIS) conservatively treated. This score combines three independent predictors of Local Recurrence. The VNPI has recently been updated with the addition of age as a fourth parameter into the scoring system (University of Southern California/ VNPI). Our database consisted of 408 women with DCIS. Applying the USC/VNPI we reviewed retrospectively 259 patients who were treated with breast conserving surgery with or without radiotherapy (RT). Of these patients 63.5% had a low VNPI score, 32% intermediate and 4.5% a high score. In the low score group, the majority of the patients underwent Conservative Surgery (CS) without RT while in the intermediate group, almost half of the patients received RT. Eighty-three percent (83%) of the patients with high VNPI were treated with Conservative Surgery plus RT. Nodal assessment by Sentinel Lymph Node Biopsy was obtained in 32 patients since 2002. Twenty-one Local Recurrences were observed (8%) with a mean follow up of 130 months: sixteen were invasive. No statistically significant differences in Disease Free Survival were reached in all groups of VNPI score between patients treated with Conservative Surgery or Conservative Surgery plus RT. However it was noted that the higher the VNPI score, the lower was the risk of local recurrence in the group treated additionally with RT, even though it was not statistically significant. Further analysis included those patients treated with Conservative Surgery alone and followed up. Disease-free survival (DFS) at 10 years was 94% with low VNPI and 83% in both intermediate and high score (P USC/VNPI is still a simple and reliable scoring system for therapeutic management of DCIS. We did not find any statistically significant advantage in groups treated with the addition of RT. Obtaining wide surgical margins appears to be the strongest prognostic

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

    Directory of Open Access Journals (Sweden)

    Gökmen Gemici

    2011-11-01

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

  16. Survival of ceramic veneers made of different materials after a minimum follow-up period of five years: a systematic review and meta-analysis.

    Science.gov (United States)

    Petridis, Haralampos P; Zekeridou, Alkisti; Malliari, Maria; Tortopidis, Dimitrios; Koidis, Petros

    2012-01-01

    The purpose of this systematic review was to compare the survival and complication rates of ceramic veneers produced with different techniques and materials after a minimum follow-up time of 5 years. A literature search was conducted, using electronic databases, relevant references, citations and journal researching, for clinical studies reporting on the survival of ceramic veneers fabricated with different techniques and materials with a mean followup time of at least 5 years. The search period spanned from January 1980 up to October 2010. Event rates were calculated for the following complications associated with ceramic veneers: fracture, debonding, marginal discoloration, marginal integrity, and caries. Summary estimates, and 5-year event rates were reported. Comparison between subgroups of different materials, as well as statistical significance, was calculated using a mixed effects model. Nine studies were selected for final analysis over an initial yield of 409 titles. No study directly compared the incidence of complications between ceramic veneers fabricated from different materials. Four of the included studies reported on the survival of ceramic veneers made out of feldspathic ceramics; four studies were on glass-ceramic veneers and one study included veneers fabricated from both materials. The mean observation time ranged between 5 and 10 years. Overall, the 5-year complication rates were low, with the exception of studies reporting on extended ceramic veneers. The most frequent complication reported was marginal discoloration (9% at 5 years), followed by marginal integrity (3.9-7.7% at 5 years). There was no statistically significant difference in the event rates between the subgroups of different materials (feldspathic vs. glass-ceramic). The results of this systematic review showed that ceramic veneers fabricated from feldspathic or glass-ceramics have an adequate clinical survival for at least 5 years of clinical service, with very low complication

  17. Course of Chronic Trypanosoma cruzi Infection after Treatment Based on Parasitological and Serological Tests: A Systematic Review of Follow-Up Studies.

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    Yanina Sguassero

    Full Text Available Chagas disease is caused by the flagellate protozoan Trypanosoma cruzi (T. cruzi. It is endemic in Latin American countries outside the Caribbean. The current criterion for cure in the chronic phase of the disease is the negativization of at least two serological tests such as enzyme-linked immunosorbent assay (ELISA, indirect immunofluorescence assay (IIF and indirect hemagglutination assay (IHA. The serological evolution of treated subjects with chronic T. cruzi infection is variable. Treatment failure is indicated by a positive parasitological and/or molecular test (persistence of parasitemia.To summarize the pattern of response to treatment of parasitological, molecular and serological tests performed during the follow-up of subjects with chronic T. cruzi infection.Electronic searches in relevant databases and screening of citations of potentially eligible articles were accomplished. Organizations focusing on neglected infectious diseases were asked for help in identifying relevant studies. Included studies were randomized controlled trials (RCTs, quasi-RCTs, and cohort studies involving adults and children with chronic infection who received trypanocidal treatment (benznidazole or nifurtimox and were followed over time. The assessment of risk of bias was performed separately for each study design. The Cochrane Collaboration's tool and the guidelines developed by Hayden et al. were used. Two reviewers extracted all data independently. A third review author was consulted in case of discordant opinion. Additional analyses were defined in ad-hoc basis. Scatter plots for percentage of positive parasitological and molecular tests and for negative serological tests were developed by using the lowess curve technique. Heterogeneity was measured by I2. The protocol was registered in PROSPERO, an international prospective register of systematic review protocols (Registration Number CRD42012002162.Out of 2,136 citations screened, 54 studies (six RCTs

  18. Social capital and the course of depression: six-month prospective cohort study.

    Science.gov (United States)

    Webber, Martin; Huxley, Peter; Harris, Tirril

    2011-03-01

    Previous research has found an inverse cross-sectional relationship between an individual's access to social capital (defined as resources embedded within social networks) and depression, but this relationship has not been rigorously tested in prospective research. This is the first longitudinal study to evaluate the effect of social capital on the course of depression and subjective quality of life in a clinical population. This was a six-month prospective cohort study of people with depression in primary care achieving a follow-up rate of 91.3% (n=158). Depression was measured with the HAD-D and social capital using the Resource Generator-UK. Potential confounding variables including socio-demographics, socio-economic status, depression history, social support, life events and attachment style were also measured. Social capital had no independent effect on the course of depression, though an interaction of access to social capital and attachment style was significantly related to change in quality of life alongside multiple covariates. The study used a small sample; a short follow-up period; no measure of ecological social capital; no genetic components; and only two time points. Emotional support is important for the alleviation of depression. Additionally, people with depression may require a secure attachment style to derive the full benefit of their social capital. Copyright © 2010 Elsevier B.V. All rights reserved.

  19. Complex distal 10q rearrangement in a girl with mild intellectual disability: follow up of the patient and review of the literature of non-acrocentric satellited chromosomes.

    Science.gov (United States)

    Sarri, Catherine; Douzgou, Sofia; Gyftodimou, Yolanda; Tümer, Zeynep; Ravn, Kirstine; Pasparaki, Angela; Sarafidou, Theologia; Kontos, Harry; Kokotas, Haris; Karadima, Georgia; Grigoriadou, Maria; Pandelia, Effie; Theodorou, Virginia; Moschonas, Nicholas K; Petersen, Michael B

    2011-11-01

    We report on an intellectually disabled girl with a de novo satellited chromosome 10 (10qs) and performed a review of the literature of the non-acrocentric satellited chromosomes (NASC). Satellites and stalks normally occur on the short arms of acrocentric chromosomes; however, the literature cites several reports of satellited non-acrocentric chromosomes, which presumably result from a translocation with an acrocentric chromosome. This is, to our knowledge, the third report of a 10qs chromosome. The phenotype observed in the proband prompted a search for a structural rearrangement of chromosome 10q. By microsatellite analysis we observed a 4 Mb deletion on the long arm of chromosome 10, approximately 145 kb from the telomere. FISH and array CGH analyses revealed a complex rearrangement involving in range from the centromere to the telomere: A 9.64 Mb 10q26.11-q26.2 duplication, a 1.3 Mb region with no copy number change, followed by a 5.62 Mb 10q26.2-q26.3 deletion and a translocation of satellite material. The homology between the repeat sequences at 10q subtelomere region and the sequences on the acrocentric short arms may explain the origin of the rearrangement and it is likely that the submicroscopic microdeletion and microduplication are responsible for the abnormal phenotype in our patient. The patient presented here, with a 15-year follow-up, manifests a distinct phenotype different from the 10q26 pure distal monosomy and trisomy syndromes. Copyright © 2011 Wiley Periodicals, Inc.

  20. Contribution of diffusion-weighted MR imaging in follow-up of inflammatory appendiceal mass: Preliminary results and review of the literature

    International Nuclear Information System (INIS)

    Özdemir, Oğuzhan; Metin, Yavuz; Metin, Nurgül Orhan; Küpeli, Ali; Kalcan, Süleyman; Taşçı, Filiz

    2016-01-01

    We aimed to search the contribution of diffusion-weighted imaging (DWI) in follow-up of patients with acute appendicitis associated inflammatory appendiceal mass (IAM). DWI was used as a monitoring imaging method to assess the response of medical treatment. 19 patients (mean age, 37+–13.1; age range, 19–69; M/F: 10/9), presented with clinical, laboratory and computed tomography (CT) findings suggestive of IAM were enrolled prospectively in this study. CT and DWI images were evaluated by two radiologists in consensus. b values 0, 500 and 1000 s/mm 2 were used, and DWI images were analysed both qualitatively and quantitatively. Laboratory parameters were C-reactive protein value and white blood cell count. During follow-up changes in the diameter of IMA and laboratory parameters were correlated with ADC values. Conservative treatment with interval appendectomy and a total conservative approach without surgery were the treatment options during follow-up. We found statistically significant correlation between the ADC values, maximum IAM diameter and laboratory parameters. During follow-up five surgical procedures were performed: one patient underwent surgery for cecal adenocarcinoma and four underwent interval appendectomy. One patient developed acute relapse of IAM at the sixth month of follow-up. DWI may be used with a significant success for follow-up of patients with IAM. As a monitoring imaging method, DWI may also aid in determining of most appropriate timing for interval appendectomy as well as may help in diagnosing alternative diagnoses (e.g. malignancy and inflammatory bowel disease) that can mimic IAM

  1. Six-month clinical outcomes after hyperopic correction with the SCHWIND AMARIS Total-Tech laser

    Science.gov (United States)

    Arbelaez, María Clara; Vidal, Camila; Arba Mosquera, Samuel

    2011-01-01

    Purpose To evaluate postoperative clinical outcomes, and corneal High Order Aberrations, among eyes with hyperopia up to +5 D of spherical equivalent, that have undergone LASIK treatments using the SCHWIND AMARIS laser system. Methods At six-month follow-up, 100 eyes with preoperative hyperopia or hyperopic astigmatism up to +5 D of spherical equivalent were retrospectively analysed. Standard examinations, pre- and postoperative wavefront analysis with a corneal-wavefront-analyzer (OPTIKON Scout) were performed. Aberration-Free aspheric treatments were planned with Custom Ablation Manager software and ablations performed using the SCHWIND AMARIS flying-spot excimer laser system (both SCHWIND eye-tech-solutions). LASIK flaps were created using a LDV femtosecond laser (Ziemer Group) in all cases. Clinical outcomes were evaluated in terms of predictability, refractive outcome, safety, and wavefront aberration. Results At six month, 90 % of eyes achieved ≥ 20/25 UCVA and 44 % achieved ≥ 20/16 UCVA. Seventy-four percent of eyes were within ± 0.25D of spherical equivalent and 89 % within ± 0.50D, with 94 % within 0.50D of astigmatism. Mean spherical equivalent was −0.12 ± 0.51D and 0.50 ± 0.51D for the astigmatism. Fifty-two percent of eyes improved BSCVA vs. only 19 % losing lines of BSCVA. Predictability slope for refraction was 1.03 and intercept +0.01 D. On average, negative corneal spherical aberrations were significantly increased by the treatments, no other aberration terms changed from pre- to postoperative values. Conclusions LASIK for hyperopia and hyperopic astigmatism with SCHWIND AMARIS yields very satisfactory visual outcomes. Preoperative refractions were postoperatively reduced to subclinical values with no clinically relevant induction of corneal HOA.

  2. Telephone follow-up initiated by a hospital-based health professional for postdischarge problems in patients discharged from hospital to home. (Review)

    NARCIS (Netherlands)

    Mistiaen, P.; Poot, E.

    2006-01-01

    Objectives: To determine the effects of follow-up telephone calls (TFU) in the first month post discharge, initiated by hospital-based health professionals, to patients discharged from hospital to home, with regard to physical and psycho-social outcomes in the first three months post discharge. The

  3. Intervention strategies for improving patient adherence to follow-up in the era of mobile information technology: a systematic review and meta-analysis.

    Science.gov (United States)

    Lin, Haotian; Wu, Xiaohang

    2014-01-01

    Patient adherence to follow-up plays a key role in the medical surveillance of chronic diseases and affects the implementation of clinical research by influencing cost and validity. We previously reported a randomized controlled trial (RCT) on short message service (SMS) reminders, which significantly improved follow-up adherence in pediatric cataract treatment. RCTs published in English that reported the impact of SMS or telephone reminders on increasing or decreasing the follow-up rate (FUR) were selected from Medline, EMBASE, PubMed, and the Cochrane Library through February 2014. The impacts of SMS and telephone reminders on the FUR of patients were systematically evaluated by meta-analysis and bias was assessed. We identified 13 RCTs reporting on 3276 patients with and 3402 patients without SMS reminders and 8 RCTs reporting on 2666 patients with and 3439 patients without telephone reminders. For the SMS reminders, the majority of the studies (>50%) were at low risk of bias, considering adequate sequence generation, allocation concealment, blinding, evaluation of incomplete outcome data, and lack of selective reporting. For the studies on the telephone reminders, only the evaluation of incomplete outcome data accounted for more than 50% of studies being at low risk of bias. The pooled odds ratio (OR) for the improvement of follow-up adherence in the SMS group compared with the control group was 1.76 (95% CI [1.37, 2.26]; Pimprovement of follow-up adherence in the telephone group compared with the control group was 2.09 (95% CI [1.85, 2.36]; Pimprove the FUR. Telephone reminders were more effective but had a higher risk of bias than SMS reminders.

  4. Intervention strategies for improving patient adherence to follow-up in the era of mobile information technology: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Haotian Lin

    Full Text Available Patient adherence to follow-up plays a key role in the medical surveillance of chronic diseases and affects the implementation of clinical research by influencing cost and validity. We previously reported a randomized controlled trial (RCT on short message service (SMS reminders, which significantly improved follow-up adherence in pediatric cataract treatment.RCTs published in English that reported the impact of SMS or telephone reminders on increasing or decreasing the follow-up rate (FUR were selected from Medline, EMBASE, PubMed, and the Cochrane Library through February 2014. The impacts of SMS and telephone reminders on the FUR of patients were systematically evaluated by meta-analysis and bias was assessed.We identified 13 RCTs reporting on 3276 patients with and 3402 patients without SMS reminders and 8 RCTs reporting on 2666 patients with and 3439 patients without telephone reminders. For the SMS reminders, the majority of the studies (>50% were at low risk of bias, considering adequate sequence generation, allocation concealment, blinding, evaluation of incomplete outcome data, and lack of selective reporting. For the studies on the telephone reminders, only the evaluation of incomplete outcome data accounted for more than 50% of studies being at low risk of bias. The pooled odds ratio (OR for the improvement of follow-up adherence in the SMS group compared with the control group was 1.76 (95% CI [1.37, 2.26]; P<0.01, and the pooled OR for the improvement of follow-up adherence in the telephone group compared with the control group was 2.09 (95% CI [1.85, 2.36]; P<0.01; both sets showed no evidence of publication bias.SMS and telephone reminders could both significantly improve the FUR. Telephone reminders were more effective but had a higher risk of bias than SMS reminders.

  5. 15-Year Follow-Up

    OpenAIRE

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

    2017-01-01

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

  6. Health-related quality of life of patients six months poststroke living in the Western Cape, South Africa

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    Anthea J. Rhoda

    2014-11-01

    Method: An observational, longitudinal study was used to collect data from a conveniently selected sample of first-ever stroke patients. The Rivermead Motor Assessment Scale and the Barthel Index were used to determine functional outcome and the EQ-5D was used to collect information relating to quality of life at two months and six months poststroke. Descriptive and inferential statistics were used to analyse the data. Results: The total sample of 100 participants consisted of 50% men and 50% women with a mean age of 61 and a standard deviation of 10.55 years. Six-month quality of life datawas analysed for 73 of the 100 participants. Of the 27 who were lost to follow-up, nine participants died, four withdrew from the study after baseline data was collected and eleven could not be followed up as they had either moved or no follow-up telephone numbers were available. A further three participants were excluded from the analysis of the EQ-5D as they were aphasic. Of these, approximately 35% had problems with mobility and self-care, whilst 42% had severe problems with everyday activities and 37.8% expressed having anxiety and depression. Quality of life at two months (p = 0.010 and urinary incontinence (p = 0.002 were significant predictors of quality of life at six months. Conclusion: Health-related quality of life was decreased in the South African stroke sample. Functional ability and urinary incontinence were the factors affecting quality of life in the sample. These factors should be considered in the rehabilitation of stroke patients in these settings.

  7. Predictors of hyperglycaemic individuals who do not follow up with physicians after screening in Japan: a cohort study.

    Science.gov (United States)

    Tsujimura, Yuka; Takahashi, Yoshimitsu; Ishizaki, Tatsuro; Kuriyama, Akira; Miyazaki, Kikuko; Satoh, Toshihiko; Ikeda, Shunya; Kimura, Shinya; Nakayama, Takeo

    2014-08-01

    Although people screened as being hyperglycaemic often fail to follow up with physicians for clinical assessment, epidemiologic findings on the frequency and predictors of not following up (hereafter, "no follow-up") are lacking. The purpose of this study was to examine the no follow-up rate with physicians after screening for diabetes and predictors of no follow-up. We assessed cases of no follow-up with physicians within six months after screening based on medical claims data from employee-based social health insurance programs in Japan, for people aged 20 to 68 years from 2005 to 2010. Among 3878 screened participants with hyperglycaemia, 2527 (65%) did not follow up with their physicians within six months after screening. Multiple logistic regression analysis revealed that younger age and lower blood glucose level predicted no follow-up among both men and women, while lower body mass index and negative proteinuria also predicted no follow-up among men. Treatment for dyslipidaemia facilitated follow-up among both genders, and treatment for hypertension or depression facilitated follow-up among men. Approximately two thirds of individuals screened as having hyperglycaemia did not follow up with their physicians within six months after screening. Predictors of no follow-up were younger age and milder hyperglycaemia. Being on treatment for co-morbidities tended to facilitate follow-up. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  8. SU-D-204-04: Correlations Between Dosimetric Indices and Follow-Up Data for Salivary Glands Six Months After Radiation Therapy for Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chera, B; Price, A; Kostich, M; Green, R; Das, S; Mavroidis, P [University of North Carolina, Chapel Hill, North Carolina (United States); Amdur, R; Mendenhall, W [University of Florida, Gainesville, FL (United States); Sheets, N [University of North Carolina, Raleigh, North Carolina (United States); Marks, L [UNC School of Medicine, Chapel Hill, NC (United States)

    2016-06-15

    Purpose: To investigate the correlation between different dosimetric indices of salivary glands (as separate or combined structures) to patient-reported dry mouth 6 months post radiotherapy using the novel patient reported outcome version of the CTCAE (PRO-CTCAE). Methods: Forty-three patients with oropharyngeal squamous cell carcinoma were treated on a prospective multi-institutional study. All patients received de-intensified 60 Gy intensity modulated radiotherapy. Dosimetric constraints were used for the salivary glands (e.g. mean dose to the contralateral-parotid < 26 Gy). We investigated correlations of individual patient dosimetric data of the parotid and submandibular glands (as separate or combined structures) to their self-reported 6 month post-treatment dry mouth responses. Moderate dry mouth responses were most prevalent and were used as the clinical endpoint indicating response. The correlation of Dmean, Dmax and a range of dosevolume (VD) points were assessed through the area under the Receiver Operating Characteristic curve (ROC) and Odds Ratios (OR). Results: Patients reporting non/mild dry mouth response (N=22) had average Dmean = 19.6 ± 6.2Gy to the contralateral-parotid compared to an average Dmean = 28.0 ± 8.3Gy and an AUC = 0.758 for the patients reporting moderate/severe/very severe dry mouth (N=21). Analysis of the range of VD’s for patients who had reported dry mouth showed that for the contralateral-parotid the indices V18 through V22 had the highest area under the curves (AUC) (0.762 – 0.772) compared to a more traditional dosimetric index V30, which had an AUC = 0.732. The highest AUC was observed for the combination of contralateral parotid and contralateral submandibular glands, for which V16 through V28 had AUC = 0.801 – 0.834. Conclusion: Patients who report moderate/severe/very severe dry mouth 6 months post radiotherapy had on average higher Dmean. The V16-V28 of the combination of the contralateral glands showed the highest correlation with the clinical endpoint.

  9. Arrest of chronic acid suppressant drug use after successful Helicobacter pylori eradication in patients with peptic ulcer disease: a six-month follow-up study

    NARCIS (Netherlands)

    Hurenkamp, G. J.; Grundmeijer, H. G.; van der Ende, A.; Tytgat, G. N.; Assendelft, W. J.; van der Hulst, R. W.

    2001-01-01

    BACKGROUND: It remains controversial whether successful H. pylori eradication leads to relief of dyspepsia and the subsequent arrest or tapering of acid-suppressant drug therapy, or to an aggravation of acid-related dyspepsia requiring more acid-suppressant drug intake. AIM: To evaluate

  10. 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.

  11. Partial maxillary osteotomy following an unsuccessful forced eruption of an impacted maxillary canine: 10 year follow-up. Review and case report

    Directory of Open Access Journals (Sweden)

    Edela Puricelli

    2012-12-01

    Full Text Available The maxillary canines are amongst the most frequently impacted teeth, second only to the third molars. Several conservative orthodontic and surgical techniques are available to position the teeth properly in the dental arch, even in severe cases. However, when an extraction is necessary, it often leaves a critical alveolar defect of difficult management. The authors present the technique of Partial Maxillary Osteotomy, in which a dento-alveolar segment is moved mesially, hence closing the remaining space, allowing for the formation of healthy periodontium and resulting in an adequate functional and aesthetic outcome. A case report is presented with a 10 year follow-up, proving the technique's stability in the long term.

  12. Black Cohosh Hepatic Safety: Follow-Up of 107 Patients Consuming a Special Cimicifuga racemosa rhizome Herbal Extract and Review of Literature

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    Fabio Firenzuoli

    2011-01-01

    Full Text Available European Medicines Agency (EMEA and the Committee on Herbal Medicinal Products (HMPC on July 2006 have released an alert to get European sanitary authorities aware of 42 cases of suspected hepatotoxic reactions in patients consuming Cimicifuga racemosa rhizome. In the public statement EMEA itself considered reliable as hepatotoxic reactions only four cases, on the base of RUCAM score: two were considered possible and two probable. Lacking in almost all of them a precise description of cases, especially a botanical-chemical analysis of the suspected substance, we think there is no real proof of supposed C. racemosa rhizome hepatotoxicity. In our department we administer from about 10 years C. racemosa as special herbal dry extract as single substance or mixed with other medicinal plants at the dose of 500–1000 mg daily, for treatment of menopause related disorders without any reported adverse effect. After EMEA's official signal we have contacted all our patients using a C. racemosa rhizome herbal extract continuously from more than 12 months to verify possible hepatotoxic effects. We followed-up 107 women, and asked them by telephone (33/107 and/or after anamnesis and clinical examination (74/107 to undergo a blood sample examination. In all the patients there was no sign of hepatic disease, or worsening of already altered but stable parameters. We think on the base of these data and current literature C. racemosa rhizome extract should not be considered a potential hepatotoxic substance.

  13. Gray Matter Heterotopia, Mental Retardation, Developmental Delay, Microcephaly, and Facial Dysmorphisms in a Boy with Ring Chromosome 6: A 10-Year Follow-Up and Literature Review.

    Science.gov (United States)

    Liu, Shu; Wang, Zhiqing; Wei, Sisi; Liang, Jinqun; Chen, Nuan; OuYang, Haimei; Zeng, Weihong; Chen, Liying; Xie, Xunjie; Jiang, Jianhui

    2018-04-14

    Ring chromosome 6, r(6), is an extremely rare cytogenetic abnormality with clinical heterogeneity which arises typically de novo. The phenotypes of r(6) can be highly variable, ranging from almost normal to severe malformations and neurological defects. Up to now, only 33 cases have been reported in the literature. In this 10-year follow-up study, we report a case presenting distinctive facial features, severe developmental delay, and gray matter heterotopia with r(6) and terminal deletions of 6p25.3 (115426-384174, 268 kb) and 6q26-27 (168697778-170732033, 2.03 Mb) encompassing 2 and 15 candidate genes, respectively, which were detected using G-banding karyotyping, FISH, and chromosomal microarray analysis. We also analyzed the available information on the clinical features of the reported r(6) cases in order to provide more valuable information on genotype-phenotype correlations. To the best of our knowledge, this is the first report of gray matter heterotopia manifested in a patient with r(6) in China, and the deletions of 6p and 6q in our case are the smallest with the precise size of euchromatic material loss currently known. © 2018 S. Karger AG, Basel.

  14. 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

    Directory of Open Access Journals (Sweden)

    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.

  15. Paravertebral Well-Differentiated Liposarcoma with Low-Grade Osteosarcomatous Component: Case Report with 11-Year Follow-Up, Radiological, Pathological, and Genetic Data, and Literature Review

    Directory of Open Access Journals (Sweden)

    Nicolas Macagno

    2017-01-01

    Full Text Available Despite being one of the most frequent soft-tissue sarcomas, well-differentiated liposarcoma has never been reported near the spine. The authors present the case of a 67-year-old man with progressive history of back pain. Physical examination revealed a mass located within the right paravertebral muscles. MR and CT imaging showed a heavily ossified central mass surrounded by a peripheral fatty component. No connection with the underlying bone was detected on imagery and during surgery. After surgical resection, histopathological examination revealed a tumor harboring combined features of well-differentiated liposarcoma and low-grade osteosarcoma. Tumor cells displayed overexpression of MDM2, CDK4, and P16 by immunohistochemistry and CGH revealed amplification of 12q13-15 as the only genetic imbalance. MDM2 FISH analysis was performed but was inconclusive. The pathological, immunohistochemical, and genetic features, the differential diagnoses, and the therapeutic management of this unusual tumor are discussed. No complementary treatment was performed initially. Following first treatment, two recurrences occurred 6 and 9 years later, both displaying histological features similar to the first occurrence. Radiotherapy was started after the second recurrence. Follow-up shows no evidence of disease 11 years after initial diagnosis. This case was unusual due to the paravertebral location of the tumor and its divergent differentiation.

  16. Nirschl surgical technique for concomitant lateral and medial elbow tendinosis: a retrospective review of 53 elbows with a mean follow-up of 11.7 years.

    Science.gov (United States)

    Schipper, Oliver N; Dunn, Jonathan H; Ochiai, Derek H; Donovan, J Skye; Nirschl, Robert P

    2011-05-01

    Combined lateral elbow tendinosis (tennis elbow) and medial elbow tendinosis (golfer's elbow) can be a disabling condition that, if unresponsive to nonoperative treatments, may be effectively treated surgically. The authors are not aware of any study that reports the outcome of a combined operation for lateral and medial elbow tendinosis (country club elbow) performed in the same operative setting. Combined surgical treatment of country club elbow in the same operative setting has similar outcomes to those seen in the literature for single operative procedures. Case series; Level of evidence 4. Outcome measurements included the Numeric Pain Intensity Scale, the Nirschl tennis elbow scoring system, and the American Shoulder and Elbow Surgeons elbow form. Forty-eight patients (53 clinical elbows) were available by telephone, with a minimum time to follow-up of 5 years (range, 5-19 years; mean, 11.7 years). The average Nirschl tennis elbow score improved from 16.7 preoperatively to 70.8 postoperatively (P Elbow Surgeons elbow score improved from 45.2 to 90.4 (P tennis elbow score, results were rated excellent in 38 elbows, good in 7 elbows, fair in 5 elbows, and poor in 3 elbows, with 85% (45 of 53) good to excellent results. Patient satisfaction with the surgery averaged 8.7 out of 10. Of the 46 patients who played sports, 44 (96%) reported returning to their sports. When nonoperative treatment of lateral and medial elbow tendinosis fails, combined surgical intervention via the Nirschl operative techniques for country club elbow is highly effective, with results similar to those of single-sided intervention.

  17. Paediatric intestinal cancer and polyposis due to bi-allelic PMS2 mutations: case series, review and follow-up guidelines.

    Science.gov (United States)

    Herkert, Johanna C; Niessen, Renée C; Olderode-Berends, Maria J W; Veenstra-Knol, Hermine E; Vos, Yvonne J; van der Klift, Heleen M; Scheenstra, Rene; Tops, Carli M J; Karrenbeld, Arend; Peters, Frans T M; Hofstra, Robert M W; Kleibeuker, Jan H; Sijmons, Rolf H

    2011-05-01

    Bi-allelic germline mutations of one of the DNA mismatch repair genes, so far predominantly found in PMS2, cause constitutional MMR-deficiency syndrome. This rare disorder is characterised by paediatric intestinal cancer and other malignancies. We report the clinical, immunohistochemical and genetic characterisation of four families with bi-allelic germline PMS2 mutations. We present an overview of the published gastrointestinal manifestations of CMMR-D syndrome and propose recommendations for gastro-intestinal screening. The first proband developed a cerebral angiosarcoma at age 2 and two colorectal adenomas at age 7. Genetic testing identified a complete PMS2 gene deletion and a frameshift c.736_741delinsTGTGTGTGAAG (p.Pro246CysfsX3) mutation. In the second family, both the proband and her brother had multiple intestinal adenomas, initially wrongly diagnosed as familial adenomatous polyposis. A splice site c.2174+1G>A, and a missense c.137G>T (p.Ser46Ile) mutation in PMS2 were identified. The third patient was diagnosed with multiple colorectal adenomas at age 11; he developed a high-grade dysplastic colorectal adenocarcinoma at age 21. Two intragenic PMS2 deletions were found. The fourth proband developed a cerebral anaplastic ganglioma at age 9 and a high-grade colerectal dysplastic adenoma at age 10 and carries a homozygous c.2174+1G>A mutation. Tumours of all patients showed microsatellite instability and/or loss of PMS2 expression. Our findings show the association between bi-allelic germline PMS2 mutations and severe childhood-onset gastrointestinal manifestations, and support the notion that patients with early-onset gastrointestinal adenomas and cancer should be investigated for CMMR-D syndrome. We recommend yearly follow-up with colonoscopy from age 6 and simultaneous video-capsule small bowel enteroscopy from age 8. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Self-transfer and mortality amongst adults lost to follow-up in ART programmes in low- and middle-income countries: systematic review and meta-analysis.

    Science.gov (United States)

    Wilkinson, Lynne S; Skordis-Worrall, Jolene; Ajose, Olawale; Ford, Nathan

    2015-03-01

    To ascertain estimates of adult patients, recorded as lost to follow-up (LTFU) within antiretroviral treatment (ART) programmes, who have self-transferred care, died or truly stopped ART in low- and middle-income countries. PubMed, EMBASE, Web of Science, Science Direct, LILACS, IndMed and AIM databases (2003-2013) and IAS/AIDS conference abstracts (2011-2013) were searched for tracing studies reporting the proportion of traced patients found to have self-transferred, died or stopped ART. These estimates were then combined using random-effects meta-analysis. Risk of bias was assessed through subgroup and sensitivity analyses. Twenty eight studies were eligible for inclusion, reporting true outcomes for 10,806 traced patients attending approximately 258 ART facilities. None were from outside sub-Saharan Africa. Twenty three studies reported 4.5-54.4% traced LTFU patients self-transferring care, providing a pooled estimate of 18.6% (95% CI 15.8-22.0%). A significant positive association was found between rates of self-transfer and LTFU in the ART cohort. The pooled estimates for unreported deaths were 38.8% (95% CI 30.8-46.8%; 27 studies) and 28.6% (95% CI 21.9-36.0%; 20 studies) for patients stopping ART. A significant decrease in unreported deaths from 50.0% (95% CI 41.5-58.4%) to 30.0% (95% CI 21.1-38.9%) was found comparing study periods before and after 31 December 2007. Substantial unaccounted for transfers and deaths amongst patients LTFU confirms that retention and mortality is underestimated where the true outcomes of LTFU patients are not ascertained. © 2014 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  19. The emergency and delay management in total talus extrusion: Case report and review of literature after 24 months of follow up

    Directory of Open Access Journals (Sweden)

    Luigi Piscitelli

    2016-07-01

    Full Text Available Total talus extrusion is a rare and severe injury. It is burdened by many complications as avascular necrosis and osteomyelitis even if a proper debridement of extruded talus is performed. Few case reports or case series were published, and because of the rarity of this event, there are no guidelines for treatment. We report the first case on an octogenarian man providing a long-term follow-up performing contrast enhanced magnetic resonances. The authors report the case of an octogenarian man who fell from an olive tree reporting a total talus extrusion associated with the fracture of the medial malleolus. After an accurate debridement and washing of the wound, the talus was anatomically repositioned and the fracture was treated with an external fixator. The wound healed with difficulty after 12 months and the patient developed a chronic osteomyelitis of the talar dome and avascular necrosis of talar head. We followed the patient for 24 months performing contrast enhanced magnetic resonances and evaluating the development of the avascular necrosis. Even if we encountered these complications, the treatment allowed the patient to walk without pain, using a talus type shoe and one crutch. Although the literature suggests that an anatomic replacement of talus allows avoiding main complications, we deem that the patient's age is an important biological feature to consider in the prognostic stratification. Moreover, primary talectomy and tibio-calcaneal fusion should be reserved as a salvage procedure. Talus replacement allows an overall good outcome for the patients, retaining height, and allowing a good quality of life.

  20. 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.

  1. 38 CFR 17.60 - Extensions of community nursing home care beyond six months.

    Science.gov (United States)

    2010-07-01

    ... nursing home care beyond six months. 17.60 Section 17.60 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Community Nursing Home Care Facilities § 17.60 Extensions of community nursing home care beyond six months. Directors of health care facilities may authorize, for any...

  2. Long-Term Memory for Context-Specific Category Information at Six Months.

    Science.gov (United States)

    Shields, Pamela J.; Rovee-Collier, Carolyn

    1992-01-01

    The ability of six-month-old infants to remember a functional category acquired in a specific context was assessed in three experiments. Findings revealed that at six months, information about the place where categories are constructed is prerequisite for retrieval of a category concept from long-term memory. (GLR)

  3. [Effect of parents' occupational and life environment exposure during six months before pregnancy on executive function of preschool children].

    Science.gov (United States)

    Ni, Lingling; Shao, Ting; Tao, Huihui; Sun, Yanli; Yan, Shuangqin; Gu, Chunli; Cao, Hui; Huang, Kun; Tao, Fangbiao; Tong, Shilu

    2016-02-01

    To examine the effect of parents' occupational and life exposure during six months before pregnancy on executive function of preschool children. Pregnant women involved in the study came from the Ma'anshan Birth Cohort Study,a part of the China-Anhui Birth Cohort Study. Between October 2008 and October 2010, pregnant women who accepted pregnancy care in four municipal medical and health institutions in Ma'anshan city were recruited as study objects. A total of 5,084 pregnant women and 4,669 singleton live births entered in this cohort. Between April 2014 and April 2015, a total of 3,803 pre-school children were followed up. Finally, except 32 preschool children did not have EF evaluation result, there were 3,771 children included in this study. By using self-designed " Maternal health handbook", we researched parents' general demographic characteristics, and life and occupational exposure during six months before pregnancy. To research preschool children's executive function, we used the Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P). Univariate and multivariate statistical method was used to analyze the association of parents' life and occupational exposure during six months before pregnancy and preschool children's EF. 3,771 preschool children's detected rate of inhibitory self-control index (ISCI), flexibility index (FI), emergent metacognition index (EMI) and global executive composite (GEC) dysplasia were 4.8% (182), 2.3% (88), 16.5% (623) and 8.6% (324) respectively. During six months before pregnancy, children whose parents were lived in a noise environment (OR=1.86, 95% CI: 1.36-2.54), whose maternal were exposed to pesticides were the risk of ISCI dysplasia(OR=3.60, 95% CI: 1.45-8.95). During six months before pregnancy, children whose maternal were exposed to pesticides (OR=6.72, 95% CI: 2.50-18.07) and whose father were exposed to occupational lead (OR=2.10, 95% CI: 1.25-3.54) were the risk of FI dysplasia. During six months

  4. Feed thickener for infants up to six months of age with gastro-oesophageal reflux.

    Science.gov (United States)

    Kwok, T'ng Chang; Ojha, Shalini; Dorling, Jon

    2017-12-05

    Gastro-oesophageal reflux (GOR) is common in infants, and feed thickeners are often used to manage it in infants as they are simple to use and perceived to be harmless. However, conflicting evidence exists to support the use of feed thickeners. To evaluate the use of feed thickeners in infants up to six months of age with GOR in terms of reduction in a) signs and symptoms of GOR, b) reflux episodes on pH probe monitoring or intraluminal impedance or a combination of both, or c) histological evidence of oesophagitis. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 2), MEDLINE via PubMed (1966 to 22 November 2016), Embase (1980 to 22 November 2016), and CINAHL (1982 to 22 November 2016). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials. We included randomised controlled trials if they examined the effects of feed thickeners as compared to unthickened feeds (no treatment or placebo) in treating GOR in term infants up to six months of age or six months of corrected gestational age for those born preterm. Two review authors independently identified eligible studies from the literature search. Two review authors independently performed data extraction and quality assessments of the eligible studies. Differences in opinion were resolved by discussion with a third review author, and consensus was reached among all three review authors. We used the GRADE approach to assess the quality of the evidence. Eight trials recruiting a total of 637 infants met the inclusion criteria for the systematic review. The infants included in the review were mainly formula-fed term infants. The trials were of variable methodological quality. Formula-fed term infants with GOR on feed thickeners had nearly two fewer episodes of regurgitation per day (mean difference -1.97 episodes per day

  5. Immunological follow-up of hydatid cyst cases

    Directory of Open Access Journals (Sweden)

    Bulut Vedat

    2001-01-01

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

  6. Health-related quality of life of patients six months poststroke living in the Western Cape, South Africa.

    Science.gov (United States)

    Rhoda, Anthea J

    2014-01-01

    The majority of individuals report a decline in health-related quality of life following a stroke. Quality of life and factors predicting quality of life could differ in individuals from lower income countries. The aim of this study was therefore to determine the quality of life and factors influencing quality of life of community-dwelling stroke patients living in low-income, peri-urban areas in the Western Cape, South Africa. An observational, longitudinal study was used to collect data from a conveniently selected sample of first-ever stroke patients. The Rivermead Motor Assessment Scale and the Barthel Index were used to determine functional outcome and the EQ-5D was used to collect information relating to quality of life at two months and six months poststroke. Descriptive and inferential statistics were used to analyse the data. The total sample of 100 participants consisted of 50% men and 50% women with a mean age of 61 and a standard deviation of 10.55 years. Six-month quality of life data was analysed for 73 of the 100 participants. Of the 27 who were lost to follow-up, nine participants died, four withdrew from the study after baseline data was collected and eleven could not be followed up as they had either moved or no follow-up telephone numbers were available. A further three participants were excluded from the analysis of the EQ-5D as they were aphasic. Of these, approximately 35% had problems with mobility and self-care, whilst 42% had severe problems with everyday activities and 37.8% expressed having anxiety and depression. Quality of life at two months ( p = 0.010) and urinary incontinence ( p = 0.002) were significant predictors of quality of life at six months. Health-related quality of life was decreased in the South African stroke sample. Functional ability and urinary incontinence were the factors affecting quality of life in the sample. These factors should be considered in the rehabilitation of stroke patients in these settings.

  7. The incidence of unprovoked seizures and occurrence of neurodevelopmental comorbidities in children at the time of their first epileptic seizure and during the subsequent six months.

    Science.gov (United States)

    Åndell, Eva; Tomson, Torbjörn; Carlsson, Sofia; Hellebro, Eva; Andersson, Tomas; Adelöw, Cecilia; Åmark, Per

    2015-07-01

    To evaluate the incidence of unprovoked seizures in children and the prevalence of related neurodevelopmental comorbidities at the time of the presumed first seizure and six months thereafter. The medical records of all children (0-18 years of age) seeking medical attention as the result of a first unprovoked seizure between September 1, 2001 and December 31, 2006, and registered in the population-based Stockholm Incidence Registry of Epilepsy (SIRE) were reviewed. Neurodevelopmental comorbidities were evaluated on the basis of the medical records from this first visit and from other healthcare during the following six months. The incidence of unprovoked seizures was between 30 and 204/100,000 person years (n=766) in the different age groups. It was highest among the youngest children and lowest among the 18-year-olds with small gender differences. The most common neurodevelopment comorbidities were developmental delay (22%, CI: 19-25%), speech/language and learning difficulties (23%, CI: 20-26%) and intellectual disability (16%, CI: 13-18%). The types of neurodevelopmental comorbidity varied by age at the time of seizure onset, with cerebral palsy being more common among the 0-5-year-olds, attention deficits among the 6-16-year-olds, and autism and psychiatric diagnosis among the older children. An associated neurodevelopmental comorbidity was more common among those experiencing recurrent than single seizures during follow-up six months from the index seizure (42% versus 66%). In 68% (CI: 64-71%) of the children there was no known or suspected neurodevelopmental comorbidity. The incidence of unprovoked, non-febrile seizures among 0-18-year-olds included in the SIRE was 67/100,000 person-years. Neurodevelopmental comorbidities were common already at the time of onset of the seizure disorder, indicating that neither seizure treatment nor seizures were the underlying cause of other neurodevelopmental symptoms in these patients during the period studied. Copyright

  8. Reasons for Stopping Exclusive Breastfeeding Between Three and Six Months: A Qualitative Study.

    Science.gov (United States)

    Alianmoghaddam, Narges; Phibbs, Suzanne; Benn, Cheryl

    Scant published qualitative literature exists focusing on why exclusive breastfeeding rates decline between three and six months. This study aims to develop an understanding of why exclusive breastfeeding tails off so dramatically between three and six months after birth in New Zealand. A generic qualitative methodology was employed in this study and social constructionism selected as the main epistemological framework underpinning the research. This study was carried out between September 2013 and July 2014, involving face-to-face interviews with 30 women who were characterised as highly motivated to complete six months exclusive breastfeeding prior to the birth of their child. In order to gain an in-depth understanding of the research material, thematic analysis of the interview transcripts was completed using manual coding techniques. After thematic analysis of the data four key themes were identified: 1) The good employee/good mother dilemma. 2) Breastfeeding is lovely, but six months exclusively is demanding. 3) Exclusive breastfeeding recommendations should be individualised. 4) Introducing solids early as a cultural practice. Most studies have linked barriers to six months exclusive breastfeeding to difficulties within the mother-infant dyad, as well as negative maternal socioeconomic and socio-demographic characteristics. However, this study has shown that the maintenance of six months exclusive breastfeeding is also challenging for this group of mothers who were socially advantaged, well-educated and highly motivated to breastfeed their babies exclusively for six months. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. A systematic review of the clinical performance of tooth-retained and implant-retained double crown prostheses with a follow-up of ≥ 3 years.

    Science.gov (United States)

    Verma, Rohini; Joda, Tim; Brägger, Urs; Wittneben, Julia-Gabriela

    2013-01-01

    The objective of this review was to systematically screen the literature for data related to the survival and complication rates observed with dental or implant double crown abutments and removable prostheses under functional loading for at least 3 years. A systematic review of the dental literature from January 1966 to December 2009 was performed in electronic databases (PubMed and Embase) as well as by an extensive hand search to investigate the clinical outcomes of double crown reconstructions. From the total of 2412 titles retrieved from the search, 65 were selected for full-text review. Subsequently, 17 papers were included for data extraction. An estimation of the cumulative survival and complication rates was not feasible due to the lack of detailed information. Tooth survival rates for telescopic abutment teeth ranged from 82.5% to 96.5% after an observation period of 3.4 to 6 years, and for tooth-supported double crown retained dentures from 66.7% to 98.6% after an observation period of 6 to 10 years. The survival rates of implants were between 97.9% and 100% and for telescopic-retained removable dental prostheses with two mandibular implants, 100% after 3.0 and 10.4 years. The major biological complications affecting the tooth abutments were gingival inflammation, periodontal disease, and caries. The most frequent technical complications were loss of cementation and loss of facings. The main findings of this review are: (I) double crown tooth abutments and dentures demonstrated a wide range of survival rates. (II) Implant-supported mandibular overdentures demonstrated a favorable long-term prognosis. (III) A greater need for prosthetic maintenance is required for both tooth-supported and implant-supported reconstructions. (IV) Future areas of research would involve designing appropriate longitudinal studies for comparisons of survival and complication rates of different reconstruction designs. © 2012 by the American College of Prosthodontists.

  10. The role of hospitals in bridging the care continuum: a systematic review of coordination of care and follow-up for adults with chronic conditions.

    Science.gov (United States)

    De Regge, Melissa; De Pourcq, Kaat; Meijboom, Bert; Trybou, Jeroen; Mortier, Eric; Eeckloo, Kristof

    2017-08-09

    Multiple studies have investigated the outcome of integrated care programs for chronically ill patients. However, few studies have addressed the specific role hospitals can play in the downstream collaboration for chronic disease management. Our objective here is to provide a comprehensive overview of the role of the hospitals by synthesizing the advantages and disadvantages of hospital interference in the chronic discourse for chronically ill patients found in published empirical studies. Systematic literature review. Two reviewers independently investigated relevant studies using a standardized search strategy. Thirty-two articles were included in the systematic review. Overall, the quality of the included studies is high. Four important themes were identified: the impact of transitional care interventions initiated from the hospital's side, the role of specialized care settings, the comparison of inpatient and outpatient care, and the effect of chronic care coordination on the experience of patients. Our results show that hospitals can play an important role in transitional care interventions and the coordination of chronic care with better outcomes for the patients by taking a leading role in integrated care programs. Above that, the patient experiences are positively influenced by the coordinating role of a specialist. Specialized care settings, as components of the hospital, facilitate the coordination of the care processes. In the future, specialized care centers and primary care could play a more extensive role in care for chronic patients by collaborating.

  11. Does Surgical Approach Affect Outcomes in Total Hip Arthroplasty Through 90 Days of Follow-Up? A Systematic Review With Meta-Analysis.

    Science.gov (United States)

    Miller, Larry E; Gondusky, Joseph S; Bhattacharyya, Samir; Kamath, Atul F; Boettner, Friedrich; Wright, John

    2018-04-01

    The choice between anterior approach (AA) and posterior approach (PA) in primary total hip arthroplasty (THA) is controversial. Previous reviews have predominantly relied on data from retrospective studies. This systematic review included prospective studies comparing postoperative outcomes through 90 days of AA vs PA in primary THA. Outcomes were pain severity, narcotic usage, hip function using Harris Hip Score, and complications. Random effects meta-analysis was performed for all outcomes. Efficacy data were reported as standardized mean difference (SMD) where values of 0.2, 0.5, 0.8, and 1.0 were defined as small, medium, large, and very large effect sizes, respectively. Complications were reported as the absolute risk difference (RD) where a positive value implied higher risk with AA and a lower value implied lower risk with AA. A total of 13 prospective comparative studies (7 randomized) with patients treated with AA (n = 524) or PA (n = 520) were included. The AA was associated with lower pain severity (SMD = -0.37, P SMD = -0.36, P = .002), and improved hip function (SMD = 0.31, P = .002) compared to PA. No differences between surgical approaches were observed for dislocation (RD = 0.2%, P = .87), fracture (RD = 0.2%, P = .87), hematoma (RD = 0%, P = .99), infection (RD = 0.2%, P = .85), thromboembolic event (RD = -0.9%, P = .42), or reoperation (RD = 1.3%, P = .26). Conclusions of this study were unchanged when subjected to sensitivity analyses. In this systematic review and meta-analysis of prospective studies comparing postoperative outcomes through 90 days of AA vs PA in primary THA, patients treated with AA reported less pain, consumed fewer narcotics, and reported better hip function. No statistical differences in complication rates were detected between AA and PA. Ultimately, the choice of surgical approach in primary THA should consider preference and experience of the surgeon as well as preference and anatomy of the patient

  12. Treatment approach, delivery, and follow-up evaluation for cardiac rhythm disease management patients receiving radiation therapy: Retrospective physician surveys including chart reviews at numerous centers

    Energy Technology Data Exchange (ETDEWEB)

    Gossman, Michael S., E-mail: MGossman@TSRCC.com [Regulation Directive Medical Physics, Russell, KY (United States); Wilkinson, Jeffrey D. [Medtronic, Inc., Mounds View, MN (United States); Mallick, Avishek [Department of Mathematics, Marshall University, Huntington, WV (United States)

    2014-01-01

    In a 2-part study, we first examined the results of 71 surveyed physicians who provided responses on how they address the management of patients who maintained either a pacemaker or a defibrillator during radiation treatment. Second, a case review study is presented involving 112 medical records reviewed at 18 institutions to determine whether there was a change in the radiation prescription for the treatment of the target cancer, the method of radiation delivery, or the method of radiation image acquisition. Statistics are provided to illustrate the level of administrative policy; the level of communication between radiation oncologists and heart specialists; American Joint Committee on Cancer (AJCC) staging and classification; National Comprehensive Cancer Network (NCCN) guidelines; tumor site; patient's sex; patient's age; device type; manufacturer; live monitoring; and the reported decisions for planning, delivery, and imaging. This survey revealed that 37% of patient treatments were considered for some sort of change in this regard, whereas 59% of patients were treated without regard to these alternatives when available. Only 3% of all patients were identified with an observable change in the functionality of the device or patient status in comparison with 96% of patients with normal behavior and operating devices. Documented changes in the patient's medical record included 1 device exhibiting failure at 0.3-Gy dose, 1 device exhibiting increased sensor rate during dose delivery, 1 patient having an irregular heartbeat leading to device reprogramming, and 1 patient complained of twinging in the chest wall that resulted in a respiratory arrest. Although policies and procedures should directly involve the qualified medical physicist for technical supervision, their sufficient involvement was typically not requested by most respondents. No treatment options were denied to any patient based on AJCC staging, classification, or NCCN practice standards.

  13. The value of gynecologic cancer follow-up

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  14. Enhancing capacity for risk factor surveillance at the regional/local level: a follow-up review of the findings of the Canadian Think Tank Forum after 4 years.

    Science.gov (United States)

    Choi, Bernard Ck; Decou, Mary Lou; Rasali, Drona; Martens, Patricia J; Mancuso, Michelina; Plotnikoff, Ronald C; Neudorf, Cory; Thanos, Joanne; Svenson, Lawrence W; Denny, Keith; Orpana, Heather; Stewart, Paula; King, Michael; Griffith, Jane; Erickson, Tannis; van Dorp, Renate; White, Deanna; Ali, Amira

    2014-01-22

    National health surveys are sometimes used to provide estimates on risk factors for policy and program development at the regional/local level. However, as regional/local needs may differ from national ones, an important question is how to also enhance capacity for risk factor surveillance regionally/locally. A Think Tank Forum was convened in Canada to discuss the needs, characteristics, coordination, tools and next steps to build capacity for regional/local risk factor surveillance. A series of follow up activities to review the relevant issues pertaining to needs, characteristics and capacity of risk factor surveillance were conducted. Results confirmed the need for a regional/local risk factor surveillance system that is flexible, timely, of good quality, having a communication plan, and responsive to local needs. It is important to conduct an environmental scan and a gap analysis, to develop a common vision, to build central and local coordination and leadership, to build on existing tools and resources, and to use innovation. Findings of the Think Tank Forum are important for building surveillance capacity at the local/county level, both in Canada and globally. This paper provides a follow-up review of the findings based on progress over the last 4 years.

  15. Comprehensive self-control training benefits depressed college students: A six-month randomized controlled intervention trial.

    Science.gov (United States)

    Yang, Xueling; Zhao, Jiubo; Chen, Yu; Zu, Simeng; Zhao, Jingbo

    2018-01-15

    Depressive disorder was associated with dysfunctional self-regulation. The current study attempted to design and test a comprehensive self-control training (CSCT) program with an overall emphasis on behaviral activation in depressed Chinese college students. Participants included 74 students who had diagnosed with major depression, they were randomly assigned to one of the two groups: intervention group (n=37), and control group (n=37). The intervention participants received an eight-week CSCT and four-month follow-up consolidation program, as compared to the control group who received only pre-post-and-follow-up measurements. All participants measured Beck Depression Inventory (BDI-Ⅱ) and Self-control Scale (SCS) at three time points: baseline, post-training, and four-month follow-up. The dropout rates were 6 (8.1%) in the intervention group and 3 (4.1%) in the control group at the end of six-month intervention. The general linear model repeated measures analysis of variance revealed that comparing with the control group, the intervention group participants had more increase in their trait self-control score, at the meantime, their depressive symptoms had significantly improved. Univariate and logistic regression analyses revealed that participants with milder baseline depressive symptoms were more likely to benefit from CSCT interventions; depression improvement was also associated with the number of sessions attended. The main limitation was related to the small sample size which consisted of college students who were relatively young and well educated. The current study demonstrates that CSCT program could temporarily enhance self-control capacity as well as improve depressive symptoms; participants who are mildly to moderately depressed, and who could adhere to the training protocol are more likely to benefit from the intervention. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Morbidity follow-up feasibility study

    International Nuclear Information System (INIS)

    Carpenter, M.

    1988-02-01

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

  17. Towards sustainability assessment follow-up

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-02-15

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

  18. Follow-up utterances in QA dialogue

    NARCIS (Netherlands)

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

    2006-01-01

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

  19. Towards sustainability assessment follow-up

    International Nuclear Information System (INIS)

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

    2014-01-01

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

  20. 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...

  1. Six-month exercise training program to treat post-thrombotic syndrome: a randomized controlled two-centre trial

    Science.gov (United States)

    Kahn, Susan R.; Shrier, Ian; Shapiro, Stan; Houweling, Adrielle H.; Hirsch, Andrew M.; Reid, Robert D.; Kearon, Clive; Rabhi, Khalil; Rodger, Marc A.; Kovacs, Michael J.; Anderson, David R.; Wells, Philip S.

    2011-01-01

    Background Exercise training may have the potential to improve post-thrombotic syndrome, a frequent, chronic complication of deep venous thrombosis. We conducted a randomized controlled two-centre pilot trial to assess the feasibility of a multicentre-based evaluation of a six-month exercise training program to treat post-thrombotic syndrome and to obtain preliminary data on the effectiveness of such a program. Methods Patients were randomized to receive exercise training (a six-month trainer-supervised program) or control treatment (an education session with monthly phone follow-ups). Levels of eligibility, consent, adherence and retention were used as indicators of study feasibility. Primary outcomes were change from baseline to six months in venous disease-specific quality of life (as measured using the Venous Insufficiency Epidemiological and Economic Study Quality of Life [VEINES-QOL] questionnaire) and severity of post-thrombotic syndrome (as measured by scores on the Villalta scale) in the exercise training group versus the control group, assessed by t tests. Secondary outcomes were change in generic quality of life (as measured using the Short-Form Health Survey-36 [SF-36] questionnaire), category of severity of post-thrombotic syndrome, leg strength, leg flexibility and time on treadmill. Results Of 95 patients with post-thrombotic syndrome, 69 were eligible, 43 consented and were randomized, and 39 completed the study. Exercise training was associated with improvement in VEINES-QOL scores (exercise training mean change 6.0, standard deviation [SD] 5.1 v. control mean change 1.4, SD 7.2; difference 4.6, 95% CI 0.54 to 8.7; p = 0.027) and improvement in scores on the Villalta scale (exercise training mean change −3.6, SD 3.7 v. control mean change −1.6, SD 4.3; difference −2.0, 95% CI −4.6 to 0.6; p = 0.14). Most secondary outcomes also showed greater improvement in the exercise training group. Interpretation Exercise training may improve post

  2. Student production: making a realistic stereo CG short film in six months

    Science.gov (United States)

    Ramasamy, Celambarasan

    2010-02-01

    This paper breaks down the R&D and production challenges faced on a stereoscopic CG short film that was developed on a six month time budget. Using this film as an example, the manner in which technical innovation and story telling techniques can be used to emphasize the strengths and hide the weaknesses of a limited timeframe student production is discussed.

  3. Public Television Channels in New York City: The First Six Months.

    Science.gov (United States)

    Calhoun, Richard

    The end results of the first six months of public access cable television (CATV) channels in New York City were in some ways disappointing. Franchise agreements for each of New York's two CATV systems called for two public-access channels to be in operation by July 1, 1971, one year after the date of the franchise awards. The channels were to be…

  4. Six-monthly vitamin A from 1 to 6 years of age DEVTA: cluster ...

    Indian Academy of Sciences (India)

    Six-monthly vitamin A from 1 to 6 years of age DEVTA: cluster-randomised trial in 1 million children in Northern India · Pre-school rural Northern India · DEVTA: cluster-randomised trial in 8000+ villages (ie, AWCs) in 72 clusters (ie, blocks) · DEVTA vitamin A schedule, 05/1999 - 04/2004 · DEVTA: biomedical monitoring.

  5. ARSENIC REMOVAL FROM DRINKING WATER BY ADSORPTIVE MEDIA AT GOFFSTOWN, NH SIX-MONTH EVALUATION REPORT

    Science.gov (United States)

    This report documents the activities performed and the results obtained from the first six months of the arsenic removal treatment technology demonstration project at the Orchard Highlands Subdivision site at Goffstown, NH. The objectives of the project are to evaluate the effect...

  6. Six-month longitudinal patterns of mental health treatment utilization by older adults with depressive symptoms

    NARCIS (Netherlands)

    Gum, Amber M.; Iser, Lindsay; King-Kallimanis, Bellinda L.; Petkus, Andrew; DeMuth, Anne; Schonfeld, Lawrence

    2011-01-01

    Aims of the study were to describe behavioral health treatment utilization patterns of community-dwelling older adults with depressive symptoms over a six-month period and to identify factors associated with treatment use, guided by a theoretical model emphasizing the dynamic nature of treatment use

  7. Recurrent patent infections with Toxocara canis in household dogs older than six months

    NARCIS (Netherlands)

    Nijsse, Rolf; Mughini-Gras, Lapo; Wagenaar, Jaap A.; Ploeger, Harm W.

    2016-01-01

    Background: To reduce environmental contamination with Toxocara canis eggs, the current general advice is to deworm all dogs older than six months on average four times a year. However, only a small proportion of non-juvenile household dogs actually shed T. canis eggs, and some dogs shed eggs

  8. Recurrent patent infections with Toxocara canis in household dogs older than six months : a prospective study

    NARCIS (Netherlands)

    Nijsse, Rolf; Mughini-Gras, Lapo; Wagenaar, Jaap A; Ploeger, Harm W

    2016-01-01

    BACKGROUND: To reduce environmental contamination with Toxocara canis eggs, the current general advice is to deworm all dogs older than six months on average four times a year. However, only a small proportion of non-juvenile household dogs actually shed T. canis eggs, and some dogs shed eggs more

  9. Feeding Practices and Weight Gain in the First Six Months of Life ...

    African Journals Online (AJOL)

    The renewed effort to encourage the practice of breast feeding has awakened interest in the study of the relationship between different modes of infant feeding and growth patterns. This relationship was studied in a cohort of 196 children in the first six months of life. The babies were classified as exclusively breastfed ...

  10. Delivery parameters, neonatal parameters and incidence of urinary incontinence six months postpartum: a cohort study.

    Science.gov (United States)

    Wesnes, Stian Langeland; Hannestad, Yngvild; Rortveit, Guri

    2017-10-01

    Contradictory results have been reported regarding most delivery parameters as risk factors for urinary incontinence. We investigated the association between the incidence of urinary incontinence six months postpartum and single obstetric risk factors as well as combinations of risk factors. This study was based on the Norwegian Mother and Child Cohort Study, conducted by the Norwegian Institute of Public Health during 1998-2008. This substudy was based on 7561 primiparous women who were continent before and during pregnancy. Data were obtained from questionnaires answered at weeks 15 and 30 of pregnancy and six months postpartum. Data were linked to the Medical Birth Registry of Norway. Single and combined delivery- and neonatal parameters were analyzed by logistic regression analyses. Birthweight was associated with significantly higher risk of urinary incontinence six months postpartum [3541-4180 g: odds ratio (OR) 1.4, 95% confidence interval (CI) 1.2-1.6; >4180 g: OR 1.6, 95% CI 1.2-2.0]. Fetal presentation, obstetric anal sphincter injuries, episiotomy and epidural analgesia were not significantly associated with increased risk of urinary incontinence. The following combinations of risk factors among women delivering by spontaneous vaginal delivery increased the risk of urinary incontinence six months postpartum; birthweight ≥3540 g and ≥36 cm head circumference; birthweight ≥3540 g and forceps, birthweight ≥3540 g and episiotomy; and ≥36 cm head circumference and episiotomy. Some combinations of delivery parameters and neonatal parameters seem to act together and may increase the risk of incidence of urinary incontinence six months postpartum in a synergetic way. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  11. Audit Follow-up Tracking System (AFTS)

    Data.gov (United States)

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

  12. Environmental monitoring six month report for the Tumulus Disposal Demonstration Project

    International Nuclear Information System (INIS)

    Yager, R.E.; Furnari, J.A.; Craig, P.M.

    1989-05-01

    The Fiscal Year 1989 Six Month Report is the fourth in a series of semi-annual Tumulus Disposal Demonstration Project (TDDP) data summary reports. This data summary spans the time from start of operations in June 1987 through the end of March 1989 with particular emphasis on the last six months: October 1988 through March 1989. The environmental data collected include run-off water quality and quantity, groundwater quality and levels, soil sampling and hydrometeorological data. These data are being used and analyzed here to demonstrate the environmental performance objectives for the TDDP as part of the overall performance assessment. Comparisons are made between pre- and post-operational data and data collected during size month period ending March 31, 1989. No significant environmental impacts have been found since operations have begun. 13 refs., 28 figs., 12 tabs

  13. Do school-based interventions focusing on physical activity, fitness, or fundamental movement skill competency produce a sustained impact in these outcomes in children and adolescents? A systematic review of follow-up studies.

    Science.gov (United States)

    Lai, Samuel K; Costigan, Sarah A; Morgan, Philip J; Lubans, David R; Stodden, David F; Salmon, Jo; Barnett, Lisa M

    2014-01-01

    The aim of this systematic review was to determine whether typically developing children and adolescents (aged 3-18 years) who have participated in school-based interventions have sustained outcomes in PA, fitness, and/or FMS. A systematic search of six electronic databases (CINAHL® Plus with Full Text, Ovid MEDLINE®, SPORTDiscus™, Scopus, PsycINFO® and ERIC) was conducted from 1995 to 26 July 2012. Included studies were school-based studies (including randomized controlled trials, longitudinal cohort, quasi-experimental, and experimental) that had a positive effect at post intervention in at least one variable and had a follow-up PA, fitness, or FMS assessment at least 6 months after the post-intervention assessment. Risk of bias assessment was guided by the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" statement. The search identified 14 articles, and some studies addressed multiple outcomes: 13 articles assessed PA; three assessed fitness; and two assessed FMS. No study in this review met four key methodological criteria that have been shown to influence results, i.e., clarity on the randomization process, assessor blinding, analyzing participants in their original groups, and retaining sufficient participants through the entire study. Three-quarters (ten of 13) of the studies addressing PA, reported PA behavior change maintenance. The length of follow-up ranged from 6 months to 20 years, and the degree of PA difference reported was between 3 and 14 min per day. Only one of the three studies assessing fitness reported a sustained impact, whilst both studies that assessed FMS reported maintenance of effects. It is likely that PA is a sustainable outcome from interventions in children and adolescents, and there is reasonable evidence that interventions of longer than 1 year and interventions that utilize a theoretical model or framework are effective in producing this sustained impact. It would seem probable that FMS are a sustainable

  14. Factors associated with exclusive breastfeeding among infants under six months of age in peninsular malaysia

    Directory of Open Access Journals (Sweden)

    Tan Kok

    2011-02-01

    Full Text Available Abstract Background Breastfeeding is accepted as the natural form of infant feeding. For mothers to be able to breastfeed exclusively to the recommended six months, it is important to understand the factors that influence exclusive breastfeeding. The aim of the study was to identify factors associated with exclusive breastfeeding in Peninsular Malaysia. Methods This was a cross-sectional study involving 682 mother-infant pairs with infants up to six months attending maternal and child health section of the government health clinics in Klang, Malaysia. Data were collected by face-to-face interviews using a pre-tested structured questionnaire over 4 months in 2006. Data on breastfeeding were based on practice in the previous one month period. Logistic regression was used to assess the independent association between the independent variables and exclusive breastfeeding adjusting for infant age. Results The prevalence of exclusive breastfeeding among mothers with infants aged between one and six months was 43.1% (95% CI: 39.4, 46.8. In the multivariate model exclusive breastfeeding was positively associated with rural residence, Malay mothers, non-working and non-smoking mothers, multiparous mothers, term infants, mothers with husbands who support breastfeeding and mothers who practice bed-sharing. Conclusions Interventions that seek to increase exclusive breastfeeding should focus on women who are at risk of early discontinuation of breastfeeding.

  15. Maternal mental health and nutritional status of six-month-old infants

    Directory of Open Access Journals (Sweden)

    Bruna Kulik Hassan

    2016-01-01

    Full Text Available ABSTRACT OBJECTIVE To analyze if maternal mental health is associated with infant nutritional status at six month of age. METHODS A cross-sectional study with 228 six-month-old infants who used primary health care units of the city of Rio de Janeiro, Southeastern Brazil. Mean weight-for-length and mean weight-for-age were expressed in z-scores considering the 2006 World Health Organization reference curves. Maternal mental health was measured by the 12-item General Health Questionnaire. The following cutoff points were used: ≥ 3 for common mental disorders, ≥ 5 for more severe mental disorders, and ≥ 9 for depression. The statistical analysis employed adjusted linear regression models. RESULTS The prevalence of common mental disorders, more severe mental disorders and depression was 39.9%, 23.7%, and 8.3%, respectively. Children of women with more severe mental disorders had, on average, a weight-for-length 0.37 z-scores lower than children of women without this health harm (p = 0.026. We also observed that the weight-for-length indicator of children of depressed mothers was, on average, 0.67 z-scores lower than that of children of nondepressed women (p = 0.010. Maternal depression was associated with lower mean values of weight-for-age z-scores (p = 0.041. CONCLUSIONS Maternal mental health is positively related to the inadequacy of the nutritional status of infants at six months.

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

    NARCIS (Netherlands)

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

    2008-01-01

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

  17. Sacroiliac Joint Fusion Using Triangular Titanium Implants vs. Non-Surgical Management: Six-Month Outcomes from a Prospective Randomized Controlled Trial.

    Science.gov (United States)

    Whang, Peter; Cher, Daniel; Polly, David; Frank, Clay; Lockstadt, Harry; Glaser, John; Limoni, Robert; Sembrano, Jonathan

    2015-01-01

    Sacroiliac (SI) joint pain is a prevalent, underdiagnosed cause of lower back pain. SI joint fusion can relieve pain and improve quality of life in patients who have failed nonoperative care. To date, no study has concurrently compared surgical and non-surgical treatments for chronic SI joint dysfunction. We conducted a prospective randomized controlled trial of 148 subjects with SI joint dysfunction due to degenerative sacroiliitis or sacroiliac joint disruptions who were assigned to either minimally invasive SI joint fusion with triangular titanium implants (N=102) or non-surgical management (NSM, n=46). SI joint pain scores, Oswestry Disability Index (ODI), Short-Form 36 (SF-36) and EuroQol-5D (EQ-5D) were collected at baseline and at 1, 3 and 6 months after treatment commencement. Six-month success rates, defined as the proportion of treated subjects with a 20-mm improvement in SI joint pain in the absence of severe device-related or neurologic SI joint-related adverse events or surgical revision, were compared using Bayesian methods. Subjects (mean age 51, 70% women) were highly debilitated at baseline (mean SI joint VAS pain score 82, mean ODI score 62). Six-month follow-up was obtained in 97.3%. By 6 months, success rates were 81.4% in the surgical group vs. 23.9% in the NSM group (difference of 56.6%, 95% posterior credible interval 41.4-70.0%, posterior probability of superiority >0.999). Clinically important (≥15 point) ODI improvement at 6 months occurred in 75% of surgery subjects vs. 27.3% of NSM subjects. At six months, quality of life improved more in the surgery group and satisfaction rates were high. The mean number of adverse events in the first six months was slightly higher in the surgical group compared to the non-surgical group (1.3 vs. 1.0 events per subject, p=0.1857). Six-month follow-up from this level 1 study showed that minimally invasive SI joint fusion using triangular titanium implants was more effective than non-surgical management

  18. Rectal neoplasms. Postoperative follow-up

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  19. Follow-up after rectal cancer

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  20. The Kepler follow-up observation program

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  1. Tympanogram findings in patients with cleft palates aged six months to seven years

    Science.gov (United States)

    Yanti, A.; Widiarni, D.; Alviandi, W.; Tamin, S.; Mansyur, M.

    2017-08-01

    Cleft palate is one of the most common congenital craniofacial deformities. Otitis media with effusion (OME) is a middle ear disease having a prevalence of almost 90% in patients with cleft palates. Tympanometry is a fast, safe, non-invasive, and easy tool for diagnosing middle ear disease qualitatively and quantitatively. Studies have been conducted using tympanometry to detect middle ear conditions in patients with cleft palates, but no research has studied tympanogram findings in patients with cleft palates in Indonesia. The aim of this study is to determine the tympanogram findings in Indonesian children aged six months to seven years with cleft palates. This is a cross-sectional study of 30 patients (17 males and 13 females) with Veau classification of palatal clefts aged six months to seven years (median 26.5 months) who underwent tympanometry examinations using a 226 Hztympanometer. Tympanograms were classified using the Jerger/Liden classification. Examinations of 58 ears found that type B tympanograms occurred most frequently (70.7%). The quantitative values of tympanometry analyzed included SAA (0.1-0.2 cm3), TPP value (-197.2-(-146.8 daPa)), Vec value (0.5-0.6 cm3), and gradient value (0.03-0.07 cm3). Using the Fisher test, a significant relationship was found between age and type of tympanogram (p = 0.0039) with the risk of type B and C tympanograms in infants (6-60 months) as high as 4.8 times that of children without cleft palates. The type B tympanogram was most frequently seen in patients with cleft palates aged six months to seven years old with the quantitative values of tympanometry lower than the normal values. Therefore, there was a significant difference in the type of tympanogram seen with age.

  2. Telephone referral education, and evidence of retention and transfer after six-months

    Directory of Open Access Journals (Sweden)

    Marshall Stuart D

    2012-06-01

    Full Text Available Abstract Background Effective communication between clinicians is essential for safe, efficient healthcare. We undertook a study to determine the longer-term effectiveness of an education session employing a structured method to teach referral-making skills to medical students. Methods All final year medical students received a forty-five minute education intervention consisting: discussion of effective telephone referrals; video viewing and critique; explanation, demonstration and practice using ISBAR; provision of a memory aid for use in their clinical work. Audio recordings were taken during a subsequent standardised simulation scenario and blindly assessed using a validated scoring system. Recordings were taken immediately before (control, several hours after (intervention, and at approximately six months after the education. Retention of the acronym and self-reports of transfer to the clinical environment were measured with a questionnaire at eight months. Results Referral clarity at six months was significantly improved from pre-intervention, and referral content showed a trend towards improvement. Both measures were lower than the immediate post-education test. The ISBAR acronym was remembered by 59.4% (n = 95/160 and used by the vast majority of the respondents who had made a clinical telephone referral (n = 135/143; 94.4%. Conclusions A brief education session improved telephone communication in a simulated environment above baseline for over six months, achieved functional retention of the acronym over a seven to eight month period and resulted in self reports of transfer of the learning into practice.

  3. Immediate and six-month space changes after premature loss of a primary maxillary first molar.

    Science.gov (United States)

    Lin, Yai-Tin; Lin, Wen-Hsien; Lin, Yng-Tzer J

    2007-03-01

    Premature loss of primary maxillary first molars has been associated with a number of consequences (such as tipping of the first permanent molar). The aim of the authors' study was to investigate dental-arch space problems arising as a result of premature loss of a primary maxillary first molar. This study was composed of 19 children who experienced unilateral premature loss of a primary maxillary first molar. The authors used each patient's intact contralateral arch segment as a control. The authors obtained maxillary dental study casts two or three days after the tooth was extracted, as well as six months later. The D + E space from the extraction side six months after removal of the tooth (mean +/- standard deviation, 15.62 +/- 1.13 millimeters) was significantly smaller than the space on the control side (16.88 +/- 1.12 mm) and the initial D + E space (16.70 +/- 0.69 mm). The authors found a significantly shorter arch length (25.47 +/- 1.58 mm) and larger intercanine width (31.29 +/- 2.49 mm) six months after the tooth was extracted compared with the initial arch length (25.66 +/- 1.64 mm) and intercanine width (30.42 +/- 2.64 mm). The early space changes to the maxillary arch subsequent to premature loss of a primary maxillary first molar are primarily distal drift of the primary canines toward the extraction space and palatal migration of the maxillary incisors. Although 1 mm of space was lost, which is statistically significant, this is not likely to be of sufficient clinical significance to warrant use of a space maintainer. If palatal movement appears to be needed, the dentist should consider use of a palatal arch rather than a band-and-loop maintainer. The effects of space maintainers need to be re-evaluated in cases of unilateral premature loss of a primary maxillary first molar.

  4. Follow up study and interested cases in subdural hematoma

    International Nuclear Information System (INIS)

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

    1983-01-01

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

  5. STATUS REPORT ON THE SIX-MONTH STUDY ON HIGH ENERGY MUON COLLIDERS

    International Nuclear Information System (INIS)

    KING, B.J.

    2001-01-01

    The structure, study topics, straw-man muon collider parameter sets and technical challenges for ''Six-Month Study on High Energy Muon Colliders: Oct'00-Apr'0l'' have been summarized at one month from completion of the study. The extremely high constituent particle energies and luminosities of the parameter sets presented in table 1 continue to suggest that muon colliders could play a central role in exploring and extending the HEP energy frontier. The study has already resulted in encouraging progress in areas such as the final focus lattice design and cost-efficient acceleration

  6. Comparison between scaling-root-planing (SRP and SRP/photodynamic therapy: six-month study

    Directory of Open Access Journals (Sweden)

    Berakdar Mohammad

    2012-04-01

    Full Text Available Abstract Introduction The purpose of this long-term clinical study was to examine the additional efficacy of photodynamic therapy (PDT to scaling and root planing (SRP in patients with chronic periodontal disease. Methods A total of 22 patients (mean age: 59.3 ± 11.7 years with chronic periodontal disease and four teeth with probing depth ≥ 5 mm were enrolled in the study. Inclusion criteria were: no systemic disease, no smoking, no pregnancy and no long-term medication. Beside the anamnesis, the following clinical parameters were assessed at baseline (one week before therapy, and one, three and six months after the therapy: bleeding on probing (BOP, plaque index (PI probing depth (PD, and clinical attachment loss. All measurements were done by the same examiner with a fixed periodontal probe (PCP 12, Hu-Friedy at six measurements/tooth. In each patient, two teeth were treated with SRP alone and two teeth with SRP and PDT (Periowave, Ondine Biopharma, Vancouver, Canada. The nonparametric Wilcoxon test for paired samples was used for comparison of the effect of the two treatments (p ≤ 0.05. Results After both types of treatment, the number of teeth positive for BOP declined. At baseline, the CAL measured 7.2 ± 1.2 mm (SRP or 8.1 ± 1.3 mm (SRP/PDT; one, three and six months after both types of treatment an improvement was observed. At baseline, the probing depth was 5.9 ± 0.8 mm (SRP or 6.4 ± 0.8 mm (SRP/PDT; after six months, an improvement of 2.4 ± 0.6 mm (SRP or 2.9 ± 0.8 mm (SRP/PDT was found. The greater reduction of the PD, achieved by a combination of SRP/PDT, was statistically significant after six months (p = 0.007. Conclusion This clinical study demonstrates that SRP in combination with PDT seems to be effective and is therefore suitable as an adjuvant therapy to the mechanical conditioning of the periodontal pockets in patients with chronic periodontal diseases.

  7. Souvenir from the Hamptons - a case of cutaneous larva migrans of six months' duration.

    Science.gov (United States)

    Esser, A C; Kantor, I; Sapadin, A N

    1999-01-01

    Cutaneous larva migrans is a distinctive serpiginous eruption caused by a reaction to burrowing hookworms. The infection is usually self-limited, normally lasting 2-8 weeks, but may persist for more than a year if misdiagnosed. Biopsies of the creeping eruption rarely reveal an organism. Thus, it is important for the infection to be recognized clinically, so that effective treatment may begin. We found topical thiabendazole to be fast and effective in treating this case of cutaneous larva migrans of six months' duration.

  8. Long-Term Outcome of Bariatric Surgery in Morbidly Obese Adolescents: a Systematic Review and Meta-Analysis of 950 Patients with a Minimum of 3 years Follow-Up.

    Science.gov (United States)

    Shoar, Saeed; Mahmoudzadeh, Habibollah; Naderan, Mohammad; Bagheri-Hariri, Shahram; Wong, Catherine; Parizi, Ahmad Shahabeddin; Shoar, Nasrin

    2017-12-01

    Obesity in pediatric and adolescent population has reached a universal pandemic. This study aimed to summarize the literature on the longest available outcome of bariatric surgery in morbidly obese adolescents. A systematic review was conducted to pool available data on the longest available (>3 years) weight loss and comorbidity resolution outcome in adolescent bariatric surgery. A total of 14 studies reporting the result of bariatric surgery after 3 years in 950 morbidly obese adolescents were included. Preoperative age and BMI ranged from 12 to 19 years and from 26 to 91 kg/m 2 , respectively. Females were the predominant gender (72.8%). Laparoscopic roux-en-Y gastric bypass (n = 453) and adjustable gastric banding (n = 265) were the most common bariatric procedure performed. The number of patients at the latest follow-up was 677 (range from 2 to 23 years). On average, patients lost 13.3 kg/m 2 of their BMI. Among comorbidities, only diabetes mellitus resolved or improved dramatically. Of 108 readmissions, 91 led to reoperation. There was a weight regain adolescents who underwent a bariatric procedure. Although bariatric surgery is a safe and effective procedure in the treatment of adolescent morbid obesity, long-term data is scarce regarding its nutritional and developmental complication in this growing population of patients.

  9. Stress hormones predict hyperbolic time-discount rates six months later in adults.

    Science.gov (United States)

    Takahashi, Taiki; Shinada, Mizuho; Inukai, Keigo; Tanida, Shigehito; Takahashi, Chisato; Mifune, Nobuhiro; Takagishi, Haruto; Horita, Yutaka; Hashimoto, Hirofumi; Yokota, Kunihiro; Kameda, Tatsuya; Yamagishi, Toshio

    2010-01-01

    Stress hormones have been associated with temporal discounting. Although time-discount rate is shown to be stable over a long term, no study to date examines whether individual differences in stress hormones could predict individuals' time-discount rates in the relatively distant future (e.g., six month later), which is of interest in neuroeconomics of stress-addiction association. We assessed 87 participants' salivary stress hormone (cortisol, cortisone, and alpha-amylase) levels and hyperbolic discounting of delayed rewards consisting of three magnitudes, at the time-interval of six months. For salivary steroid assays, we employed a liquid chromatography/ mass spectroscopy (LC/MS) method. The correlations between the stress hormone levels and time-discount rates were examined. We observed that salivary alpha-amylase (sAA) levels were negatively associated with time-discount rates in never-smokers. Notably, salivary levels of stress steroids (i.e., cortisol and cortisone) negatively and positively related to time-discount rates in men and women, respectively, in never-smokers. Ever-smokers' discount rates were not predicted from these stress hormone levels. Individual differences in stress hormone levels predict impulsivity in temporal discounting in the future. There are sex differences in the effect of stress steroids on temporal discounting; while there was no sex defference in the relationship between sAA and temporal discounting.

  10. Polyurethane-Coated Breast Implants Revisited: A 30-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Nikki Castel

    2015-03-01

    Full Text Available BackgroundPolyurethane coating of breast implants has been shown to reduce capsular contracture in short-term follow-up studies. This 30-year study is the longest examination of the use of polyurethane-coated implants and their correlation with capsular contracture.MethodsThis study evaluates the senior surgeon's (F.D.P. experience with the use of polyurethane-coated implants in aesthetic breast augmentation in 382 patients over 30 years. Follow-up evaluations were conducted for six months after surgery. After the six-month follow-up period, 76 patients returned for reoperation. The gross findings, histology, and associated capsular contracture were noted at the time of explantation.ResultsNo patient during the six-month follow-up period demonstrated capsular contracture. For those who underwent reoperation for capsular contracture, Baker II/III contractures were noted nine to 10 years after surgery and Baker IV contractures were noted 12 to 21 years after surgery. None of the explanted implants had macroscopic evidence of polyurethane, which was only found during the first five years after surgery. The microscopic presence of polyurethane was noted in all capsules up to 30 years after the original operation.ConclusionsAn inverse correlation was found between the amount of polyurethane coating on the implant and the occurrence of capsular contracture. Increasingly severe capsular contracture was associated with a decreased amount of polyurethane coating on the surface of the implants. No contracture occurred in patients whose implants showed incomplete biodegradation of polyurethane, as indicated by the visible presence of polyurethane coating. We recommend research to find a non-toxic, non-biodegradable synthetic material as an alternative to polyurethane.

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

    DEFF Research Database (Denmark)

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

    2002-01-01

    OBJECTIVE: To evaluate whether follow-up services for stroke survivors could improve functional outcome and reduce readmission rate. In this paper results of functional outcome are reported. DESIGN: Randomized controlled trial allocating patients to one of three different types of aftercare: (1......) follow-up home visits by a physician, (2) physiotherapist instruction in the patient's home, or (3) standard aftercare. SUBJECTS: Stroke patients with persisting impairment and disability who, after completing inpatient rehabilitation, were discharged to their homes. OUTCOME MEASURES: Six months after...... discharge, functional outcome was assessed with Functional Quality of Movement, Barthel Index, Frenchay Activity Index and Index of Extended Activites of Daily Living. RESULTS: One-hundred and fifty-five stroke patients were included in the study. Fifty-four received follow-up home visits by a physician, 53...

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

    NARCIS (Netherlands)

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

    1997-01-01

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

  13. A review of the cases done in the first six months of the male ...

    African Journals Online (AJOL)

    % of the patients had been referred to the VMMC centre from Voluntary Counselling and Testing (VCT) centres. Ninety percent of clients seeking male circumcision were sexually active. Close to 11% of VMMC clients had had a Sexually ...

  14. Impact of a Six-Month Empowerment-Based Exercise Intervention Programme in Non-Physically Active Adolescent Swedish Girls

    Science.gov (United States)

    Lindgren, Eva-Carin; Baigi, Amir; Apitzsch, Erwin; Bergh, Hakan

    2011-01-01

    Objective: This study evaluated changes in self-efficacy in non-physically active adolescent girls (13-19 years old) who participated in a six-month, empowerment-based exercise intervention programme (EIP). Design: The study used a pre- and post-test randomized group design and included one pre- and one post-test (at six months) and non-physically…

  15. Seroprevalence of transplacentally acquired measles antibodies in HIV-exposed versus HIV-unexposed infants at six months of age

    Directory of Open Access Journals (Sweden)

    Sneha Jain

    2017-01-01

    Interpretation & conclusions: Most HEI lacked measles antibodies at six months age and were, therefore, more vulnerable to measles than HUnI. Seroconversion in response to a single dose of measles vaccine administered at six months age was low in these infants, signifying the need of additional dose(s of measles/measles-containing vaccine.

  16. Cooled Radiofrequency Ablation of the Genicular Nerves for Chronic Pain due to Knee Osteoarthritis: Six-Month Outcomes.

    Science.gov (United States)

    McCormick, Zachary L; Korn, Marc; Reddy, Rajiv; Marcolina, Austin; Dayanim, David; Mattie, Ryan; Cushman, Daniel; Bhave, Meghan; McCarthy, Robert J; Khan, Dost; Nagpal, Geeta; Walega, David R

    2017-09-01

    Determine outcomes of cooled radiofrequency ablation (C-RFA) of the genicular nerves for treatment of chronic knee pain due to osteoarthritis (OA). Cross-sectional survey. Academic pain medicine center. Consecutive patients with knee OA and 50% or greater pain relief following genicular nerve blocks who underwent genicular nerve C-RFA. Survey administration six or more months after C-RFA. Pain numeric rating scale (NRS), Medication Quantification Scale III (MQSIII), Patient Global Impression of Change (PGIC), and total knee arthroplasty (TKA) data were collected. Logistic regression was used to identify factors that predicted treatment success. Thirty-three patients (52 discrete knees) met inclusion criteria. Thirty-five percent (95% confidence interval [CI] = 22-48) of procedures resulted in the combined outcome of 50% or greater reduction in NRS score, reduction of 3.4 or more points in MQSIII score, and PGIC score consistent with "very much improved/improved." Nineteen percent (95% CI = 10-33) of procedures resulted in complete pain relief. Greater duration of pain and greater than 80% pain relief from diagnostic blocks were identified as predictors of treatment success. The accuracy of the model was 0.88 (95% CI = 0.78-0.97, P  <   0.001). Genicular C-RFA demonstrated a success rate of 35% based on a robust combination of outcome measures, and 19% of procedures resulted in complete relief of pain at a minimum of six months of follow-up. Report of 80% or greater relief from diagnostic blocks and duration of pain of less than five years are associated with high accuracy in predicting treatment success. Further prospective study is needed to optimize the patient selection protocol and success rate of this procedure. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  17. The importance of early diagnosis in spontaneous osteonecrosis of the knee - A case series with six year follow-up.

    Science.gov (United States)

    Jordan, Robert W; Aparajit, Prasad; Docker, Charles; Udeshi, Umesh; El-Shazly, Mohi

    2016-08-01

    Spontaneous osteonecrosis of the knee has an unknown aetiology. Management options include conservative, surgical and pharmacological interventions. The aim of this study was to report the experience of the authors in conservative management of SONK using non-operative measures by analysing the functional outcome and need for surgical intervention. All patients treated for SONK between 1st August 2001 and 1st April 2014 were retrospectively reviewed. Treatment consisted of touch-down weight bearing for around six weeks. MR imaging was evaluated for size of lesion, the condyles involved and the time taken for resolution. Tegner Activity Scale, VAS pain, Lysholm, WOMAC and IKDC scores were recorded at presentation and final follow-up (mean six years, range six months to 13years). Forty cases were included; the mean age of the group was 55.3years and 67.5% were male. The medial femoral condyle was the most commonly affected (52.5%). A statistically significant improvement was reported in all functional outcome measures (p<0.001). Only one patient required arthroscopic surgical intervention and no patients required arthroplasty during the follow-up period. Early stage spontaneous osteonecrosis of the knee can be managed successfully without surgery if diagnosed early. Thus early investigation of acute knee pain with MRI scanning is recommended. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Follow-up after acute respiratory distress syndrome caused by influenza a (H1N1 virus infection

    Directory of Open Access Journals (Sweden)

    Carlos Toufen Jr.

    2011-01-01

    Full Text Available BACKGROUND: There are no reports on the long-term follow-up of patients with swine-origin influenza A virus infection that progressed to acute respiratory distress syndrome. METHODS: Four patients were prospectively followed up with pulmonary function tests and high-resolution computed tomography for six months after admission to an intensive care unit. RESULTS: Pulmonary function test results assessed two months after admission to the intensive care unit showed reduced forced vital capacity in all patients and low diffusion capacity for carbon monoxide in two patients. At six months, pulmonary function test results were available for three patients. Two patients continued to have a restrictive pattern, and none of the patients presented with abnormal diffusion capacity for carbon monoxide. All of them had a diffuse ground-glass pattern on high-resolution computed tomography that improved after six months. CONCLUSIONS: Despite the marked severity of lung disease at admission, patients with acute respiratory distress syndrome caused by swine-origin influenza A virus infection presented a late but substantial recovery over six months of follow-up.

  19. Malignant Transformation Six Months after Removal of Intracranial Epidermoid Cyst: A Case Report

    Directory of Open Access Journals (Sweden)

    Fayçal Lakhdar

    2011-01-01

    Full Text Available Intracranial epidermoid cysts are uncommon benign tumors of developmental origin; malignant transformation of benign epidermoid cysts is rare, and their prognosis remains poor. We report a case of squamous cell carcinoma arising in the cerebellopontine angle. A 52-year-old man presented with left facial paralysis and cerebellar ataxia. He had undergone total removal of a benign epidermoid cyst six months previously. Postoperative magnetic resonance imaging of the brain revealed a heterogeneous and cystic lesion in the left cerebellopontine angle with hydrocephalus. The cyst wall was enhanced by gadolinium. He underwent ventricle-peritoneal shunt and removal again; the histopathological examination revealed a squamous cell carcinoma possibly arising from an underlying epidermoid cyst. This entity is being reported for its rarity. The presence of contrast enhancement at the site of an epidermoid cyst combined with an acute, progressive neurological deficit should alert the neurosurgeon to the possibility of a malignant transformation.

  20. Former foster youth's perspectives on independent living preparation six months after discharge.

    Science.gov (United States)

    Jones, Loring P

    2014-01-01

    Research findings have developed a troubling narrative of youth leaving foster care. Congress attempted to address the post-discharge difficulties of foster youth by passing the Independent Living Initiative in 1986, which mandated that the states develop services that would prepare youth for life after foster care. However, it is unclear what effect these programs have on post-foster care trajectories. This largely qualitative study examined the perceptions of a sample of discharged foster six months after leaving care. Most youth felt prepared for life and foster care. They were also for the most part were satisfied with their independent living program, but had significant dissatisfactions with elements of the program. These satisfactions and dissatisfactions are reported along with suggestions for improvement. The policy and practice implications of these suggestions are considered.

  1. Spectroscopic follow up of Kepler planet candidates

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  2. Multifactor leadership styles and new exposure to workplace bullying: a six-month prospective study

    Science.gov (United States)

    TSUNO, Kanami; KAWAKAMI, Norito

    2014-01-01

    This study investigated the prospective association between supervisor leadership styles and workplace bullying. Altogether 404 civil servants from a local government in Japan completed baseline and follow-up surveys. The leadership variables and exposure to bullying were measured by Multifactor Leadership Questionnaire and Negative Acts Questionnaire-Revised, respectively. The prevalence of workplace bullying was 14.8% at baseline and 15.1% at follow-up. Among respondents who did not experience bullying at baseline (n=216), those who worked under the supervisors as higher in passive laissez-faire leadership had a 4.3 times higher risk of new exposure to bullying. On the other hand, respondents whose supervisors with highly considerate of the individual had a 70% lower risk of new exposure to bullying. In the entire sample (n=317), passive laissez-faire leadership was significantly and positively associated, while charisma/inspiration, individual consideration, and contingent reward were negatively associated both after adjusting for demographic and occupational characteristics at baseline, life events during follow-up, and exposure to workplace bullying at baseline. Results indicated that passive laissez-faire and low individual consideration leadership style at baseline were strong predictors of new exposure to bullying and high individual consideration leadership of supervisors/managers could be a preventive factor against bullying. PMID:25382384

  3. Multifactor leadership styles and new exposure to workplace bullying: a six-month prospective study.

    Science.gov (United States)

    Tsuno, Kanami; Kawakami, Norito

    2015-01-01

    This study investigated the prospective association between supervisor leadership styles and workplace bullying. Altogether 404 civil servants from a local government in Japan completed baseline and follow-up surveys. The leadership variables and exposure to bullying were measured by Multifactor Leadership Questionnaire and Negative Acts Questionnaire-Revised, respectively. The prevalence of workplace bullying was 14.8% at baseline and 15.1% at follow-up. Among respondents who did not experience bullying at baseline (n=216), those who worked under the supervisors as higher in passive laissez-faire leadership had a 4.3 times higher risk of new exposure to bullying. On the other hand, respondents whose supervisors with highly considerate of the individual had a 70% lower risk of new exposure to bullying. In the entire sample (n=317), passive laissez-faire leadership was significantly and positively associated, while charisma/inspiration, individual consideration, and contingent reward were negatively associated both after adjusting for demographic and occupational characteristics at baseline, life events during follow-up, and exposure to workplace bullying at baseline. Results indicated that passive laissez-faire and low individual consideration leadership style at baseline were strong predictors of new exposure to bullying and high individual consideration leadership of supervisors/managers could be a preventive factor against bullying.

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

    Science.gov (United States)

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

    2017-05-01

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

  5. Electronic Whiteboards and Intensive Care Unit follow up

    DEFF Research Database (Denmark)

    Østergaard, Kija Lin; Brandrup, Morten

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

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

    Science.gov (United States)

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

    2013-10-01

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

  7. Mindfulness facets and problematic Internet use: A six-month longitudinal study.

    Science.gov (United States)

    Calvete, Esther; Gámez-Guadix, Manuel; Cortazar, Nerea

    2017-09-01

    The aim of this study was to study the cross-sectional and longitudinal associations between mindfulness facets and problematic Internet use in adolescents. The sample consisted of 609 adolescents (313 girls, 296 boys; Mean age=14.21years, SD=1.71; age range 11-18). Participants completed a measure of five facets of mindfulness (describing, observing, acting with awareness, non-judging and non-reacting) at the beginning of the year, and measures of several components of problematic Internet use (preference for online social interactions, the use of the Internet to regulate mood, deficient self-regulation and negative outcomes) at beginning of the year and six months later. Findings indicated that non-judging is the only dimension of mindfulness that predicts a decrease in preference for online social interactions over face-to-face relationships. Moreover, non-judging indirectly predicted reductions in the rest of the problematic Internet use components. The observing and acting with awareness dimensions of mindfulness directly predicted less deficient self-regulation of Internet use and indirectly predicted less negative outcomes through their impact on deficient self-regulation. Thus, these dimensions seem to act when the maladaptive use of the Internet is consolidated. These findings suggest that interventions should include approaches to develop those mindfulness facets that protect against the development of problematic Internet use. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Panel reactive HLA antibodies, soluble CD30 levels, and acute rejection six months following renal transplant.

    Science.gov (United States)

    Domingues, Elizabeth M F L; Matuck, Teresa; Graciano, Miguel L; Souza, Edison; Rioja, Suzimar; Falci, Mônica C; Monteiro de Carvalho, Deise B; Porto, Luís Cristóvão

    2010-01-01

    Specific anti-human leukocyte antigen antibodies (HLA) in the post-transplant period may be present with acute rejection episodes (ARE), and high soluble CD30 (sCD30) serum levels may be a risk factor for ARE and graft loss. HLA cross-matching, panel reactive antibodies (PRA), and sCD30 levels were determined prior to transplantation in 72 patients. Soluble CD30 levels and PRA were re-assessed at day 7, 14, 21, and 28, and monthly up to the sixth.   Twenty-four subjects had a positive PRA and 17 experienced ARE. Nine of 17 ARE subjects demonstrated positive PRA and 16 had HLA mismatches. Positive PRA was more frequent in ARE subjects (p = 0.03). Eight subjects with ARE had donor-specific antibodies (DSA) in serum samples pre-transplantation, two subjects developed DSA. Three subjects without ARE had positive PRA only in post-transplantation samples. Soluble CD30 levels were higher in pre-transplant samples and ARE subjects than non-ARE subjects (p = 0.03). Post-transplant sCD30 levels were elevated in subjects who experienced rejection and were significantly higher at seven d (p = 0.0004) and six months (p = 0.03). Higher sCD30 levels following transplant were associated with ARE. Elevated sCD30 levels may represent a risk factor for acute rejection. © 2009 John Wiley & Sons A/S.

  9. Swedish women's food habits during pregnancy up to six months post-partum: A longitudinal study.

    Science.gov (United States)

    Wennberg, Anna Lena; Isaksson, Ulf; Sandström, Herbert; Lundqvist, Anette; Hörnell, Agneta; Hamberg, Katarina

    2016-06-01

    Diet influences the health of the foetus and the woman during pregnancy and later in life. It is therefore important to investigate pregnant women's food habits. The aim of this study was to describe women's food habits during pregnancy and up to six months post-partum. A Food Frequency Questionnaire (VIP-FFQ) was distributed to 163 pregnant women on five occasions during and after pregnancy. Data were analysed using Friedman's ANOVA and a Bonferroni post-hoc test. Food habits in relation to the National Food Agency's (NFA) food index. The pregnant women's diets were inadequate according to the NFA food index. A tendency towards an even poorer diet after delivery was identified, something which was related to an increased intake of discretionary food, e.g. sweets, cakes, cookies, crisps, ice cream, and decreased intake of fruit and vegetable. The alcohol consumption was low throughout. The food habits during pregnancy were inadequate compared to recommendations and these habits became unhealthier after delivery. These suggest that dietary counselling needs to be more effective and continued into the lactating period. An increased focus should be given to healthy eating from the life course perspective, not just focus on effects on the foetus and pregnancy outcomes. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Neuropsychologic function in children with brain tumors. III. Interval changes in the six months following treatment

    International Nuclear Information System (INIS)

    Mulhern, R.K.; Kun, L.E.

    1985-01-01

    Twenty-six children with primary brain tumors were studied prospectively with regard to their sensorimotor, intellectual, academic, and emotional status. Serial evaluations were conducted after surgery (pre-irradiation) and six months after the completion of radiation therapy. The timing of the second evaluation was chosen so as to antedate the late effects of irradiation. Children over 6 years old displayed significant improvement of intellectual function over time, with only 11% exhibiting deterioration on one or more cognitive parameters. In contrast, 68% of younger children clinically deteriorated in one or more areas of intellectual functioning, with prominent difficulties in memory and selective attention for age. Children under 6 years old with supratentorial tumors were less likely than those with posterior fossa tumors to improve their cognitive performance. At the second evaluation, 23% of the patients were functioning below normal (IQ less than 80) intellectually, with 50% of the younger children and 11% of the older children receiving special educational assistance. Approximately 40-50% of the patients manifested emotional adjustment problems at each evaluation. The results are discussed in terms of the clinical need to follow similar patient populations with formal psychological assessments over time, and in terms of the difficulties involved in defining factors that determine the functional status of children surviving brain tumors

  11. Quality of life of victims of traumatic brain injury six months after the trauma

    Directory of Open Access Journals (Sweden)

    Rita de Cássia Almeida Vieira

    2013-07-01

    Full Text Available OBJECTIVE: to describe the quality of life of victims of traumatic brain injury six months after the event and to show the relationship between the results observed and the clinical, sociodemographic and return to productivity data. METHOD: data were analyzed from 47 victims assisted in a trauma reference hospital in the municipality of Aracaju and monitored in an outpatient neurosurgery clinic. The data were obtained through analysis of the patient records and structured interviews, with the application of the World Health Organization Quality of Life, brief version, questionnaire. RESULTS: the victims presented positive perceptions of their quality of life, and the physical domain presented the highest mean value (68.4±22.9. Among the sociodemographic characteristics, a statistically significant correlation was found between marital status and the psychological domain. However, the return to productivity was related to all the domains. CONCLUSION: the return to productivity was an important factor for the quality of life of the victims of traumatic brain injury and should direct the public policies in promoting the health of these victims.

  12. Quality of life of victims of traumatic brain injury six months after the trauma.

    Science.gov (United States)

    Vieira, Rita de Cássia Almeida; Hora, Edilene Curvelo; de Oliveira, Daniel Vieira de; Ribeiro, Maria do Carmo de Oliveira; de Sousa, Regina Márcia Cardoso

    2013-01-01

    to describe the quality of life of victims of traumatic brain injury six months after the event and to show the relationship between the results observed and the clinical, sociodemographic and return to productivity data. data were analyzed from 47 victims assisted in a trauma reference hospital in the municipality of Aracaju and monitored in an outpatient neurosurgery clinic. The data were obtained through analysis of the patient records and structured interviews, with the application of the World Health Organization Quality of Life, brief version, questionnaire. the victims presented positive perceptions of their quality of life, and the physical domain presented the highest mean value (68.4±22.9). Among the sociodemographic characteristics, a statistically significant correlation was found between marital status and the psychological domain. However, the return to productivity was related to all the domains. the return to productivity was an important factor for the quality of life of the victims of traumatic brain injury and should direct the public policies in promoting the health of these victims.

  13. Six-Month Market Exclusivity Extensions To Promote Research Offer Substantial Returns For Many Drug Makers.

    Science.gov (United States)

    Kesselheim, Aaron S; Rome, Benjamin N; Sarpatwari, Ameet; Avorn, Jerry

    2017-02-01

    To incentivize pharmaceutical manufacturers to invest in areas of unmet medical need, policy makers frequently propose extending the market exclusivity period of desired drugs. Some such proposals are modeled after the pediatric exclusivity patent extension program, which since 1997 has provided six additional months of market exclusivity for drugs studied in children. The most recent proposal would encourage rare disease research by providing six months of extended exclusivity for any existing drug that is granted subsequent FDA approval for a new rare disease indication. Yet the economic impact of such proposals is rarely addressed. We found that for the thirteen FDA-approved drugs that gained supplemental approval for a rare disease indication from 2005 through 2010, the median projected cost of clinical trials leading to approval was $29.8 million. If the exclusivity extension had been in place, the median discounted financial gain to manufacturers would have been $94.6 million. Median net returns would have been $82.4 million, with higher returns for drugs with higher annual sales. Extending market exclusivity would provide substantial compensation to many manufacturers, particularly for top-selling products, far in excess of the cost of conducting these trials. Alternative strategies to incentivize the study of approved drugs for rare diseases may offer similar benefits at a lower cost. Project HOPE—The People-to-People Health Foundation, Inc.

  14. Maternal Knowledge and Attitude toward Exclusive Breastfeeding in Six Months after Birth in Shiraz, Iran

    Directory of Open Access Journals (Sweden)

    Mahnaz Haghighi

    2016-11-01

    Full Text Available Background To develop the culture of breastfeeding, it is needed to know the level of maternal knowledge. Hence, the aim of this study was to evaluate maternal knowledge and attitude toward exclusive breastfeeding in six months after birth in Shiraz, Iran. Materials and Methods This was a cross-sectional study carried out on mothers who referred to health centers. Four health centers were selected from four geographic areas of Shiraz city; finally, 201 mothers was selected and their demographic information and knowledge and attitude toward exclusive breastfeeding were gathered through a researcher made questionnaire. Data were analyzed using SPSS version 14.0.  Results 201 mothers who were 18-45 years old were studied. 43% of them were 30-34 years old. 46% of maternal education level was bachelor andMaster of Science or more and 80% of them were housewives. Their level of knowledge was low (69.2%, moderate (11.4% and high (19.4% respectively. Regarding the level of attitude 11.4% of them were low, 15.4% of them were moderate and the others were high. There was a significant relationship between maternal knowledge with parents’ education and infants’ nutrition (breastfeeding (P

  15. ARSENIC REMOVAL FROM DRINKING WATER BY ADSORPTIVE MEDIA - USEPA DEMONSTRATION PROJECT AT DESERT SANDS MDWCA, NM SIX MONTH EVALUATION

    Science.gov (United States)

    This report documents the activities performed during, and the results obtained from, the first six months of the arsenic removal treatment technology demonstration project at the Desert Sands Mutual Domestic Water Consumers Association (MDWCA) facility in Anthony, NM. The object...

  16. Therapeutic abortion follow-up study.

    Science.gov (United States)

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

    1971-05-15

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

  17. Colon neoplasms. Postoperative follow-up

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  18. Signs and symptoms indicative of community-acquired pneumonia in infants under six months

    Directory of Open Access Journals (Sweden)

    Maria de Fátima Bazhuni Pombo March

    Full Text Available OBJECTIVE: Evaluation of the clinical signs and symptoms predicting bacterial and viral pneumonia, in accordance with the Brazilian National Control Program for Acute Respiratory (ARI. METHODS: Observational prospective study. Seventy-six children from birth to six months of age who had pneumonia were studied in the emergency room. The patients were subdivided into two groups, based on radiological findings (gold-standard: 47 had bacterial pneumonia, and 29 had viral pneumonia. The frequencies, sensitivities, and specificities of the signs and symptoms were evaluated. RESULTS: The sensibilities and sensitivities of general findings in bacterial pneumonia were, respectively: fever 53.2%/40.0%; hypoactivity 68.4%/55.6% and prostration detected by the doctor 72.7%/55.0%. The same findings in viral pneumonias showed, respectively: 37.9%/40.0%, 66.7%/55.6% and 66.7%/55.6%. The sensibilities and sensitivities of respiratory findings in bacterial pneumonia were, respectively: coughing 66.0/38.1%, Respiratory rate = 50 ripm 76.6%/38.1%, altered respiratory auscultation 91.3%/10.5%, and chest indrawing 46.7%/80.0%. The same findings in viral pneumonias were, respectively: 69.0%/38.1%, 86.2%/38.1%, 85.7%/10.5% and 44.8%/80.0%. CONCLUSION: Analysis of signs and symptoms in each group did not distinguish bacterial from viral pneumonia. Our findings reinforce the adequacy of the ARI program in Brazil, which gives an early diagnosis of pneumonia, independent of its etiology.

  19. [Six-months outcomes after admission in acute geriatric care unit secondary to a fall].

    Science.gov (United States)

    Dickes-Sotty, Hélène; Chevalet, Pascal; Fix, Marie-Hélène; Riaudel, Typhaine; Serre-Sahel, Caroline; Ould-Aoudia, Vincent; Berrut, Gilles; De Decker, Laure

    2012-12-01

    Fall in elderly subject is a main event by its medical and social consequences, but few studies were dedicated to the prognosis from hospitalization in geriatric acute care unit. Describe the outcome of elderly subjects hospitalized after a fall in geriatric acute care unit. Longitudinal study of 6 months follow-up, 100 patients of 75 and more years old hospitalized after a fall in acute care geriatric unit. On a total of 128 patients hospitalized for fall, 100 agreed to participate in the study, 3 died during the hospitalization, so 97 subjects were able to be followed. During 6 months after the hospitalization, 14 patients died (14.9%), 51 (58%) have fallen again (58%) and 11 (22%) of them suffer from severe injuries. Thirty seven (39.7%) were rehospitalized and 10 of them related to fall. Among the patients coming from their home, 25 had been institutionalized. The main risk factor which have been identified to be associated with a new fall during the follow-up was a known dementia at the entry. The medical and social prognosis of an elderly subject hospitalized in an acute care unit is severe. The main comorbidity which influences the medical and social outcome is a known dementia, in addition to a history of previous fall.

  20. Follow-up radiological surveillance, Marshall Islands

    International Nuclear Information System (INIS)

    Greenhouse, N.A.

    1978-01-01

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

  1. Comparing Stent Thrombosis associated with Zotarolimus Eluting Stents versus Everolimus Eluting Stents at 1 year follow up: a systematic review and meta-analysis of 6 randomized controlled trials.

    Science.gov (United States)

    Bundhun, Pravesh Kumar; Yanamala, Chandra Mouli; Huang, Wei-Qiang

    2017-03-16

    Two thousand fifteen has been a winning year for Drug Eluting Stents (DES). Increase in the number of patients with cardiovascular diseases treated by Percutaneous Coronary Intervention (PCI) has resulted to a high demand for second generation DES. This current analysis aimed to compare the different types of Stent Thrombosis (ST) associated with Zotarolimus Eluting Stents (ZES) versus Everolimus Eluting Stents (EES) at 1 year follow up. Electronic databases were searched for studies comparing ZES with EES. Different types of ST reported at 1 year follow up were considered as the primary endpoints in this analysis. Odds Ratios (OR) with 95% Confidence Intervals (CIs) were used as the statistical parameters and the pooled analyses were carried out by the RevMan 5 · 3 software. A total number of 10,512 patients were included in this analysis. No significant difference in any definite ST, acute definite ST, subacute definite ST, and late definite ST were observed between ZES and EES, at 1 year follow up with OR: 1.70, 95% CI: 0.92 - 3.16; P = 0.09, OR: 3.44, 95% CI: 0.82 - 14.43; P = 0.09, OR: 1.13, 95% CI: 0.43 - 2.95; P = 0.80 and OR: 2.39, 95% CI: 0.83 - 6.85; P = 0.11 respectively. Moreover, any definite or probable ST and definite/probable/possible ST were also not significantly different with OR: 1.39, 95% CI: 0.89 - 2.17; P = 0.15 and OR: 1.19, 95% CI: 0.84 - 1.70; P = 0.33 respectively. In addition, any probable ST, acute probable ST, late probable ST and possible ST were also not significantly different at 1 year follow up with OR: 1.11, 95% CI: 0.60 - 2.05; P = 0.75, OR: 0.53, 95% CI: 0.12 - 2.40; P = 0.41, OR: 1.67, 95% CI: 0.35 - 7.86; P = 0.52 and OR: 1.08, 95% CI: 0.64 - 1.82; P = 0.78 respectively. At 1 year follow up, ZES were not associated with significantly lower or higher definite and probable ST compared to EES. In addition, no significant difference was observed in acute, subacute and late

  2. Effect of royal jelly ingestion for six months on healthy volunteers

    Directory of Open Access Journals (Sweden)

    Morita Hiroyuki

    2012-09-01

    Full Text Available Abstract Background Royal jelly is a widely ingested supplement for health, but its effects on humans are not well known. The objective was to evaluate the effects of long-term royal jelly ingestion on humans. Methods We conducted a randomized placebo-controlled, double-blind trial. A total of 61 healthy volunteers aged 42-83 years were enrolled and were randomly divided into a royal jelly group (n = 31 and a control group (n = 30. Three thousand mg of royal jelly (RJ or a placebo in 100 ml liquid/day were ingested for 6 months. The primary outcomes were changes in anthropometric measurements and biochemical indexes from baseline to 6 months after intervention. Results Thirty subjects in the RJ group and 26 in the control group were included in the analysis of endpoints. In an adjusted mean change of the variables from the baseline, significant differences between the two groups could be found in red blood cell counts (+0.16x106 /μL for the RJ group vs. -0.01x106 /μL for the control group, P = 0.0134, hematocrit (+0.9% vs. -0.8%, P = 0.0251, log (fasting plasma glucose (+0.01 ± 0.01 log mg/dL vs. +0.05 ± 0.01 log mg/dL, P = 0.0297, log (insulinogenic index (+0.25 vs. -0.13, P = 0.0319, log dehydroepiandrosterone sulfate (DHEA-S (+0.08 log μg/dL vs. +0.20 log μg/dL, P = 0.0483, log testosterone (T (+0.12 ± 0.04 log ng/mL vs. -0.02 ± 0.05 log ng/mL, P = 0.0416, log T/DHEA-S ratio (+0.05 ± 0.05 vs. -0.23 ± 0.59, P = 0.0015, and in one of the SF-36 subscale scores, mental health (MH (+4 vs. -7, P = 0.0276. Conclusions Six-month ingestion of RJ in humans improved erythropoiesis, glucose tolerance and mental health. Acceleration of conversion from DHEA-S to T by RJ may have been observed among these favorable effects.

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

    Science.gov (United States)

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

    2016-02-01

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

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

    Science.gov (United States)

    2012-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  6. Medication Adherence Mediates the Association between Type D Personality and High HbA1c Level in Chinese Patients with Type 2 Diabetes Mellitus: A Six-Month Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Xuemei Li

    2017-01-01

    Full Text Available Aims. To examine the association between Type D personality and HbA1c level and to explore the mediating role of medication adherence between them in patients with type 2 diabetes mellitus (T2DM. Methods. 330 patients went on to complete a self-report measure of medication adherence and the HbA1c tests. Chi-square test, T test, Ordinary Least Square Regression (OLS, and Recentered Influence Function Regression (RIF were employed. Results. Patients with Type D personality had significantly higher HbA1c value (P0.1. On the other hand, when Type D personality was operationalized as a continuous variable, only SI trait was associated with HbA1c level (P<0.01. When NA, SI, and NA×SI term together were entered into regression, only SI was not related to HbA1c level. Furthermore, medication adherence had a significant mediation effect between Type D personality and HbA1c, accounting for 54.43% of the total effect. Conclusion. Type D personality was associated with HbA1c in direct and indirect ways, and medication adherence acted as a mediator role.

  7. Efeito da timpanoplastia no zumbido de pacientes com hipoacusia condutiva: seguimento de seis meses The effect of timpanoplasty on tinnitus in patients with conductive hearing loss: a six month follow-up

    Directory of Open Access Journals (Sweden)

    Adriana da Silva Lima

    2007-06-01

    Full Text Available O timpanoplastia tem como objetivos erradicar a doença da orelha média e restaurar os mecanismos de condução sonora. Contudo, alguns pacientes apresentam incômodo com o zumbido e muitas vezes questionam o médico sobre os resultados da cirurgia em relação ao zumbido. OBJETIVO: Avaliar a evolução do zumbido em pacientes com hipoacusia condutiva após timpanoplastia. Forma de Estudo: Coorte prospectiva. CASUÍSTICA E MÉTODO: Foram avaliados 23 pacientes com queixa de zumbido e diagnóstico de otite média crônica simples com indicação cirúrgica. Os pacientes foram submetidos a um protocolo de investigação médica e audiológica do zumbido antes, 30 e 180 dias após a timpanoplastia. RESULTADOS: 82,6% dos pacientes apresentaram melhora ou abolição do zumbido. Melhora significante do incômodo do zumbido no pré-operatório (5,26 em relação ao pós-operatório (1,91 com 30 e 180 dias, assim como entre o incômodo da perda auditiva pré-operatória (6,56 e pós-operatória (3,65 e 2,91. A audiometria revelou melhora do limiar tonal em todas as freqüências, com exceção de 8KHz, havendo fechamento ou gap máximo de 10dB NA em 61% dos casos. Pega total do enxerto em 78% dos casos. CONCLUSÃO: Além da melhora da perda auditiva, a timpanoplastia também proporciona bons resultados sobre o controle do zumbido.Tympanoplasty is done to eradicate ear pathology and to restore the conductive hearing mechanism (eardrum and ossicles. Some patients, however, do not tolerate tinnitus and question physicians about the results of surgery when tinnitus persists. AIM: to evaluate the progression of tinnitus in patients with conductive hearing loss after tympanoplasty. STUDY DESIGN: a prospective cohort study. Material and Methods: 23 consecutive patients with tinnitus due to chronic otitis media underwent tympanoplasty. The patients underwent a medical and audiological protocol for tinnitus before and after tympanoplasty. RESULTS: 82.6% of patients had improvement or elimination of tinnitus after tympanoplasty The mean score of postoperative intolerance to tinnitus (1.91 for 30 and 180 days was significantly different from preoperative scores (5.26. As to hearing loss, patients improved medically 30 and 180 days after surgery (3.65 and 2.91 compared to the preoperative condition (6.56. Audiometry revealed improvement at all frequencies from 0.25 to 6KHz, except at 8KHz. The air-bone gap was closed or was within 10dB in 14 cases (61%. An intact tympanic membrane was achieved in 78% of the cases. CONCLUSION: Aside from the classical improvement of hearing loss, tympanoplasty also offers good control of tinnitus.

  8. 焦虑障碍患者共病人格障碍的6个月随访调查%Six month Follow-up of Anxiety Disorders Co-morbid with Personality Disorders

    Institute of Scientific and Technical Information of China (English)

    黄建军; 杨蕴萍

    2008-01-01

    目的 探讨人格障碍对焦虑障碍临床特点及对预后等的影响.方法 对127例符合DSM-Ⅳ轴Ⅰ障碍定式临床检查(the structured clinical interview for diagnostic and statistical manual of mental disorders.4th ed,SCID-Ⅰ)焦虑障碍的患者,予以DSM-Ⅳ轴Ⅱ障碍定式临床检查(the structured interview diagnostic and statistical manual of mental disorders.4th ed,SCID-Ⅱ),评估其人格障碍,同时评估焦虑和抑郁水平,6个月后对其临床特点及治疗细节等进行再次评估.结果 共病人格障碍的焦虑障碍患者较单纯焦虑障碍有更加严重的焦虑、抑郁状况,社会功能更差,治疗依从性差,预后差,对治疗满意度低,得到的社会支持少,更多的使用2种及2种以上抗焦虑抑郁药或合并使用其他抗精神病药,更倾向于选择多家医疗机构及多名医生就诊.结论 焦虑障碍与人格障碍的共病率高,人格障碍对焦虑障碍影响明显,在接诊焦虑障碍患者时,应对其人格障碍给予充分的评估和处理.

  9. Breakfast and Energy Drink Consumption in Secondary School Children: Breakfast Omission, in Isolation or in Combination with Frequent Energy Drink Use, is Associated with Stress, Anxiety, and Depression Cross-Sectionally, but not at Six-Month Follow-Up

    OpenAIRE

    Gareth eRichards; Andrew Paul Smith

    2016-01-01

    A considerable amount of research suggests that breakfast omission and the frequent use of caffeinated energy drinks may be associated with undesirable effects, and particularly so in children and adolescents. The current paper presents cross-sectional and longitudinal data from the Cornish Academies Project to investigate the effects of consuming energy drinks and missing breakfast on stress, anxiety, and depression in a cohort of secondary school children from the South West of England. Que...

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

    Directory of Open Access Journals (Sweden)

    Vizzeri Gianmarco

    2011-12-01

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

  11. Disseminated cysticercosis: clinical spectrum, Toll-like receptor-4 gene polymorphisms and role of albendazole: A prospective follow-up of 60 cases with a review of 56 published cases.

    Science.gov (United States)

    Qavi, Abdul; Garg, Ravindra Kumar; Malhotra, Hardeep Singh; Jain, Amita; Kumar, Neeraj; Malhotra, Kiran Preet; Srivastava, Pradeep Kumar; Verma, Rajesh; Sharma, Praveen Kumar

    2016-09-01

    In this study, we describe clinical and imaging spectrum, and the natural course of patients with disseminated cysticercosis. How albendazole affects the course of disease has also been evaluated. We assessed the Toll-like receptor-4 gene polymorphisms, to know the reason for the apparently higher prevalence of disseminated cysticercosis in India.Sixty consecutive patients with disseminated cysticercosis were enrolled. Sixty age-and-sex-matched healthy controls were also enrolled for the purpose of genetic study. Twenty patients, who gave consent, were treated with albendazole along with corticosteroids. Forty patients did not give consent for antiparasitic therapy. Assessment for Toll-like receptor-4 gene polymorphisms (Asp299Gly and Thr399Ile genes) was done. Patients were followed for 6 months. We also performed a literature search of cases published in English language using PubMed electronic database and analyzed 56 cases thus available.There was an increased risk (6.63 fold and 4.61 fold) of disseminated cysticercosis in the presence of Asp299Gly and Thr399Ile polymorphisms in Toll-like receptor-4, respectively. The allelic frequency of Gly (11% vs. 3%, P = 0.024, odds ratio [OR] = 3.52) and Ile alleles (11% vs. 2%, P = 0.009, OR = 4.738) in disseminated cysticercosis was high. Albendazole resulted in complete disappearance of all cerebral lesions in 35% (7/20) patients and reduction in lesion load in remaining 65% (13/20) patients. No significant change in number of cysticercal lesion was noted in patients who did not receive albendazole. No major adverse reaction following antiparasitic treatment was noted. Three deaths were recorded in patients who did not receive antiparasitic treatment.Of the 56 cases reported in PubMed, 33 patients received antiparasitic treatment with follow-up data available for 31 patients. Most (24) of these patients received albendazole. A significant clinical and/or imaging improvements, on follow up, were observed in 27 patients

  12. METABOLIC SIDE EFFECTS OF HALOPERIDOL AND RISPERIDONE- A SIX MONTHS FOLLOWUP STUDY

    Directory of Open Access Journals (Sweden)

    Kalaimathi B

    2017-03-01

    Full Text Available BACKGROUND To compare and analyse the metabolic side effects of Risperidone and Haloperidol in newly diagnosed drug-naive schizophrenic disorder patients attending Govt. Stanley Medical College Hospital during initial 6 months of therapy. MATERIALS AND METHODS Newly diagnosed drug-naïve Schizophrenic Patients (n = 60 aged between 18 - 45 years are recruited and randomly allocated into Group A (Risperidone 4 - 6 mg daily and Group B (Haloperidol 5 - 10 mg daily after getting informed consent from the patient’s family members. Patients are followed up monthly for the occurrence of metabolic abnormalities like weight gain, rise in blood pressure, elevated fasting, post-prandial blood sugar level, dyslipidaemia for a period of 6 months. RESULTS Risperidone group showed the mean body weight increase from 64.40 to 69.27, SBP/DBP increase from 123.80/79 to 129.90/83.13; FBS/PPBS increase from 100.20/129.30 to 135.40/185.00; TC increase from 177.23 to 206.23; LDL from 124.30 to 158.30; HDL 48.83 to 50.07; TG 133.47 to 197.83: Haloperidol group showed the mean body weight increase from 64.07 to 68.48, SBP/DBP increase from 123.80/79.00 to 124.27/81.67; FBS/PPBS increase from 100.20/129.30 to 119.87/167.10; TC increase from 177.23 to 197.40; LDL from 119.77 to 139.00; HDL remained 48.83; TG 133.47 to 171.40. CONCLUSION This study showed that patients in both the groups had weight gain, rise in blood sugar, LDL cholesterol and Triglycerides level, but the rise was significant in patients on Risperidone when compared to those on Haloperidol during the 6-month followup.

  13. Al-Anon newcomers: benefits of continuing attendance for six months.

    Science.gov (United States)

    Timko, Christine; Laudet, Alexandre; Moos, Rudolf H

    2016-07-01

    Al-Anon Family Groups, a 12-step mutual-help program for people concerned about another person's drinking, is the most widely used form of help by Concerned Others. This longitudinal study examined newcomers' outcomes of attending Al-Anon. Aims were to better understand early gains from Al-Anon to inform efforts in the professional community to facilitate concerned others' attendance of and engagement in Al-Anon. We compared two groups of Al-Anon newcomers who completed surveys at baseline and 6 months later: those who discontinued attendance by the 6-month follow-up (N = 133), and those who were still attending Al-Anon meetings (N = 97); baseline characteristics were controlled in these comparisons. Newcomers who sustained participation in Al-Anon over the first 6 months of attendance were more likely than those who discontinued participation during the same period to report gains in a variety of domains, such as learning how to handle problems due to the drinker, and increased well-being and functioning, including reduced verbal or physical abuse victimization. Newcomers to Al-Anon reported more personal gains than drinker-related gains. The most frequent drinker gain was a better relationship with the Concerned Other; attendees were more likely to report this, as well as daily, in-person contact with the drinker. Al-Anon participation may facilitate ongoing interaction between Concerned Others and drinkers, and help Concerned Others function and feel better. Thus, short-term participation may be beneficial. Health-care professionals should consider providing referrals to Al-Anon and monitoring early attendance.

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

    Directory of Open Access Journals (Sweden)

    Martin Jelínek

    2016-01-01

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

  15. Prognostic factors for hereditary cancer distress six months after BRCA1/2 or HNPCC genetic susceptibility testing

    NARCIS (Netherlands)

    van Oostrom, Iris; Meijers-Heijboer, Hanne; Duivenvoorden, Hugo J.; Brocker-Vriends, Annette H. J. T.; van Asperen, Christi J.; Sijmons, Rolf H.; Seynaeve, Caroline; Van Gool, Arthur R.; Klijn, Jan G. M.; Tibben, Aad

    This study explored predictors for hereditary cancer distress six months after genetic susceptibility testing for a known familial BRCA1/2 or HNPCC related mutation, in order to gain insight into aspects relevant for the identification of individuals needing additional psychosocial support. Coping,

  16. Correlation of Blood Lead Level in Mothers and Exclusively Breastfed Infants: A Study on Infants Aged Less Than Six Months

    Directory of Open Access Journals (Sweden)

    Ahmadshah Farhat

    2013-12-01

    How to cite this article: Farhat A, Mohammadzadeh A, Balali-Mood M, Aghajanpoor-Pasha M, Ravanshad Y. Correlation of Blood Lead Level in Mothers and Exclusively Breastfed Infants: A Study on Infants Aged Less Than Six Months. Asia Pac J Med Toxicol 2013;2:150-2.

  17. ARSENIC REMOVAL FROM DRINKING WATER BY ADSORPTIVE MEDIA -- USEPA DEMONSTRATION PROJECT AT ROLLINSFORD, NH, SIX MONTH EVALUTION REPORT

    Science.gov (United States)

    This report documents the activities performed during and the results obtained from the first six months of the arsenic removal treatment technology demonstration project at the Rollinsford Water and Sewer District facility in Rollinsford, NH. The objectives of the project are to...

  18. ARSENIC REMOVAL FROM DRINKING WATER BY ADSORPTIVE MEDIA USEPA DEMONSTRATION PROJECT AT VALLEY VISTA, AZ SIX-MONTH EVALUATION REPORT

    Science.gov (United States)

    This report documents the activities performed and the results obtained from the first six months of the EPA arsenic removal technology demonstration project at the Arizona Water Company (AWC) facility in Sedona, AZ, commonly referred to as Valley Vista. The main objective of the...

  19. ARSENIC REMOVAL FROM DRINKING WATER BY ADSORPTIVE MEDIA, USEPA DEMONSTRATION PROJECT AT RIMROCK, AZ, SIX-MONTH EVALUATION REPORT

    Science.gov (United States)

    This report documents the activities performed during and the results obtained from the first six months of the arsenic removal treatment technology demonstration project at Rimrock, AZ. The objectives of the project are to evaluate the effectiveness of AdEdge Arsenic Package Uni...

  20. ARSENIC REMOVAL FROM DRINKING WATER BY ADSORPTION MEDIA USEPA DEMONSTRATION PROJECT AT BROWN CITY, MI SIX MONTH EVALUATION REPORT

    Science.gov (United States)

    This report documents the activities performed during and the results obtained from the first six months of the arsenic removal treatment technology demonstration project in Brown City, MI. The objectives of the project are to evaluate the effectiveness of Severn Trent Services (...

  1. ARSENIC REMOVAL FROM DRINKING WATER BY IRON REMOVAL. USEPA DEMONSTRATION PROJECT AT CLIMAX, MN SIX-MONTH EVALUATION REPORT

    Science.gov (United States)

    This report documents the activities performed and the results obtained from the first six months of the arsenic removal treatment technology demonstration project at the Climax, MN site. The objectives of the project are to evaluate (1) the effectiveness of Kinetico’s Macrolite®...

  2. Six-Month Results for the Kelly Air Force Base Compressed Work Week Survey

    Science.gov (United States)

    1993-07-01

    plans to continue the CWS past the 1-year original plan. REFERENCES 1. Balch, B.W. The four day week and the older workers. Personnel Journal, 394-396...8217 perceptions of the four - day week . California Management Review, 28, 31-35, 1975. 15. Mills, M.E. Core-12: A controlled study of the impact of 12 hour scheduling

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

    Science.gov (United States)

    Bouillon, C; Fauque, P

    2013-05-01

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

  4. Paraquat induced lung injury: long-term follow-up of HRCT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Tong; Kim, Hyun Cheol; Bae, Won Kyung; Kim, Il Young; Im, Han Hyek [Soonchunhyang Univ., Chunan (Korea, Republic of)

    2004-03-01

    To determine the long-term follow-up CT findings of paraquat-induced lung injury. Six patients who ingested paraquat underwent sequential follow-up CT scanning during a period of at least six months, and the results were analysed. Scans were obtained 1-6 (mean, 3.3) time during a 7-84 (mean, 25.7) months period, and the findings at 1-2 months, 3-12 months, 1-2 years, 2-3 years and more than above 7 years after poisoning were analyzed. We observed irregular-shaped areas of consolidation with traction bronchiectasis at 1-2 months (5/5), irregular-shaped consolidation and ground-glass opacity (5/5) at 3-12 months, and irregular-shaped consolidations/ground-glass opacity (4/5) and focal honeycombing (1/5) one year later. In the same patients, follow-up CT scans showed that some areas of focal consolidation could not be visualized and the radio-opacity of the lesions had decreased. The HRCT findings of paraquat-induced lung injury were irregular shaped areas of consolidation 1-2 months after ingestion, and irregular-shaped consolidation and ground-glass opacity or focal honeycombing 3-12 months later. At this thim slight improvement was observed.

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

    Directory of Open Access Journals (Sweden)

    Chopra I

    2014-08-01

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

  6. Methodological systematic review: mortality in elderly patients with cervical spine injury: a critical appraisal of the reporting of baseline characteristics, follow-up, cause of death, and analysis of risk factors.

    NARCIS (Netherlands)

    Middendorp, J.J. van; Albert, T.J.; Veth, R.P.H.; Hosman, A.J.F.

    2010-01-01

    STUDY DESIGN: Methodologic systematic review. OBJECTIVE: To determine the validity of reported risk factors for mortality in elderly patients with cervical spine injury. SUMMARY OF BACKGROUND DATA: In elderly patients with cervical spine injury, mortality has frequently been associated with the type

  7. Long-Term Outcome of Bariatric Surgery in Morbidly Obese Adolescents : A Systematic Review and Meta-Analysis of 950 Patients with a Minimum of 3 years Follow-Up

    NARCIS (Netherlands)

    Shoar, Saeed; Mahmoudzadeh, Habibollah; Naderan, Mohammad; Bagheri-Hariri, Shahram; Wong, Catherine; Shahabeddin Parizi, Ahmad; Shoar, Nasrin

    2017-01-01

    Background: Obesity in pediatric and adolescent population has reached a universal pandemic. This study aimed to summarize the literature on the longest available outcome of bariatric surgery in morbidly obese adolescents. Methods :A systematic review was conducted to pool available data on the

  8. FUNCTIONAL IMPROVEMENT UP TO SIX MONTHS AFTER TOTAL KNEE ARTHROPLASTY: MEASURED BY KNEE RANGE OF MOTION AND SELF-REPORTED QUESTIONNAIRE

    Directory of Open Access Journals (Sweden)

    Mirjana Kocić

    2015-12-01

    Full Text Available The primary aim of this study was to assess knee range of motion (ROM as well as patients’ reported pain, stiffness and function up to six months after total knee arthroplasty (TKA. The secondary aim was to analyze the extent to which knee ROM correlates with patient-rated outcome. A prospective study included 60 patients with primary TKA for osteorthritis, admitted at Physical Medicine and Rehabilitation Clinic from April 2009 to October 2014. The patients were evaluated at 4 time points: at admission and at discharge, as well as at follow-up at 3 and at 6 months after surgery. The outcome parameters included: active knee ROM, as well as pain, stiffness and function according to self reported Western Ontario and McMaster Universities Osteoarthritis (WOMAC questionnaire. Statistically highly significant improvement in flexion and extension was observed from admission to all other assessment time points (p<0.001. Also, statistically significant improvement of all three WOMAC subscales (pain, stiffness and function was found between all assessments points (p<0.001. According to values of Spearman correlation coefficient, there was significant negative correlation of flexion with all WOMAC subscales at all assessment points, whereas correlation of extension with any assessed outcome parameter was without significance. It can be concluded that in TKA patients all outcome measures improved significantly from admission to 6 months follow-up. Knee flexion ROM negatively and moderately to strongly correlated with pain, stiffness and function, whereas correlation of extension with any assessed outcome measure was without significance.

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

    Science.gov (United States)

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

    2014-10-01

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

  10. Synthesis report of the End-Users survey and review of ASAMPSA-E guidance and final workshop conclusions. Identification of follow-up useful activities after ASAMPSA-E

    International Nuclear Information System (INIS)

    Guigueno, Yves; Rahni, Nadia; Vasseur, Dominique; Brac, Pascal; Nitoi, Mirela; Prosek, Andrej; Ostapchuk, Serhii; Gumenyuk, Dmytro; Ivanov, Ivan

    2017-01-01

    The ASAMPSA-E project aims at helping to develop efficiently PSAs methodologies able to identify low probability events or combinations of events which can lead to extreme consequences and at discussing their application in the NPP safety enhancement decision making process. Seventeen draft reports, related to general issues for extended PSA, selection of hazards and development of PSAs have been written during the main phase of the project. They reflect the expertise and experience available within the project. Preliminary versions of the reports have been sent for external review together with a final questionnaire. The objective of the review was to collect proposal for improvements of the preliminary ASAMPSA-E reports while the objectives of the questionnaire was to gather PSA End-Users opinions on the fulfilment of their initial needs, on conclusions and recommendations presented in the reports and on additional needs. This document presents the responses to the questionnaire and a synthesis of improvements proposed by reviewers. A draft version has been used to present the responses and feedbacks during an international workshop hosted by Vienna University on 12, 13 and 14 September 2016. The final version of this document incorporates a synthesis of the discussions during the Vienna workshop. (authors)

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

    Science.gov (United States)

    Pacik, Peter T; Geletta, Simon

    2017-06-01

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

  12. 29 CFR 99.315 - Audit findings follow-up.

    Science.gov (United States)

    2010-07-01

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

  13. Long-term follow-up of aneurysms treated electively with woven stent-assisted coiling.

    Science.gov (United States)

    Cheung, Nicholas K; Chiu, Albert Hy; Cheung, Andrew K; Wenderoth, Jason D

    2017-12-15

    Preliminary short-term results for stent-assisted coil embolization (SACE) using woven/braided stents have been promising. However, evidence supporting mid- to long-term efficacy and durability is lacking. To report the long-term results for the durability of elective intracranial aneurysms treated with woven stents. Between May 2012 and May 2015, 98 consecutive patients with 103 aneurysms underwent elective woven SACE across three Australian neurovascular centres. All patients had immediate, 6- and 18-month clinical and radiological follow-up. Radiological assessment was performed with modified Raymond-Roy occlusion scores based on angiography results, while clinical assessment was based on the modified Rankin Scale. Six-month follow-up was available in 100 aneurysms, and an 18-month follow-up in 97 aneurysms. Total occlusion rates of 82% were achieved at inception, 82% at 6 months, and 90% at 18 months. Satisfactory occlusion with small neck remnants was present in 17% at inception, 16% at 6 months, and 9% at 18 months. Good neurological outcomes were achieved in 95% at 18 months. Intraprocedural thromboembolic events were recorded in 3% and delayed events in 1% (all in patients taking clopidogrel). Aneurysm recurrence occurred in one patient (1%). Technical complications occurred in 5%. The total complication rate was 10%. Woven SACE is safe, efficacious, and durable at long-term 18-month follow-up, with very low recurrence and re-treatment rates. Preliminary results appear better than those for traditional laser-cut stents. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

    Science.gov (United States)

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

    2016-01-01

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

  15. Comparative study of conventional US, contrast enhanced US and enhanced MR for the follow-up of prostatic radiofrequency ablation.

    Science.gov (United States)

    Feng, Chao; Hu, Bin; Hu, Bing; Chen, Lei; Li, Jia; Huang, Jin

    2017-06-01

    The aim of the present study was to evaluate and compare the effectiveness of different imaging methods during follow-up of prostatic radiofrequency ablation. Prostatic radiofrequency ablation (RFA) was performed in 20 healthy beagle dogs. Various imaging examinations were used to monitor the results of RFA, including conventional ultrasound (US), contrast enhanced ultrasound (CEUS) and enhanced magnetic resonance (MR). Imaging exams were performed at five phases: Immediately following RFA, one week later, one month later, three months later and six months later. The morphology for each imaging test and histological results were recorded and compared in each phase. Based on the actual results from autopsy, the accuracy of those imaging exams was evaluated. The canine prostate gland demonstrated typical coagulative necrosis immediately following RFA. The lesion would develop into stable cyst if no other complications occurred within the six-month follow-up. Regarding the RFA lesion volume measurement and the reflection of pathological changes, conventional US was not able to accurately measure the volume of RFA lesion and missed many more details concerning the RFA-treated area than CEUS and MR during the three months. The results from CEUS exhibited comparable accuracy to those from enhanced MR at each phase. However, there were no significant differences in the results from US, CEUS and MR at six months, which may contribute to the complete formation of lesion cyst. In the early phase, conventional US was not sufficient for evaluating the efficacy of RFA. Enhanced US and MR provided clear images and accurate information. However, CEUS has the advantage of being more economical, using more convenient equipment and faster scanning, thus identifying it as the more feasible choice. Furthermore, no notable advantages were observed among any image examinations in the long-term follow-up.

  16. Quality-of-Life Impairments Persist Six Months After Treatment of Graves' Hyperthyroidism and Toxic Nodular Goiter: A Prospective Cohort Study.

    Science.gov (United States)

    Cramon, Per; Winther, Kristian Hillert; Watt, Torquil; Bonnema, Steen Joop; Bjorner, Jakob Bue; Ekholm, Ola; Groenvold, Mogens; Hegedüs, Laszlo; Feldt-Rasmussen, Ulla; Rasmussen, Åse Krogh

    2016-08-01

    The treatment of hyperthyroidism is aimed at improving health-related quality of life (HRQoL) and reducing morbidity and mortality. However, few studies have used validated questionnaires to assess HRQoL prospectively in such patients. The purpose of this study was to assess the impact of hyperthyroidism and its treatment on HRQoL using validated disease-specific and generic questionnaires. This prospective cohort study enrolled 88 patients with Graves' hyperthyroidism and 68 with toxic nodular goiter from endocrine outpatient clinics at two Danish university hospitals. The patients were treated with antithyroid drugs, radioactive iodine, or surgery. Disease-specific and generic HRQoL were assessed using the thyroid-related patient-reported outcome (ThyPRO) and the Medical Outcomes Study 36-item Short Form (SF-36), respectively, evaluated at baseline and six-month follow-up. The scores were compared with those from two general population samples who completed ThyPRO (n = 739) and SF-36 (n = 6638). Baseline scores for patients with Graves' hyperthyroidism and toxic nodular goiter were significantly worse than those for the general population scores on all comparable ThyPRO scales and all SF-36 scales and component summaries. ThyPRO scores improved significantly with treatment on all scales in Graves' hyperthyroidism and four scales in toxic nodular goiter, while SF-36 scores improved on five scales and both component summaries in Graves' hyperthyroidism and only one scale in toxic nodular goiter. In Graves' hyperthyroidism, large treatment effects were observed on three ThyPRO scales (Hyperthyroid Symptoms, Tiredness, Overall HRQoL) and moderate effects on three scales (Anxiety, Emotional Susceptibility, Impaired Daily Life), while moderate effects were seen in two ThyPRO scales in toxic nodular goiter (Anxiety, Overall HRQoL). However, significant disease-specific and generic HRQoL deficits persisted on multiple domains across both patient groups. Graves

  17. A Rare Case of Retrogastric Abscess Occurring Six Months after N-Butyl-2-Cyanoacrylate Injection into Gastric Varices

    Directory of Open Access Journals (Sweden)

    Ikram Hussain

    2018-01-01

    Full Text Available Background. Injection with N-butyl-2-cyanoacrylate is a proven and successful therapeutic modality for treatment of patients with bleeding gastric varices. However, a variety of complications have also been associated with its use. Here, we report a rare case of retrogastric abscess which occurred almost six months after this therapy. This abscess was attributed to the hampered microbial clearance caused by the venous obliterations from N-butyl-2-cyanoacrylate. The abscess was successfully treated with 3 months of antibiotics.

  18. Combating information overload: a six-month pilot evaluation of a knowledge management system in general practice.

    Science.gov (United States)

    O'Brien, C; Cambouropoulos, P

    2000-01-01

    A six-month prospective study was conducted on the usefulness and usability of a representative electronic knowledge management tool, the WAX Active Library, for 19 general practitioners (GPs) evaluated using questionnaires and audit trail data. The number of pages accessed was highest in the final two months, when over half of the access trails were completed within 40 seconds. Most GPs rated the system as easy to learn, fast to use, and preferable to paper for providing information during consultations. Such tools could provide a medium for the activities of knowledge officers, help demand management, and promote sharing of information within primary care groups and across NHSnet or the Internet. PMID:10962792

  19. Visual function after implantation of single-piece toric hydrophilic acrylic intraocular lenses with hydrophobic surface six months after cataract surgery

    Directory of Open Access Journals (Sweden)

    Alja Črnej

    2012-06-01

    Conclusion: Patients with medium to high corneal astigmatism and implanted single-piece toric hydrophilic acrylic IOLs with hydrophobic surface have very good visual function six months postoperatively.

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

    NARCIS (Netherlands)

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

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

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

    NARCIS (Netherlands)

    Verberne, Charlotte

    2016-01-01

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

  2. Follow-up of P dispersion after transcatheter closure of an atrial septal defect in children

    International Nuclear Information System (INIS)

    Baspinar, O.; Kervancioglu, M.; Kilinc, M.; Irdem, A.; Koruk, S.

    2014-01-01

    Objectives: To determine in paediatric patients with atrial septal defects whether differences in P wave dispersion occurred with transcatheter closures using the Amplatzer septal occluder. Method: A total of 31 children who had undergone transcathater closures were evaluated. P maximum, P minimum, and P dispersion were measured with 12-lead surface electrocardiography, before the procedure and one week, one month, three months, six months and one year following the procedure. SPSS 10 was used for statistical analysis. Results: There were 23 (74.2%) females and 8 (25.8%) males with an overall mean age of 7.5+-4.1 years and mean weight of 26.2+-16.9kg. The P maximum and P minimum measurements differed between patients during the follow-up period. Both measurements decreased with time. However, P dispersion was not significantly different throughout the follow-up period (before the procedure P maximum 95.4+-15.6 ms, P minimum 64.5+-15.4 ms, and P dispersion 30.8+-11.4ms; one year later, P maximum 76.1+-14.6 ms, P minimum 47.1+-12.1 ms, and P dispersion 29.1+-9.1ms). Conclusion: Over time, there are no P dispersion differences in transcatheter closures using the Amplatzer septal occluder. (author)

  3. Emergency department blood alcohol level associates with injury factors and six-month outcome after uncomplicated mild traumatic brain injury.

    Science.gov (United States)

    Yue, John K; Ngwenya, Laura B; Upadhyayula, Pavan S; Deng, Hansen; Winkler, Ethan A; Burke, John F; Lee, Young M; Robinson, Caitlin K; Ferguson, Adam R; Lingsma, Hester F; Cnossen, Maryse C; Pirracchio, Romain; Korley, Frederick K; Vassar, Mary J; Yuh, Esther L; Mukherjee, Pratik; Gordon, Wayne A; Valadka, Alex B; Okonkwo, David O; Manley, Geoffrey T

    2017-11-01

    The relationship between blood alcohol level (BAL) and mild traumatic brain injury (mTBI) remains in need of improved characterization. Adult patients suffering mTBI without intracranial pathology on computed tomography (CT) from the prospective Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot study with emergency department (ED) Glasgow Coma Scale (GCS) 13-15 and recorded blood alcohol level (BAL) were extracted. BAL≥80-mg/dl was set as proxy for excessive use. Multivariable regression was performed for patients with six-month Glasgow Outcome Scale-Extended (GOSE; functional recovery) and Wechsler Adult Intelligence Scale Processing Speed Index Composite Score (WAIS-PSI; nonverbal processing speed), using BAL≥80-mg/dl and GOSE≤7; 38.1% vs. 11.5%; p=0.025) and lower WAIS-PSI (92.4±12.7, 30th-percentile vs. 105.1±11.7, 63rd-percentile; pGOSE≤7 and an adjusted mean decrease of 8.88-points (95% CI [0.67-17.09]; p=0.035) on WAIS-PSI. Day-of-injury BAL>80-mg/dl after uncomplicated mTBI was associated with decreased GCS score and prolongation of reported LOC. BAL may be a biomarker for impaired return to baseline function and decreased nonverbal processing speed at six-months postinjury. Future confirmatory studies are needed. Published by Elsevier Ltd.

  4. Effects of sex and obesity on gait biomechanics before and six months after total knee arthroplasty: A longitudinal cohort study.

    Science.gov (United States)

    Paterson, K L; Sosdian, L; Hinman, R S; Wrigley, T V; Kasza, J; Dowsey, M; Choong, P; Bennell, K L

    2018-03-01

    Gait biomechanics, sex, and obesity can contribute to suboptimal outcomes from primary total knee arthroplasty. The aims of this study were to i) determine if sex and/or obesity influence the amount of change in gait biomechanics from pre-surgery to six months post-surgery and; ii) assess if gait returns to normal in men and women. Three-dimensional gait analysis was performed on 43 patients undergoing primary total knee arthroplasty for knee osteoarthritis (pre- and six months post-operative) and 40 asymptomatic controls. Mixed linear regression models were fit to assess which factors influenced change in gait biomechanics within the arthroplasty cohort, and interaction terms were included to assess if biomechanics returned to normal following surgery. Male peak knee adduction moment (p biomechanics after arthroplasty. Men retained abnormal gait patterns after surgery, whilst women did not. Further research should determine the long-term implications of gait abnormalities seen in men after arthroplasty. Copyright © 2018 Elsevier B.V. All rights reserved.

  5. Differentiating maternal fatigue and depressive symptoms at six months and four years post partum: Considerations for assessment, diagnosis and intervention.

    Science.gov (United States)

    Giallo, Rebecca; Gartland, Deirdre; Woolhouse, Hannah; Brown, Stephanie

    2015-02-01

    fatigue and depressive symptoms are common among women in the postpartum period, and it has been proposed that fatigue is a risk factor for later depression. To progress this research, there is a need to clarify the conceptual and measurement issue of whether these two sets of symptoms are distinct constructs. There is also a need to determine whether they are distinct constructs beyond the postnatal period. The aim of the study was to assess the construct and discriminant validity of fatigue and depressive symptoms as measured by the SF-36 Vitality subscale (SF-36) and the Edinburgh Postnatal Depression Scale (EPDS) at six months and at four years post partum. data from over 1000 women participating in the Maternal Health Study, a longitudinal study of women׳s physical and psychological health and recovery after childbirth were used. confirmatory factor analysis revealed a two-factor model of fatigue and depressive symptoms represented as distinct but related constructs was a better fit to the data than a one-factor model of fatigue and depression sharing the same underlying construct at both six months and four years post partum. this study provides empirical evidence that maternal fatigue and depression in the first year after having a baby and at four years post partum are best understood as separate psychological constructs or experiences. The findings have important implications for clinical practice, in particular underlining the importance of differentiating tiredness from depression. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Iodine status and associations with feeding practices and psychomotor milestone development in six-month-old South African infants.

    Science.gov (United States)

    Osei, Jennifer; Baumgartner, Jeannine; Rothman, Marinel; Matsungo, Tonderayi M; Covic, Namukolo; Faber, Mieke; Smuts, Cornelius M

    2017-10-01

    Iodine is important for normal growth and psychomotor development. While infants below 6 months of age receive iodine from breast milk or fortified infant formula, the introduction of complementary foods poses a serious risk for deteriorating iodine status. This cross-sectional analysis assessed the iodine status of six-month-old South African infants and explored its associations with feeding practices and psychomotor milestone development. Iodine concentrations were measured in infant (n = 386) and maternal (n = 371) urine (urinary iodine concentration [UIC]), and in breast milk (n = 257 [breast milk iodine concentrations]). Feeding practices and psychomotor milestone development were assessed in all infants. The median (25th-75th percentile) UIC in infants was 345 (213-596) μg/L and was significantly lower in stunted (302 [195-504] μg/L) than non-stunted (366 [225-641] μg/L) infants. Only 6.7% of infants were deficient. Maternal UIC (128 [81-216] μg/L; r s  = 0.218, p psychomotor developmental scores were observed. Our results suggest that iodine intake in the studied six-month-old infants was adequate. Iodine in breast milk and commercial infant cereals potentially contributed to this adequate intake. © 2016 John Wiley & Sons Ltd.

  7. The follow-up time issue on small roundabouts

    Directory of Open Access Journals (Sweden)

    Janusz WOCH

    2008-01-01

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

  8. The association between quality of HIV care, loss to follow-up and mortality in pediatric and adolescent patients receiving antiretroviral therapy in Nigeria.

    Directory of Open Access Journals (Sweden)

    Bisola Ojikutu

    Full Text Available Access to pediatric HIV treatment in resource-limited settings has risen significantly. However, little is known about the quality of care that pediatric or adolescent patients receive. The objective of this study is to explore quality of HIV care and treatment in Nigeria and to determine the association between quality of care, loss-to-follow-up and mortality. A retrospective cohort study was conducted including patients ≤18 years of age who initiated ART between November 2002 and December 2011 at 23 sites across 10 states. 1,516 patients were included. A quality score comprised of 6 process indicators was calculated for each patient. More than half of patients (55.5% were found to have a high quality score, using the median score as the cut-off. Most patients were screened for tuberculosis at entry into care (81.3%, had adherence measurement and counseling at their last visit (88.7% and 89.7% respectively, and were prescribed co-trimoxazole at some point during enrollment in care (98.8%. Thirty-seven percent received a CD4 count in the six months prior to chart review. Mortality within 90 days of ART initiation was 1.9%. A total of 4.2% of patients died during the period of follow-up (mean: 27 months with 19.0% lost to follow-up. In multivariate regression analyses, weight for age z-score (Adjusted Hazard Ratio (AHR: 0.90; 95% CI: 0.85, 0.95 and high quality indicator score (compared a low score, AHR: 0.43; 95% CI: 0.26, 0.73 had a protective effect on mortality. Patients with a high quality score were less likely to be lost to follow-up (Adjusted Odds Ratio (AOR: 0.42; 95% CI: 0.32, 0.56, compared to those with low score. These findings indicate that providing high quality care to children and adolescents living with HIV is important to improve outcomes, including lowering loss to follow-up and decreasing mortality in this age group.

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

    Science.gov (United States)

    2017-08-27

    Blood Donors Screening Positive for Cbagas Disease presented at/published to Military Health System Research Symposium (Florida, 27-30 Aug 2017) in...disease upon blood donation at JBSA -Lackland 6. TITLE OF MATERIAL TO BE PUBLISHED OR PRESENTED: Follow-up evaluation of Air Force blood donors ...Designated Exempt Reviewer Follow-up evaluation of Air Force blood donors screening positive for Chagas disease Joseph Marcus1, Bryant Webber2, Leo Cropper2

  10. The Danish Cerebral Palsy Follow-up Program

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  11. Can follow-up examination of tuberculosis patients be simplified? A study in Chhattisgarh, India.

    Directory of Open Access Journals (Sweden)

    Debashish Kundu

    Full Text Available BACKGROUND: Each follow-up during the course of tuberculosis treatment currently requires two sputum examinations. However, the incremental yield of the second sputum sample during follow-up of different types of tuberculosis patients has never been determined precisely. OBJECTIVES: To assess the incremental yield of the second sputum sample in the follow-up of tuberculosis patients under the Revised National Tuberculosis Control Programme (RNTCP in Chhattisgarh, India. METHODOLOGY: A record review of tuberculosis (TB patients registered in 2009 using a structured proforma from two sources, Tuberculosis and Laboratory Register, was undertaken in the six districts of Chhattisgarh, India. RESULTS: In smear positive cases, of 10,048 follow-up examinations, 45 (0.5% were found to be smear positive only on the second sputum when the result of the first sample was negative. In smear negative pulmonary and extra pulmonary TB patients, of 6,206 follow-up smear examinations, 11(0.2% were found to be smear positive. CONCLUSIONS: The incremental yield of a second smear examination was very low, indicating that examination of one sputum sample is enough during follow-up among TB patients. There is insufficient yield to support sputum smear microscopy for monitoring smear negative pulmonary TB and extra pulmonary TB patients. These results indicate that the follow-up smear microscopy can be substantially simplified with favourable resource implications.

  12. Follow-up Medical Care After Cancer Treatment

    Science.gov (United States)

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

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

    Data.gov (United States)

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

  14. The value of gynecologic cancer follow-up: evidence-based ignorance?

    Science.gov (United States)

    Lajer, Henrik; Jensen, Mette B; Kilsmark, Jannie; Albæk, Jens; Svane, Danny; Mirza, Mansoor R; Geertsen, Poul F; Reerman, Diana; Hansen, Kåre; Milter, Maya C; Mogensen, Ole

    2010-11-01

    To explore the extent of evidence-based data and cost-utility of follow-up after primary treatment of endometrial and ovarian cancer, addressing perspectives of technology, organization, economics, and patients. Systematic literature searches according to the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions were conducted separately for each of the 4 perspectives. In addition, the organizational analysis included a nationwide questionnaire survey among all relevant hospital departments, and the operating costs were calculated. None of the identified studies supported a survival benefit from hospital-based follow-up after completion of primary treatment of endometrial or ovarian cancer. The methods for follow-up were of low technology (gynecologic examination with or without ultrasound examination). Other technologies had poor sensitivity and specificity in detecting recurrence. Small changes in applied technologies and organization lead to substantial changes in costs. Substantial differences especially in frequency and applied methods were found between departments. The literature review did not find evidence that follow-up affects the women's quality of life. The main purpose of follow-up after treatment of cancer is improved survival. Our review of the literature showed no evidence of a positive effect on survival in women followed up after primary treatment of endometrial or ovarian cancer. The conception of follow-up among physicians, patients, and their relatives therefore needs revision. Follow-up after treatment should have a clearly defined and evidence-based purpose. Based on the existing literature, this purpose should presently focus on other end points rather than early detection of relapse and improved survival. These end points could be quality of life, treatment toxicity, and economy.

  15. Limited Fine Motor and Grasping Skills in Six-month-old Infants at High Risk for Autism

    Science.gov (United States)

    Libertus, Klaus; Sheperd, Kelly A.; Ross, Samuel W.; Landa, Rebecca J.

    2014-01-01

    Atypical motor behaviors are common among children with Autism Spectrum Disorders (ASD). However, little is known about onset and functional implications of differences in early motor development among infants later diagnosed with ASD. Two prospective experiments were conducted to investigate motor skills among six-month-olds at increased risk (high-risk) for ASD (N1 = 129; N2 = 46). Infants were assessed using the Mullen Scales of Early Learning (MSEL) and during toy play. Across both experiments, high-risk infants exhibited less mature object manipulation in a highly structured (MSEL) context and reduced grasping activity in an unstructured (free play) context than infants with no family history of ASD. Longitudinal assessments suggest that between six and ten months, grasping activity increases in high-risk infants. PMID:24978128

  16. Preoperative hypoalgesia after cold pressor test and aerobic exercise is associated with pain relief six months after total knee replacement

    DEFF Research Database (Denmark)

    Vaegter, Henrik Bjarke; Handberg, Gitte; Emmeluth, Claus

    2017-01-01

    OBJECTIVES: Chronic pain after total knee replacement (TKR) is not uncommon. Preoperative impaired conditioning pain modulation (CPM) has been used to predict chronic postoperative pain. Interestingly, exercises reduce pain sensitivity in patients with knee osteoarthritis. This pilot study...... investigated the association between exercise-induced hypoalgesia (EIH) and CPM on post-TKR pain relief. METHODS: Before and six months post-TKR, 14 patients with chronic knee osteoarthritis performed the cold pressor test on the non-affected leg and two exercise conditions (bicycling and isometric knee...... at the affected leg improved post-TKR compared with pre-TKR (PCPM and bicycling EIH assessed by the increase in cPTT correlated with reduction in NRS pain scores post-TKR (PCPM and EIH responses after TKR were significantly correlated with reduction in NRS pain scores...

  17. One-year follow-up study of first suicide attempts in first episode psychosis: Personality traits and temporal pattern.

    Science.gov (United States)

    Canal-Rivero, Manuel; Barrigón, Maria Luisa; Perona-Garcelán, Salvador; Rodriguez-Testal, Juan F; Giner, Lucas; Obiols-Llandrich, Jordi E; Ruiz-Veguilla, Miguel

    2016-11-01

    The highest suicide rates occur after psychiatric hospitalization or soon after discharge. In addition to other factors, personality traits have been suggested as predictors of suicide attempts (SA) after first episode psychosis (FEP). In this study we examined their temporal pattern and the influence of personality traits on first suicide attempts (fSA) during one year after FEP. One-year follow-up of 65 FEP patients. Bivariate and multivariable analyses were performed to explore the relationship between personality traits and fSA. This analysis was also adjusted for a set of sociodemographic, clinical and psychopathological variables. fSAs in the six months following FEP were predicted by higher scores in passive-dependent personality traits (OR = 2.42, 95% CI = 1.15-5.09) and severity of symptoms at onset (OR = 2.00, 95% CI = 1.07-3.76). Severity of symptoms at onset (OR = 2.71, CI = 1.15-6.39) was the most significant predictor of fSA from six to twelve months after FEP. Seventy percent of fSA occurred during the first six months after FEP, decreasing considerably afterwards. Our study suggests that personality traits play a role in fSA after FEP. Specifically, passive-dependent personality traits emerged as a predictor of fSA in the six months following FEP. Severity of symptoms at onset predicted early and late first suicide attempts. We also found that risk of fSA is highest during the six months following FEP. These results can contribute to the implementation of prevention program. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Correlation between hemoglobin levels of mothers and children on exclusive breastfeeding in the first six months of life

    Directory of Open Access Journals (Sweden)

    Rosa de Fátima da Silva Vieira Marques

    Full Text Available Abstract Objective: To evaluate the correlation between hemoglobin levels of mothers and their children on exclusive breastfeeding in the first six months of life. Methods: Cross-sectional study with 221 binomials (mother-child enrolled in a breastfeeding support program, who were stratified into six groups according to the children's age group. The sample consisted of children born at term with normal weight, with no neonatal complications and whose mothers did not have anemia or infectious disease at the time of data collection. Interviews were carried out with the mothers, blood was collected by peripheral venipuncture from mothers and children, and children's anthropometric data were assessed. Pearson's correlation coefficients between the hemoglobin levels of mothers and children were calculated. Six multiple linear regression models were adjusted with regression coefficient estimates, considering as statistically significant associations with p ≤ 0.05. Results: The correlation coefficients of hemoglobin levels of mothers and children ranged from 0.253, at three months, to 0.601, at five months. The hemoglobin level of mothers was correlated with the hemoglobin level of their children at four months (r = 0.578 and at five months (r = 0.601. In the adjusted multiple linear regression, the regression coefficients were higher at four months (β = 1.134; p = 0.002 and at five months (β = 0.845; p < 0.001. Conclusion: These findings allow for the conclusion that there is a correlation between the hemoglobin of mothers and the hemoglobin of their children on exclusive breastfeeding in the first six months of life.

  19. Specific job anxiety in comparison to general psychosomatic symptoms at admission, discharge and six months after psychosomatic inpatient treatment.

    Science.gov (United States)

    Muschalla, Beate; Linden, Michael

    2012-01-01

    Job anxiety is a severe problem in many patients with chronic mental disorders, as it usually results in specific participation problems in the workplace and long-term sick leave. The aim of this study was to explore the development of sick leave in dependence on general psychosomatic complaints and job anxiety from admission to a psychosomatic inpatient treatment until 6 months after discharge. A convenience sample of 91 patients, suffering from multiple mental disorders, filled in self-rating questionnaires on job anxiety (Job Anxiety Scale) and on general psychosomatic symptom load (Symptom Checklist-90-Revised) at the beginning, the end, and 6 months after discharge from an inpatient psychosomatic treatment. Additionally, sick leave status and employment status were assessed before and 6 months after the treatment. 15.4% of 91 patients were on sick leave before inpatient treatment and at follow-up (SS group), 20.9% were fit for work at intake and follow-up (FF group), 6.6% were fit for work initially and on sick leave later (FS group), and 57.1% on sick leave first and working at follow-up (SF group). In regard to general psychosomatic complaints, there were initially high scores on the SCL, a marked reduction during inpatient treatment, and a bouncing back to initial levels at follow-up for all 4 patient groups. SS and FS patients showed the highest scores at intake and follow-up. Concerning job anxiety, SS patients had the highest scores at all three assessments, while FF patients had significantly lower scores, with only low variation between assessments. SF patients started with comparatively high scores of job anxiety, which even increased before reentering work, but decreased in the follow-up period when they were confronted with work again. FS patients started low (like the FF patients) at intake, reduced their job anxiety further till discharge, but increased to higher scores at follow-up. General psychosomatic symptom load and job anxiety show a

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

    DEFF Research Database (Denmark)

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

    2000-01-01

    the completion of inpatient rehabilitation, were discharged to their homes. The patients were randomized to 1 of 2 follow-up interventions provided in addition to standard care or to standard aftercare. Fifty-four received follow-up home visits by a physician (INT1-HVP), 53 were provided instructions......BACKGROUND AND PURPOSE: About 50% of stroke survivors are discharged to their homes with lasting disability. Knowledge, however, of the importance of follow-up services that targets these patients is sparse. The purpose of the present study was to evaluate 2 models of follow-up intervention after...... by a physiotherapist in their home (INT2-PI), and 48 received standard aftercare only (controls). Baseline characteristics for the 3 groups were comparable. Six months after discharge, data were obtained on readmission and institutionalization. RESULTS: The readmission rates within 6 months after discharge were...

  1. Electronic Detection of Delayed Test Result Follow-Up in Patients with Hypothyroidism.

    Science.gov (United States)

    Meyer, Ashley N D; Murphy, Daniel R; Al-Mutairi, Aymer; Sittig, Dean F; Wei, Li; Russo, Elise; Singh, Hardeep

    2017-07-01

    Delays in following up abnormal test results are a common problem in outpatient settings. Surveillance systems that use trigger tools to identify delayed follow-up can help reduce missed opportunities in care. To develop and test an electronic health record (EHR)-based trigger algorithm to identify instances of delayed follow-up of abnormal thyroid-stimulating hormone (TSH) results in patients being treated for hypothyroidism. We developed an algorithm using structured EHR data to identify patients with hypothyroidism who had delayed follow-up (>60 days) after an abnormal TSH. We then retrospectively applied the algorithm to a large EHR data warehouse within the Department of Veterans Affairs (VA), on patient records from two large VA networks for the period from January 1, 2011, to December 31, 2011. Identified records were reviewed to confirm the presence of delays in follow-up. During the study period, 645,555 patients were seen in the outpatient setting within the two networks. Of 293,554 patients with at least one TSH test result, the trigger identified 1250 patients on treatment for hypothyroidism with elevated TSH. Of these patients, 271 were flagged as potentially having delayed follow-up of their test result. Chart reviews confirmed delays in 163 of the 271 flagged patients (PPV = 60.1%). An automated trigger algorithm applied to records in a large EHR data warehouse identified patients with hypothyroidism with potential delays in thyroid function test results follow-up. Future prospective application of the TSH trigger algorithm can be used by clinical teams as a surveillance and quality improvement technique to monitor and improve follow-up.

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

    Science.gov (United States)

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

    2013-09-01

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

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

    Science.gov (United States)

    Klinken, Sven; Humphries, Charlotte; Ferguson, John

    2017-10-01

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

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

    Science.gov (United States)

    Wood, W C

    1991-09-01

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

  5. Follow-up care of children suffered from burns

    Directory of Open Access Journals (Sweden)

    Konstantin Aleksandrovich Afonichev

    2015-03-01

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

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

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  7. One-Year Follow-Up of Combined Parent and Child Intervention for Young Children with ADHD

    Science.gov (United States)

    Webster-Stratton, Carolyn; Reid, M. Jamila; Beauchaine, Theodore P.

    2012-01-01

    Objective Efficacies of the Incredible Years (IY) interventions are well established in children with oppositional defiant disorder (ODD), but not among those with a primary diagnosis of attention-deficit/hyperactivity disorder (ADHD). We sought to evaluate one-year follow-up outcomes among young children with ADHD who were treated with the IY interventions. Method Four- to six-year-olds with ADHD (n=49, 73% males) participated in six months of treatment using the IY parent and child interventions. Results Immediate post-treatment results indicated improvements in parenting, children’s externalizing and attention problems, and social contact at school. At one-year follow up, 22 of 27 variables that showed significant post-treatment effects demonstrated maintenance to one-year follow up. Children with higher ODD symptoms at baseline showed more improvement in oppositionality and total behavior problems, and their mothers showed more improvement on harsh discipline scores. Approximately 70–75% of children were reported by their parents and teachers to fall below clinical cut-offs on measures of externalizing symptoms at the one-year follow up (compared to 50% at baseline) and more than 50% fell below clinical cut-offs on measures of hyperactivity and inattentiveness (all were in the clinical range at baseline). Conclusions Children with ADHD who were treated with the IY parent and child treatment programs showed maintenance of treatment effects one year after treatment. PMID:23020199

  8. The development of insight and its relationship with suicidality over one year follow-up in patients with first episode psychosis.

    Science.gov (United States)

    Barrett, Elizabeth A; Mork, Erlend; Færden, Ann; Nesvåg, Ragnar; Agartz, Ingrid; Andreassen, Ole A; Melle, Ingrid

    2015-03-01

    Insight into psychosis has been linked to suicidality, although inconsistently. The co-variation between insight and suicidality over time is under-investigated. The aim of the present study was to investigate predictors of suicidality in patients with first episode of psychosis (FEP) over one year, focusing on the relationship between insight and suicidality. Patients with FEP (n=146) were interviewed as soon as possible after treatment starts and at one year follow-up. At baseline 37% of patients were suicidal, significantly reduced to 20% at follow-up. The effect of insight on suicidality was in different directions at different time-points, with insight at baseline increasing and insight at follow-up decreasing the risk of suicidality at follow-up. Patients with stable levels of insight across baseline and follow-up did not differ in risk for suicidality at follow-up. However, patients who lost insight from baseline to follow-up were more often suicidal at follow-up, whilst patients who gained insight were more seldom suicidal at follow-up. Other predictors of suicidality at follow-up were more depressive episodes before study entry, longer duration of untreated psychosis, more suicide attempts six months prior to follow-up, and depression at follow-up. The results indicate that the effect of insight on suicidality in FEP-patients depends on time of assessment and of changes in insight. Gaining insight during treatment was associated with reduced risk for suicidality, whilst losing insight had the opposite effect, underlining the need to monitor insight over time and tailor interventions according to illness phase. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Human Milk, Environmental Toxins and Pollution of Our Infants: Disturbing Findings during the First Six Months of Life.

    Science.gov (United States)

    Lackmann, Gerd-Michael

    2006-06-01

    Toxic organochlorine compounds (OC) are transmitted from mother to infant during lactation. OC are ingested by and stored in their offspring. Different harmful effects later in life have been attributed to the body pollution with these OC, although these findings are still discussed in an argumentative manner, since first other investigators could demonstrate beneficial effects of breast-feeding despite elevated OC concentrations, and second the benefits of breast-feeding are an unchallenged fact, especially in those countries, where infant formulas are not available. It was the aim of the present study to determine the lactational uptake of different OC (polychlorinated biphenyls (PCB), hexachlorobenzene (HCB), and DDE) in breast-fed vs. bottle-fed infants up to six months of age. With the written informed consent of the parents, blood samples were taken from each ten breast-fed and bottle-fed infants, respectively. The specimens were immediately centrifuged, and serum was stored in glass tubes without an anticoagulant up to analysis. Three higher-chlorinated PCB congeners (IUPAC Nos. 138, 153, and 180), HCB, and DDE, the main metabolite of DDT in mammals, were determined with capillary gas chromatography with electron capture detection. In addition, reliability was tested with gas chromatography-mass spectrometry. Possible correlations of OC with personal data were tested with a standard multivariate regression model. Differences between study groups were tested on mean differences with Wilcoxons test for independent samples. We could demonstrate that breast-fed infants have significantly (p<0.0001) elevated serum concentrations of all OC as early as at the age of six weeks (90%), which over and above nearly doubled further until the age of six months. (Median (μg/L); A=six weeks; B=six months): PCB 138, A: 0.40 vs. 0.09; B: 0.72 vs. 0.07; PCB 153, A: 0.57 vs. 0.11; B: 0.99 vs. 0.09; PCB 180, A: 0.33 vs. 0.04; B: 0.58 vs. 0.02; PCB (sum of the three PCB

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

    International Nuclear Information System (INIS)

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

    1986-01-01

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

  11. Follow up of Graves' Opthalmopathy after radioiodine therapy

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  12. Effectiveness of graded activity versus physiotherapy in patients with chronic nonspecific low back pain: midterm follow up results of a randomized controlled trial.

    Science.gov (United States)

    Magalhães, Maurício Oliveira; Comachio, Josielli; Ferreira, Paulo Henrique; Pappas, Evangelos; Marques, Amélia Pasqual

    Low back pain (LBP) is a major health and economic problem worldwide. Graded activity and physiotherapy are commonly used interventions for nonspecific low back pain. However, there is currently little evidence to support the use of one intervention over the other in the medium-term. To compare the effectiveness of graded activity exercises to physiotherapy-based exercises at mid-term (three and six months' post intervention) in patients with chronic nonspecific LBP. Sixty-six patients were randomly allocated to two groups: graded activity group (n=33) and physiotherapy group (n=33). These patients received individual sessions twice a week for six weeks. Follow-up measurements were taken at three and six months. The main outcome measurements were intensity pain (Pain Numerical Rating Scale) and disability (Rolland Morris Disability Questionnaire). No significant differences between groups after three and six month-follow ups were observed. Both groups showed similar outcomes for pain intensity at three months [between group differences: -0.1 (95% confidence interval [CI]=-1.5 to 1.2)] and six months [0.1 (95% CI=-1.1 to 1.5)], disability at three months was [-0.6 (95% CI=-3.4 to 2.2)] and six months [0.0 (95% CI=-2.9 to 3.0)]. The results of this study suggest that graded activity and physiotherapy have similar effects in the medium-term for patients with chronic nonspecific low back pain. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  13. Six-month low level chlorine dioxide gas inhalation toxicity study with two-week recovery period in rats

    Directory of Open Access Journals (Sweden)

    Akamatsu Akinori

    2012-02-01

    Full Text Available Abstract Background Chlorine dioxide (CD gas has a potent antimicrobial activity at extremely low concentration and may serve as a new tool for infection control occupationally as well as publicly. However, it remains unknown whether the chronic exposure of CD gas concentration effective against microbes is safe. Therefore, long-term, low concentration CD gas inhalation toxicity was studied in rats as a six-month continuous whole-body exposure followed by a two-week recovery period, so as to prove that the CD gas exposed up to 0.1 ppm (volume ratio is judged as safe on the basis of a battery of toxicological examinations. Methods CD gas at 0.05 ppm or 0.1 ppm for 24 hours/day and 7 days/week was exposed to rats for 6 months under an unrestrained condition with free access to chow and water in a chamber so as to simulate the ordinary lifestyle in human. The control animals were exposed to air only. During the study period, the body weight as well as the food and water consumptions were recorded. After the 6-month exposure and the 2-week recovery period, animals were sacrificed and a battery of toxicological examinations, including biochemistry, hematology, necropsy, organ weights and histopathology, were performed. Results Well regulated levels of CD gas were exposed throughout the chamber over the entire study period. No CD gas-related toxicity sign was observed during the whole study period. No significant difference was observed in body weight gain, food and water consumptions, and relative organ weight. In biochemistry and hematology examinations, changes did not appear to be related to CD gas toxicity. In necropsy and histopathology, no CD gas-related toxicity was observed even in expected target respiratory organs. Conclusions CD gas up to 0.1 ppm, exceeding the level effective against microbes, exposed to whole body in rats continuously for six months was not toxic, under a condition simulating the conventional lifestyle in human.

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

    Directory of Open Access Journals (Sweden)

    Lidia B. Giúdici

    2016-07-01

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

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

    Science.gov (United States)

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

    1990-05-01

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

  16. 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...

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-02-15

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

  18. Pediatric superficial scald burns--reassessment of our follow-up protocol.

    Science.gov (United States)

    Egro, Francesco M; O'Neill, Jennifer K; Briard, Robert; Cubison, Tania C S; Kay, Alan R; Estela, Catalina M; Burge, Timothy S

    2010-01-01

    The most common pediatric burn injury is a superficial scald. The current follow-up protocol for such burns includes review of the patient at 2 weeks postinjury and then 2 months later. The authors decided to review the protocol to assess the need for this second follow-up. A retrospective study reviewed the case notes of patients younger than 16 years at the time of their injury presenting with a scald over 5% TBSA. The progress of healing and scar development up to 5 years follow-up was assessed. This study showed that scalds healing within 2 weeks following injury rarely became hypertrophic. A prospective study was performed over a 10-month period. All children who suffered a superficial partial-thickness scald injury were included. At the 2-week appointment, the need for further follow-up was predicted. The accuracy of this prediction was assessed 2 months later. This study showed that an experienced member of the burns team could reliably predict at 2-week appointment those children who could be safely discharged with no subsequent need for scar management. This study suggests that it will be safe to modify the follow-up protocol, reducing the number of clinic attendances.

  19. The effect of post-discharge educational intervention on patients in achieving objectives in modifiable risk factors six months after discharge following an episode of acute coronary syndrome, (CAM-2 Project: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    de Teresa-Galván ß Eduardo

    2010-11-01

    Full Text Available Abstract Objectives We investigated whether an intervention mainly consisting of a signed agreement between patient and physician on the objectives to be reached, improves reaching these secondary prevention objectives in modifiable cardiovascular risk factors six-months after discharge following an acute coronary syndrome. Background There is room to improve mid-term adherence to clinical guidelines' recommendations in coronary heart disease secondary prevention, specially non-pharmacological ones, often neglected. Methods In CAM-2, patients discharged after an acute coronary syndrome were randomly assigned to the intervention or the usual care group. The primary outcome was reaching therapeutic objectives in various secondary prevention variables: smoking, obesity, blood lipids, blood pressure control, exercise and taking of medication. Results 1757 patients were recruited in 64 hospitals and 1510 (762 in the intervention and 748 in the control group attended the six-months follow-up visit. After adjustment for potentially important variables, there were, between the intervention and control group, differences in the mean reduction of body mass index (0.5 vs. 0.2; p Conclusions At least in the short term, lifestyle changes among coronary heart disease patients are achievable by intensifying the responsibility of the patient himself by means of a simple and feasible intervention.

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

    Directory of Open Access Journals (Sweden)

    Boschman Julitta S

    2012-10-01

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

  1. Predictors of loss to follow-up among patients on ART at a rural hospital in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Arnesen, Rachel; Moll, Anthony P; Shenoi, Sheela V

    2017-01-01

    Improved HIV outcomes as a result of expanded antiretroviral therapy (ART) access is threatened by increasing rates of loss to follow up (LTFU) among those on ART, largely reported in urban populations. Some reports suggest that LTFU rates are overestimated due to patient movement to other facilities and inadequate medical records. To define the proportion disengaging from HIV care as well as the characteristics of those LTFU in order to design and implement appropriate interventions to increase retention. We performed a retrospective review of patients who discontinued ART at a central hospital ART clinic in rural South Africa and compared with patients receiving care at the 15 primary health clinics (PHCs) to determine the true proportion of those who were LTFU. We also compared those who discontinued ART with those who did not at the central hospital ART clinic to determine predictors of loss to follow up. Among 3242 patients on ART, 820 were originally marked as LTFU. Among all patients, 272 (8.4%) were found at a clinic on treatment, 56 (1.7%) were found at a clinic from which they had since discontinued treatment, and 10 (0.3%) returned to care between June and July 2016, leaving 475 (14.7%) unaccounted for and thus categorized as 'true' LTFU. Factors found to be associated with discontinuation include being male, age 18-35, having a CD4 count under 200 cells/μL, and being on ART for under six months. Young men with low CD4 counts early after ART initiation are at highest risk of ART disengagement in this rural South African HIV clinic. Novel interventions targeting this group are needed to improve retention in care.

  2. A Pilot Study on Telephone Cognitive Behavioral Therapy for Patients Six-Months Post-Bariatric Surgery

    Science.gov (United States)

    Cassin, Stephanie E.; Wnuk, Susan; Du, Chau; Jackson, Timothy; Hawa, Raed; Parikh, Sagar V.

    2017-01-01

    Objective This study aimed to determine the feasibility and preliminary efficacy of a post-operative telephone-based cognitive behavioral therapy intervention (Tele-CBT) in improving eating pathology and psychosocial functioning. Methods Six-month post-operative bariatric surgery patients (n = 19) received six sessions of Tele-CBT. Study outcome variables included binge eating (BES), emotional eating (EES), depressive symptoms (PHQ-9), and anxiety symptoms (GAD-7). Results Retention was 73.7 % post-intervention. Tele-CBT resulted in significant reductions in mean difference scores on BES, EES-Total, EES-Anxiety, EES-Anger, PHQ9, and GAD7. Tele-CBT patients experienced a mean weight loss of 8.62 ± 15.02 kg between 6-months post-surgery (pre-Tele-CBT) and 12-months post-surgery. Conclusions These preliminary results suggest that post-surgery Tele-CBT is feasible and can improve post-surgery symptoms of psychopathology in this uncontrolled study, supporting the need for a randomized controlled trial. PMID:27491293

  3. Aflatoxin biosynthesis control produced by Aspergillus flavus in layer hens feed during storage period of six months.

    Science.gov (United States)

    Hassan, S M; Sultana, B; Iqbal, M

    2017-06-01

    Aflatoxins (AFTs) are a group of closely related toxins that are produced by different fungus species. Food and feed contamination with AFT is a worldwide health-related problem. As a result of fungal attack, the food and feed resulted in a principal socioeconomic loss and toxins produced in feed and food items harm the humans and animals in different ways. The anti-aflatoxigenic effect Psidium guajava, Ficus benghalensis, Gardenia radicans, Punica granatum and Ziziphus jujuba leaves were evaluated against aflatoxins (AFTs), produced by Aspergillus flavus in layer feed during storage. Among the investigated medicinal plant leaves, P. granatum showed highly promising anti-aflatoxigenic activity and completely inhibited the AFTs (B1 and B2) production over storage period without compromising the nutritive quality of feed (ash, protein, fat, fiber, Fe, Ca, P and K contents). Leaves of F. benghalensis and Z. jujuba were also effective however, higher concentration (15%) inhibited the AFTs production up to 99% and also maintained nutritive quality of feed. G. radicans was found least effective in controlling the AFTs production. Results revealed that all plant leaves were effective in controlling AFTs production in layer feed over the storage period of six months and these plants are potential candidate to replace the fungicides used to protect feed and other agricultural commodities from AFTs production during storage. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  4. C-reactive protein and fibrinogen of bedridden older patients in a six-month vitamin D supplementation trial.

    Science.gov (United States)

    Bjorkman, M P; Sorva, A J; Tilvis, R S

    2009-05-01

    To elucidate the association between vitamin D status, C-reactive protein (CRP) and fibrinogen. Secondary analysis of a randomised double-blind placebo controlled trial. Four longterm care hospitals (1215 beds) in Helsinki, Finland. 218 long-term inpatients aged over 65 years. Eligible patients (n = 218) were randomized to receive 0 IU/d, 400 IU/d, or 1200 IU/d cholecalciferol for six months. Plasma 25-hydroxyvitamin D (25-OHD), parathyroid hormone (PTH), high sensitive CRP, fibrinogen, amino-terminal propeptide of type I procollagen (PINP), and carboxy-terminal telopeptide of type I collagen (ICTP) were measured. The patients were aged (84.5 +/- 7.5 years), vitamin D deficient (25-OHD = 23 +/- 10 nmol/l), chronically bedridden and in stable general condition. The mean baseline CRP and fibrinogen were 10.86 mg/l (0.12 mg/l - 125.00 mg/l) and 4,7 g/l (2.3 g/l - 8.6 g/l), respectively. CRP correlated with ICTP (r = 0.217, p = 0.001), but not with vitamin D status. Supplementation significantly increased 25-OHD concentrations, but the changes in CRP and fibrinogen were insignificant and inconsistent. The post-trial CRP concentrations (0.23 mg/l -138.00 mg/l) correlated with ICTP (r = 0.156, p bedridden older patients.

  5. ARSENIC REMOVAL FROM DRINKING WATER BY ADSORPTIVE MEDIA U.S. EPA DEMONSTRATION PROJECT AT RICHMOND ELEMENTARY SCHOOL IN SUSANVILLE, CA SIX-MONTH EVALUATION REPORT

    Science.gov (United States)

    This report documents the activities performed during and the results obtained from the first six months of the performance evaluation study of the Aquatic Treatment Systems, Inc. (ATS) adsorptive media arsenic removal system at Richmond Elementary School in Susanville, Californi...

  6. 38 CFR 41.315 - Audit findings follow-up.

    Science.gov (United States)

    2010-07-01

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

  7. Follow-up of conservatively treated sleep apnoea patients

    African Journals Online (AJOL)

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

  8. 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.

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

    Science.gov (United States)

    Mehallis, Mantha Vlahos

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

  10. Factors Associated with Adherence to Follow-up Colposcopy

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2014-02-01

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

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

    African Journals Online (AJOL)

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

  13. [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.

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

    DEFF Research Database (Denmark)

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

    1990-01-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  17. A Follow-Up Study of the Deaf.

    Science.gov (United States)

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

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

  18. Loss to Follow-Up: Issues and Recommendations

    Science.gov (United States)

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

    2011-01-01

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

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

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

    International Nuclear Information System (INIS)

    Maday, J.H. Jr.

    1989-10-01

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

  1. Diagnosis and Follow-up US Evaluation of Ruptures of the Medial Head of the Gastrocnemius

    International Nuclear Information System (INIS)

    Kwak, Hyo-Sung; Han, Young-Min; Lee, Sang-Yong; Kim, Ki-Nam; Chung, Gyung Ho

    2006-01-01

    The purpose of this study was to demonstrate the ultrasonographic (US) findings of rupture and the healing process of the medial head of the gastrocnemius ('Tennis Leg'). Twenty-two patients (age range: 30 to 45 years) with clinically suspected ruptures of the medial head of the gastrocnemius were referred to us for US examination. All the patients underwent US of the affected limb and the contralateral asymptomatic limb. Follow-up clinical evaluation and US imaging of all patients were performed at two-week intervals during the month after injury and at one-month intervals during the following six months. Of the 22 patients who had an initial US examination after their injury, partial rupture of the medial head of the gastrocnemius muscle was identified in seven patients (31.8%); the remaining 15 patients were diagnosed with complete rupture. Fluid collection between the medial head of the gastrocnemius and the soleus muscle was identified in 20 patients (90.9%). The thickness of the fluid collection, including the hematoma in the patients with complete rupture (mean: 9.7 mm), was significantly greater than that seen in the patients with partial tear (mean: 6.8 mm) (p < 0.01). The primary union of the medial head of the gastrocnemius with the soleus muscle in all the patients with muscle rupture and fluid collection was recognized via the hypoechoic tissue after four weeks. Ultrasonography is a useful imaging modality for the diagnosis and follow-up examination for the patients suffering with rupture of the medial head of the gastrocnemius

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2010-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Peter Clarys

    2011-02-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1985-11-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

  7. A six-month double-blind, placebo-controlled, randomized clinical trial of duloxetine for the treatment of fibromyalgia

    Directory of Open Access Journals (Sweden)

    Amy S Chappell

    2008-12-01

    Full Text Available Amy S Chappell1, Laurence A Bradley2, Curtis Wiltse1, Michael J Detke1,3,4, Deborah N D’Souza1, Michael Spaeth51Lilly Research Laboratories, Indianapolis, IN, USA; 2University of Alabama at Birmingham, Birmingham, Alabama, USA; 3Indiana University School of Medicine, Indianapolis, IN, USA; 4Harvard Medical School, Boston, MA, USA; 5Practice for Internal Medicine/Rheumatology, Graefelfing, GermanyObjective: Assess the efficacy of duloxetine 60/120 mg (N = 162 once daily compared with placebo (N = 168 in the treatment of patients with fibromyalgia, during six months of treatment.Methods: This was a phase-III, randomized, double-blind, placebo-controlled, parallel-group study assessing the efficacy and safety of duloxetine.Results: There were no significant differences between treatment groups on the co-primary efficacy outcome measures, change in the Brief Pain Inventory (BPI average pain severity from baseline to endpoint (P = 0.053 and the Patient’s Global Impressions of Improvement (PGI-I at endpoint (P = 0.073. Duloxetine-treated patients improved significantly more than placebo-treated patients on the Fibromyalgia Impact Questionnaire pain score, BPI least pain score and average interference score, Clinical Global Impressions of Severity scale, area under the curve of pain relief, Multidimensional Fatigue Inventory mental fatigue dimension, Beck Depression Inventory-II total score, and 36-item Short Form Health Survey mental component summary and mental health score. Nausea was the most common treatment-emergent adverse event in the duloxetine group. Overall discontinuation rates were similar between groups.Conclusions: Although duloxetine 60/120 mg/day failed to demonstrate significant improvement over placebo on the co-primary outcome measures, in this supportive study, duloxetine demonstrated significant improvement compared with placebo on numerous secondary measures.Keywords: fibromyalgia, duloxetine, placebo, double-blind, trial

  8. Six-month evaluation of a resin/dentin interface created by methacrylate and silorane-based materials

    Directory of Open Access Journals (Sweden)

    Renata Kirita Doi SAMPAIO

    2013-01-01

    Full Text Available Objectives This study aimed to compare the micro-tensile bond strength of methacrylate resin systems to a silorane-based restorative system on dentin after 24 hours and six months water storage. Material and Methods The restorative systems Adper Single Bond 2/Filtek Z350 (ASB, Clearfil SE Bond/Z350 (CF, Adper SE Plus/Z350 (ASEP and P90 Adhesive System/Filtek P90 (P90 were applied on flat dentin surfaces of 20 third molars (n=5. The restored teeth were sectioned perpendicularly to the bonding interface to obtain sticks (0.8 mm2 to be tested after 24 hours (24 h and 6 months (6 m of water storage, in a universal testing machine at 0.5 mm/min. The data was analyzed via two-way Analysis of Variance/Bonferroni post hoc tests at 5% global significance. Results Overall outcomes did not indicate a statistical difference for the resin systems (p=0.26 nor time (p=0.62. No interaction between material × time was detected (p=0.28. Mean standard-deviation in MPa at 24 h and 6 m were: ASB 31.38 (4.53 and 30.06 (1.95, CF 34.26 (3.47 and 32.75 (4.18, ASEP 29.54 (4.14 and 33.47 (2.47, P90 30.27 (2.03 and 31.34 (2.19. Conclusions The silorane-based system showed a similar performance to methacrylate-based materials on dentin. All systems were stable in terms of bond strength up to 6 month of water storage.

  9. A xeroradiographic study of the developing equine foredigit and metacarpophalangeal region from birth to six months of age

    International Nuclear Information System (INIS)

    Smallwood, J.E.; Albright, S.M.; Metcalf, M.R.; Thrall, D.E.; Harrington, B.D.

    1989-01-01

    The purpose of the project was to provide a reference for radiographic anatomy of the developing equine foredigit and metacarpophalangeal region. Using xeroradiographic techniques, both foredigits and meta-carpophalangeal regions of six Quarter Horse foals were radiographed at one day of age and at two-week intervals until the foals were six weeks old. The foals were then radiographed at four-week intervals until they were 12 months old. This report deals specifically with the first six months of postnatal development. Lateromedial and dorsopalmar xeroradiographs of each foredigit and metacarpophalangeal region and a dorsal 65° proximal-palmarodistal oblique view of the distal part of the digit were made for each examination. The foals were weighed and measured at the withers immediately prior to each examination. Representative xeroradiographs were selected and appropriately labeled to demonstrate normal radio-graphic anatomy of these regions. First radiographic appearance of distal epiphyseal ossification in metacarpal 2 and metacarpal 4 was extremely variable and ranged from four to 38 weeks. Radiographic closure of the proximal physis of the middle phalanx ranged from 18 to 30 weeks (mean = 26 weeks). Radiographic closure of the proximal physis of the proximal phalanx ranged from 22 to 38 weeks (mean = 30 weeks). Radiographic closure of the distal physis of metacarpal 3 ranged from 18 to 38 weeks (mean = 29 weeks). When xeroradiographic physeal closure times were compared with scintigraphic closure times from a companion study, results correlated very well. A crena marginis solearis was observed in ten of 12 forelimbs (83.3%); its first radiographic appearance ranged from four to 22 weeks (mean = 11–12 weeks). A consistent groove in the hoof wall, which formed near the time of birth and moved distally at about 3 mm per week, was noted. The groove's distance from the proximal hoof border may be useful in age estimation of foals less than 18–20 weeks old

  10. Cytologic follow-up of patients with invasive cervical carcinoma treated by radiotherapy

    International Nuclear Information System (INIS)

    Muram, D.; Curry, R.H.; Drouin, P.

    1982-01-01

    In an 11-year study done at the Ottawa Civic Hospital, cytologic assessment of 323 patients treated by radiotherapy for invasive cervical carcinoma was reviewed. The value and limitations of gynecologic cytology in the follow-up of these patients are discussed

  11. Report: EPA Needs to Improve Its Information Technology Audit Follow-Up Processes

    Science.gov (United States)

    Report #16-P-0100, March 10, 2016. The EPA’s audit follow-up oversight for offices reviewed did not ensure that agreed-to corrective actions were managed effectively in the agency’s Management Audit Tracking System (MATS).

  12. What Facilitates "Patient Empowerment" in Cancer Patients During Follow-Up

    DEFF Research Database (Denmark)

    Jørgensen, Clara R; Thomsen, Thora G; Ross, Lone

    2018-01-01

    Empowerment is a concept of growing importance in cancer care, but little is known about cancer patients' experiences of empowerment during follow-up. To explore this area, a qualitative systematic literature review was conducted in PubMed, CINAHL, and PsycINFO. A total of 2,292 papers were...

  13. Distal tibiofibular synostosis after ankle fracture. A 14-year follow-up study

    NARCIS (Netherlands)

    Albers, G. H.; de Kort, A. F.; Middendorf, P. R.; van Dijk, C. N.

    1996-01-01

    Over an eight-year period up to 1983, a total of 322 consecutive patients had operations for ankle fractures; 176 were Weber type B and 128 type C. We were able to review 230 of these patients after a mean follow-up of six years (1 to 11) including 128 with Weber B and 102 with Weber C fractures. We

  14. Results of remote follow-up and monitoring in young patients with cardiac implantable electronic devices.

    Science.gov (United States)

    Silvetti, Massimo S; Saputo, Fabio A; Palmieri, Rosalinda; Placidi, Silvia; Santucci, Lorenzo; Di Mambro, Corrado; Righi, Daniela; Drago, Fabrizio

    2016-01-01

    Remote monitoring is increasingly used in the follow-up of patients with cardiac implantable electronic devices. Data on paediatric populations are still lacking. The aim of our study was to follow-up young patients both in-hospital and remotely to enhance device surveillance. This is an observational registry collecting data on consecutive patients followed-up with the CareLink system. Inclusion criteria were a Medtronic device implanted and patient's willingness to receive CareLink. Patients were stratified according to age and presence of congenital/structural heart defects (CHD). A total of 221 patients with a device - 200 pacemakers, 19 implantable cardioverter defibrillators, and two loop recorders--were enrolled (median age of 17 years, range 1-40); 58% of patients were younger than 18 years of age and 73% had CHD. During a follow-up of 12 months (range 4-18), 1361 transmissions (8.9% unscheduled) were reviewed by technicians. Time for review was 6 ± 2 minutes (mean ± standard deviation). Missed transmissions were 10.1%. Events were documented in 45% of transmissions, with 2.7% yellow alerts and 0.6% red alerts sent by wireless devices. No significant differences were found in transmission results according to age or presence of CHD. Physicians reviewed 6.3% of transmissions, 29 patients were contacted by phone, and 12 patients underwent unscheduled in-hospital visits. The event recognition with remote monitoring occurred 76 days (range 16-150) earlier than the next scheduled in-office follow-up. Remote follow-up/monitoring with the CareLink system is useful to enhance device surveillance in young patients. The majority of events were not clinically relevant, and the remaining led to timely management of problems.

  15. Effect of Systematic Follow-Up by General Practitioners after Deliberate Self-Poisoning: A Randomised Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Tine K Grimholt

    Full Text Available To assess whether systematic follow-up by general practitioners (GPs of cases of deliberate self-poisoning (DSP by their patients decreases psychiatric symptoms and suicidal behaviour compared with current practice.Randomised clinical trial with two parallel groups.General practices in Oslo and the eastern part of Akershus County.Patients aged 18-75 years admitted to hospital for DSP. We excluded patients diagnosed with psychoses, without a known GP, those not able to complete a questionnaire, and patients admitted to psychiatric in-patient care or other institutions where their GP could not follow them immediately after discharge.The GPs received a written guideline, contacted the patients and scheduled a consultation within one week after discharge, and then provided regular consultations for six months. We randomised the patients to either intervention (n = 78 or treatment as usual (n = 98.Primary outcome measure was the Beck Scale for Suicide Ideation (SSI. Secondary outcomes were Beck Depression Inventory (BDI and Beck Hopelessness Scale (BHS, self-reported further self-harm and treatment for DSP in a general hospital or an emergency medical agency (EMA. We assessed patients on entry to the trial and at three and six months. We collected data from interviews, self-report questionnaires, and hospital and EMA medical records.There were no significant differences between the groups in SSI, BDI, or BHS mean scores or change from baseline to three or six months. During follow-up, self-reported DSP was 39.5% in the intervention group vs. 15.8% in controls (P = 0.009. Readmissions to general hospitals were similar (13% in both groups (P = 0.963, while DSP episodes treated at EMAs were 17% in the intervention group and 7% in the control group (P = 0.103.Structured follow-up by GPs after an episode of DSP had no significant effect on suicide ideation, depression or hopelessness. There was no significant difference in repeated episodes of DSP in

  16. 75 FR 70365 - Agency Information Collection (Follow-Up Study of a National Cohort of Gulf War and Gulf Era...

    Science.gov (United States)

    2010-11-17

    ... (Follow-Up Study of a National Cohort of Gulf War and Gulf Era Veterans) Activity Under OMB Review AGENCY...).'' SUPPLEMENTARY INFORMATION: Titles: Follow-Up Study of a National Cohort of Gulf War and Gulf Era Veterans, VA..., will help VA to assess the health of Gulf War veterans who were exposed to a variety of environmental...

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

    International Nuclear Information System (INIS)

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

    1990-01-01

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

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

    International Nuclear Information System (INIS)

    Fischnaller, M.

    1986-01-01

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

  19. Treatment of craniopharyngioma estimated by follow-up CT

    Energy Technology Data Exchange (ETDEWEB)

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

    1981-12-01

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

  20. 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)

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

    Science.gov (United States)

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

    2014-07-01

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

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

    Science.gov (United States)

    Morgan, David L

    2015-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Supe A

    1990-10-01

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

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

    Science.gov (United States)

    Azevedo, Monalisa Ferreira; Casulari, Luiz Augusto

    2010-02-01

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

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

    International Nuclear Information System (INIS)

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

    1993-01-01

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

  6. Feasibility of an EIS Follow-up Program

    International Nuclear Information System (INIS)

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

    1982-12-01

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

  7. Follow-up of prenatally diagnosed unilateral hydronephrosis

    DEFF Research Database (Denmark)

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

    1996-01-01

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

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

    Science.gov (United States)

    North Conejos School District, Capulin, CO.

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

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

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

    Science.gov (United States)

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

    2016-06-01

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

  12. Follow-Up Photometry of Kelt Transiting Planet Candidates

    Science.gov (United States)

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

    2017-10-01

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

  13. DESGW: Optical Follow-up of BBH LIGO-Virgo Events with DECam

    Energy Technology Data Exchange (ETDEWEB)

    Butler, Robert E. [Indiana U.; Soares-Santos, M. [Brandeis U.; Annis, j. [Fermilab; Herner, K. [Fermilab

    2017-12-14

    The DESGW program is a collaboration between members of the Dark Energy Survey, the wider astronomical community, and the LIGO-Virgo Collaboration to search for optical counterparts of gravitational wave events, such as those expected from binary neutron star mergers or neutron star-black hole mergers. While binary black hole (BBH) events are not expected to produce an electromagnetic (EM) signature, emission is certainly not impossible. The DESGW program has performed follow-up observations of four BBH events detected by LIGO in order to search for any possible EM counterpart. Failure to nd such counterparts is still relevant in that it produces limits on optical emission from such events. This is a review of follow-up results from O1 BBH events and a discussion of the status of ongoing uniform re-analysis of all BBH events that DESGW has followed up to date.

  14. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-01-15

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

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  17. Long-term Follow-up of MDD Patients Who Respond to Deep rTMS: A Brief Report.

    Science.gov (United States)

    Rosenberg, Oded; Dinur Klein, Limor; Gersner, Roman; Kotler, Moshe; Zangen, Abraham; Dannon, Pinhas

    2015-01-01

    Deep transcranial magnetic stimulation (dTMS) is effective in treatment of Major Depressive Disorder (MDD), and in re-treatment in case of relapse. Our study evaluates the long-term durability of dTMS in MDD. Seventeen patients that responded to dTMS treatment evaluated. Follow-up period was 9.3 months. Patients were considered as relapsed if: HDRS (Hamilton Depression Rating Scale) score was 16 points or more, in case of change in antidepressants, hospitalization due to exacerbation, referral to ECT. Six months after last treatment three patients relapsed (17.6%). During the follow-up of 9.3 months, nine relapsed. Relapse rate was 5.6 per 100 person-months. Patients continued to improve in HDRS following the treatment. We have found number of treatment sessions, stimulation, age, age of depressive disorder onset, length of depressive episode prior to the first treatment, as well as number of depressive episodes to have no predictive value regarding propensity to relapse in these patients. The study's main limitations are the relatively small sample size, patients differing in follow-up periods and the lack of a control group. Relapse rates after dTMS are comparable to pharmacotherapy and ECT.

  18. Health-related quality of life before planned admission to intensive care: memory over three and six months

    Directory of Open Access Journals (Sweden)

    Tadini Laura

    2010-09-01

    Full Text Available Abstract Background The validity of Health-Related Quality of Life (HRQOL recalled by ICU admitted patients have not been published. The aim of this study was to compare the baseline HRQOL measured before surgery and ICU admission with that recalled at 3 and 6 months in a population of patients with planned ICU admission after surgery. Methods This prospective study was performed in three Italian centres on patients who had undergone General, Orthopaedic or Urologic surgery. All adult patients with planned ICU admission between October 2007 and July 2008 were considered for enrolment. At hospital admission, the Mini Mental Status Examination and EuroQoL (EQ questionnaire (referring to the last two weeks were administered to the patients who consented. Three and six months after ICU admission, the researchers administered by phone the EQ questionnaire and Post-Traumatic Stress Syndrome 14 questions Inventory, asking the patients to rate their HRQOL before surgery and ICU admission. Past medical history demographic and clinical ICU-related variables were collected. Statistical analysis Chi-square test and non parametric statistics were used to compare groups of patients. The EQ-5D was transformed in the time trade-off (TTO to obtain a continuous variable, subsequently analysed using the Intraclass Correlation Coefficient (ICC. Results Of the 104 patients assessed at baseline and discharged from the hospital, 93 had the EQ administered at 3 months, and 89 at 6 months. The ICC for TTO recalled at 3 months vs pre-ICU TTO was 0.851, and that for TTO recalled at 6 months vs pre-ICU TTO was 0.833. The ICC for the EQ-VAS recalled at 3 months vs pre-ICU EQ-VAS was 0.648, and that for the EQ-VAS recalled at 6 months vs pre-ICU EQ-VAS was 0.580. Forty-two (45% patients assessed at 3 months gave the same score in all EQ-5D items as at baseline. They underwent mainly orthopaedic surgery (p 0.011, and perceived the severity of their illness as lower (p 0

  19. Perception and management of fever in infants up to six months of age: A survey of US pediatricans

    Directory of Open Access Journals (Sweden)

    Markson Leona E

    2010-12-01

    Full Text Available Abstract Background A fever is an increase in the body's temperature above normal. This study examined how US pediatricians perceive and manage fever generally versus fever occurring after vaccination in infants up to six months of age. Methods A web-based survey of 400 US pediatricians subscribing to the Physician Desk Reference was conducted in December 2008. Data were collected on the respondents' socio-demographics, number of years in practice, type of practice, their definition of fever severity in infants, and their recommendations for managing fever. Generalized Estimating Equations were used to estimate the odds of a pediatrician recommending an emergency room visit (ER or a hospital admission, office visits, or other treatment option, as a function of infant's age, temperature, whether the infant has recently received a vaccine, and whether the fever was reported during or after office hours, adjusting for practice type and socio-demographic variables. Results On average, the 400 responding pediatricians' (64% were female, average age of 49 years, years in practice = 20 years threshold for extremely serious fever was ≥39.5°C and ≥ 40.0°C for infants 0-2 month and >2-6 month of age respectively. Infants were more likely to be referred to an ER or hospital admission if they were ≤ 2 months of age (Odds Ratio [OR], 29.13; 95% Confidence interval [95% CI], 23.69-35.82 or >2-4 months old (OR 3.37; 95% CI 2.99-3.81 versus > 4 to 6 months old or if they had a temperature ≥ 40.0°C (OR 21.06; 95% CI 17.20-25.79 versus a temperature of 38.0-38.5°C. Fever after vaccination (OR 0.29; 95% CI 0.25-0.33 or reported during office hours (OR 0.17; 95% CI 0.15-0.20 were less likely to result in referral to ER or hospital admission. Conclusion Within this sample of US pediatricians, perception of the severity of fever in infants, as well as the response to infant fever are likely to depend on the infant's age. Recommendations for the management

  20. Posttraumatic stress disorder and somatic symptoms among child and adolescent survivors following the Lushan earthquake in China: A six-month longitudinal study.

    Science.gov (United States)

    Zhang, Jun; Zhu, Shenyue; Du, Changhui; Zhang, Ye

    2015-08-01

    To explore somatic conditions in a sample of 2299 child and adolescent survivors of an earthquake and their relationship to posttraumatic stress disorder (PTSD) symptoms. The Children's Revised Impact of Event Scale, the Patient Health Questionnaire (PHQ)-13 scale, a short version of PHQ-15 scale that omits two items involving sexual pain/problems and menstrual problems, and a project-developed questionnaire were administered to participants three and six months after the earthquake. Among child and adolescent survivors, the prevalence rates of probable PTSD were 37.4 and 24.2% three and six months, respectively, after the earthquake. The most common somatic symptoms were trouble sleeping (58.4 and 48.4%), feeling tired or having low energy (52.0 and 46.1%), and stomach pain (45.8 and 45.4%) after three and six months, respectively. Several specific somatic symptoms evaluated three months after the earthquake including trouble sleeping, headache, and shortness of breath were predictors of the overall PTSD symptoms evaluated six months after the earthquake. Additionally, the symptom of hyperarousal evaluated after three months could predict the overall somatic symptoms evaluated after six months. PTSD and somatic symptoms were common after the earthquake, and a longitudinal association between PTSD and somatic symptoms was detected among child and adolescent survivors. These findings have implications in China and possibly elsewhere. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Computerized follow-up of discrepancies in image interpretation between emergency and radiology departments

    OpenAIRE

    Siegel, Eliot; Groleau, Georgina; Reiner, Bruce; Stair, Thomas

    1998-01-01

    Radiographs are ordered and interpreted for immediate clinical decisions 24 hours a day by emergency physicians (EP’s). The Joint Commission for Accreditation of Health Care Organizations requires that all these images be reviewed by radiologists and that there be some mechanism for quality improvement (QI) for discrepant readings. There must be a log of discrepancies and documentation of follow up activities, but this alone does not guarantee effective Q.I. Radiologists reviewing images from...

  2. Value of early follow-up CT in paediatric tuberculous meningitis

    International Nuclear Information System (INIS)

    Andronikou, Savvas; Wieselthaler, Nicky; Smith, Bruce; Douis, Hassan; Fieggen, A. Graham; Toorn, Ronald van; Wilmshurst, Jo

    2005-01-01

    The value of CT in the diagnosis of tuberculous meningitis (TBM) in children is well reported. Follow-up CT scanning for these patients is, however, not well described and, in particular, the value of early follow-up CT has not been addressed for children with TBM. To assess the value of early follow-up CT in children with TBM in identifying diagnostic, prognostic and therapeutically relevant features of TBM. A retrospective 4-year review of CT scans performed within 1 week and 1 month of initial CT in children with proven (CSF culture-positive) and probable TBM (CSF profile-positive but culture-negative) and comparison with initial CT for the diagnostic, prognostic and therapeutic CT features of TBM. The CT scans of 50 children were included (19 ''definite'' TBM; 31 ''probable'' TBM). Of these, 30 had CT scans performed within 1 week of the initial CT. On initial CT, 44 patients had basal enhancement. Only 24 patients had contrast medium-enhanced follow-up scans. Important findings include: 8 of 29 patients (who were not shunted) developed new hydrocephalus. New infarcts developed in 24 patients; 45% of those who did not have infarction initially developed new infarcts. Three of the six patients who did not show basal enhancement on initial scans developed this on the follow-up scans, while in seven patients with pre-existing basal enhancement this became more pronounced. Two patients developed hyperdensity in the cisterns on non-contrast medium scans. Eight patients developed a diagnostic triad of features. Three patients developed CT features of TBM where there was none on the initial scans. Early follow-up CT is useful in making a diagnosis of TBM by demonstrating features that were not present initially and by demonstrating more sensitive, obvious or additional features of TBM. In addition, follow-up CT is valuable as a prognostic indicator as it demonstrates additional infarcts which may have developed or become more visible since the initial study. Lastly

  3. Value of early follow-up CT in paediatric tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Andronikou, Savvas [University of Cape Town, Department of Radiology, Cape Town (South Africa); Wieselthaler, Nicky; Smith, Bruce; Douis, Hassan [Red Cross Children' s Hospital, Department of Paediatric Radiology, School of Child and Adolescent Health, Cape Town (South Africa); Fieggen, A. Graham; Toorn, Ronald van; Wilmshurst, Jo [Red Cross Children' s Hospital, Department of Paediatric Radiology, School of Child and Adolescent Health, Cape Town (South Africa); Red Cross Children' s Hospital, Department of Neurosciences, School of Child and Adolescent Health, Cape Town (South Africa)

    2005-11-01

    The value of CT in the diagnosis of tuberculous meningitis (TBM) in children is well reported. Follow-up CT scanning for these patients is, however, not well described and, in particular, the value of early follow-up CT has not been addressed for children with TBM. To assess the value of early follow-up CT in children with TBM in identifying diagnostic, prognostic and therapeutically relevant features of TBM. A retrospective 4-year review of CT scans performed within 1 week and 1 month of initial CT in children with proven (CSF culture-positive) and probable TBM (CSF profile-positive but culture-negative) and comparison with initial CT for the diagnostic, prognostic and therapeutic CT features of TBM. The CT scans of 50 children were included (19 ''definite'' TBM; 31 ''probable'' TBM). Of these, 30 had CT scans performed within 1 week of the initial CT. On initial CT, 44 patients had basal enhancement. Only 24 patients had contrast medium-enhanced follow-up scans. Important findings include: 8 of 29 patients (who were not shunted) developed new hydrocephalus. New infarcts developed in 24 patients; 45% of those who did not have infarction initially developed new infarcts. Three of the six patients who did not show basal enhancement on initial scans developed this on the follow-up scans, while in seven patients with pre-existing basal enhancement this became more pronounced. Two patients developed hyperdensity in the cisterns on non-contrast medium scans. Eight patients developed a diagnostic triad of features. Three patients developed CT features of TBM where there was none on the initial scans. Early follow-up CT is useful in making a diagnosis of TBM by demonstrating features that were not present initially and by demonstrating more sensitive, obvious or additional features of TBM. In addition, follow-up CT is valuable as a prognostic indicator as it demonstrates additional infarcts which may have developed or become more

  4. 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

  5. Intensive care delirium - effect on memories and health-related quality of life - a follow-up study

    DEFF Research Database (Denmark)

    Svenningsen, Helle; Tønnesen, Else K; Videbech, Poul

    2013-01-01

    after intensive care unit. Interviews were repeated after two and six months and supplemented with Short Form-36 and the Barthel Index. RESULTS: Delirium was detected in 60% of the patients in our study, and delirious patients had significantly fewer factual memories and more memories of delusion than...... than half of the patients in intensive care unit experience delirium, which is associated with fewer factual memories and more memories of delusions. Short Form-36 might not be sensitive to delirium-related outcomes. Future research should include the development of better assessment tools to determine...... the long-term consequences of intensive care unit delirium. RELEVANCE TO CLINICAL PRACTICE: We recommend regular assessment to prevent, detect and treat delirium. We also recommend an intensive care unit follow-up programme providing an opportunity for postintensive care unit patients, particularly...

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

    Science.gov (United States)

    Kohler, Susanna

    2016-02-01

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

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

    Science.gov (United States)

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

    2017-07-01

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

  8. Neuroradiolological diagnosis and follow-up of brain tumors

    International Nuclear Information System (INIS)

    Kummer, R. von

    1997-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Nath Rajendra

    2010-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-07-15

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

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-09-01

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

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

    Science.gov (United States)

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

    1982-06-01

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

  14. A follow-up of transients. Stage 1

    International Nuclear Information System (INIS)

    Enekull, Aa.; Wallner, B.

    1981-09-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Ashley, Paul R.

    2008-03-01

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

  16. Follow-up of young road accident victims.

    Science.gov (United States)

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

    2003-10-01

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

  17. Automated medical follow-up and delayed industrial risks

    International Nuclear Information System (INIS)

    Smith, M.E.

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

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

    International Nuclear Information System (INIS)

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

    1990-01-01

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

  19. Simplified method evaluation for piping elastic follow-up

    International Nuclear Information System (INIS)

    Severud, L.K.

    1983-05-01

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

  20. Pediatric vocal fold immobility: natural history and the need for long-term follow-up.

    Science.gov (United States)

    Jabbour, Jad; Martin, Timothy; Beste, David; Robey, Thomas

    2014-05-01

    IMPORTANCE The clinical course and outcomes of pediatric vocal fold immobility (VFI) vary widely in the literature, and follow-up in these patients varies accordingly. A better understanding of the natural history of pediatric VFI is crucial to improved management. OBJECTIVE To characterize the natural history of pediatric VFI, including symptoms and rates of resolution and surgical intervention. DESIGN, SETTING, AND PARTICIPANTS Retrospective review at an academically affiliated private pediatric otolaryngology practice in a metropolitan area of all patients seen between July 15, 2001, and September 1, 2012, with a diagnosis of complete or partial VFI. After elimination of 92 incomplete or duplicate files, 404 patient records were reviewed for demographic characteristics, etiologies, symptoms, follow-up, resolution, and interventions. Follow-up records were available for 362 patients (89.6%). MAIN OUTCOMES AND MEASURES Resolution of VFI confirmed by repeated laryngoscopy, length of follow-up, and surgical intervention rates. RESULTS Among the 404 patients, left VFI was present in 66.8%, right VFI in 7.9%, and bilateral VFI in 25.3%. Median (range) age at presentation was 2.9 (0-528.1) months. Major etiological categories included cardiac surgery in 68.8%, idiopathic immobility in 21.0%, and neurologic disease in 7.4%. At presentation, 61.4%experienced dysphonia, 54.0%respiratory symptoms, and 49.5%dysphagia. Tracheotomy was performed in 25.7%and gastrostomy in 40.8%. Median (range) duration of follow-up among the 89.6%of patients with follow-up was 17.2 (0.2-173.5) months. Resolution evidenced by laryngoscopy was found in 28.0%, with a median (range) time to resolution of 4.3 (0.4-38.7) months. In patients without laryngoscopic resolution, median follow-up was 26.0 months, and 28.9% reported symptomatic resolution. CONCLUSIONS AND RELEVANCE The natural history of pediatric VFI involves substantial morbidity, with lasting symptoms and considerable rates of surgical

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

    Science.gov (United States)

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

    2018-06-01

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

  2. Follow-up of pineal cysts in children. Is it necessary?

    Energy Technology Data Exchange (ETDEWEB)

    Jussila, Miro-Pekka [Oulu University Hospital and University of Oulu, Department of Diagnostic Radiology, Oulu (Finland); Oulu University Hospital and University of Oulu, Department of Children and Adolescents, Oulu (Finland); Olsen, Paeivi [Oulu University Hospital and University of Oulu, Department of Children and Adolescents, Oulu (Finland); University of Oulu, PEDEGO Research Group, Medical Research Center, Oulu (Finland); Salokorpi, Niina [Oulu University Hospital and University of Oulu, Department of Neurosurgery, Oulu (Finland); University of Oulu, Medical Research Center, Oulu (Finland); Suo-Palosaari, Maria [Oulu University Hospital and University of Oulu, Department of Diagnostic Radiology, Oulu (Finland); University of Oulu, Medical Research Center, Oulu (Finland)

    2017-12-15

    Pineal cysts are common incidental findings in children undergoing magnetic resonance imaging (MRI). Several studies have suggested MRI follow-up if the cyst is larger than 10 mm. However, cysts do not usually change during follow-up. Prevalence, growth, and structure of the pineal cysts were analyzed to decide if follow-up MRI is necessary. A retrospective review between 2010 and 2015 was performed using 3851 MRI examinations of children aged 0-16 years to detect pineal cysts having a maximum diameter ≥ 10 mm. Eighty-one children with pineal cysts were identified and 79 of them had been controlled by MRI. Cysts were analyzed for the size, growth, and structure. A total of 1.8% of the children had a pineal cyst with a diameter ≥ 10 mm. Cysts were present in 48 girls (59.3%) and 33 boys (40.7%). Most pineal cysts (70/79) did not significantly grow during the follow-up (median 10 months, range 3-145 months). A total of 11.4% (9/79) of the cysts grew with the biggest change measured from the outer cyst wall sagittal anteroposterior dimension (mean 3.4 mm ± 1.7 mm). Only one cyst grew more than 5 mm. We found no factors correlating with the cyst growth among 9 cysts that grew > 2 mm. A majority of pineal cysts remained unchanged during the MRI follow-up. Results of this study suggest that routine MRI follow-up of pineal cysts is not necessary in the absence of unusual radiological characteristics or related clinical symptoms. (orig.)

  3. Obese patients lose weight independently of nutritional follow-up after bariatric surgery

    Directory of Open Access Journals (Sweden)

    Beatriz Helena Tess

    2015-04-01

    Full Text Available Summary Objective: to examine the association between preoperative body weight, adherence to postsurgical nutritional follow-up, length of postoperative period, and weight loss during the first 18 months among adults who have undergone bariatric surgery. Methods: a retrospective cohort study was conducted on 241 consecutive patients who underwent open Roux-en-Y gastric bypass (RYGBP from January 2006 to December 2008, in a teaching hospital in São Paulo (Brazil. Data were collected through hospital records review and the variables analyzed included sex, age, immediate preoperative weight, adherence to postsurgical nutritional visits and length of postoperative period. Proportional body weight reductions during the 18-month follow-up period were examined using generalized estimating equations. Results: 81% (n=195 of participants were female, with overall mean age of 44.4 ± 11.6 years, mean preoperative weight of 123.1± 21.2 kg and mean preoperative body mass index of 47.2± 6.2 kg/m2. The overall adherence to postoperative follow- up schedule was 51% (95%CI: 44.5-57.5%. Preoperative body weight and adherence were not associated with proportional weight reduction (Wald’s test p > 0.18. Weight loss leveled off at the end of the 18-month follow-up period for both compliant and non-compliant patients (Wald’s test p = 0.00. Conclusions: our study showed that weight loss occurred steadily over the first 18 months after RYGBP, leveling off at around 40% weight reduction. It was associated with neither presurgical weight, nor nutritional follow-up and it may be primarily dependent on the surgical body alterations themselves. This finding may have implications for intervention strategies aimed at motivating patients to comply with early postsurgical and life-long follow-up.

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

    International Nuclear Information System (INIS)

    Hirata, Nobuhide

    1987-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Guillermo Antonio Guerrero-González

    2014-07-01

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

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

    International Nuclear Information System (INIS)

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

    2001-01-01

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

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

    International Nuclear Information System (INIS)

    Rush, S.C.; Newall, J.

    1988-01-01

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

  8. Follow-up of breast cancer by bone scintigraphy

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  9. Six-month outcome after transcatheter edge-to-edge repair of severe tricuspid regurgitation in patients with heart failure.

    Science.gov (United States)

    Orban, Mathias; Besler, Christian; Braun, Daniel; Nabauer, Michael; Zimmer, Marion; Orban, Martin; Noack, Thilo; Mehilli, Julinda; Hagl, Christian; Seeburger, Joerg; Borger, Michael; Linke, Axel; Thiele, Holger; Massberg, Steffen; Ender, Joerg; Lurz, Philipp; Hausleiter, Jörg

    2018-06-01

    Severe tricuspid regurgitation (TR) is common in patients with right-sided heart failure (HF) and causes substantial morbidity and mortality. Treatment options beyond medical therapy are limited for high-risk patients. Transcatheter edge-to-edge tricuspid valve (TV) repair showed procedural safety and short-term efficacy. Impact on mid-term outcome is unclear. This dual-centre observational study evaluates the mid-term safety, efficacy and clinical outcome after edge-to-edge TV repair for severe TR in patients with HF. Overall, 50 patients with right-sided HF and severe TR were treated with the transcatheter edge-to-edge repair technique; 14 patients were treated for isolated TR and 36 patients for combined mitral regurgitation (MR) and TR. At 6-month follow-up (available for 98% of patients), a persistent reduction of at least one echocardiographic TR grade was achieved in 90% of patients and New York Heart Association class improved in 79% of patients. The 6-minute walk distance increased by 44% (+84 m, P edge-to-edge TV repair for severe TR is safe and effective in reducing TR. It appears to be associated with improved clinical outcome in the majority of patients. © 2018 The Authors. European Journal of Heart Failure © 2018 European Society of Cardiology.

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

    International Nuclear Information System (INIS)

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

    1995-01-01

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

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  12. Follow-up of basal cell carcinomas: an audit of current practice.

    Science.gov (United States)

    Mc Loone, N M; Tolland, J; Walsh, M; Dolan, O M

    2006-07-01

    Follow-up of patients after treatment of basal cell carcinoma (BCC) allows for monitoring of recurrence and detection of new tumours, but adds a significant burden to outpatient clinics. At the skin tumour clinic in the dermatology department, the Royal Hospitals, Belfast, all patients are reviewed for 2 years after surgical excision of a low-risk primary BCC. An audit was undertaken to determine the quality of data set recorded relating to prognostic factors for BCCs to determine the rate of recurrence and number of new primary tumours detected and to determine the completeness of follow-up by patients. Patients who had primary BCCs treated by excision were identified from a database held at the clinic. Medical charts were reviewed to determine data recorded about lesions, the number of recurrent BCCs and new tumours detected, and the number of patients completing follow-up. Between January 1999 and December 2000, 114 patients had 121 primary BCCs excised. BCC location and size were recorded in 100% and 35% of cases, respectively. Histological type was stated for morphoeic or multifocal lesions. Two years of follow-up was completed by 53% of patients and 1 year by 78% of patients. The rate of recurrence was low, with 2 BCC recurring within 2 years of excision. The risk of developing a new BCC was 11.6% in the first year and 6.3% in the second year. Follow-up of patients after excision of a low-risk BCC at the clinic has been reduced to 1 year. A proforma has been developed to encourage documentation of prognostic factors.

  13. Six-month Outcomes of Mobile Phone Application-based Self-management in a Patient with Type 2 Diabetes.

    Science.gov (United States)

    Hong, Mi Kyeong; Cho, Young Yun; Rha, Mi Yong; Kim, Jae Hyeon; Lee, Moon-Kyu

    2015-07-01

    We report the case in order to examine the effect of a mobile application program ("Diabetes & Nutrition") developed in 2011-2012 for self-management in patients with type 2 diabetes and to recommend important considerations when the mobile application program is developed. A 46-year-old man was newly diagnosed with type 2 diabetes in 2013 and had no complications. The height of the patient was 168 cm and the body weight was 75.6 kg. Nutrition education was conducted according to a medical prescription, and follow-up nutrition education was conducted after 3 and 6 months. After nutrition education, the patient was engaged in self-management using "Diabetes & Nutrition" program during 3 months. At 3 months, the body weight had decreased by 4.4 kg (from 75.6 to 71.2 kg), waist circumference by 5 cm (from 88 to 83 cm) and HbA1c level from 7.9% to 6.1%. Also at 3 months, the medication was reduced from from the dose of 850 mg to the dose of 500 mg metformin per twice a day. Since then, the patient did not continue to use the "Diabetes & Nutrition" because the level of blood glucose had stabilized, and the patient felt inconvenient and annoying to use the program. At 6 months, no significant change in the body weight and body composition was observed in comparison with those at 3 months. The present case demonstrates that the early use of "Diabetes & Nutrition" could be helpful for self-management of glycemic control in patients with type 2 diabetes. Developing self-management mobile application programs in the future will require strategies of how to promote continuous use of application program and self-management of type 2 diabetes.

  14. Six-month outcomes of co-occurring delirium, depression, and dementia in long-term care.

    Science.gov (United States)

    McCusker, Jane; Cole, Martin G; Voyer, Philippe; Monette, Johanne; Champoux, Nathalie; Ciampi, Antonio; Vu, Minh; Belzile, Eric

    2014-12-01

    To describe the 6-month outcomes of co-occurring delirium (full syndrome and subsyndromal symptoms), depression, and dementia in a long-term care (LTC) population. Observational, prospective cohort study with 6-month follow-up conducted from 2005 to 2009. Seven LTC facilities in the province of Quebec, Canada. Newly admitted and long-term residents recruited consecutively from lists of residents aged 65 and older admitted for LTC, with stratification into groups with and without severe cognitive impairment. The study sample comprised 274 residents with complete data at baseline on delirium, dementia, and depression. Outcomes were 6-month mortality, functional decline (10-point decline from baseline on 100-point Barthel scale), and cognitive decline (3-point decline on 30-point Mini-Mental State Examination). Predictors included delirium (full syndrome or subsyndromal symptoms, using the Confusion Assessment Method), depression (Cornell Scale for Depression in Dementia), and dementia (chart diagnosis). The baseline prevalences of delirium, subsyndromal symptoms of delirium (SSD), depression, and dementia were 11%, 44%, 19%, and 66%, respectively. By 6 months, 10% of 274 had died, 19% of 233 had experienced functional decline, and 17% of 246 had experienced cognitive decline. An analysis using multivariable generalized linear models found the following significant interaction effects (P delirium and depression for functional decline, and between SSD and dementia for cognitive decline. Co-occurrence of delirium, SSD, depression, and dementia in LTC residents appears to affect some 6-month outcomes. Because of limited statistical power, it was not possible to draw conclusions about the effects of the co-occurrence of some syndromes on poorer outcomes. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  15. Short interval follow-up after a benign concordant MR-guided vacuum assisted breast biopsy - is it worthwhile?

    Energy Technology Data Exchange (ETDEWEB)

    Shaylor, Sara D.; Melsaether, Amy N.; Gupta, Avani; Babb, James; Moy, Linda [NYU School of Medicine, Department of Radiology, New York, NY (United States); Heller, Samantha L. [St. George' s Healthcare Trust, Department of Radiology, London (United Kingdom); Gupta, Dipti [Northwestern Memorial Hospital, Breast and Women' s Imaging Center, Chicago, IL (United States)

    2014-06-15

    To determine the utility of short-interval follow-up after benign concordant MRI-guided breast biopsy. Institutional review board approved, retrospective review of consecutive biopsies performed over 3 years (2007-10) yielded 170 women with 188 lesions that were considered benign concordant. Indication for original study, biopsy results, follow-up recommendations, compliance and outcomes of subsequent MRI and mammography examinations were reviewed. The most common indication for breast MRI was high-risk screening 119/170 (70 %). Overall, 59 % of lesions (113/188) had follow-up MRI. Of those lesions (n = 113), 43 % (49/113) presented within 7 months, 26 % (29/113) presented within 8-13 months, 11.5 % (13/113) presented within 14-22 months, and 19 % (22/113) presented after 23 months. At initial follow-up, 37 % of lesions were stable and 61 % were decreased in size. Three lesions were recommended for excision based on follow-up imaging with one malignancy diagnosed 2 years following biopsy. One additional patient had MRI-detected bilateral cancers remote from the biopsy site 3 years after biopsy. Overall cancer yield of lesions with follow-up MRI was 0.9 % (1/113); no cancers were detected at 6 months. Our data suggests that 6-month follow-up may not be required and that annual screening MRI would be acceptable to maintain a reasonable cancer detection rate. (orig.)

  16. Short interval follow-up after a benign concordant MR-guided vacuum assisted breast biopsy - is it worthwhile?

    International Nuclear Information System (INIS)

    Shaylor, Sara D.; Melsaether, Amy N.; Gupta, Avani; Babb, James; Moy, Linda; Heller, Samantha L.; Gupta, Dipti

    2014-01-01

    To determine the utility of short-interval follow-up after benign concordant MRI-guided breast biopsy. Institutional review board approved, retrospective review of consecutive biopsies performed over 3 years (2007-10) yielded 170 women with 188 lesions that were considered benign concordant. Indication for original study, biopsy results, follow-up recommendations, compliance and outcomes of subsequent MRI and mammography examinations were reviewed. The most common indication for breast MRI was high-risk screening 119/170 (70 %). Overall, 59 % of lesions (113/188) had follow-up MRI. Of those lesions (n = 113), 43 % (49/113) presented within 7 months, 26 % (29/113) presented within 8-13 months, 11.5 % (13/113) presented within 14-22 months, and 19 % (22/113) presented after 23 months. At initial follow-up, 37 % of lesions were stable and 61 % were decreased in size. Three lesions were recommended for excision based on follow-up imaging with one malignancy diagnosed 2 years following biopsy. One additional patient had MRI-detected bilateral cancers remote from the biopsy site 3 years after biopsy. Overall cancer yield of lesions with follow-up MRI was 0.9 % (1/113); no cancers were detected at 6 months. Our data suggests that 6-month follow-up may not be required and that annual screening MRI would be acceptable to maintain a reasonable cancer detection rate. (orig.)

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

    DEFF Research Database (Denmark)

    Thomsen, Thora Grothe; Hølge-Hazelton, Bibi

    2017-01-01

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

  18. Scintigraphic follow-up of fracture healing in animals

    International Nuclear Information System (INIS)

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

    1983-01-01

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

  19. Scintigraphic follow-up of fracture healing in animals

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-08-01

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

  20. Epidemiological follow-up study of Japanese Thorotrast cases

    International Nuclear Information System (INIS)

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

    1979-01-01

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

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

    Science.gov (United States)

    Gillis, A

    1975-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-08-15

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

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

    Science.gov (United States)

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

    2013-03-14

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

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-09-01

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

  7. Clinical outcome and follow-up of prenatal hydronephrosis

    Directory of Open Access Journals (Sweden)

    Afshin Safaei Asl

    2012-01-01

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

  8. Cost-Effective Mobile-Based Healthcare System for Managing Total Joint Arthroplasty Follow-Up.

    Science.gov (United States)

    Bitsaki, Marina; Koutras, George; Heep, Hansjoerg; Koutras, Christos

    2017-01-01

    Long-term follow-up care after total joint arthroplasty is essential to evaluate hip and knee arthroplasty outcomes, to provide information to physicians and improve arthroplasty performance, and to improve patients' health condition. In this paper, we aim to improve the communication between arthroplasty patients and physicians and to reduce the cost of follow-up controls based on mobile application technologies and cloud computing. We propose a mobile-based healthcare system that provides cost-effective follow-up controls for primary arthroplasty patients through questions about symptoms in the replaced joint, questionnaires (WOMAC and SF-36v2) and the radiological examination of knee or hip joint. We also perform a cost analysis for a set of 423 patients that were treated in the University Clinic for Orthopedics in Essen-Werden. The estimation of healthcare costs shows significant cost savings (a reduction of 63.67% for readmission rate 5%) in both the University Clinic for Orthopedics in Essen-Werden and the state of North Rhine-Westphalia when the mobile-based healthcare system is applied. We propose a mHealth system to reduce the cost of follow-up assessments of arthroplasty patients through evaluation of diagnosis, self-monitoring, and regular review of their health status.

  9. On the evaluation of elastic follow-up of a high temperature discontinuous structure

    International Nuclear Information System (INIS)

    Lee, J. M.; Kim, J. B.; Lee, H. Y.; Lee, J. H.

    2003-01-01

    While high temperature structures of LMR experience inelastic deformation such as plasticity and creep due to high temperature operating temperature of 530∼550 .deg. C, geometric nonlinear structures may undergo elastic follow-up behavior due to the interaction between stiff region and weak region. Thus, careful consideration should be given to the design and analysis of high temperature geometric nonlinear structure. In this study, the elastic follow-up behavior of geometric nonlinear structure has been investigated and the current status of design method implemented in the ASME-NH, Japanese BDS, French RCC-MR, and UK R-5 codes to consider elastic follow-up behavior has been reviewed. It has been shown that the ratio of the stiff region and the weak region and the type of loading affect the elastic follow-up behavior greatly from the detailed inelastic analyses of two bar model and L-shaped structure subjected to various loading situation. The applicability and the conservatism of simplified analysis methods implemented among various design codes need to be studied further

  10. The value of routine follow-up imaging in pediatric blunt liver trauma

    Energy Technology Data Exchange (ETDEWEB)

    Navarro, O.; Babyn, P.S. [Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON (Canada); Pearl, R.H. [Division of General Surgery, Hospital for Sick Children, Toronto, ON (Canada)

    2000-08-01

    Purpose. To evaluate the utility of routine follow-up computed tomography (CT) and/or ultrasound (US) scans in children with blunt hepatic trauma initially managed non-operatively. Materials and methods. Review of the records of 66 children with proven blunt liver injury on initial CT scan, who were initially managed non-operatively during the period January 1991 to December 1996. Follow-up CT and US studies were analyzed and correlated with clinical outcome. Results. Of the 66 children, 30 were not followed with any imaging study, 26 were followed with US only, 7 with CT only and 3 with US and CT. Disappearance of the liver lesion(s) was seen in 25 patients (range: 6 days - 14 months) and decrease in size was noted in 10. In one patient, who developed abdominal and right shoulder pain 10 days after presentation with subsequent hemoglobin drop, CT showed contrast medium extravasation into a hepatic hematoma from portal vein injury that required surgery. Conclusion. Our series suggests that in asymptomatic patients, US and CT follow-up studies do not provide the additional information needed for patient management. Therefore, we believe that in asymptomatic children with blunt hepatic trauma who are clinically stable, routine follow-up imaging studies are of very limited value. (orig.)

  11. The value of routine follow-up imaging in pediatric blunt liver trauma

    International Nuclear Information System (INIS)

    Navarro, O.; Babyn, P.S.; Pearl, R.H.

    2000-01-01

    Purpose. To evaluate the utility of routine follow-up computed tomography (CT) and/or ultrasound (US) scans in children with blunt hepatic trauma initially managed non-operatively. Materials and methods. Review of the records of 66 children with proven blunt liver injury on initial CT scan, who were initially managed non-operatively during the period January 1991 to December 1996. Follow-up CT and US studies were analyzed and correlated with clinical outcome. Results. Of the 66 children, 30 were not followed with any imaging study, 26 were followed with US only, 7 with CT only and 3 with US and CT. Disappearance of the liver lesion(s) was seen in 25 patients (range: 6 days - 14 months) and decrease in size was noted in 10. In one patient, who developed abdominal and right shoulder pain 10 days after presentation with subsequent hemoglobin drop, CT showed contrast medium extravasation into a hepatic hematoma from portal vein injury that required surgery. Conclusion. Our series suggests that in asymptomatic patients, US and CT follow-up studies do not provide the additional information needed for patient management. Therefore, we believe that in asymptomatic children with blunt hepatic trauma who are clinically stable, routine follow-up imaging studies are of very limited value. (orig.)

  12. ARSENIC REMOVAL FROM DRINKING WATER BY POINT OF USE REVERSE OSMOSIS. EPA DEMONSTRATION PROJECT AT SUNSET RANCH DEVELOPMENT IN HOMEDALE, ID. SIX-MONTH EVALUATION REPORT

    Science.gov (United States)

    This report documents the activities performed during and the results obtained from the first six months of the point of use arsenic removal treatment technology demonstration project at the Sunset Ranch Development in Homedale, ID. The objectives of the project are to evaluate t...

  13. Improved patency and reduced intimal hyperplasia in PTFE grafts with luminal immobilized heparin compared with standard PTFE grafts at six months in a sheep model.

    Science.gov (United States)

    Pedersen, G; Laxdal, E; Ellensen, V; Jonung, T; Mattsson, E

    2010-06-01

    The aim of this study was to compare the performance of polytetrafluoroethylene (PTFE) grafts with luminal coating of immobilized heparin to that of standard PTFE grafts at six months. Twenty-eight common carotid arteries in fourteen sheep were bypassed with heparin-coated PTFE grafts (6 mm diameter, 6 cm length) on one side and standard PTFE grafts on the other. The grafts were explanted after six months. The thickness of intimal hyperplasia (IH) in open grafts was measured with histomorphometrical methods. Two of 14 heparinized PTFE grafts and nine of 14 grafts in the control PTFE-group were occluded at explantation (P=0.006). Six-month patency rates for heparinized PTFE grafts and for standard PTFE grafts were 86% and 36%, respectively. Mean graft anastomotic IH thickness in open grafts were 0.074 mm for heparinized PTFE grafts and 0.259 mm for PTFE-grafts (P=0.006). PTFE grafts with luminal coating containing immobilized heparin had significantly better patency and recruited less intimal hyperplasia than standard PTFE grafts at six months.

  14. ARSENIC REMOVAL FROM DRINKING WATER BY IRON REMOVAL. U.S. EPA DEMONSTRATION PROJECT AT VILLAGE ON THE PONDS IN DELAVAN, WI. SIX-MONTH EVALUATION REPORT

    Science.gov (United States)

    This report documents the activities performed and the results obtained from the first six months of the arsenic removal treatment technology demonstration project at Vintage on the Ponds at Delavan, WI. The objectives of the project are to evaluate: (1) the effectiveness of Kine...

  15. Arsenic Removal from Drinking Water by Iron Removal. U.S. EPA Demonstration Project at Sabin, MN. Six-Month Evaluation Report

    Science.gov (United States)

    This report documents the activities performed during and the results obtained from the first six months of the EPA arsenic removal technology demonstration project at the Sabin, MN. The main objective of the project is to evaluate the effectiveness of the Kinetico FM-248-AS ars...

  16. Effect of dietary fat supplementation during late pregnancy and first six months of lactation on maternal and infant vitamin A status in rural Bangladesh

    NARCIS (Netherlands)

    Alam, D.S.; Raaij, van J.M.A.; Hautvast, J.G.A.J.; Yunus, M.; Wahed, M.A.; Fuchs, G.J.

    2010-01-01

    Dietary fat intake is extremely low in most communities with vitamin A deficiency. However, its role in vitamin A status of pregnant and lactating women is poorly understood. The aim of the study was to examine the effect of supplementing women with fat from mid-/late pregnancy until six months

  17. ARSENIC REMOVAL FROM DRINKING WATER BY ADSORPTIVE MEDIA U.S. EPA DEMONSTRATION PROJECT AT BRUNI, TX, SIX-MONTH EVALUATION REPORT

    Science.gov (United States)

    This report documents the activities performed and the results obtained from the first six months of the arsenic removal treatment technology demonstration project at the Webb Consolidated Independent School District (Webb CISD) site at Bruni, TX. The main objective of the projec...

  18. ARSENIC REMOVAL FROM DRINKING WATER BY ADSORPTIVE MEDIA U.S. EPA DEMONSTRATION PROJECT AT DUMMERSTON, VT SIX-MONTH EVALUATION REPORT

    Science.gov (United States)

    This report documents the activities performed during and the results obtained from the first six months (from June 22, 2005 through December 22, 2005) of the arsenic removal treatment technology demonstration project at Charette Mobile Home Park (CMHP) in Dummerston, Vermont. T...

  19. ARSENIC REMOVAL FROM DRINKING WATER BY ADSORPTIVE MEDIA U.S. EPA DEMONSTRATION PROJECT AT SPRING BROOK MOBILE HOME PARK IN WALES, ME SIX-MONTH EVALUATION REPORT

    Science.gov (United States)

    This report documents the activities performed during and the results obtained from the first six months of the arsenic removal treatment technology demonstration project at the Spring Brook Mobile Home Park in Wales, ME. The objectives of the project are to evaluate the effectiv...

  20. ARSENIC REMOVAL FROM DRINKING WATER BY ADSORPTIVE MEDIA. U.S. EPA DEMONSTRATION PROJECT AT BOW, NH , SIX MONTH EVALUATION REPORT

    Science.gov (United States)

    This report documents the activities performed during and the results obtained from the first six months of the arsenic removal treatment technology demonstration project at the White Rock Water Company (WRWC) public water system, a small residential drinking water facility in Bo...

  1. Arsenic Removal from Drinking Water by Coagulation/Filtration U.S. EPA Demonstration Project at Sandusky, MI. Six-Month Evaluation Report

    Science.gov (United States)

    This report documents the activities performed during and the results obtained from the first six months of the EPA arsenic removal technology demonstration project at the City of Sandusky, MI facility. The objectives of the project are to evaluate 1) the effectiveness of Siemen...

  2. ARSENIC REMOVAL FROM DRINKING WATER BY ADSORPTIVE MEDIA U.S. EPA DEMONSTRATION PROJECT AT CHATEAU ESTATES MOBILE HOME PARK IN SPRINGFIELD, OH. SIX-MONTH EVALUATION REPORT

    Science.gov (United States)

    This report documents the activities performed for and the results obtained from the first six months of the arsenic removal treatment technology demonstration project at the Chateau Estates Mobile Home Park at Springfield, OH. The objectives of the project are to evaluate the ef...

  3. ARSENIC REMOVAL FROM DRINKING WATER BY IRON REMOVAL AND ADSORPTIVE MEDIA USEPA DEMONSTRATION PROJECT AT STEWART, MN. SIX-MONTH EVALUATION REPORT

    Science.gov (United States)

    This report documents the activities performed and the results obtained from the first six months of the EPA arsenic removal technology demonstration project at the Stewart, MN facility. The main objective of the project is to evaluate the effectiveness of Siemens¿ Type II AERALA...

  4. ARSENIC REMOVAL FROM DRINKING WATER BY ION EXCHANGE. U.S. EPA DEMONSTRATION PROJECT AT FRUITLAND, ID SIX-MONTH EVALUATION REPORT

    Science.gov (United States)

    This report documents the activities performed during and the results obtained from the first six months of the performance evaluation of a Kinetico ion exchange (IX) system to remove arsenic (As) and nitrate from source water at the City of Fruitland in Idaho. The 250-gal/min (g...

  5. ARSENIC REMOVAL FROM DRINKING WATER BY IRON REMOVAL USEPA DEMONSTRATION PROJECT AT BIG SAUK LAKE MOBILE HOME PARK IN SAUK CENTRE, MN. SIX MONTH EVALUATION REPORT

    Science.gov (United States)

    This report documents the activities performed and the results obtained from the first six months of the arsenic removal treatment technology demonstration project at the Big Sauk Lake Mobile Home Park (BSLMHP) in Sauk Centre, MN. The objectives of the project are to evaluate the...

  6. ARSENIC REMOVAL FROM DRINKING WATER BY ADSORPTIVE MEDIA. EPA DEMONSTRATION PROJECT AT QUEEN ANNES COUNTY, MARYLAND SIX-MONTH EVALUATION REPORT

    Science.gov (United States)

    This report documents the activities performed and the results obtained from the first six months of the arsenic removal treatment technology demonstration project at the community of Prospect Bay at Grasonville in Queen Anne’s County, MD. The objectives of the project were to ev...

  7. Dentin bond strength of two resin-ceramic computer-aided design/computer-aided manufacturing (CAD/CAM) materials and five cements after six months storage.

    Science.gov (United States)

    Flury, Simon; Schmidt, Stefanie Zita; Peutzfeldt, Anne; Lussi, Adrian

    2016-10-01

    The aim was to investigate dentin bond strength of two resin-ceramic materials and five cements after 24 h and six months storage. Cylinders (n=15/group) of Lava Ultimate (3M ESPE) and VITA ENAMIC (VITA Zahnfabrik) were cemented to mid-coronal dentin of 300 extracted human molars with RelyX Ultimate (3M ESPE), PANAVIA F2.0 (Kuraray), Variolink II (Ivoclar Vivadent), els cem (Saremco Dental), or Ketac Cem Plus (3M ESPE). Shear bond strength (SBS) was measured after 24 h or six months storage (37°C, 100% humidity) and statistically analyzed (significance level: α=0.05). SBS varied markedly between Lava Ultimate and VITA ENAMIC, between the five cements, and between storage of either 24 h or six months. After six months, SBS was highest when Lava Ultimate was cemented with RelyX Ultimate and when VITA ENAMIC was cemented with RelyX Ultimate or with Variolink II. Lava Ultimate was somewhat more sensitive to storage than was VITA ENAMIC.

  8. Half of the adults who present to hospital with stroke develop at least one contracture within six months: an observational study.

    Science.gov (United States)

    Kwah, Li Khim; Harvey, Lisa A; Diong, Joanna H L; Herbert, Robert D

    2012-01-01

    What is the incidence of contractures six months after stroke? Can factors measured within four weeks of stroke predict the development of elbow, wrist, and ankle contractures six months later? Prospective cohort study. Consecutive sample of 200 adults with stroke admitted to a Sydney hospital. Loss of range of motion in major joints of the body was measured using a 4-point ordinal contracture scale. In addition, elbow extension, wrist extension, and ankle dorsiflexion range of motion were measured using torque-controlled procedures. Potential predictors of contracture were age, pre-morbid function, severity of stroke, muscle strength, spasticity, motor function, and pain. Measurements were obtained within four weeks of stroke and at six months after stroke. 52% of participants developed at least one contracture. Incidence of contracture varied across joints from 12% to 28%; shoulders and hips were most commonly affected. Muscle strength was a significant predictor of elbow, wrist, and ankle joint range. Prediction models explained only 6% to 20% of variance in elbow, wrist, and ankle joint range. About half of all patients with stroke develop at least one contracture within six months of stroke. Incidence of contractures across all joints ranged from 12% to 28%. Muscle strength is a significant predictor of elbow, wrist, and ankle contractures but cannot be used to accurately predict contractures in these joints. Copyright © 2012 Australian Physiotherapy Association. Published by .. All rights reserved.

  9. Six month-duration Tephrosia vogelii Hook.f. and Tithonia diversifolia (Hemsl.). A.Gray planted-fallows for improving maize production in Kenya

    NARCIS (Netherlands)

    Rutunga, V.; Karanja, N.K.; Gachene, C.K.K.

    2008-01-01

    An experiment including planted Tephrosia vogelii and Tithonia diversifolia fallow species and natural fallow was conducted at Maseno, Kenya, for assessing whether these fallows grown on a nutrient depleted land could produce sufficient green manure in six month period, whether their biomass

  10. Long term follow-up of 43 pure dural arteriovenous fistulae (AVF) of the lateral sinus

    International Nuclear Information System (INIS)

    Fermand, M.; Reizine, D.; Melki, J.P.; Riche, M.C.; Merland, J.J.

    1987-01-01

    Fourty-three patients with arterio-venous fistulae of the dura of the transverse sinus with a complaint of tinnitus are reviewed, with a follow-up of 12 months to 11 years. 34 patients were embolized, 2 treated surgically, and 7 were untreated. Embolization appears to have been beneficial. The benign nature of this abnormality must be emphasized, and serious psychological study of the patient must be made before deciding on therapy. (orig.)

  11. Long term follow-up of 43 pure dural arteriovenous fistulae (AVF) of the lateral sinus

    Energy Technology Data Exchange (ETDEWEB)

    Fermand, M; Reizine, D; Melki, J P; Riche, M C; Merland, J J

    1987-07-01

    Fourty-three patients with arterio-venous fistulae of the dura of the transverse sinus with a complaint of tinnitus are reviewed, with a follow-up of 12 months to 11 years. 34 patients were embolized, 2 treated surgically, and 7 were untreated. Embolization appears to have been beneficial. The benign nature of this abnormality must be emphasized, and serious psychological study of the patient must be made before deciding on therapy.

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

    Science.gov (United States)

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

    2018-06-01

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

  13. 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

  14. MR findings of neuro-Behcet's disease: initial and follow-up changes

    International Nuclear Information System (INIS)

    Kim, Hyun Beom; Chang, Ki Hyun; Kim, Hong Dae; Han, Moon Hee; Kang, Heung Sik; Lee, Joon Woo; Yu, In Kyu; Seong, Su Ok; Kim, Hyung Seok

    2000-01-01

    To evaluate the MR findings of neuro B ehcet's disease, and changes occurring during follow up. Brain MR imaging was performed in 19 patients in whom neuro-Behcet's disease had been clinically diagnosed. After treatment with corticosteroids and immunosuppressive agents, 23 follow-up MR images were obtained in 12 patients, and a total of 42 MR images were retrospectively reviewed by two radiologists. Of the 19 patients, 17 (89%) had parenchymal lesions, and the other two had dural venous sinus thrombosis. Among the 17 patients with parenchymal lesions, three showed leptomeningeal enhancement. A total of 72 parenchymal lesions were detected on initial MR images; 55 (76%) were patchy or nodular in shape and the lesion of the internal capsule appeared linear. Seventeen lesions (24%) in 12 patients were confluent. In order of frequency, the involved sites were the pons, midbrain, thalamus, basal ganglia, internal capsule, and frontal lobe. Thirteen lesions of 39 lesions detected on postcontrast images were enhanced, and a mass effect was seen in the area of 16 parenchymal lesions. Associated findings were microhemorrhage of the brain in two patients and spinal cord involvement in one. On short-term follow-up images obtained 1 week to 2 months after intensive treatment during the acute stage of the illness, the leptomeningeal enhancement seen in three patients had decreased and most parenchymal lesions showed improvement. Long-term follow-up images obtained 3 months to 3 years late showed that parenchymal lesions had relapsed in five patients, and brainstem atrophy had developed or progressed in five others. The most characteristic MR finding of neuro-Behcet's disease is multiple non-hemorrhagic lesions involving the brainstem. Leptomeningeal enhancement and dural venous sinus thrombosis may also be noted. On follow-up MR, the lesions may show either improvement or aggravation, and brainstem atrophy is not uncommon. (author)

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

    Science.gov (United States)

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

    2007-03-01

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

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

    Science.gov (United States)

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

    2008-03-01

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

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

    Science.gov (United States)

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

    2014-02-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  19. Long term follow up in hemodialysis patients with parathyroidectomy

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    Bruno Bonnechère

    2017-03-01

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

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

    Science.gov (United States)

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

    2002-04-01

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

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

    LENUS (Irish Health Repository)

    Ramsay, M E

    1994-04-01

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

  4. Follow-up Sonography after Sonoguided Renal Biopsy

    International Nuclear Information System (INIS)

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

    1996-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Solmio, H

    1995-11-01

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

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

    Science.gov (United States)

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

    2018-05-01

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

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

    International Nuclear Information System (INIS)

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

    1987-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1987-09-01

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

  9. WFIRST Microlensing Exoplanet Characterization with HST Follow up

    Science.gov (United States)

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

    2018-01-01

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

  10. Two Siblings Followed Up for Hereditary Multiple Exostoses

    Directory of Open Access Journals (Sweden)

    Meltem Erol

    2014-06-01

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

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

    Science.gov (United States)

    1998-12-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  13. Follow-up of obstructive sleep apnea in children

    Directory of Open Access Journals (Sweden)

    Emília Leite de Barros

    2014-07-01

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

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

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  15. Tratamiento quirúrgico del granuloma central de células gigantes: estudio y seguimiento de 10 casos. Revisión de la literatura Surgical treatment of central giant-cell granuloma: Study and follow-up of 10 cases. Literature review

    Directory of Open Access Journals (Sweden)

    M. Fernández Ferro

    2011-03-01

    recurrences. The scientific literature was reviewed. Material and methods: A retrospective study was made of 10 cases treated surgically at our center between 1998 and 2008. The mean age of patients was 35 years. The clinical and radiological characteristics of each case were described, as well as the best surgical option and the evaluation, complications, and recurrences. Results: All 10 cases, 4 of which exhibited aggressive clinical and radiologic behavior, were treated surgically. The treatment of choice was excision and curettage to healthy bone in 60% and resection with a surgical margin in the rest. Mean follow-up was 6.7 years and the recurrence rate was 1%. Conclusion: The authors share the opinion of other authors that surgery is currently the treatment of choice. Adequate diagnosis and clear differentiation between aggressive and non-aggressive lesions is important in deciding how radical the intervention should be.

  16. Short-Term Rationing of Combination Antiretroviral Therapy: Impact on Morbidity, Mortality, and Loss to Follow-Up in a Large HIV Treatment Program in Western Kenya

    Directory of Open Access Journals (Sweden)

    April J. Bell

    2012-01-01

    Full Text Available Background. There was a 6-month shortage of antiretrovirals (cART in Kenya. Methods. We assessed morbidity, mortality, and loss to follow-up (LTFU in this retrospective analysis of adults who were enrolled during the six-month period with restricted cART (cap or the six months prior (pre-cap and eligible for cART at enrollment by the pre-cap standard. Cox models were used to adjust for potential confounders. Results. 9009 adults were eligible for analysis: 4,714 pre-cap and 4,295 during the cap. Median number of days from enrollment to cART initiation was 42 pre-cap and 56 for the cap (P<0.001. After adjustment, individuals in the cap were at higher risk of mortality (HR=1.21; 95% CI : 1.06–1.39 and LTFU (HR=1.12; 95% CI : 1.04–1.22. There was no difference between the groups in their risk of developing a new AIDS-defining illness (HR=0.92 95% CI 0.82–1.03. Conclusions. Rationing of cART, even for a relatively short period of six months, led to clinically adverse outcomes.

  17. Following up adult patients with tetralogy of fallot: The role of echocardiography.

    Science.gov (United States)

    Daraban, Ana Maria; Jurcuţ, Ruxandra; Bădilă, Elisabeta; Bartoş, Daniela; Dan, Gheorghe Andrei

    2017-02-01

    Tetralogy of Fallot (TOF) is one of the most common cyanotic congenital heart diseases. With surgical repair and the advances in postoperative care, contemporary mortality has dramatically improved and an increasing number of patients survive into adulthood, leading to a growing number of adult TOF. However, residual anatomic and hemodynamic abnormalities are encountered in nearly all patients, making follow-up mandatory. Furthermore, mortality starts to increase 25 years after surgery, emphasizing that, in adult TOF, closer monitoring is necessary. We review here the role of echocardiography in the follow-up of the TOF patients, emphasizing the role of multiple echocardiographic techniques. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:79-95, 2017. © 2016 Wiley Periodicals, Inc.

  18. Appraisal of elastic follow-up for a generic mechanical structure through two simplified methods

    International Nuclear Information System (INIS)

    Gamboni, S.; Ravera, C.; Stretti, G.; Rebora, A.

    1989-01-01

    Elastic follow-up (EFU) is a complex phenomenon which affects the behaviour of some structural components, especially in high temperature operations. One of the major problems encountered by the designer is the quantitative evaluation of the amount of elastic follow-up that must be taken into account for the structures under examination. In the present paper a review of the guidance furnished by the ASME Code regarding EFU is presented through an application concerning a structural problem in which EFU occurs. This has been carried out with the additional purpose of comparing the percentage EFU obtained by two simplified methods: an inelastic simplified method involving relaxation analysis; the reduced elastic modulus procedure generally used for EFU problems in piping systems. The results obtained demonstrate a substantial agreement between the two methodologies when applied to a general type structure. (author)

  19. MRI follow-up examinations in multiple sclerosis: guidelines for quality assurance

    International Nuclear Information System (INIS)

    Gass, A.; Radue, E.W.; Filippi, M.; Kappos, L.

    1999-01-01

    Magnetic resonance imaging (MRI) is highly sensitive to pathological tissue changes in multiple sclerosis (MS) patients. It demonstrates the frequently subclinical disease activity and follow-up examinations regularly show the accumulation of new lesions and the development of atrophy. The increasing importance of follow-up examinations in MS patients makes it necessary to provide comparable MRI data even over long observation periods. This review article focusses on critical variables in this regard and technical issues; practical guidelines for MRI protocols in MS patients are presented. The influence of field strenght, MR systems from different manufacturers, and new software releases is described. Guidelines concerning the graphic planning of the examination, sequence protocols, documentation and reporting of cranial MR studies in MS patients are presented. (orig.) [de

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

    Directory of Open Access Journals (Sweden)

    Raquel Marques

    2015-12-01

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

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  2. 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...

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

    Science.gov (United States)

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

    2010-01-01

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

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

    International Nuclear Information System (INIS)

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

    1997-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Gupta P

    2009-01-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-01-01

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

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

    Science.gov (United States)

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

    2002-08-01

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

  9. Usefulness of follow-up computed tomography after surgery for early gastric cancer

    International Nuclear Information System (INIS)

    Ma, Hoon; Lee, Soon Jin; Kim, Soo Ah; Lim, Hyo Keun; No, Jae Hyung; Son, Tae Sung; Kim, Sung; Kim, Yong Il

    2002-01-01

    To analyze the recurrent rate, time of recurrence, type of recurrence and the relationship between recurrence and histopathologic findings after radical gastrectomy for early gastric cancer and evaluate the usefulness of follow up abdominal computed tomography after surgery. We retrospectively evaluated 617 abdominal computed tomographic examinations of 144 patients (101 male, 43 female, mean age, 53 years) who underwent radical subtotal gastrectomy for early gastric cancer between July 1994 and July 1997. Follow-up abdominal CT scans were reviewed by three abdominal radiologists for detection of recurrence of early gastric cancer, and endoscopic and pathologic findings were correlated. We also reviewed the surgical pathologic reports for location, size, cell type and depth of invasion of early gastric cancer and lymph node invasion. We analyzed the recurrent rate, time and type of recurrence, and relationship between recurrence rate and pathologic characteristics of early gastric cancer. The recurrent rate was 4.2% (6/144) during 5-7 years after radical subtotal gastrectomy for early gastric cancer. The recurrence was detected on 2-5 years after operation. The types of recurrence were lymph node metastasis (n=5), liver metastasis (n=4), recurrence in the residual stomach or anastomotic site (n=3), adrenal metastasis (n=1), and lung metastasis (n=1). Relationship between recurrence and location, size, depth of invasion and cell type of early gastric cancer and lymph node metastasis was non significant statistically (p>0.4). The recurrence rate of early gastric cancer after radical subtotal gastrectomy is very low and occurs after two years. The follow up-CT scans can detect all recurrence of early gastric cancer, so regular follow=up abdominal CT examination is useful

  10. Outcomes of allergy/immunology follow-up after an emergency department evaluation for anaphylaxis.

    Science.gov (United States)

    Campbell, Ronna L; Park, Miguel A; Kueber, Michael A; Lee, Sangil; Hagan, John B

    2015-01-01

    Anaphylaxis guidelines currently recommend referring patients with anaphylaxis seen in the emergency department (ED) to an allergist for follow up. The objective of our study was to evaluate outcomes of allergy/immunology follow-up after an ED visit for anaphylaxis. A retrospective health records review was conducted from April 2008 to August 2012. Charts were reviewed independently by 2 allergists to determine outcomes. Descriptive statistics with corresponding 95% CIs were calculated. Among 573 patients seen in the ED who met anaphylaxis diagnostic criteria, 217 (38%) had a documented allergy/immunology follow-up. After allergy/immunology evaluation, 16 patients (7% [95% CI, 5%-12%]) had anaphylaxis ruled out. Among those with an unknown ED trigger (n = 74), 24 (32% [95% CI, 23%-44%]) had a trigger identified; and, among those who had a specific suspected ED trigger (n = 143), 9 (6% [95% CI, 3%-12%]) had a trigger identified in a category other than the one suspected in the ED, and 28 (20% [95% CI, 14%-27%]) had an unknown trigger. Thus, there were a total of 77 patients (35% [95% CI, 29%-42%]) who had an alteration in the diagnosis of anaphylaxis or trigger after allergy/immunology evaluation. Four patients (2% [95% CI, 0.7%-4.6%]) were diagnosed with a mast cell activation disorder, and 13 patients (6% [95% CI, 4%-10%]) underwent immunotherapy or desensitization. Overall, 35% of the patients with suspected anaphylaxis in the ED had an alteration in the diagnosis or suspected trigger after allergy/immunology evaluation. These results underscore the importance of allergy/immunology follow-up after an ED visit for anaphylaxis. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  11. Comparison of Intermittent Fasting Versus Caloric Restriction in Obese Subjects: A Two Year Follow-Up.

    Science.gov (United States)

    Aksungar, F B; Sarıkaya, M; Coskun, A; Serteser, M; Unsal, I

    2017-01-01

    Caloric restriction (CR) is proven to be effective in increasing life span and it is well known that, nutritional habits, sleeping pattern and meal frequency have profound effects on human health. In Ramadan some Muslims fast during the day-light hours for a month, providing us a unique model of intermittent fasting (IF) in humans. In the present study, we have investigated the effects of IF versus CR on the same non-diabetic obese subjects who were followed for two years according to the growth hormone (GH)/Insulin like growth factor (IGF)-1 axis and insulin resistance. Single-arm Interventional Human Study. 23 female subjects (Body Mass Index (BMI) 29-39, aged between 28-42years). Follow-up is designed as 12 months of CR, after which there was a month of IF and 11 months of CR again, to be totally 24 months. Subjects' daily diets were aligned as low calorie diet during CR and during the IF period, the same subjects fasted for 15 hours in a day for a month and there was no daily calorie restriction. Nutritional pattern was changed as 1 meal in the evening and a late supper before sleeping and no eating and drinking during the day light hours in the IF model. Subjects made brisk walking twice a day during the whole follow-up including both CR and IF periods. BMI, Blood glucose, insulin, TSH, GH, HbA1c, IGF-1, Homa-IR and urinary acetoacetate levels were monitored once in three months and twice in the fasting month. While subjects lost 1250 ± 372g monthly during the CR, in the IF period, weight loss was decreased to 473 ± 146 g. BMI of all subjects decreased gradually and as the BMI decreased, glucose, HbA1c, insulin, Homa-IR and TSH levels were decreased. GH levels were at baseline at the beginning, increased in the first six months and stayed steady during the CR and IF period than began decreasing after the IF period, while IGF-I increased gradually during the CR period and beginning with the 7th day of IF period, it decreased and kept on decreasing till the

  12. Angiographic follow-up after carotid artery stenting of bifurcation stenosis; Angiographische Verlaufskontrolle nach Stentimplantation zur Behandlung der Karotisbifurkationsstenose

    Energy Technology Data Exchange (ETDEWEB)

    Hauth, E.A.; Forsting, M. [Inst. fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitaetsklinik Essen (Germany); Jansen, C.; Drescher, R.; Mathias, K. [Radiologische Klinik, Klinikum Dortmund (Germany); Schwarz, M. [Neurologische Klinik, Klinikum Dortmund (Germany); Christmann, A. [Fachbereich Statistik, Univ. Dortmund (Germany); Jaeger, H. [Radiologische Klinik, Klinikum Dortmund (Germany); Marien-Hospital Wesel, Praxis fuer Radiologie, Neuroradiologie and Nuklearmedizin (Germany)

    2006-08-15

    Purpose: the purpose of this prospective study was to determine the restenosis grade, the intima hyperplasia and the stent expansion via angiographic follow-up six months after carotid artery stenting. Materials and methods: in 100 patients, angiographic follow-up was performed 5.9 months (range: 2.9 - 11.4 months) after carotid artery stenting. The restenosis grade, the intima hyperplasia and the stent expansion were measured by selective angiography of the treated carotid artery. Results: the mean restenosis grade was 16% (range: 0 - 78%). In 6 of 100 patients (6%), a restenosis grade of > 50% was measured. In 4 patients the restenosis grade was 50 - 70%. In 2 patients the restenosis grade was > 70%. In 91 of 100 patients (91%), the restenosis was localized in the former area of stenosis of the carotid artery, and in 9 of 100 patients (9%), the restenosis was localized in the cranial stent end. The mean grade of intima hyperplasia was 31% (range: 2 - 70%). The mean increase in stent expansion at the time of follow-up was 10% (range: 0 - 59%). No correlation was able to be determined between the grade of stenosis and the grade of restenosis (rho = 0,017, range: -0.180 - 0.213), between the grade of residual stenosis and the grade of restenosis (rho = 0,257, range: 0.064 - 0.431) and between intima hyperplasia and the grade of restenosis (rho = 0,476, range: 0.309 - 0.615). Conclusions: carotid artery stenting is associated with a low incidence of high-grade restenosis 6 months after an intervention. The intima hyperplasia, which can be observed in each Wallstent, is partly compensated by the expansion of the self-expandable stent. Without a correlation between the grade of residual stenosis and the grade of restenosis, low-grade residual stenosis can be accepted. Therefore, we recommend undersized postdilation of the Wallstent. (orig.)

  13. Cooking quality properties and free and bound phenolics content of brown, black, and red rice grains stored at different temperatures for six months.

    Science.gov (United States)

    Ziegler, Valmor; Ferreira, Cristiano Dietrich; Hoffmann, Jessica Fernanda; Chaves, Fábio Clasen; Vanier, Nathan Levien; de Oliveira, Maurício; Elias, Moacir Cardoso

    2018-03-01

    The changes in cooking quality and phenolic composition of whole black and red rice grains stored during six months at different temperatures were evaluated. Brown rice with known cooking quality properties and low phenolic levels was used for purposes comparison. All rice genotypes were stored at 13% moisture content at temperatures of 16, 24, 32, and 40°C. Cooking time, hardness, free and bound phenolics, anthocyanins, proanthocyanidins, and free radical scavenging capacity were analysed. The traditional rice with brown pericarp exhibited an increase in cooking time and free phenolics content, while rice with black pericarp exhibited a reduction in cooking time after six months of storage at the highest studied temperature of 40°C. There as increases in ferulic acid levels occurred as a function of storage temperature. Red pericarp rice grains showed decreased antioxidant capacity against ABTS radical for the soluble phenolic fraction with increased time and storage temperature. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. A six-month prospective evaluation of personality traits, psychiatric symptoms and quality of life in ayahuasca-naïve subjects.

    Science.gov (United States)

    Barbosa, Paulo Cesar Ribeiro; Cazorla, Irene Maurício; Giglio, Joel Sales; Strassman, Rick

    2009-09-01

    The authors assessed 23 subjects immediately before and six months (27.5 weeks) after their first ayahuasca experience in an urban Brazilian religious setting, either Santo Daime (N = 15) or União do Vegetal (N = 8). Measures included scores on instruments assessing psychiatric symptoms, personality variables and quality of life. Independent variables were the frequency of ayahuasca use throughout the period and the length of ayahuasca wash-out after six months. Santo Daime subjects had a significant reduction of minor psychiatric symptoms, improvement of mental health, and a change in attitude towards more confidence and optimism. The União do Vegetal group had a significant decrease in physical pain, and attitude change towards more independence. Independence was positively correlated with the frequency of ayahuasca use and negatively correlated with the wash-out period. We discuss possible mechanisms by which these changes may occur and suggest areas for future research.

  15. Different effect of psyllium and guar dietary supplementation on blood pressure control in hypertensive overweight patients: a six-month, randomized clinical trial.

    Science.gov (United States)

    Cicero, Arrigo F G; Derosa, Giuseppe; Manca, Marco; Bove, Marilisa; Borghi, Claudio; Gaddi, Antonio V

    2007-08-01

    In the setting of a six-month, open-label clinical trial, 141 consecutively enrolled, hypertensive, overweight patients were randomized to the oral ingestion of psyllium powder or guar gum 3.5 gr t.i.d., to be taken 20 min before the main two meals, or to standard diet. Both fibers improved significantly BMI, FPG, FPI, HOMA Index, HbA1c, LDL-C, and ApoB. Psyllium supplementation only exerted a significant improvement in plasma TG concentration, in SBP and DBP. In our study, six-month supplementation with psyllium fiber, but not with guar fiber nor standard diet, appears to significantly reduce both SBP and DBP in hypertensive overweight subjects.

  16. [Impairment and disability in patients with a severe ischemic cerebral infarction at admission to the rehabilitation center and six months after stroke].

    Science.gov (United States)

    Prevo, A J; Dijkman, M M; Le Fèvre, F A

    1998-03-21

    Evaluation of impairment and disability in stroke patients with a severe cortical infarction at admission as well as six months after the stroke. Prospective and descriptive study. Rehabilitation Centre Heliomare, Wijk aan Zee, the Netherlands. Between 1 January 1987 en 31 May 1992 stroke patients were admitted to the rehabilitation centre with a severe, first ever, cortical infarction without any comorbidity. The patients were dependent in activities of daily living and wheel-chair-bound. Motor and neuropsychological impairment and disability were evaluated at admission to the rehabilitation centre as well as six months after the stroke. Return to home and length of stay were evaluated. 43 patients were included. Recovery of arm and hand function was very poor (there was complete paresis at admission in 33 patients (77%) and six months after the CVA in 25 patients (58%)); recovery of the affected leg was reasonable (complete paresis in 10 (23%) and 0 patients, respectively). Cognitive deficits diminished in severity, but remained noticeable in three-quarters of the patients. Independent walking was achieved by 30 patients (70%), independence in personal activities of daily living by 32 patients (74%) and returning home by 36 patients (84%). The mean hospital stay was 26 weeks (SD: 9.26; range: 11-30). Prognosis of personal independence and returning home after a severe cortical infarction was rather good despite poor recovery of motor and cognitive impairment.

  17. Micronutrient supplementation adherence and influence on the prevalences of anemia and iron, zinc and vitamin A deficiencies in preemies with a corrected age of six months

    Directory of Open Access Journals (Sweden)

    Brunnella Alcantara Chagas de Freitas

    Full Text Available OBJECTIVE: To analyze adherence to the recommended iron, zinc and multivitamin supplementation guidelines for preemies, the factors associated with this adherence, and the influence of adherence on the occurrence of anemia and iron, zinc and vitamin A deficiencies. METHODS: This prospective cohort study followed 58 preemies born in 2014 until they reached six months corrected age. The preemies were followed at a referral secondary health service and represented 63.7% of the preterm infants born that year. Outcomes of interest included high or low adherence to iron, zinc and multivitamin supplementation guidelines; prevalence of anemia; and prevalences of iron, zinc, and vitamin A deficiencies. The prevalence ratios were calculated by Poisson regression. RESULTS: Thirty-eight (65.5% preemies presented high adherence to micronutrient supplementation guidelines. At six months of corrected age, no preemie had vitamin A deficiency. The prevalences of anemia, iron deficiency and zinc deficiency were higher in the low-adherence group but also concerning in the high-adherence group. Preemies with low adherence to micronutrient supplementation guidelines were 2.5 times more likely to develop anemia and 3.1 times more likely to develop zinc deficiency. Low maternal education level increased the likelihood of nonadherence to all three supplements by 2.2 times. CONCLUSIONS: Low maternal education level was independently associated with low adherence to iron, zinc and vitamin A supplementation guidelines in preemies, which impacted the prevalences of anemia and iron and zinc deficiencies at six months of corrected age.

  18. High grade squamous intraepithelial lesion in inmates from Ohio: cervical screening and biopsy follow-up

    Directory of Open Access Journals (Sweden)

    Rofagha Soraya

    2006-01-01

    Full Text Available Abstract Background Cervical carcinoma remains the second leading cause of cancer death in women worldwide and sexual behavior is regarded as the main contributing factor. We studied cervical cytology screening with surgical biopsy follow-up in women prisoners and compared the findings to those in the general population. Methods We reviewed 1024 conventional cervical smears, 73 cervical biopsies and 2 loop electrosurgical excision procedure (LEEP specimens referred to us from the Correctional Center in Columbus, Ohio during a 12-month period. The results were compared to 40,993 Pap smears from the general population for the same 12-month period. Results High grade squamous intraepithelial lesion (HGSIL was diagnosed in 1.3% of the cervical smears from the inmate population versus 0.6% in the general population (p < 0.01. The unsatisfactory rate was 1.6% compared to 0.3% in the general population (p < 0.01. Among the study population, follow-up tissue diagnosis was obtained in 24.3% of the abnormal cytology results (ASCUS, LGSIL, and HGSIL. Of the HGSIL Pap smears, 61.5% had a subsequent tissue diagnosis. Thirty-nine biopsies (52% of the all inmate biopsies and LEEP showed CIN II/III (cervical intraepithelial neoplasia II/III. Eight of these thirty-nine follow-up biopsies diagnosed as CIN II/III had a previous cervical cytology diagnosis of ASCUS. The average age for HGSIL was 30.5 years (S.D. = 5.7 and for low grade squamous intraepithelial lesion (LGSIL was 27.2 years (S.D. = 6.1. Conclusion A significantly higher prevalence of HGSIL cervical cytology and unsatisfactory smears was encountered in female inmates, with tissue follow-up performed in less than two thirds of the patients with HGSIL. These results are in keeping with data available in the literature suggesting that the inmate population is high-risk and may be subject to less screening and tissue follow-up than the general population. Clinicians should proceed with urgency to improve

  19. Follow Up for Emergency Department Patients After Intravenous Contrast and Risk of Nephropathy

    Directory of Open Access Journals (Sweden)

    Getaw Worku Hassen

    2014-05-01

    Full Text Available Introduction: Contrast-induced nephropathy (CIN, defined as an increase in serum creatinine (SCr greater than 25% or ≥0.5 mg/dL within 3 days of intravenous (IV contrast administration in the absence of an alternative cause, is the third most common cause of new acute renal failure in hospitalized patients. It is known to increase in-hospital mortality up to 27%. The purpose of this study was to investigate the rate of outpatient follow up and the occurrence of CIN in patients who presented to the emergency department (ED and were discharged home after computed tomography (CT of the abdomen and pelvis (AP with IV contrast. Methods: We conducted a single center retrospective review of charts for patients who required CT of AP with IV contrast and who were discharged home. Patients’ clinical data included the presence of diabetes mellitus, hypertension, chronic kidney disease (CKD and congestive heart failure (CHF. Results: Five hundred and thirty six patients underwent CT of AP with IV contrast in 2011 and were discharged home. Diabetes mellitus was documented in 96 patients (18%. Hypertension was present in 141 patients (26.3%, and 82 patients (15.3% were on angiotensin-converting-enzyme inhibitors (ACEI. Five patients (0.9% had documented CHF and all of them were taking furosemide. Seventy patients (13% had a baseline SCr >1.2 mg/dL. One hundred fifty patients (28% followed up in one of the clinics or the ED within one week after discharge, but only 40 patients (7.5% had laboratory workup. Out of 40 patients who followed up within 1 week after discharge, 9 patients (22.5% developed CIN. One hundred ninety patients (35.4% followed up in one of the clinics or the ED after 7 days and within 1 month after discharge, but only 71 patients (13.2% had laboratory workup completed. Out of 71 patients who followed up within 1 month, 11 patients (15% developed CIN. The overall incidence of CIN was 15.3% (17 out of 111 patients. Conclusion: There was a

  20. Treatment of diffuse in-stent restenosis with rotational atherectomy followed by radiation therapy with a 188Re-MAG3-filled balloon: six-month clinical and angiographic results of R4 registry

    International Nuclear Information System (INIS)

    Moon, D. H.; Oh, S. J.; Park, S. W.; Hong, M. K.; Lee, C. H.; Kim, J. Z.; Park, S. J.; Lee, H. K.

    2000-01-01

    Intracoronary β-irradiation after rotational atherectomy may be a reasonable approach to prevent recurrent in-stent restenosis (ISR). This study was done to evaluate the feasibility and efficacy of β-radiation therapy with a 188 Re-MAG3-filled balloon following rotational atherectomy for ISR. Fifty consecutive patients with diffuse ISR (length >10 mm) in native coronary arteries underwent rotational atherectomy and adjunctive balloon angioplasty followed by β-irradiation using 188 Re-MAG3-filled balloon catheter. The radiation doses was 15 Gy at 1.0 mm deep into vessel wall. Mean length of the lesion and irradiated segment was 25.6±12.7 mm and 37.6±11.2 mm, respectively. The radiation was delivered successfully to all patients, with a mean irradiation time of 20.1±61 7 sec. No adverse event including myocardial infarction, death, or stent thrombosis occurred during the follow-up period (mean 10.3±3.7 mon) and non-target vessel revascularization was needed in one patient. Six-month binary angiographic restenosis rate was 10.4% (2 focal ISR and 3 edge restenosis) and loss index was 0.17±0.31. Irradiation using 188 Re-MAG3-filled balloon following rotational atherectomy for patients with diffuse ISR may improve the clinical and angiographic outcomes. Further prospective randomized trials are warranted to evaluate the synergistic effect of debulking and irradiation in patients with diffuse ISR

  1. Treatment of diffuse in-stent restenosis with rotational atherectomy followed by radiation therapy with a {sup 188}Re-MAG3-filled balloon: six-month clinical and angiographic results of R4 registry

    Energy Technology Data Exchange (ETDEWEB)

    Moon, D. H.; Oh, S. J.; Park, S. W.; Hong, M. K.; Lee, C. H.; Kim, J. Z.; Park, S. J.; Lee, H. K. [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)

    2000-07-01

    Intracoronary {beta}-irradiation after rotational atherectomy may be a reasonable approach to prevent recurrent in-stent restenosis (ISR). This study was done to evaluate the feasibility and efficacy of {beta}-radiation therapy with a {sup 188}Re-MAG3-filled balloon following rotational atherectomy for ISR. Fifty consecutive patients with diffuse ISR (length >10 mm) in native coronary arteries underwent rotational atherectomy and adjunctive balloon angioplasty followed by {beta}-irradiation using {sup 188}Re-MAG3-filled balloon catheter. The radiation doses was 15 Gy at 1.0 mm deep into vessel wall. Mean length of the lesion and irradiated segment was 25.6{+-}12.7 mm and 37.6{+-}11.2 mm, respectively. The radiation was delivered successfully to all patients, with a mean irradiation time of 20.1{+-}61 7 sec. No adverse event including myocardial infarction, death, or stent thrombosis occurred during the follow-up period (mean 10.3{+-}3.7 mon) and non-target vessel revascularization was needed in one patient. Six-month binary angiographic restenosis rate was 10.4% (2 focal ISR and 3 edge restenosis) and loss index was 0.17{+-}0.31. Irradiation using {sup 188}Re-MAG3-filled balloon following rotational atherectomy for patients with diffuse ISR may improve the clinical and angiographic outcomes. Further prospective randomized trials are warranted to evaluate the synergistic effect of debulking and irradiation in patients with diffuse ISR.

  2. Two years follow-up study of the pain-relieving effect of gold bead implantation in dogs with hip-joint arthritis

    Directory of Open Access Journals (Sweden)

    Søli Nils

    2007-03-01

    Full Text Available Abstract Seventy-eight dogs with pain from hip dysplasia participated in a six-month placebo-controlled, double-blinded clinical trial of gold bead implantation. In the present, non-blinded study, 73 of these dogs were followed for an additional 18 months to evaluate the long-term pain-relieving effect of gold bead implantation. The recently-published results of the six month period revealed that 30 of the 36 dogs (83% in the gold implantation group showed significant improvement (p = 0.02, included improved mobility and reduction in the signs of pain, compared to the placebo group (60% improvement. In the long-term two-year follow-up study, 66 of the 73 dogs had gold implantation and seven dogs continued as a control group. The 32 dogs in the original placebo group had gold beads implanted and were followed for a further 18 months. A certified veterinary acupuncturist used the same procedure to insert the gold beads as in the blinded study, and the owners completed the same type of detailed questionnaires. As in the blinded study, one investigator was responsible for all the assessments of each dog. The present study revealed that the pain-relieving effect of gold bead implantation observed in the blinded study continued throughout the two-year follow-up period.

  3. The use of administrative sanctions to prevent environmental damage in impact assessment follow-ups.

    Science.gov (United States)

    Garcia, Luiz Carlos; Fonseca, Alberto

    2018-08-01

    Scholars have long been highlighting the value of administrative sanctions in improving environmental policy enforcement. However, few studies have evaluated how such sanctions are implemented, particularly in the context of environmental impact assessments (EIA) and their respective follow-up programs. The main objective of this article was to evaluate how administrative sanctions have been used in EIA follow-ups, using the Brazilian state of Minas Gerais as the empirical context. More specifically it tried to understand what have been the main triggers, frequency, nature and financial values of the sanctions issued to noncompliant mining projects operating under the conditions of environmental licenses. First, through literature reviews, the study characterized the institutional and regulatory framework in which administrative sanctions are applied. Content analyzes of 29 infraction processes further revealed that lump sum fines are the preferred option of administrative sanction in EIA follow-ups. The analysis also revealed that the fines could be perceived as disproportionally small if one considers the size and financial power of non-compliant companies. The great majority of the fines were paid by developers: a fact that contradicts previous empirical findings and anecdotal evidence in Brazil. Overall, the study suggests that the impact of administrative sanctions in corporate behavior, while unclear, is likely small. The study concludes by discussing practical and academic implications. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Long-Term Follow-Up of Percutaneous Balloon Angioplasty in Adult Aortic Coarctation

    International Nuclear Information System (INIS)

    Paddon, Alex J.; Nicholson, Anthony A.; Ettles, Duncan F.; Travis, Simon J.; Dyet, John F.

    2000-01-01

    Purpose: To assess long-term outcomes following percutaneous transluminal angioplasty (PTA) of congenital aortic coarctation in adults.Methods: Seventeen patients underwent PTA for symptomatic adult coarctation of the aorta. Sixteen patients, with a mean age of 28 years (range 15-60 years), were