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Sample records for 1-year follow-up visit

  1. The Safe Dates program: 1-year follow-up results.

    PubMed Central

    Foshee, V A; Bauman, K E; Greene, W F; Koch, G G; Linder, G F; MacDougall, J E

    2000-01-01

    OBJECTIVES: An earlier report described desirable 1-month follow-up effects of the Safe Dates program on psychological, physical, and sexual dating violence. Mediators of the program-behavior relationship also were identified. The present report describes the 1-year follow-up effects of the Safe Dates program. METHODS: Fourteen schools were in the randomized experiment. Data were gathered by questionnaires in schools before program activities and 1 year after the program ended. RESULTS: The short-term behavioral effects had disappeared at 1 year, but effects on mediating variables such as dating violence norms, conflict management skills, and awareness of community services for dating violence were maintained. CONCLUSIONS: The findings are considered in the context of why program effects might have decayed and the possible role of boosters for effect maintenance. PMID:11029999

  2. XEN Glaucoma Implant with Mitomycin C 1-Year Follow-Up: Result and Complications

    PubMed Central

    Bilgic, Alper; Eltanamly, Rasha

    2017-01-01

    Purpose. To evaluate gel microstent (XEN, Aquesys, Inc) for treatment of primary open angle glaucoma (POAG). Methods. In this prospective interventional study, 13 eyes with POAG underwent XEN implantation with subconjunctival mitomycin-C. Of those eyes, 3 were pseudophakic and 10 underwent simultaneous phacoemulsification and XEN. Patients had uncontrolled IOP, had intolerance to therapy, or had maximal therapy but undergoing cataract extraction. Follow-up visits included IOP, number of medications, vision, and complications and lasted for 1 year. Complete success was defined as IOP reduction ≥20% from preoperative baseline at 1 year without any glaucoma medications while partial success as IOP reduction of ≥20% at 1 year with medications. Results. IOP dropped from 16 ± 4 mmHg pre-op to 9 ± 5, 11 ± 6, 12 ± 5, 12 ± 4, and 12 ± 3 mmHg at 1 week, 1, 3, 6, and 12 months (p = 0.004, 0.026, 0.034, 0.01, and 0.01, Wilcoxon Signed Ranks) consecutively. BCVA (LogMAR) was 0.33 ± 0.34 and improved to 0.13 ± 0.11 at 1 year. Mean number of medications dropped from 1.9 ± 1 preoperatively to 0.3 ± 0.49 (p = 0.003) at 1 year. 42% of eyes achieved complete success and 66% qualified success. Complications included choroidal detachment in 2 eyes, and implant extrusion in 1 eye, and 2 eyes underwent trabeculectomy. Conclusion. XEN implant is an effective surgical treatment for POAG, with significant reduction in IOP and glaucoma medications at 1 year follow-up. PMID:28348884

  3. Robot-assisted laparoscopic pyeloplasty: minimum 1-year follow-up

    NASA Astrophysics Data System (ADS)

    Patel, Vipul; Thaly, Rahul; Shah, Ketul

    2007-02-01

    Objectives: To evaluate the feasibility and efficacy of robotic-assisted laparoscopic pyeloplasty. Laparoscopic pyeloplasty has been shown to have a success rate comparable to that of the open surgical approach. However, the steep learning curve has hindered its acceptance into mainstream urologic practice. The introduction of robotic assistance provides advantages that have the potential to facilitate precise dissection and intracorporeal suturing. Methods: A total of 50 patients underwent robotic-assisted laparoscopic dismembered pyeloplasty. A four-trocar technique was used. Most patients were discharged home on day 1, with stent removal at 3 weeks. Patency of the ureteropelvic junction was assessed in all patients with mercaptotriglycylglycine Lasix renograms at 1, 3, 6, 9, and 12 months, then every 6 months for 1 year, and then yearly. Results: Each patient underwent a successful procedure without open conversion or transfusion. The average estimated blood loss was 40 ml. The operative time averaged 122 minutes (range 60 to 330) overall. Crossing vessels were present in 30% of the patients and were preserved in all cases. The time for the anastomosis averaged 20 minutes (range 10 to 100). Intraoperatively, no complications occurred. Postoperatively, the average hospital stay was 1.1 days. The stents were removed at an average of 20 days (range 14 to 28) postoperatively. The average follow-up was 11.7 months; at the last follow-up visit, each patient was doing well. Of the 50 patients, 48 underwent one or more renograms, demonstrating stable renal function, improved drainage, and no evidence of recurrent obstruction. Conclusions: Robotic-assisted laparoscopic pyeloplasty is a feasible technique for ureteropelvic junction reconstruction. The procedure provides a minimally invasive alternative with good short-term results.

  4. Predictors of Relapse after Inpatient Opioid Detoxification during 1-Year Follow-Up

    PubMed Central

    2016-01-01

    Introduction. Relapse rate after opioid detoxification is very high. We studied the possibility that predetoxification patient characteristics might predict relapse at follow-up and thus conducted this 1-year follow-up study to assess the predictors of relapse after inpatient opioid detoxification. Materials and Methods. We conducted this study in our tertiary care institute in India over two-year time period (1 Jan 2014 to 31 Dec 2015). Out of 581 patients admitted, 466 patients were considered for study. Results and Discussion. No significant difference was found between relapsed and nonrelapsed patients regarding sociodemographic profile; however substance abuse pattern and forensic history showed significant differences. Relapsed patients abused greater amount and used injections more commonly, as compared to nonrelapsed group. Longer duration of abuse was also a significant risk factor. Patients with past attempt of opioid detoxification and family history (parental or first degree) of alcohol abuse had decreased possibility of maintaining remission during 1-year follow-up. Relapsed patients were found to abuse their spouse or parents. Conclusion. Our study compared profiles of relapsed and nonrelapsed patients after inpatient detoxification and concluded predictors of relapse during 1-year follow-up period. Early identification of predictors of relapse and hence high risk patients might be helpful in designing more effective and focused treatment plan. PMID:27722007

  5. Endoscopic sleeve gastroplasty with 1-year follow-up: factors predictive of success

    PubMed Central

    Lopez-Nava, G.; Galvao, M.; Bautista-Castaño, I.; Fernandez-Corbelle, J. P.; Trell, M.

    2016-01-01

    Background and study aims: Bariatric endoscopy has emerged as an aid in the nonsurgical treatment of obesity. The objective of this study is to critically provide the results and follow-up of endoscopic sleeve gastroplasty 1 year after the procedure. Patients and methods: Prospective single-center follow-up study of 25 patients (5 men, 20 women) who underwent flexible endoscopic suturing for endoluminal gastric volume reduction. A multidisciplinary team provided post-procedure care. Patient outcomes were recorded at 1 year after the procedure. Linear regression analysis was done to evaluate the variables associated with best results at 1 year of follow-up. Results: Mean body mass index (BMI) was 38.5 ± 4.6 kg/m2 (range 30 – 47) and mean age 44.5 ± 8.2 years (range 29 – 60). At 1 year, 22 patients continued with the follow-up (2 dropped out at 6 months and 1 at 3 months). There were no major intra-procedural, early, or delayed adverse events. Mean BMI loss was 7.3 ± 4.2 kg/m2, and mean percentage of total body weight loss was 18.7 ± 10.7 at 1 year. In the linear regression analysis, adjusted by initial BMI, variables associated with %TBWL involved the frequency of nutritional (β = 0.563, P = 0.014) and psychological contacts (β = 0.727, P = 0.025). The number of nutritional and psychological contacts were predictive of good weight loss results. Conclusions: Endoscopic sleeve gastroplasty is a feasible, reproducible, and effective procedure to treat obesity. Nutritional and psychological interaction are predictive of success. PMID:26878054

  6. Disclusion time measurement studies: stability of disclusion time--a 1-year follow-up.

    PubMed

    Kerstein, R

    1994-08-01

    Six of seven women were recalled after 1 year to remeasure their right- and left-side working disclusion times. Before the occlusal adjustment technique known as immediate complete anterior guidance development (ICAGD), these patients presented lengthy mean disclusion times (> 1.0 second) and multiple chronic myofascial pain dysfunction syndrome (MPDS) symptoms. After ICAGD, these patients presented with short mean disclusion times (< 0.7 second) and no chronic MPDS symptoms were observed. At 1-year follow-up, there was no statistical difference between present measurements of disclusion time and those of 1 year earlier. In addition, all six posttreatment patients demonstrated no observed chronic MPDS symptoms. However, the symptom of nocturnal bruxism appeared to recur with some chronic regularity. These results suggest that, for this population, disclusion time was stable over the 1-year period of observation, and the short disclusion time appears to allow normal daily muscle function with significantly lessened appearance of chronic myofacial pain dysfunction symptoms.

  7. Induction of Maturogenesis by Partial Pulpotomy: 1 Year Follow-Up

    PubMed Central

    Bacaksiz, A.; Alaçam, A.

    2013-01-01

    In cariously exposed immature permanent teeth, the treatment choice is controversial in pediatric dentistry. Radical root canal treatment usually appears to be the solution for these teeth. Even partial pulpotomy is a vital treatment for traumatically exposed immature permanent teeth; extending the borders of indication towards cariously exposed immature permanent teeth with reversible pulpitis may abolish the necessity of pulpectomy. This article describes the partial pulpotomy of a cariously affected immature permanent teeth and the follow-up for 1 year. A healthy 11-year-old male patient was referred to Gazi University Faculty of Dentistry Department of Pediatric Dentistry. The patient had reversible pulpitis symptoms on teeth numbered 45. At radiographic examination, immature apex and deep caries lesion were observed and partial pulpotomy was performed by using calcium hydroxide to maintain vitality of the pulp and allow continued development of root dentin expecting the root will attain full maturity. Clinical and radiographic follow-up demonstrated a vital pulp besides not only closure of the apex (apexogenesis), but also physiologic root development (maturogenesis) after 1 year. Partial pulpotomy is an optional treatment for cariously exposed immature permanent teeth for preserving vitality and physiological root development. PMID:24324899

  8. Induction of maturogenesis by partial pulpotomy: 1 year follow-up.

    PubMed

    Bacaksiz, A; Alaçam, A

    2013-01-01

    In cariously exposed immature permanent teeth, the treatment choice is controversial in pediatric dentistry. Radical root canal treatment usually appears to be the solution for these teeth. Even partial pulpotomy is a vital treatment for traumatically exposed immature permanent teeth; extending the borders of indication towards cariously exposed immature permanent teeth with reversible pulpitis may abolish the necessity of pulpectomy. This article describes the partial pulpotomy of a cariously affected immature permanent teeth and the follow-up for 1 year. A healthy 11-year-old male patient was referred to Gazi University Faculty of Dentistry Department of Pediatric Dentistry. The patient had reversible pulpitis symptoms on teeth numbered 45. At radiographic examination, immature apex and deep caries lesion were observed and partial pulpotomy was performed by using calcium hydroxide to maintain vitality of the pulp and allow continued development of root dentin expecting the root will attain full maturity. Clinical and radiographic follow-up demonstrated a vital pulp besides not only closure of the apex (apexogenesis), but also physiologic root development (maturogenesis) after 1 year. Partial pulpotomy is an optional treatment for cariously exposed immature permanent teeth for preserving vitality and physiological root development.

  9. Colles' fracture treated with non-bridging external fixation: a 1-year follow-up.

    PubMed

    Andersen, J K; Høgh, A; Gantov, J; Vaesel, M T; Hansen, T Baek

    2009-08-01

    The results in 75 of 105 patients with Older type II/III (AO type A2.2, A3.1, A3.2) Colles' fractures, treated with non-bridging external fixation are presented. The mean age was 67.8 years, and all patients were followed prospectively for 12 months with radiological and functional assessment. No statistically significant loss of radial length, angulation or inclination was seen between the postoperative reduction and the 1-year follow-up examination. The clinical results after 1 year were 66 (88%) excellent/good, nine (12%) fair and 0 (0%) poor according to the modified Gartland and Werley score. Mean visual analogue scale pain score after 1 year was 0.8. In three patients (4%), re-displacement of the fracture occurred and was treated with plating. Non-bridging external fixation offers a reliable method of maintaining radiological reduction of Older type II/III fractures of the distal radius and gives a good functional outcome after 1 year.

  10. Recovery of aphasia after stroke: a 1-year follow-up study.

    PubMed

    El Hachioui, Hanane; Lingsma, Hester F; van de Sandt-Koenderman, Mieke E; Dippel, Diederik W J; Koudstaal, Peter J; Visch-Brink, Evy G

    2013-01-01

    Semantics, phonology, and syntax are essential elements of aphasia diagnosis and treatment. Until now, these linguistic components have not been specifically addressed in follow-up studies of aphasia recovery after stroke. The aim of this observational prospective follow-up study was to investigate semantic, phonological, and syntactic recovery in aphasic stroke patients. In addition, we investigated the recovery of verbal communication and of aphasia severity. We assessed 147 aphasic patients at 1, 2, and 6 weeks, 3 and 6 months, and 1 year after stroke with the ScreeLing, a screening test for detecting deficits on the three main linguistic components, the aphasia severity rating scale (ASRS), a measure of verbal communication, and the Token test, a measure of aphasia severity. We investigated the differences in scores between the six time points with mixed models. Semantics and syntax improved up to 6 weeks (p < 0.001) after stroke, and phonology up to 3 months (p ≤ 0.001). ASRS improved up to 6 months (p < 0.05) and the Token test up to 3 months (p < 0.001). We conclude that in aphasia after stroke, various linguistic components have a different recovery pattern, with phonology showing the longest period of recovery that paralleled aphasia severity, as measured with the Token test. The improvement of verbal communication continues after the stabilization of the recovery of the linguistic components.

  11. Shock-wave therapy for tennis and golfer's elbow--1 year follow-up.

    PubMed

    Krischek, O; Hopf, C; Nafe, B; Rompe, J D

    1999-01-01

    Thirty patients with chronic medial epicondylitis were treated with low-energy shock waves. They received 500 impulses of 0.08 mJ/mm2 three times at weekly intervals. At 1 year follow-up examinations were performed. According to the Verhaar criteria, only seven patients reached excellent or good results. In eight cases a fair outcome was recorded, and in 14 patients the outcome was poor. Only six patients were satisfied with the treatment. The average relief of pain was 32%. These data were significantly worse than for identically treated patients with chronic tennis elbow. Thus, the question arises as to whether extracorporal shock-wave therapy is indicated in medial epicondylitis.

  12. The Effect of Clozapine on Hematological Indices: A 1-Year Follow-Up Study.

    PubMed

    Lee, Jimmy; Takeuchi, Hiroyoshi; Fervaha, Gagan; Powell, Valerie; Bhaloo, Amaal; Bies, Robert; Remington, Gary

    2015-10-01

    Clozapine is the antipsychotic of choice for treatment-resistant schizophrenia and is linked to a need for mandatory hematological monitoring. Besides agranulocytosis, other hematological aberrations have resulted in premature termination in some cases. Considering clozapine's role in immunomodulation, we proceeded to investigate the impact of clozapine on the following 3 main hematological cell lines: red blood cells, platelets, white blood cells (WBCs), and its differential counts. Data were extracted from patients initiated on clozapine between January 2009 and December 2010 at a single hospital. Patients with a preclozapine complete blood count, who were receiving clozapine during the 1-year follow-up period, were included in the present investigation. Counts of red blood cells, platelets, WBC, and its differential including neutrophils, lymphocytes, monocytes, eosinophils, and basophils were extracted and trajectories plotted. One hundred one patients were included in this study and 66 remained on clozapine at the end of 1 year. There was a synchronized but transient increase in WBC, neutrophils, monocytes, eosinophils, basophils, and platelets beginning as early as the first week of clozapine treatment. There were no cases of agranulocytosis reported in this sample, and five developed neutropenia. A spike in neutrophils immediately preceded the onset of neutropenia in three of the five. The cumulative incidence rates were 48.9% for neutrophilia, 5.9% for eosinophilia, and 3% each for thrombocytosis and thrombocytopenia. Early hematological aberrations are visible across a range of cell lines, primarily of the myeloid lineage. These disturbances are transient and are probably related to clozapine's immunomodulatory properties. We do not suggest discontinuing clozapine as a consequence of the observed aberrations.

  13. Effect of Language Barriers on Follow-up Appointments After an Emergency Department Visit

    PubMed Central

    Sarver, Joshua; Baker, David W

    2000-01-01

    OBJECTIVE To determine whether patients who encountered language barriers during an emergency department visit were less likely to be referred for a follow-up appointment and less likely to complete a recommended appointment. DESIGN Cohort study. SETTING Public hospital emergency department. PARTICIPANTS English- and Spanish-speaking patients (N =714) presenting with nonemergent medical problems. MEASUREMENTS AND MAIN RESULTS Patients were interviewed to determine sociodemographic information, health status, whether an interpreter was used, and whether an interpreter should have been used. The dependent variables were referral for a follow-up appointment after the emergency department visit and appointment compliance, as determined by chart review and the hospital information system. The proportion of patients who received a follow-up appointment was 83% for those without language barriers, 75% for those who communicated through an interpreter, and 76% for those who said an interpreter should have been used but was not (P =.05). In multivariate analysis, the adjusted odds ratio for not receiving a follow-up appointment was 1.92 (95% confidence interval [CI], 1.11 to 3.33) for patients who had an interpreter and 1.79 (95% CI, 1.00 to 3.23) for patients who said an interpreter should have been used (compared with patients without language barriers). Appointment compliance rates were similar for patients who communicated through an interpreter, those who said an interpreter should have been used but was not, and those without language barriers (60%, 54%, and 64%, respectively; P =.78). CONCLUSIONS Language barriers may decrease the likelihood that a patient is given a follow-up appointment after an emergency department visit. However, patients who experienced language barriers were equally likely to comply with follow-up appointments. PMID:10760001

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

    SciTech Connect

    Anselmetti, Giovanni Carlo; Manca, Antonio; Marcia, Stefano; Chiara, Gabriele; Marini, Stefano; Baroud, Gamal; Regge, Daniele; Montemurro, Filippo

    2013-05-08

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

  15. The Stability and Structure of Career Decision-Making Profiles: A 1-Year Follow-Up

    ERIC Educational Resources Information Center

    Gati, Itamar; Levin, Nimrod

    2012-01-01

    The Career Decision-Making Profile (CDMP) questionnaire is a multidimensional measure of the way individuals make career decisions, developed as an alternative to the single, most-dominant trait approach. Using a sample of freshmen students, the 2-week reliability (N = 273) and 1-year stability (N = 182) of the CDMP was tested for each of the 12…

  16. A Program To Promote Positive Body Image: A 1-Year Follow-Up Evaluation.

    ERIC Educational Resources Information Center

    McVey, Gail L.; Davis, Ron

    2002-01-01

    Evaluated the effectiveness of a program designed to promote body image satisfaction and prevent eating problems in young adolescent girls over a 1-year period. Found no program effect. Found instead, significant increases in body image satisfaction and decreases in eating problem scores over time for participants in both the prevention and…

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

    PubMed Central

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

    2013-01-01

    The objective of this report was to use topical gaseous ozone as an adjunct to conventional treatment methods and to describe the multidisciplinary management of bisphosphonate associated bone necrosis, which developed following endodontic treatment. No complaints were noted by the patients at their 1-year follow-up and the treatment showed favorable prognosis. PMID:24353427

  18. Radio-frequency ablation of small renal tumors: minimum follow up of 1 year

    NASA Astrophysics Data System (ADS)

    Patel, Vipul; Thaly, Rahul; Shah, Ketul

    2007-02-01

    OBJECTIVE: With the increased utility of complex imaging modalities small renal tumors are being diagnosed with rising frequency. We performed radiofrequency ablation to treat tumors less than 4cm in size using a combination of temperature, impedance, ultrasound and laparoscopic guidance. In this article we reviewed the outcome of radiofrequency ablation of renal tumors at one year at our institution. MATERIALS AND METHODS: Over a three-year period 75 patients with a total of 93 renal tumors underwent radiofrequency ablation. Average patient age was 64.5 years with ASA of 2.9. Indications for nephron sparing were imperative in 33 (solitary kidney 21, renal insufficiency 12). Seventeen patients had significant co-morbidities with ASA score of 3 or more and were thought to be poor candidates for nephrectomy or partial nephrectomy. Five were Jehovah's Witness patients. Average tumor size was 3.2 cm (1.5-4.0). 60% of the tumors were exophytic and 40% deep. Radiofrequency ablation was performed via a transperitoneal approach using the single pronged 3cm Cool tip electrode (Radionics Inc). Tumor was isolated laparoscopically. Prior to ablation the lesions were biopsied. Ablation was performed using both laparoscopic and real-time ultrasound imaging of the boarders of the tumor. During ablation impedance and temperature monitoring was performed. For each tumor two separate ablations were performed at perpendicular angles, the first ablation was for 6 minutes and the second for 3 minutes. The center and periphery of the tumor was monitored to insure that the temperature rose above 70 degrees Celsius. Patients were followed at three-month intervals with triple phase CT scan or MRI to evaluate efficacy of the ablation. Our criteria for recurrent tumor were growth or enhancement of the lesion. RESULTS: Average operative time was 109 minutes with and average EBL of <25cc. Mean hospital stay was 1.4 days. At average follow up of 19.2 months (range 2-24), one lesion showed

  19. MRI as outcome measure in facioscapulohumeral muscular dystrophy: 1-year follow-up of 45 patients.

    PubMed

    Andersen, Grete; Dahlqvist, Julia R; Vissing, Christoffer R; Heje, Karen; Thomsen, Carsten; Vissing, John

    2017-03-01

    There is no effective treatment available for facioscapulohumeral muscular dystrophy type 1 (FSHD1), but emerging therapies are under way that call for a better understanding of natural history in this condition. In this prospective, longitudinal study, we used quantitative MRI to assess yearly disease progression in patients with FSHD1. Ambulatory patients with confirmed diagnosis of FSHD1 (25/20 men/women, age 20-75 years, FSHD score: 0-12) were tested with 359-560-day interval between tests. Using the MRI Dixon technique, muscle fat replacement was evaluated in paraspinal, thigh, and calf muscles. Changes were compared with those in FSHD score, muscle strength (hand-held dynamometry), 6-minute-walk-distance, 14-step-stair-test, and 5-time-sit-to-stand-test. Composite absolute fat fraction of all assessed muscles increased by 0.036 (CI 0.026-0.046, P < 0.001), with increases in all measured muscle groups. The clinical severity FSHD score worsened (10%, P < 0.05), muscle strength decreased over the hip (8%), neck (8%), and back (17%) (P < 0.05), but other strength measures, 6-minute-walk-distance, 5-times-sit-to-stand-test, and 14-step-stair-test were unchanged. Changes in muscle strength, FSHD score, and fat fraction did not correlate. This first study to systemically monitor quantitative fat replacement longitudinally in FSHD1 shows that MRI provides an objective measure of disease progression, often before changes can be appreciated in strength and functional tests. The study indicates that quantitative MRI can be a helpful end-point in follow-up and therapeutic trials of patients with FSHD1.

  20. Follow-up Visits and Changes in Pain Scores Reported by Oncology Outpatients After Initial Presentation With Severe Pain

    PubMed Central

    Hill, Brett; Moulin, Dwight

    2017-01-01

    Background In addition to tumour treatment, the management of symptoms such as pain is an important component of cancer care. Pain management is a complex field and prior studies have highlighted many different clinical care responses to a cancer patient presenting with severe pain. We explored follow-up and how pain screening scores changed over time, among a cohort of cancer outpatients, and how follow-up was scheduled after the initial visit. Methods The care provided to 96 patients seen at the London Regional Cancer Program was reviewed for the 12-week period following presentation with severe pain >7/10. Follow-up ESAS (Edmonton Symptom Assessment System) scores, visits, and compliance were documented. Results Follow-up ESAS data was available for 41/96 patients. Mean ESAS pain decreased from 8.4/10 to 3.6/10 among those patients with follow-up; however, for 55/96 patients, no follow-up ESAS score was available (deceased n=3, no follow-up visit n=41, no pain score reported, n=11). Conclusions Despite a very high proportion of documented active pain management plans in the case of cancer patients presenting with severe pain, very little follow-up directed specifically at pain management was performed. Cancer treatment appears to be the primary determinant of oncology follow-up timing at our centre. PMID:28191369

  1. Course and predictors of physical aggressive behaviour after discharge from a psychiatric inpatient unit: 1 year follow-up.

    PubMed

    Amore, Mario; Tonti, Cristina; Esposito, William; Baratta, Stefano; Berardi, Domenico; Menchetti, Marco

    2013-08-01

    The present study analyzes course and predictors of physically aggressive behaviour over a 1-year follow up in a sample of patients discharged from a psychiatric inpatient unit. One hundred and eighty-six patients discharged from a locked short-term Psychiatric Inpatient Unit at the Bologna University Hospital. After discharge, two data collection contacts at 1 month and at 1 year were scheduled. In particular, psychiatrists, nurses, and other professionals were interviewed by the research staff using the Overt Aggression Scale. About 20 % of discharged patients showed physical aggressiveness in subsequent follow-up contacts. Risk factors for physical violence in the short-time period were social problems and a longer time from the first psychiatric contact. Living in residential facilities and physical aggressiveness during hospitalization were correlated to violence in the long-time period. Risk factors for physically violent behaviour differed in the short-term and long-term follow-ups; different causes of violent behaviour could be hypothesized.

  2. After the diabetes care trial ends, now what? A 1-year follow-up of the RxING study

    PubMed Central

    Al Hamarneh, Yazid N; Sauriol, Luc; Tsuyuki, Ross T

    2015-01-01

    Introduction There is strong evidence that pharmacist care improves patients’ glycaemic control. However, the sustainability and durability of such interventions beyond the research period is not known. RxING was the first trial of pharmacist prescribing in diabetes and it showed an improvement in glycated haemoglobin (HbA1c) of 1.8% over 6 months. Objective 1° objective: To evaluate glycaemic control in the RxING study patients 12 months after the end of the formal study follow-up. 2° objective: To assess the patients’ risk of cardiovascular events in the next 10 years. Methods We contacted the participating pharmacists to check if the patients who participated in the RxING study are still taking insulin, the dose of insulin they are taking, and their HbA1c. There were no mandated follow-up visits with the pharmacist after the study completion. Results A total of 100 patients with poorly controlled type 2 diabetes were enrolled in the original RxING study; 93 of them completed the study, while 83 participated in the 12-month follow-up. Seventy-five patients were still taking insulin, with the average dose increasing from 31.1 units (SD 18.4) at study completion to 37.4 units (SD 30.8) (95% CI −13.3 to 0.88, p=0.085). HbA1c was reduced from 9.1% (SD 1) at baseline to 7.3% (SD 0.9) at study completion (95% CI 1.4 to 2, p <0.001), and increased to 8.1% (SD 1.3) 12 months later (95% CI −1.1 to −0.5, p <0.001 vs study completion). Conclusions Twelve months after completing the intervention, approximately half of the glycaemic control gains were lost. This highlights the importance of structured follow-up with the pharmacist in this patient population. Trial registration number clinicaltrials.gov; Identifier: NCT01335763. PMID:26270946

  3. 1-year follow-up of neurofeedback treatment in adolescents with attention-deficit hyperactivity disorder: randomised controlled trial

    PubMed Central

    Bongers, Ilja L.; Popma, Arne; Janssen, Tieme W.P.; van Nieuwenhuizen, Chijs

    2016-01-01

    Background Estimates of the effectiveness of neurofeedback as a treatment for attention-deficit hyperactivity disorder (ADHD) are mixed. Aims To investigate the long-term additional effects of neurofeedback (NFB) compared with treatment as usual (TAU) for adolescents with ADHD. Method Using a multicentre parallel-randomised controlled trial design, 60 adolescents with a DSM-IV-TR diagnosis of ADHD receiving NFB+TAU (n=41) or TAU (n=19) were followed up. Neurofeedback treatment consisted of approximately 37 sessions of theta/sensorimotor rhythm (SMR)-training on the vertex (Cz). Outcome measures included behavioural self-reports and neurocognitive measures. Allocation to the conditions was unmasked. Results At 1-year follow-up, inattention as reported by adolescents was decreased (range ηp2=0.23–0.36, P<0.01) and performance on neurocognitive tasks was faster (range ηp2=0.20–0.67, P<0.005) irrespective of treatment group. Conclusions Overall, NFB+TAU was as effective as TAU. Given the absence of robust additional effects of neurofeedback in the current study, results do not support the use of theta/SMR neurofeedback as a treatment for adolescents with ADHD and comorbid disorders in clinical practice. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703763

  4. Risk factor control, adherence to medication and follow up visit, five years after coronary artery bypass graft surgery

    PubMed Central

    Salari, Arsalan; Hasandokht, Tolou; Mahdavi-Roshan, Marjan; Kheirkhah, Jalal; Gholipour, Mahboueh; Pouradollah Tootkaoni, Mahsa

    2016-01-01

    Introduction: Inadequate adherence to medication and follow up visits were proposed correlated with cardiovascular mortality and complications. This study was planned to evaluate medication and follow up adherence and risk factor control in patients with coronary artery disease 5 years after coronary artery bypass grafting (CABG). Methods: In this retrospective cohort study, adult patients who underwent CABG in 2010 were enrolled. Conventional and probable risk factor control and adherence to medication and follow up visits were assessed. Results: 196 patients were recruited to the study. Uncontrolled blood pressure, blood glucose and low-density lipoprotein (LDL)were reported in 48%, 61% and 32% of patients, respectively. More than 63% of former smokers restarted smoking during 6-12 months after bypass. Poor medication adherence was present in 10.7% in the study population. The last follow up visit time for 30% of patients was later than 12 months after CABG. Conclusion: Poor risk factors control and adherence to follow up visits was common among patients undergoing CABG. PMID:28210470

  5. Longitudinal changes in prospective memory and their clinical correlates at 1-year follow-up in first-episode schizophrenia

    PubMed Central

    Ungvari, Gabor S.; Ng, Chee H.; Zhou, Yan; Zhang, Liang; Zhou, Jingjing; Shum, David H. K.; Man, David; Liu, Deng-Tang; Li, Jun; Xiang, Yu-Tao

    2017-01-01

    This study aimed to investigate prospective memory (PM) and the association with clinical factors at 1-year follow-up in first-episode schizophrenia (FES). Thirty-two FES patients recruited from a university-affiliated psychiatric hospital in Beijing and 17 healthy community controls (HCs) were included. Time- and event-based PM (TBPM and EBPM) performances were measured with the Chinese version of the Cambridge Prospective Memory Test (C-CAMPROMPT) at baseline and at one-year follow-up. A number of other neurocognitive tests were also administered. Remission was determined at the endpoint according to the PANSS score ≤ 3 for selected items. Repeated measures analysis of variance revealed a significant interaction between time (baseline vs. endpoint) and group (FES vs. HCs) for EBPM (F(1, 44) = 8.8, p = 0.005) and for all neurocognitive components. Paired samples t-tests showed significant improvement in EBPM in FES (13.1±3.7 vs. 10.3±4.8; t = 3.065, p = 0.004), compared to HCs (15.7±3.6 vs. 16.5±2.3; t = -1.248, p = 0.230). A remission rate of 59.4% was found in the FES group. Analysis of covariance revealed that remitters performed significantly better on EBPM (14.9±2.6 vs. 10.4±3.6; F(1, 25) = 12.2, p = 0.002) than non-remitters at study endpoint. The association between EBPM and 12-month clinical improvement in FES suggests that EBPM may be a potential neurocognitive marker for the effectiveness of standard pharmacotherapy. Furthermore, the findings also imply that PM may not be strictly a trait-related endophenotype as indicated in previous studies. PMID:28245266

  6. 1-year follow-up after radiofrequency tonsillotomy and laser tonsillotomy in children: a prospective, double-blind, clinical study.

    PubMed

    Stelter, Klaus; Ihrler, Stephan; Siedek, Vanessa; Patscheider, Martin; Braun, Thomas; Ledderose, Georg

    2012-02-01

    In the last decade, tonsillotomy has come into vogue again, whereas the number of tonsillectomies is decreasing rapidly. In a previous study, the tonsillotomy with laser or radiofrequency therapy proved as a safe and effective procedure with minimal pain and hemorrhage. This follow-up study determines which method is more effective with respect to long-term outcome, recurrence of tonsillar hyperplasia and recurrence of tonsillitis. A prospective, randomised, double-blinded controlled clinical study was conducted at the Department of Otorhinolaryngology of the Ludwig-Maximilians-University, Munich, Germany. Twenty-six children with tonsillar hypertrophy were included. Tonsillotomy was performed on one side with monopolar radiofrequency and on the other side with a carbon dioxide laser. Exactly 1 year after the procedure, all 26 patients were documented by digital photography to define a possible recurrence of tonsillar hyperplasia. All parents were asked for occurring tonsillitis and fulfilled the Glasgow Children's Benefit Inventory (GCBI) for health-related quality of life after surgical procedures. In seven children, a slightly visible recurrence of the tonsillar hyperplasia occurred, without any symptoms or correlation to the different methods and sides. One child with recurrent tonsillitis and hyperplasia had to be tonsillectomized 8 months after the initial tonsillotomy procedure. The specimen showed open crypts with bacterial infection in the deep. The GCBI resulted in highly significant benefits of the surgery in all categories and subcategories. In conclusion, both methods, the laser tonsillotomy and the radiofrequency method, were equal concerning the effectiveness and safety after 1 year. Further investigations have to aim at the long-term outcome after tonsillotomy in patients with recurrent infections.

  7. A comparison of outcome of medical and surgical treatment of migraine headache: In 1 year follow-up

    PubMed Central

    Omranifard, Mahmood; Abdali, Hossein; Ardakani, Mehdi Rasti; Talebianfar, Mohsen

    2016-01-01

    Background: This study was designed to compare the efficacy of the medical treatment versus the surgical treatment approach to decompression of trigger point nerves in patients with migraine headaches. Materials and Methods: Fifty volunteers were randomly assigned to the medical treatment group (n = 25) or the surgical treatment group (n = 25) after examination by the team neurologist to ensure a diagnosis of migraine headache. All patients received botulinum toxin type A to confirm the trigger sites. The surgical treatment group underwent surgical deactivation of the trigger site(s). The medical treatment group underwent prophylactic pharmacologic interventions by the neurologist. Pretreatment and 12-month posttreatment migraine headache frequency, duration, and intensity were analyzed and compared to determine the success of the treatments. Results: Nineteen of the 25 patients (76%) in the surgical treatment group and 10 of the 25 patients (40%) in the medical treatment group experienced a successful outcome (at least a 50% decrease in migraine frequency, duration, or intensity) after 1 year from surgery. Surgical treatment had a significantly higher success rate than medical treatment (P < 0.001). Nine patients (36%) in the surgical treatment group and one patient (4%) in the medical treatment group experienced cessation of migraine headaches. The elimination rate was significantly higher in the surgical treatment group than in the medical treatment group (P < 0.001). Conclusions: Based on the 1-year follow-up data, there is strong evidence that surgical manipulation of one or more migraine trigger sites can successfully eliminate or reduce the frequency, duration, and intensity of migraine headaches in a lasting manner. PMID:27563631

  8. A nurse-driven outpatient clinic for thiopurine-treated inflammatory bowel disease patients reduces physician visits and increases follow-up efficiency.

    PubMed

    López, María; Dosal, Angelina; Villoria, Albert; Moreno, Laura; Calvet, Xavier

    2015-01-01

    Patients on thiopurine therapy need frequent monitoring to prevent drug adverse events. To describe the structure and main results of a nurse-driven outpatient clinic (NDOC) program for the follow-up of patients receiving treatment with thiopurine immunosuppressants, we retrospectively reviewed patients' clinical charts on thiopurine drugs, azathioprine (AZA), and 6-mercaptopurine. We evaluated the efficacy of the NDOC by comparing the number of physician visits and the adequacy of laboratory controls for each patient before and after inclusion in the program. From January 2006 to December 2008, 179 patients were included. Of these, 102 had received thiopurines for at least 1 year before the start of the NDOC. Mean age was 42 ± 15 years; 83 were female. In all, 137 of the 179 patients (76%) had Crohn disease. AZA was the most frequent drug used (97%). Mean time of follow-up was 2.03 ± 0.9 years. Implementation of this program decreased the number of physician visits per year-from 4.6 ± 1.9 to 2.4 ± 1.3 (p < .001)-and the number of periods longer than 4 months without laboratory control (from 68% to 45%; p = .01). Leucopenia episodes and complications did not differ significantly before and after the start of the NDOC. Nurse-driven follow-up of these patients reduces physician visits while improving tightness of the follow-up.

  9. Associated anomalies among infants with oral clefts at birth and during a 1-year follow-up.

    PubMed

    Rittler, Monica; Cosentino, Viviana; López-Camelo, Jorge S; Murray, Jeffrey C; Wehby, George; Castilla, Eduardo E

    2011-07-01

    Reports of birth defects rates may focus on defects observed in the newborn period or include defects diagnosed at older ages. However, little information is available on the rates of additional anomalies detected after birth or on the ages at which such anomalies are diagnosed. The aims of this work were to describe the initial diagnoses of oral clefts, isolated or associated with other defects, in newborn infants ascertained in hospitals of the ECLAMC network, and diagnostic changes that occurred due to detection of additional defects during a 1-year follow-up period. Seven hundred ten liveborn infants with cleft lip only (CLO), cleft lip with cleft palate (CLP), or cleft palate (CP) were ascertained between 2003 and 2005. Prevalence estimates of isolated and associated (ASO) clefts, diagnoses in infants with associated clefts, and the percentage of isolated clefts that were reclassified as associated were established. Birth prevalence estimates (per 1,000) were as follows: Total: 1.7; CLP: 0.94 (ASO = 23.5%); CP: 0.46 (ASO = 42.3%); CLO: 0.28 (ASO = 7.6%). Initial diagnoses in infants with associated clefts included 38 infants with chromosomal abnormalities, 33 with non-chromosomal syndromes, 16 with malformation sequences, and 98 with multiple anomalies of unknown etiology. Seven percent of newborns initially classified as isolated were later reclassified as associated. Ten infants without associated defects or clinically suspected syndromes were diagnosed as syndromic only through laboratory findings or family history, illustrating the difference between the terms associated versus isolated, which refers to presence or absence of associated anomalies, and syndromic versus non-syndromic, which refers to etiology.

  10. Predictors of Non-Attendance to the Postpartum Follow-up Visit.

    PubMed

    Wilcox, Annemieke; Levi, Erika E; Garrett, Joanne M

    2016-11-01

    Objectives This study aimed to measure the incidence and identify predictors of postpartum visit non-attendance, using medical records of women who received prenatal care and went on to deliver live births at Montefiore Hospital in 2013. Methods Pearson's Chi square tests were used to assess the association between maternal demographics, insurance status, and delivery information with non-attendance of a postpartum visit. Logistic regression and modified Poisson regression models were then used to identify statistically significant predictors of postpartum visit non-attendance. Results We found that one-third of all women who attended a prenatal visit at Montefiore Hospital did not return for a postpartum visit. Variables significantly associated with non-attendance include having Medicaid or no insurance (RR 1.4, 95 % CI 1.2-1.6), being Hispanic or Latino (RR 1.2, 95 % CI 1.1-1.3), having a vaginal delivery (RR 1.2, 95 % CI 1.1-1.4), and age <20 years (RR 0.77, 95 % CI 0.64-0.92). Conclusions for Practice We conclude that the risk of postpartum visit non-attendance disproportionately impacts socially and economically vulnerable patients who are: younger, part of a minority ethnic background, and depend on state funded health insurance. Our results highlight the disparity in access to postpartum care and the importance of identifying barriers to attendance as well as developing creative strategies of providing postpartum care outside of the traditional postpartum visit framework.

  11. Replacing Ambulatory Surgical Follow-Up Visits With Mobile App Home Monitoring: Modeling Cost-Effective Scenarios

    PubMed Central

    Semple, John L; Coyte, Peter C

    2014-01-01

    Background Women’s College Hospital (WCH) offers specialized surgical procedures, including ambulatory breast reconstruction in post-mastectomy breast cancer patients. Most patients receiving ambulatory surgery have low rates of postoperative events necessitating clinic visits. Increasingly, mobile monitoring and follow-up care is used to overcome the distance patients must travel to receive specialized care at a reduced cost to society. WCH has completed a feasibility study using a mobile app (QoC Health Inc, Toronto) that suggests high patient satisfaction and adequate detection of postoperative complications. Objective The proposed cost-effectiveness study models the replacement of conventional, in-person postoperative follow-up care with mobile app follow-up care following ambulatory breast reconstruction in post-mastectomy breast cancer patients. Methods This is a societal perspective cost-effectiveness analysis, wherein all costs are assessed irrespective of the payer. The patient/caregiver, health care system, and externally borne costs are calculated within the first postoperative month based on cost information provided by WCH and QoC Health Inc. The effectiveness of telemedicine and conventional follow-up care is measured as successful surgical outcomes at 30-days postoperative, and is modeled based on previous clinical trials containing similar patient populations and surgical risks. Results This costing assumes that 1000 patients are enrolled in bring-your-own-device (BYOD) mobile app follow-up per year and that 1.64 in-person follow-ups are attended in the conventional arm within the first month postoperatively. The total cost difference between mobile app and in-person follow-up care is $245 CAD ($223 USD based on the current exchange rate), with in-person follow-up being more expensive ($381 CAD) than mobile app follow-up care ($136 CAD). This takes into account the total of health care system, patient, and external borne costs. If we examine

  12. Cohort profile update: The 1993 Pelotas (Brazil) birth cohort follow-up visits in adolescence.

    PubMed

    Gonçalves, Helen; Assunção, Maria Cf; Wehrmeister, Fernando C; Oliveira, Isabel O; Barros, Fernando C; Victora, Cesar G; Hallal, Pedro C; Menezes, Ana Mb

    2014-08-01

    In this paper we update the profile of the 1993 Pelotas (Brazil) Birth Cohort Study, with emphasis on a shift of priority from maternal and child health research topics to four main categories of outcome variables, collected throughout adolescence: (i) mental health; (ii) body composition; (iii) risk factors for non-communicable diseases (NCDs); (iv) human capital. We were able to trace 81.3% (n = 4106) of the original cohort at 18 years of age. For the first time, the 18-years visit took place entirely on the university premises, in a clinic equipped with state-of-the-art equipment for the assessment of body composition. We welcome requests for data analyses from outside scientists. For more information, refer to our website (http://www.epidemio-ufpel.org.projetos_de_pesquisas/estudos/coorte_1993) or e-mail the corresponding author.

  13. Decrease in Television Viewing Predicts Lower Body Mass Index at 1-Year Follow-Up in Adolescents, but Not Adults

    ERIC Educational Resources Information Center

    French, Simone A.; Mitchell, Nathan R.; Hannan, Peter J.

    2012-01-01

    Objective: To examine associations between television viewing, sugar-sweetened beverage consumption, eating out, physical activity, and body weight change over 1 year. Design: Secondary data analysis from randomized intervention trial. Setting: Households in the community. Participants: Adults (n = 153) and adolescents (n = 72) from the same…

  14. Children's Spoken Word Recognition and Contributions to Phonological Awareness and Nonword Repetition: A 1-Year Follow-Up

    ERIC Educational Resources Information Center

    Metsala, Jamie L.; Stavrinos, Despina; Walley, Amanda C.

    2009-01-01

    This study examined effects of lexical factors on children's spoken word recognition across a 1-year time span, and contributions to phonological awareness and nonword repetition. Across the year, children identified words based on less input on a speech-gating task. For word repetition, older children improved for the most familiar words. There…

  15. Endovascular treatment of a bleeding secondary aorto-enteric fistula. A case report with 1-year follow-up.

    PubMed

    Brountzos, Elias N; Vasdekis, Spyros; Kostopanagiotou, Georgia; Danias, Nikolaos; Alexopoulou, Efthymia; Petropoulou, Konstantina; Gouliamos, Athanasios; Perros, Georgios

    2007-01-01

    We report a patient with life-threatening gastrointestinal bleeding caused by a secondary aorto-enteric fistula. Because the patient had several comorbid conditions, we succesfully stopped the bleeding by endovascular placement of a bifurcated aortic stent-graft. The patient developed periaortic infection 4 months later, but he was managed with antibiotics. The patient is well 1 year after the procedure.

  16. Consultation-Based Academic Interventions for Children with Attention Deficit Hyperactivity Disorder: Effects on Reading and Mathematics Outcomes at 1-Year Follow-Up

    ERIC Educational Resources Information Center

    Volpe, Robert J.; DuPaul, George J.; Jitendra, Asha K.; Tresco, Katy E.

    2009-01-01

    The purpose of this follow-up study was to evaluate the effectiveness of two consultation-based models to enhance the educational functioning of children with attention deficit hyperactivity disorder (ADHD) after 1 year of no treatment. Children (N = 167) meeting "Diagnostic Statistical Manual" (4th ed., text revision; 2000) criteria for attention…

  17. A longitudinal, event-related potential pilot study of adult obsessive-compulsive disorder with 1-year follow-up

    PubMed Central

    Yamamuro, Kazuhiko; Okada, Koji; Kishimoto, Naoko; Ota, Toyosaku; Iida, Junzo; Kishimoto, Toshifumi

    2016-01-01

    Aim Earlier brain imaging research studies have suggested that brain abnormalities in obsessive-compulsive disorder (OCD) normalize as clinical symptoms improve. However, although many studies have investigated event-related potentials (ERPs) in patients with OCD compared with healthy control subjects, it is currently unknown whether ERP changes reflect pharmacological and psychotherapeutic effects. As such, the current study examined the neurocognitive components of OCD to elucidate the pathophysiological abnormalities involved in the disorder, including the frontal-subcortical circuits. Methods The Yale-Brown Obsessive-Compulsive Scale was used to evaluate 14 adult patients with OCD. The present study also included ten age-, sex-, and IQ-matched controls. The P300 and mismatch negativity (MMN) components during an auditory oddball task at baseline for both groups and after 1 year of treatment for patients with OCD were measured. Results Compared with controls, P300 amplitude was attenuated in the OCD group at Cz and C4 at baseline. Pharmacotherapy and psychotherapy treatment for 1 year reduced OCD symptomology. P300 amplitude after 1 year of treatment was significantly increased, indicating normalization compared with baseline at Fz, Cz, C3, and C4. We found no differences in P300 latency, MMN amplitude, or MMN latency between baseline and after one year of treatment. Conclusion ERPs may be a useful tool for evaluating pharmacological and cognitive behavioral therapy in adult patients with OCD. PMID:27713631

  18. Self-Inflicted Gingival Injury Due to Habitual Fingernail Scratching: A Case Report with a 1-Year Follow Up

    PubMed Central

    Dilsiz, Alparslan; Aydin, Tugba

    2009-01-01

    Injuries to oral soft-tissues can occur due to accidental, iatrogenic, and factitious traumas. Traumatic lesions, whether chemical, physical, or thermal in nature, are among the most common in the mouth. A type of physical injury to the gingival tissues is self-inflicted. Sometimes the lesions are termed gingivitis artefacta. Self-inflicted gingival injuries in children and adolescents can occur as a result of accidental trauma, premeditated infliction, or chronic habits such as fingernail biting, digit sucking, or sucking on objects such as pens, pencils or pacifiers. The purpose of this case report was to illustrate the destructive nature of the habit and to describe the successful treatment of this case. A 14-year-old girl with moderate pain, gingival bleeding and recession in the anterior mandibulary region was admitted to periodontology clinic. Upon questioning, the patient readily admitted traumatizing her gingiva with her fingernail. Treatment consisted of oral hygiene instruction, mechanical debridement, psychological support and surgical periodontal treatment. Postoperatively, complete root coverage, gains in clinical attachment levels, and highly significant increases in the width of keratinized gingiva were observed. This case report shows that it is possible to treat gingival injury and maintain the periodontal health of a patient with destructive habit. Patient compliance, regular dental follow-ups, and psychological support may be useful in stabilizing the periodontal condition of these patients. Dentists must be aware that self-inflicted gingival injury, although thought to be uncommon, is quite widespread. PMID:19421397

  19. Melamine-induced infant urinary calculi: a report on 24 cases and a 1-year follow-up.

    PubMed

    Zhang, Xiangbo; Bai, Jinliang; Ma, Pengcheng; Ma, Jianhua; Wan, Jianghou; Jiang, Bin

    2010-10-01

    Melamine has been the main factor leading to infant urinary calculi occurring on a rather wide scale in China in 2008, which were the results of a rapid aggradation of metabolites such as cyanuric acid diamide, cyanuric acid, etc., causing uric acid stone to accumulate. Here, we present a report on 24 infants who were admitted to our department, their ages ranging from 3 to 10 months. All of these infants had a confirmed history of having been fed with the "Sanlu" brand milk powder, which contained excessive levels of melamine, with the highest being 2,563 mg/kg. The diagnosis, medical treatment and follow-up by ultrasonography at 1, 3, 6, 12 months were reported. 22 cases of these infants were rehabilitated after medical treatment and 1 infant underwent pyelolithotomy for relieving an obvious ureter obstruction. No recurrence was found in these babies thereafter. Another infant died from rapidly worsening renal failure. Therefore, this series of cases have demonstrated that melamine contained in the "Sanlu" milk powder was the main cause of these urinary stones. Urine alkalinization and stone liberalization were the most effective treatments. Fast diagnosis and treatment of acute obstructive urolithiasis may prevent the development of acute renal failure, which is associated with high morbidity and mortality rates.

  20. Children with baby bottle tooth decay treated under general anesthesia or sedation: behavior in a follow-up visit.

    PubMed

    Peretz, B; Faibis, S; Ever-Hadani, P; Eidelman, E

    2000-01-01

    The purpose of the present study was to compare the behaviors of a group of children, who were treated for baby bottle tooth decay (BBTD) under general anesthesia (GA) or under sedation in a dental school environment in a routine follow-up examination, and to assess the dental anxiety levels of the parents. Sixty-five children, who were treated for BBTD in the Pediatric Dentistry clinic of the Hebrew University-Hadassah School of Dental Medicine between 1995-1997 under GA (34 children) or sedation (31 children). The parents of these children agreed to attend our clinic for recall examination 13 months post treatment following a telephone conversation. Frankl's behavioral scale and the sitting pattern were recorded for each child. In the sedation group, Frankl's scores of the present visits were then compared to the scores recorded at the initial examination visit that were obtained from the dental records. The accompanying parents were asked to note the number of visits to the dentist in the past two years, and to complete Corah's dental anxiety scale (DAS). No difference was observed between the children in both groups. Most of the children in the GA and in the sedation groups sat alone on the dental chair, without the assistance of the parents. Parents of the sedation group showed higher scores than the GA group in the total DAS (9.35 and 8.90 respectively), however these differences were not statistically significant. It is concluded that children treated for BBTD under GA or under sedation at a very young age behave similarly in a follow-up examination nearly 13 months postoperatively.

  1. Associated Anomalies among Infants with Oral Clefts at Birth and during a 1 year Follow-up

    PubMed Central

    Rittler, Monica; Cosentino, Viviana; López-Camelo, Jorge S; Murray, Jeffrey C; Wehby, George; Castilla, Eduardo E

    2012-01-01

    Reports of birth defects rates may focus on defects observed in the newborn period or include defects diagnosed at older ages. However, little information is available on the rates of additional anomalies detected after birth or on the ages at which such anomalies are diagnosed. The aims of this work were to describe the initial diagnoses of oral clefts, isolated or associated with other defects, in newborn infants ascertained in hospitals of the ECLAMC network, and diagnostic changes that occurred due to detection of additional defects during a one-year follow-up period. Seven hundred ten liveborn infants with cleft lip only (CLO), cleft lip with cleft palate (CLP), or cleft palate (CP) were ascertained between 2003 and 2005. Prevalence estimates of isolated and associated clefts, diagnoses in infants with associated clefts, and the percentage of isolated clefts that were reclassified as associated were established. Birth prevalence estimates (per 1,000) were as follows: Total: 1.7; CLP: 0.94 (ASO=23.5%); CP: 0.46 (ASO=42.3%); CLO: 0.28 (ASO=7.6%). Initial diagnoses in infants with associated clefts included 38 infants with chromosomal abnormalities, 33 with non-chromosomal syndromes, 16 with malformation sequences, and 98 with multiple anomalies of unknown etiology. Seven percent of newborns initially classified as isolated were later reclassified as associated. Ten infants without associated defects or clinically suspected syndromes were diagnosed as syndromic only through laboratory findings or family history, illustrating the difference between the terms associated vs. isolated, which refers to presence or absence of associated anomalies, and syndromic vs. non-syndromic, which refers to etiology. PMID:21671378

  2. Risk and protective factors for peer victimization: a 1-year follow-up study of urban American students.

    PubMed

    Karlsson, Elisabeth; Stickley, Andrew; Lindblad, Frank; Schwab-Stone, Mary; Ruchkin, Vladislav

    2014-09-01

    This study examined whether internalizing problems, parental warmth and teacher support were associated with adolescents' experience of future peer victimization in school. Data were drawn from two rounds of the longitudinal Social and Health Assessment (SAHA). Study subjects comprised 593 US urban adolescents (aged 13.8 ± 0.8 years; 56 % female). Results showed that there was a substantial degree of continuity in peer victimization over a 1-year period. The presence of internalizing (anxiety, depressive and somatic) symptoms at baseline was associated with an increased risk of peer victimization over time. Both parental warmth and teacher support were uniquely associated with a lower risk for peer victimization. Implications of these findings for prevention efforts are discussed.

  3. Impact of screen time on mental health problems progression in youth: a 1-year follow-up study

    PubMed Central

    Wu, Xiaoyan; Tao, Shuman; Zhang, Shichen; Zhang, Yukun; Chen, Kaihua; Yang, Yajuan; Hao, Jiahu; Tao, Fangbiao

    2016-01-01

    Objectives We examined the relationships between screen time (ST) and mental health problems and also increment of ST and progression of mental health problems in a college-based sample of Chinese youth. Methods We assessed 2521 Chinese college freshmen from October 2013 to December 2014. At baseline, the mean age of participants was 18.43 years (SD 0.96 years), and 1215 (48.2%) participants reported ST >2 h/day. We estimated multivariable-adjusted ORs by using logistic regression models for the risk of developing mental health problems (anxiety, depression and psychopathological symptoms) and/or progression of these problems, according to baseline ST exposure and changes in exposure at follow-up. Results At baseline, when ST >2 h/day was compared with ST ≤2 h/day, the OR was 1.38 (95% CI 1.15 to 1.65) for anxiety, 1.55 (95% CI 1.25 to 1.93) for depression and 1.49 (95% CI 1.22 to 1.83) for psychopathological symptoms. The results remained unchanged for depressive and psychopathological symptoms but not for anxiety, after additional adjustment for sex, age, residential background, body mass index, perceived family economy, sleep quality, smoking, alcohol intake, exercise after school and physical activity. When participants who had increased their ST exposure to >2 h/day were compared with those with no change and ST ≤2 h/day, the OR was 1.78 (95% CI 1.12 to 2.83) for anxiety, 1.92 (95% CI 1.23 to 2.83) for depression and 1.93 (95% CI 1.16 to 3.21) for psychopathological symptoms. These associations also remained after additional adjustment. Conclusions The overall effects are consistent yet small for ST/ST increment on mental health problems and its progression. Given the small effect size of the current results, it remains unclear the degree to which ST is a practically significant risk factor for mental health outcomes. Future studies of high quality are necessary to further examine this association and the direction of causality. PMID:28186926

  4. Changes in Corneal Endothelial Cell after Ahmed Glaucoma Valve Implantation and Trabeculectomy: 1-Year Follow-up

    PubMed Central

    Kim, Min Su; Kim, Kyoung Nam

    2016-01-01

    Purpose To compare changes in corneal endothelial cell density (CECD) after Ahmed glaucoma valve (AGV) implantation and trabeculectomy. Methods Changes in corneal endothelium in patients that underwent AGV implantation or trabeculectomy were prospectively evaluated. Corneal specular microscopy was performed at the central cornea using a non-contact specular microscope before surgery and 6 months and 12 months after surgery. The CECD, hexagonality of the endothelial cells, and the coefficient of variation of the cell areas were compared between the two groups. Results Forty eyes of 40 patients with AGV implantation and 28 eyes of 28 patients with trabeculectomy were studied. Intraocular pressure in the AGV implantation group was significantly higher than that in the trabeculectomy group (p < 0.001), but there was no significant difference in other clinical variables between the two groups. In the AGV implantation group, the mean CECD significantly decreased by 9.4% at 6 months and 12.3% at 12 months compared with baseline values (both, p < 0.001), while it decreased by 1.9% at 6 months and 3.2% at 12 months in the trabeculectomy group (p = 0.027 and p = 0.015, respectively). The changes at 6 months and 12 months in the AGV implantation group were significantly higher than those in the trabeculectomy group (p = 0.030 and p = 0.027, respectively). In the AGV implantation group, there was a significant decrease in the CECD between baseline and 6 months and between 6 months and 12 months (p < 0.001 and p = 0.005, respectively). However, in the trabeculectomy group, a significant decrease was observed only between baseline and 6 months (p = 0.027). Conclusions Both the AGV implantation group and the trabeculectomy group showed statistically significant decreases in the CECD 1 year after surgery. The decrease in CECD in the AVG implantation group was greater and persisted longer than that in the trabeculectomy group. PMID:27980360

  5. Attribution in somatizers: stability and relationship to outcome at 1-year follow-up. Grupo Morbilidad Psiquica y Psicosomática de Zaragoza (GMPPZ).

    PubMed

    García-Campayo, J; Larrubia, J; Lobo, A; Pérez-Echeverría, M J; Campos, R

    1997-05-01

    The aim of this study was to determine whether attributional style is a stable pattern in somatizers, to analyse the sociodemographic and psychopathological characteristics that can modify it, and to study the relationship between attributional pattern and outcome. A total of 147 somatizers and 46 psychologizers from a representative sample (n = 1559) of primary care patients in Zaragoza, Spain were followed up for 1 year. Attribution of somatic symptoms was a stable construct in somatizers. Patients who modified attribution were younger (by 15 years on average), tended to be without a partner, and had a shorter illness duration (by 20 months on average) than those who maintained it. Attribution showed no correlation with outcome at the 1-year follow-up.

  6. Mortality in primary angioplasty patients starting antiplatelet therapy with prehospital prasugrel or clopidogrel: a 1-year follow-up from the European MULTIPRAC Registry

    PubMed Central

    Goldstein, Patrick; Grieco, Niccolò; Ince, Hüseyin; Danchin, Nicolas; Ramos, Yvonne; Goedicke, Jochen; Clemmensen, Peter

    2016-01-01

    Aim MULTIPRAC was designed to provide insights into the use and outcomes associated with prehospital initiation of antiplatelet therapy with either prasugrel or clopidogrel in the context of primary percutaneous coronary intervention. After a previous report on efficacy and safety outcomes during hospitalization, we report here the 1-year follow-up data, including cardiovascular (CV) mortality. Methods and results MULTIPRAC is a multinational, prospective registry of patients with ST-elevation myocardial infarction (STEMI) from 25 hospitals in nine countries, all of which had an established practice of prehospital start of dual antiplatelet therapy in place. The key outcome was CV death at 1 year. Among 2,036 patients followed-up through 1 year, 49 died (2.4%), 10 during the initial hospitalization and 39 within 1 year after hospital discharge. The primary analysis was based on the P2Y12-inhibitor, used from prehospital loading dose through hospital discharge. Prasugrel (n=824) was more commonly used than clopidogrel (n=425). The observed 1-year rates for CV death were 0.5% with prasugrel and 2.6% with clopidogrel. After adjustment for differences in baseline characteristics, treatment with prasugrel was associated with a significantly lower risk of CV death than treatment with clopidogrel (odds ratio 0.248; 95% confidence interval 0.06–0.89). Conclusion In STEMI patients from routine practice undergoing primary angioplasty, who were able to start oral antiplatelet therapy prehospital, treatment with prasugrel as compared to clopidogrel was associated with a lower risk of CV death at 1-year follow-up. PMID:27143908

  7. Follow up policy after treatment for Hodgkin's disease: too many clinic visits and routine tests? A review of hospital records.

    PubMed Central

    Radford, J. A.; Eardley, A.; Woodman, C.; Crowther, D.

    1997-01-01

    OBJECTIVE: To examine the effectiveness of routine clinic review in detecting relapse after treatment for Hodgkin's disease. DESIGN: Review of hospital records. SETTING: Regional centre for cancer treatment and research. SUBJECTS: 210 patients with Hodgkin's disease recruited to a chemotherapy trial protocol between 1984 and the end of 1990 who had achieved a complete or partial remission after treatment. MAIN OUTCOME MEASURES: The number of clinic visits made by patients over the period of observation, the number of relapses occurring during that time, and the route by which relapse was detected. RESULTS: The 210 patients generated 2512 outpatient reviews, and 37 relapses were detected. Thirty relapses (81%) were diagnosed in patients who described symptoms, which in 15 cases had resulted in an earlier appointment being arranged. In only four cases (11%; 95% confidence interval 4% to 25%) was relapse detected as a result of routine physical examination on investigation of a patient who did not have symptoms. CONCLUSIONS: Relapse of Hodgkin's disease after treatment is usually detected as a result of the investigation of symptoms rather than by routine screening of asymptomatic patients. It is therefore proposed that the frequency of routine follow up visits should be reduced and greater emphasis placed on patient education. This should underline the importance of symptoms and encourage patients to arrange an earlier appointment if these develop. PMID:9040326

  8. Counselee participation in follow-up breast cancer genetic counselling visits and associations with achievement of the preferred role, cognitive outcomes, risk perception alignment and perceived personal control.

    PubMed

    Albada, Akke; Ausems, Margreet G E M; van Dulmen, Sandra

    2014-09-01

    The purpose of the study was to assess the counselee participation in the follow-up visits, compared to the first visits, for breast cancer genetic counselling and to explore associations with counselees' achievement of their preferred role in decision making, information recall, knowledge, risk perception alignment and perceived personal control. First and follow-up visits for breast cancer genetic counselling of 96 counselees of a Dutch genetics center were videotaped (2008-2010). Counselees completed questionnaires before counselling (T1), after the follow-up visit (T2) and one year after the follow-up visit (T3). Consultations were rated with the Roter Interaction Analysis System (RIAS). Counselee participation was measured as the percentage of counselee utterances, the percentage of counselee questions and the interactivity (number of turns per minute). Follow-up visits had higher levels of counselee participation than first visits as assessed by the percentage of counselee talk, the interactivity and counselee questions. More counselee talk in the follow-up visit was related to higher achievement of the preferred role (T2) and higher perceived personal control (T3). Higher interactivity in the follow-up visit was related to lower achievement of the preferred role in decision making and lower information recall (T2). There were no significant associations with the percentage of questions asked and none of the participation measures was related to knowledge, risk perception alignment and perceived personal control (T2). In line with the interviewing admonishment 'talk less and listen more', the only assessment of counselee participation associated to better outcomes is the percentage of counselee talk. High interactivity might be associated with lower recall in breast cancer genetic counselees who are generally highly educated. However, this study was limited by a small sample size and a heterogeneous group of counselees. Research is needed on the interactions

  9. The effects of antipsychotics on weight gain, weight-related hormones and homocysteine in children and adolescents: a 1-year follow-up study.

    PubMed

    Baeza, Inmaculada; Vigo, Laura; de la Serna, Elena; Calvo-Escalona, Rosa; Merchán-Naranjo, Jessica; Rodríguez-Latorre, Pamela; Arango, Celso; Castro-Fornieles, Josefina

    2017-01-01

    To analyze weight gain, metabolic hormones, and homocysteine (Hcys) levels in children and adolescents on antipsychotics (AP) during a year-long follow-up. 117 patients, AP-naïve or quasi-naïve (less than 30 days on AP), were included. Weight, body mass index (BMI), BMI z-score (z-BMI), and levels of leptin, insulin, insulin resistance (HOMA-IR), adiponectin, ghrelin, thyroid stimulating hormone (TSH), free thyroxine (FT4), and Hcys were measured at baseline, and at 3, 6, and 12 months, while patients remained on the same AP. Patients (mean age: 14.4 ± 3 years; 64.1 % male) were on risperidone (N = 84), olanzapine (N = 20) or quetiapine (N = 13) from baseline up to 1-year follow-up and significantly increased weight (5.8 ± 4.3 kg at 3-month, 8.1 ± 6.1 kg at 6-month, and 11.6 ± 7.0 kg at 1 year), BMI, and z-BMI. Leptin levels significantly increased from baseline to 3 and 6 months, as did TSH levels from baseline to 3 months, while FT4 levels decreased from baseline to 3 and 6 months. Patients with BMI >85th percentile at baseline (N = 16) significantly increased weight, BMI, and z-BMI, more than patients with normal BMI over time. Higher baseline levels of insulin, HOMA-IR, and leptin were associated with increased weight/BMI during follow-up, while higher baseline levels of FT4, adiponectin, and ghrelin were associated with lower weight/BMI during follow-up. All AP were associated with increased weight and BMI/z-BMI in all of the assessments; however, at 1-year assessment, this increase was significantly higher for patients on quetiapine. Both higher baseline levels of insulin, HOMA-IR, and leptin, as well as being overweight/obese at baseline were associated with increased weight/BMI during 1-year follow-up in children and adolescents on AP. Awareness of weight-related parameters in this population may help inform decisions regarding AP prescriptions.

  10. Symptom load and general function among patients with erythema migrans: a prospective study with a 1-year follow-up after antibiotic treatment in Norwegian general practice

    PubMed Central

    Eliassen, Knut Eirik; Hjetland, Reidar; Reiso, Harald; Lindbæk, Morten; Tschudi-Madsen, Hedda

    2017-01-01

    Objective Promptly treated erythema migrans (EM) has good prognosis. However, some patients report persistent symptoms. Do patients with EM have more symptoms than the general population? We describe individual symptoms and general function in EM-patients at time of diagnosis and one year after treatment. Design Prospective study with 1-year follow up after treatment. Questionnaires included a modified version of the Subjective Health Complaints Inventory, comprising three additional Lyme borreliosis (LB) related symptoms. General function was assessed using a five-point scale modified from the COOP/WONCA charts. Setting Norwegian general practice. Subjects A total of 188 patients were included in a randomized controlled trial comparing three antibiotic regimens for EM, of whom 139 had complete data for this study. Main outcome measures Individual symptoms, symptom load and general function. Results Mild symptoms were common, reported by 84.9% at baseline and by 85.6% at follow-up. At baseline, patients reported a mean of 5.4 symptoms, compared with 6.2 after one year. Severely bothersome symptoms and severely impaired general function were rare. Tiredness was the most reported symptom both at baseline and at follow-up. Palsy (other than facial) was the least reported symptom, but the only one with a significant increase. However, this was not associated to the EM. Conclusion The symptom load was comparable to that reported in the general population. We found an increase in symptom load at follow-up that did not significantly affect general function. Implication: Monitoring patients’ symptom loads prior to treatment reduce the probability of attributing follow-up symptoms to LB. Key points Erythema migrans has a good prognosis.Patients treated for erythema migrans have a slight increase in symptom load one year after treatment. This increase does not affect general function. The levels of subjective health complaints in patients treated for erythema migrans are

  11. Virtual Reality–Enhanced Cognitive–Behavioral Therapy for Morbid Obesity: A Randomized Controlled Study with 1 Year Follow-Up

    PubMed Central

    Cesa, Gian Luca; Bacchetta, Monica; Castelnuovo, Gianluca; Conti, Sara; Gaggioli, Andrea; Mantovani, Fabrizia; Molinari, Enrico; Cárdenas-López, Georgina; Riva, Giuseppe

    2016-01-01

    Abstract It is well known that obesity has a multifactorial etiology, including biological, environmental, and psychological causes. For this reason, obesity treatment requires a more integrated approach than the standard behavioral treatment based on dietary and physical activity only. To test the long-term efficacy of an enhanced cognitive–behavioral therapy (CBT) of obesity, including a virtual reality (VR) module aimed at both unlocking the negative memory of the body and to modify its behavioral and emotional correlates, 163 female morbidly obese inpatients (body mass index >40) were randomly assigned to three conditions: a standard behavioral inpatient program (SBP), SBP plus standard CBT, and SBP plus VR-enhanced CBT. Patients' weight, eating behavior, and body dissatisfaction were measured at the start and upon completion of the inpatient program. Weight was assessed also at 1 year follow-up. All measures improved significantly at discharge from the inpatient program, and no significant difference was found among the conditions. However, odds ratios showed that patients in the VR condition had a greater probability of maintaining or improving weight loss at 1 year follow-up than SBP patients had (48% vs. 11%, p = 0.004) and, to a lesser extent, than CBT patients had (48% vs. 29%, p = 0.08). Indeed, only the VR-enhanced CBT was effective in further improving weight loss at 1 year follow-up. On the contrary, participants who received only the inpatient program regained back, on average, most of the weight they had lost. Findings support the hypothesis that a VR module addressing the locked negative memory of the body may enhance the long-term efficacy of standard CBT. PMID:26430819

  12. Virtual Reality-Enhanced Cognitive-Behavioral Therapy for Morbid Obesity: A Randomized Controlled Study with 1 Year Follow-Up.

    PubMed

    Manzoni, Gian Mauro; Cesa, Gian Luca; Bacchetta, Monica; Castelnuovo, Gianluca; Conti, Sara; Gaggioli, Andrea; Mantovani, Fabrizia; Molinari, Enrico; Cárdenas-López, Georgina; Riva, Giuseppe

    2016-02-01

    It is well known that obesity has a multifactorial etiology, including biological, environmental, and psychological causes. For this reason, obesity treatment requires a more integrated approach than the standard behavioral treatment based on dietary and physical activity only. To test the long-term efficacy of an enhanced cognitive-behavioral therapy (CBT) of obesity, including a virtual reality (VR) module aimed at both unlocking the negative memory of the body and to modify its behavioral and emotional correlates, 163 female morbidly obese inpatients (body mass index >40) were randomly assigned to three conditions: a standard behavioral inpatient program (SBP), SBP plus standard CBT, and SBP plus VR-enhanced CBT. Patients' weight, eating behavior, and body dissatisfaction were measured at the start and upon completion of the inpatient program. Weight was assessed also at 1 year follow-up. All measures improved significantly at discharge from the inpatient program, and no significant difference was found among the conditions. However, odds ratios showed that patients in the VR condition had a greater probability of maintaining or improving weight loss at 1 year follow-up than SBP patients had (48% vs. 11%, p = 0.004) and, to a lesser extent, than CBT patients had (48% vs. 29%, p = 0.08). Indeed, only the VR-enhanced CBT was effective in further improving weight loss at 1 year follow-up. On the contrary, participants who received only the inpatient program regained back, on average, most of the weight they had lost. Findings support the hypothesis that a VR module addressing the locked negative memory of the body may enhance the long-term efficacy of standard CBT.

  13. Clinical performance of a resin-modified glass-ionomer and two polyacid-modified resin composites in cervical lesions restorations: 1-year follow-up.

    PubMed

    Chinelatti, M A; Ramos, R P; Chimello, D T; Palma-Dibb, R G

    2004-03-01

    The aim of this study was to assess the clinical performance of a resin-modified glass-ionomer cement (Vitremer) and two polyacid-modified resin composites (F2000 and Freedom) over 1 year. Nineteen patients with at least three cervical lesions were selected, providing an initial sample size of 87 restorations (29 per material), being 78 to non-carious and nine to carious lesions. Restorations were evaluated at baseline, 6 months and 1 year after placement, using modified US Public Health Service criteria: colour match, marginal discoloration, caries, anatomical form, marginal integrity and surface texture. At baseline, restorations were considered as acceptable for all criteria. At 1-year recall, 21 restorations per material were re-examined. Freedom was rated Bravo or Charlie for all the examined criteria and Vitremer earned an Alfa rating solely for the criterion caries. On the contrary, F2000 showed the best overall results, although presenting significant alteration in colour match. Statistical analysis of data was performed using chi-square and Mc Nemar tests. As to the evaluated periods, significant difference was observed solely between baseline and 1-year recall. Freedom and Vitremer were statistically different (P < 0.01) as to anatomical form and surface texture. For F2000, significant difference (P < 0.05) was noticed as to colour match and anatomical form. After 1-year follow-up, F2000 showed the most acceptable results as to the analysed criteria.

  14. PEEK Cages versus PMMA Spacers in Anterior Cervical Discectomy: Comparison of Fusion, Subsidence, Sagittal Alignment, and Clinical Outcome with a Minimum 1-Year Follow-Up

    PubMed Central

    Krüger, Marie T.; Sircar, Ronen; Kogias, Evangelos; Scholz, Christoph; Volz, Florian; Scheiwe, Christian; Hubbe, Ulrich

    2014-01-01

    Purpose. To compare radiographic and clinical outcomes after anterior cervical discectomy in patients with cervical degenerative disc disease using PEEK cages or PMMA spacers with a minimum 1-year follow-up. Methods. Anterior cervical discectomy was performed in 107 patients in one or two levels using empty PEEK cages (51 levels), Sulcem PMMA spacers (49 levels) or Palacos PMMA spacers (41 levels) between January, 2005 and February, 2009. Bony fusion, subsidence, and sagittal alignment were retrospectively assessed in CT scans and radiographs at follow-up. Clinical outcome was measured using the VAS, NDI, and SF-36. Results. Bony fusion was assessed in 65% (PEEK cage), 57% (Sulcem), and 46% (Palacos) after a mean follow-up of 2.5 years. Mean subsidence was 2.3–2.6 mm without significant differences between the groups. The most pronounced loss of lordosis was found in PEEK cages (−4.1°). VAS was 3.1 (PEEK cage), 3.6 (Sulcem), and 2.7 (Palacos) without significant differences. Functional outcome in the PEEK cage and Palacos group was superior to the Sulcem group. Conclusions. The substitute groups showed differing fusion rates. Clinical outcome, however, appears to be generally not correlated with fusion status or subsidence. We could not specify a superior disc substitute for anterior cervical discectomy. This trial is registered with DRKS00003591. PMID:25110734

  15. Single-Center Experience and 1-Year Follow-up Results of 'Sandwich Technique' in the Management of Common Iliac Artery Aneurysms During EVAR

    SciTech Connect

    Ricci, Carmelo; Ceccherini, Claudio Cini, Marco; Vigni, Francesco; Leonini, Sara; Tommasino, Giulio; Muzzi, Luigi; Tucci, Enrico; Benvenuti, Antonio; Neri, Eugenio

    2012-10-15

    Purpose: Abdominal aortic aneurysm (AAA) accompanied by common iliac artery (CIA) aneurysms requires a more demanding procedure owing to the difficulties in obtaining an adequate distal landing zone for the stent-graft limb(s), a potential site of endoleak. The 'sandwich technique' is a procedure to increase EVAR feasibility in the setting of adverse or challenging CIA anatomy. Its main advantages include no restrictions in terms of CIA diameter or length or internal iliac artery (IIA) diameter, no need to wait for a specific stent-graft. Our purpose is to describe our single-center experience and one year follow-up results of this new procedure. Materials and Methods: From April 2009 to June 2010, the sandwich technique was performed in our institution in 7 patients treated for AAA and unilateral CIA aneurysms (n. 5) or bilateral CIA aneurysms (n. 2). Inclusion criteria were the presence of unilateral or bilateral CIA aneurysm (independently from its diameter), IIA artery measuring up to 9 mm in its maximum diameter, not dilatation of IIA and EIA. Results: The mean follow-up length was 15 months (range: 14-20 months). All stent-implanted iliac branches remained patent on 1 year follow-up and IIA flow was preserved. None of the patients had symptoms of pelvic ischemia. CT scan follow-up showed aneurysm shrinkage in five patients, without any sign of endoleaks in all cases. Conclusions: In selected cases, the 'sandwich technique' showed good outcomes confirming to be a safe and easy to perform way to overcome anatomical constraints and expanding the limits of EVAR.

  16. The Effect of Exposure to Persistent Organic Pollutants on Metabolic Health among KOREAN Children during a 1-Year Follow-Up

    PubMed Central

    Lee, Hye Ah; Park, Su Hyun; Hong, Young Sun; Ha, Eun Hee; Park, Hyesook

    2016-01-01

    Previous evidence suggests the potential for adverse effects of persistent organic pollutants (POPs) on metabolic health even at low-dose exposure levels common among the general population, but there is less evidence of these associations among children. Therefore, as part of a prospective cohort study, 214 children were measured for POPs exposure. After the 1-year follow-up, we assessed the effect of circulating POPs exposure among 158 children aged 7–9 years (at baseline) on the change of metabolic components of metabolic syndrome using multiple regression analysis. In addition, we calculated the continuous metabolic syndrome (cMetS) score and assessed the variation among individuals by POPs exposure. The concentrations of marker polychlorinated biphenyls (PCBs) were significantly associated with increased change in diastolic blood pressure (BP) and triglyceride levels during a 1-year follow-up, after controlling for sex, age, household income, and change in body mass index. Total PCBs also showed a marginal association with increasing cMetS score from the baseline. Of the metabolic components, change in diastolic BP over time showed a notable association with specific PCBs, but no association with organochlorine pesticides. Here, we found that low-dose exposures to PCBs among children in the general population could negatively influence metabolic health, particularly diastolic BP. Increased disease sensitivity during childhood can continue to adulthood, thus, these results support the need for continuous assessment of the health impact of POPs. PMID:26938545

  17. Dynamics of resilience in forced migration: a 1-year follow-up study of longitudinal associations with mental health in a conflict-affected, ethnic Muslim population

    PubMed Central

    Siriwardhana, Chesmal; Abas, Melanie; Siribaddana, Sisira; Sumathipala, Athula; Stewart, Robert

    2015-01-01

    Objective The concept of ‘resilience’ is of increasing interest in studies of mental health in populations facing adversity. However, lack of longitudinal data on the dynamics of resilience and non-usage of resilience-specific measurements have prevented a better understanding of resilience-mental health interactions. Hence, the present study was conducted to investigate the stability of levels of resilience and its associations with sociodemographic and mental health exposures in a conflict-affected internal-migrant population in Sri Lanka. Design A prospective follow-up study of 1 year. Setting Puttalam district of North Western province in postconflict Sri Lanka (baseline in 2011, follow-up in 2012). Participants An ethnic Muslim population internally displaced 20 years ago (in 1990) from Northern Sri Lanka, aged 18 or above and currently in the process of return migration. Measures It was hypothesised that levels of resilience would be associated with mental health outcomes. Resilience was measured on both occasions using the 14-item Resilience Scale (RS-14), social support by the Multidimensional Social Support Scale and Lubben Social Network Scale and common mental disorders by the Patient Health Questionnaire (PHQ). Results Of 450 participants interviewed at baseline in 2011, 338 (75.1%) were re-interviewed in 2012 after a 1-year follow-up. The mean resilience scores measured by RS-14 were 80.2 (95% CI 78.6 to 81.9) at baseline and 84.9 (83.5 to 86.3) at follow-up. At both time points, lower resilience was independently associated with food insecurity, lower social support availability and social isolation. At both time points, there were significant associations with common mental disorders (CMDs) in unadjusted analyses, but they only showed independence at baseline. The CMD prevalence, maintenance and incidence at follow-up was 8.3%, 28.2% and 2.2%, respectively. Conclusions In this displaced population facing a potential reduction in adversity

  18. Clinical and imaging predictors of 1-year and long-term mortality in light chain (AL) amyloidosis: a 5-year follow-up study.

    PubMed

    Migrino, Raymond Q; Harmann, Leanne; Christenson, Richard; Hari, Parameswaran

    2014-11-01

    Light chain amyloidosis (AL) involves multiorgan failure induced by amyloidogenic light chain proteins, and is associated with high mortality. We aimed to identify clinical, laboratory, and imaging parameters that would predict 1-year and long-term AL mortality. Forty-four biopsy-proven AL patients (61.5 ± 12 years, 20 females) underwent clinical evaluation including laboratory assays, echocardiography, and contrast cardiac magnetic resonance imaging (CMR, n = 31) prior to chemotherapy. Patients were prospectively followed for median duration of 62.7 months (interquartile range 35.5 months). Clinical and laboratory parameters were compared between 1-year survivors and nonsurvivors. Univariate Kaplan-Meier survival plots were calculated followed by stepwise logistic regression analysis to assess independent predictors of long-term survival. Eighteen (40.9 %) patients died within 1 year and an additional 10 subjects died during long-term follow-up. Patients who expired within 1 year presented with more advanced class of heart failure, higher alkaline phosphatase and uric acid, lower limb lead voltage on electrocardiography, shorter left ventricular ejection time (ET) on echocardiography, and a higher proportion of late gadolinium enhancement on CMR. On multivariable analysis, only ET ≤240 ms on echocardiography (hazard ratio (HR) 5.07, 95 % confidence interval (CI) 1.83-14.1, P = 0.002) and New York Heart Association functional class II-IV presentation (HR 1.0058, 95 % CI 1.0014-1.0103, P = 0.01) were independent predictors of AL mortality. In conclusion, AL amyloidosis is associated with high 1-year and long-term mortality. Among clinical, laboratory, and imaging parameters tested, an echocardiographic finding of ET ≤240 ms has independent and additive prognostic value to clinical heart failure evaluation in determining long-term survival of AL patients. This result may be important in the early identification of patients at risk.

  19. Further Evidence for the JuSt Program as Treatment for Insomnia in Adolescents: Results from a 1-Year Follow-Up Study

    PubMed Central

    Roeser, Karolin; Schwerdtle, Barbara; Kübler, Andrea; Schlarb, Angelika A.

    2016-01-01

    Study Objectives: Insomnia in adolescence adversely affects young people's current and future functioning, as well as their mental and physical health. Thus, effective and economic treatment is invaluable. The present study evaluated a 6-session multimodal group therapy, JuSt, for adolescents suffering from insomnia including cognitive-behavioral elements and clinical hypnosis. Methods: Participants (n = 19, 68.4% female) were aged 11–16 years and suffered from insomnia. Sleep onset latency (SOL), time spent awake time after sleep onset (WASO), and sleep efficiency (SE) were measured with sleep logs before and after treatment, and at 3-, 6-, and 12-month follow-up. Results: Compared to baseline, SOL and WASO significantly decreased, while there was a significant increase in SE and the feeling of being rested after the JuSt treatment. At 12-month follow-up, all parameters were still significantly different from their baseline level. The long-term effect sizes were at least as large as the short-term effects, indicating a stable improvement. Conclusions: These results suggest that the JuSt program represents a potent intervention to sustainably reduce insomniac complaints in adolescents. Given the unselected nature of our sample, a broad indication can be assumed. To further evaluate the program's efficacy, randomized controlled trials should be conducted. Citation: Roeser K, Schwerdtle B, Kübler A, Schlarb AA. Further evidence for the just program as treatment for insomnia in adolescents: results from a 1-year follow-up study. J Clin Sleep Med 2016;12(2):257–262. PMID:26446249

  20. Salter-Harris type III and IV displaced fracture of the hallux in young gymnasts: A series of four cases at 1-year follow-up.

    PubMed

    Perugia, Dario; Fabbri, Mattia; Guidi, Marco; Lepri, Marco; Masi, Vincenzo

    2014-12-01

    The purpose of this study was to describe four exceptional cases of Salter-Harris type III and IV fractures of the proximal phalanx of the hallux in young high-level gymnasts. All gymnasts underwent the same mechanism of injury of hyperadduction, which indicates a role of the abductor hallucis muscle in the genesis and displacement of these fractures. An open reduction and internal fixation was performed to achieve an anatomical reduction and avoid chronic disability. At 1-year follow-up, all patients had an excellent American Orthopaedic Foot and Ankle Society (AOFAS) score (100 points), and there was no shortening or angulation of the first ray and no evidence of degenerative joint disease on X-ray. Moreover, all the gymnasts had returned to pre-injury levels of sporting activity. To our knowledge, there are no previous studies that address these types of injuries and how they are handled in gymnasts.

  1. Pretreatment clinical and psychosocial predictors of remission from depression after short-term psychodynamic psychotherapy and solution-focused therapy: a 1-year follow-up study.

    PubMed

    Marttunen, Mauri; Valikoski, Maarit; Lindfors, Olavi; Laaksonen, Maarit A; Knekt, Paul

    2008-03-01

    The mutual importance of different predictors of remission was studied in 163 outpatients with depression receiving either short-term psychodynamic psychotherapy or solution-focused therapy. After a 1-year follow-up, the percentage of remission significantly varied between sociodemographic subgroups and was dependent on severity of symptoms, personality disorder, and psychosocial factors but not on psychiatric history, previous psychiatric treatment, or type of therapy received. Simultaneous study showed that the most significant predictors were sense of coherence (based on Sense of Coherence Scale [SOCS]), symptom severity (based on Symptom Checklist-90 [SCL-90] Global Severity Index [GSI]), and education. The relative risks of remission between the lowest and highest quartiles of SOCS and SCL-90 GSI were 0.06 and 0.22 (95% confidence intervals = 0.01-0.35 and 0.05-0.97), respectively. In conclusion, several background factors, especially sense of coherence, predict remission.

  2. Comparing the predictive accuracy of frailty, comorbidity, and disability for mortality: a 1-year follow-up in patients hospitalized in geriatric wards

    PubMed Central

    Ritt, Martin; Ritt, Julia Isabel; Sieber, Cornel Christian; Gaßmann, Karl-Günter

    2017-01-01

    Background Studies evaluating and comparing the power of frailty, comorbidity, and disability instruments, together and in parallel, for predicting mortality are limited. Objective This study aimed to evaluate and compare the measures of frailty, comorbidity, and disability in predicting 1-year mortality in geriatric inpatients. Design Prospective cohort study. Patients and setting A total of 307 inpatients aged ≥65 years in geriatric wards of a general hospital participated in the study. Measurements The patients were evaluated in relation to different frailty, comorbidity, and disability instruments during their hospital stays. These included three frailty (the seven-category Clinical Frailty Scale [CFS-7], a 41-item frailty index [FI], and the FRAIL scale), two comorbidity (the Cumulative Illness Rating Scale for Geriatrics [CIRS-G] and the comorbidity domain of the FI [Comorbidity-D-FI]), and two disability instruments (disability in basic activities of daily living [ADL-Katz] and the instrumental and basic activities of daily living domains of the FI [IADL/ADL-D-FI]). The patients were followed-up over 1 year. Results Using FI, CIRS-G, Comorbidity-D-FI, and ADL-Katz, this study identified a patient group with a high (≥50%) 1-year mortality rate in all of the patients and the two patient subgroups (ie, patients aged 65–82 years and ≥83 years). The CFS-7, FI, FRAIL scale, CIRS-G, Comorbidity-D-FI, and IADL/ADL-D-FI (analyzed as full scales) revealed useful discriminative accuracy for 1-year mortality (ie, an area under the curve >0.7) in all the patients and the two patient subgroups (all P<0.001). Thereby, CFS-7 (in all patients and the two patient subgroups) and FI (in the subgroup of patients aged ≥83 years) showed greater discriminative accuracy for 1-year mortality compared to other instruments (all P<0.05). Conclusion All the different instruments emerged as suitable tools for risk stratification in geriatric inpatients. Among them, CFS-7, and in

  3. Adolescents in mental health crisis: the role of routine follow-up calls after emergency department visits.

    PubMed

    Hopper, S M; Pangestu, I; Cations, J; Stewart, C; Sharwood, L N; Babl, F E

    2011-02-01

    To improve care of adolescents in mental health crisis, the role of routine follow-up calls in discharged patients with referral plans after emergency department (ED) presentation to a children's hospital was explored. Main outcome measure was patient attendance at referral sites. In 113 mental health patients with follow-up appointments, either patient/carers or corresponding referral services could be contacted. Median age was 14 years, 77% were girls, and most presentations were after self-harm/depression (61%). Eighty-three per cent (95% CI 75% to 90%) were compliant with the discharge plan without prompting from the ED staff. Fourteen per cent (95% CI 8% to 22%) did not comply after being called by ED staff, and only 3% (95% CI 1% to 7%) were persuaded to attend their outpatient care after being prompted by ED staff. Routine follow-up calls for adolescent mental health patients after ED care are not warranted in all settings.

  4. Relationship between distal radius fracture malunion and arm-related disability: A prospective population-based cohort study with 1-year follow-up

    PubMed Central

    2011-01-01

    Background Distal radius fracture is a common injury and may result in substantial dysfunction and pain. The purpose was to investigate the relationship between distal radius fracture malunion and arm-related disability. Methods The prospective population-based cohort study included 143 consecutive patients above 18 years with an acute distal radius fracture treated with closed reduction and either cast (55 patients) or external and/or percutaneous pin fixation (88 patients). The patients were evaluated with the disabilities of the arm, shoulder and hand (DASH) questionnaire at baseline (concerning disabilities before fracture) and one year after fracture. The 1-year follow-up included the SF-12 health status questionnaire and clinical and radiographic examinations. Patients were classified into three hypothesized severity categories based on fracture malunion; no malunion, malunion involving either dorsal tilt (>10 degrees) or ulnar variance (≥1 mm), and combined malunion involving both dorsal tilt and ulnar variance. Multivariate regression analyses were performed to determine the relationship between the 1-year DASH score and malunion and the relative risk (RR) of obtaining DASH score ≥15 and the number needed to harm (NNH) were calculated. Results The mean DASH score at one year after fracture was significantly higher by a minimum of 10 points with each malunion severity category. The RR for persistent disability was 2.5 if the fracture healed with malunion involving either dorsal tilt or ulnar variance and 3.7 if the fracture healed with combined malunion. The NNH was 2.5 (95% CI 1.8-5.4). Malunion had a statistically significant relationship with worse SF-12 score (physical health) and grip strength. Conclusion Malunion after distal radius fracture was associated with higher arm-related disability regardless of age. PMID:21232088

  5. A 1-year follow-up study exploring the associations between perception of illness and health-related quality of life in persons with chronic obstructive pulmonary disease.

    PubMed

    Bonsaksen, Tore; Haukeland-Parker, Stacey; Lerdal, Anners; Fagermoen, May Solveig

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disease with an increasing prevalence worldwide. Its potential consequences, including reduced function and reduced social participation, are likely to be associated with decreased health-related quality of life (HRQoL). However, illness perceptions and self-efficacy beliefs may also play a part in determining HRQoL in persons with COPD. The aim of this study was to explore the relationships between illness perceptions, self-efficacy, and HRQoL in a sample of persons with COPD in a longitudinal perspective. The context of the study was a patient education course from which the participants were recruited. Data concerning sociodemographic variables, social support, physical activity, illness perceptions, general self-efficacy, and HRQoL were collected before the course started and 1 year after completion. Linear regression was used in the analyses. The results showed that less consequences and less symptoms (identity) were associated with higher physical HRQoL (PCS) at baseline and at 1-year follow-up. Less emotional response was similarly associated with higher mental HRQoL (MCS) at both time points. Lower self-efficacy showed a borderline significant association with higher PCS at baseline, but was unrelated to MCS at both time points. Self-efficacy showed no influence on the associations between illness perceptions and HRQoL. In conclusion, the study showed that specific illness perceptions had a stable ability to predict HRQoL in persons with COPD, whereas self-efficacy did not. The associations between illness perceptions and HRQoL were not mediated by self-efficacy.

  6. Sacral Reconstruction with a 3D-Printed Implant after Hemisacrectomy in a Patient with Sacral Osteosarcoma: 1-Year Follow-Up Result

    PubMed Central

    Kim, Doyoung; Lim, Jun-Young; Shim, Kyu-Won; Han, Jung Woo; Yi, Seong; Yoon, Do Heum; Kim, Keung Nyun; Ha, Yoon; Ji, Gyu Yeul

    2017-01-01

    Pelvic reconstruction after sacral resection is challenging in terms of anatomical complexity, excessive loadbearing, and wide defects. Nevertheless, the technological development of 3D-printed implants enables us to overcome these difficulties. Here, we present a case of sacral osteosarcoma surgically treated with hemisacrectomy and sacral reconstruction using a 3D-printed implant. The implant was printed as a customized titanium prosthesis from a 3D real-sized reconstruction of a patient's CT images. It consisted mostly of a porous mesh and incorporated a dense strut. After 3-months of neoadjuvant chemotherapy, the patient underwent hemisacretomy with preservation of contralateral sacral nerves. The implant was anatomically installed on the defect and fixed with a screw-rod system up to the level of L3. Postoperative pain was significantly low and the patient recovered sufficiently to walk as early as 2 weeks postoperatively. The patient showed left-side foot drop only, without loss of sphincter function. In 1-year follow-up CT, excellent bony fusion was noticed. To our knowledge, this is the first report of a case of hemisacral reconstruction using a custom-made 3D-printed implant. We believe that this technique can be applied to spinal reconstructions after a partial or complete spondylectomy in a wide variety of spinal diseases. PMID:28120579

  7. Sacral Reconstruction with a 3D-Printed Implant after Hemisacrectomy in a Patient with Sacral Osteosarcoma: 1-Year Follow-Up Result.

    PubMed

    Kim, Doyoung; Lim, Jun Young; Shim, Kyu Won; Han, Jung Woo; Yi, Seong; Yoon, Do Heum; Kim, Keung Nyun; Ha, Yoon; Ji, Gyu Yeul; Shin, Dong Ah

    2017-03-01

    Pelvic reconstruction after sacral resection is challenging in terms of anatomical complexity, excessive loadbearing, and wide defects. Nevertheless, the technological development of 3D-printed implants enables us to overcome these difficulties. Here, we present a case of sacral osteosarcoma surgically treated with hemisacrectomy and sacral reconstruction using a 3D-printed implant. The implant was printed as a customized titanium prosthesis from a 3D real-sized reconstruction of a patient's CT images. It consisted mostly of a porous mesh and incorporated a dense strut. After 3-months of neoadjuvant chemotherapy, the patient underwent hemisacretomy with preservation of contralateral sacral nerves. The implant was anatomically installed on the defect and fixed with a screw-rod system up to the level of L3. Postoperative pain was significantly low and the patient recovered sufficiently to walk as early as 2 weeks postoperatively. The patient showed left-side foot drop only, without loss of sphincter function. In 1-year follow-up CT, excellent bony fusion was noticed. To our knowledge, this is the first report of a case of hemisacral reconstruction using a custom-made 3D-printed implant. We believe that this technique can be applied to spinal reconstructions after a partial or complete spondylectomy in a wide variety of spinal diseases.

  8. Effects of one-month continuous passive motion after arthroscopic rotator cuff repair: results at 1-year follow-up of a prospective randomized study.

    PubMed

    Garofalo, Raffaele; Conti, Marco; Notarnicola, Angela; Maradei, Leonardo; Giardella, Antonio; Castagna, Alessandro

    2010-05-01

    The study included 100 patients who underwent an arthroscopic rotator cuff repair. All patients suffered about a rotator cuff tear that was repaired arthroscopically with a suture anchor technique. Immediately postoperatively, patients were randomly allocated to one of two different postoperative physiotherapy regimens: passive self-assisted range of motion exercise (controls: 46 patients) versus passive self-assisted range of motion exercise associated with use of continuous passive motion (CPM) for a total of 2 h per day (experimental group: 54 patients), for 4 weeks. After this time, all the patients of both groups underwent the same physical therapy protocol. An independent examiner assessed the patients at 2.5, 6 and 12 months particularly about pain with the VAS scale (0-10) and the range of motion (ROM). Our findings show that postoperative treatment of an arthroscopic rotator cuff repair with passive self-assisted exercises associated with 2-h CPM a day provides a significant advantage in terms of ROM improvement and pain relief when compared to passive self-assisted exercise alone, at the short-term follow-up. No significant differences between the two groups were observed at 1 year postoperatively.

  9. Outcome of venous stenting following catheter directed thrombolysis for acute proximal lower limb venous thrombosis: a prospective study with venous Doppler follow-up at 1-year.

    PubMed

    Srinivas, B C; Patra, Soumya; Reddy, Babu; Nagesh, C M; Agarwal, Naveen; Manjunath, C N

    2015-10-01

    Functional outcome of venous stent placement for the management of acute iliofemoral deep vein thrombosis (DVT) following catheter-directed thrombolysis (CDT), remain undefined. The purpose of this study was to assess immediate and intermediate term outcomes among patients treated with venous stenting following CDT in patients with proximal lower limb DVT. Thirty consecutive patients aged between 20-70 years with proximal lower limb DVT formed the study group. The mean duration of CDT done with streptokinase was 4.5 ± 1.3 days. Patients with residual venous obstruction and/or large clot burden were treated further with venous angioplasty and/or stenting. Primary endpoint was to evaluate the safety, efficacy and patency of venous stenting in the management of incomplete result following CDT. After 12 months, post-thrombotic syndrome (PTS) was assessed clinically using Villalta scale and deep venous patency was assessed through duplex ultrasound. We studied 8 (5 female and 3 male) patients with 9 (3 left and 6 right) limb involvement and 13 stent (4 balloon expandable and 9 self expandable) placement. All patients improved clinically immediately following venous stenting. Technical success was achieved in all patients. One patient developed pulmonary embolism during course of hospital stay. One patient had stent thrombosis and PTS and another patient died due to carcinoma breast during follow-up. Deep venous stenting is an effective mode of treatment in proximal acute lower limb DVT with high late patency rate up to 1-year.

  10. A practice-based study on stepwise excavation of deep carious lesions in permanent teeth: a 1-year follow-up study.

    PubMed

    Bjørndal, L; Thylstrup, A

    1998-04-01

    This study reports results from a practice-based study in which deep carious lesions were treated by general dental practitioners using stepwise excavation. The material comprised 94 teeth with deep carious lesions which the clinicians considered would result in pulp perforation if treated by a single and terminal excavation. At the first visit excavation of the peripheral dentine was completed. The outermost part of the central and necrotic dentine was gently removed with a sharp excavator. Standardized assessments of the dentine colour and consistency were made before application of a calcium hydroxide-containing base material and temporary filling. The final excavation was completed after a treatment interval ranging from 2 to 19 months, with a median of 6 months. Reassessments of the dentine colour and consistency were made before complete removal of demineralized dentine. The central dentine was significantly browner and less softened after the sealing period. After removal of the dark-brownish dentine during the final excavation, the colour and consistency of the exposed central dentine was found to resemble that of the completely excavated peripheral dentine. Only five cases resulted in pulp perforation during the final excavation. The high success rate of teeth surviving the final treatment without pulp exposure after 1 year of observation shows that it was possible for dentists in general practice to administer and manage the treatment of deep carious lesions, a process which may prolong tooth survival compared with conventional endodontic techniques.

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

    PubMed Central

    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. Time to lack of persistence with pharmacological treatment among patients with current depressive episodes: a natural study with 1-year follow-up

    PubMed Central

    Li, Kanglai; Wei, Qinling; Li, Guanying; He, Xiangjun; Liao, Yingtao; Gan, Zhaoyu

    2016-01-01

    Introduction Medication nonadherence remains a big challenge for depressive patients. This study aims to assess and compare the medication persistence between unipolar depression (UD) and bipolar depression (BD). Methods A total of 146 UD and 187 BD patients were recruited at their first index prescription. Time to lack of persistence with pharmacological treatment (defined as a gap of at least 60 days without taking any medication) was calculated, and clinical characteristics were collected. Final diagnosis was made at the end of 1-year follow-up. Results A total of 101 (69.2%) UD and 126 (67.4%) BD patients discontinued the treatment, with a median duration of 36 days and 27 days, respectively. No significant difference was found between UD and BD in terms of time to lack of persistence with pharmacological treatment. The highest discontinuation rate (>40%) occurred in the first 3 months for both groups of patients. For UD patients, those with a higher risk of suicide (odds ratio [OR] =0.696, P=0.035) or comorbidity of any anxiety disorder (OR =0.159, P<0.001) were less likely to prematurely drop out (drop out within the first 3 months), while those with onset in the summer (OR =4.702, P=0.049) or autumn (OR =7.690, P=0.012) were more likely to prematurely drop out than those with onset in the spring (OR =0.159, P<0.001). For BD patients, being female (OR =2.250, P=0.012) and having a history of spontaneous remission or switch to hypomania (OR =2.470, P=0.004) were risk factors for premature drop out, while hospitalization (OR =0.304, P=0.023) and misdiagnosis as UD (OR =0.283, P<0.001) at the first index prescription were protective factors. Limitation Conservative definition of nonadherence, low representativeness of sample. Conclusion Treatment discontinuation was frequently seen in patients with UD or BD, especially in the first 3 months of treatment. In spite of the similar pattern of medication persistence, UD and BD differ from each other in predictors of

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

    PubMed Central

    Nishizawa, Kazuya; Nakamura, Akira; Imai, Shinji

    2016-01-01

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

  14. Clinical evaluation of ultrasound screening in follow-up visits of infants with cerebral palsy at high risk for developmental dysplasia of the hip

    PubMed Central

    Qiu, Aizhen; Yang, Zhongxiu; Wang, Jiping; Wang, Taotao

    2016-01-01

    The aim of the study was to assess the clinical value of ultrasound screenings for the developmental dysplasia of the hip (DDH) and explore its etiology in high-risk infants with cerebral palsy in follow-up visits. A group of 98 cases of infants at high-risk of cerebral palsy who received rehabilitation treatment between July, 2009 and July, 2010 were selected. Infants included 58 men and 40 women, aged <6 months and not lost to follow-up visits. Ultrasound (using Graf static inspection) screening of hips was performed and the infants with abnormalities were given clinical intervention, and 1- to 2-year-old infants were given outpatient follow-ups. The results were analyzed and there were 40 abnormal cases among the 98 cases of infants at high risk of cerebral palsy, including 18 cases of unstable hip joint, and 22 cases of DDH (12 cases of hip dysplasia, 3 cases of hip subluxation and 7 cases of hip dislocation). Early clinical intervention for infants with hip dysplasia and outpatient follow up for infants aged 1–2 years was carried out and had ischemic necrosis of femoral head, with the exception of 1 case of femoral detorsion that was poorly restored. In conclusion, the probability of DDH was higher in infants at high-risk of cerebral palsy compared to the normal infants. Hip ultrasound is a safe, simple, and effective screening method for these infants, which is of great clinical significance for an earlier diagnosis and treatment of DDH in infants with cerebral palsy. PMID:27698744

  15. Coil therapy for patients with severe emphysema and bilateral incomplete fissures – effectiveness and complications after 1-year follow-up: a single-center experience

    PubMed Central

    Kontogianni, Konstantina; Gerovasili, Vasiliki; Gompelmann, Daniela; Schuhmann, Maren; Hoffmann, Hans; Heussel, Claus Peter; Herth, Felix JF; Eberhardt, Ralf

    2017-01-01

    Background Lung volume reduction coil (LVRC) treatment is established in daily endoscopic lung volume reduction routine. The aim of this study was to evaluate the safety and efficacy of LVRC treatment. Patients and methods This was a retrospective analysis of 86 patients (male/female: 40/46, mean age: 64±7 years) with severe COPD and bilateral incomplete fissures. A total of 10 coils were unilaterally implanted in a single lobe, and 28 out of 86 patients were treated bilaterally. At 90-, 180-, and 365-day follow-up, changes in pulmonary function test (PFT), 6-minute walk test (6MWT) and modified Medical Research Council (mMRC) dyspnea scale, as well as possible complications, were recorded. Results At 90 days, the forced expiratory volume in 1 second did improve (P<0.001), but the improvement was not sustained at the 180- and 365-day follow-up (baseline: 0.71±0.21 vs 0.77±0.23 vs 0.73±0.22 vs 0.70±0.18 L). Both vital capacity and residual volume improved significantly (P<0.001) at the 90- and 180-day follow-up, but the improvement was lost after 365 days. Total lung capacity decreased at the 90-day follow-up but returned to baseline values at the 180- and 365-day follow-up. 6MWT (P=0.01) and mMRC (P=0.007) also improved at 90 and 180 days (Δ6MWT of 31±54 and 20±60 m, respectively), but the improvement was also lost at the 365-day follow-up. No significant further improvement was evident at any point in the follow-up after the second procedure. A total of 4 out of 86 patients passed away due to complications. Significant complications in the first 3 months and then at 12 months included the following: severe hemoptysis in 4 (3.5%) and 4 (3.5%) patients, pneumonia requiring hospitalization in 32 (28.1%) and 9 (7.9%) patients and pneumothorax in 7 (6.1%) and 2 (1.7%) patients, respectively. Milder adverse events included self-limited hemoptysis, pneumonias, or COPD exacerbations treated orally. Conclusion LVRC improved PFT, 6MWT and mMRC initially, but the

  16. Low Compliance in a Health-Conscience Spending Era Likely Helps Obviates the Need for 6 month BI-RADS 3 Breast MRI Follow-up After 1 year.

    PubMed

    Mosier, Andrew; Gupta, Esha; Ataya, Dana; Bhatt, Kavita; Rim, Alice

    2017-03-01

    The goal of our IRB-approved study was to assess if a follow-up MRI every 6 months for 2 years is the most appropriate short-interval follow-up schedule. 203 breast MRI exams were performed from October 2009 to January 2014 as part of a BI-RADS 3 follow-up representing 2.6% of all breast MRIs (7,822) performed. We performed a retrospective longitudinal medical records review of compliance; malignancy rate of BI-RADS 3 exams; and average time and number of breast MRIs necessary prior to definitive disposition. While 77.8% eventually returned, only 45.5% of patients were compliant with follow-up at or near 6 months (4.5-7.5 months). Of those who eventually returned, it took an average of 1.31 follow-up MRIs (95% CI: 1.20-1.43 exams) and 10.3 months (95% CI: 9.0-11.7 months) before definitive disposition. 93.5% of initial findings were dispositioned as benign after two follow-up MRI exams (malignancy rate: 0.98%). Our results lend support to the possibility that the follow-up interval for BI-RADS 3 breast MRIs could be lengthened to 12 months if additional follow-up MRIs are necessary after the first year of 6-month follow-up breast MRIs. Foremost, this appears to be a safe follow-up alternative since benign definitive disposition can usually be made in less than 1 year. Supplemental reasons include persistent low-patient compliance (as redemonstrated in our study) and the higher cost of breast MRI compared to mammogram/ultrasound follow-up. Finally, this paper's findings further support the suggested MRI follow-up interval in the newest BI-RADS atlas.

  17. Significance of Cardiac Rehabilitation on Visit-to-Visit Variability of Blood Pressure in Patients With Cardiovascular Disease in a 12-Month Follow-Up

    PubMed Central

    Ishida, Toshihisa; Miura, Shin-ichiro; Fujimi, Kanta; Futami, Makito; Ueda, Yoko; Ueda, Takashi; Arimura, Tadaaki; Koyoshi, Rie; Shiga, Yuhei; Kitajima, Ken; Saku, Keijiro

    2017-01-01

    Background Visit-to-visit variability (VVV) in blood pressure (BP) has been shown to be a strong predictor of cardiovascular disease (CVD). However, the long-term effect of comprehensive cardiac rehabilitation (CR) with exercise training on VVV in BP has not yet been established. Therefore, we evaluated the long-term effects of CR on VVV in BP in patients with CVD. Methods Twenty-two CVD patients in a 12-month CR program who had at least six clinic visits per month to measure BP were enrolled. We determined VVV in BP expressed as the standard deviation of average BP every month for 12 months. Results The mean age was 70 ± 8 years and the body mass index was 24.4 ± 4.9 kg/m2. In addition, the percentage (%) of males, % heart failure and % ischemic heart disease were 77%, 55% and 27%, respectively. Patients who had uncontrolled BP at baseline showed a significant reduction of both systolic BP (SBP) and diastolic BP (DBP). VVV in SBP in the first month was significantly less than that in the last month, although there was no difference in VVV in DBP. Patients were divided into larger (L-) and smaller (S-) VVV in SBP groups according to the average value of VVV in SBP as a cut-off. The L-VVV in SBP group, but not the S-VVV in SBP group, showed a significant reduction of VVV in SBP. Conclusion Comprehensive CR may improve VVV in SBP in CVD patients who have larger VVV in SBP. PMID:28270895

  18. Marine n-3 polyunsaturated fatty acids affect the blood pressure control in patients with newly diagnosed hypertension - a 1-year follow-up study.

    PubMed

    Bagge, Carina N; Strandhave, Charlotte; Skov, Charlotte M; Svensson, My; Schmidt, Erik B; Christensen, Jeppe H

    2017-02-28

    Marine long-chained n-3 polyunsaturated fatty acids (PUFA) are recognized for their cardio-protective effects, including potential lowering of blood pressure. We hypothesized that higher habitual fish intake and n-3 PUFA plasma levels were associated with lower blood pressure and being less likely to receive antihypertensive medication after one-year follow-up. In this prospective study of 115 patients, we assessed 24 h ambulatory and central blood pressure, plasma phospholipid fatty acid composition using gas chromatography and participants completed a food frequency questionnaire, including fish-eating habits. All measurements were repeated at one-year follow-up. At baseline, patients consuming fish ≥2 times per month for dinner had significantly higher plasma levels of total marine n-3 PUFA, docosahexaenoic acid and eicosapentaenoic acid as well as significantly lower central blood pressure and a trend towards lower peripheral blood pressure. At follow-up, 21 patients (18%) without antihypertensive medication had significantly higher plasma levels of n-3 PUFA, docosahexaenoic acid and eicosapentaenoic acid as well as a higher, but still acceptable 24 h ambulatory blood pressure (137/85 mmHg) compared to subjects receiving antihypertensive medication. The untreated group was more prone to take fish oil capsules and increased their plasma levels of n-3 PUFA compared to baseline. In patients with newly diagnosed, untreated hypertension, regular fish consumption was accompanied by lower blood pressure. After one year, patients without antihypertensive medication were characterized by a significant increase and higher plasma levels of n-3 PUFA. This supports a blood pressure-lowering effect and suggests an increase in marine n-3 PUFA intake as part of non-pharmacological treatment of hypertension.

  19. Self-labelling and stigma as predictors of attitudes towards help-seeking among people at risk of psychosis: 1-year follow-up.

    PubMed

    Xu, Ziyan; Müller, Mario; Heekeren, Karsten; Theodoridou, Anastasia; Dvorsky, Diane; Metzler, Sibylle; Brabban, Alison; Corrigan, Patrick W; Walitza, Susanne; Rössler, Wulf; Rüsch, Nicolas

    2016-02-01

    Mental health service use is helpful but rare among young people at risk of psychosis. The label and stigma associated with mental illness may affect attitudes towards help-seeking. We examined 67 individuals at risk of psychosis over the course of 1 year. An increase of self-labelling as "mentally ill" predicted more positive attitudes towards psychiatric medication, while increased perceived stigma and the cognitive appraisal of stigma as a stressor predicted poorer attitudes towards psychotherapy after 1 year. Early intervention could improve non-stigmatizing awareness of at-risk mental state and reduce the public stigma associated with at-risk status to facilitate help-seeking.

  20. Cognitive therapy for autogenous and reactive obsessions: clinical and cognitive outcomes at post-treatment and 1-year follow-up.

    PubMed

    Belloch, Amparo; Cabedo, Elena; Carrió, Carmen; Larsson, Christina

    2010-08-01

    This study provides data about the differential effectiveness of cognitive therapy (CT) for obsessive-compulsive disorder (OCD) symptom presentation. Two OCD manifestations, autogenous and reactive, are considered. Seventy OCD patients started CT; 81.40% completed it and 72.85% were available 1 year later. Fifteen of the 57 treatment completers had autogenous obsessions, whereas 33 had reactive obsessions. Nine patients had both obsession modalities. Reactive patients were more severe, as they scored higher on thought suppression and on the dysfunctional beliefs of intolerance to uncertainty and perfectionism. Autogenous patients scored higher on the over-importance of thoughts beliefs. Although CT was effective in reducing OCD severity and the ascription to dysfunctional beliefs and neutralizing strategies in both the autogenous and the reactive patients, a significantly better outcome was observed for the autogenous patients, both at post-treatment (with 73.33% recovering versus 33.33% for reactives) and 1 year later.

  1. Behcet's disease presenting with sudden-onset paraplegia due to anterior spinal artery involvement: 1-year follow-up of rehabilitation in conjunction with medication.

    PubMed

    Duman, Iltekin; Guzelkucuk, Umut; Tezel, Kutay; Aydemir, Koray; Yılmaz, Bilge

    2013-06-01

    A 26-year-old male patient with sudden-onset paraplegia was presented. Clinical and imaging evaluation revealed isolated spinal cord lesions at thoracal levels and anterior spinal arterial involvement. Diagnosis of Behcet's disease was established with associating clinical findings with medical history. Vigorous medication and rehabilitation program were performed. Through the 1-year rehabilitation period in conjunction with medication, strength and functions improved gradually. A satisfactory functional gain as a rehabilitative goal in independence in activities of daily living and long-distance ambulation achieved around 4 months. The patient reached full independence after 1-year. As conclusion, Behcet's disease can present with sudden-onset paraplegia. In case of no evident etiology for paraplegia in young male, neuro-Behcet's disease also should be kept in mind. Contrary to assumption, early aggressive treatment and continuous rehabilitation in conjunction with medication might provide good prognosis with excellent clinical outcome in spinal cord involvement. Satisfactory functional recovery should be expected only after 3-4 months, and complete independence can be achieved after 1 year.

  2. Neurobiological stress responses predict aggression in boys with oppositional defiant disorder/conduct disorder: a 1-year follow-up intervention study.

    PubMed

    Schoorl, Jantiene; van Rijn, Sophie; de Wied, Minet; van Goozen, Stephanie H M; Swaab, Hanna

    2017-02-08

    To improve outcome for children with antisocial and aggressive behavior, it is important to know which individual characteristics contribute to reductions in problem behavior. The predictive value of a parent training (Parent Management Training Oregon; PMTO), parenting practices (monitoring, discipline, and punishment), and child neurobiological function (heart rate, cortisol) on the course of aggression was investigated. 64 boys with oppositional defiant disorder or conduct disorder (8-12 years) participated; parents of 22 boys took part in PMTO. All data were collected before the start of the PMTO, and aggression ratings were collected three times, before PMTO, and at 6 and 12 month follow-up. Parent training predicted a decline in aggression at 6 and 12 months. Child neurobiological variables, i.e., higher cortisol stress reactivity and better cortisol recovery, also predicted a decline in aggression at 6 and 12 months. Heart rate and parenting practices were not related to the course of aggression. These results indicate that child neurobiological factors can predict persistence or reduction of aggression in boys with ODD/CD, and have unique prognostic value on top of the parent training effects.

  3. Handgrip strength, quadriceps muscle power, and optimal shortening velocity roles in maintaining functional abilities in older adults living in a long-term care home: a 1-year follow-up study

    PubMed Central

    Kozicka, Izabela; Kostka, Tomasz

    2016-01-01

    Purpose To assess the relative role of handgrip strength (HGS), quadriceps muscle power (Pmax), and optimal shortening velocity (υopt) in maintaining functional abilities (FAs) in older adults living in a long-term care home over a 1-year follow-up. Subjects and methods Forty-one inactive older institutionalized adults aged 69.8±9.0 years participated in this study. HGS, Pmax, υopt, cognitive function using the Mini-Mental State Examination, depressive symptoms using the Geriatric Depression Scale, nutritional status using the Mini Nutritional Assessment (MNA), and physical activity (PA) using the Seven-Day Physical Activity Recall Questionnaire were assessed at baseline and at 1-year follow-up. FAs were assessed with activities of daily living (ADL), instrumental ADL, and Timed Up & Go test. Results Both at baseline and at follow-up, FAs were related to age, HGS, Pmax/kg, υopt, MNA, and PA. These associations were generally similar in both sexes. As revealed in multiple regression analysis, υopt was the strongest predictor of FA, followed by Pmax/kg, PA, and MNA. FA deteriorated after 1 year as measured by ADL and Timed Up & Go test. Pmax and υopt, but not HGS, also decreased significantly after 1 year. Nevertheless, 1-year changes in FAs were not related to changes in HGS, Pmax, υopt, or PA. Conclusion The 1-year period of physical inactivity among older institutionalized adults was found to have a negative effect on their FAs, Pmax, and υopt. The present study demonstrates that Pmax and, especially, υopt correlated with FAs of older adults more than HGS, both at baseline and at follow-up. Despite this, 1-year natural fluctuations of PA, Pmax, and υopt are not significant enough to influence FAs in inactive institutionalized older adults. PMID:27307720

  4. Free thyroxine levels are associated with cognitive changes in individuals with a first episode of psychosis: A prospective 1-year follow-up study.

    PubMed

    Labad, J; Barbero, J D; Gutiérrez-Zotes, A; Montalvo, I; Creus, M; Cabezas, Á; Solé, M; Algora, M J; Garcia-Parés, G; Vilella, E

    2016-03-01

    The results of previous cross-sectional studies suggest that free thyroxine (FT4) levels are associated with cognitive abilities (particularly attention/vigilance) during the early stages of psychosis. We aimed to explore whether hypothalamic-pituitary-thyroid hormones predict cognitive changes in a 1-year longitudinal study following first episodes of psychosis (FEP). We studied 36 FEP patients and a control group of 50 healthy subjects (HS). Plasma levels of thyroid-stimulating hormone (TSH) and FT4 were measured. Cognitive assessment was performed with the MATRICS Cognitive Consensus Cognitive Battery (MCCB). FEP patients were assessed twice (baseline and after 1year), whereas HS were assessed only once. We compared cognitive changes at 1year between three groups based on baseline FT4 levels: 1) lowest quartile (Q1, FT4<1.16ng/dL); 2) medium quartiles (Q2-Q3, FT4 1.16-1.54ng/dL); and 3) highest quartile (Q4, FT4>1.54ng/dL). No differences in TSH or FT4 levels were found between HS and FEP patients. All participants had FT4 levels within the normal range. HS outperformed FEP patients in all cognitive tasks. In relation to the relationship between FT4 levels and cognitive changes, a U-shaped pattern was observed: FEP patients from the middle quartiles (Q2-Q3) improved in attention/vigilance, whereas both extreme quartiles (Q1 and Q4) showed a worsening in this cognitive domain over time. Patients with lower FT4 (Q1) showed poorer baseline attention; therefore, lower baseline FT4 levels predicted a poorer prognosis in terms of attention performance. Our study suggests that baseline FT4 levels are associated with changes in attention and vigilance performance over one year in FEP patients.

  5. Are early MRI findings correlated with long-lasting symptoms following whiplash injury? A prospective trial with 1-year follow-up

    PubMed Central

    Sorensen, Joan S.; Andersen, Hans; Keseler, Bjarne; Jensen, Troels S.; Bendix, Tom

    2008-01-01

    Neck pain is the cardinal symptom following whiplash injuries. The trauma mechanism could theoretically lead to both soft tissue and bone injury that could be visualised by means of MRI. From previous quite small trials it seems that MRI does not demonstrate significant tissue damage. Large prospectively followed cohorts are needed to identify possible clinically relevant MRI findings. The objective of this trial was to evaluate (1) the predictive value of cervical MRI after whiplash injuries and (2) the value of repeating MRI examinations after 3 months including sequences with flexion and extension of the cervical spine. Participants were included after rear-end or frontal car collisions. Patients with fractures or dislocations diagnosed by standard procedures at the emergency unit were not included. MRI scans of the cervical spine were performed at baseline and repeated after 3 months. Clinical follow-ups were performed after 3 and 12 months. Outcome parameters were neck pain, headache, neck disability and working ability. A total of 178 participants had a cervical MRI scan on average 13 days after the injury. Traumatic findings were observed in seven participants. Signs of disc degeneration were common and most frequent at the C5–6 and C6–7 levels. Findings were not associated with outcome after 3 or 12 months. The population had no considerable neck trouble prior to the whiplash injury and the non-traumatic findings represent findings to be expected in the background population. Trauma-related MRI findings are rare in a whiplash population screened for serious injuries in the emergency unit and not related to a specific symptomatology. Also, pre-existing degeneration is not associated with prognosis. PMID:18512085

  6. Depression in relation to anxiety, obsessionality and phobia among neurosurgical patients with a primary brain tumor: a 1-year follow-up study.

    PubMed

    Mainio, Arja; Hakko, Helinä; Niemelä, Asko; Koivukangas, John; Räsänen, Pirkko

    2011-10-01

    Depression is found to be present in up to 44% of brain tumor patients during their illness process. Anxiety as a comorbid psychiatric disorder with depression has formerly been studied, but phobia or obsessive-compulsive symptoms among brain tumor patients have not yet been noticed. By using a clinical prospective database of primary brain tumor patients (n=77) we studied the level of depression, anxiety, obsessionality (traits and symptoms) and phobic anxiety symptoms. Psychiatric symptoms were assessed before tumor operation as well as at three months and at one year after operation. The presence of comorbid anxiety, obsessionality and phobic anxiety symptoms was assessed before operation and at follow-ups in depressed and non-depressed patients, separately. Before tumor operation 16% of the patients had depression according to Beck Depression Inventory (BDI), while 10% had depression at three months and 15% at one year after operation. The depressed patients had statistically significantly higher anxiety scores and phobic scores at all three measurement points compared to corresponding scores among non-depressed brain tumor patients. The mean obsessionality scores among depressed brain tumor patients were significantly higher when measured before operation and at one year after the operation compared to non-depressed patients. To our knowledge, this is the first study so far in which comorbidity of psychiatric symptoms has been shown among depressive brain tumor patients. Concurrent comorbid conditions have been shown to be associated with increased severity, morbidity and chronicity of depression. It is recommended that treatment of depressive patients complicated with comorbid psychiatric disorders be planned by psychiatric units.

  7. Dual chamber rate responsive pacing system driven by contractility: final assessment after 1-year follow-up. The European PEA Clinical Investigation Group.

    PubMed

    Clémenty, J

    1998-11-01

    The aim of this study was to assess the long-term performance of a new dual chamber rate responsive pacing system based on the dynamic measurement of the peak endocardial acceleration (PEA) index of cardiac contractility. Seventy patients who participated in the Multicenter European Clinical Evaluation were studied 1 year after implantation by continuously recording the PEA and the heart rate (HR) during exercise stress testing and during 24 hours of usual activities. A complete examination of standard parameters was also performed to assess the pacing/sensing lead characteristics. Statistical comparisons were performed with the data recorded with the same protocol at 1 month after implant for each patient. A linear correlation coefficient was calculated between PEA and sinus rate when the patient showed predominant atrial tracked rhythm. There were no significant differences between PEA values measured at 1 month and 1 year (PEA = 0.41 +/- 0.26 g vs 0.45 +/- 0.29 g at rest and PEA = 1.63 +/- 0.77 g vs 1.72 +/- 0.83 g during peak exercise). The correlation coefficient remained stable (0.67 +/- 0.15 vs 0.65 +/- 0.14 during daily life and 0.74 +/- 0.14 vs 0.77 +/- 0.11 during exercise). The PEA signal detected by the sensor was reliable and stable. No long-term complications or adverse effects were observed, and the lead performance was comparable to that of a standard lead.

  8. [Revival after Ebola: multidisciplinary assessment at 1 year, prospect and follow-up study of surviving patients from Ebola in Guinea (PostEboGui cohort)].

    PubMed

    Msellati, P; Touré, A; Sow, M S; Cécé, K; Taverne, B; Desclaux, A; Barry, M; Etard, J-F; Delaporte, E

    2016-10-01

    Ebola virus disease (EVD) epidemic that spread in West Africa from the end of 2013 to early 2016 has reached more people than all past epidemics. Beyond care management of acute phase ill patients and measures for the control of the epidemic, the outcome of Ebola survivors became an important question as their number increased and raised new issues. A multidisciplinary prospective cohort of survivors in Guinea has been launched by IRD UMI 233 and Donka National Hospital, Conakry, Guinea, to assess the long-term clinical, psychological, sociological, immunological, and viral outcomes potentially related to EVD. This paper describes PostEboGui Programme, constraints and changes to the initial proposal, participants, first results, and new issues, 1 year after its start, in a descriptive and critical view. We started also to work on ethical aspects in the context of epidemics and of mass interventions with a risk of overinvestigation of patients.

  9. Effectiveness of Comprehensive Health Education Combining Lifestyle Education and Hot Spa Bathing for Male White-Collar Employees: A Randomized Controlled Trial with 1-Year Follow-Up

    PubMed Central

    Kamioka, Hiroharu; Nakamura, Yosikazu; Okada, Shinpei; Kitayuguchi, Jun; Kamada, Masamitsu; Honda, Takuya; Matsui, Yuzuru; Mutoh, Yoshiteru

    2009-01-01

    Background Physical activity is known to prevent obesity and metabolic syndrome in middle-aged and elderly people; however, the effectiveness of a comprehensive health education program for male white-collar employees is uncertain. Methods Forty-three men volunteered to participate in this study and were randomly assigned into 2 groups. The intervention group participated in a 2-hour program comprising comprehensive health education and hot spa bathing, offered once every 2 weeks, in addition to individualized programs once a week, for 24 weeks. The control group received only general health guidance. We compared their lifestyle characteristics and physical and mental health criteria at baseline, immediately after the intervention, and 1 year after the end of the intervention. Results Rates of adherence to individualized programs were 60.0 ± 27.2% and 30.5 ± 29.6% at the end of the intervention and at 1 year after the end of the intervention, respectively. Significant (P < 0.05) interaction of criteria was observed for cluster of differentiation 4+ (CD4+) cells and the ratio of cluster of differentiation 4+ to 8+ (CD4/8) cells, which were used to represent the participants' immunological function. We divided the intervention group into 2 subgroups on the basis of their attendance. Among the resulting 3 groups, significant interaction of criteria was observed for CD4+ and CD4/8 cells. In addition, the high attendance group had the highest CD4+ count and CD4/8 ratio. Conclusions Participants who attended classes and/or performed the supplementary individualized programs tended to maintain their immunological function and to experience a decrease in body fat percentage. However, few effects were noted in participants with poor adherence, even in the intervention group. PMID:19687610

  10. Use of Percutaneous Aspiration Thrombectomy vs. Anticoagulation Therapy to Treat Acute Iliofemoral Venous Thrombosis: 1-year Follow-up Results of a Randomised, Clinical Trial

    SciTech Connect

    Cakir, Volkan; Gulcu, Aytac; Akay, Emrah; Capar, Ahmet E.; Gencpinar, Tugra; Kucuk, Banu; Karabay, Ozalp; Goktay, A. Yigit

    2014-08-15

    PurposeThe purpose of this study was to compare the efficacy of percutaneous aspiration thrombectomy (PAT) followed by standard anticoagulant therapy, with anticoagulation therapy alone, for the treatment of acute proximal lower extremity deep vein thrombosis.MethodsIn this randomised, prospective study, 42 patients with acute proximal iliofemoral deep vein thrombosis documented via Doppler ultrasound examination, were separated into an interventional treatment group (16 males, 5 females, average age 51 years) and a medical treatment group (13 males, 8 females, average age 59 years). In the interventional group, PAT with large-lumen 9-F diameter catheterisation was applied, after initiation of standard anticoagulant therapy. Balloon angioplasty (n 19) and stent implementation (n: 14) were used to treat patients with residual stenosis (>50 %) after PAT. Prophylactic IVC filters were placed in two patients. The thrombus clearance status of the venous system was evaluated by venography. In both the medical and interventional groups, venous patency rates and clinical symptom scores were evaluated at months 1, 3, and 12 after treatment.ResultsDeep venous systems became totally cleared of thrombi in 12 patients treated with PAT. The venous patency rates in month 12 were 57.1 and 4.76 % in the interventional and medical treatment groups, respectively. A statistically significant improvement was observed in clinical symptom scores of the interventional group (PAT) with or without stenting (4.23 ± 0.51 before treatment; 0.81 ± 0.92 at month 12) compared with the medical treatment group (4.00 ± 0.63 before treatment; 2.43 ± 0.67 at month 12). During follow-up, four patients in the medical treatment and one in the interventional group developed pulmonary embolisms.ConclusionsFor treatment of acute deep vein thrombosis, PAT with or without stenting is superior to anticoagulant therapy alone in terms of both ensuring venous patency and improving clinical

  11. Comparison of lumbar spine stabilization exercise versus general exercise in young male patients with lumbar disc herniation after 1 year of follow-up

    PubMed Central

    Ye, Chaoqun; Ren, Jixin; Zhang, Jianzheng; Wang, Chongwei; Liu, Zhi; Li, Fang; Sun, Tiansheng

    2015-01-01

    Objective: The safest and most effective conservative treatment for patients with lumbar disc herniation (LDH) has not been established. The purpose of this study was to evaluate the effect of lumbar spine stabilization exercise (LSSE) and general exercise (GE) on pain intensity and functional capacity in young male patients with LDH. Methods: Sixty-three young male adults aged 20 to 29 years with the diagnosis of LDH were enrolled and divided into an LSSE group (n=30) and a GE group (n=33). Patients in both groups received low-power laser (LPL) therapy during the first week of the onset of LDH. Patients in the GE group underwent a GE program. Patients in the LSSE group followed an LSSE program for 3 months. All of the patients were subjected to pain intensity and functional capacity evaluations four times: at pre-and post-LPL therapy, and at 3 months and 1 year post-exercise. Pain intensity of the lower back and legs was evaluated with the visual analogue scale (VAS), and functional capacity was evaluated with the Oswestry Disability Index (ODI). Results: Both groups showed a significant reduction in VAS and ODI scores at 3 and 12 months post-exercise compared with before treatment (P<0.001). The LSSE group showed a significant reduction in the average score of the VAS for low back pain (P=0.012) and the ODI (P=0.003) at 12 months post-exercise compared with the GE group. Conclusions: LSSE and GE are considered as effective interventions for young male patients with LDH. Moreover, LSSE is more effective than GE, and physical therapy, such as LPL, is required during acute LDH. PMID:26309670

  12. The Effect of Mobile App Follow-up Care on the Number of In-person Visits Following Ambulatory Surgery: A Randomized Control Trial.

    PubMed

    Armstrong, Kathleen; Coyte, Peter; Semple, John

    2015-01-01

    Women's College Hospital (WCH) in Toronto offers specialized ambulatory surgical procedures. A feasibility study using a mobile appliciation (app) to supplement in-person follow-up care after surgery suggests that the mobile app adequately detects postoperative complications, eliminates the need for in-person follow-up care and is cost-effective. This is concordant with other postoperative telemedicine studies. The purpose of this study is to determine if we can avert in-person follow-up care through the use of mobile app compared to conventional, in-person follow-up care in the first month following surgery amongst breast reconstruction patients at WCH. This will be a pragmatic, single-centre, open, controlled, 2-arm parallel-group superiority randomized trial. Mobile app follow-up care is a novel approach to managing patients postoperatively with the potential to avert in-person follow-up and generate cost-savings for the healthcare system and patient.

  13. Multicomponent physical exercise with simultaneous cognitive training to enhance dual-task walking of older adults: a secondary analysis of a 6-month randomized controlled trial with 1-year follow-up

    PubMed Central

    Eggenberger, Patrick; Theill, Nathan; Holenstein, Stefan; Schumacher, Vera; de Bruin, Eling D

    2015-01-01

    Background About one-third of people older than 65 years fall at least once a year. Physical exercise has been previously demonstrated to improve gait, enhance physical fitness, and prevent falls. Nonetheless, the addition of cognitive training components may potentially increase these effects, since cognitive impairment is related to gait irregularities and fall risk. We hypothesized that simultaneous cognitive–physical training would lead to greater improvements in dual-task (DT) gait compared to exclusive physical training. Methods Elderly persons older than 70 years and without cognitive impairment were randomly assigned to the following groups: 1) virtual reality video game dancing (DANCE), 2) treadmill walking with simultaneous verbal memory training (MEMORY), or 3) treadmill walking (PHYS). Each program was complemented with strength and balance exercises. Two 1-hour training sessions per week over 6 months were applied. Gait variables, functional fitness (Short Physical Performance Battery, 6-minute walk), and fall frequencies were assessed at baseline, after 3 months and 6 months, and at 1-year follow-up. Multiple regression analyses with planned comparisons were carried out. Results Eighty-nine participants were randomized to three groups initially; 71 completed the training and 47 were available at 1-year follow-up. DANCE/MEMORY showed a significant advantage compared to PHYS in DT costs of step time variability at fast walking (P=0.044). Training-specific gait adaptations were found on comparing DANCE and MEMORY: DANCE reduced step time at fast walking (P=0.007) and MEMORY reduced gait variability in DT and DT costs at preferred walking speed (both trend P=0.062). Global linear time effects showed improved gait (P<0.05), functional fitness (P<0.05), and reduced fall frequency (−77%, P<0.001). Only single-task fast walking, gait variability at preferred walking speed, and Short Physical Performance Battery were reduced at follow-up (all P<0.05 or

  14. Esthetic outcomes in relation to implant-abutment interface design following a standardized treatment protocol in a multicenter randomized controlled trial--a cohort of 12 cases at 1-year follow-up.

    PubMed

    McGuire, Michael K; Scheyer, Todd; Ho, Daniel K; Stanford, Clark M; Feine, Jocelyne S; Cooper, Lyndon F

    2015-01-01

    The design of an implant-abutment interface may have an impact on the peri-implant soft tissue esthetics. In an ongoing randomized controlled trial (RCT) with 141 participants, the authors evaluated the peri-implant tissue responses around three different implant-abutment interface designs used to replace single teeth in the esthetic zone. The aim of this report is to describe the treatment protocol utilized in this ongoing RCT by (1) demonstrating in detail a clinical case treated under this protocol and (2) reporting peri-implant soft tissue responses in a cohort of 12 representative cases from the RCT at 1-year follow-up. Male and female adults requiring single implants in the anterior maxilla were enrolled in the RCT according to the study protocol. Five months following any required extraction and/or socket bone grafting/ridge augmentation, one of the following three implant-abutment interfaces was placed and immediately provisionalized: (1) conical interface (CI; OsseoSpeed, Dentsply Implants), n = 4; (2) flat-to-flat interface (FI; NobelSpeedy Replace, Nobel Biocare), n = 4; or (3) platform-switch interface (PS; NanoTite Certain Prevail, Biomet 3i), n = 4. Twelve weeks later, definitive crowns were delivered. Throughout the treatment, peri-implant buccal gingival zenith height and mesial/distal papilla height were measured on stereotactic device photographs, and pink esthetic scores (PES) were determined. The demographics of the participants in each of the three implant-abutment interface groups were very similar. All 12 study sites had ideal ridge form with a minimum width of 5.5 mm following implant site development performed according to the described treatment protocol. Using this treatment protocol for single-tooth replacement in the anterior maxilla, the clinicians were able to obtain esthetic peri-implant soft tissue outcomes with all three types of implant-abutment interface designs at 1-year follow-up as shown by the Canfield data and PES. The

  15. Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year

    PubMed Central

    GARGARI, M.; PRETE, V.; PUJIA, M.; CERUSO, F. M.

    2013-01-01

    SUMMARY Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year. Objective The aim of this study is to compare functional efficiency and patients satisfaction between tooth-supported and implant-supported overdenture through a questionnaire that accurately reflects the real concerns of patients with dental prosthesis. Methods Forty-three patients were selected from the out patient clinic, Department of Dentistry “Fra G.B. Orsenigo Ospedale San Pietro F.B.F.”, Rome, Italy. Their age were ranging from 61 to 83 years. Eighteen patients were rehabilitated with overdentures supported by natural teeth and twenty-five with overdentures implant-supported. Discussion and Result The questionnaire proposed one year after the insertion of the prosthetis has showed that there isn’t difference statistically significant in terms of function, phonetics and aesthetics between overdenture implant-supported and tooth-supported. Conclusions The results of the questionnaire showed that the patients generally had a high level of satisfaction concern to the masticatory function, esthetics and phonetics. In addition, on average, they haven’t difficulty in removal and insertion of the denture and in oral hygiene. They haven’t in both groups problems related to fractures. PMID:23741602

  16. Elevated Patient Body Mass Index Does Not Negatively Affect Self-Reported Outcomes of Thoracolumbar Surgery: Results of a Comparative Observational Study with Minimum 1-Year Follow-Up.

    PubMed

    Manson, Neil A; Green, Alana J; Abraham, Edward P

    2016-03-01

    Study Design Retrospective study. Objective Quantify the effect of obesity on elective thoracolumbar spine surgery patients. Methods Five hundred consecutive adult patients undergoing thoracolumbar spine surgery to treat degenerative pathologies with minimum follow-up of at least 1 year were included. Primary outcome measures included Numerical Rating Scales for back and leg pain, the Short Form 36 Physical Component Summary and Mental Component Summary, the modified Oswestry Disability Index, and patient satisfaction scores collected preoperatively and at 3, 6, 12, and 24 months postoperatively. Secondary outcome measures included perioperative and postoperative adverse events, postoperative emergency department presentation, hospital readmission, and revision surgeries. Patients were grouped according to World Health Organization body mass index (BMI) guidelines to isolate the effect of obesity on primary and secondary outcome measures. Results Mean BMI was 30 kg/m(2), reflecting a significantly overweight population. Each BMI group reported statistically significant improvement on all self-reported outcome measures. Contrary to our hypothesis, however, there was no association between BMI group and primary outcome measures. Patients with BMI of 35 to 39.99 visited the emergency department with complaints of pain significantly more often than the other groups. Otherwise, we did not detect any differences in the secondary outcome measures between BMI groups. Conclusions Patients of all levels of obesity experienced significant improvement following elective thoracolumbar spine surgery. These outcomes were achieved without increased risk of postoperative complications such as infection and reoperation. A risk-benefit algorithm to assist with surgical decision making for obese patients would be valuable to surgeons and patients alike.

  17. Treatment and Follow Up

    MedlinePlus

    ... B , flu and pneumococcal immunization status 3-6 Month Visit You should see your physician 3-6 ... IgA) Repeat routine tests, if previously abnormal 12 Month Visit At your 12 month visit, your anti- ...

  18. Lumbar Radiofrequency Rhizotomy in Patients with Chronic Low Back Pain Increases the Diagnosis of Sacroiliac Joint Dysfunction in Subsequent Follow-Up Visits

    PubMed Central

    2017-01-01

    Chronic back pain is often a result of coexisting pathologies; secondary causes of pain can become more apparent sources of pain once the primary pathology has been addressed. The objective of our study was to determine if there is an increase in diagnosis of Sacroiliac joint pain following a Lumbar Rhizotomy. A list of patients who underwent Lumbar Radiofrequency during a 6-month period in our clinic was generated. Records from subsequent clinic visits were reviewed to determine if a new diagnosis of SI joint pathology was made. In patients who underwent a recent Lumbar Rhizotomy procedure to treat facetogenic pain, the prevalence of Sacroiliac joint pain increased to 70%. We infer that there is a significant increase in the diagnosis of Sacroiliac joint syndrome following a Lumbar Rhizotomy, potentially due to unmasking of a preexisting condition. In patients presenting with persistent back pain after Lumbar Rhizotomy, the clinician must have a high degree of suspicion for latent Sacroiliac joint pain prior to attributing the pain to block failure. It would be prudent to use >80% relief of pain after a diagnostic medial branch block as a diagnostic criterion for facetogenic pain rather than the currently accepted >50% in order to minimize unmasking of preexisting subclinical pain from the SI joint. PMID:28255260

  19. Lumbar Radiofrequency Rhizotomy in Patients with Chronic Low Back Pain Increases the Diagnosis of Sacroiliac Joint Dysfunction in Subsequent Follow-Up Visits.

    PubMed

    Rimmalapudi, Varun Kumar; Kumar, Sanjeev

    2017-01-01

    Chronic back pain is often a result of coexisting pathologies; secondary causes of pain can become more apparent sources of pain once the primary pathology has been addressed. The objective of our study was to determine if there is an increase in diagnosis of Sacroiliac joint pain following a Lumbar Rhizotomy. A list of patients who underwent Lumbar Radiofrequency during a 6-month period in our clinic was generated. Records from subsequent clinic visits were reviewed to determine if a new diagnosis of SI joint pathology was made. In patients who underwent a recent Lumbar Rhizotomy procedure to treat facetogenic pain, the prevalence of Sacroiliac joint pain increased to 70%. We infer that there is a significant increase in the diagnosis of Sacroiliac joint syndrome following a Lumbar Rhizotomy, potentially due to unmasking of a preexisting condition. In patients presenting with persistent back pain after Lumbar Rhizotomy, the clinician must have a high degree of suspicion for latent Sacroiliac joint pain prior to attributing the pain to block failure. It would be prudent to use >80% relief of pain after a diagnostic medial branch block as a diagnostic criterion for facetogenic pain rather than the currently accepted >50% in order to minimize unmasking of preexisting subclinical pain from the SI joint.

  20. Impact of Age-related Macular Degeneration on Vision-Specific Quality of Life: Follow-Up from the 10-Year and 15-Year Visits of The Study of Osteoporotic Fractures

    PubMed Central

    Coleman, Anne L.; Yu, Fei; Ensrud, Kristine E.; Stone, Katie L.; Cauley, Jane A; Pedula, Kathryn L.; Hochberg, Marc C.; Mangione, Carol M.

    2010-01-01

    Purpose To assess vision-specific quality of life (QOL), based on abbreviated surveys derived from the National Eye Institute Visual Function Questionnaire (NEI-VFQ), in a cohort of US women who participated in the Study of Osteoporotic Fractures (SOF). Design Prospective, observational cohort study Methods Age-related macular degeneration (AMD) status, based on a three level classification (no AMD, early AMD, late AMD), and vision-specific QOL, based on abbreviated NEI-VFQ surveys were calculated for 1,674 women enrolled in the SOF at 4 centers within the US, who had gradable fundus photographs at both the 10-year and 15-year follow-up visits. The associations among 5-year changes in NEI-VFQ composite scores, change in AMD status, and distance visual acuity were examined. Results Compared to study participants without AMD at both visits, study participants with late AMD at both visits and those that progressed from early AMD to late AMD demonstrated the greatest declines in adjusted NEI-VFQ composite scores, up to a mean decrease of 16.2 out of a scale of 100. Visual acuity declines were also most prominent for patients with late AMD at both visits and for those that progressed from early AMD to late AMD. Change in visual acuity was found to correlate significantly with change in vision-specific QOL. Conclusions The abbreviated NEI-VFQ surveys provide reliable assessments of vision-specific QOL in AMD patients. The decline in vision-specific QOL associated with the progression of AMD is clinically meaningful. PMID:20691423

  1. Combined therapy (intravitreal bevacizumab plus verteporfin photodynamic therapy) versus intravitreal bevacizumab monotherapy for choroidal neovascularization due to age-related macular degeneration: a 1-year follow-up study

    PubMed Central

    Saviano, Sandro; Leon, Pia Easter; Mangogna, Alessandro; Tognetto, Daniele

    2016-01-01

    Purpose To assess the efficacy and safety of combined intravitreal bevacizumab and low-fluency-rate photodynamic therapy (PDT) in the treatment of choroidal neovascularization (CNV) associated with age-related macular degeneration (AMD) and to compare it with intravitreal bevacizumab monotherapy. Methods A total of 62 eyes of 62 patients with angiographic evidence of CNV were divided into 2 groups: the eyes of one group were treated with a combined therapy of 1 intravitreal bevacizumab injection (1.25 mg) and PDT within 7 days; the eyes of the other group received intravitreal bevacizumab monotherapy. Clinical evidence of complications, best-corrected visual acuity (BVCA) and fluorescein leakage were evaluated. Best-corrected visual acuity and optical coherence tomography (OCT) were tested monthly and followed for 12 months. Results In the combined group the mean BCVA increased from 0.61 logMAR before the treatment to 0.54 logMAR at 12 months’ follow-up. In the monotherapy group the mean BCVA increased from 0.65 logMAR to 0.60 logMAR at 12 months’ follow-up. There was no significant difference in visual acuity outcomes between groups (P > 0.05). In the combined group the mean number of treatments was 1.19 per patient; in the monotherapy group, 5.31 per patient (P < 0.01). Conclusions Combined therapy appears to be an effective option for CNV associated with AMD treatment allowing a significant reduction of intravitreal injections. PMID:27582675

  2. Initial Clinical Experience With the Strut-Adjusted Volume Implant (SAVI) Breast Brachytherapy Device for Accelerated Partial-Breast Irradiation (APBI): First 100 Patients With More Than 1 Year of Follow-Up

    SciTech Connect

    Yashar, Catheryn M.; Scanderbeg, Daniel; Kuske, Robert; Wallace, Anne; Zannis, Victor; Blair, Sarah; Grade, Emily; Swenson, Virginia H.; Quiet, Coral

    2011-07-01

    Purpose: The Strut-Adjusted Volume Implant (SAVI; Cianna Medical, Aliso Viejo, CA) is a multichannel single-entry brachytherapy device designed to allow dose modulation to minimize normal tissue dose while simultaneously maximizing target coverage. This is the first report on the initial 102 patients with nearly 2 years of median follow-up. Methods and Materials: One hundred two patients were treated at two institutions. Data were collected on eligibility and dosimetry and followed for toxicity and recurrence. Results: The median follow-up is 21 months. Overall dosimetry is outstanding (median percent of target volume receiving 90% of the prescription dose was 95.9%, volume of target receiving 150% of the prescription dose was 27.8 mL, and volume of target receiving 200% of the prescription dose was 14.0 cm{sup 3}). No devices were pulled prior to treatment completion. For patients with a skin bridge of less than 7 mm, the maximum median skin dose was 280 cGy (median percent of target volume receiving 90% of the prescription dose was 95.2%, volume of target receiving 150% of the prescription dose was 25.8 cm{sup 3} and volume of target receiving 200% of the prescription dose was 12.7 mL). For patients with both chest wall and skin of less than 7 mm, the maximum median lung dose was 205 cGy with simultaneous skin dose of 272 cGy. The rate of telangiectasia was 1.9%. Grade 1 hyperpigmentation developed in 10 patients (9.8%) and Grade 2 fibrosis in 2 patients (1.9%). There were 2 symptomatic seromas and 2 cases of asymptomatic fat necrosis (1.9%). Of the patients, 27% were not eligible for MammoSite balloon brachytherapy (Hologic, Inc., Marlborough, MA) and 5% were not eligible for any balloon brachytherapy. The recurrence rate was 1%. Conclusions: The SAVI appears to safely allow an increase in eligibility for APBI over balloon brachytherapy or three-dimensional conformal radiation, highlighting the outstanding device flexibility to maximize the target dose and

  3. A review of 1985 Volvo Award winner in clinical science: objective assessment of spine function following industrial injury: a prospective study with comparison group and 1-year follow-up.

    PubMed

    Rainville, James; Kim, Richard S; Katz, Jeffrey N

    2007-08-15

    It is now 2 decades since Mayer et al published their Volvo Award-winning paper entitled "Objective assessment of spine function following industrial injury: a prospective study with comparison group and one-year follow-up." Their landmark paper reported that return to work rates of patients that underwent a "functional restoration" treatment program were double that of a comparative group of patients that were denied treatment by their insurers. These results were considered extraordinary and inspired both debate and enthusiasm. Our goal is to review this landmark study, report on its strengths and weaknesses, and review the studies that have attempted to replicate this work in other settings. We also highlight its contribution to our current knowledge about the treatment of back pain and disability. The major weaknesses of the paper of Mayer et al are the possibility of selection bias in the development of their cohort of patients and the lack of a true randomized controlled study design. These factors may have inflated the rates of return to work. Regardless, their reported results were robust, and cannot be easily dismissed. During the last 20 years, this treatment model has received considerable study worldwide, and it is generally agreed that it is superior to standard care for reducing work absence in patients with chronic low back pain. Additionally, the concepts underlying functional restoration have been found to be highly relevant to patients with chronic low back pain, medical providers, and disability systems and continue to gain acceptance and integration into the care of patients throughout the industrialized world.

  4. PROJECT TALENT, 1-YEAR FOLLOW-UP STUDIES.

    ERIC Educational Resources Information Center

    COOLEY, WILLIAM W.; FLANAGAN, JOHN C.

    THE "PROJECT TALENT" FOLLOWUP STUDIES WERE CONCERNED WITH VARIOUS ASPECTS OF CAREER DEVELOPMENT OF AMERICAN YOUTH, CONSISTING PRIMARILY OF THE EDUCATIONAL AND VOCATIONAL PLANS AND DECISIONS WHICH ONE MAKES DURING HIGH SCHOOL AND IMMEDIATELY FOLLOWING HIGH SCHOOL. RELATIONSHIPS WERE SOUGHT BETWEEN TRAITS EXHIBITED BY STUDENTS IN HIGH…

  5. [Follow-up of encopresis in children].

    PubMed

    Steinmüller, A; Steinhausen, H C

    1990-03-01

    The course of encopresis in 41 children who had been presented at a child and adolescent university clinic was examined by means of a follow-up interview which took place on an average of 3;6 years after the initial visit. The symptoms in this sample diminished considerably: 76% of the children were free of symptoms at the time of the follow-up interview, whereby most of these children had experienced a spontaneous remission. Eighty-one percent of the children were evaluated as having improved in regards to their whole development while in about one third of all the children new problems arose. Remission occurred within the first two years of the initial consultation in 81% of the sample. An examination of the prognostic factors yielded the following relationships: the total remission of symptoms was considerably greater if the frequency of encopresis had been low, if the subjects were male, and if there had not been any therapeutic intervention. However, treatment was usually reserved for relatively serious cases. Favorable outcome tended to be marked by the following factors: normal psychosocial conditions, higher intelligence, the absence of constipation, a concurrently presenting enuresis, and a low degree of behavioral disorders as evaluated by a parental questionnaire. A comparison of the behavioral disorders at the time of the initial consultation and at follow-up revealed a significant reduction of emotional disturbances and hyperactivity. This favorable development was not evident for conduct disorders.

  6. Hyper Cold Systems follow up

    NASA Astrophysics Data System (ADS)

    Berges, Jean Claude; Beltrando, Gerard; Cacault, Philippe

    2016-04-01

    The follow up of intense precipitation system is a key information for climate studies. Whereas some rainfall measurement series cover more than one century they cannot retrieve these phenomena in their spatial and temporal continuity. The geostationary satellite data offer a good trade-off between the length of data series and the retrieval accuracy. However a difficulty arise from ambiguous interpretation of the lone infrared signal in nephanalysis. Hence the tropopause temperature is used as a proxy to characterize extreme precipitation event. That does not mean that the more intense rain-rate will be always collocated with the coldest temperature but that most of these intense events is produced by systems whose a part is colder than tropopause. Computations have been carried out on 38 months of MSG and Meteosat/IODC. System follow up is achieved by a simple 3D connexity algorithm, the time being considered as the third dimension. This algorithm produce three dimension clusters from where the main system parameters can be easily extracted. Thus the systems can be classified trajectory characteristic (duration, speed ans size variation). A drawback of this simple threshold method relies is some over-segmentation. In most of case the bias is minor as unconnected clusters are small and short-lived. However an aggregating algorithm have been developed to retrieve the most complex system trajectories. To assess the efficiency of this method three regional studies are displayed: the North African Maghreb, the West African Sahel and the Indian Ocean. On Maghreb, the location of system initialization shows a dramatic difference between the eastern and western parts. Whereas in Tunisia a significant part of these systems are generated on sea and most have no clear relation with relief, the Morocco is mainly characterized with land initiated system with a strong orographic effect on system triggering. Another difference relies on the low level wind shear impact which

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

    PubMed Central

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

    2016-01-01

    Post-traumatic endocrine dysfunction is a complication of traumatic brain injury (TBI). However, there is lack of long-term follow-up and large sample size studies. This study included patients suffering from TBI registered in the Health Insurance Database. Endocrine disorders were identified using the ICD codes: 244 (acquired hypothyroidism), 253 (pituitary dysfunction), 255 (disorders of the adrenal glands), 258 (polyglandular dysfunction), and 259 (other endocrine disorders) with at least three outpatient visits within 1 year or one admission diagnosis. Overall, 156,945 insured subjects were included in the final analysis. The 1- and 5-year incidence rates of post-traumatic endocrinopathies were 0.4% and 2%, respectively. The risks of developing a common endocrinopathy (p < 0.001) or pituitary dysfunction (P < 0.001) were significantly higher in patients with a TBI history. Patients with a skull bone fracture had a higher risk of developing pituitary dysfunction at the 1-year follow up (p value < 0.001). At the 5-year follow up, the association between intracranial hemorrhage and pituitary dysfunction (p value: 0.002) was significant. The risk of developing endocrine dysfunction after TBI increased during the entire 5-year follow-up period. Skull bone fracture and intracranial hemorrhage may be associated with short and long-term post-traumatic pituitary dysfunction, respectively. PMID:27608606

  8. Results of Medium Seventeen Years' Follow-Up after Laparoscopic Choledochotomy for Ductal Stones.

    PubMed

    Quaresima, Silvia; Balla, Andrea; Guerrieri, Mario; Lezoche, Giovanni; Campagnacci, Roberto; D'Ambrosio, Giancarlo; Lezoche, Emanuele; Paganini, Alessandro M

    2016-01-01

    Introduction. In a previously published article the authors reported the long-term follow-up results in 138 consecutive patients with gallstones and common bile duct (CBD) stones who underwent laparoscopic transverse choledochotomy (TC) with T-tube biliary drainage and laparoscopic cholecystectomy (LC). Aim of this study is to evaluate the results at up to 23 years of follow-up in the same series. Methods. One hundred twenty-one patients are the object of the present study. Patients were evaluated by clinical visit, blood assay, and abdominal ultrasound. Symptomatic patients underwent cholangio-MRI, followed by endoscopic retrograde cholangiopancreatography (ERCP) as required. Results. Out of 121 patients, 61 elderly patients died from unrelated causes. Fourteen patients were lost to follow-up. In the 46 remaining patients, ductal stone recurrence occurred in one case (2,1%) successfully managed by ERCP with endoscopic sphincterotomy. At a mean follow-up of 17.1 years no other patients showed signs of bile stasis and no patient showed any imaging evidence of CBD stricture at the site of choledochotomy. Conclusions. Laparoscopic transverse choledochotomy with routine T-tube biliary drainage during LC has proven to be safe and effective at up to 23 years of follow-up, with no evidence of CBD stricture when the procedure is performed with a correct technique.

  9. Results of Medium Seventeen Years' Follow-Up after Laparoscopic Choledochotomy for Ductal Stones

    PubMed Central

    Quaresima, Silvia; Balla, Andrea; Guerrieri, Mario; Campagnacci, Roberto; D'Ambrosio, Giancarlo; Lezoche, Emanuele; Paganini, Alessandro M.

    2016-01-01

    Introduction. In a previously published article the authors reported the long-term follow-up results in 138 consecutive patients with gallstones and common bile duct (CBD) stones who underwent laparoscopic transverse choledochotomy (TC) with T-tube biliary drainage and laparoscopic cholecystectomy (LC). Aim of this study is to evaluate the results at up to 23 years of follow-up in the same series. Methods. One hundred twenty-one patients are the object of the present study. Patients were evaluated by clinical visit, blood assay, and abdominal ultrasound. Symptomatic patients underwent cholangio-MRI, followed by endoscopic retrograde cholangiopancreatography (ERCP) as required. Results. Out of 121 patients, 61 elderly patients died from unrelated causes. Fourteen patients were lost to follow-up. In the 46 remaining patients, ductal stone recurrence occurred in one case (2,1%) successfully managed by ERCP with endoscopic sphincterotomy. At a mean follow-up of 17.1 years no other patients showed signs of bile stasis and no patient showed any imaging evidence of CBD stricture at the site of choledochotomy. Conclusions. Laparoscopic transverse choledochotomy with routine T-tube biliary drainage during LC has proven to be safe and effective at up to 23 years of follow-up, with no evidence of CBD stricture when the procedure is performed with a correct technique. PMID:26880900

  10. Report on Follow-Up Visit to Ecuador, Part 2

    DTIC Science & Technology

    1961-01-21

    broiler chicks . Once the hous- ing equipment is purchased it is expected that the sale of the month-old chickens upon termination of the experiment will...34 is as a constituent of poultry feed. The broiler industry in Ecuador is rapidly expanding blt the poul- try feeds consist of imported soybean

  11. Report on Follow-up Visit to Ecuador, Part 1

    DTIC Science & Technology

    1961-01-21

    Servicio Cooperativo Interamericano de Salud Pdblica Mr, Milton Lobell, Director of the Servicio Cooperativo Interamericano de Agricultura Mr. David Luscombe, Chief of the Misicn Andina0 ...were familiar with the survey and were present in Ecuador in 1959 include Mr. Harold Conger, Director, Health Servicio , USOM; Mr. Milton Lobeli Director...Agriculture Servicio ; Mr. John Hummel, Head of USOM; Mrs. Leslie Smith, Home Econonrist, USOM; Dr. John J. Kevany, WHO Consultant to INNE;

  12. Improving pediatric Inflammatory Bowel Disease (IBD) follow-up

    PubMed Central

    Dykes, Dana; Williams, Elizabeth; Margolis, Peter; Ruschman, Jennifer; Bick, Julianne; Saeed, Shehzad; Opipari, Lisa

    2016-01-01

    Standardization of Inflammatory Bowel Disease (IBD) care through participation in the ImproveCareNow (ICN) Network has improved outcomes for pediatric patients with IBD, but under the current care model, our improvements have plateaued. Current ICN model care guidelines recommend health supervision visits every six months. We identified a gap in our practice's ability to ensure either a routine six month follow-up or a rapid follow-up after a disease flare, and a significant number of patients with active disease status during a six month period lacked timely reassessment after interventions or medication changes. Telemedicine provides an alternative method of care delivery to address these gaps, but has had limited use in patients with IBD. A multi-step approach to offer alternative follow-up care options via telemedicine was developed with potential impact on remission rates and quality of life. Short term goals of the pilot were to improve telemedicine access for patients with IBD were to 1) increase the percent of patients with active disease with a follow-up completed within two months of a visit from 40% to 70%, 2) increase the percent of patients with a visit scheduled within two months of their last sick visit from 20% to 70% (interim measure), 3) increase the number of eVisits from zero visits per month to two visits per month during pilot phase, 4) increase electronic communication with patients from zero messages per month to 200 messages per month, 5) no change in complications or adverse events (defined as an unplanned visit or ED (emergency department) encounter within 30 days of an eVisit. The expected outcomes of the e-visit model were to: maintain baseline care standards and health screening capabilities, improve access to care, and provide equivalent care delivery (no increase in the number of unplanned clinical encounters). Using the IHI model for improvement (Plan-Do-Study-Act) we have seen a progressive increase in the rate of patient signups

  13. Prospect Follow Up Pays Dividends in Enrollment.

    ERIC Educational Resources Information Center

    Wassom, Julie

    1993-01-01

    Describes a follow-up program for enrolling day care center prospects. Follow-up within the center utilizes contact management software and a prospect profile system to record information about potential customers. External follow-up includes a telephone call to confirm an appointment to the center or to provide additional information to the…

  14. Feasibility of tailored follow-up for patients with early breast cancer.

    PubMed

    van Hezewijk, Marjan; Smit, Dennis J F; Bastiaannet, Esther; Scholten, Astrid N; Ranke, Gemma M C; Kroep, Judith R; Marijnen, Corrie A M; van de Velde, Cornelis J H

    2014-12-01

    As the number of breast cancer survivors increases, this study prospectively examined whether tailored follow-up with differentiated number of visits per risk group, based on a prognostic index for local recurrence, is feasible and acceptable for patients and professionals. Between March 2007 and March 2010, 180 breast cancer patients (pT1-2N0-2cM0) were included. Primary endpoint was feasibility of tailored follow-up, based on the number of follow-up visits, patient satisfaction, anxiety and attitude towards follow-up. Secondary endpoints were reasons for visits, incidence, time to detection of local recurrences and the use of alternative care. In the second and third year of follow-up, the results show a 22% reduction in visits per patient in the low-risk group compared to the intermediate-risk group; 2.8 versus 3.6 visits. The majority of interval visits in both groups was initiated by the professional. No significant differences were found in attitude towards follow-up, patient satisfaction, anxiety and depression, alternative health care use or local recurrences between the risk groups. In conclusion, implementation of a tailored follow-up programme with decreased number of visits for low-risk patients is feasible and acceptable to patients. Appointing one coordinating professional, possibly a nurse practitioner, could further reduce the number of follow-up visits.

  15. Pediatric Celiac Disease: Follow-Up in the Spotlight.

    PubMed

    Valitutti, Francesco; Trovato, Chiara Maria; Montuori, Monica; Cucchiara, Salvatore

    2017-03-01

    The follow-up of celiac disease (CD) is challenging due to the scarcity of published data and the lack of standardized evidence-based protocols. The worldwide frequency and methods of CD follow-up appear to be heavily influenced by expert opinions of the individual physicians who assess children with CD. The aim of this review was to summarize the available studies on CD follow-up in children. We conducted a literature search with the use of PubMed, Medline, and Embase (from 1900 to 15 December 2016) for terms relevant to this review, including CD, follow-up, dietary adherence or dietary compliance, nutrition, comorbidities, complications, and quality of life. The aims of follow-up are as follows: to ensure strict adherence to a gluten-free diet, to ensure nutritional adequacy, to improve quality of life, and to prevent disease complications. For the correct evaluation of children with CD at follow-up, a clinical and biochemical evaluation is necessary on a regular basis. It is advisable to assess compliance, nutrition, comorbidities, or possible complications once a year at the referral center. Laboratory tests might be useful for a thorough evaluation of any patient with CD to rule out a micronutrient deficiency (full blood count, ferritin, folic acid, vitamin B-6, and vitamin B-12) and possible cardiovascular risk factors (glucose, LDL cholesterol, triglycerides). Biochemical evaluation is essential when there are clinical problems and should be customized on the basis of the specific clinical suspicion. Associated autoimmune thyroiditis should also be screened for yearly by measuring thyroid-stimulating hormone and thyroid autoantibody concentrations, regardless of symptoms, because hypothyroidism is often subtle and methods for early treatment are available and desirable. Although evidence-based recommendations for follow-up of pediatric patients with CD have not yet been established, we advise a yearly follow-up visit as the safest approach.

  16. Francoise, a Fifteen-Year Follow Up.

    ERIC Educational Resources Information Center

    Rondal, J. A.; Elbouz, M.; Ylieff, M.; Docquier, L.

    2003-01-01

    This paper reports on a 15-year follow-up of the linguistic and cognitive profile of a woman with standard trisomy 21 (Down syndrome). The follow-up found recent rapid deterioration in receptive and productive language skills. However, basic phonological and morphosyntactic skills are preserved. Her changing profile mirrors that found in aging…

  17. Towards sustainability assessment follow-up

    SciTech Connect

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

    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. Pacemaker follow-up and adequacy of Medicare guidelines.

    PubMed

    Vallario, L E; Leman, R B; Gillette, P C; Kratz, J M

    1988-07-01

    The time of occurrence of cardiac pacemaker problems after implantation was identified to assess the adequacy of published federal guidelines for clinic and transtelephonic follow-up. One hundred eighty-nine pacemaker patients' charts were examined retrospectively to identify pacemaker problems: inadequate sensing, non-capture, battery failure, myoinhibition, muscle stimulation, and inadequate threshold safety margin. Twenty-nine patients (15%) were identified as having pacemaker problems. A total of 41 problems were identified, of which 28 (68%) were corrected by reprogramming. Sixty-one percent of the problems were found during a clinic visit. Problems occurred more frequently during the first year in dual-chamber devices (62%) vs single-chamber devices (35%). During years 1 to 4, when few problems are expected, 30% of all problems of single-chamber devices occurred and 39% of all problems of dual-chamber devices occurred. This is a period of time that Medicare guidelines allow for one clinic visit per year for single- and two visits per year for dual-chamber devices. These data suggest: (1) Many pacemaker problems will be missed with transtelephonic follow-up alone. (2) The majority of problems involving dual-chamber devices occurred in the first year. (3) For both dual- and single-chamber devices, an unexpected significant percentage of problems occurred in 1 to 4 years. (4) Medicare guidelines may be inadequate for follow-up during this time period.

  19. Long-term follow-up of ophthalmic Graves' disease.

    PubMed Central

    Agapitos, P J; Hart, I R

    1987-01-01

    Sixteen patients with ophthalmic Graves' disease (clinically euthyroid with ophthalmopathy or exophthalmos) were followed up for 4.3 to 14.3 (mean 9.1) years to determine whether thyroid dysfunction developed and whether their ophthalmopathy progressed, regressed or remained stable. Five patients (31%) manifested hyperthyroidism or hypothyroidism, all before the end of the fifth year of follow-up. The ophthalmopathy was mild, and none of the patients required specific treatment. The thyroid function of patients with ophthalmic Graves' disease should be periodically monitored for at least 5 years. PMID:3815199

  20. The dangers of "follow-up" feeds.

    PubMed

    Greiner, T

    1991-09-01

    Artificial feeds constituted with contaminated water and unclean bottles are the leading cause of diarrhea in infants. Companies market artificial feeds globally as infant formula (a substitute for breast milk) and follow-up formula (a complement to breast milk). Breast milk is best for all 0-12 month old infants. Breast-fed infants do not need any formula even follow-up formula. Indeed 6-month old infants require solid healthful foods and breast milk. Like infant formulas, follow-up formula made with contaminated water or bottles can cause the infant to become ill with an infection, and offering follow-up formulas to infants impedes weaning and is costly. Follow-up formulas do not complement breast milk, but instead tend to replace it. The 1986 WHO World Health Assembly has even declared that, in some countries, provision of follow-up formula is not necessary. WHO fears mothers could use follow-up formula instead of infant formula because it has a higher protein and mineral content thus increasing the risk of dehydration during diarrhea. Follow-up formula can result in an unbalanced diet. Since the International Code of Marketing of Breastmilk Substitutes does not address formulas marketed as a complement to breast milk, formula companies market follow-up formulas in both developed and developing countries. Most mothers do not know the risks of using follow-up formulas, however. Governments have several alternatives to stop the marketing of these formulas. They can design and implement a code that defines breast-milk substitutes as any formula perceived and used as a breast milk option even if promoted as a breast-milk complement. They can also amend an existing code. WHO offers technical assistance to any member government who wishes to design, implement, and monitor such a code.

  1. Retention in care within 1 year of initial HIV care visit in a multisite US cohort: who's in and who's out?

    PubMed

    Tedaldi, Ellen M; Richardson, James T; Debes, Rachel; Young, Benjamin; Chmiel, Joan S; Durham, Marcus D; Brooks, John T; Buchacz, Kate

    2014-01-01

    Biannual attendance at medical visits is an established measure of retention in HIV care. We examined factors associated with attending at least 2 clinic visits at least 90 days apart among HIV-infected, antiretroviral therapy (ART)-naive HIV Outpatient Study participants entering care during 2000 to 2011. Of 1441 patients, 85% were retained in care during the first year of observation. Starting ART during the year was the strongest correlate of retention (adjusted odds ratio [aOR] 6.4, 95% confidence interval [CI] 4.4-9.4). After adjusting for starting ART, publicly insured patients (aOR 0.6, 95% CI 0.4-1.0), and patients with baseline CD4 counts <200 cells/mm(3) (aOR 0.5, 95% CI 0.3-0.9) or missing CD4 counts (aOR 0.3, 95% CI 0.2-0.6) were less likely to be retained in care. Although most patients had recommended biannual care visits, some ART-naive individuals may require additional interventions to remain in care. Promptly initiating ART may facilitate engagement in care.

  2. Robotic Follow-Up for Human Exploration

    NASA Technical Reports Server (NTRS)

    Fong, Terrence; Bualat, Maria; Deans, Matthew C.; Adams, Byron; Allan, Mark; Altobelli, Martha; Bouyssounouse, Xavier; Cohen, Tamar; Flueckiger, Lorenzo; Garber, Joshua; Palmer, Elizabeth; Heggy, Essam; Jurgens, Frank; Kennedy, Tim; Kobayashi, Linda; Lee, Pascal; Lee, Susan Y.; Lees, David; Lundy, Mike; Park, Eric; Pedersen, Liam; Smith, Trey; To, Vinh; Utz, Hans; Wheeler, Dawn

    2010-01-01

    We are studying how "robotic follow-up" can improve future planetary exploration. Robotic follow-up, which we define as augmenting human field work with subsequent robot activity, is a field exploration technique designed to increase human productivity and science return. To better understand the benefits, requirements, limitations and risks associated with this technique, we are conducting analog field tests with human and robot teams at the Haughton Crater impact structure on Devon Island, Canada. In this paper, we discuss the motivation for robotic follow-up, describe the scientific context and system design for our work, and present results and lessons learned from field testing.

  3. Heart Valve Surgery Recovery and Follow Up

    MedlinePlus

    ... Venous Thromboembolism Aortic Aneurysm More Heart Valve Surgery Recovery and Follow Up Updated:Sep 14,2016 What to expect after heart valve surgery The normal recovery time after a heart valve surgery is usually ...

  4. TEX-SIS FOLLOW-UP: Student Follow-up Management Information System. Data Processing Manual.

    ERIC Educational Resources Information Center

    Tarrant County Junior Coll. District, Ft. Worth, TX.

    Project FOLLOW-UP was conducted to develop, test, and validate a statewide management information system for follow-up of Texas public junior and community college students. The result of this project was a student information system (TEX-SIS) consisting of seven subsystems: (1) Student's Educational Intent, (2) Nonreturning Student Follow-up, (3)…

  5. [Lyme borreliosis: follow up criteria after antibiotherapy?].

    PubMed

    Christmann, D

    2007-01-01

    The post therapeutic follow-up of Lyme borreliosis is managed according to clinical and serological data. The evolution of antibody rates is such that it doesn't constitute the best element to rely on for follow-up. Indeed, after a sometimes transitory increase of this rate during or after antibiotherapy, the decrease is very slow, sometimes several months, and often incomplete. The follow-up should thus be made according to clinical symptoms and their resolution. Resolution of some but not all symptoms must lead to discussing two options. The first is that of administrating a complementary antibiotherapy with a different mode of action than the first antibiotic used. The second is that this may be due to recontamination, especially in highly endemic zones, given that antibodies present have no protecting effect. In this case, a new antibiotherapy must of course be initiated.

  6. The Kepler Follow-Up Observation Program

    NASA Astrophysics Data System (ADS)

    Gautier, Thomas N., III; Dunham, E. W.; Gilliland, R.; Jenkins, J.; Batalha, N.; Borucki, W. J.; Cochran, W. D.; Howell, S.; Koch, D.; Latham, D.; Marcy, G.; Kepler Team

    2010-01-01

    The Kepler Mission to find Earth-size exoplanets was launched on March 6, 2009, began science observations on May 11, 2009 and is now in full operation. Many planet candidates have been identified and ground based follow-up observations are weeding out false positive planet detections and beginning to confirm true planets. False positive identification techniques planned during the pre-flight phase of Kepler are proving to work well. The fraction of false positive planet detections due to binary stars sent for ground based follow-up appears small.

  7. WCTC Graduate Follow-Up Report, 2002.

    ERIC Educational Resources Information Center

    Waukesha County Technical Coll., Pewaukee, WI.

    This paper reports on a survey of 2001-02 graduates of Waukesha County Technical College (WCTC), Wisconsin. The report indicates 1,257 students were awarded Associate's Degrees, technical diplomas, and apprenticeship certificates by WCTC in 2001-02. Of those graduates, 702 (56%) responded to the Graduate Follow-up Survey. Also, 84% of all…

  8. Follow-Up Research on Agoraphobics.

    ERIC Educational Resources Information Center

    Chambless, Dianne L.

    In vivo exposure is the most commonly used and generally the most effective behavioral treatment for agoraphobia. Follow-up studies are difficult to interpret because additional treatment does not necessarily indicate relapse and non-treatment does not necessarily indicate non-relapse. Relapse rates are difficult to estimate because of lack of…

  9. Facilitating Follow-Up in ELT INSET

    ERIC Educational Resources Information Center

    Waters, Alan

    2006-01-01

    There is evidence that ELT INSET does not always result in the desired level of "follow-up," i.e. impact on teachers' classroom practices. Nevertheless, little research appears to have been carried out concerning how the design of INSET systems affects such outcomes. This paper therefore attempts to throw light on some of the factors…

  10. Outpatient follow-up after traumatic injury: Challenges and opportunities

    PubMed Central

    Hansen, Luke; Shaheen, Aisha; Crandall, Marie

    2014-01-01

    Background: It has been shown that rates of ambulatory follow-up after traumatic injury are not optimal, but the association with insurance status has not been studied. Aims: To describe trauma patient characteristics associated with completed follow-up after hospitalization and to compare relative rates of healthcare utilization across payor types. Setting and Design: Single institution retrospective cohort study. Materials and Methods: We compared patient demographics and healthcare utilization behavior after discharge among trauma patients between April 1, 2005 and April 1, 2010. Our primary outcome of interest was outpatient provider contact within 2 months of discharge. Statistical Analysis: Multivariate logistic regression was used to determine the association between characteristics including insurance status and subsequent ambulatory and acute care. Results: We reviewed the records of 2906 sequential trauma patients. Patients with Medicaid and those without insurance were significantly less likely to complete scheduled outpatient follow-up within 2 months, compared to those with private insurance (Medicaid, OR 0.67, 95% CI 0.51-0.88; uninsured, OR 0.29, 95% CI 0.23-0.36). Uninsured and Medicaid patients were twice as likely as privately insured patients to visit the Emergency Department (ED) for any reason after discharge (uninsured patients (Medicaid, OR 2.6, 95% CI 1.50-4.53; uninsured, OR 2.10, 94% CI 1.31-3.36). Conclusion: We found marked differences between patients in scheduled outpatient follow-up and ED utilization after injury associated with insurance status; however, Medicaid seemed to obviate some of this disparity. Medicaid expansion may improve outpatient follow-up and affect patient outcome disparities after injury. PMID:25400385

  11. The LCOGT NEO Follow-up Network

    NASA Astrophysics Data System (ADS)

    Lister, Tim; Greenstreet, Sarah; Gomez, Edward; Christensen, Eric J.; Larson, Stephen M.

    2016-10-01

    The LCOGT NEO Follow-up Network is using the telescopes of the Las Cumbres Observatory Global Telescope Network (LCOGT) and a web-based target selection, scheduling and data reduction system to confirm NEO candidates and characterize radar-targeted known NEOs. Starting in July 2014, the LCOGT NEO Follow-up Network has observed over 3,500 targets and reported more than 16,000 astrometric and photometric measurements to the Minor Planet Center (MPC).The LCOGT NEO Follow-up Network's main aims are to perform confirming follow-up of the large number of NEO candidates and to perform characterization measurements of radar targets to obtain light curves and rotation rates. The NEO candidates come from the NEO surveys such as Catalina, PanSTARRS, ATLAS, NEOWISE and others. In particular, we are targeting objects in the Southern Hemisphere, where the LCOGT NEO Follow-up Network is the largest resource for NEO observations.LCOGT has completed the first phase of the deployment with the installation and commissioning of the nine 1-meter telescopes at McDonald Observatory (Texas), Cerro Tololo (Chile), SAAO (South Africa) and Siding Spring Observatory (Australia). The telescope network has been fully operational since 2014 May, and observations are being executed remotely and robotically. Future expansion to a site at Ali Observatory, Tibet is planned for 2017-2018.We have developed web-based software called NEOexchange which automatically downloads and aggregates NEO candidates from the Minor Planet Center's NEO Confirmation Page, the Arecibo and Goldstone radar target lists and the NASA ARM list. NEOexchange allows the planning and scheduling of observations on the LCOGT Telescope Network and the tracking of the resulting blocks and generated data. We have recently extended the NEOexchange software to include automated data reduction to re-compute the astrometric solution, determine the photometric zeropoint and find moving objects and present these results to the user via

  12. [Nutritional follow-up after gastric bypass].

    PubMed

    Gasteyger, C; Giusti, V

    2006-03-29

    Roux-en-Y gastric bypass has become one of the main bariatric procedures. This surgical operation shows excellent results in weight evolution and quality of life and allows a decrease of mortality. However, it leads, relatively often, to nutritional deficiencies which need an effective post-operative follow-up. This follow-up includes not only medical and dietetic encounters but also regular blood analyses made every 3 months during the first post-operative year, every 6 months the second year, then each year. The most frequent deficiencies are those in vitamin B12, iron and folic acid. The secondary hyperparathyroidism characterized by an increase of PTH associated to a low vitamin D and a normal calcium, is quite frequent.

  13. The Kepler Follow-up Observation Program

    NASA Astrophysics Data System (ADS)

    Gautier, Thomas N., III; Borucki, W. J.; Caldwell, D. A.; Koch, D. G.

    2007-07-01

    The Kepler mission will use a space based, 95 cm Schmidt telescope to survey >100,000 late type dwarf stars for transiting Earth-sized planets over a period of 4 years. Up to 2000 such planets might be detected along with a hundred or more transiting giant planets. About 1000 false positive planet detections, due mainly to eclipsing binary stars, are also expected. A ground based follow-up program is planned to observe all of the planet candidates found by Kepler to weed out these false positives and produce a final catalog with a reliability greater than 95%. In addition, follow-up observations will, where possible, measure the mass of confirmed planets and look for any non-transiting giant planets. The Kepler Project is Funded by the National Aeronautics and Space Administration as a Discovery Mission.

  14. The LCOGT NEO Follow-up Network

    NASA Astrophysics Data System (ADS)

    Lister, Tim A.; Greenstreet, S.; Gomez, E.; Christensen, E.; Larson, S.

    2016-01-01

    Las Cumbres Observatory Global Telescope Network (LCOGT) has deployed a homogeneous telescope network of nine 1-meter telescopes to four locations in the northern and southern hemispheres, with a planned network size of twelve 1-meter telescopes at 6 locations. This network is very versatile and is designed to respond rapidly to target of opportunity events and also to perform long term monitoring of slowly changing astronomical phenomena. The global coverage of the network and the apertures of telescope available make LCOGT ideal for follow-up and characterization of Solar System objects (e.g. asteroids, Kuiper Belt Objects, comets, Near-Earth Objects (NEOs)) and additionally for the discovery of new objects. We are using the LCOGT network to confirm newly detected NEO candidates produced by the major sky surveys such as Catalina Sky Survey (CSS) and PanSTARRS (PS1&2) and several hundred targets are now being followed per year. An increasing amount of time is being spent to obtain follow-up astrometry and photometry for radar-targeted objects and those on the Near-Earth Object Human Space Flight Accessible Targets Study (NHATS) or Asteroid Retrieval Mission (ARM) lists in order to improve the orbits, determine the light curves and rotation periods and improve the characterization. This will be extended to obtain more light curves of other NEOs which could be targets. Recent results have included the first period determinations for several of the Goldstone-targeted NEOs. We are in the process of building a NEO follow-up portal which will allow professionals, amateurs and Citizen Scientists to plan, schedule and analyze NEO imaging and spectroscopy observations and data using the LCOGT Network and to act as a co-ordination hub for the NEO follow-up efforts.

  15. Prompt GRB optical follow-up experiments

    SciTech Connect

    Park, H-S; Williams, G; Ables, E; Band, D; Barthelmy, S; Bionta, R; Cline, T; Gehrels, N; Hartmann, D; Hurley, K; Kippen, M; Nemiroff, R; Pereira, W; Porrata, R

    2000-11-13

    Gamma Ray Bursts (GRBs) are brief, randomly located, releases of gamma-ray energy from unknown celestial sources that occur almost daily. The study of GRBs has undergone a revolution in the past three years due to an international effort of follow-up observations of coordinates provided by Beppo/SAX and IPN GRB. These follow-up observations have shown that GRBs are at cosmological distances and interact with surrounding material as described by the fireball model. However, prompt optical counterparts have only been seen in one case and are therefore very rare or much dimmer than the sensitivity of the current instruments. Unlike later time afterglows, prompt optical measurements would provide information on the GRB progenitor. LOTIS is the very first automated and dedicated telescope system that actively utilizes the GRB Coordinates Network (GCN) and it attempts to measure simultaneous optical light curve associated with GRBs. After 3 years of running, LOTIS has responded to 75 GRB triggers. The lack of any optical signal in any of the LOTIS images places numerical limits on the surrounding matter density, and other physical parameters in the environment of the GRB progenitor. This paper presents LOTIS results and describes other prompt GRB follow-up experiments including the Super-LOTIS at Kitt Peak in Arizona.

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

    SciTech Connect

    Milano, Michael T.; Katz, Alan W.; Zhang Hong; Okunieff, Paul

    2012-07-01

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

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

    PubMed

    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.

  18. Treating Sexually Abused Children: 1 Year Follow-Up of a Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Cohen, J.A.; Mannarino, A.P.; Knudsen, K.

    2005-01-01

    Objective:: To measure the durability of improvement in response to two alternative treatments for sexually abused children. Method:: Eighty-two sexually abused children ages 8-15 years old and their primary caretakers were randomly assigned to trauma-focused cognitive-behavioral therapy (TF-CBT) or non-directive supportive therapy (NST) delivered…

  19. Stereotactic posteroventral pallidotomy: clinical methods and results at 1-year follow up.

    PubMed

    Dalvi, A; Winfield, L; Yu, Q; Côté, L; Goodman, R R; Pullman, S L

    1999-03-01

    Twenty consecutive patients with idiopathic Parkinson's disease underwent stereotactic posteroventral pallidotomy. Schwab and England ADL scores in the "off" state were improved by 18% and in the "on" state the scores declined by 2%. Three patients also reported marked improvement in "off" state dystonia. One-year data are available on 12 patients who underwent evaluations according to the Core Assessment Program for Intracerebral Transplantation protocol preoperatively and at 3, 6, and 12 months after surgery. Significant improvements in Unified Parkinson's Disease Rating Scale sections II and III scores in the "off" state, composite "off" state scores of bradykinesia and rigidity, contralateral tremor in the "off" state, and contralateral dyskinesias were observed. Although there was reduction in the daily levodopa dose, this did not reach statistical significance. Major complications (15%) included hemiparesis (one of 20) and visual field cuts (two of 20); minor complications (45%) included mild cognitive dysfunction (four of 20), reading difficulty not related to visual disturbance (one of 20), and 5-10 lb weight gain (four of 20).

  20. Cryoplasty for Occlusive Disease of the Femoropopliteal Arteries: 1-Year Follow-Up

    SciTech Connect

    Korteweg, Mies A.; Gils, Marjon van; Hoedt, Marco T.; Valk, Pieter H. M. van der; Tutein Noltenius, Rudolf P.; Avontuur, Jurgen A.; Bronswijk-Monster, Krien F.; Elgersma, Otto E. H.

    2009-03-15

    Atherosclerosis of femoropopliteal arteries is an important cause of morbidity and mortality. Percutaneous transluminal angioplasty (PTA) has only limited success in treating these arteries, mainly because of the high rate of recurrent stenosis. Cryoplasty has been proposed as a technique which might improve treatment outcome. This study reports our single-center experience with cryoplasty. Thirty-two claudicants, 33 arteries, in whom conservative therapy failed, were consecutively included. Duplex ultrasound (US), angiography, and ankle-brachial index (ABI) measurement were performed before the procedure; ABI and duplex US, 2 weeks and 3, 6, and 12 months after the procedure. Patients' symptoms were categorized according to the Rutherford classification. Lesions were classified as TASC A, B, or C according to angiographic appearance. Differences in ABI before and after the procedure were defined as significant at p < 0.05 by paired t-test. Patency was evaluated using duplex US by determining the peak systolic velocity ratio. Sixteen TASC A lesions, 13 TASC B lesions, and 4 TASC C lesions were included. ABI improved significantly for TASC A lesions 2 weeks and 3 months postprocedure. Patency after 2 weeks, 6 months, and 12 months was 93%, 67%, and 64% for TASC A lesions, 83%, 31%, and 31% for TASC B lesions, and 100%, 50%, and 33% for TASC C lesions, respectively. In conclusion, cryoplasty has good immediate success rates and patency rates similar to the results of conventional PTA in the literature.

  1. Irlen Colored Filters in the Classroom: A 1-Year Follow-Up

    ERIC Educational Resources Information Center

    Ritchie, Stuart J.; Della Sala, Sergio; McIntosh, Robert D.

    2012-01-01

    Colored filters are used to treat Irlen syndrome (IS), a controversial disorder posited to be the cause of a substantial proportion of reading difficulties. Previously, we found that Irlen colored filters do not produce any short-term alleviation of reading difficulties in schoolchildren aged 7-12. Here, we tested whether colored filters show…

  2. Pragmatic Functions in Late Talkers: A 1-Year Follow-Up Study

    ERIC Educational Resources Information Center

    MacRoy-Higgins, Michelle; Kliment, Sarah

    2017-01-01

    This study analyzed spontaneous language samples of three-year-olds with a history of expressive language delay (late talkers) and age-matched controls using Dore's Conversational Acts analysis (1978) and Mean Length of Utterance (MLU; Brown, 1973). Differences were observed between groups in utterances classified as organizational device and…

  3. Disk Detective Follow-Up Program

    NASA Astrophysics Data System (ADS)

    Kuchner, Marc

    As new data on exoplanets and young stellar associations arrive, we will want to know: which of these planetary systems and young stars have circumstellar disks? The vast allsky database of 747 million infrared sources from NASA's Wide-field Infrared Survey Explorer (WISE) mission can supply answers. WISE is a discovery tool intended to find targets for JWST, sensitive enough to detect circumstellar disks as far away as 3000 light years. The vast WISE archive already serves us as a roadmap to guide exoplanet searches, provide information on disk properties as new planets are discovered, and teach us about the many hotly debated connections between disks and exoplanets. However, because of the challenges of utilizing the WISE data, this resource remains underutilized as a tool for disk and planet hunters. Attempts to use WISE to find disks around Kepler planet hosts were nearly scuttled by confusion noise. Moreover, since most of the stars with WISE infrared excesses were too red for Hipparcos photometry, most of the disks sensed by WISE remain obscure, orbiting stars unlisted in the usual star databases. To remedy the confusion noise problem, we have begun a massive project to scour the WISE data archive for new circumstellar disks. The Disk Detective project (Kuchner et al. 2016) engages layperson volunteers to examine images from WISE, NASA's Two Micron All-Sky Survey (2MASS) and optical surveys to search for new circumstellar disk candidates via the citizen science website DiskDetective.org. Fueled by the efforts of > 28,000 citizen scientists, Disk Detective is the largest survey for debris disks with WISE. It has already uncovered 4000 disk candidates worthy of follow-up. However, most host stars of the new Disk Detective disk candidates have no known spectral type or distance, especially those with red colors: K and M stars and Young Stellar Objects. Others require further observations to check for false positives. The Disk Detective project is supported by

  4. The Kepler Follow-up Observation Program

    NASA Astrophysics Data System (ADS)

    Gautier, T. N.; Borucki, W. J.; Caldwell, D. A.; Koch, D. G.

    2007-07-01

    The Kepler mission will use a space based, 95-cm Schmidt telescope to survey 100,000 late type dwarf stars for transiting Earth-sized planets over a period of 4 years. Up to ˜ 2000 such planets might be detected along with a hundred or more transiting giant planets. About 1,000 false positive planet detections, due mainly to eclipsing binary stars, will also be found. A ground based follow-up program is planned to observe all of the planet candidates found by Kepler to weed out these false positives and produce a final catalog with a reliability greater than 95%.

  5. The LCOGT NEO Follow-up Network

    NASA Astrophysics Data System (ADS)

    Lister, Tim; Gomez, Edward; Greenstreet, Sarah

    2015-08-01

    Las Cumbres Observatory Global Telescope Network (LCOGT) has deployed a homogeneous telescope network of nine 1-meter telescopes to four locations in the northern and southern hemispheres, with a planned network of twelve 1-meter telescopes at 6 locations. This network is very versatile and is designed to respond rapidly to target of opportunity events and also to perform long term monitoring of slowly changing astronomical phenomena. The global coverage of the network and the apertures of telescope available make LCOGT ideal for follow-up and characterization of Solar System objects (e.g. asteroids, Kuiper Belt Objects, comets, Near-Earth Objects (NEOs)) and ultimately for the discovery of new objects.LCOGT has completed the first phase of the deployment with the installation and commissioning of the nine 1-meter telescopes at McDonald Observatory (Texas), Cerro Tololo (Chile), SAAO (South Africa) and Siding Spring Observatory (Australia). The telescope network has been fully operational since 2014 May, and observations are being executed remotely and robotically. Future expansion to sites in the Canary Islands and Tibet is planned for 2016.I am using the LCOGT network to confirm newly detected NEO candidates produced by the major sky surveys such as Catalina Sky Survey (CSS) and PanSTARRS (PS1) and several hundred targets are now being followed-up per year. An increasing amount of time is being spent to obtain follow-up astrometry and photometry for radar-targeted objects and those on the Near-Earth Object Human Space Flight Accessible Targets Study (NHATS) or Asteroid Retrieval Mission (ARM) lists in order to improve the orbits, determine the light curves and rotation periods and improve the characterization. This will be extended to obtain more light curves of other NEOs which could be targets. Recent results have included the first period determinations for several of the Goldstone-targeted NEOs. We are in the process of building a NEO Portal which will allow

  6. Spectroscopic Follow Up of Kepler Planet Candidates

    NASA Astrophysics Data System (ADS)

    Latham, David W.; Cochran, W. D.; Marcy, G. W.; Buchhave, L.; Endl, M.; Isaacson, H.; Gautier, T. N.; Borucki, W. J.; Koch, D.; Kepler Team

    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 high-resolution spectrometers on the Lick 3.0-m Shane Telescope, the McDonald 2.7-m Reflector, the 2.5-m Nordic Optical Telescope, and the 1.5-m Tillinghast Reflector at the Whipple observatory. In this paper we will summarize the scope and organization of the spectroscopic follow-up observations, showing examples of the types of false positives found and ending with a presentation of the characteristics of a confirmed planet.

  7. NASA Audit Follow-up Handbook

    NASA Technical Reports Server (NTRS)

    1990-01-01

    This NASA Audit Follow-up Handbook is issued pursuant to the requirements of the Office of Management and Budget (OMB) Circular A-50, Audit Follow-up, dated September 29, 1982. It sets forth policy, uniform performance standards, and procedural guidance to NASA personnel for use when considering reports issued by the Office of Inspector General (OIG), other executive branch audit organizations, the Defense Contract Audit Agency (DCAA), and the General Accounting Office (GAO). It is intended to: specify principal roles; strengthen the procedures for management decisions (resolution) on audit findings and corrective action on audit report recommendations; emphasize the importance of monitoring agreed upon corrective actions to assure actual accomplishment; and foster the use of audit reports as effective tools of management. A flow chart depicting the NASA audit and management decision process is in Appendix A. This handbook is a controlled handbook issued in loose-leaf form and will be revised by page changes. Additional copies for internal use may be obtained through normal distribution channels.

  8. Neonatal follow-up programs and follow-up studies: Historical and current perspectives

    PubMed Central

    Sauve, Reg; Lee, Shoo K

    2006-01-01

    The present report reviews some highlights in the history of neonatal intensive care and neonatal follow-up programs, particularly developments and reports that were based on experiences in Canada. Early outcomes reported from ‘preemie baby units’ were distressing, but attention has consistently been paid to preterm infant outcomes, even from the early days of neonatal intensive care units. Most current follow-up programs have goals related to ‘audit’ functions, education and clinical roles, but existing literature related to these functions is limited. Several reports have provided guidance in terms of neonatal follow-up research issues, and these strengthen the place of follow-up studies in outcomes research. PMID:19030284

  9. GNAT Student Follow-Up Pilot Project

    NASA Astrophysics Data System (ADS)

    Roberts, Noll S.; Jaggi, N.; Milne, C.

    2006-12-01

    The Global Network of Astronomical Telescopes (GNAT) has discovered some 25,000 new variable star candidates along an equatorial strip of the sky with a non-moving (drift scan) telescope. With three closely spaced observations of any given star being made on the order of 100 nights spread over three years, GNAT could not determine the types of variability and periods of the short period, aliased light curve stars in their MG-1 Variable Star Catalog. Such determinations typically require, for each star, hundreds of closely spaced observations over a number of nights with a modest-aperture tracking telescope equipped for CCD photometry. Many college and amateur observatories are capable of making such observation. At Cuesta College we have initiated a GNAT follow-up pilot program to determine how students at small observatories could efficiently make such determinations in a single-semester research course. We used a 10” Meade LX-200 telescope equipped with a SBIG ST-8XE camera to observe nine GNAT candidates, looking for short-term variability. We found two of the nine to be very short-term variables. We obtained 1397 one-minute integrations on the GNAT star GM1-15036 (GSC 13:95) over seven nights. We determined its period to be about 0.16 days. Its sinusoidal waveform has a peak-to-peak amplitude of 0.2 magnitudes. This star is most likely an RR Lyrae pulsating variable. The second short-term variable star is now being repeatedly observed and, in parallel, we are examining a second batch of nine candidates for short-term variability. At the end of the fall 2006 semester, we will summarize what have learned about one-semester GNAT student follow-up observations. We are pleased to acknowledge the assistance of Eric Craine from GNAT, Russell Genet from Cuesta College and Orion Observatory, and Thomas Smith from Dark Ridge Observatory.

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

    SciTech Connect

    Wessels, Jan-Albert

    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

  11. Wartenberg's migrant sensory neuritis: a prospective follow-up study.

    PubMed

    Stork, Abraham C J; van der Meulen, Marjon F G; van der Pol, W-Ludo; Vrancken, Alexander F J E; Franssen, Hessel; Notermans, Nicolette C

    2010-08-01

    Migrant sensory neuropathy (Wartenberg's migrant sensory neuritis) is characterized by sudden numbness in the distribution of one or multiple cutaneous nerves. To study disease course and outcome, we prospectively followed 12 patients who presented to our tertiary referral neuromuscular outpatient clinic between January 2003 and January 2004. Medical history, neurological, laboratory and electrophysiological examinations were obtained from all patients. All patients were reviewed a second time in 2007, and five had a follow-up electrophysiological examination. At the first visit, 50% described an episode of stretching preceding the sensory complaints. All but three described pain in the affected area before or concomitant with sensory loss. At clinical examination a median of six skin areas were affected, and in 75% this could be confirmed by nerve conduction studies in at least one nerve. Forty-two percent had involvement of the trigeminal nerve. After a mean disease duration of 7.5 years, three patients reported a complete disappearance of sensory complaints and five that the pain had disappeared, but numbness remained. Three patients still had both painful and numb sensory deficits. One patient developed a distal symmetric sensory polyneuropathy. In conclusion, Wartenberg's sensory neuritis is a distinct, exclusively sensory, neuropathy, marked by pain preceding numbness in affected nerves. An episode of stretching preceding pain is not necessary for the diagnosis. Wartenberg's sensory neuritis often retains its spotty, exclusively sensory characteristics after long term follow-up.

  12. Long-term follow-up after bronchoscopic lung volume reduction treatment with coils in patients with severe emphysema

    PubMed Central

    Hartman, Jorine E; Klooster, Karin; Gortzak, Kiki; ten Hacken, Nick HT; Slebos, Dirk-Jan

    2015-01-01

    Background and objective Bronchoscopic lung volume reduction coil (LVR-coil) treatment has been shown to be safe and clinically effective in patients with severe emphysema in the short term; however, long-term safety and effectiveness has not been evaluated. The aim of this study was to investigate the long-term safety and effectiveness of LVR-coil treatment in patients with severe emphysema. Methods Thirty-eight patients with severe emphysema (median age is 59 years, forced expiratory volume in 1 s is 27% predicted) who were treated in LVR-coil clinical trials were invited for a voluntary annual visit. Safety was evaluated by chest X-ray and recording of adverse events and by efficacy by pulmonary function testing, 6-min walk distance (6MWD) and questionnaires. Results Thirty-five patients visited the hospital 1 year, 27 patients 2 years and 22 patients 3 years following coil placement. No coil migrations were observed on X-rays. At 1-year follow-up, all clinical outcomes significantly improved compared with baseline. At 2 years, residual volume % pred, modified Medical Research Council (mMRC) and the SGRQ score were still significantly improved. At 3 years, a significant improvement in mMRC score remained, with 40% of the patients reaching the 6MWD minimal important difference, and 59% for the St George's Respiratory Questionnaire (SGRQ) minimal important difference. Conclusions Follow-up of the patients treated with LVR-coils in our pilot studies showed that the coil treatment is safe with no late pneumothoraces, coil migrations or unexpected adverse events. Clinical benefit gradually declines over time; at 3 years post-treatment, around 50% of the patients maintained improvement in 6MWD, SGRQ and mMRC. PMID:25418910

  13. Follow-up of adolescent oral contraceptive users.

    PubMed

    Delmore, T; Kalagian, W F; Loewen, I R

    1991-01-01

    Clients in birth control centers (St. Catharines, Niagara Falls, and Welland) in Ontario, Canada were profiled in 1989; factors affecting compliance with the use of oral contraceptives (OCs) were investigated. Compliance was assessed for those 16 years and after 3 months of OC use. A control group and 2 study groups were randomly formed. 1 group was told about a follow up telephone call if the 3-month checkup appointment was not kept and the other not told. Compliance was determined by keeping the follow-up appointment and taking the pill as directed. Self-administered questionnaires were obtained at the 1st appointment and the 2nd study group was interviewed at the 3-month appointment time. Of the 334 intake interviews, 28.4% were adolescents 16 years old. Information on birth control came most frequently from friends (78.7%; then high school classmates, 61.4% grade school classmates, 61.4%; and family, 38.0%). 94.3% had a boyfriend, primarily a steady one. 82.4% were sexually active before the Center visit. 21.3% had had sex when 15 years old. 9.2% of those sexually active had never used birth control. 85.2% of those using contraception had used a condom at least once, and 33.9% used withdrawal. In the preceding month, birth control was used 60% of the time. 46% of mothers and 25% of fathers were considered supportive of birth control. 228 16 years participated in the compliance study. The 2 study groups and the control group were not significantly different in their compliance. The only statistically significant predictor of compliance (from the intake interview) was the previous use of the condom. Those more likely to be compliant were the 10.9% sexually active who had never used a condom. Continuing with the family doctor, not sexually active, advice to stop, side effects concerns, and remembering to take the pill were the most common reasons for noncompliance. The implication for health and sex education is that emphasis needs to the placed on the risks taken

  14. Visit-to-visit blood pressure variability, average BP level and carotid arterial stiffness in the elderly: a prospective study.

    PubMed

    Nagai, M; Dote, K; Kato, M; Sasaki, S; Oda, N; Kagawa, E; Nakano, Y; Yamane, A; Kubo, Y; Higashihara, T; Miyauchi, S; Harada, W; Masuda, H

    2016-10-20

    In a cross-sectional study, visit-to-visit blood pressure (BP) variability was shown to be associated with artery remodelling. Here, we investigated the impact of visit-to-visit BP variability and average BP on the carotid artery remodelling progression in high-risk elderly according to different classes of antihypertension medication use/non-use. BP measurements and carotid ultrasound were performed in the common carotid artery in 164 subjects (mean age 79.7 years at baseline, 74.7% females) with one or more cardiovascular risk factors. Based on 12 visits (1 × /month for 1 year), we calculated visit-to-visit BP variability expressed as the standard deviation (s.d.), coefficient of variation (CV), maximum BP, minimum BP and delta (maximum-minimum) BP. We measured mean intima-media thickness (IMT) as well as stiffness parameter β were measured at baseline and at the mean 4.2-year follow-up. In a multiple regression analysis, the maximum, minimum, s.d. and average of systolic BP (SBP) were significantly associated with a change in β-values between the baseline and follow-up after adjustment for age, smoking, lower high-density lipoprotein level, baseline β-value and follow-up period. There were no significant associations between the visit-to-visit BP variability measures and the change in mean IMT. Significant associations of maximum, minimum, s.d. and average SBP were found with increased β-values in the subjects without calcium channel blocker (CCB) use and in the subjects using renin-angiotensin system inhibitors (RASIs). Thus, exaggerated visit-to-visit SBP variability and a high average SBP level were significant predictors of progression in carotid arterial stiffness in high-risk elderly without CCBs use and in those using a RASI.Journal of Human Hypertension advance online publication, 20 October 2016; doi:10.1038/jhh.2016.77.

  15. Limiting loss to follow-up in a multicenter randomized trial in orthopedic surgery.

    PubMed

    Sprague, Sheila; Leece, Pamela; Bhandari, Mohit; Tornetta, Paul; Schemitsch, Emil; Swiontkowski, Marc F

    2003-12-01

    Even the best-designed, randomized controlled trials suffer when patients are lost to follow-up. Incomplete follow-up biases the results of a trial when patients who drop out are different from those who complete follow-up. This is exaggerated further when there are differential dropout rates between study groups. Previous randomized controlled trials in orthopedic trauma have reported up to 28% loss to follow-up. Only by striving to achieve a 0% loss to follow-up rate can we be certain that this type of bias does not affect our results. In our ongoing multicenter, randomized controlled trial comparing reamed and nonreamed intramedullary nailing of tibial shaft fractures, we have implemented several innovative strategies to minimize loss to follow-up. The exclusion criteria and consent process are designed to minimize losses. Study staff are carefully trained in communication and negotiation with patients. Additionally, a central methods center monitors all patient follow-up and aids in finding lost patients. Through these primary, secondary, and tertiary interventions, we have achieved 94% complete 1-year follow-up for the first 440 patients enrolled in the trial. Eleven patients withdrew consent, and we are unable to locate 17 patients. We have successfully minimized the loss to follow-up rate in our trial by incorporating innovative prevention and retention strategies into its design and conduct. Through planning, organization, and committing time and resources to minimizing loss to follow-up, other orthopedic trauma trials can hope to achieve the same high rates of follow-up.

  16. Hallucinations in Parkinson's disease: a follow-up study.

    PubMed

    de Maindreville, Anne Doé; Fénelon, Gilles; Mahieux, Florence

    2005-02-01

    To study prevalence of hallucinations in patients with Parkinson's disease (PD) during a 1-year period, and identify factors predictive of the onset of hallucinations in patients who were hallucination-free at baseline, 141 unselected outpatients with PD were evaluated prospectively for a set of demographic, clinical, and therapeutic variables and the presence of hallucinations during the previous 3 months. Patient groups were compared with nonparametric tests, and logistic regression was applied to significant data. Follow-up data were available for 127 patients. The hallucination prevalence rates (%) at the first and second evaluation were, respectively, 41.7 and 49.6 for hallucinations of all types (NS), 29.1 and 40.2 for minor hallucinations (i.e., presence or passage hallucinations, and illusions) (P = 0.02), 22.8 and 21.2 for formed visual hallucinations (NS), and 8.7 and 8.7 for auditory hallucinations (NS). Hallucinations rarely started or ceased during the study. The most labile forms were minor hallucinations, which developed in 20% of patients and ceased in 9%. During follow-up, 15% of patients started to hallucinate. Three factors, all present at the first evaluation, independently predicted the onset of hallucinations in patients previously free of hallucinations at baseline (odds ratio; 95% confidence interval): severe sleep disturbances (14.3; 2.5-80.9), ocular disorders (9.1; 1.6-52.0), and a high axial motor score (5.7; 1.2-27.4). Hallucinations have a chronic course in most parkinsonian patients. Factors predicting the onset of hallucinations point to a role of extranigral brainstem involvement and a nonspecific, facilitating role of ocular disorders.

  17. Outpatient Follow-Up versus 30-day Readmission among General and Vascular Surgery Patients: A Case for Redesigning Transitional Care

    PubMed Central

    Saunders, Richard Scott; Fernandes-Taylor, Sara; Rathouz, Paul J.; Saha, Sandeep; Wiseman, Jason T.; Havlena, Jeffrey; Matsumura, Jon; Kent, K. Craig

    2014-01-01

    Background The association between early outpatient follow-up and 30-day readmission has not been evaluated in any surgical population. Our study characterizes the relationship between outpatient follow-up and early readmissions among surgical patients. Methods We queried the medical record at a large, tertiary care institution (July 2008-December 2012) to determine rates of 30-day outpatient follow-up and readmission for general or vascular surgical procedures. Results The majority of discharges for general (84% of 7552) and vascular (75% of 2362) surgery had a follow-up visit before readmission or within 30 days of discharge. General surgery patients who were not readmitted had high rates of follow-up (88%) and received follow-up at approximately 2-weeks post-discharge (median time 11 days after discharge). In contrast, readmitted general surgery patients received first follow-up at one week (a median time of 8 days); 49% had follow-up. Vascular surgery patients showed a similar trend. Over half of patients readmitted after follow-up were readmitted within 24 hours of their most recent outpatient visit. Conclusions Current routine follow-up does not occur early enough to detect adverse events and prevent readmission. Early outpatient care may prevent readmission in some patients, but often serves as a conduit for readmission among patients already experiencing complications. PMID:25239351

  18. Employer Follow-up Data Summary--1976-77. Tex-SIS FOLLOW-UP; Postsecondary Student Follow-up Management Information System. Monograph 8.

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin. Dept. of Occupational Education and Technology.

    The Tex-SIS Follow-up system Employer Follow-up Survey involved four Texas community colleges, providing a statewide composite of employer data on the competency of occupational/technical graduates. The mailing list for prospective survey participants was derived from occupational/technical graduates' responses to a survey conducted in 1975-76. A…

  19. 33 CFR 179.15 - Follow-up report.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... discovered as of the date of the follow-up report; (3) The number of units in which corrective action has been completed as of the date of the follow-up report; (4) The number of first purchasers not notified... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Follow-up report. 179.15...

  20. Conservative surgical management of in situ subungual melanoma: long-term follow-up*

    PubMed Central

    Anda-Juárez, Mariana Catalina De; Martínez-Velasco, María Abril; Fonte-Ávalos, Verónica; Toussaint-Caire, Sonia; Domínguez-Cherit, Judith

    2016-01-01

    Subungual melanoma represents 20% of all melanomas in Hispanic population. Here, we report the outcome of 15 patients with in situ subungual melanoma treated with resection of the nail unit with a 5-mm margin without amputation, followed up for 55.93 ± 43.08 months. The most common complications included inclusion cysts and nail spicules. We found no evidence of local or distant recurrences at the last visit of our follow up. Functional outcome was good, with only one patient reporting persistent mild pain. These results support functional, non-amputative surgical management of in situ subungual melanomas. PMID:28099619

  1. Treatment Outcomes and Mediators of Parent Management Training: A One-Year Follow-Up of Children with Conduct Problems

    ERIC Educational Resources Information Center

    Hagen, Kristine Amlund; Ogden, Terje; Bjornebekk, Gunnar

    2011-01-01

    This effectiveness study presents the results of a 1-year follow-up of a randomized controlled trial of Parent Management Training. Families of 112 Norwegian girls and boys with clinic-level conduct problems participated, and 75 (67%) families were retained at follow-up. Children ranged in age from 4 to 12 at intake (M = 8.44). Families randomized…

  2. Treatment Outcome in Eating Disorders: A One-Year Follow-Up.

    ERIC Educational Resources Information Center

    Espelage, Dorothy L.; Quittner, Alexandra L.; McKenna, Molly C.; Sherman, Roberta; Thompson, Ron

    The effectiveness of an outpatient eating disorders treatment program was evaluated for 50 women over a 1-year follow-up period. Unlike many eating disorders programs now in place, this data was collected at a time when this program had relatively few exclusion criteria for potential participants; anyone with an eating disorder not requiring…

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

    PubMed

    Nørregaard, J; Bülow, P M; Prescott, E; Jacobsen, S; Danneskiold-Samsøe, B

    1993-01-01

    The primary objectives of this study were to examine to what extent fibromyalgia patients later on developed presumpted causative somatic diseases and to examine symptoms and muscle strength some years after the diagnosis of fibromyalgia was established. A secondary objective was to describe the overlap between fibromyalgia and chronic fatigue syndrome. Only in two of 91 the muscle pain was found to be caused by another somatic disease during the median 4 year follow-up period. In one of the 83 attending subjects a somatic disease associated with muscle symptoms was established at the follow-up visit. 60 out of 83 reported increased pain, 8 reported improvement of pain. The 83 subjects showed no significant fall in muscle strength during the follow-up period. The majority reported severe fatigue but only one fifth fulfilled the proposed chronic fatigue syndrome criteria.

  4. Self-Determination Theory and Outpatient Follow-Up After Psychiatric Hospitalization.

    PubMed

    Sripada, Rebecca K; Bowersox, Nicholas W; Ganoczy, Dara; Valenstein, Marcia; Pfeiffer, Paul N

    2016-08-01

    The objective of this study was to assess whether the constructs of self-determination theory-autonomy, competence, and relatedness-are associated with adherence to outpatient follow-up appointments after psychiatric hospitalization. 242 individuals discharged from inpatient psychiatric treatment within the Veterans Health Administration completed surveys assessing self-determination theory constructs as well as measures of depression and barriers to treatment. Medical records were used to count the number of mental health visits and no-shows in the 14 weeks following discharge. Logistic regression models assessed the association between survey items assessing theory constructs and attendance at mental healthcare visits. In multivariate models, none of the self-determination theory factors predicted outpatient follow-up attendance. The constructs of self-determination theory as measured by a single self-report survey may not reliably predict adherence to post-hospital care. Need factors such as depression may be more strongly predictive of treatment adherence.

  5. Three-year follow-up of a randomized controlled trial comparing preoperative neuroscience education for patients undergoing surgery for lumbar radiculopathy

    PubMed Central

    Louw, Adriaan; Diener, Ina; Landers, Merrill R.; Zimney, Kory

    2016-01-01

    Background Results from a previous multicenter randomized controlled trial (RCT) on preoperative pain neuroscience education (PNE) for lumbar radiculopathy found no significant difference in patient reported outcomes between groups. However, patients who received PNE viewed their surgical experience more favorably and utilized significantly less healthcare compared to those that did not. The purpose is to determine if the reduction in healthcare costs from 1-year would be continued at 3-year following surgery, and to explore differences (if any) in patient reported outcomes. Study design—analysis of 3-year follow-up data from RCT on preoperative PNE for lumbar radiculopathy. Methods Participating patients from the previous RCT were contacted for 3-year follow-up. Of the 67 patients who commenced in the study, there were 61 who completed 1-year follow-up. Data packets were sent to these 61 patients to examine post-operative utilization of healthcare (Utilization of Healthcare Questionnaire); LBP [numeric rating scale (NRS)]; leg pain (NRS); function (Oswestry disability index); and beliefs and experiences related to LS (10 item survey with Likert responses). Results At 3-year follow-up, 50 patients (29 females) responded, with 22 patients in the experimental group (EG) and 28 in the control group (CG). Cumulative medical expenses were 37% lower for the EG, with those patients spending less on X-rays and visits to their family physician, physical therapist, and massage therapist. There were no differences in patient reported outcomes between groups. Patients who received PNE continued to view their surgical experience more favorably compared to those that did not. Conclusions Adding a single PNE session prior to surgery for lumbar radiculopathy results in significant healthcare savings over 3 years. Educating such patients about normal responses to lumbar surgery (LS) in a neuroscience framework may result in lasting behavior changes following surgery. PMID

  6. Impact of clinical follow-up and diagnostic testing on intervention for tetralogy of Fallot

    PubMed Central

    House, Aswathy Vaikom; Danford, David A; Spicer, Robert L; Kutty, Shelby

    2015-01-01

    Objective Our purpose was to evaluate yield of tools commonly advocated for surveillance of tetralogy of Fallot (TOF). Methods All patients (pts) with TOF, seen at any time from 1/2008 to 9/2013 in an academic cardiology practice were studied. At the first and each subsequent outpatient visit, the use of tools including history and physical (H&P), ECG, Holter (HOL), echocardiogram (Echo), MR or CT (MR-CT) and stress testing (STR) were noted. Recommendations for intervention (INT) and for time to next follow-up were recorded; rationale for each INT with attribution to one or more tools was identified. Results There were 213 pts (mean 11.5 years, 130 male) who had 916 visits, 123 of which (13.4%) were associated with 138 INTs (47 surgical, 54 catheter-mediated, 37 other medical). Recommended follow-up interval was 9.44±6.5 months, actual mean follow-up interval was 11.7 months. All 916 (100%) patient visits had a H&P which contributed to 47.2% of INT decisions. Echo was performed in 652 (71.2%) of visits, and contributed to 53.7% of INTs. MR-CT was obtained in 129 (14.1%) of visits, and contributed to 30.1% of INTs. ECG was applied in 137 (15%) visits, and contributed to 1.6% of INTs. HOL was obtained in 188 (20.5%) visits, and contributed to 11.3% of INTs. STR was performed at 101 (11%) of visits, and contributed to 8.9% of INTs. Conclusions INTs are common in repaired TOF, but when visits average every 11–12 months, most visits do not result in INT. H&P, Echo and HOL were the most frequently applied screens, and all frequently yielded relevant information to guide INT decisions. STR and MR/CT were applied as targeted testing and in this limited, non-screening role had high relevance for INT. There was low utilisation of ECG and major impact on INT was not demonstrated. Risk stratification in TOF may be possible, and could result in more efficient surveillance and targeted testing. PMID:25973212

  7. Graduate Follow-Up Studies: How Useful Are They?

    ERIC Educational Resources Information Center

    Smedley, Rande H.; Olson, George H.

    Follow-up surveys may fall prey to several sources of bias and error, among them lack of control over independent variables, lack of item validity and reliability, sampling biases, and observation bias. Two follow-up studies have been dissected to expose inherent limitations: the Texas Education Product Study (TEPS) and Project TALENT. The…

  8. 33 CFR 179.15 - Follow-up report.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Follow-up report. 179.15 Section 179.15 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) BOATING SAFETY DEFECT NOTIFICATION § 179.15 Follow-up report. (a) Each manufacturer who makes an...

  9. First Grade Follow-Up of Kidi-Prep.

    ERIC Educational Resources Information Center

    Stank, Peggy L.

    A 1971-72 study compared the effects of a Kindergarten Diagnostic Prereading Program with the effects of traditional kindergarten on children's predicted reading levels. A follow-up study of the first grade reading achievement of the children from both kindergarten programs was recently completed. The purpose of the follow-up study was to answer…

  10. 49 CFR 219.211 - Analysis and follow-up.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Analysis and follow-up. 219.211 Section 219.211... Analysis and follow-up. (a) The laboratory designated in appendix B to this part undertakes prompt analysis... notification of the results of the toxicological analysis, any provision of collective bargaining...

  11. 49 CFR 219.211 - Analysis and follow-up.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Analysis and follow-up. 219.211 Section 219.211... Analysis and follow-up. (a) The laboratory designated in appendix B to this part undertakes prompt analysis... notification of the results of the toxicological analysis, any provision of collective bargaining...

  12. Treatment Summaries and Follow-Up Care Instructions for Cancer Survivors: Improving Survivor Self-Efficacy and Health Care Utilization

    PubMed Central

    Kvale, Elizabeth A.; Rocque, Gabrielle B.; Demark-Wahnefried, Wendy; Martin, Michelle Y.; Jackson, Bradford E.; Meneses, Karen; Partridge, Edward E.; Pisu, Maria

    2016-01-01

    Background. Treatment summaries and follow-up care plan information should be provided to cancer survivors. This study examines the association of receiving summaries and care plans with cancer survivor self-efficacy for chronic illness management, and whether self-efficacy was associated with health care utilization. Methods. Four hundred forty-one cancer survivors (≥2 years from diagnosis and had completed treatment) ≥65 years old from 12 cancer centers across 5 states completed telephone surveys. Survivors responded to three questions about receiving a written treatment summary, written follow-up plan, and an explanation of follow-up care plans. Respondents completed the Stanford Chronic Illness Management Self-Efficacy Scale and reported emergency room visits and hospitalizations in the past year. Three multiple linear regression models estimated the association of written treatment summary, written follow-up care plan, and verbal explanation of follow-up plan with total self-efficacy score. Log-binomial models estimated the association of self-efficacy scores with emergency room visits and hospitalizations (yes/no). Results. Among survivors, 40% and 35% received a written treatment summary and follow-up care plan, respectively. Seventy-nine percent received an explanation of follow-up care plans. Receiving a verbal explanation of follow-up care instructions was significantly associated with higher self-efficacy scores (β = 0.72, p = .009). Higher self-efficacy scores were significantly associated with lower prevalence ratios of emergency room visits (prevalence ratio, 0.92; 95% confidence interval, 0.88–0.97) and hospitalizations (prevalence ratio, 0.94; 95% confidence interval, 0.89–0.99). Conclusion. Explanation of the follow-up care plan, beyond the written component, enhances survivor self-efficacy for managing cancer as a chronic condition—an important mediator for improving health care utilization outcomes. Implications for Practice: Older

  13. How to shorten patient follow-up after treatment for Trypanosoma brucei gambiense sleeping sickness.

    PubMed

    Mumba Ngoyi, Dieudonné; Lejon, Veerle; Pyana, Pati; Boelaert, Marleen; Ilunga, Médard; Menten, Joris; Mulunda, Jean Pierre; Van Nieuwenhove, Simon; Muyembe Tamfum, Jean Jacques; Büscher, Philippe

    2010-02-01

    BACKGROUND. Clinical management of human African trypanosomiasis requires patient follow-up of 2 years' duration. At each follow-up visit, cerebrospinal fluid (CSF) is examined for trypanosomes and white blood cells (WBCs). Shortening follow-up would improve patient comfort and facilitate control of human African trypanosomiasis. METHODS. A prospective study of 360 patients was performed in the Democratic Republic of the Congo. The primary outcomes of the study were cure, relapse, and death. The WBC count, immunoglobulin M level, and specific antibody levels in CSF samples were evaluated to detect treatment failure. The sensitivity and specificity of shortened follow-up algorithms were calculated. RESULTS. The treatment failure rate was 37%. Trypanosomes, a WBC count of > or = 100 cells/microL, and a LATEX/immunoglobulin M titer of 1:16 in CSF before treatment were risk factors for treatment failure, whereas human immunodeficiency virus infection status was not a risk factor. The following algorithm, which had 97.8% specificity and 94.4% sensitivity, is proposed for shortening the duration of follow-up: at 6 months, patients with trypanosomes or a WBC count of > or = 50 cells/microL in CSF are considered to have treatment failure, whereas patients with a CSF WBC count of > or = 5 cells/microL are considered to be cured and can discontinue follow-up. At 12 months, the remaining patients (those with a WBC count of > or = 6-49 cells/microL) need a test of cure, based on trypanosome presence and WBC count, applying a cutoff value of > or = 20 cells/microL. CONCLUSION. Combining criteria for failure and cure allows follow-up of patients with second-stage human African trypanosomiasis to be shortened to a maximum duration of 12 months.

  14. A randomized study of electronic mail versus telephone follow-up after emergency department visit.

    PubMed

    Ezenkwele, Ugo A; Sites, Frank D; Shofer, Frances S; Pritchett, Ellen N; Hollander, Judd E

    2003-02-01

    This study was conducted to determine whether electronic mail (e-mail) increases contact rates after patients are discharged from the emergency department (ED). Following discharge, patients were randomized to be contacted by telephone or e-mail. The main outcome was success of contact. Secondary outcome was the median time of response. There were 1561 patients initially screened. Of these, 444 had e-mail and were included in the study. Half were contacted by telephone and the rest via e-mail. Our telephone contact rate was 58% (129/222) after two calls in a 48-h period and our e-mail contact was 41% (90/222). The telephone was nearly two times better than e-mail. The median time of response was 48 h for e-mail and 18 h for telephone. It is concluded that the telephone is a better modality of contact than e-mail for patients discharged from the ED.

  15. The transitioning from trials to extended follow-up studies

    PubMed Central

    Drye, Lea T.; Casper, Anne S.; Sternberg, Alice L.; Holbrook, Janet T.; Jenkins, Gabrielle; Meinert, Curtis L.

    2014-01-01

    Background Investigators may elect to extend follow-up of participants enrolled in a randomized clinical trial after the trial comes to its planned end. The additional follow-up may be initiated to learn about longer term effects of treatments including adverse events, costs related to treatment, or for reasons unrelated to treatment such as to observe the natural course of the disease using the established cohort from the trial. Purpose We examine transitioning from trials to extended follow-up studies when the goal of additional follow-up is to observe longer term treatment effects. Methods We conducted a literature search in selected journals from 2000–2012 to identify trials that extended follow-up for the purpose of studying longer term treatment effects and extracted information on the operational and logistical issues in the transition. We also draw experience from three trials coordinated by the Johns Hopkins Coordinating Centers that made transitions to extended followup: the Alzheimer’s Disease Anti-inflammatory Prevention Trial (ADAPT); Multicenter Uveitis Steroid Treatment (MUST) trial; and Childhood Asthma Management Program (CAMP). Results Transitions are not uncommon in multicenter clinical trials, even in trials that continued to the planned end of the trial. Transitioning usually necessitates new participant consents. If study infrastructure is not maintained during the transition, participants will be lost and re-establishing the staff and facilities will be costly. Merging data from the trial and follow-up study can be complicated by changes in data collection measures and schedules. Limitations Our discussion and recommendations are limited to issues that we have experienced in transitions from trials to follow-up studies. Discussion We discuss issues such as maintaining funding, IRB and consent requirements, contacting participants, and combining data from the trial and follow-up phases. We conclude with a list of recommendations to

  16. Itolizumab provides sustained remission in plaque psoriasis: a 5-year follow-up experience.

    PubMed

    Budamakuntla, L; Madaiah, M; Sarvajnamurthy, S; Kapanigowda, S

    2015-03-01

    There is an unmet need for psoriasis therapies that provide long-term remission. Itolizumab is a humanized recombinant anti-CD6 monoclonal antibody shown to be effective in psoriasis. We report a patient who received itolizumab in a phase 2 clinical trial, and experienced long-term remission. At baseline, the patient's Psoriasis Area and Severity Index (PASI) was 12.2, and Physician's Global Assessment (PGA) score was 3. After 8 weeks of treatment, the patient achieved 97% improvement in PASI. She continued to have ≥ 90% improvement, initially for 4 weeks (follow-up phase), and later for 20 weeks (follow-up extension phase). She continued to visit the hospital after the final study visit; her most recent visit was on 10 May 2013. PGA results during the visits revealed sustained response for 4 years and 5 months after stopping itolizumab. Itolizumab could be therefore an important treatment option for moderate to severe psoriasis, with potential to provide long-lasting remission.

  17. Short-Term Follow-Up of Narcotic Addicts

    ERIC Educational Resources Information Center

    Swartz, June; Jabara, Raymond

    1974-01-01

    A follow-up questionnaire was mailed to 144 narcotic addict veterans approximately six months after termination from treatment at a multimodality drug program. It was found that 75 percent continued to use drugs, and 38 percent became readdicted. (Author)

  18. Outpatient follow-up for critical limb ischemia.

    PubMed

    Watch, Libby

    2014-09-01

    Outpatient follow-Up for critical limb ischemia offers the clinician the opportunity to monitor the patient for risk factor modification and wound healing. Routine surveillance following intervention will improve long-term patency.

  19. Radiological follow-up of pediatric pneumonia: principle and practice.

    PubMed

    Mahmood, Dhia; Vartzelis, George; McQueen, Paula; Perkin, Michael R

    2007-03-01

    A study was undertaken to evaluate the trends in radiological follow up of childhood pneumonia among consultant pediatricians throughout the United Kingdom. A questionnaire was sent to 120 consultant pediatricians. Among the 88 respondents, 18% would carry out a repeat chest radiograph on follow-up of all their patients admitted with pneumonia, whereas 78% would perform the investigation selectively. Among the criteria for selection, persistence of symptoms and collapse or effusion were cited, although a considerable number would repeat a chest radiograph in children with lobar pneumonia. The mean timing of a repeat chest radiograph was 5.5 weeks after presentation (range 2-12 weeks). Only 23% of the respondents worked in units with written guidelines for the follow-up of children with pneumonia. Written guidelines, specifying the categories of children who would benefit from follow-up chest radiographs, should be present and implemented in all pediatric departments.

  20. Women with abnormal screening mammography lost to follow-up

    PubMed Central

    Kuo, Chia-Sheng; Chen, Guan-Ru; Hung, Shou-Hung; Liu, Yi-Lien; Huang, Kuo-Chin; Cheng, Shao-Yi

    2016-01-01

    Abstract Breast cancer has the highest incidence among all cancers for women in Taiwan. The current screening policy in Taiwan suggested a biennial mammography for all women 40 to 69 years of age. A recommendation for additional testing is recommended for women with a BI-RADS result of 0 or 4; a request made via postal mail. Approximately 20% of high-risk patients do not receive additional follow-up. Therefore, we aimed to explore the causes of these patients being lost to follow-up, despite an abnormal mammogram. Two questionnaires were designed separately according to the conceptual framework of the Health Belief Model. Study participants, women who received a screening mammography at the National Taiwan University Hospital in 2011 with a BI-RAD of 0 or 4, were interviewed via telephone. The dependent variable was receipt of follow-up or not. The analyses were performed by using χ2 tests and logistic regression models. In total, 528 women were enrolled in the study: 51.2% in BI-RADS 0 group and 56.6% in BI-RADS 4, respectively. In the BI-RADS 0 group, those patients who received a follow-up examination cited the most likely causes to be physician suggestion, health implications, and concerns regarding breast cancer. Patients who did not receive a follow-up examination cited a lack of time and a perception of good personal health as primary reasons. In the BI-RADS 4 group, those patients who received a follow-up examination cited the physician's recommendation and a recognition of the importance of follow-up examinations. Patients who did not receive a follow-up examination cited having received follow-up at another hospital and a desire for a second opinion. In the BI-RADS 0 group, multivariate analysis showed that patients with higher scores in the “perceived benefits” domain were statistically more likely to receive a follow-up examination. There was no significant difference in perceived threats, perceived barriers, action cues, or self-efficacy between

  1. Evaluating an outreach service for paediatric burns follow up.

    PubMed

    Cubitt, Jonathan J; Chesney, Amy; Brown, Liz; Nguyen, Dai Q

    2015-09-01

    Complications following paediatric burns are well documented and care needs to be taken to ensure the appropriate follow up of these patients. Historically this has meant follow up into adulthood however this is often not necessary. The centralisation of burns services in the UK means that patients and their parents may have to travel significant distances to receive this follow up care. To optimise our burns service we have introduced a burns outreach service to enable the patients to be treated closer to home. The aim of this study is to investigate the impact of the introduction of the burns outreach service and within this environment define the optimum length of time needed to follow up these patients. A retrospective analysis was carried out of 100 consecutive paediatric burns patients who underwent surgical management of their burn. During the follow up period there were 43 complications in 32 patients (32%). These included adverse scarring (either hypertrophic or keloid), delayed healing (taking >1 month to heal) and contractures (utilising either splinting or surgical correction). Fifty-nine percent of these complications occurred within 6 months of injury and all occurred within 18 months. Size of burn was directly correlated to the risk of developing a complication. The outreach service reduced the distance the patient needs to travel for follow up by more than 50%. There was also a significant financial benefit for the service as the follow up clinics were on average 50% cheaper with burns outreach than burns physician. Burns outreach is a feasible service that not only benefits the patients but also is cheaper for the burns service. The optimum length of follow up for paediatric burns in 18 months, after which if there have not been any complications they can be discharged.

  2. Effect of Planned Follow-up on Married Women's Health Beliefs and Behaviors Concerning Breast and Cervical Cancer Screenings.

    PubMed

    Kolutek, Rahsan; Avci, Ilknur Aydin; Sevig, Umit

    2016-09-24

    The objective of this study was to identify the effect of planned follow-up visits on married women's health beliefs and behaviors concerning breast and cervical cancer screenings. The study was conducted using the single-group pre-test/post-test and quasi-experimental study designs. The sample of the study included 153 women. Data were collected using a Personal Information Form, the Health Belief Model (HBM) Scale for Breast Cancer Screening, the HBM Scale for Cervical Cancer Screening, and a Pap smear test. Data were collected using the aforementioned tools from September 2012 to March 2013. Four follow-up visits were conducted, nurses were educated, and telephone reminders were utilized. Friedman's test, McNemar's test, and descriptive statistics were used for data analyzing. The frequency of performing breast self-examination (BSE) at the last visit increased to 84.3 % compared to the pre-training. A statistically significant difference was observed between the pre- and post-training median values in four subscales except for the subscale of perceived seriousness of cervical cancer under "the Health Belief Model Scale for Cervical Cancer and the Pap Smear Test" (p < 0.001). The rate of performing BSE significantly increased after the training and follow-up visits. Also, the rate of having a Pap smear significantly increased after the follow-up visits.

  3. Revisiting High School Visits

    ERIC Educational Resources Information Center

    Flagel, Andrew

    2012-01-01

    NACAC's anniversary is a great time to follow up on an article on high school visits, a topic of ongoing discussion in every admission and guidance office. The article highlights a variety of potential good outcomes that can be derived from collaborative interactions. Sadly, however, admission representatives are apt to be described by the…

  4. Lung Tumors Treated With Percutaneous Radiofrequency Ablation: Computed Tomography Imaging Follow-Up

    SciTech Connect

    Palussiere, Jean Marcet, Benjamin; Descat, Edouard; Deschamps, Frederic; Rao, Pramod; Ravaud, Alain; Brouste, Veronique; Baere, Thierry de

    2011-10-15

    Purpose: To describe the morphologic evolution of lung tumors treated with radiofrequency ablation (RFA) by way of computed tomography (CT) images and to investigate patterns of incomplete RFA at the site of ablation. Materials and Methods: One hundred eighty-nine patients with 350 lung tumors treated with RFA underwent CT imaging at 2, 4, 6, and 12 months. CT findings were interpreted separately by two reviewers with consensus. Five different radiologic patterns were predefined: fibrosis, cavitation, nodule, atelectasis, and disappearance. The appearance of the treated area was evaluated at each follow-up CT using the predefined patterns. Results: At 1 year after treatment, the most common evolutions were fibrosis (50.5%) or nodules (44.8%). Differences were noted depending on the initial size of the tumor, with fibrosis occurring more frequently for tumors <2 cm (58.6% vs. 22.9%, P = 1 Multiplication-Sign 10{sup -5}). Cavitation and atelectasis were less frequent patterns (2.4% and 1.4%, respectively, at 1 year). Tumor location (intraparenchymatous, with pleural contact <50% or >50%) was not significantly correlated with follow-up image pattern. Local tumor progressions were observed with each type of evolution. At 1 year, 12 local recurrences were noted: 2 cavitations, which represented 40% of the cavitations noted at 1 year; 2 fibroses (1.9%); 7 nodules (7.4%); and 1 atelectasis (33.3%). Conclusion: After RFA of lung tumors, follow-up CT scans show that the shape of the treatment zone can evolve in five different patterns. None of these patterns, however, can confirm the absence of further local tumor progression at subsequent follow-up.

  5. Factors Associated with Follow-Up Attendance among Rape Victims Seen in Acute Medical Care

    PubMed Central

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

    2016-01-01

    Objective Rape is associated with Posttraumatic Stress Disorder and related comorbidities. Most victims do not obtain treatment for these conditions. Acute care medical settings are well-positioned to link patients to services; however, difficulty engaging victims and low attendance at provided follow-up appointments is well documented. Identifying factors associated with follow-up can inform engagement and linkage strategies. Method Administrative, patient self-report, and provider observational data from Harborview Medical Center were combined for the analysis. Using logistic regression, we examined factors associated with follow-up health service utilization after seeking services for rape in the emergency department. Results Of the 521 diverse female (n=476) and male (n=45) rape victims, 28% attended the recommended medical/counseling follow-up appointment. In the final (adjusted) logistic regression model, having a developmental or other disability (OR=0.40, 95% CI=0.21-0.77), having a current mental illness (OR=0.25, 95% CI=0.13-0.49), and being assaulted in public (OR=0.50, 95% CI=0.28-0.87) were uniquely associated with reduced odds of attending the follow-up. Having a prior mental health condition (OR= 3.02 95% CI=1.86-4.91), a completed SANE examination (OR=2.97, 95% CI=1.84-4.81), and social support available to help cope with the assault (OR=3.54, 95% CI=1.76-7.11) were associated with an increased odds of attending the follow-up. Conclusions Findings point to relevant characteristics ascertained at the acute care medical visit for rape that may be used to identify victims less likely to obtain posttraumatic medical and mental health services. Efforts to improve service linkage among these patients is warranted and may require alternative models to engage these patients to support posttraumatic recovery. PMID:26168030

  6. Feasibility of a Team Approach to Complex Congenital Heart Defect Neurodevelopmental Follow-Up

    PubMed Central

    Chorna, Olena; Baldwin, H. Scott; Neumaier, Jamie; Gogliotti, Shirley; Powers, Deborah; Mouvery, Amanda; Bichell, David; Maitre, Nathalie L.

    2017-01-01

    Infants with complex congenital heart disease are at high risk for poor neurodevelopmental outcomes. However, implementation of dedicated congenital heart disease follow-up programs presents important infrastructure, personnel, and resource challenges. We present the development, implementation, and retrospective review of 1- and 2-year outcomes of a Complex Congenital Heart Defect Neurodevelopmental Follow-Up program. This program was a synergistic approach between the Pediatric Cardiology, Cardiothoracic Surgery, Pediatric Intensive Care, and Neonatal Intensive Care Unit Follow-Up teams to provide a feasible and responsible utilization of existing infrastructure and personnel, to develop and implement a program dedicated to children with congenital heart disease. Trained developmental testers administered the Ages and Stages Questionnaire-3 over the phone to the parents of all referred children at least once between 6 and 12 months’ corrected age. At 18 months’ corrected age, all children were scheduled in the Neonatal Intensive-Care Unit Follow-Up Clinic for a visit with standardized neurological exams, Bayley III, multidisciplinary therapy evaluations and continued follow-up. Of the 132 patients identified in the Cardiothoracic Surgery database and at discharge from the hospital, a total number of 106 infants were reviewed. A genetic syndrome was identified in 23.4% of the population. Neuroimaging abnormalities were identified in 21.7% of the cohort with 12.8% having visibly severe insults. As a result, 23 (26.7%) received first-time referrals for early intervention services, 16 (13.8%) received referrals for new services in addition to their existing ones. We concluded that utilization of existing resources in collaboration with established programs can ensure targeted neurodevelopmental follow-up for all children with complex congenital heart disease. PMID:27220370

  7. Effect of Health Literacy on Research Follow-Up.

    PubMed

    Leak, Cardella; Goggins, Kathryn; Schildcrout, Jonathan S; Theobald, Cecelia; Donato, Katharine M; Bell, Susan P; Schnelle, John; Kripalani, Sunil

    2015-01-01

    Previous research has not examined the effect of health literacy on research subjects' completion of scheduled research follow-up. This article evaluates patient factors associated with incomplete research follow-up at three time points after enrollment in a large, hospital-based prospective cohort study. Predictor variables included health literacy, age, race, gender, education, employment status, difficulty paying bills, hospital diagnosis, length of stay, self-reported global health status, depression, perceived health competence, medication adherence, and health care system distrust. In a sample of 2,042 patients, multivariable models demonstrated that lower health literacy and younger age were significantly associated with a lower likelihood of completing research follow-up interviews at 2-3 days, 30 days, and 90 days after hospital discharge. In addition, patients who had less education, were currently employed, and had moderate financial stress were less likely to complete 90-day follow-up. This study is the first to demonstrate that lower health literacy is a significant predictor of incomplete research follow-up.

  8. Cancer Related Follow-up Care among Hispanic and non-Hispanic Childhood Cancer Survivors: The Project Forward Study

    PubMed Central

    Milam, Joel; Meeske, Kathleen; Slaughter, Rhona; Sherman-Bien, Sandra; Ritt-Olson, Anamara; Kuperberg, Aura; Freyer, David R.; Hamilton, Ann S.

    2014-01-01

    Background Follow-up care is critical for childhood cancer survivors (CCS) who are at high risk for co-morbidities and late effects of cancer treatments. Understanding factors associated with maintaining follow-up care is needed, especially for Hispanic CCS who are underrepresented in previous studies. Methods Risk and protective factors for receiving cancer-related follow-up care were examined among 193 Los Angeles County CCS diagnosed between 2000–2007 (54% Hispanic; mean age=19.9, SD=2.8; mean age at diagnosis=12.1, SD=3.0; mean years since diagnosis=7.8, SD=2.0). Self-report surveys assessed follow-up care, insurance status, demographics, clinical factors, and psychosocial risk (e.g., depression) and protective [e.g., self-efficacy (SE)] factors. Multivariable logistic regression was used to determine factors associated with previous (in prior 2 years) and intent for future cancer-related follow-up care. Results Seventy-three percent of CCS reported a cancer follow-up visit in the prior 2 years, which was positively associated (p’s<.05) with having health insurance, White ethnicity (vs. Hispanic), younger age and greater treatment intensity. Sixty-nine percent reported intent for follow-up care in the next two years, which was positively associated (p’s<.05) with having health insurance and greater SE. Conclusions Hispanics and older CCS are more likely to lack previous follow-up care. Because health insurance was strongly associated with both previous follow-up care and intent to seek care, recent changes in health coverage may improve follow-up among CCS. Interventions targeting improved SE may help increase intent to receive follow-up care for this population. PMID:25345867

  9. Cognitive behavioural therapy for depression in multiple endocrine neoplasia type IIB: a 1-year follow-up

    PubMed Central

    Mejía-Castrejón, Jessica; Landa-Ramírez, Edgar

    2014-01-01

    This case report describes a 24-year-old man diagnosed with multiple endocrine neoplasia type IIB and major depression. Because cognitive behavioural therapy (CBT) has proven effective in the treatment of major depression in the general population and patients with cancer, we decided to adapt and use this therapy and evaluate its impact on major depression and the patient’s quality of life. The therapy was conducted individually in 15 sessions that were given over a span of 25 weeks. The data show that therapy was a useful treatment that reduced depression according to the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria and self-report instruments. CBT also helped improve the patient’s quality of life, and it was considered to be an acceptable intervention for the patient, with ongoing positive results 1 year after the last psychotherapy session. CBT is a potential option for treating depression in this population but further research is needed. PMID:24898996

  10. Psychological and Work Stress Assessment of Patients following Angioplasty or Heart Surgery: Results of 1-year Follow-up Study.

    PubMed

    Fiabane, Elena; Giorgi, Ines; Candura, Stefano M; Argentero, Piergiorgio

    2015-12-01

    The aim of this study was to explore changes in subjective psychological health and perceived work stress among patients who returned to work (RTW) after a multidisciplinary cardiac rehabilitation (CR) following cardiac interventions. A total of 108 patients were evaluated at the beginning of their CR, at 6 and 12 months after discharge. Self-report questionnaires were used to assess depression, anxiety, illness perception and work stress at each time stage. Results showed reports of depressive symptoms significantly decreased (p < 0.05) and subjective mental (p = 0.001) and physical health (p < 0.001) improved over time. Patients revealed a decrease in Type A behaviour pattern (p < 0.001) and in job satisfaction levels (p = 0.01), greater internal locus of control (p < 0.01) and increased use of the coping strategy 'Involvement' (p < 0.01). Major findings are that cardiac patients had an improvement in subjective psychological health and did not perceive increased work stress after their RTW. Patients' psychological health and work stress need to be assessed during the CR and should be also carefully monitored after the RTW in order to identify patients' psychological and work-related barriers and facilitate a safe and successful work reintegration.

  11. Continuous passive motion following total knee replacement: a prospective randomized trial with follow-up to 1 year.

    PubMed

    Leach, W; Reid, J; Murphy, F

    2006-10-01

    We have carried out a prospective randomised, single blind clinical trial to investigate the effect of continuous passive motion on range of knee flexion, lack of extension, pain levels and analgesic use after total knee replacement surgery. 85 subjects were randomly allocated to control or study group. All subjects followed the existing rehabilitation protocol, which permits immediate active range of motion exercises and mobilisation with the study group using continuous passive motion for 1 h, twice a day. Outcome measures employed were range of motion, pain assessed on a visual analogue scale and analgesic use according to the WHO ladder. Blinded evaluation was carried out preoperatively, at time of discharge from hospital, 6 weeks, 6 and 12 months postoperation. No significant difference was observed between groups at all time intervals for each outcome variable using Wilcoxon Rank sum tests. The results substantiate previous findings that short duration continuous passive motion following total knee arthroplasty does not influence outcome of range of motion or reported pain.

  12. Suicide Prevention and Follow-Up Services: A Narrative Review

    PubMed Central

    Ghanbari, Behrooz; Malakouti, Seyed Kazem; Nojomi, Marzieh; Alavi, Kaveh; Khaleghparast, Shiva

    2016-01-01

    Previous suicide attempt is the most important predictor of death by suicide. Thus preventive interventions after attempting to suicide is essential to prevent reattempts. This paper attempts to determine whether phone preventive interventions or other vehicles (postal cards, email and case management) are effective in reattempt prevention and health promotion after discharge by providing an overview of studies on suicide reattempts. The research investigated in this review conducted from 1995 to 2014. A total of 26 cases related to the aim of this research were derived from 36 English articles with the aforementioned keywords Research shows that providing comprehensive aids, social support, and follow-up after discharge can significantly prevent suicide reattempts. Several studies showed that follow-up support (phone calls, crisis cards, mails, postal cards.) after discharge can significantly decrease the risk of suicide. More randomized controlled trials (RCT) are required to determine what factors of follow-up are more effective than other methods. PMID:26652085

  13. Breast cancer follow-up in the adjuvant setting.

    PubMed

    Khatcheressian, James; Swainey, Craig

    2008-01-01

    Breast cancer may recur through 15 years and beyond after diagnosis; thus, breast cancer patients require long-term follow-up after adjuvant treatment to detect recurrent disease. History taking, physical examination, and regular mammography are still the foundation of appropriate breast cancer follow-up in the adjuvant setting. Clearly, breast MRI has a role in certain high-risk patients, but in moderate-risk patients, the decision to use MRI must be based on the complexity of the clinical scenario. Other routine imaging studies (CT, positron emission tomography, and bone scans) and laboratory testing--including tumor marker assessments--in asymptomatic patients have not demonstrated an improvement in survival, quality of life, toxicity, or cost-effectiveness. Survivorship issues are also an inherent part of breast cancer follow-up; physicians should make every effort to address supportive care issues unique to breast cancer survivors including hot flashes, bone health, neuropathy, and risk-reduction strategies.

  14. Acromegalic patients lost to follow-up: a pilot study.

    PubMed

    Kasuki, Leandro; Marques, Nelma Verônica; Nuez, Maria José Braga La; Leal, Vera Lucia Gomes; Chinen, Renata N; Gadelha, Mônica R

    2013-06-01

    Approximately 50 % of all acromegalic patients will require lifelong medical treatment to normalize mortality rates and reduce morbidity. Thus, adherence to therapy is essential to achieve treatment goals. To date, no study has evaluated the frequency and reasons for loss to follow-up in the acromegalic population. The current study aimed at evaluating the frequency of acromegalic patient loss to follow-up in three reference centers and the reasons responsible for their low compliance with treatment. All of the files for the acromegalic patients in the three centers were reviewed. Those patients, who had not followed up with the hospital for more than a year, were contacted via phone and/or mail and invited to participate. Patients who agreed to participate were interviewed, and blood samples were collected. A total of 239 files were reviewed; from these 42 patients (17.6 %) were identified who were lost to follow-up. It was possible to contact 27 of these patients, 10 of whom did not attend the appointments for more than one time and 17 of whom agreed to participate in the study. Fifteen of these 17 patients had active disease (88.2 %), and all of the patients restarted treatment in the original centers. The main reason for loss to follow-up was an absence of symptoms. High-quality follow-up is important in acromegaly to successfully achieve the aims of the treatment. An active search for patients may allow the resumption of treatment in a significant proportion of these cases, contributing to reduced morbidity and mortality in this patient population.

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

    PubMed

    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. Retrieval of foreign body from a postoperative defect in the mandible during the follow-up period: A bizarre occurrence

    PubMed Central

    Saluja, Harish M. C.; Rudagi, Bhimmapa Mallapa; Mahindra, Uma Rajan; Gaikwad, Prafful T.; Dehane, Vipin V.

    2014-01-01

    Though reported cases of foreign bodies left intraoperatively in the oral cavity are very few, there is no case mentioned in the literature where foreign body was left behind during follow-up visits. Here, we present an operated case of unicystic ameloblastoma of mandibular ramus region, in which a needle hub was left at the operated site (cavity created because of wound dehiscence) during some of the follow-up visits, which was detected accidently by radiograph and later on retrieved. The case reported was because of negligence of trainee surgeons, might be because of overburden or because of minimal interest in these repeated follow ups. But, a trainee should understand that their work also has similar importance as that of surgeon's work. PMID:25298722

  17. Follow-Up Observations of Known EC 14026-TYPE Pulsators

    NASA Astrophysics Data System (ADS)

    Wolf, G. W.; Reed, M. D.; Zhou, A.-Y.; Terndrup, D. M.; Harms, S. L.; An, D.; Chen, C.-W.; Lin, H.-C.; Zola, S.; Baran, A.; Ogloza, W.; Siwak, M.; Gazeas, K. D.; Niarchos, P. G.; Kilkenny, D.

    We present follow-up observations of pulsating sdB stars as part of our efforts to resolve the pulsation spectra for use in asteroseismological analyses. This paper reports on our overall efforts, but specifically on our results for the pulsating sdB stars KPD 2109+4401 and PG 0154+182.

  18. Follow-Up of the Fall 1990 FTIC Cohort.

    ERIC Educational Resources Information Center

    Windham, Patricia

    Drawing from data provided by the Florida Education and Training Placement Information Program (FETPIP), this series of reports provides follow-up information on FTIC students entering Tallahassee Community College (TCC) in fall 1990. The four reports compare students based on race, entry level test pass rates, full-/part-time status, and grade…

  19. Sexually Abstinent Adolescents: An 18-Month Follow-Up

    ERIC Educational Resources Information Center

    Blinn-Pike, Lynn; Berger, Thomas J.; Hewett, John; Oleson, Jacob

    2004-01-01

    This study was a longitudinal follow-up of 697 early adolescents from 20 schools in Missouri, investigating students who, in 1997, indicated on a survey of sexual attitudes and behaviors that they had not had sexual intercourse. They completed the Reasons for Abstinence Scale (RAS) by identifying those items that were reasons why they had not had…

  20. Factors Associated with Adherence to Follow-up Colposcopy

    ERIC Educational Resources Information Center

    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…

  1. 10 CFR 1022.17 - Follow-up.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... ENERGY (GENERAL PROVISIONS) COMPLIANCE WITH FLOODPLAIN AND WETLAND ENVIRONMENTAL REVIEW REQUIREMENTS Procedures for Floodplain and Wetland Reviews § 1022.17 Follow-up. For those DOE actions taken in a floodplain or wetland, DOE shall verify that the implementation of the selected alternative,...

  2. 10 CFR 1022.17 - Follow-up.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... ENERGY (GENERAL PROVISIONS) COMPLIANCE WITH FLOODPLAIN AND WETLAND ENVIRONMENTAL REVIEW REQUIREMENTS Procedures for Floodplain and Wetland Reviews § 1022.17 Follow-up. For those DOE actions taken in a floodplain or wetland, DOE shall verify that the implementation of the selected alternative,...

  3. 10 CFR 1022.17 - Follow-up.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... ENERGY (GENERAL PROVISIONS) COMPLIANCE WITH FLOODPLAIN AND WETLAND ENVIRONMENTAL REVIEW REQUIREMENTS Procedures for Floodplain and Wetland Reviews § 1022.17 Follow-up. For those DOE actions taken in a floodplain or wetland, DOE shall verify that the implementation of the selected alternative,...

  4. 10 CFR 1022.17 - Follow-up.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... ENERGY (GENERAL PROVISIONS) COMPLIANCE WITH FLOODPLAIN AND WETLAND ENVIRONMENTAL REVIEW REQUIREMENTS Procedures for Floodplain and Wetland Reviews § 1022.17 Follow-up. For those DOE actions taken in a floodplain or wetland, DOE shall verify that the implementation of the selected alternative,...

  5. 10 CFR 1022.17 - Follow-up.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ENERGY (GENERAL PROVISIONS) COMPLIANCE WITH FLOODPLAIN AND WETLAND ENVIRONMENTAL REVIEW REQUIREMENTS Procedures for Floodplain and Wetland Reviews § 1022.17 Follow-up. For those DOE actions taken in a floodplain or wetland, DOE shall verify that the implementation of the selected alternative,...

  6. Extended Follow-Up | Division of Cancer Prevention

    Cancer.gov

    NCI supports the continued follow-up of participants in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) to strengthen the PLCO as a valuable resource for molecular epidemiologic research as well as provide long-term data on the trial’s primary endpoints. |

  7. Loss to Follow-Up: Issues and Recommendations

    ERIC Educational Resources Information Center

    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…

  8. Follow-Up Study of 1994 Dental Hygiene Graduates.

    ERIC Educational Resources Information Center

    Holt, Marianne; Lucas, John A.

    In an effort to evaluate the effectiveness of its dental hygiene program, William Rainey Harper College (WRHC), in Illinois, conducted a follow-up study of program graduates from 1994. Surveys were mailed to all 30 1994 dental hygiene associate degree graduates, receiving responses from 77% (n=23). Study findings included the following: (1) all…

  9. Graduate Follow-Up Report, 1994-95.

    ERIC Educational Resources Information Center

    Wisconsin State Board of Vocational, Technical, and Adult Education, Madison.

    Each year, a follow-up study is conducted to gather data on the activities and perceptions of students approximately 6 months after their graduation from Wisconsin's Technical Colleges (WTC). Specifically, the survey seeks to identify the current activities of the WTC graduates, determine the extent to which current activities are related to the…

  10. Three Year Follow-Up of 1974 Graduates.

    ERIC Educational Resources Information Center

    Baratta, Mary Kathryne

    To evaluate the long-term benefits of attendance at Moraine Valley Community College (MVCC), a three-year follow-up study was conducted of the 620 1974 graduates (324 transfer and 296 occupational students). Each graduate was sent a questionnaire collecting information on involvement with MVCC after graduation, present educational status,…

  11. Follow-Up Activities for the HISD Kindergarten Screening Instrument.

    ERIC Educational Resources Information Center

    Perry, Pat; Cater, Margot

    The Kindergarten Screening Instrument consists of five sub-scales and attempts to screen for possible difficulty in the areas of distant vision, hearing, eye-hand coordination, language learning, and gross motor performance. In response to many requests for follow-up activities after screening, this manual was prepared by Volunteers in Public…

  12. 1988-89 Graduate Follow-Up Report.

    ERIC Educational Resources Information Center

    Wisconsin State Board of Vocational, Technical, and Adult Education, Madison.

    In 1989, a graduate follow-up survey was conducted to gather data regarding student perceptions and activities following graduation from the Wisconsin Vocational, Technical and Adult Education System (VTAE). Primary objectives of the survey were to identify current activities of VTAE graduates, determine whether the activities were related to the…

  13. 1987-88 Graduate Follow-Up Report.

    ERIC Educational Resources Information Center

    Davison, Glen A.

    The Wisconsin Vocational, Technical, and Adult Education (VTAE) System annually conducts a student follow-up survey to gather data on the activities and perceptions of graduates of Designed to provide information for career awareness and program planning efforts, the survey investigates the current activities of VTAE graduates and the relationship…

  14. Follow-up photometry of iPTF16geu

    NASA Astrophysics Data System (ADS)

    Lee, C.-H.

    2016-10-01

    We report follow-up photometry of the strongly lensed SNIa iPTF16geu (ATel #9603, #9626). We observed iPTF16geu on 2016/10/17 with the 2.5-m Isaac Newton Telescope (INT) + WFC at La Palma, under ~0.9" seeing condition.

  15. Trident Technical College 1998 Graduate Follow-Up.

    ERIC Educational Resources Information Center

    Trident Technical Coll., Charleston, SC.

    Presents the results of South Carolina's Trident Technical College's (TTC's) 1998 graduate follow-up survey report of 915 TTC graduates. Graduates were surveyed and results were obtained for the following items: graduate goals, employment, placement rates, graduates in related fields, when job were obtained, job finding methods, job locations, job…

  16. Trident Technical College 1999 Graduate Follow-Up Report.

    ERIC Educational Resources Information Center

    Trident Technical Coll., Charleston, SC.

    Presents the results of South Carolina's Trident Technical College's (TTC's) 1999 graduate follow-up survey report. Graduates were surveyed and results were obtained for the following items: graduate goals, employment, placement rates, graduates in related fields, when job obtained, job finding methods, job locations, job satisfaction, job…

  17. Job Training Partnership Act 8% Follow-up Summary Report.

    ERIC Educational Resources Information Center

    Peterson, Charlene M.; And Others

    From September through November 1986, the Wisconsin Department of Public Instruction (DPI) conducted a follow-up survey of Job Training Partnership Act (JTPA) 8% program participants in the 1985-86 school year. The DPI is responsible for administering half of the JTPA 8% Education Coordination and Grants for economically disadvantaged youth, ages…

  18. Cleft lip and palate surgery: 30 years follow-up

    PubMed Central

    Guerrero, Cesar A.

    2012-01-01

    Ten cleft lip and palate patients with complete unilateral (five patients) and bilateral (five patients) clefts were treated by a multidisciplinary team integrated by psychologists, surgeons, orthodontists, prosthodontists, pediatric dentists, and speech pathologists, to obtain ideal soft tissue and hard tissue continuity, facial symmetry, functional and esthetic dentitions, excellent nasal architecture, subtle, and hidden lip scars. No hypernasality and adequate social adaptation were found in the 30 years follow-up (20-30 years follow-up with an average of 25.5 years). The patients were treated in a pro-active fashion avoiding complications and related problems, executing the ideal surgical, dental, and speech therapy plan, based on a close follow-up over the entire period. Those patients treated at the right time required less surgeries and less salvaging maneuvers and presented complete dentitions with less dental prosthesis or dental implants and stable occlusions, than those who missed the ideal dental and surgical treatment opportunities. The focus of this article is the need of a close long-term follow-up to ensure an ideal patient's quality of life. PMID:23483117

  19. Matching Methods for Selection of Participants for Follow-Up

    ERIC Educational Resources Information Center

    Stuart, Elizabeth A.; Lalongo, Nicholas S.

    2010-01-01

    This work examines ways to make the best use of limited resources when selecting individuals to follow up in a longitudinal study estimating causal effects. In the setting under consideration, covariate information is available for all individuals but outcomes have not yet been collected and may be expensive to gather, and thus only a subset of…

  20. Racial and Ethnic Disparities in Functioning at Discharge and Follow-Up Among Patients With Motor Complete Spinal Cord Injury

    PubMed Central

    Fyffe, Denise C.; Deutsch, Anne; Botticello, Amanda L.; Kirshblum, Steven; Ottenbacher, Kenneth J.

    2015-01-01

    Objective To examine racial and ethnic differences in self-care and mobility outcomes for persons with a motor complete, traumatic spinal cord injury (SCI) at discharge and 1-year follow-up. Design Retrospective cohort study. Setting Sixteen rehabilitation centers contributing to the Spinal Cord Injury Model Systems (SCIMS) database. Participants Adults with traumatic, motor complete SCI (N=1766; American Spinal Injury Association Impairment Scale grade A or B) enrolled in the SCIMS between 2000 and 2011. Selected cases had complete self-reported data on race and ethnicity (non-Hispanic white, non-Hispanic black, or Hispanic) and motor FIM scores assessed at inpatient rehabilitation admission, discharge, and 1-year follow-up. Interventions Not applicable. Main Outcome Measures Functional outcomes were measured by FIM self-care and mobility scores on a 1 to 7 FIM scale, at discharge and 1-year follow-up. Results Multiple regression models stratified by neurologic category and adjusted for sociodemographic and injury characteristics assessed racial and ethnic group differences in FIM self-care and mobility change scores at discharge and 1-year follow-up. At discharge, non-Hispanic black participants with tetraplegia and paraplegia had significantly poorer gains in FIM self-care and mobility scores relative to non-Hispanic white and Hispanic participants. At 1-year follow-up, similar FIM self-care and mobility change scores were found across racial and ethnic groups within each neurologic category. Conclusions Non-Hispanic white and Hispanic participants had comparatively more improvement in self-care and mobility during inpatient rehabilitation compared with non-Hispanic black participants. At 1-year follow-up, no differences in self-care and mobility outcomes were observed across racial and ethnic groups. Additional research is needed to identify potential modifiable factors that may contribute to racially and ethnically different patterns of functional outcomes

  1. Seven-year follow-up of expanded polytetrafluoroethylene (PTFE) femoropopliteal bypass grafts.

    PubMed Central

    McAuley, C E; Steed, D L; Webster, M W

    1984-01-01

    Expanded polytetrafluoroethylene (PTFE) grafts have proven to be an acceptable short-term alternative for femoropopliteal reconstruction in those patients without suitable autologous saphenous vein. One hundred and twenty-seven femoropopliteal arterial bypass operations utilizing PTFE grafts were performed in 105 patients. Seven-year follow-up is now available for 20 grafts, 6-year follow-up for 47 grafts, and 5-year follow-up for 62 grafts. Graft occlusion was determined by angiography, Doppler assessment, loss of previously palpable pulses, or return of symptoms. Thirty nonocclusive graft losses were due to death, infection, aneurysm, amputation, or proximal occlusive disease. Overall cumulative patency rate, according to occlusive criteria alone and calculated by the life-table method, was 74% at 6 months, 63% at 1 year, 48% at 3 years, 40% at 5 years, and 35% at 7 years. Excluding early bypass failures (less than 1 year patency), 75% of grafts were patent at 3 years, 63% at 5 years, and 55% patent 7 years following operation. Diabetes mellitus was associated with a significantly lower patency rate. Patency rates were not adversely affected by graft diameter, distal popliteal anastomotic site, number of patent runoff vessels, preoperative symptoms, or prior arterial reconstruction. In patients without suitable autologous saphenous vein, the PTFE graft has proven to be a durable and dependable long-term alternative for femoropopliteal reconstruction. PMID:6691731

  2. KLENOT Project - Near Earth Objects Follow-up Program

    NASA Astrophysics Data System (ADS)

    Tichy, Milos; Ticha, Jana; Kocer, Michal; Tichy, Milos

    2015-08-01

    Near Earth Object (NEO) research is important not only as a great challenge for science but also as an important challenge for planetary defense. Therefore NEO discoveries, astrometric follow-up, orbit computations as well as physical studies are of high interest both to science community and humankind.The KLENOT Project of the Klet Observatory, South Bohemia, Czech Republic pursued the confirmation, early follow-up, long-arc follow-up and recovery of NEOs since 2002. Tens of thousands astrometric measurements helped to make inventory of NEOs as well as to understand the NEO distribution. It ranked among the world most prolific professional NEO follow-up programmes during its first phase from 2002 to 2008.The fundamental improvement of the 1.06-m KLENOT Telescope was started in autumn 2008. The new computer controlled paralactic mount was built to substantially increase telescope-time efficiency, the number of observations, their accuracy and limiting magnitude. The testing observations of the KLENOT Telescope Next Generation were started in October 2011. The new more efficient CCD camera FLI ProLine 230 was installed in summer 2013.The original Klet Software Package has been continually upgraded over the past two decades of operation.Both the system and strategy for the NEO follow-up observation used in the framework of the KLENOT Project are described here, including methods for selecting useful and important targets for NEO follow-up astrometry.The modernized KLENOT System was put into full operation in September 2013. More than 8000 of minor planet and comet astrometric positions including NEA measurements were published from September 2013 to February 2015.The 1.06-m KLENOT telescope is still the largest telescope in continental Europe used exclusively for observations of asteroids and comets. Full observing time is dedicated to the KLENOT team. Considering our results and long-time experience obtained at the Klet Observatory, we have the large potential to

  3. Integrated Management of Childhood Illnesses strategy: compliance with referral and follow-up recommendations in Gezira State, Sudan.

    PubMed Central

    al Fadil, Sumaia Mohammed; Alrahman, Samira Hamid Abd; Cousens, Simon; Bustreo, Flavia; Shadoul, Ahmed; Farhoud, Suzanne; el Hassan, Samia Mohamed

    2003-01-01

    OBJECTIVES: To determine the extent to which families follow referral and follow-up recommendations given in accordance with the Integrated Management of Childhood Illnesses (IMCI) strategy and the factors that influence families' responses to such recommendations. METHODS: Children aged 2 months-5 years who presented to an IMCI-trained health worker in Massalamia Health Area, Sudan, were recruited. Children with an IMCI classification that indicated the need for referral or follow-up were traced to determine whether the family complied with the referral or follow-up recommendation. Caretakers were interviewed to find out why they had or had not complied. Focus group discussions were held with health workers, caretakers, and community members. FINDINGS: Overall, 5745 children were enrolled. Of these, 162 (3%) were considered to be in need of urgent referral: 53 (33%) attended a hospital on the day of the referral, with a further 37 (23%) visiting the hospital later than the day of referral. About half of families cited cost as the reason for not visiting a hospital. A total of 1197 (21%) children were classified as needing follow-up. Compliance with a follow-up recommendation was 44% (529 children). Almost 165 (90%) of caretakers who were aware of and did not comply with follow-up, said they had not done so because the child was better. Compliance increased with the caretaker's level of education, if drugs were provided during the first visit, and if the follow-up period was short (2 or 5 days). CONCLUSION: In Massalamia--a resource-constrained environment in which IMCI implementation was well received by the community--only about half of children judged to be in need of urgent referral were taken for that care within 24 hours. Most children in need of follow-up received their first treatment dose in the health facility. This aspect of IMCI was commented upon favourably by caretakers, and it may encourage them to return for follow-up. Rates of return might also

  4. Multiwavelength Follow-up of a Rare Icecube Neutrino Multiplet

    NASA Technical Reports Server (NTRS)

    Kocevski, Daniel

    2017-01-01

    IceCube detected three neutrino-induced track events arriving within less than 100s from a similar direction. Expected chance occurrence rate of 1 every 14 years, so not exceptionally rare, but interesting. If astrophysical in nature, the source would have to be relatively nearby or be an exceptional bright neutrino emitter. Follow-up observations by Swift-BAT, Swift-XRT, Master, ASAS-SN, LCOG, Veritas, FACT, and HAWC. The IceCube collaboration wanted to produce a paper summarizing the non-detections and outlining the follow-up network they have assembled. We were asked by Anna Franckowiak to contribute Fermi analysis to their write-up of this event.

  5. Longitudinal follow-up of occupational status in tinnitus patients.

    PubMed

    Andersson, G

    2000-01-01

    In this study, the long-term outcome of tinnitus patients was studied in terms of changes in occupational status from admission to follow-up for an average duration of 5 years. A consecutive series of 189 tinnitus patients seen between the years 1988 and 1995 were sent a postal questionnaire booklet; 146 provided usable responses (a 77% response rate). Results showed a significant change in occupational status, which was explained partly by retirement because of old age. Few were unemployed at follow-up, and relatively few were on sick leave. These data suggest that tinnitus patients may be less of a demand for the sickness benefit system in Sweden, but it may reflect also that tinnitus is not accepted as a cause for sick absenteeism.

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

    PubMed

    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.

  7. [Follow-up after radiation therapy for cervical cancer].

    PubMed

    Cao, K I; Mazeron, R; Barillot, I

    2015-10-01

    Radiation therapy plays a central role in treatment strategies of cervical cancer. Follow-up after external pelvic radiation therapy and brachytherapy is based upon French and international specific recommendations. It aims to assess early tumour response, and to detect local or metastatic recurrences which can be suitable for salvage treatment. Follow-up after radiation therapy for cervical cancer should also assess gastro-intestinal, urinary and sexual toxicities which may have an impact on quality of life. This is a major concern in the evaluation of the results of intensity-modulated radiation therapy (IMRT) and MRI-guided brachytherapy, which should lead to a better local control and to a better bowel tolerance.

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

    PubMed

    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.

  9. A Follow-up Study: The Registered Nurses Program, 1977.

    ERIC Educational Resources Information Center

    Kondwros, Jerry M.

    Twenty-seven (77.1%) of the thirty-five 1977 graduates of the South Georgia Colleges' Division of Nursing responded to a follow-up survey, producing the following information: (1) 17 were employed full-time, two were employed part-time, and eight were unemployed; (2) 88.9% agreed they were prepared adequately for the state board examination; (3)…

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

    ERIC Educational Resources Information Center

    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…

  11. Paediatrician office follow-up of common minor fractures

    PubMed Central

    Koelink, Eric; Boutis, Kathy

    2014-01-01

    BACKGROUND: Evidence suggests that minor paediatric fractures can be followed by primary care paediatricians (PCPs). OBJECTIVES: To determine PCP opinions, knowledge and perceived barriers to managing minor paediatric fractures in the office. METHODS: An online survey was sent between June and September 2013 to all paediatricians who subscribed to the American Academy of Pediatrics PROS-Net Listerv and to those who were registered with the Scott’s Canadian Medical Directory as paediatricians who treated children in a primary care capacity. The primary outcome was the proportion of PCPs who agreed with PCP follow-up of minor paediatric fractures. Secondary outcomes included PCP’s perceived barriers to office follow-up. RESULTS: A total of 1752 surveys were sent; 1235 were eligible and 459 (37.2%) responded to the survey. Overall, 296 (69.5% [95% CI 65.2% to 74.0%]) PCPs agreed that minor paediatric fractures could be followed in a PCP office. The most frequently reported barriers were lack of materials to replace immobilization (58.1%), PCP knowledge deficits (44.8%) and a perceived parental preference for an orthopedic surgeon (38.6%). Finally, 58.8% of respondents believed that further education was necessary if PCPs assumed responsibility for follow-up of midshaft clavicle fractures, while 66.5% and 77.1% (P<0.0001) believed this was necessary for distal radius buckle and fibular fractures, respectively. CONCLUSIONS: More than two-thirds of responding PCPs in Canada and the United States agreed that minor common paediatric fractures can be followed-up by paediatricians. However, PCPs reported some barriers to this management strategy, including a desire for more education on this topic. PMID:25382996

  12. Energy Conservation in the Food Industry : Follow-up Report.

    SciTech Connect

    United Industries Corporation.

    1986-06-01

    United Industries Corporation (UIC) conducted an energy analysis at five food processing plants (SIC 20) in the winter of 1984-1985. Tour of plants (Alpac, Carnation, Terminal flour mill, Tree Top) were revisited eighteen months later to determine what energy conservation measures (ECM's) had been or would be implemented. Additionally, the follow-up investigation evaluated the actual energy savings that accrued for the implemented ECM's and recorded the plants' views on the usefulness of the energy analysis.

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

    PubMed Central

    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

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

    SciTech Connect

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

    2006-08-15

    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.

  15. Follow-up after treatment for breast cancer

    PubMed Central

    Sisler, Jeffrey; Chaput, Genevieve; Sussman, Jonathan; Ozokwelu, Emmanuel

    2016-01-01

    Objective To offer FPs a summary of evidence-based recommendations to guide their follow-up survivorship care of women treated for breast cancer. Quality of evidence A literature search was conducted in MEDLINE from 2000 to 2016 using the search words breast cancer, survivorship, follow-up care, aftercare, guidelines, and survivorship care plans, with a focus on review of recent guidelines published by national cancer organizations. Evidence ranges from level I to level III. Main message Survivorship care involves 4 main tasks: surveillance and screening, management of long-term effects, health promotion, and care coordination. Surveillance for recurrence involves only annual mammography, and screening for other cancers should be done according to population guidelines. Management of the long-term effects of cancer and its treatment addresses common issues of pain, fatigue, lymphedema, distress, and medication side effects, as well as longer-term concerns for cardiac and bone health. Health promotion emphasizes the benefits of active lifestyle change in cancer survivors, with an emphasis on physical activity. Survivorship care is enhanced by the involvement of various health professionals and services, and FPs play an important role in care coordination. Conclusion Family physicians are increasingly the main providers of follow-up care after breast cancer treatment. Breast cancer should be viewed as a chronic medical condition even in women who remain disease free, and patients benefit from the approach afforded other chronic conditions in primary care. PMID:27737976

  16. A follow-up study of attempted railway suicides.

    PubMed

    O'Donnell, I; Arthur, A J; Farmer, R D

    1994-02-01

    This paper reports the subsequent mortality of 94 persons who attempted suicide by jumping in front of London Underground trains between 1977 and 1979. The follow-up period was 10 yr. Despite the apparent seriousness of the method, completion of suicide was not found to be higher than in previous studies of attempted suicide by other methods. By the end of the follow-up period 18 persons had died, nine of natural causes. Coroners' inquests were held for the unnatural deaths. Seven verdicts of suicide and two of accidental death were recorded. Of the nine unnatural deaths four were from multiple injuries, three from drowning, one from asphyxia and one from acute narcotic poisoning. All four multiple injury deaths were women, three of these were from repeated incidents involving London Underground trains. The time interval between the index attempt and eventual death for the suicide/accident group ranged from 1 day to 43 months. For ethical reasons it was not possible to follow-up attempted suicides who were presumed to have remained alive.

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

    PubMed

    Brand, Paul L P; Stiggelbout, Anne M

    2013-12-01

    Paediatricians spend a considerable proportion of their time performing follow-up visits for children with chronic conditions, but they rarely receive specific training on how best to perform such consultations. The traditional method of running a follow-up consultation is based on the doctor's agenda, and is problem-oriented. Patients and parents, however, prefer a patient-centered, and solution-focused approach. Although many physicians now recognize the importance of addressing the patient's perspective in a follow-up consultation, a number of barriers hamper its implementation in practice, including time constraints, lack of appropriate training, and a strong tradition of the biomedical, doctor-centered approach. Addressing the patient's perspective successfully can be achieved through shared decision making, clinicians and patients making decisions together based on the best clinical evidence. Research shows that shared decision making not only increases patient, parent, and physician satisfaction with the consultation, but also may improve health outcomes. Shared decision making involves building a physician-patient-parent partnership, agreeing on the problem at hand, laying out the available options with their benefits and risks, eliciting the patient's views and preferences on these options, and agreeing on a course of action. Shared decision making requires specific communication skills, which can be learned, and should be mastered through deliberate practice.

  18. X-Linked Retinoschisis in Juveniles: Follow-Up by Optical Coherence Tomography

    PubMed Central

    Hu, Qin-rui; Huang, Lv-zhen; Xia, Hui-ka; Li, Tian-qi

    2017-01-01

    Purpose. To explore the structural progression of X-linked retinoschisis (XLRS) in patients by using spectral-domain optical coherence tomography (SD-OCT). Design. Retrospective, observational study. Methods. Patients who were diagnosed with XLRS by genetic testing underwent comprehensive ophthalmological examinations from December 2014 to October 2016. Each eye was measured by SD-OCT using the same clinical protocol. A correlation between best-corrected visual acuity (VA) and SD-OCT measurements was observed. Results. Six patients demonstrated retinoschisis (12 eyes) and typical foveal cyst-like cavities (10 eyes) on SD-OCT images with a mean logMAR VA of 0.48. The median age was 7.5 years at the initial visit. Their foveal retinal thickness (516.9 μm) and choroid thickness (351.4 μm) decreased at a rate of 38.1 and 7.5 μm, respectively, at the 10.5-month follow-up visit; however, there were no significant differences (P = 0.622 and P = 0.406, resp.). There was no significant correlation between VA, the foveal retinal thickness, and subfoveal choroid thickness. Conclusions. SD-OCT images for XLRS patients during the juvenile period revealed no significant changes in the fundus structure, including the foveal retinal thickness and choroid thickness within one-year follow-up. There was a lack of correlation between VA, foveal retinal thickness, and subfoveal choroid thickness. PMID:28286756

  19. Motor development in children at risk of autism: a follow-up study of infant siblings.

    PubMed

    Leonard, Hayley C; Bedford, Rachael; Charman, Tony; Elsabbagh, Mayada; Johnson, Mark H; Hill, Elisabeth L

    2014-04-01

    Recently, evidence of poor or atypical motor skills in autism spectrum disorder has led some to argue that motor impairment is a core feature of the condition. The current study uses a longitudinal prospective design to assess the development of motor skills of 20 children at increased risk of developing autism spectrum disorder, who were recruited and tested at 9 and 40 months of age, on the basis of having an older sibling diagnosed with the condition. All children completed a range of motor, face processing, IQ and diagnostic assessments at a follow-up visit (aged 5-7 years), providing a detailed profile of development in this group from a number of standardised, parental report and experimental measures. A higher proportion of children than expected demonstrated motor difficulties at the follow-up visit and those highlighted by parental report as having poor motor skills as infants and toddlers were also more likely to have lower face processing scores and elevated autism-related social symptoms at 5-7 years, despite having similar IQ levels. These data lend support to the argument that early motor difficulties may be a risk factor for later motor impairment as well as differences in social communication and cognition, traits that are related to autism spectrum disorder.

  20. [Model of a prospective follow-up study of patients managed in intensive care].

    PubMed

    Ritz, R

    1988-04-30

    For ethical and economic reasons, follow-up--especially after intensive care--is important as a form of quality control which could serve as a basis for more differentiated indications for patient admission. A follow-up model, involving questionnaires 3 months, 1 year and 3 years after intensive care, and preliminary results of patients in 1985 are presented. Only a few patients described their present health situation as bad, but unstable situations showed little improvement between 3 months and 1 year after intensive care. There was a rather high percentage of rehospitalization and/or need for continued medical care. Only 10% of respondent patients were unable to work 1 year after intensive care, and 12% still depended on help from others. 15-35% described their quality of life as restricted; only 4% had negative memories of intensive care (fear, pain), and only 0.6% of respondent patients thought their previous admission to the intensive care unit had been a wrong decision.

  1. Neurocysticercosis: HP10 Antigen Detection Is Useful for the Follow-up of the Severe Patients

    PubMed Central

    Fleury, Agnès; Garcia, Esperanza; Hernández, Marisela; Carrillo, Roger; Govezensky, Tzipe; Fragoso, Gladis; Sciutto, Edda; Harrison, Leslie J. S.; Parkhouse, R. Michael Evans

    2013-01-01

    Background The most severe clinical form of neurocysticercosis (NC) occurs when cysticerci are located in the subarachnoid space at the base of the brain (SaB). The diagnosis, monitoring and treatment of NC-SaB, constitutes a severe clinical challenge. Herein we evaluate the potential of the HP10 antigen detection enzyme-linked immunosorbent assay (HP10 Ag-ELISA) in the long term follow-up of NC-SaB cases. Assay performance was compared with that of Magnetic Resonance Imaging (MRI). In addition, the robustness of the HP10 Ag-ELISA was evaluated independently at two different institutions. Methodology/Principal Findings A double-blind prospective cohort trial was conducted involving 38 NC-SaB cases and a total of 108 paired serum and cerebrospinal fluid (CSF) samples taken at intervals of 4 to 8 months for up to 43 months. At each medical visit, results of sera and CSF HP10 Ag-ELISA and MRI obtained at last visit were compared and their accuracy was evaluated retrospectively, considering radiological evolution between appointments. In the long-term follow-up study, HP10 Ag-ELISA had a better agreement than MRI with retrospective radiological evaluation. High reproducibility of HP10 Ag-ELISA between laboratories was also demonstrated. Conclusions Results reported in this study establish for the first time the usefulness of the comparatively low cost HP10 Ag-ELISA for long term follow-up of NC-SaB patients. PMID:23505587

  2. Quality of life in patients with progressive supranuclear palsy: one-year follow-up.

    PubMed

    Pekmezović, Tatjana; Ječmenica-Lukić, Milica; Petrović, Igor; Špica, Vladana; Tomić, Aleksandra; Kostić, Vladimir S

    2015-09-01

    The aim of this prospective cohort study that included 46 patients with progressive supranuclear palsy (PSP) was to estimate which demographic and clinical factors were the main contributors to the health-related quality of life (HRQoL) and how did the HRQoL change over a follow-up period of 1 year in these patients. The hierarchical regression analyses showed that the final models demonstrated that gender, included clinical variables and psychiatric/neuropsychological scales, accounted for 68% of the variance in the Physical Composite Score and 73% of the variance of the Mental Composite Score of the 36-item Short Form Health Survey (SF-36). Among variables in both final models, only the score of the Apathy Evaluation Scale showed statistically significant negative predictive value (p < 0.05). Changes in the HRQoL scores were assessed in 28 PSP patients who completed 1-year follow-up period after the baseline examination. Statistically significant decline in the HRQoL was detected for the following scales of the SF-36: physical functioning, vitality, social functioning, and role emotional, as well as in both composite scores (Physical Composite Score and Mental Composite Score). The analyses of magnitude of changes in the HRQoL during 1-year follow-up period showed large effect size (≥0.80) for total scores, as well as for the physical functioning, vitality, and social functioning. In conclusion, despite certain limitations, our study provided some new insights into potential predictors of the HRQoL and its longitudinal changes in patients with PSP.

  3. Mid-term Clinical Outcomes of Stand-alone Posterior Interbody Fusion with Rectangular Cages: A 4-year-minimum Follow-up

    PubMed Central

    Cho, Kyung Rae; Lee, Sun-Ho; Kim, Eun Sang

    2013-01-01

    Objective We sought to determine minimum 4 years of clinical outcomes including fusion rate, revision rate and complications of patients who underwent placement of rectangular stand-alone cages. Methods Thirty-three cases of degenerative spine that had been followed for at least 4-years were reviewed retrospectively. Cages were inserted at L4-L5 level or L5-S1 in 27 or in 6 cases respectively. Visual analogue scale (VAS), Odom's criteria, fusion rate, intervertebral disc height and lumbar lordosis were determined pre- and post-operatively on standing x-rays. Amount of intra- and postoperative blood loss, total volume transfused, duration of surgery and perioperative complications were also evaluated. Results The mean VAS score of back pain and sciatica were improved from 8.0 and 7.0 points to 3.4 and 2.4 during 1 years follow-up visit and the scores was raised gradually. Also, during the follow-up, 94% of patients showed excellent or good outcomes by the Odom's criteria. Intervertebral disc height was increased from 8.2±1.4mm to 9.2±1.9mm at the first year of follow-up, however, found to be decreased and stabilized to 8.3±1.8mm after 2 years. The fusion rate was approximately 91% after 4 year postoperative. The segmental angle of lordosis was increased significantly by two years but it was not maintained after four years. A statistically insignificant change in total lumbar lordosis was also observed. Three patients (9%) had experienced perioperative complications. Conclusion The use of rectangular stand-alone cages for posterior lumbar interbody fusion (PLIF) resulted in a various degree of subsidence and demonstrate very low complication rate, high functional stability and improved clinical outcomes in patients with degenerative lumbar disc disease. PMID:24757473

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

    NASA Astrophysics Data System (ADS)

    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

  5. Profile and follow-up of patients with tuberculosis in a priority city in Brazil

    PubMed Central

    Pereira, Jisleny da Cruz; Silva, Marcio Roberto; da Costa, Ronaldo Rodrigues; Guimarães, Mark Drew Crosland; Leite, Isabel Cristina Gonçalves

    2015-01-01

    OBJECTIVE To analyze the cases of tuberculosis and the impact of direct follow-up on the assessment of treatment outcomes. METHODS This open prospective cohort study evaluated 504 cases of tuberculosis reported in the Sistema de Informação de Agravos de Notificação (SINAN – Notifiable Diseases Information System) in Juiz de Fora, MG, Southeastern Brazil, between 2008 and 2009. The incidence of treatment outcomes was compared between a group of patients diagnosed with tuberculosis and directly followed up by monthly consultations during return visits (287) and a patient group for which the information was indirectly collected (217) through the city’s surveillance system. The Chi-square test was used to compare the percentages, with a significance level of 0.05. The relative risk (RR) was used to evaluate the differences in the incidence rate of each type of treatment outcome between the two groups. RESULTS Of the outcomes directly and indirectly evaluated, 18.5% and 3.2% corresponded to treatment default and 3.8% and 0.5% corresponded to treatment failure, respectively. The incidence of treatment default and failure was higher in the group with direct follow-up (p < 0.05) (RR = 5.72, 95%CI 2.65;12.34, and RR = 8.31, 95%CI 1.08;63.92, respectively). CONCLUSIONS A higher incidence of treatment default and failure was observed in the directly followed up group, and most of these cases were neglected by the disease reporting system. Therefore, effective measures are needed to improve the control of tuberculosis and data quality. PMID:25741659

  6. Surveying Supported Employment in Finland: A Follow-up

    ERIC Educational Resources Information Center

    Saloviita, Timo; Pirttimaa, Raija

    2007-01-01

    The longitudinal status of supported employment in Finland was examined via a 2003 nationwide survey sent to job coaches involved in supporting workers with intellectual and other disabilities. Sustained supported employment, defined as "paid work in integrated settings with ongoing supports that contained at least two on-site visits per…

  7. [Barrett's oesophagus: endoscopic diagnosis and follow-up].

    PubMed

    Ponsot, P

    2006-01-01

    Barrett's oesophagus (BO), or replacement of the squamous mucosa by a specialized intestinal metaplasia due to gastro-oesophageal reflux disease (GORD), predisposes to adenocarcinoma. It is estimated that 6 to 12% of patients undergoing GI endoscopy have short BO (< 3 cm), and 1% have a long BO. Macroscopic diagnosis of BO is sometimes difficult and, in case of doubt, endoscopy should be redone after a period of efficient anti-secretory treatment. Diagnosis of BO is histological and should be confirmed by biopsies. The incidence of adenocarcinoma is globally estimated at 0.5% patient by year of follow-up, and exists for both short and long BO. Due to this low incidence, screening for BO is only justified in patients at high risk for adenocarcinoma (male gender, age > 50 ans, old GORD in a young patient). Low-grade dysplasia (LGD) then high-grade dysplasia (HGD) precedes adenocarcinoma. Histological diagnosis of LGD is difficult: the main cause of confusion is inflammation so diagnosis of LGD must be confirmed after a 3-month high-dose anti-secretory treatment. Diagnosis of HGD is easier but multiple biopsies are needed to determine the focal or multifocal disposition of HGD. The benefit of follow-up of BO is debated. Aged patients should be followed only if dysplasia is present. When dysplasia is absent, an endoscopic control with biopsies is desirable within 3 to 5 years. In case of dysplasia, the latter must be confirmed by another examination of biopsies, particularly in case of suspicion of HGD and after antisecretory treatment. In case of LGD, endoscopy with biopsies should be redone 6 months later to screen for HGD, then every year if LGD is confirmed. In case of HGD, the 5-year risk of cancer is 60% so surgical or endoscopic treatment is usually proposed. If HGD follow-up is decided, it should be performed on a 3- to 6-month basis.

  8. Klenot Project - Near Earth Objects Follow-Up Program

    NASA Astrophysics Data System (ADS)

    Tichý, Miloš; Tichá, Jana; Kočer, Michal

    2016-01-01

    NEO research is a great challenge just now - for science, for exploration and for planetary defence. Therefore NEO discoveries, astrometric follow-up, orbit computations as well as physical studies are of high interest both to science community and humankind. The KLENOT Project of the Klet Observatory, South Bohemia, Czech Republic pursued the confirmation, early follow-up, long-arc follow-up and recovery of Near Earth Objects since 2002. Tens of thousands astrometric measurements helped to make inventory of NEOs as well as to understand the NEO population. It ranked among the world most prolific professional NEO follow-up programmes during its first phase from 2002 to 2008. The fundamental improvement of the 1.06-m KLENOT Telescope was started in autumn 2008. The new computer controlled paralactic mount was built to substantially increase telescope-time efficiency, the number of observations, their accuracy and limiting magnitude. The testing observations of the KLENOT Telescope Next Generation (NG) were started in October 2011. The new more efficient CCD camera FLI ProLine 230 was installed in summer 2013. The original Klet Software Package has been continually upgraded over the past two decades of operation. Along with huge hardware changes we have decided for essential changes in software and the whole KLENOT work-flow. Using the current higher computing power available, enhancing and updating our databases and astrometry program, the core of our software package, will prove highly beneficial. Moreover, the UCAC4 as the more precise astrometric star catalog was implemented. The modernized KLENOT System was put into full operation in September 2013. This step opens new possibilities for the KLENOT Project, the long-term European Contribution to Monitoring and Cataloging Near Earth Objects. KLENOT Project Goals are confirmatory observations of newly discovered fainter NEO candidates, early follow-up of newly discovered NEOs, long-arc follow-up astrometry of NEOs

  9. Follow-up study of small-for-dates babies.

    PubMed

    Fancourt, R; Campbell, S; Harvey, D; Norman, A P

    1976-06-12

    A group of small-for-dates full-term babies whose intra-uterine growth was followed by serial ultrasonic cephalometry were examined at a mean age of 4 years. Those children whose skull growth had begun to slow in utero before 34 weeks' menstrual age were more likely to have a height and weight less than the 10th centile. When the onset of growth failure had occurred before 26 weeks there was a lower developmental quotient at follow-up using the Griffiths extended scales. Prolonged slow growth in utero therefore seems to be followed by slow growth and development after birth.

  10. Root Resorption a 6-Year Follow-up Case Report

    PubMed Central

    Dias, Caroline; Closs, Luciane; Barletta, Fernando; Reston, Eduardo; Tovo, Maximiano F; Lambert, Paula

    2015-01-01

    This paper describes the clinical course of a pediatric patient developing cervical external root resorption (CERR). An 11-year old male patient had sustained dental trauma and was diagnosed with crown fracture affecting the incisal and middle thirds of the maxillary right permanent central incisor and the maxillary right permanent lateral incisor with pulp exposure and CERR after 24 months. Diagnosis and treatment of CERR are a challenge for dental practitioners. In this case, preservation of natural dentition is shown as a successful treatment in a 6-year follow-up. PMID:25870717

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

    SciTech Connect

    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 document. Details and

  12. [Ataxia telangiectasia. Diagnosis and follow-up in 4 cases].

    PubMed

    Monterrubio Ledezma, César Eduardo; Corona Rivera, Alfredo; Corona Rivera, Jorge Román; Rodríguez Casillas, Lourdes Jocelyn; Hernández Rocha, Juan; Barros Nuñez, Patricio; Bobadilla Morales, Lucina

    2013-01-01

    Ataxia telangiectasia (AT) is a chromosomal instability syndrome with autosomal recessive inheritance, it is caused by more than 500 mutations of the ATM gene, which is involved in the cellular response to DNA damage. The diagnosis becomes difficult due to the evolution of the disease, their poor knowledge, and limited access to diagnostic tests. Chromosomal damage induced by ionizing radiation (IR) assay is still a sensitive method for early diagnosis, and it is essential for better management and genetic counseling. This paper shows diagnosis and follow-up in four cases with AT.

  13. Juvenile Hyaline Fibromatosis: A 10-year Follow-up

    PubMed Central

    Baltacioglu, Esra; Guzeldemir, Esra; Sukuroglu, Erkan; Yildiz, Kadriye; Yuva, Pinar; Aydin, Güven; Karacal, Naci

    2017-01-01

    Juvenile hyaline fibromatosis (JHF) is a rare hereditary disease with an autosomal recessive transmission. JHF is characterized by papulonodular skin lesions, osteolytic bone lesions, flexural joint contractures, and gingival hyperplasia and usually diagnosed in infancy or early childhood. JHF is thought to be a disorder of collagen metabolism and characterized by homogenous amorphous eosinophilic material and fibrous tissue. We report the case of a 14-year-old male child with multiple papulonodular skin lesions, progressive flexion contractures of joints, and severe gingival hyperplasia, with a 10-year follow-up. Although the lesions were totally removed thrice during the last 10 years, they recurred rigorously.

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

    ERIC Educational Resources Information Center

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

    2013-01-01

    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 1-year follow-up outcomes among young children with ADHD who were treated with the IY interventions.…

  15. Endometrial cancer. Prevention, detection, management, and follow up.

    PubMed Central

    Elit, L.

    2000-01-01

    OBJECTIVE: To review risk factors for uterine cancer; to discuss strategies for detecting uterine cancer; to outline prognostic factors and treatment; and to review the role of follow up for patients who have completed primary therapy. QUALITY OF EVIDENCE: MEDLINE was searched from January 1996 to June 1998 using the terms endometrial neoplasms, estrogen replacement therapy, hormone replacement therapy, tamoxifen, and screening. Only English language articles were reviewed. Study types included reviews. Bibliographies of articles found were searched for further relevant titles. Causation literature is available from well conducted cohort trials. Treatment recommendations are based in part on prognostic information and a few randomized controlled trials. MAIN MESSAGE: Risk factors, both intrinsic and extrinsic, are associated with uterine cancer. Family physicians have a role in preventing disease by ensuring that all women with uteri in situ using hormone replacement therapy (HRT) have progesterone therapy as part of the HRT regimen. Detection is crucial; abnormal uterine bleeding or undiagnosed postmenopausal bleeding warrants investigation with endometrial biopsy. The goal of surgery is to remove the uterus and ovaries and identify factors that make the disease at high risk of recurrence. Although adjuvant radiation therapy does not prolong survival, it does alter the pattern of disease recurrence. The goal of follow up after primary therapy is to identify recurrent disease while it is still curable. CONCLUSIONS: Family physicians play an important role in preventing uterine cancer, initiating early diagnosis of disease, and in the future, might be more actively involved in caring for patients following primary therapy. PMID:10790821

  16. Long-term follow-up of atomic bomb survivors.

    PubMed

    Sakata, Ritsu; Grant, Eric J; Ozasa, Kotaro

    2012-06-01

    The Life Span Study (LSS) is a follow-up study of atomic bomb (A-bomb) survivors to investigate the radiation effects on human health and has collected data for over 60 years. The LSS cohort consists of 93,741 A-bomb survivors and another 26,580 age and sex-matched subjects who were not in either city at the time of the bombing. Radiation doses have been computed based on individual location and shielding status at the time of the bombings. Age at death and cause of death are gathered through the Japanese national family registry system and cancer incidence data have been collected through the Hiroshima and Nagasaki cancer registries. Noncancer disease incidence and health information are collected through biannual medical examinations among a subset of the LSS. Radiation significantly increases the risks of death (22% at 1 Gy), cancer incidence (47% at 1 Gy), death due to leukemia (310% at 1 Gy), as well as the incidence of several noncancer diseases (e.g. thyroid nodules, chronic liver disease and cirrhosis, uterine myoma, and hypertension). Significant effects on maturity (e.g. growth reduction and early menopause) were also observed. Long-term follow-up studies of the A-bomb survivors have provided reliable information on health risks for the survivors and form the basis for radiation protection standards for workers and the public.

  17. [Long-term follow-up of osteochondritis dissecans].

    PubMed

    Gudas, Rimtautas; Kunigiskis, Giedrius; Kalesinskas, Romas Jonas

    2002-01-01

    Fifty-two patients with osteochondritis dissecans lesions were evaluated after 7-25 years after excision of a partially detached (grade III) fragment or loose (grade IV) fragment from the medial femoral condyles. Average follow-up time was 17.2 (range 7-25 years). Two homogenic groups based on special inclusion criteria were formed; 31 patient was in the first and 21--in the second group. The only difference between the groups was the age; the age average in the first group was--25.6 years (range 15-35 years), and -45.2 years (range 35-55 years) in the second group. Patients were evaluated through ICRS (International Cartilage Repair Society), modified HSS and KOOS (Knee injury and osteoarthritis Outcome score) scales, and with X-rays. Evaluation with the ICRS, modified HSS and KOOS rating scales for osteochondritis dissecans revealed in 9 cases (17%) good results, 32 cases (62%)--fair, and 11 cases (21%)--failure results. Final ICRS and modified HSS evaluation showed statistically significantly better results in the younger patient group at the 21 years (p < 0.04). At an average 17.2 year follow-up X-rays and KOOS evaluation form showed initial and second-degree (according to Ahlbäck) osteoarthritis signs in the knees. The long-term results of the natural history of osteochondritis dissecans are extremely poor. Consequently, we recommend autologous osteochondral grafting for the replacement of the osteochondritis dissecans defects in the knee joint.

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

    SciTech Connect

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

    2001-05-15

    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.

  19. The LCOGT near-Earth-object follow-up network

    NASA Astrophysics Data System (ADS)

    Lister, T.

    2014-07-01

    Las Cumbres Observatory Global Telescope (LCOGT) network is a planned homogeneous network that will eventually consist of over 35 telescopes at 6 locations in the northern and southern hemispheres [1]. This network is versatile and designed to respond rapidly to target of opportunity events and also to do long term monitoring of slowly changing astronomical phenomena. The global coverage of the network and the apertures of telescope available make the LCOGT network ideal for follow-up and characterization of a wide range of solar-system objects (e.g. asteroids, Kuiper-belt objects, comets) and in particular near-Earth objects (NEOs). There are 3 classes to the telescope resources: 2-meter aperture, 1-meter aperture and 0.4-meter aperture. We have been operating our two 2-meter telescopes since 2005 and began a specific program of NEO follow-up for the Pan-STARRS survey in October 2010. The combination of all-sky access, large aperture, rapid response, robotic operation and good site conditions allows us to provide time-critical follow-up astrometry and photometry on newly discovered objects and faint objects as they recede from the Earth, allowing the orbital arc to be extended and preventing loss of objects. These telescope resources have greatly increased as LCOGT has completed the first phase of the deployment, designated as ''Version 1.0'', with the installation, commissioning and ongoing operation of nine 1-meter telescopes. These are distributed among four sites with one 1-meter at McDonald Observatory (Texas), three telescopes at Cerro Tololo (Chile), three telescopes at SAAO (South Africa) and the final two telescope at Siding Spring Observatory (Australia). In addition to the 1-meter network, the scheduling and control system for the two 2-meter telescopes have been upgraded and unified with that of the 1-meter network to provide a coherent robotic telescopic network. The telescope network is now operating and observations are being executed remotely and

  20. A 3-year follow-up of hypertension in Delhi.

    PubMed Central

    Gopinath, N.; Chadha, S. L.; Shekhawat, S.; Tandon, R.

    1994-01-01

    A follow-up study of hypertension was carried out among adults in Delhi 3 years after an initial community-based epidemiological survey of the same population. The treatment and the severity status of 1115 out of 1749 individuals with hypertension detected in the initial survey were compared with those observed in the follow-up. The proportion of treated cases with controlled blood pressure rose from 10.8% to 60.8%. Among the cohort of 3611 subjects aged 25-64 years who were normotensive in the initial survey, 132 new cases of hypertension, were detected. The annual incidence of hypertension was the same in men and women (12.2 per 1000). Diabetes and regular alcohol consumption were significant risk factors for hypertension, being present in 13 and 7 cases, respectively. Electrocardiograms (ECGs) were recorded for 871 of the 1115 cases of hypertension. Abnormal ECGs were exhibited by 307 cases (35.2%), of which 24 (2.7%) had had myocardial infarction, 133 (15.3%) had ischaemic ST-T changes, 54 (6.2%) had left ventricular hypertrophy, and 96 (11.0%) had conduction defects and arrhythmias. PMID:7955019

  1. Ablative radioiodine therapy for hyperthyroidism: long term follow up study.

    PubMed Central

    Kendall-Taylor, P; Keir, M J; Ross, W M

    1984-01-01

    A total of 225 patients were treated for hyperthyroidism with 555 MBq (15 mCi) radioiodine to ablate the thyroid and induce early hypothyroidism. The efficacy of this treatment in eradicating hyperthyroidism and problems of follow up were assessed one to six years later from case records and questionnaires. Information was received from 197 out of 219 live patients (90%) and from 160 doctors concerning 207 patients (92%). Only three patients were not traced and six had died since treatment. The modal time to hypothyroidism was three months, and 64% of patients were hypothyroid at one year; 5.6% had failed to become euthyroid within one year. Ninety five per cent of patients had been seen by the doctor and 82% had had a thyroid test done within the past two years. Most doctors preferred patients to be returned to their care once thyroxine treatment was stabilised. An ablative dose of 131I is recommended as an effective means of treatment which has clear advantages over conventional methods. Good communications and effective follow up should ensure success. PMID:6432100

  2. Serial extraction: 20 years of follow-up

    PubMed Central

    de ALMEIDA, Renato Rodrigues; de ALMEIDA, Marcio Rodrigues; OLTRAMARI-NAVARRO, Paula Vanessa Pedron; CONTI, Ana Cláudia de Castro Ferreira; NAVARRO, Ricardo de Lima; de SOUZA, Karen Regina Siqueira

    2012-01-01

    This paper reports a case treated by a serial extraction program at the mixed dentition stage followed by a corrective orthodontic treatment, with a long-term follow-up period. Twenty years after the interceptive treatment, a harmonious face was observed along with treatment stability in the anterior posterior direction, deep overbite (which has been mentioned as a disadvantage of the serial extraction program), and a small relapse of anterior tooth crowding. All these conditions have been regarded as normal occurrences for most orthodontic treatments with a long-term follow-up period. This case report demonstrated that the establishment of a serial extraction protocol determined relevant esthetic changes that afforded an improvement of the patient's self-esteem, with a positive social impact. Furthermore, the low cost of this protocol permits the use of this therapy with underprivileged populations. It is important to emphasize that an early correction of tooth crowding by this protocol does not guarantee stability, but small relapses do not invalidate its accomplishment. PMID:23032213

  3. Tuberculosis of the knee -- a long term follow-up.

    PubMed

    Chow, S P; Yau, A

    1980-01-01

    Thirty cases of tuberculosis of the knee followed up for an average of 15 years were reviewed. The majority of patients developed the disease during childhood. All had received standard anti-tuberculous drug treatment. Fifteen were treated conservatively alone, while the other 15 had a debridement type of surgery in addition to drugs. At review, one-third had occasional mild pain, but this was only present in the conservatively treated group. Stiffness, however, was more predominant in the operated and in the late onset groups. Some mild deformity was seen in 17 out of 30 patients and was related not so much to disturbance of epiphyseal growth, but rather, to bone collapse. Interesting X-ray appearances at follow-up were found. The factors which could lead to a good outcome included young age of onset, treatment within six months of onset, and early mobilisation. If the disease is well advanced, surgical treatment will lead to a painless joint, but with greater restriction of joint movement.

  4. Language outcomes of toddlers with autism spectrum disorders: a two year follow-up.

    PubMed

    Paul, Rhea; Chawarska, Katarzyna; Cicchetti, Domenic; Volkmar, Fred

    2008-04-01

    Thirty-seven children 15-25 months of age received clinical diagnoses of autism spectrum disorder (ASD) and were re-evaluated two years later. All subjects were judged to have retained a diagnosis of ASD at the follow-up evaluation. Communication scores for the group as a whole during the first visit were significantly lower than nonverbal IQ. However, by the second visit, verbal and nonverbal scores were no longer significantly different. The group was divided into two subgroups, based on expressive language (EL) outcome at the second visit. The two groups were similar in the second year of life in terms of expressive communication skills and autistic symptoms, except for a trend toward more stereotypic and repetitive behavior in the worse outcome group. By the second visit, however, the groups differed significantly on all standard measures of expression and reception, as well as on autistic symptomotology and nonverbal IQ. When assessed during their second year, children who ended up in the better outcome group showed higher average nonverbal cognitive level, receptive language (RL) scores, number of sounds and words produced, use of symbolic play schemes, and response to joint attention bids. Regression analysis revealed that the variables for which significant differences between the two outcome groups in their second year of life were found provided significant prediction of EL outcome at age four. Stepwise regression identified RL and presence of stereotypic and repetitive at the first visit as significantly associated with EL outcome. Implications of these findings for early identification and intervention are discussed.

  5. Relationship between Early Physician Follow-Up and 30-Day Readmission after Acute Myocardial Infarction and Heart Failure

    PubMed Central

    Tung, Yu-Chi; Chang, Guann-Ming; Chang, Hsien-Yen

    2017-01-01

    Background Thirty-day readmission rates after acute myocardial infarction (AMI) and heart failure are important patient outcome metrics. Early post-discharge physician follow-up has been promoted as a method of reducing 30-day readmission rates. However, the relationships between early post-discharge follow-up and 30-day readmission for AMI and heart failure are inconclusive. We used nationwide population-based data to examine associations between 7-day physician follow-up and 30-day readmission, and further associations of 7-day same physician (during the index hospitalization and at follow-up) and cardiologist follow-up with 30-day readmission for non-ST-segment-elevation myocardial infarction (NSTEMI) or heart failure. Methods We analyzed all patients 18 years or older with NSTEMI and heart failure and discharged from hospitals in 2010 in Taiwan through Taiwan’s National Health Insurance Research Database. Cox proportional hazard models with robust sandwich variance estimates and propensity score weighting were performed after adjustment for patient and hospital characteristics to test associations between 7-day physician follow-up and 30-day readmission. Results The study population for NSTEMI and heart failure included 5,008 and 13,577 patients, respectively. Early physician follow-up was associated with a lower hazard ratio of readmission compared with no early physician follow-up for patients with NSTEMI (hazard ratio [HR], 0.47; 95% confidence interval [CI], 0.39–0.57), and for patients with heart failure (HR, 0.54; 95% CI, 0.48–0.60). Same physician follow-up was associated with a reduced hazard ratio of readmission compared with different physician follow-up for patients with NSTEMI (HR, 0.56; 95% CI, 0.48–0.65), and for patients with heart failure (HR, 0.69; 95% CI, 0.62–0.76). Conclusions For each condition, patients who have an outpatient visit with a physician within 7 days of discharge have a lower risk of 30-day readmission. Moreover

  6. Virtual reality cognitive-behavior therapy for public speaking anxiety: one-year follow-up.

    PubMed

    Safir, Marilyn P; Wallach, Helene S; Bar-Zvi, Margalit

    2012-03-01

    Public speaking anxiety (PSA) is a common social phobia. Although cognitive-behavior therapy (CBT) is the treatment of choice, difficulties arise with both in vivo and in vitro exposure (lack of therapist control, patient's inability to imagine, self-flooding, and a lack of confidentiality resulting from public exposure). Virtual reality CBT (VRCBT) enables a high degree of therapist control, thus overcoming these difficulties. In a previous publication, the authors reported on their findings that VRCBT (n = 28) and CBT (n = 30) groups were significantly more effective than a wait-list control (WLC; n = 30) group in anxiety reduction on four of five anxiety measures as well as on participant's self-rating of anxiety during a behavioral task. No significant differences were found between VRCBT and CBT. However, twice as many clients dropped out of CBT (15) than from VRCBT (6). Results demonstrated that VRCBT is an effective and brief treatment regimen, equal to CBT. This brief report examined durability of these changes. They found that both VRCBT (25) and CBT (24) groups maintained their improvement from post treatment to follow-up, on all five measures. In addition, they found that the CBT group continued to improve from post treatment to follow-up on Liebowitz Social Anxiety Scale (LSAS) fear. Thus, treatment gains were maintained at a 1-year follow-up.

  7. Follow-up report on 50 subjects vaccinated against herpes genitalis with Skinner vaccine.

    PubMed

    Skinner, G R; Fink, C G; Cowan, M; Buchan, A; Fuller, A; Hartley, C E; Durham, J; Wiblin, C; Melling, J

    1987-01-01

    Fifty subjects at risk of herpes genitalis received 109 immunizations with Skinner herpes vaccine and were assessed after a follow-up period of 4-48 months, representing a total follow-up period of 694 patient months. There was no evidence of contraction of herpes genitalis in 49 subjects. The risk of virus transmission and rate of contraction of disease was quantified by construction of two functions, namely a unit of exposure risk calculated per year (UYE) and standard contraction rate (SCR); in this study the SCR was 0.02. There was no evidence of significant side-effects from vaccination. Administration of Alhydrogel adjuvant with vaccine induced temporary granuloma formation in most subjects but was only detectable beyond 1 year of follow-up in one subject, in whom a painless swelling of 0.2 cm was detected 3 years after vaccination. There was no evidence of immunological reactivity to host cell or calf serum antigens in any of the subjects vaccinated.

  8. Three-year follow-up of a girl with chronic paroxysmal hemicrania.

    PubMed

    Talvik, Inga; Peet, Aleksandr; Talvik, Tiina

    2009-01-01

    This is a follow-up report of a girl, 5 years 4 months old, with classic symptoms of chronic paroxysmal hemicrania from the age of 2 years 3 months who had a complete response to indomethacin therapy. The patient suffered from frequent episodes of severe unilateral headaches for 1 year and 10 months before the diagnosis of chronic paroxysmal hemicrania was established. Indomethacin treatment lasted for 2 years and 6 months. During the first year of treatment, several doses of indomethacin were missed, which was followed by immediate return of hemicrania episodes and then quick resolution of symptoms after administration of indomethacin. After 2 years and 6 months of treatment, the parents missed the treatment for 1 week and the episodes did not recur. The treatment was discontinued. The patient was free from pain and off the medication 1 year later.

  9. [Management control and operative outcome of the Radio Institute "O. Alberti." Management of oncologic follow-up].

    PubMed

    Micheletti, E; La Face, B; Huscher, A; Catalano, G; Spiazzi, R

    1997-03-01

    Post-treatment cancer patient surveillance is an area with few given standards where the need of guidelines has become imperative with the recent emphasis on controlling the ever-increasing health care cost. Unfortunately, literature reports are often inconclusive and ambiguous, mostly because of the lack of properly controlled trials comparing the cost and benefits of various follow-up protocols. In addition, the actual impact on patient survival and quality of life is questionable. At the Istituto del Radio "O. Alberti" (IRA), we consider the follow-up as a sort of population screening aimed at the early detection and treatment of recurrent disease. While aggressive surveillance undoubtedly detects some cancers before symptoms develop, it is debated whether the impact on survival and quality of life are measurable. The early detection of relapse is only a potential survival benefit if recurrent disease is curable with further treatment or at least if salvage treatment is more effective in patients with less severe disease. We investigated the effectiveness, efficacy and medical care of our follow-up protocol. April to June, 1996, we examined 1,223 of 2,148 expected patients; 225 patients disattended the scheduled visits. IRA spent about It. L. 33,800 per examination. Fifty-seven patients were hospitalized to carry out treatment and IRA hospitalization charges were about It. L. 1,100,000 while overall social expenses were about It. L. 6,600,000. Regular visits to see an oncologist provide easy access to specialist medicine and convey a sense of being looked after with a caring system. 94.5% of patients prefers to continue the follow-up program with scheduled visits. Most patients (70%) know about the examinations they undergo but consistently overestimate the importance of laboratory tests and imaging findings and underestimate the importance of medical history and physical examination. In addition, most patients (95%) misinterpret the term "normal" relative to a

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

    PubMed

    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.

  11. Endobronchial valves for advanced emphysema: an endobronchial follow-up.

    PubMed

    Salcedo, Pablo S; Seijo, Luis M; Zulueta, Javier J

    2014-01-01

    Lung volume reduction surgery is a therapeutic option for selected patients with advanced emphysema. However, it is an invasive procedure benefitting only a selected group of patients with heterogeneous upper lobe predominant disease and limited exercise capacity. The most widely studied alternatives are endobronchial valves. Hundreds of patients worldwide have undergone endobronchial valve placement. Although short-term outcomes have been described, little is known about the long-term side effects following this treatment, and endoscopic follow-up is virtually nonexistent. The images, biopsies, and microbiologic evidence accrued from this patient are witnesses to the natural evolution of endobronchial valves in the airways and should offer a word of caution with regard to valve placement in patients with life expectancies exceeding those typical of severe chronic obstructive lung disease.

  12. A New GRB follow-up Software at TUG

    NASA Astrophysics Data System (ADS)

    Dindar, M.; Parmaksizoglu, M.; Helhel, S.; Esenoglu, H.; Kirbiyik, H.

    2016-12-01

    A gamma-ray burst (GRB) optical photometric follow-up system at TUBITAK (Scientic and Technological Research Council of Turkey) National Observatory (TUG) has been planned. It uses the 0.6 m Telescope (T60) and can automatically respond to GRB Coordinates Network (GCN) alerts. The telescopes slew relatively fast, being able to point to a new target field within 30 s upon a request. Whenever available, the 1 m T100 and 2.5 m RTT150 telescopes will be used in the future. As an example in 2015, the GRB software system (will be server side) at T60-telescope responded to GRB alert and started the observation as early as 129 s after the GRB trigger autonomously.

  13. [Follow-up of tetralogy of Fallot after repair].

    PubMed

    Van Aerschot, Isabelle; Iserin, Laurence

    2011-01-01

    Repair of tetralogy of Fallot (TOF) exists for more than 40 years. This repair results in a pulmonary regurgitation, which is usually well tolerated for two decades or so, but eventually this is injurious for the right ventricle (RV). The RV enlargement and severe RV dysfunction increase risk for ventricular tachycardia (VT) and sudden death in the long-term. The pulmonary valve replacement (PVR) is shifting earlier to preserve RV function before patients develop symptoms. Several parameters have to be considered to facilate correct timing for PVR (surgically of by catheterization) : echocardiography, magnetic resonance imaging, electrocardiogram and cardiopulmonary exercise. All patients should have regular follow-up in a specialized grown-up congenital heart disease (GUCH) center to detect as soon as possible pathological signs of RV enlargement. Implantable cardioverter-defibrillator (ICD) implantation for primary prevention and programmed ventricular stimulation in repaired TOF remain controversal.

  14. A follow-up campaign for fast radio bursts

    NASA Astrophysics Data System (ADS)

    Petroff, Emily; Possenti, Andrea; Johnston, Simon; Kramer, Michael; Bailes, Matthew; Burke-Spolaor, Sarah; van Straten, Willem; Keane, Evan; Champion, David; Jameson, Andrew; Ng, Cherry; Barr, Ewan; Flynn, Chris; Caleb, Manisha

    2014-04-01

    Fast Radio Bursts (FRBs) are bright, millisecond-duration radio pulses hypothesized to originate at cosmological distances. To date, no counterpart sources have been associated with FRBs and their origins remain a puzzling mystery. Some have proposed FRBs come from Crab-like pulsar giant pulses or rare bursts from main sequence flare stars in our Galaxy. Both mechanisms would generate observable subsequent FRB-like events. In this proposal we directly test this hypothesis by conducting several follow-up observations on the eight FRBs from the High Time Resolution Universe Survey. This sample represents the majority of the dozen or so known FRB sources. With these observations we will set strict limits on any repetition of FRBs while using the 12 off-source beams of the multi-beam receiver as real-time FRB and transient detectors.

  15. Late follow-up of the Braunwald-Cutter valve.

    PubMed

    Jonas, R A; Garratt-Boyes, B G; Kerr, A R; Whitlock, R M

    1982-06-01

    A retrospective review has been made of 234 patients who received 239 Braunwald-Cutter valves (109 aortic, 130 mitral). For the aortic valve, the thromboembolic rate was very high (10.3 per 100 patient-years). This was associated with severe strut cloth wear in 94.5% of valves and with long strands of fibrin attached to the worn cloth in 58% of valves studied at reoperation or postmortem examination. The aortic poppet showed a mean decrease in volume of 4%, and poppet escape was recognized in 4 patients. The actuarial incidence of poppet escape was less than that predicted in earlier reports. There was a 4% incidence of stenosis of the valve. The hospital mortality associated with removal of the aortic Braunwald-Cutter valve and replacement with another device was 4%. Performance of the mitral Braunwald-Cutter valve appears satisfactory to date (mean follow-up, 42 months). Its electric removal is not recommended.

  16. Endoscopic palliation for inoperable malignant dysphagia: long term follow up.

    PubMed Central

    Maunoury, V; Brunetaud, J M; Cochelard, D; Boniface, B; Cortot, A; Paris, J C

    1992-01-01

    This prospective non-randomised trial of 128 selected patients with unresectable oesophageal or gastrooesophageal junction cancers aims to evaluate the initial relief of malignant obstruction by means of bipolar electrocoagulation for both circumferential and submucosal strictures of Nd:YAG laser for the other patients. A limited dilatation was performed initially if a small calibre endoscope was unable to pass through the stricture. Prompt and significant relief of dysphagia without complications was achieved in 83% of patients. Improved patients were retreated monthly during the follow up period. Radiotherapy was recommended when possible. Symptomatic relief of obstruction lasted 4.2 months on average and 76% of patients remained palliated until death. Monthly retreatment using the most appropriate endoscopic procedure for the tumour configuration and radiotherapy after endoscopic relief of obstruction seems to give the best palliation for patients with unresectable cancers of the oesophagus or gastrooesophageal junction. PMID:1283144

  17. Bleeding oesophageal varices with long term follow up.

    PubMed Central

    Spence, R A; Johnston, G W; Odling-Smee, G W; Rodgers, H W

    1984-01-01

    Complete long term follow up was obtained in 27 children who had bled from oesophageal varices. Most presented with haematemesis or melaena at an average age of 5.2 years in the portal vein thrombosis group (20 children) and 9.5 years in the intrahepatic group (7 children). All had splenomegaly. Only 6 of 20 children with portal vein thrombosis had a possible precipitating factor. A total of 182 admissions for bleeding are reported, in 68 of which injection sclerotherapy was used to control bleeding. Control rate with injection sclerotherapy was 97%. Shunts performed below age 10 years were associated with a high thrombosis rate. A conservative approach to bleeding varices in children is recommended with transfusion, pitressin, and injection sclerotherapy. Oesophageal transection may have a role in the emergency management of the few children in whom bleeding is not controlled by injection sclerotherapy. PMID:6609683

  18. Home/community monitoring using telephonic follow-up.

    PubMed

    Martin, Elisabeth Moy; French, Louis; Janos, Alicia

    2010-01-01

    Service members who have had a traumatic brain injury (TBI) in a war theatre [Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF)] may have associated injuries far different and/or more complex (i.e., polytrauma) than injuries obtained outside the theatre of operation. This article expands on what has been learned from monitoring patients injured during peacetime to the newly injured war veterans being monitored in the home setting via routine telephonic follow-up. As Tanielian et al. state TBI, post traumatic stress disorder (PTSD) and major depression may occur during and following deployment/s which then pose a significant health risk to these veterans. This is particularly important as veterans of these two conflicts may incur these "invisible wounds of war". Thus, safe and effective monitoring of these veterans by nurses/case managers in the home/community setting becomes important in the recovery process.

  19. [Patient education: the way for long-term follow up].

    PubMed

    Ruiz, J

    2008-06-04

    Therapeutic education is now perfectly integrated in caring and medicine. Its field of application is primarily in chronic diseases for the acquisition of competences in the management of treatments, in co-operation with health professionals. In ambulatory medicine, patients and health professionals are currently running up against the difficulties of the long-term follow-up with its part of uncertainty, lassitude and economic pressure. EBM and the various models of health psychology light us only partially the way. A new type of reflexive step is emerging. This way of thinking should place in its center the concept of therapeutic relation: between science and being. We summarize here our reflexive process in the course of an interdisciplinary team gathering social sciences, art and medicine.

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

    SciTech Connect

    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; 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.

  1. The LCOGT Near Earth Object (NEO) Follow-up Network

    NASA Astrophysics Data System (ADS)

    Lister, Tim; Gomez, Edward; Christensen, Eric; Larson, Steve

    2014-11-01

    Las Cumbres Observatory Global Telescope (LCOGT) network is a planned homogeneous network of over 35 telescopes at 6 locations in the northern and southern hemispheres. This network is versatile and designed to respond rapidly to target of opportunity events and also to do long term monitoring of slowly changing astronomical phenomena. The global coverage of the network and the apertures of telescope available make LCOGT ideal for follow-up and characterization of Solar System objects (e.g. asteroids, Kuiper Belt Objects, comets, Near-Earth Objects (NEOs)) and ultimately for the discovery of new objects.LCOGT has completed the first phase of the deployment with the installation and commissioning of nine 1-meter telescopes at McDonald Observatory (Texas), Cerro Tololo (Chile), SAAO (South Africa) and Siding Spring Observatory (Australia). The telescope network is now operating and observations are being executed remotely and robotically.I am using the LCOGT network to confirm newly detected NEO candidates produced by the major sky surveys such as Catalina Sky Survey (CSS), NEOWISE and PanSTARRS (PS1). Over 600 NEO candidates have been targeted so far this year with 250+ objects reported to the MPC, including 70 confirmed NEOs. An increasing amount of time is being spent to obtain follow-up astrometry and photometry for radar-targeted objects in order to improve the orbits and determine the rotation periods. This will be extended to obtain more light curves of other NEOs which could be Near-Earth Object Human Space Flight Accessible Targets Study (NHATS) or Asteroid Retrieval Mission (ARM) targets. Recent results have included the first period determination for the Apollo 2002 NV16 and our first NEO spectrum from the FLOYDS spectrographs on the LCOGT 2m telescopes obtained for 2012 DA14 during the February 2013 closepass.

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

    NASA Technical Reports Server (NTRS)

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

    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.

  3. Submillimeter Follow-Up of WISE-Selected Hyperluminous Galaxies

    NASA Technical Reports Server (NTRS)

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

    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 (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 microns, yet are clearly detected at 12 and 22 microns. 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 microns, 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 microns, 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 C120 K using a single-temperature model. Their infrared luminosities are well over 10(exp 13) Stellar 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.

  4. Symptom prevalence and longitudinal follow-up in cancer outpatients receiving chemotherapy.

    PubMed

    Yamagishi, Akemi; Morita, Tatsuya; Miyashita, Mitsunori; Kimura, Fukuko

    2009-05-01

    Palliative care for cancer patients receiving chemotherapy in the outpatient setting is important. The aims of this study were 1) to identify symptom prevalence and intensity in cancer patients receiving chemotherapy and 2) to describe longitudinal follow-up data obtained from repeated assessment using the distress thermometer (DT). Questionnaires were distributed to consecutive cancer outpatients newly starting chemotherapy at the first appointment and at every hospital visit. The questionnaire included the severity of 11 symptoms (M. D. Anderson Symptom Inventory [MDASI], Japanese version), the DT, and the need for help in four psychosocial areas (decision-making, economic problems, nutrition, and daily activities). In total, 4000 questionnaires were returned by 462 patients. The frequently identified problems were oral problems (21%), insomnia (19%), psychological distress (defined as a DT score of 6 or more; 15%), help with information and decision-making (14%), severe fatigue (8.2%), and severe appetite loss (6.3%). Cluster analysis identified four symptom clusters: 1) fatigue and somnolence; 2) pain, dyspnea, and numbness; 3) nausea, appetite loss, and constipation; and 4) psychological distress. Of 165 patients with a DT of score 6 or more, 115 patients (70%) demonstrated a DT score below 6 at a median of 17 days follow-up. In the remaining 50 patients who had a DT score of 6 or more at follow-up, 34 patients (68%) had one or more physical symptoms rated at 7 or more on an 11-point numeric rating scale. Compared with patients with a DT score below 6 at follow-up, patients with a DT score of 6 or more at follow-up had higher levels of all physical symptoms. Frequent symptoms experienced by cancer outpatients receiving chemotherapy may be categorized as: 1) psychosocial issues (insomnia, psychological distress, decision-making support); 2) nutrition-gastrointestinal issues (oral problems, appetite loss, nausea); 3) fatigue; and 4) pain, dyspnea, and numbness

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

    SciTech Connect

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

    2009-09-15

    The purpose of this study was to evaluate the clinical results, complications, and secondary interventions during long-term follow-up after endovascular aneurysm repair (EVAR) and to investigate the impact of endoleak sizes on aneurysm shrinkage. From 1997 to March 2007, 127 patients (12 female, 115 male; age, 73.0 {+-} 7.2 years) with abdominal aortic aneurysms were treated with Talent stent-grafts. Follow-up included clinical visits, contrast-enhanced MDCT, and radiographs at 3, 6, and 12 months and then annually. Results were analyzed with respect to clinical outcome, secondary interventions, endoleak rate and management, and change in aneurysm size. There was no need for primary conversion surgery. Thirty-day mortality was 1.6% (two myocardial infarctions). Procedure-related morbidity was 2.4% (paraplegia, partial infarction of one kidney, and inguinal bleeding requiring surgery). Mean follow-up was 47.7 {+-} 34.2 months (range, 0-123 months). Thirty-nine patients died during follow-up; three of the deaths were related to aneurysm (aneurysm rupture due to endoleak, n = 1; secondary surgical reintervention n = 2). During follow-up, a total of 29 secondary procedures were performed in 19 patients, including 14 percutaneous procedures (10 patients) and 15 surgical procedures (12 patients), including 4 cases with late conversion to open aortic repair (stent-graft infection, n = 1; migration, endoleak, or endotension, n = 3). Overall mean survival was 84.5 {+-} 4.7 months. Mean survival and freedom from any event was 66.7 {+-} 4.5 months. MRI depicted significantly more endoleaks compared to MDCT (23.5% vs. 14.3%; P < 0.01). Patients in whom all aneurysm side branches were occluded prior to stent-grafting showed a significantly reduced incidence of large endoleaks. Endoleaks >10% of the aneurysm area were associated with reduced aneurysm shrinkage compared to no endoleaks or <10% endoleaks ({Delta} at 3 years, -1.8% vs. -12.0%; P < 0.05). In conclusion, endovascular

  6. Shaky drawing: what is the rate of decline during prospective follow-up of essential tremor?

    PubMed Central

    Louis, Elan D; Michalec, Monica; Gillman, Art

    2014-01-01

    Objective Few studies have attempted to estimate the rate of decline over time in essential tremor (ET). The study objectives were to: (1) measure change, deriving a single summary measure for the entire group, and relate it to a commonly used clinical rating scale (ie, yearly change in points on that scale); (2) to assess change as a function of baseline clinical characteristics and (3) to answer the basic clinical question—is change perceptible/obvious during the follow-up of ET cases? Setting Prospective collection of longitudinal data on ET cases enrolled in a study of the environmental epidemiology of ET at Columbia University Medical Center (2000–2008). Participants 116 unselected ET cases. Interventions Each case underwent the same evaluation at baseline and during one follow-up visit (mean follow-up interval (range)=5.8 (1.4–12.4) years). Primary and secondary outcome measures We assessed tremor during a commonly affected daily activity—drawing (ie, spirography), quantifying tremor using a simple, standardised 10-point rating scale developed by Bain and Findley. Results The Bain and Findley spiral score increased at an average rate of 0.12±0.23 points per year (maximum=1 point/year). In cases who had been followed for ≥5 years, the change was obvious—a blinded neurologist was able to correctly order their spirals (baseline vs follow-up) in three-fourth of cases. The rate of change was higher in cases with versus without familial ET (p=0.01). Conclusions Tremor in ET is slowly progressive; yet in the majority of cases, a clear difference in handwritten spirals was visible with a follow-up interval of five or more years. There may be differences between familial and non-familial ET in the rate of progression. These clinical data are intended to aid in the prognostic discussions that treating physicians have with their patients with ET. PMID:24722199

  7. One-year follow-up of guided self-help for parents of preschool children with externalizing behavior.

    PubMed

    Ise, Elena; Kierfeld, Frauke; Döpfner, Manfred

    2015-02-01

    Self-help programs are an effective intervention for parents of children with externalizing behavior. A number of studies have shown that self-administered parent training has positive short-term effects on a child's behavior, but there is little research done on long-term outcomes. This paper reports results from a 1-year follow-up of a randomized controlled prevention trial of self-administered parent training with minimal therapist contact. In the initial prevention trial, we randomly assigned 48 preschool children with elevated levels of externalizing behavior to either a treatment group (TG) or a waitlist control group (WLC). The intervention consisted of written material and brief weekly telephone consultations. Thirty-six families (25 TG families, 11 WLC families) completed the self-help program. Twenty-five of these participated in a follow-up assessment 1 year after the intervention. There were no significant changes from post-test to follow-up on measures of child behavior (e.g., Attention-Deficit/Hyperactivity Disorder and Oppositional Defiant Disorder symptom rating scales) and parental mental health, indicating that gains achieved post-intervention were maintained for at least 1 year. Moreover, the percentage of children with substantial behavior problems was reduced from pre-intervention to follow-up. These findings provide evidence that telephone-assisted self-help programs can be effective in the prevention of disruptive behavior problems.

  8. Three-Year Follow-up of Conservative Treatments of Shoulder Osteoarthritis in Older Patients.

    PubMed

    Guo, Jiong Jiong; Wu, Kailun; Guan, Huaqing; Zhang, Lei; Ji, Cheng; Yang, Huilin; Tang, Tiansi

    2016-07-01

    Little is known about the mid-term results of nonsurgical treatment for shoulder osteoarthritis (OA), especially in a Chinese population. This study sought to determine the efficacy of nonsurgical management in older patients with shoulder OA. A total of 129 conservatively treated unilateral shoulder OA patients who were older than 65 years were evaluated prospectively at the initial office visit and then subsequently at 3, 6, 12, 18, 24, and 36 months later. During the 36-month follow-up period, all patients could receive conventional therapy, such as nonsteroidal anti-inflammatory medication, corticosteroid injection, sodium hyaluronate, and education, at the discretion of treating physicians. Some patients received physiotherapy, rehabilitation training, and a shoulder strap to improve the range of motion and muscular strength training from a physical therapist. Parameters measured included comparative effectiveness of each therapeutic method, visual analog scale (VAS), Simple Shoulder Test (SST), and Short Form (36) Health Survey (SF-36) scores. At 3-year follow-up, most patients had a significant increase from their pretreatment values in pain, self-assessed shoulder function, mental health, and 5 of 8 SF-36 domains. The study showed a decline in SST and VAS at 6 and 12 months after an initial ascent at 3 months, and then it was rescued and continued at 3-year follow-up. Combined therapy could improve symptoms significantly. This study suggests that a conservative approach may be more appropriate and can produce satisfactory mid-term outcomes in selected cases. The findings of this study suggest that conservative treatments should be extended for longer than 12 months before the decision regarding shoulder arthroplasty is made. [Orthopedics. 2016; 39(4):e634-e641.].

  9. Long-term follow-up results of foot and ankle tuberculosis in Turkey.

    PubMed

    Gursu, Sarper; Yildirim, Timur; Ucpinar, Hanifi; Sofu, Hakan; Camurcu, Yalkin; Sahin, Vedat; Sahin, Nursu

    2014-01-01

    The incidence of tuberculosis has been increasing, especially in the past 2 decades. Skeletal tuberculosis is very rare compared with the frequency of the pulmonary form. In the present study, we have shared our long-term experience with foot and ankle tuberculosis, providing information about the different aspects of the disease. A total of 70 patients with foot and ankle tuberculosis, treated from 1983 to 2005, were evaluated. The mean patient age was 34.4 (range 7 to 85) years at the diagnosis. The mean interval between the first symptoms and the diagnosis was 26.4 months (range 1 month to 15 years). The mean follow-up period was 21.7 (range 8 to 30) years. The infection affected both the joint and the bones in 29 patients, only the joints in 13, only the bones in 22, and the soft tissues alone in the remaining 6 patients. The most common joint location was the tibiotalar joint. The talus was the most commonly infiltrated bone. All patients underwent biopsy, and 28 patients underwent additional surgical procedures. In 18 patients (25.7%), 1 to 4 recurrences developed during the follow-up period. In the last follow-up visits, either severe destruction of the bones or end-stage arthrosis was evident in 39 patients (55.7%), especially in those with osseous tuberculosis. Foot and ankle tuberculosis is very rare. The diagnosis of the disease will often be late owing to the lack of pathognomonic findings. A histopathologic evaluation should not be omitted in cases with suspicion. The incidence of residual deformity or end-stage arthrosis has been high in the long term; however, the patients will usually be without any symptoms.

  10. Closing the Feedback Loop: An Interactive Voice Response System to Provide Follow-up and Feedback in Primary Care Settings

    PubMed Central

    Willig, James H.; Krawitz, Marc; Panjamapirom, Anantachai; Ray, Midge N.; Nevin, Christa R.; English, Thomas M.; Cohen, Mark P.; Berner, Eta S.

    2013-01-01

    In primary care settings, follow-up regarding the outcome of acute outpatient visits is largely absent. We sought to develop an automated interactive voice response system (IVRS) for patient follow-up with feedback to providers capable of interfacing with multiple pre-existing electronic medical records (EMRs). A system was designed to extract data from EMRs, integrate with the IVRS, call patients for follow-up, and provide a feedback report to providers. Challenges during the development process were analyzed and summarized. The components of the technological solution and details of its implementation are reported. Lessons learned include: (1) Modular utilization of system components is often needed to adapt to specific clinic workflow and patient population needs (2) Understanding the local telephony environment greatly impacts development and is critical to success, and (3) Ample time for development of the IVRS questionnaire (mapping all branching paths) and speech recognition tuning (sensitivity, use of barge-in tuning, use of “known voice”) is needed. With proper attention to design and development, modular follow-up and feedback systems can be integrated into existing EMR systems providing the benefits of IVRS follow-up to patients and providers across diverse practice settings. PMID:23340825

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

    PubMed Central

    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

  12. Multi-wavelength follow-up of ANTARES neutrino alerts

    NASA Astrophysics Data System (ADS)

    Mathieu, Aurore

    2015-10-01

    Transient sources are often associated with the most violent phenomena in the Universe, where the acceleration of hadrons may occur. Such sources include gamma-ray bursts (GRBs), active galactic nuclei (AGN) or core-collapse supernovae (CCSNe), and are promising candidates for the production of high energy cosmic rays and neutrinos. The ANTARES telescope, located in the Mediterranean sea, aims at detecting these high energy neutrinos, which could reveal the presence of a cosmic ray accelerator. However, to enhance the sensitivity to transient sources, a method based on multi-wavelength follow-up of neutrino alerts has been developed within the ANTARES collaboration. This program, denoted as TAToO, triggers a network of robotic optical telescopes and the Swift-XRT with a delay of only a few seconds after a neutrino detection. The telescopes start an observation program of the corresponding region of the sky in order to detect a possible electromagnetic counterpart to the neutrino event. The work presented in this thesis covers the development and implementation of an optical image analysis pipeline, as well as the analysis of optical and X-ray data to search for fast transient sources, such as GRB afterglows, and slowly varying transient sources, such as CCSNe.

  13. Benzene-induced chromosome aberrations: A follow-up study

    SciTech Connect

    Forni, A.

    1996-12-01

    To study the evolution of cytogenetic damage from past exposure to high concentrations of benzene and its health significance, chromosome aberrations (CA) in lymphocytes were reinvestigated after approximately 20 years in four subjects with past severe hemopathy and in seven controls studied in the late 1960s. Increased chromosome-type aberrations were still present up to 30 years after benzene toxicity, but blood counts were normal. The vital status at the end of 1993 was ascertained for 32 subjects with a history of benzene toxicity and for 31 controls studied for CA from 1965 to 1970, who differed significantly for CA rates. Of the 32 benzene-exposed subjects, 1 was lost to follow-up, 20 were still alive, and 11 had died at ages 36 to 83, between 1 and 20 years after the last CA study. Five deaths were from neoplasia (acute erythroleukemia, brain tumor, cancer of lung, paranasal cavity, esophagus). The deceased subjects had significantly higher rates of chromosome-type aberrations than those alive, and those who died of neoplasia had the highest rates of these aberrations in the last study before death or diagnosis of cancer. Out of the 31 controls, 12 had died from 4 to 23 years after the CA study. Three deaths were from neoplasia (two lung cancer, one brain tumor). Even if this is a small sample, the results suggest a higher risk of cancer for the benzene-exposed cohort, who had persistently high CA rates in lymphocytes. 10 refs., 4 tabs.

  14. Cohort Profile: The Manitoba Follow-up Study (MFUS).

    PubMed

    Tate, Robert B; Cuddy, T Edward; Mathewson, Francis A L

    2015-10-01

    The Manitoba Follow-up Study (MFUS) is Canada's longest running study of cardiovascular disease and ageing. The MFUS cohort consists of 3983 men recruited from the Royal Canadian Air Force at the end of World War II. At entry to the study, 1 July 1948, their mean age was 31 years, with 90% between ages 20 and 39 years. All study members were free of clinical evidence of ischaemic heart disease. The protocol of MFUS was to obtain routine medical examinations from these men at regular intervals over time. The research goal of the study was to examine the role that any abnormalities detected on routine electrocardiograms from apparently healthy men might play in the prediction of subsequent diagnoses of cardiovascular disease. Over the course of 65 years, about 35% of the cohort has documented evidence of ischaemic heart disease. The research focus was expanded in 1996 to explore the roles of physical, mental and social functioning in support of healthy and successful ageing. On 1 July 2013, 429 original cohort members were alive with a mean age of 92 years. Collaborative research with others outside the in-house team is welcomed.

  15. Follow-up skeletal survey use by child abuse pediatricians.

    PubMed

    Harper, Nancy S; Lewis, Terri; Eddleman, Sonja; Lindberg, Daniel M

    2016-01-01

    Skeletal survey is frequently used to identify occult fractures in young children with concern for physical abuse. Because skeletal survey is relatively insensitive for some abusive fractures, a follow-up skeletal survey (FUSS) may be undertaken at least 10-14 days after the initial skeletal survey to improve sensitivity for healing fractures. This was a prospectively planned secondary analysis of a prospective, observational study of 2,890 children who underwent subspecialty evaluation for suspected child physical abuse at 1 of 19 centers. Our objective was to determine variability between sites in rates of FUSS recommendation, completion and fracture identification among the 2,049 participants who had an initial SS. Among children with an initial skeletal survey, the rate of FUSS recommendation for sites ranged from 20% to 97%; the rate of FUSS completion ranged from 10% to 100%. Among sites completing at least 10 FUSS, rates of new fracture identification ranged from 8% to 28%. Among completed FUSS, new fractures were more likely to be identified in younger children, children with higher initial level of concern for abuse, and those with a fracture or cutaneous injury identified in the initial evaluation. The current variability in FUSS utilization is not explained by variability in occult fracture prevalence. Specific guidelines for FUSS utilization are needed.

  16. Continued Astrometric Follow-up Of Near-Earth Objects

    NASA Technical Reports Server (NTRS)

    Spahr, Timothy; Johnson, Lindley (Technical Monitor)

    2005-01-01

    As the grant periods overlapped, some of this information below will also be present on the previous final report. During the period May 1 2004 to April 30 2005, approximately 100 NEOs fainter than V = 20 were observed on separate nights from the 1.2-m telescope at Mt. Hopkins. Additionally, a few comets were targeted, including astrometric support of the Deep Impact mission by observing comet P/Tempel 1. Kyle Smalley was again employed as an independent contractor, and he was trained in use of the telescope, performed several remote observing runs on his own, and has now begun critical software support of the observing program. Code to automatically operate the telescope, given a target list, is approximately 90% done. During the first observing run scheduled in late September or early October, this code will be tested at on the telescope. It is probable that the 1.2m telescope will be run automatically all night without any interruption from the observer for anything during this time. Additional work on selecting which NEO targets to observe is progressing, with a beta-release of a simple target selection web page. Additionally, two-night objects with the potential of being NEOs have been extracted on a routine basis during this last grant cycle. These will also be added to a web page to facilitate additional astrometric follow-up.

  17. [Cardiological follow-up in patients with Fabry disease].

    PubMed

    Pieruzzi, Federico; Pieroni, Maurizio; Chimenti, Cristina; Frustaci, Andrea; Sarais, Cristiano; Cecchi, Franco

    2010-01-01

    Fabry disease is a rare tesaurismosis due to a deficit of the lysosomal enzyme activity of alpha-galactosidase, needed for the normal catabolism of globotriaosylceramides (GL3). Fabry cardiac involvement has several clinical manifestations: concentric left ventricular hypertrophy without left ventricular dilation and severe loss of left ventricular systolic function, mitral and aortic valvulopathy, disorders of the atrioventricular conduction or repolarization, and compromised diastolic function. Differentiating Fabry disease from similar conditions is often quite straightforward, e.g., cardiac amyloidosis is often associated with low electrocardiographic voltages, and systemic symptoms are usually associated with hemochromatosis and sarcoidosis. However, sometimes second-level (genetic analysis, alpha-galactosidase levels) or invasive investigations are required, which can include endomyocardial biopsy. Diagnostic imaging techniques have been described, but they lack specificity. Echocardiographic imaging with tissue Doppler analysis and/or strain rate analysis can allow diagnosis of Fabry disease even before left ventricular hypertrophy becomes apparent. This review illustrates the techniques for staging cardiac involvement and damage in Fabry disease and for the long-term follow-up of Fabry patients with or without cardiac involvement. Careful cardiac monitoring is especially important in elderly female carriers, who often develop renal disorders and/or left ventricular hypertrophy as the only manifestations of their late Fabry disease. In some clinical series, Fabry disease was diagnosed in 12% of women with adult-onset hypertrophic cardiomyopathy. Cardiological problems and outcomes of enzyme replacement therapy, associated with or without other cardiological treatments, are also discussed.

  18. [Follow-up and counselling after pelvic inflammatory disease].

    PubMed

    Derniaux, E; Lucereau-Barbier, M; Graesslin, O

    2012-12-01

    Pelvic inflammatory disease (PID) can be responsible for infertility and chronic pelvic pain. Treatment of acute PID is very important as it can reduce the risk of sequelae. However, follow-up, partner treatment and counselling are also useful to reduce the reinfection rate. Few weeks after PID, clinical evaluation as well as transvaginal and transabdominal sonography must be performed. The interest of systematic bacteriological tests is not proved. Hysterosalpingography and second-look laparoscopy should be considered only for women with infertility and severe infection. Use of condom is advisable in this population in order to prevent sexually transmitted diseases (STD) including HIV and to decrease rate of recurrence, associated to contraceptive pill, which is also a good option. In selected cases, intrauterine devices can be used in patients with history of PID if the infection is resolved and no significant risk factors for STD exist. Infertility and chronic pelvic pain are the most common sequelae in the population of young women with severe and recurrent infection. The risk of ectopic pregnancy is higher for these women and must be kept in mind. Counselling and risk-reduction interventions decreased significatively the rate of recurrence and sequelae in PID.

  19. A follow-up study on three caries activity tests.

    PubMed

    Shi, Sizhen; Deng, Qing; Hayashi, Yoshihiro; Yakushiji, Masashi; Machida, Yukio; Liang, Qin

    2003-01-01

    The purpose of this research was to study the efficacy of three CAT's (Dentocult SM, Dentocult LB and Dentobuff Strip) in revealing caries condition and predicting caries progress, and provide a reference for application by comparing the three tests. Oral condition and results of the three CAT's of 82 children aged 3 to 4 were recorded and followed up. The examination was checked again two years later. The caries incidence, dft and CSI data from the two examinations were analyzed statistically. The results were that each Dentocult SM degree showed significant variances in incidence rate, as did the dft and CSI results in the second examination. The dft and CSI of both examinations exhibited a high degree of statistical significance. The same may be said of the Dentocult LB findings for the two years. No noticeable variances in caries incidence rate, dft and CSI from the Dentobuff Strip test were observed in both years' study, nor was there any statistical significance drawn from the findings, except for those of the second exam. No gender differences were observed in the distribution by degree with the three CATs The conclusion is that Dentocult SM is the best of the three tests for the diagnosis of the presence of caries and prognosis of its progress, Dentocult LB is second best whereas the Dentobuff Strip shows no detection capability. The findings serve as an application reference.

  20. Strategies to photometric follow-up transiting exoplanets

    NASA Astrophysics Data System (ADS)

    Mancini, L.

    2014-03-01

    It is now well ascertained that those extrasolar planets that transit in front to their parent stars deserve extensive follow-up observations because they are the only ones for which we can directly measure all their physical parameters. This information currently provides the best route to constructing the mass-radius diagram of exoplanets, which channels the theoretical formation/evolution models in the right path. However, many of the discovered transiting planets do not have high-quality light curves, so their physical properties are poorly known. In this perspective, we are leading a large program to obtain ultra-high-precision photometry of transit events, which are analyzed to accurately measure the physical properties of know planetary systems. Besides measuring and refining the physical properties of the planets and their parent stars, we also try to obtain additional information from the light curves, by identifying particular features of the systems (e.g. stellar activity) and investigating the composition of the planetary atmospheres by transmission photometry. In this conference-proceedings contribution I present several observational strategies that we adopt to achieve these goals. %

  1. French consensus. Idiopathic hypersomnia: Investigations and follow-up.

    PubMed

    Leu-Semenescu, S; Quera-Salva, M-A; Dauvilliers, Y

    Idiopathic hypersomnia is a rare, central hypersomnia, recently identified and to date of unknown physiopathology. It is characterised by a more or less permanent, excessive daytime sleepiness, associated with long and unrefreshing naps. Night-time sleep is of good quality, excessive in quantity, associated with sleep inertia in the subtype previously described as "with long sleep time". Diagnosis of idiopathic hypersomnia is complex due to the absence of a quantifiable biomarker, the heterogeneous symptoms, which overlap with the clinical picture of type 2 narcolepsy, and its variable evolution over time. Detailed evaluation enables other frequent causes of somnolence, such as depression or sleep deprivation, to be eliminated. Polysomnography and multiple sleep latency tests (MSLT) are essential to rule out other sleep pathologies and to objectify excessive daytime sleepiness. Sometimes the MSLT do not show excessive sleepiness, hence a continued sleep recording of at least 24hours is necessary to show prolonged sleep (>11h/24h). In this article, we propose recommendations for the work-up to be carried out during diagnosis and follow-up for patients suffering from idiopathic hypersomnia.

  2. COPD and microalbuminuria: a 12-year follow-up study.

    PubMed

    Romundstad, Solfrid; Naustdal, Thor; Romundstad, Pål Richard; Sorger, Hanne; Langhammer, Arnulf

    2014-04-01

    Chronic obstructive pulmonary disease (COPD), low lung function independent of diagnosis and markers of inflammation are all associated with increased morbidity and mortality. Microalbuminuria, reflecting endothelial dysfunction, could be a relevant inflammatory marker of potential systemic effects of COPD. We hypothesised that there was a positive association between microalbuminuria and mortality in individuals with COPD. We conducted a 12-year follow-up study of 3129 participants in the second survey of the Nord-Trøndelag Health Study (HUNT), Norway. At baseline, albuminuria was analysed in three urine samples and spirometry was performed. Among the participants, 136 had COPD and microalbuminuria, defined as a urinary albumin/creatinine ratio between 2.5 and 30.0 mg·mmol(-1). The main outcome measures were hazard ratio of all-cause mortality according to microalbuminuria. Compared to those with COPD without microalbuminuria, the adjusted hazard ratio for all-cause mortality in those with COPD and microalbuminuria was 1.54, 95% CI 1.16-2.04. This result was similar after excluding cardiovascular disease at baseline. Classifying COPD severity by Global Initiative for Chronic Obstructive Lung Disease, there was a positive association trend with increasing severity stages. Microalbuminuria is associated with all-cause mortality in individuals with COPD and could be a relevant tool in identification of patients with poor prognosis.

  3. Integrated GW-EM Follow-up Analysis

    NASA Astrophysics Data System (ADS)

    Ackley, Kendall; Eikenberry, Stephen; Klimenko, Sergey; LSC Collaboration

    2015-04-01

    Advanced Gravitational-Wave (GW) detectors such as Advanced LIGO and Advanced Virgo are expected to become operational for observation runs in 2015, with an expected ultimate improvement in sensitivity over previous configurations by a factor of 10 by 2019. There are many potential electromagnetic (EM) counterparts to GWs including short and long gamma-ray bursts (GRBs) and kilonovae. While SGRBs and LGRBs predominantly emit in the X-ray, and the recently-observed kilonova primarily in the infrared, all three sources are expected to have detectable traces in the optical band, albeit requiring very sensitive optical telescopes. In order to aid in the optimization of GW trigger follow-up procedures, we perform an end-to-end analysis feasibility study using synthesized Advanced detector data simulating a GW detection with a theoretical EM counterpart injected into archival optical images. We use images from Robotic Optical Transient Search Experiment (ROTSE) and Palomar Transient Factory (PTF), and inject candidate events following observed lightcurves of SGRBs, LGRBs, and kilonovae. The use of Zernike PSF decomposition on candidate objects offers a fast way to identify point sources, speeding up the automated identification of transient sources in the images. We present our method of transient recovery and the latest results of our feasibility study of a joint GW-EM observation.

  4. Surveys, Astrometric Follow-Up, and Population Statistics

    NASA Astrophysics Data System (ADS)

    Jedicke, R.; Granvik, M.; Micheli, M.; Ryan, E.; Spahr, T.; Yeomans, D. K.

    Asteroid surveys are the backbone of asteroid science, and with this in mind we begin with a broad review of the impact of asteroid surveys on our field. We then provide a brief history of asteroid discoveries so as to place contemporary and future surveys in perspective. Surveys in the United States (U.S.) have discovered the vast majority of the asteroids, and this dominance has been consolidated since the publication of Asteroids III. Our descriptions of the asteroid surveys that have been operational since that time are focused on those that have contributed the vast majority of asteroid observations and discoveries. We also provide some insight into upcoming next-generation surveys that are sure to alter our understanding of the small bodies in the inner solar system and provide evidence to untangle their complicated dynamical and physical histories. The Minor Planet Center, the nerve center of the asteroid discovery effort, has improved its operations significantly in the past decade so that it can manage the increasing discovery rate, and ensure that it is well-placed to handle the data rates expected in the next decade. We also consider the difficulties associated with astrometric follow-up of newly identified objects. It seems clear that both of these efforts must operate in new modes in order to keep pace with expected discovery rates of next-generation ground- and spacebased surveys.

  5. Asbestos and cancer: a cohort followed up to death.

    PubMed Central

    Enterline, P E; Hartley, J; Henderson, V

    1987-01-01

    The mortality experience of 1074 white men who retired from a United States asbestos company during the period 1941-67 and who were exposed to asbestos working as production and maintenance employees for the company is reported to the end of 1980 when 88% of this cohort was known to be dead. As noted in earlier reports the mortality for respiratory and gastrointestinal cancer was raised. A more detailed examination of causes of death shows that the excess in gastrointestinal cancer was largely due to a statistically significant excess in stomach cancer. A statistically significant excess was also noted for kidney cancer, cancer of the eye, and non-malignant respiratory disease. Eight deaths from malignant mesothelioma were observed, two of which were peritoneal. Asbestos exposures for these mesothelioma cases were low relative to other members of the cohort. Continuing follow up of this cohort shows a dose response relation for respiratory cancer that has become increasingly linear. Standardised mortality ratios peaked 10 to 15 years after retirement and were relatively constant at around 250 in each five year interval starting in 1950. This excess might have been detected as early as 1960 but certainly by 1965. The mortality experience of this cohort reflects the ultimate effects of asbestos since nearly all of the cohort has now died. PMID:3606968

  6. Cost effectiveness of group follow-up after structured education for type 1 diabetes: a cluster randomised controlled trial

    PubMed Central

    2014-01-01

    Background This study examines the cost effectiveness of group follow-up after participation in the Dose Adjustment for Normal Eating (DAFNE) structured education programme for type 1 diabetes. Methods Economic evaluation conducted alongside a cluster randomised controlled trial involving 437 adults with type 1 diabetes in Ireland. Group follow-up involved two group education ‘booster’ sessions post-DAFNE. Individual follow-up involved two standard one-to-one hospital clinic visits. Incremental costs, quality-adjusted life years (QALYs) gained and cost effectiveness were estimated at 18 months. Uncertainty was explored using sensitivity analysis and by estimating cost effectiveness acceptability curves. Results Group follow-up was associated with a mean reduction in QALYs gained of 0.04 per patient (P value, 0.052; 95% CI, −0.08 to 0.01, intra-class correlation (ICC), 0.033) and a mean reduction in total healthcare costs of €772 (P value, 0.020; 95% CI, −1,415 to −128: ICC, 0.016) per patient. At alternative threshold values of €5,000, €15,000, €25,000, €35,000, and €45,000, the probability of group follow-up being cost effective was estimated to be 1.000, 0.762, 0.204, 0.078, and 0.033 respectively. Conclusions The results do not support implementation of group follow-up as the sole means of follow-up post-DAFNE. Given the reported cost savings, future studies should explore the cost effectiveness of alternative models of group care for diabetes. Trial registration Current Controlled Trials ISRCTN79759174 (assigned: 9 February 2007). PMID:24927851

  7. Follow up on the crystal growth experiments of the LDEF

    NASA Technical Reports Server (NTRS)

    Nielsen, K. F.; Lind, M. D.

    1993-01-01

    The results of the 4 solution growth experiments on the LDEF have been published elsewhere. Both the crystals of CaCO3, which were large and well shaped, and the much smaller TTF-TCNQ crystals showed unusual morphological behavior. The follow up on these experiments was begun in 1981, when ESA initiated a 'Concept Definition Study' on a large, 150 kg, Solution Growth Facility (SGF) to be included in the payload of EURECA-1, the European Retrievable Carrier. This carrier was a continuation of the European Spacelab and at that time planned for launch in 1987. The long delay of the LDEF retrieval and of subsequent missions brought about reflections both on the concept of crystal growth in space and on the choice of crystallization materials that had been made for the LDEF. Already before the LDEF retrieval, research on TTF-TCNQ had been stopped, and a planned growth experiment with TTF-TCNQ on the SGF/EURECA had been cancelled. The target of the SGF investigation is now more fundamental in nature. None of the crystals to be grown here are, like TTF-TCNQ, in particular demand by science or industry, and the crystals only serve the purpose of model crystals. The real purpose of the investigation is to study the growth behavior. One of the experiments, the Soret Coefficient Measurement experiment is not growing crystals at all, but has it as its sole purpose to obtain accurate information on thermal diffusion, a process of importance in crystal growth from solution.

  8. Effectiveness of antismoking telephone helpline: follow up survey.

    PubMed Central

    Platt, S.; Tannahill, A.; Watson, J.; Fraser, E.

    1997-01-01

    OBJECTIVE: To evaluate the effectiveness of an antismoking campaign conducted by the Health Education Board for Scotland. DESIGN: Descriptive survey of adult callers to a telephone helpline (Smokeline) for stopping smoking; panel study of a random sample of adult callers; assessment of changes in prevalence of smoking in Scotland before and after introduction of the helpline. SETTING: Telephone helpline. SUBJECTS: Callers to Smokeline over the initial one year period. Detailed information was collected on a 10% sample (n = 8547). A cohort of adult smokers who called Smokeline (total n = 848) was followed up by telephone interview three weeks, six months, and one year after the initial call. MAIN OUTCOME MEASURES: Numbers of adult smokers calling helpline; changes in smoking behaviour, especially stopping smoking among cohort members; and changes in prevalence of smoking in the general population. RESULTS: An estimated 82782 regular adult smokers made genuine contact with Smokeline over the year, representing about 5.9% of all adult smokers in Scotland. At one year 143 of the cohort of 848 callers (23.6%; 95% confidence interval 20.2% to 27.0%) reported that they had stopped smoking and 534 (88.0%; 85.4% to 90.6%) reported having made some change. About 19500 (16700 to 22350) adult smokers, equivalent to 1.4% (1.2% to 1.6%) of the mean adult smoking population, stopped smoking with direct help from Smokeling. During the second year of the campaign (1994) smoking prevalence among 25-65 year olds in Scotland was 6% (2.0% to 10.0%) lower than it had been before the start of the campaign. CONCLUSION: The Health Education Board for Scotland's antismoking campaign reached a high number of adult smokers, was associated with a highly acceptable quit rate among adults given direct help through Smokeline, and contributed considerably to an accelerated decline in smoking prevalence in Scotland. PMID:9161308

  9. Latex allergy: a follow up study of 1040 healthcare workers

    PubMed Central

    Filon, F Larese; Radman, G

    2006-01-01

    Background Natural rubber latex allergy can cause skin and respiratory symptoms The aim of this study was to evaluate the prevalence and incidence of latex related symptoms and sensitisation among a large group of healthcare workers in Trieste hospitals, followed for three years before and after the introduction of powder‐free gloves with low latex release. Methods In the years 1997–99 the authors evaluated 1040 healthcare workers exposed to latex allergen for latex related symptoms and sensitisation by means of a questionnaire, a medical examination, skin prick tests, and IgE specific antibody assay. The second evaluation was carried out in the years 2000–02, subsequent to the changeover to a powder‐free environment. Results Glove related symptoms were seen in 21.8% of the nurses (227), mostly consisting of mild dermatitis: 38 (3.6%) complaining of contact urticaria and 24 (2.3%) of asthma and/or rhinitis. These symptoms were significantly related to skin prick tests positive to latex (OR = 9.70; 95% CI 5.5 to 17) and to personal atopy (OR = 2.29; 95% CI 1.6 to 3.2). Follow up was completed in 960 subjects (92.3%): 19 new subjects (2.4%) complained of itching erythema when using gloves, but none was prick positive to latex. Symptoms significantly improved and in most cases disappeared (p<0.0001). Conclusions Simple measures such as the avoidance of unnecessary glove use, the use of non‐powdered latex gloves by all workers, and use of non‐latex gloves by sensitised subjects can stop the progression of latex symptoms and can avoid new cases of sensitisation. PMID:16421390

  10. Six month-follow up of laparoscopic sleeve gastrectomy

    PubMed Central

    Keleidari, Behrouz; Mahmoudie, Mohsen; Anaraki, Amin Ghanei; Shahraki, Masoud Sayadi; Jamalouee, Samira Dvashi; Gharzi, Mahsa; Mohtashampour, Farnoosh

    2016-01-01

    Background: The rising prevalence of obesity in today populations has led obese individuals to seek medical interventions. Aside from special diets, routine exercise and in some cases, medical treatment, most of the obese patients, favoring those with morbid or super obesity can benefit from bariatric surgery to lose weight. Laparoscopic sleeve gastrectomy (LSG) is relatively new method to limit the compliance of stomach. The consequent quick satiety during each meal results in gradual weight loss in patients. We investigated the efficacy and safety of this method among a group of our patients. Materials and Methods: This cross-sectional study was conducted in Isfahan, Iran, from January 2012 to January 2013. Thirty-five cases of obesity that had undergone LSG were enrolled and their baseline data of weight, body mass index (BMI), blood sugar, lipid profile, liver function indexes and blood pressure were collected. The patients were followed up for 6 months. The 6-month results were analyzed. Results: There was significant reduction in BMI, weight, blood sugar, blood pressure, liver enzymes and lipid profile components (P < 0.05), except for alkaline phosphatase (ALP) (P = 0.3). The average of excess weight loss percentage after 6 months was 69.2 ± 20.9%. No mortality occurred. Two of the patients had micro anastomotic leaks that were treated with nonoperative management. A case of gross leakage was treated with tube jejunostomy. Conclusion: Our study confirmed the efficacy and safety of LSG as a single surgical intervention for body weight reduction in morbidly and super obese patients. PMID:27110546

  11. Impact of involuntary out-patient commitment on reducing hospital services: 2-year follow-up.

    PubMed

    Castells-Aulet, Laura; Hernández-Viadel, Miguel; Jiménez-Martos, Jesús; Cañete-Nicolás, Carlos; Bellido-Rodríguez, Carmen; Calabuig-Crespo, Roman; Asensio-Pascual, Pedro; Lera-Calatayud, Guillem

    2015-08-01

    Aims and method To evaluate whether involuntary out-patient commitment (OPC) in patients with severe mental disorder reduces their use of hospital services. This is a retrospective case-control study comparing a group of patients on OPC (n = 75) and a control group (n = 75) which was composed of patients whose sociodemographic variables and clinical characteristics were similar to those of the OPC group. Each control case is paired with an OPC case, so the control case must have an involuntary admission in the month that the index OPC case admission occurred. Emergency room visits, admissions and average length of hospital stay over a 2-year follow-up after the initiation of OPC were compared. Results No statistically significant evidence was found in the use of mental healthcare services between the two groups. Different reasons for admission found between the groups limit similarity when comparing the two. Clinical implications The findings cast doubt over the effectiveness of this legal measure to reduce emergency visits, the number of admissions and the length of stay in the hospital.

  12. Mobile phone-based telemedicine system for the home follow-up of patients undergoing ambulatory surgery.

    PubMed

    Martínez-Ramos, Carlos; Cerdán, María Teresa; López, Rodrigo S

    2009-01-01

    A pilot study was done to address the efficacy of a General Packet Radio Service mobile phone-based telemedicine system used to improve follow-up after ambulatory surgery. The method involves sending images of surgical wounds or other areas from the patient's home, to assess local complications and avoid unnecessary hospital visits. Ninety-six (N = 96) patients were enrolled in the study. The phone used was a Nokia 6600, which provides images in Joint Photographic Experts Group format. These images were sent via e-mail and visualized on a standard 17-inch screen of a personal computer. After the follow-up period, self-reported patient satisfaction was assessed by analyzing the replies to a 9-item questionnaire. Thirty of the 96 patients (31.3%) reported local problems including: hematoma in 20 (66.7%) patients, surgical bandage blood-stained in 7 (23.3%), exudates in 1 (3.3%), allergic skin reactions in 1 (3.3%), and bandage too tight in 1 (3.3%). In total, 225 photographs were evaluated by 3 physicians. In all cases, it was possible to identify and assess the postoperative problem with consensus among the 3 physicians. Images served to resolve patients' concerns in 20 individuals (66.7%). In 10 patients (33.3%), concerns were satisfied but it was suggested that follow-up images be sent in the following days. Only 1 patient (3.3%) was asked to visit the hospital. The telemedicine system proposed increases the efficiency of home follow-up to ambulatory surgery, avoids unnecessary hospital visits, and clearly improves patient satisfaction.

  13. Transcatheter aortic valve implantation in very elderly patients: immediate results and medium term follow-up

    PubMed Central

    Pascual, Isaac; Muñoz-García, Antonio J; López-Otero, Diego; Avanzas, Pablo; Jimenez-Navarro, Manuel F; Cid-Alvarez, Belén; del Valle, Raquel; Alonso-Briales, Juan H; Ocaranza-Sanchez, Raimundo; Hernández, José M; Trillo-Nouche, Ramiro; Morís, César

    2015-01-01

    Objective To evaluate immediate transcatheter aortic valve implantation (TAVI) results and medium-term follow-up in very elderly patients with severe and symptomatic aortic stenosis (AS). Methods This multicenter, observational and prospective study was carried out in three hospitals. We included consecutive very elderly (> 85 years) patients with severe AS treated by TAVI. The primary endpoint was to evaluate death rates from any cause at two years. Results The study included 160 consecutive patients with a mean age of 87 ± 2.1 years (range from 85 to 94 years) and a mean logistic EuroSCORE of 18.8% ± 11.2% with 57 (35.6%) patients scoring ≥ 20%. Procedural success rate was 97.5%, with 25 (15.6%) patients experiencing acute complications with major bleeding (the most frequent). Global mortality rate during hospitalization was 8.8% (n = 14) and 30-day mortality rate was 10% (n = 16). Median follow up period was 252.24 ± 232.17 days. During the follow-up period, 28 (17.5%) patients died (17 of them due to cardiac causes). The estimated two year overall and cardiac survival rates using the Kaplan-Meier method were 71% and 86.4%, respectively. Cox proportional hazard regression showed that the variable EuroSCORE ≥ 20 was the unique variable associated with overall mortality. Conclusions TAVI is safe and effective in a selected population of very elderly patients. Our findings support the adoption of this new procedure in this complex group of patients. PMID:26345138

  14. Frequency and long-term follow-up of trapped fourth ventricle following neonatal posthemorrhagic hydrocephalus.

    PubMed

    Pomeraniec, I Jonathan; Ksendzovsky, Alexander; Ellis, Scott; Roberts, Sarah E; Jane, John A

    2016-05-01

    OBJECTIVE Intraventricular hemorrhage (IVH) is a common complication of premature neonates with small birth weight, which often leads to hydrocephalus and treatment with ventriculoperitoneal (VP) shunting procedures. Trapped fourth ventricle (TFV) can be a devastating consequence of the subsequent occlusion of the cerebral aqueduct and foramina of Luschka and Magendie. METHODS The authors retrospectively reviewed 8 consecutive cases involving pediatric patients with TFV following VP shunting for IVH due to prematurity between 2003 and 2012. The patients ranged in gestational age from 23.0 to 32.0 weeks, with an average age at first shunting procedure of 6.1 weeks (range 3.1-12.7 weeks). Three patients were managed with surgery. Patients received long-term radiographic (mean 7.1 years; range 3.4-12.2 years) and clinical (mean 7.8 years; range 4.6-12.2 years) follow-up. RESULTS The frequency of TFV following VP shunting for neonatal posthemorrhagic hydrocephalus was found to be 15.4%. Three (37.5%) patients presented with symptoms of posterior fossa compression and were treated surgically. All of these patients showed signs of radiographic improvement with stable or improved clinical examinations during postoperative follow-up. Of the 5 patients treated conservatively, 80% experienced stable ventricular size and 1 patient experienced a slight increase (3 mm) on imaging. All of the nonsurgical patients showed stable to improved clinical examinations over the follow-up period. CONCLUSIONS The frequency of TFV among premature IVH patients is relatively high. Most patients with TFV are asymptomatic at presentation and can be managed without surgery. Symptomatic patients may be treated surgically for decompression of the fourth ventricle.

  15. Office-based cryoablation of breast fibroadenomas with long-term follow-up.

    PubMed

    Kaufman, Cary S; Littrup, Peter J; Freeman-Gibb, Laurie A; Smith, J Stanley; Francescatti, Darius; Simmons, Rache; Stocks, Lewis H; Bailey, Lisa; Harness, Jay K; Bachman, Barbara A; Henry, C Alan

    2005-01-01

    Approximately 10% of women will experience a breast fibroadenoma in their lifetime. Cryoablation is a new treatment that combines the better attributes of the current standards: surveillance and surgery. It is a minimally invasive office-based procedure that is administered without the use of general anesthesia, involving minimal patient discomfort and little to no scarring. This work aimed to establish the long-term (2-3 years) efficacy, safety, and satisfaction of the procedure, as well as the impact of cryoablation on mammogram and ultrasound images. Thirty-seven treated fibroadenomas were available for assessment with an average follow-up period of 2.6 years. Of the original 84% that were palpable prior to treatment, only 16% remained palpable to the patient as of this writing. Of those fibroadenomas that were initially < or = 2.0 cm in size, only 6% remained palpable. A median volume reduction of 99% was observed with ultrasound. Ninety-seven percent of patients and 100% of physicians were satisfied with the long-term treatment results. Mammograms and ultrasounds showed cryoablation produced no artifact that would adversely affect interpretation. Cryoablation for breast fibroadenomas has previously been reported as safe and effective both acutely and at the 1-year follow-up mark, and thus has been implemented as a treatment option. At long-term follow-up, cryoablation as a primary therapy for breast fibroadenomas demonstrates progressive resolution of the treated area, durable safety, and excellent patient and physician satisfaction. The treatment is performed in an office setting rather than an operating room, resulting in a cost-effective and patient-friendly procedure. Cryoablation should be considered a preferred option for those patients desiring definitive therapy for their fibroadenomas without surgical intervention.

  16. Driving While Intoxicated Among Individuals Initially Untreated for Alcohol Use Disorders: One- and Sixteen-Year Follow-Ups*

    PubMed Central

    Timko, Christine; Desai, Akash; Blonigen, Daniel M.; Moos, Bernice S.; Moos, Rudolf H.

    2011-01-01

    Objective: This study examined associations between frequency of driving while intoxicated (DWI) at baseline and obtaining alcohol-related help at follow-up, and between obtaining help and subsequent reductions in DWI. It also examined improvements on personal functioning and life context indices as mediators between obtaining help and reduced occurrences of DWI. Method: A total of 628 individuals who were initially untreated for alcohol use problems completed a baseline inventory; follow-ups were 1, 3, and 16 years later. Results: More extended participation in outpatient treatment and Alcoholics Anonymous (AA) during Year 1 was associated with a lower likelihood of DWI at the 1-year follow-up. More extended participation in AA through Year 3 was associated with a lower likelihood of DWI at the 16-year follow-up. Improvement on personal functioning and life context indices was associated with reduced risk of subsequent occurrences of DWI. Decreases in drinking-related problems, impulsivity, and drinking to reduce tension mediated associations between more AA participation and reductions in DWI at 1 year. Conclusions: Among initially untreated individuals, sustained mutual help may be associated with a reduced number of occurrences of DWI via fewer drinking consequences and improved psychological functioning and coping. Treatment providers should attend to these concomitants of DWI and consider actively referring individuals to AA to ensure ongoing AA affiliation. PMID:21388590

  17. Mortality patterns among workers exposed to acrylamide: 1994 follow up

    PubMed Central

    Marsh, G. M.; Lucas, L. J.; Youk, A. O.; Schall, L. C.

    1999-01-01

    OBJECTIVE: To update the mortality experience of a cohort of 8508 workers with potential exposure to acrylamide at three plants in the United States from 1984-94. METHODS: Analyses of standardised mortality ratios (SMR) with national and local rates and relative risk (RR) regression modelling were performed to assess site specific cancer risks by demographic and work history factors, and exposure indicators for acrylamide and muriatic acid. RESULTS: For the 1925-94 study period, excess and deficit overall mortality risks were found for cancer sites of interest: brain and other central nervous system (CNS) (SMR 0.65, 95% confidence interval (95% CI) 0.36 to 1.09), thyroid gland (SMR 2.11, 95% CI 0.44 to 6.17), testis and other male genital organs (SMR 0.28, 95% CI 0.01 to 1.59), and cancer of the respiratory system (SMR 1.10, 95% CI 0.99 to 1.22); however, none was significant or associated with exposure to acrylamide. A previously reported excess mortality risk of cancer of the respiratory system at one plant remained increased among workers with potential exposure to muriatic acid (RR 1.50, 95% CI 0.86 to 2.59), but was only slightly increased among workers exposed or unexposed to acrylamide. In an exploratory exposure-response analysis of rectal, oesophageal, pancreatic, and kidney cancer, we found increased SMRs for some categories of exposure to acrylamide, but little evidence of an exposure-response relation. A significant 2.26-fold risk (95% CI 1.03 to 4.29) was found for pancreatic cancer among workers with cumulative exposure to acrylamide > 0.30 mg/m3.years; however, no consistent exposure-response relations were detected with the exposure measures considered when RR regression models were adjusted for time since first exposure to acrylamide. CONCLUSION: The contribution of 1115 additional deaths and nearly 60,000 person-years over the 11 year follow up period corroborate the original cohort study findings of little evidence for a causal relation between

  18. Kepler Data Validation and Follow-up Programs

    NASA Technical Reports Server (NTRS)

    William, Borucki J.

    2009-01-01

    The approach that the Kepler Mission uses to remove false positive events and to validate the discoveries consists of two parts; data validation (DPI) and follow up observations program (FOP). DV consists of several methods of examining the data from the spacecraft observations. First, to rule out statistical fluctuations in the data, accept only signals that show 3 or more transits and that have a total signal-to-noise ratio that exceeds 7 sigma. Second. to identify small stellar companions to the target star, we check for secondary eclipses and determine if the transit characteristics are appropriate for a planetary companion. Third, check for background binaries that are in the target aperture. Here we measure the movement of the image centroid before, during, and after the transit. If the target is producing the signal, a dimming wi11 move the image centroid in a known direction and magnitude. If the signal comes from a nearby star, the amplitude and direction of the motion wi11 be different, This test is expected to rule out the hundreds of binary signals expected from background stars. The precision of the measurement depends on the stellar fluxes and positions but can be better than 0.01 pixel; i.e., 0.04". Those candidates that pass these tests are examined using ground-based telescopes and radial velocity spectrometers. First medium precision RV is used to rule out any remaining stellar companions. Then high spatial resolution imaging is used to check for nearby stars that are in the aperture- (The Kepler apertures depend on magnitude but are of order 36 sq are sec in area.) If no stars are present that quid generate the observed signal, then the candidate goes to a large telescope such as Keck, HET, or Wi1lilam Herschel for high precision observations to get the planet mass or an upper limit to it, if there are some stars in the aperture, then the photometric observations are employed to look for the transit by cane of the confounding stars. If none are

  19. Psychological type: a 32-year follow-up.

    PubMed

    Bradway, K; Detloff, W

    1996-10-01

    This study is a follow-up to three previous studies of psychological type published in this Journal in 1964, 1976 and 1978 by Bradway, Bradway and Detloff, and Bradway and Joseph Wheelwright. Participants in all of our studies were limited to Jungian analysts and candidates. Participants of the first two studies and of the current study were from California; participants of the 1978 study included the participants from the previous study plus persons attending the 1974 International Congress in London. In 1993 we sent letters to the 232 current analysts and candidates in the San Francisco and Los Angeles C.G. Jung Institutes, as well as to the nine participants in our 1974 study who were no longer members of the Institutes but could be located, asking them to fill out a questionnaire that included self-typing, and to self-administer the Gray-Wheelwrights Jungian Type Survey (GW). The response rate was high: 196 or 81% of the 241 persons to whom we sent letters returned filled-in questionnaires and GWs; all 67 or 100% of the participants in the 1974 study who could be located returned the filled-in material. Eight of those 67 had also been in the 1961 study. The current study provides data on the changes in psychological type over time, in some instances over a period of 32 years. It added for the first time a consideration of analysts' rating of themselves as primarily clinically or symbolically orientated, and a survey of analyst opinions as to the determinants of psychological type. Summarizing the results: A smaller percentage of analysts typed themselves as intuitive thinking than in 1961; the percentages of congruence between self-typing and the Gray-Wheelwrights scores in the three dimensions (introvert/extravert, sensation/intuition, and thinking/feeling) in 1961, 1974 and 1993 are between 76% and 96%; changes in typology from 1961 to 1993 occur more frequently in the younger age group than in the older age group; 65% of the participants considered the

  20. Job factors, radiation and cancer mortality at Oak Ridge National Laboratory: follow-up through 1984.

    PubMed

    Wing, S; Shy, C M; Wood, J L; Wolf, S; Cragle, D L; Tankersley, W; Frome, E L

    1993-02-01

    A previous study of mortality among white men hired at Oak Ridge National Laboratory between 1943 and 1972 (n = 8,318) revealed an association between low-dose external penetrating ionizing radiation and cancer mortality in follow-up through 1984. The association was not observed in follow-up through 1977. This report considers the role of possible selection and confounding factors not previously studied. Control for hire during the World War II era and employment duration of less than 1 year had little effect on the radiation risk estimates. Risks associated with length of time spent in 15 job categories were considered as proxies for the effects of other occupational carcinogens. Adjustment for employment duration in each job category one at a time produced only small changes in the radiation risk estimate. Adjustment for potential exposures to beryllium, lead, and mercury also had little effect on the radiation risk estimates. These analyses suggest that selection factors and potential for chemical exposure do not account for the previously noted association of external radiation dose with cancer mortality. However, power to detect effects of chemical exposures is limited by a lack of individual exposure measures.

  1. Surgical Resection of a Progressive Giant Arteriovenous Malformation After 13-year Follow-Up

    PubMed Central

    Fu, Chao; Yu, Weidong; Feng, Zheng; Zhao, Conghai; Xu, Donghui; Li, Dongyuan

    2015-01-01

    Abstract Giant arteriovenous malformation (AVM) is a complex and relatively rare congenital lesion with high morbidity and mortality. Its optimal treatment, however, remains controversial. Normal perfusion pressure breakthrough (NPPB) is a potentially devastating complication following surgical resection. Generally, strict blood pressure control is particularly recommended for preventing this phenomenon. Here we present a case of a 21-year-old patient with a progressive giant AVM who developed frequent seizures and subsequently underwent microsurgical total resection after 13-year follow-up, complicated by NPPB. Hypertensive hypervolemic treatment rather than strict blood pressure control was administrated postoperatively; however thalamic infarction occurred. During the 1 year of follow-up, the patient remained seizure-free with only mild right-sided hemiparesis. This case highlights that, in view of potential growth of the lesion, early intervention is necessary when possible. Microsurgical resection is challenging but remains to be an effective option for eliminating such giant AVM, and it is vital to keep risks associated with surgery in mind, such as NPPB. Moreover, whether blood pressure control is needed or not should be individualized. PMID:26131829

  2. Job factors, radiation and cancer mortality at Oak Ridge National Laboratory: Follow-up through 1984

    SciTech Connect

    Wing, S.; Shy, C.M.; Wood, J.L.; Wolf, S.; Cragle, D.L.; Tankersley, W.; Frome, E.L. )

    1993-01-01

    A previous study of mortality among white men hired at Oak Ridge National Laboratory between 1943 and 1972 (n = 8,318) revealed an association between low-dose external penetrating ionizing radiation and cancer mortality in follow-up through 1984. The association was not observed in follow-up through 1977. This report considers the role of possible selection and confounding factors not previously studied. Control for hire during the World War II era and employment duration of less than 1 year had little effect on the radiation risk estimates. Risks associated with length of time spent in 15 job categories were considered as proxies for the effects of other occupational carcinogens. Adjustment for employment duration in each job category one at a time produced only small changes in the radiation risk estimate. Adjustment for potential exposures to beryllium, lead, and mercury also had little effect on the radiation risk estimates. These analyses suggest that selection factors and potential for chemical exposure do not account for the previously noted association of external radiation dose with cancer mortality. However, power to detect effects of chemical exposures is limited by a lack of individual exposure measures.

  3. Crown-root fracture with pulp exposure: a case report with 16-year follow-up.

    PubMed

    Moura, Lucia Fatima Almeida de Deus; Leao, Valeria Leopoldino de Area; de Moura, Marcoeli Silva; de Moura, Carmem Dolores Vilarinho Soares; Goncalves, Alessandro Ribeiro; Lima, Cacilda Castelo Branco; de Lima, Marina de Deus Moura

    2015-01-01

    A 12-year-old boy presented for dental care 35 days after he fell from his bicycle. Clinical and radiographic examinations revealed a longitudinal crown-root fracture with pulp exposure in the maxillary left central incisor. The radiograph also suggested necrosis of the maxillary right central incisor. Urgent treatment of the left central incisor involved gingivectomy followed by autogenous bonding of the tooth fragment with self-curing composite resin. Immediately after bonding, coronal access was prepared, chemical and mechanical preparation was completed, and a calcium hydroxide intracanal dressing was placed. One week after the initial appointment, endodontic treatment was initiated in the right central incisor. The root canal of the maxillary left central incisor was maintained with calcium hydroxide paste (replaced at 45-day intervals) for 1 year and then definitively obturated. At the 16-year follow-up, satisfactory periodontal, esthetic, and clinical conditions were observed, and a radiograph revealed no resorption or periapical changes.

  4. MR Imaging of nonalcoholic Wernicke encephalopathy: a follow-up study.

    PubMed

    Zhong, Chunjiu; Jin, Lirong; Fei, Guoqiang

    2005-10-01

    We investigated the correlation of MR imaging features with the pathological evolution and prognosis of nonalcoholic Wernicke encephalopathy. A retrospective review and analysis was conducted of 6 cases of nonalcoholic Wernicke encephalopathy, consisting of MR imaging features, clinical characteristics, and outcomes after thiamine administration. One patient died, 1 patient entered a persistent vegetative state, and the others recovered fully from Wernicke encephalopathy within 2 weeks to 1 year after thiamine administration. Typical MR imaging showed areas of increased T2-weighted and fluid-attenuated inversion recovery (FLAIR) signals symmetrically surrounding the aqueduct and the third ventricle, at the floor of fourth ventricle, in the medial thalami, and in the capita of caudate nuclei. Two patients presenting without coma showed increased T2-weighted and FLAIR signals of the periaqueductal area only. All 4 patients presenting with coma showed increased T2-weighted and FLAIR signals symmetrically in the medial thalami and in the capita of caudate nuclei. Of the 4 patients with coma, 2 patients with deep coma showed increased T2-weighted and FLAIR signals in the medial thalami and caudate nuclei as well as in the frontal and parietal cortices. According to the follow-up results, increased T2-weighted and FLAIR signals in the 4 patients without cortical damage decreased in intensity, consistent with clinical recovery within 2 weeks to 1 year. The patient in a persistent vegetative state exhibited progressive atrophy of the whole brain during the 2 years of the follow-up study. MR imaging is helpful not only to diagnose acute nonalcoholic Wernicke encephalopathy but also to evaluate the pathologic evolution and prognosis of the disorder.

  5. Sleep Patterns in School-Age Children with Asperger Syndrome or High-Functioning Autism: A Follow-Up Study

    ERIC Educational Resources Information Center

    Allik, Hiie; Larsson, Jan-Olov; Smedje, Hans

    2008-01-01

    The course of sleep patterns over 2-3 years was compared between 16 school-age children with Asperger syndrome (AS) or high-functioning autism (HFA) and 16 age- and gender-matched typically developing children, using 1-week actigraphy at baseline and follow-up. At baseline (mean age 11.1 years), children with AS/HFA had longer sleep latency and…

  6. Team-based innovations in primary care delivery in Quebec and timely physician follow-up after hospital discharge: a population-based cohort study

    PubMed Central

    Riverin, Bruno D.; Li, Patricia; Naimi, Ashley I.; Diop, Mamadou; Provost, Sylvie; Strumpf, Erin

    2017-01-01

    Background: Outpatient follow-up has been a key intervention point in addressing gaps in care after hospital discharge. We sought to estimate the association between enrolment in new team-based primary care practices and 30-day postdischarge physician follow-up among older patients and patients with chronic illnesses who were admitted to hospital in Quebec, Canada. Methods: Patients were selected into this cohort if a primary care physician enrolled them as a "vulnerable patient" between November 2002 and January 2005. Data for this analysis included province-wide health insurance claims for inpatient and outpatient services delivered between November 2002 and January 2009 in Quebec. The primary analysis examined time to the first outpatient postdischarge follow-up service provided by either a primary care physician or a medical specialist. We used marginal structural models to estimate adjusted rates of follow-up with a primary care physician or with a medical specialist by primary care delivery models. Results: We extracted billing data for 312 377 patients that represented 620 656 index admissions for any cause from 2002 to 2009. Rates of 30-day follow-up were 374 visits to primary care physicians and 422 visits to medical specialists per 1000 discharges. Rates of primary care physician follow-up were similar across primary care delivery models, except for patients with very high morbidity; these patients had significantly higher rates of follow-up with a primary care physician if they were enrolled in team-based primary care practices (30-d rate difference [RD] 13.3 more follow-up visits per 1000 discharges, 95% confidence interval [CI] 6.8 to 19.8). Rates of follow-up with a medical specialist were lower among patients enrolled in team-based practices, particularly within 15 days of hospital discharge (15-d RD 25.1 fewer follow-up visits per 1000 discharges, 95% CI 21.1 to 29.1). Interpretation: Our study found lower rates of postdischarge follow-up with a

  7. Long-term follow-up of pacing of the conditioned diaphragm in quadriplegia.

    PubMed

    Elefteriades, John A; Quin, Jacquelyn A; Hogan, James F; Holcomb, Wade G; Letsou, George V; Chlosta, William F; Glenn, William W W L

    2002-06-01

    The authors have previously shown that conditioning of the diaphragm for continuous bilateral pacing is a feasible and effective means of ventilation in patients with complete respiratory paralysis from high cervical (above C3) quadriplegia. The present study reports the long-term results of continuous diaphragmatic pacing. Twelve quadriplegia patients underwent bilateral phrenic nerve pacemaker placement and diaphragm conditioning from 1981 to 1987. Pacing was initiated at 11 Hz and progressively decreased to 7.1 Hz. A pulse train duration of 1.3 seconds for adults and 0.9 seconds for children was used. Long-term follow-up information obtained included pacing status (full-time, part-time, or mechanical ventilation), ventilation parameters, and social circumstances. Of the 12 patients, 6 continued to pace full time (mean 14.8 years); all were living at home. Three patients paced for an average of 1.8 years before stopping; two were institutionalized. One patient who paced full time for 6.5 years before lapsing to part time, lived at home. Two patients were deceased; one paced continuously for 10 years before his demise, the other stopped pacing after 1 year. Patients who stopped full-time pacing did so mainly for reasons of inadequate social or financial support or associated medical problems. All patients demonstrated normal tidal volumes and arterial blood gases while pacing full time. Despite theoretical concerns about long-term nerve damage, no patient lost the ability to pace the phrenic nerve. Threshold currents did not increase over time (original/follow-up: 0.46/0.47 for right, 0.45/0.46 for left), nor did maximal currents (original/follow-up: 1.16/1.14 for right, 1.37/1.26 for left). This follow-up confirms that quadriplegic patients are able to meet long-term, full-time ventilation requirements using phrenic nerve stimulation of the conditioned diaphragm. Careful review of diaphragmatic pacing candidates with respect to associated medical conditions

  8. 5-year Angiographic and Clinical Follow-up of Coil-embolised Intradural Saccular Aneurysms

    PubMed Central

    Batista, LL.; Mahadevan, J.; Sachet, M.; Alvarez, H.; Rodesch, G.; Lasjaunias, P.

    2002-01-01

    Summary The purpose of the paper is the follow-up of embolised intradural saccular Arterial Aneurysms (AA), excluding giant, dissecting, inflammatory, fusiform or AA associated to BVAM. Since its introduction in 1991, the Guglielmi Detachable Coil has offered protection against aneurysmal rebleeding in the critical few days and months after SAH regardless of the grade. A number of questions remain: is complete angiographic obliteration necessary at first embolisation? What duration of clinical / angiographic follow-up (FU) is required to ensure the risk of haemorrhage has been eliminated? What is the long-term protection against rebleeding? One hundred and two patients with 160 intradural saccular AA embolised before april 1997 were selected for this study. They had at least 5-yrs clinical FU, of which 22 patients had a midterm (3 years) and 45 patients had a 5year or more angiographic FU (mean 67,7 months per patient). Twenty-eight embolised AAs with 100% occlusion at 1 year, remained unchanged on the 5year angiograms. A further 14 patients with complete occlusion at 1 year showed persisting complete occlusion on angiogram at 3-years FU, which in our series means that complete occlusion after the first year post-embolisation implies that the aneurysm will remain completely occluded. All secondary spontaneous thromboses (27.6% of cases), occurred during the first year pos-embolisation. In six patients with subtotal or partial occlusion no change was seen for three consecutive years of FU; none showed later change at 5-year angiography. Below 80% occlusion our series does not provide enough information but we consider the situation instable. No mortality related to the procedure was observed in the unruptured AA group. No bleeding or re-bleeding has occurred since the beginning of our experience (1993) in saccular AA treated by GDC-Coil. Coil-embolisation of properly selected patients is effective in protecting against bleeding or re-bleeding at short and long

  9. Percutaneous Transforaminal Endoscopic Lumbar Interbody Fusion: Clinical and Radiological Results of Mean 46-Month Follow-Up

    PubMed Central

    Lee, Sang-Ho; Erken, H. Yener

    2017-01-01

    Background. Spinal fusion has been shown to be the preferred surgical option to reduce pain, recover function, and increase quality of life in the treatment of a variety of lumbar spinal disorders. The main goal of the present study is to report our clinical experience and results of percutaneous transforaminal endoscopic lumbar interbody fusion (PELIF) applications using the expandable spacer in a single institution. Methods. We performed a retrospective review of 18 patients with >12-month follow-up who had been operated on PELIF using expandable spacer from 2001 to 2007. Their clinical and radiological data were collected and analyzed. Results. The mean follow-up period was 46 months. The mean DH before the surgery was 8.3 mm which improved to 11.4 mm at the early postoperative period and regressed to 9.3 mm at the last follow-up visit. The VAS-B, VAS-L, and ODI scores at the last follow-up showed a 54%, 72%, and 69% improvement from the preoperative period, respectively. Conclusions. The presented PELIF technique with the expandable spacer seems to be a promising surgical technique for the treatment of a variety of lumbar spinal disorders. Conversely, radiological results including disc space subsidence make the stand-alone application of the expandable spacer debatable. PMID:28337448

  10. Percutaneous Transforaminal Endoscopic Lumbar Interbody Fusion: Clinical and Radiological Results of Mean 46-Month Follow-Up.

    PubMed

    Lee, Sang-Ho; Erken, H Yener; Bae, Junseok

    2017-01-01

    Background. Spinal fusion has been shown to be the preferred surgical option to reduce pain, recover function, and increase quality of life in the treatment of a variety of lumbar spinal disorders. The main goal of the present study is to report our clinical experience and results of percutaneous transforaminal endoscopic lumbar interbody fusion (PELIF) applications using the expandable spacer in a single institution. Methods. We performed a retrospective review of 18 patients with >12-month follow-up who had been operated on PELIF using expandable spacer from 2001 to 2007. Their clinical and radiological data were collected and analyzed. Results. The mean follow-up period was 46 months. The mean DH before the surgery was 8.3 mm which improved to 11.4 mm at the early postoperative period and regressed to 9.3 mm at the last follow-up visit. The VAS-B, VAS-L, and ODI scores at the last follow-up showed a 54%, 72%, and 69% improvement from the preoperative period, respectively. Conclusions. The presented PELIF technique with the expandable spacer seems to be a promising surgical technique for the treatment of a variety of lumbar spinal disorders. Conversely, radiological results including disc space subsidence make the stand-alone application of the expandable spacer debatable.

  11. Long-term follow-up of vitrectomy in patients with pathologic myopic foveoschisis

    PubMed Central

    Zhang, Ting; Zhu, Ying; Jiang, Chun-Hui; Xu, Ge-Zhi

    2017-01-01

    AIM To report the long-term surgical outcomes of pathologic myopic foveoschisis (MF) following vitrectomy. METHODS We performed a retrospective case series analysis of 50 consecutive patients diagnosed with MF who experienced vision loss due to progression of foveoschisis. The 50 patients (67 eyes) were treated in our hospital with vitrectomy with internal limiting membrane (ILM) peeling from December 2004 to September 2010. Best corrected visual acuity (BCVA), refractive error, optical coherence tomography (OCT), and routine examination results were analysed. The changes of BCVA, foveal anatomical features on OCT scan, and complications were the main outcome measures. RESULTS The mean follow-up duration was 42±17mo (range 24 to 93mo). BCVA improved significantly postoperatively (0.76±0.65 logMAR) compared with preoperative baselines (1.31±0.78 logMAR, P<0.0001), and in 53 eyes (79%) including 3 lines gain in 44 eyes (66%) at the last follow-up visit. OCT scans showed that central retinal thickness decreased from 580.0±270.0 µm preoperatively (n=67) to 179.7±84.7 µm postoperatively (n=58, P<0.0001). Total resolution of foveoschisis occurred in 41 eyes (61%). Preoperative BCVA correlated well with postoperative BCVA, whereas other factors such as age, axial length, and refractive error were not correlated. The most common complications were cataract and full-thickness macular hole formation in 14 and 9 cases, respectively. CONCLUSION Patients with progressive vision loss due to MF who were treated with vitrectomy with ILM peeling show favourable outcomes. In most eyes, visual acuity and foveal structure remain stable during long-term observation. PMID:28251089

  12. Long-term follow-up of behavioral treatment for obesity: patterns of weight regain among men and women.

    PubMed

    Kramer, F M; Jeffery, R W; Forster, J L; Snell, M K

    1989-01-01

    Maintenance of weight loss continues to be a critical concern in behavioral treatment programs. Problems with the acquisition and/or application of behavioral skills are a likely contributor to relapse. However, biological models, especially the hypothesis of a body weight setpoint, are being offered increasingly as alternative explanations for maintenance failure. Within the context of these sometimes opposing viewpoints the present study describes long-term weight outcomes for 114 men and 38 women assessed annually for 4 or 5 years following completion of a 15 week behavioral weight loss program. Although significant mean weight loss was evident at long-term follow-up, a negatively accelerating pattern of weight regain was the predominant outcome. Less than 3 percent of the subjects were at or below their posttreatment weight on all follow-up visits. Consistent sex differences were found, with women having better weight loss maintenance than men. Implications and potential future directions are discussed.

  13. Corneal Cross-Linking (with a Partial Deepithelization) in Keratoconus with Five Years of Follow-Up

    PubMed Central

    Galvis, Virgilio; Tello, Alejandro; Carreño, Néstor I.; Ortiz, Alvaro I.; Barrera, Rodrigo; Rodriguez, Carlos Julián; Ochoa, Miguel E.

    2016-01-01

    We performed a retrospective interventional case series including 80 eyes of 48 patients with keratoconus (KC) who were treated with modified corneal cross-linking (CXL) for KC (with a partial deepithelization in a pattern of stripes). The average follow-up was 5.8 years (with a minimum of 5 years). At the last follow-up visit, compared with preoperative values, there were no significant changes in spherical equivalent, average keratometry, corneal thickness, corneal hysteresis, or corneal resistance factor. The distance-corrected visual acuity was 20/39 preoperatively and 20/36 postoperatively (P = 0.3). The endothelial cell count decreased by 4.7% (P < 0.005). These findings suggest that this modified corneal CXL technique is a safe and effective alternative to halt the progression of KC up to five years after the procedure. However, some concerns remain as to whether this technique can affect in some degree the corneal endothelial cells. PMID:27199574

  14. A prospective follow-up study of first-episode acute transient psychotic disorder in Latvia

    PubMed Central

    2014-01-01

    Background Acute and transient psychotic disorder (ATPD) has been described as an acute psychosis with brief onset and polymorphous symptomatology (WHO, 1993). The study of ATPD is growing increasingly relevant as scientists start an active discussion of the possibility of changing the ATPD classification in the next International Classification of Diseases (ICD-11). The aims of this study were to describe the clinical features of the index episode of ATPD in patients in Latvia, to analyse the stability and longitudinal changes of the diagnosis, to explore potential correlations between the sociodemographic and disease characteristics and to describe stressful life events before the first ATPD episode. Methods A prospective follow-up study of all first-time admitted patients from the Riga Centre of Psychiatry and Addiction Disorders who fulfilled the ICD-10 criteria for ATPD (WHO, 1993) during the 15-month period from 9 January 2010 to 30 March 2011 and followed up until 31 October 2012. Stressful life events, demographics and clinical features during the index episode were assessed. Results One hundred two patients were admitted with first-episode ATPD. The majority were females (60.7%). Over an average 26.5-month follow-up period, 59.8% of the patients were not readmitted. The overall stability rate of ATPD diagnosis in our sample was 67.4% (p = 0.0001). In the subgroup of patients who were readmitted, 70.7% had their diagnosis converted to schizophrenia in subsequent visits. Stressful life events before the first episode were found in 49.0% of first-episode ATPD patients. Thought disorder was found to be the strongest statistically significant predictor of ATPD diagnosis conversation to schizophrenia (odds ratio 4.3), with high Wald's criterion (9.435) in binary logistic regression. Conclusions ATPD is prevalent in Latvia, with rather high overall stability rate. Combining these data from first-episode ATPD patients in Latvia with data from other countries

  15. Is nursing profession my first choice? A follow up survey in pre-registeration student nurses.

    PubMed

    Lai, Hui-Ling; Lin, Ya-Ping; Chang, Hui-Kuan; Chen, Chia-Jung; Peng, Tai-Chu; Chang, Fwu-Mei

    2008-08-01

    The purpose of this study was to explore how nursing students' value factors, motivational factors, institutional factors and competence factors contributed to career intent. All fifth-year nursing students (n=231) in a college in eastern Taiwan completed a survey which followed-up a study done 1 year previously in the same population were followed for 1 year. A validated and reliable self-administered questionnaire developed by the investigators in 2004 and modified in 2005 was used in the study. Data on value factors, competence factors, motivational factors, and situational factors were collected. The overall response rate was 87.4%. The rates of considering nursing as their first choice improved from 19.1% at the point of college-entry to 34.6% in 2004 and 46.5% in 2005 in the same cohort students. Past experience with being ill, degree of stress, self-rated clinical competency, perceived support from staff nurses, and perceived value were associated with career decision after the completion of a whole year of clinical practice (p<0.05-0.01). In multivariate analysis, perceived support from staff nurses, past experience with being ill, and perceived value proved to be significant predictors of the career intent of pre-registration student nurses. Nursing faculty and nurse administrators need to provide assistance to reduce nursing students' career attrition.

  16. High Remission Rate of Chronic Immune Thrombocytopenia in Children: Result of 20-Year Follow-Up

    PubMed Central

    Kim, Chae Young; Lee, Eun Hye

    2016-01-01

    Purpose This study examined the outcomes of children with chronic immune thrombocytopenia (ITP). Materials and Methods We retrospectively analyzed the medical records of all patients diagnosed with ITP from January 1992 to December 2011 at our institution. Results A total of 128 patients (64%) satisfied the criteria for newly diagnosed ITP, 31 (15%) for persistent ITP, and 41 (21%) for chronic ITP. The median age at diagnosis was 4.5 years (range, 1 month to 18 years). The median platelet count at diagnosis was 32×109/L. A comparison of the initial treatment data from 2001 to 2011 with those from 1992 to 2000 showed that the number of bone marrow examinations decreased, whereas observation increased. Chronic ITP presented at an older age than newly diagnosed and persistent ITP (6.6 years vs. 3.8 years vs. 4.1 years, respectively); however, the difference did not reach statistical significance (p=0.17). The probability of complete remission of chronic ITP was 50% and 76% at 2 and 5 years after diagnosis, respectively. Patients aged <1 year at diagnosis had a significantly better prognosis than did older patients (hazard ratio, 3.86; p=0.02). Conclusion Children with chronic ITP showed a high remission rate after long-term follow-up. This study suggests that invasive treatments such as splenectomy in children with chronic ITP can be delayed for 4 to 5 years if thrombocytopenia and therapeutic medication do not affect the quality of life. PMID:26632392

  17. A Prospective Follow-Up of Adipocytokines in Cohort Patients With Gout: Association With Metabolic Syndrome But Not With Clinical Inflammatory Findings

    PubMed Central

    García-Méndez, Sergio; Rivera-Bahena, Carolina Bustos; Montiel-Hernández, José Luis; Xibillé-Friedmann, Daniel; Álvarez-Hernández, Everardo; Peláez-Ballestas, Ingris; Burgos-Vargas, Rubén; Vázquez-Mellado, Janitzia

    2015-01-01

    Abstract The aim of this study was to determine the levels of leptin (Lep) and adiponectin (AdipoQ) in patients with gout and its relationship with joint inflammatory data and/or with metabolic syndrome (MetS) variables, during 1 year follow-up. Forty-one patients (40 males) with gout diagnosis, attending for the first time to a rheumatology department, were included. Evaluations were performed baseline, at 6 and 12 months. Variables included the following: demographic, clinical and laboratory data related to gout and associated diseases. Lep and AdipoQ determinations by the ELISA method were performed in frozen serum from each visit. The pharmacological and no-pharmacological treatment for gout and associated diseases was individualized for each patient according to published guidelines. Statistical analysis included Mann–Whitney U test, Fisher test, x2, ANOVA, Cochran Q, Pearson and Spearman correlation tests, as well as linear regression. In the baseline evaluation, 29.2% had MetS (hypertriglyceridemia 66%, hypertension 44% and obesity 37%); patients with MetS had higher C reactive protein (CRP) levels [34.1 ± 28.6 vs. 12.2 ± 11.2 mg/dL, P = 0.033]. Although not significant, also had higher Lep and lower AdipoQ levels (3.2 ± 3.0 vs. 1.9 ± 1.2 ng/mL, P = 0.142 and 40.5 ± 26.8 vs. 38.0 ± 24.9 ng/mL, P = 0.877, respectively). During follow-up, our patients had significant improvement in serum uric acid (sUA) levels and variables evaluating pain and joint swelling (P ≤ 0.05). Metabolic abnormalities tended to persist or even worsen during the monitoring period: significant increase in total cholesterol (P = 0.004), tendency to higher triglycerides (P = 0.883) and slight improvement in glycaemia (P = 0.052). Lep values increased significantly during follow-up (P = 0.001) while AdipoQ levels diminished slightly (P = 0.317). Neither Lep nor AdipoQ values showed important correlation (r > 0

  18. Antiretroviral treatment and quality of life in Africans living with HIV: 12-month follow-up in Burkina Faso

    PubMed Central

    Jaquet, Antoine; Garanet, Franck; Balestre, Eric; Ekouevi, Didier K.; Azani, Jean Claude; Bognounou, René; Dah, Elias; Kondombo, Jean Charlemagne; Dabis, François; Drabo, Joseph

    2013-01-01

    Introduction The scale-up of highly active antiretroviral therapy (HAART) has led to a significant improvement in survival of the HIV-positive patient but its effects on health-related quality of life (HRQOL) are less known and context-dependent. Our aim was to assess the temporal changes and factors associated with HRQOL among HIV-positive adults initiating HAART in Burkina Faso. Methods HIV-positive people initiating HAART were prospectively included and followed over a one-year period in three HIV clinics of Ouagadougou. HRQOL was assessed at baseline and at each follow-up visit using physical (PHS) and mental (MHS) summary scores derived from the Medical Outcome Study 36-Item short-form health survey (MOS SF-36) questionnaire. Toxicity related to HAART modification and self-reported symptoms were recorded during follow-up visits. Determinants associated with baseline and changes in both scores over a one-year period were assessed using a mixed linear model. Results A total of 344 patients were included. Their median age at baseline was 37 years [interquartile range (IQR) 30–44] and their median CD4 count was 181 cells/mm3 (IQR 97–269). The mean [standard deviation (SD)] PHS score increased from 45.4 (11.1) at baseline to 60.0 (3.1) at 12 months (p<10−4) and the mean (SD) MHS score from 42.2 (8.7) to 43.9 (3.4) (p<10−2). After one year of treatment, patients that experienced on average two symptoms during follow-up presented with significantly lower PHS (63.9) and MHS (43.8) scores compared to patients that presented no symptoms with PHS and MHS of 68.2 (p<10−4) and 45.3 (p<10−3), respectively. Discussion The use of HAART was associated with a significant increase in both physical and mental aspects of the HRQOL over a 12-month period in this urban African population. Perceived symptoms experienced during follow-up visits were associated with a significant impairment in HRQOL. The appropriate and timely management of reported symptoms during the

  19. Educational Goals and Student Flow: Model for Institutional Student Flow and Follow-up. TEX-SIS FOLLOW-UP SC7.

    ERIC Educational Resources Information Center

    Hood, Duane

    This report details the development and implementation of a follow-up system, by Western Texas Community College (WTCC) as a subcontractor for Project FOLLOW-UP, relating student flow patterns to educational goals. Phase I of this project involved establishment of a data base which included elements designed to reveal an adequate picture of…

  20. Loss to follow-up and bias assessment among a cohort of Thai men who have sex with men in Bangkok, Thailand.

    PubMed

    Pattanasin, Sarika; Wimonsate, Wipas; Chonwattana, Wannee; Tongtoyai, Jaray; Chaikummao, Supaporn; Sriporn, Anuwat; Sukwicha, Wichuda; Mock, Philip A; Holtz, Timothy H

    2016-03-01

    Minimising loss to follow-up is essential to obtain unbiased results. This study aimed to assess factors associated with loss to follow-up and effects on biasing exposure-outcome associations in a cohort of men who have sex with men in Bangkok. We enrolled sexually-active Thai men who have sex with men, at least 18 years old, in a study with four-monthly follow-up visits. At each visit, men answered HIV risk behaviour questions using audio computer-assisted self-interview. Logistic regression was used to evaluate factors associated with loss to follow-up and bias between exposures and prevalent HIV infection were estimated using adjusted relative odds ratios. From 2006 to 2010, we enrolled 1744 men who have sex with men; as of April, 2014, 1256 (72%) had completed at least the month-36 visit; loss to follow-up was 9.6%. Factors independently associated with loss to follow-up were age (18-21 years), education (primary level or less, secondary or vocational education), living outside Bangkok and vicinity, sexual orientation (bisexual, heterosexual), previous HIV testing, HIV infection, and behaviour in the past 4 months (recreational drug use, reporting group sex). An effect of loss to follow-up on factors of prevalent HIV infection was found by sexual orientation (transgender) and unprotected anal intercourse (receptive/insertive). These findings highlight the need to strengthen post-HIV test counselling. Directed counselling for HIV care should be given to young men who have sex with men and recreational drug users.

  1. Utility of Baseline Home Visit Audit in Home Hemodialysis.

    PubMed

    François, Karlien; Faratro, Rose; d'Gama, Céline; Wong, Elizabeth; Fung, Stella; Chan, Christopher T

    2015-01-01

    We conducted a retrospective cohort study in a university hospital-based home hemodialysis (HHD) program to evaluate the effectiveness of a home visit audit tool. We aimed to delineate safety risk in HHD patients and to ascertain whether this is associated with clinical outcomes. All incident HHD patients between July 18, 2008, and June 30, 2013 with follow-up until December 31, 2013, were included in the cohort. Primary outcome was the description of the presence of safety risk evaluated by the home visit audit at the start of HHD. Secondary outcomes were patient-reported adverse events and technique survival. In our cohort of 84 patients, a baseline home visit audit was surveyed in 56 (67%) patients. Overall, patients were 45.8 ± 14.1 years old, and 51.2% were men. Eighteen of the 35 potential safety risks were documented at least once in the cohort. Thrity-three of the 56 surveyed subjects presented more than one safety risk. The performance of an audit did not influence adverse events or technique survival. Process and methods of auditing a home visit should be reviewed to improve judicious resource use.

  2. General practice vs surgical-based follow-up for patients with colon cancer: randomised controlled trial

    PubMed Central

    Wattchow, D A; Weller, D P; Esterman, A; Pilotto, L S; McGorm, K; Hammett, Z; Platell, C; Silagy, C

    2006-01-01

    This trial examined the optimal setting for follow-up of patients after treatment for colon cancer by either general practitioners or surgeons. In all, 203 consenting patients who had undergone potentially curative treatment for colon cancer were randomised to follow-up by general practitioners or surgeons. Follow-up guidance recommended three monthly clinical review and annual faecal occult blood tests (FOBT) and were identical in both study arms. Primary outcome measures (measured at baseline, 12 and 24 months were (1) quality of life, SF-12; physical and mental component scores, (2) anxiety and depression: Hospital Anxiety and Depression Scale and (3) patient satisfaction: Patient Visit-Specific Questionnaire. Secondary outcomes (at 24 months) were: investigations, number and timing of recurrences and deaths. In all, 170 patients were available for follow-up at 12 months and 157 at 24 months. At 12 and 24 months there were no differences in scores for quality of life (physical component score, P=0.88 at 12 months; P=0.28 at 24 months: mental component score, P=0.51, P=0.47; adjusted), anxiety (P=0.72; P=0.11) depression (P=0.28; P=0.80) or patient satisfaction (P=0.06, 24 months). General practitioners ordered more FOBTs than surgeons (rate ratio 2.4, 95% CI 1.4–4.4), whereas more colonoscopies (rate ratio 0.7, 95% CI 0.5–1.0), and ultrasounds (rate ratio 0.5, 95% CI 0.3–1.0) were undertaken in the surgeon-led group. Results suggest similar recurrence, time to detection and death rates in each group. Colon cancer patients with follow-up led by surgeons or general practitioners experience similar outcomes, although patterns of investigation vary. PMID:16622437

  3. Corneal Aberrations, Contrast Sensitivity, and Light Distortion in Orthokeratology Patients: 1-Year Results

    PubMed Central

    2016-01-01

    Purpose. To evaluate the corneal higher-order aberrations (HOA), contrast sensitivity function (CSF), and light distortion (LD) in patients undergoing orthokeratology (OK). Methods. Twenty healthy subjects (mean age: 21.40 ± 8 years) with mean spherical equivalent refractive error M = −2.19 ± 0.97 D were evaluated at 1 day, 1 month, and 1 year after starting OK treatment. Monocular LD, photopic monocular CSF, and corneal HOA for 6 mm pupil size were measured. Results. LD showed an increase after the first night (p < 0.05) and recovery to baseline after 1 month, remaining stable after 1 year (p > 0.05). Spherical-like, coma-like, and secondary astigmatism HOA RMS increased significantly (p ≤ 0.022) from baseline to 1-month visit, remaining unchanged over the follow-up. Contrast sensitivity for medium frequencies (3.0, 4.24, and 6.00 cpd) was significantly correlated with LD parameters at baseline (r ≤ −0.529, p < 0.001). However, after 1 year of treatment, this correlation was only statistically significant for 12 cpd spatial frequency (r ≤ −0.565, p < 0.001). Spherical-like RMS for 6 mm pupil size correlated with irregularity of the LD (r = −0.420, p < 0.05) at the 1-year visit. Conclusion. LD experienced by OK patients recovers after one month of treatment and remains stable in the long term while optical aberrations remain significantly higher than baseline. PMID:27867660

  4. Corneal Aberrations, Contrast Sensitivity, and Light Distortion in Orthokeratology Patients: 1-Year Results.

    PubMed

    Santolaria-Sanz, Elena; Cerviño, Alejandro; González-Méijome, José M

    2016-01-01

    Purpose. To evaluate the corneal higher-order aberrations (HOA), contrast sensitivity function (CSF), and light distortion (LD) in patients undergoing orthokeratology (OK). Methods. Twenty healthy subjects (mean age: 21.40 ± 8 years) with mean spherical equivalent refractive error M = -2.19 ± 0.97 D were evaluated at 1 day, 1 month, and 1 year after starting OK treatment. Monocular LD, photopic monocular CSF, and corneal HOA for 6 mm pupil size were measured. Results. LD showed an increase after the first night (p < 0.05) and recovery to baseline after 1 month, remaining stable after 1 year (p > 0.05). Spherical-like, coma-like, and secondary astigmatism HOA RMS increased significantly (p ≤ 0.022) from baseline to 1-month visit, remaining unchanged over the follow-up. Contrast sensitivity for medium frequencies (3.0, 4.24, and 6.00 cpd) was significantly correlated with LD parameters at baseline (r ≤ -0.529, p < 0.001). However, after 1 year of treatment, this correlation was only statistically significant for 12 cpd spatial frequency (r ≤ -0.565, p < 0.001). Spherical-like RMS for 6 mm pupil size correlated with irregularity of the LD (r = -0.420, p < 0.05) at the 1-year visit. Conclusion. LD experienced by OK patients recovers after one month of treatment and remains stable in the long term while optical aberrations remain significantly higher than baseline.

  5. Long-Term Follow-Up of Patients after Percutaneous Coronary Intervention with Everolimus-Eluting Bioresorbable Vascular Scaffold

    PubMed Central

    Meneguz-Moreno, Rafael Alexandre; Costa Junior, José de Ribamar; Moscoso, Freddy Antônio Britto; Staico, Rodolfo; Tanajura, Luiz Fernando Leite; Centemero, Marinella Patrizia; Chaves, Auréa Jacob; Abizaid, Andrea Claudia Leão de Sousa; Sousa, Amanda Guerra de Moraes Rego e; Abizaid, Alexandre Antonio Cunha

    2017-01-01

    Background Bioresorbable vascular scaffolds (BVS) were developed to improve the long-term results of percutaneous coronary intervention, restoring vasomotion. Objectives To report very late follow-up of everolimus-eluting Absorb BVS (Abbott Vascular, Santa Clara, USA) in our center. Methods Observational retrospective study, in a single Brazilian center, from August 2011 to October 2013, including 49 patients submitted to Absorb BVS implantation. Safety and efficacy outcomes were analyzed in the in-hospital and very late follow-up phases (> 2 years). Results All 49 patients underwent a minimum follow-up of 2.5 years and a maximum of 4.6 years. Mean age was 56.8 ± 7.6 years, 71.4% of the patients were men, and 26.5% were diabetic. Regarding clinical presentation, the majority (94%) had stable angina or silent ischemia. Device success was achieved in 100% of cases with 96% overall procedure success rate. Major adverse cardiovascular events rate was 4% at 30 days, 8.2% at 1 year, and 12.2% at 2 years, and there were no more events until 4.6 years. There were 2 cases of thrombosis (1 subacute and 1 late). Conclusions In this preliminary analysis, Absorb BVS showed to be a safe and effective device in the very late follow-up. Establishing the efficacy and safety profiles of these devices in more complex scenarios is necessary. PMID:28076449

  6. Impact of Physician-Coordinated Intensive Follow-Up on Long-Term Medical Costs in Patients with Unstable Angina Undergoing Percutaneous Coronary Intervention

    PubMed Central

    Jia, Jing-Jing; Dong, Ping-Shuan; Du, Lai-Jing; Li, Zhi-Guo; Lai, Li-Hong; Yang, Xu-Ming; Wang, Shao-Xin; Yang, Xi-Shan; Li, Zhi-Juan; Shang, Xi-Yan; Fan, Xi-Mei

    2017-01-01

    Background To investigate the impact of professional physician-coordinated intensive follow-up on long-term expenditures after percutaneous coronary intervention (PCI) in unstable angina (UA) patients. Methods In this study, there were 669 UA patients who underwent successful PCI and followed up for 3 years, then divided into the intensive follow-up group (N = 337), and the usual follow-up group (N = 332). Patients were provided with detailed discharge information and individualized follow-up schedules. The intensive group received the extra follow-up times and medical consultations, and all patients were followed up for approximately 3 years. Results At the 3-year mark after PCI, the cumulative major adverse cardiac events (MACE), recurrence of myocardial ischemia, cardiac death, all-cause death and revascularization in the intensive group were lower than in the usual group. Additionally, the proportion of good medication adherence was significantly higher than in the usual group (56.4% vs. 46.1%, p < 0.001). The hospitalization daytime, total hospitalization cost and total medical cost in the intensive group were lower. Multiple linear regression showed that diabetes, hypertension, intensive follow-up and good medication adherence were associated with emergency and regular clinical cost (p < 0.05), the re-hospitalization cost (p < 0.05) and the total medical cost (p < 0.05) of patient care. Intensive follow-up and good adherence were negatively correlated with the cost of re-hospitalization (standardized coefficients = -0.132, -0.128, p < 0.05) and total medical costs (standardized coefficients = -0.072, -0.086, p < 0.05). Conclusions Intensive follow-up can reduce MACE, improve medication adherence and save long-term total medical costs, just by increasing the emergency and regular clinical visits cost in UA patients after PCI. PMID:28344421

  7. Return to Work after a Stroke in Working Age Persons; A Six-Year Follow Up

    PubMed Central

    Westerlind, Emma; Persson, Hanna C.; Sunnerhagen, Katharina S.

    2017-01-01

    Objectives Stroke is one of the most common and resource intensive diseases for society. Stroke in the working age population is increasing in different parts of the world. An incomplete return to work (RTW) after sick leave post stroke entails negative consequences for the affected person and an economical burden for society. The aim of this study was to explore the RTW rate and factors associated with RTW in a six-year follow up post stroke. Methods Data from 174 persons 63 years or younger, with first ever stroke in 2009–2010 in Gothenburg were analyzed. Baseline characteristics were collected through medical records and the Swedish Health Insurance Office provided information on sick leave up to 6 years post stroke. Time-to-event was presented and cox regression as well as logistic regression were used to analyze risk factors for no-RTW. Results The RTW rate was 74.7%, at the end of follow up. Participants continued to RTW until just over 3 years post stroke. Dependency at discharge (in the modified Rankin Scale) and sick leave prior to the stroke were significant risk factors for no-RTW after 1 year with odds ratio 4.595 and 3.585, respectively. The same factors were significant in time-to-event within six years post stroke with hazard ratio 2.651 and 1.929, respectively. Conclusions RTW after a stroke is incomplete, however RTW is possible over a longer period of time than previously thought. More severe disability at discharge from hospital and sick leave prior to the stroke were shown to be risk factors for no-RTW. This knowledge can contribute to more individualized vocational rehabilitation. PMID:28061507

  8. Pyridoxine-dependent convulsions among children with refractory seizures: A 3-year follow-up study

    PubMed Central

    Chandra, Sadanandavalli Retnaswami; Issac, Thomas Gregor; Deepak, Sai; Teja, Ravi; Kuruthukulangara, Seby

    2016-01-01

    Introduction: Epilepsy accounts for 1% of the global disease burden and about 8–10 million epilepsy patients live in India. About 30–40% of these patients become drug-resistant and land up with palliative or disease-modifying surgeries. This is a situation causing great concern in view of the psychosocial and economic burden on the patient and the family apart from severe cognitive and motor consequences, especially in children. Therefore, it is mandatory to have an insight into the wide spectrum of causes with reference to refractoriness to antiepileptic medications in children with epilepsy. Patients and Methods: Children admitted under our team with refractory epilepsy as per the International League Against Epilepsy (ILAE) criteria in the last 3 years were included in the study. Results: Refractory epilepsy constituted 13.3% of inpatients in the pediatric group. Males dominated with 68.9% of these patients. Nearly 34.4% of these patients were found to suffer from various neurometabolic diseases. Almost 3.5% were due to pyridoxine-dependent convulsions. This group of patients showed an excellent response to dietary manipulation, disease-modifying treatment for the metabolic disorder, and supportive small-dose anticonvulsants. During follow-up, they showed very good response with reference to global development and seizure control. Conclusion: Pyridoxine-dependent convulsions are relatively rare forming about 3.5% of refractory epilepsies in this series. With initiation of appropriate therapy, results with reference to seizure control as well as neurodevelopment became evident within 2 weeks, and at 1-year follow-up, complete independence for majority of the needed activities is achieved with minimum cost, almost zero side effects, and absolute elimination of the need for palliative surgery. PMID:27857784

  9. Fiber technology in space maintainer: a clinical follow-up study.

    PubMed

    Saravanakumar, M S; Siddaramayya, Jayaraman; Sajjanar, Arunkumar B; Godhi, Brinda Suhas; Reddy, N Simhachalam; Krishnam, Raju P

    2013-11-01

    Various space maintainers are used in pediatric dentistry. However, their construction requires time consuming laboratory procedures. Recently fiber-reinforced composite resin (FRCR) has been introduced for various application in dentistry. Polyethylene fibers appear to have the best properties in elasticity, translucency, adaptability, tenaciousness, resistance to traction and to impact. The purpose of this study was to clinically evaluate the long-term effect of FRCR space maintainer made with Ribbond(®) bondable reinforcement ribbon in children over a period of 18 months. A total of thirty FRCR space maintainers were applied to 30 children between the age group of 6 to 9 years old, follow-up visits were done at 1, 6, 12 and 18 months. The data obtained was subjected to statistical analysis. Maxillary appliances survived more than mandibular appliances. Mean survival time of space maintainer were found to be 12 months (minimum 1 and maximum 18 months). The present study suggested that FRCR space maintainers (Ribbond(®)), which was observed for up to 18 months, can be accepted as a successful alternative to conventional band-loop space maintainer only for short periods.

  10. Follow-up study of renal transplant recipients treated at the Guatemalan Social Security Hospital.

    PubMed

    Sánchez-Polo, V; Lou-Meda, R; Castillo, M; Herrera, C; Mollinedo, A

    2004-03-01

    Guatemala is Central America's westernmost country, with a ratio of 500,000 inhabitants per nephrologist. Yearly reports show an average of 150 new end-stage renal disease patients and 40 renal transplants, which are performed at two public health care facilities. The aim of this study was to describe the results of the transplant program at one of these centers (Social Security Hospital of Guatemala). Our program began in 1986, performing an average of 17 transplants per year. Cyclosporine has been used since 1992, and since 2001, C2 has been routinely monitored. Data on 255 patients (of 293) were available for analysis. Male-to-female ratio was 7:1, with 94% having received hemodialysis as their replacement therapy. The mean age at transplant was 35 years and living related donors used in 95%. The average duration of follow-up was 7 years. The mean creatinine and C2 level at most recent visit were 1.36 mg/dL and 864 ng/mL, respectively. A significant reduction in the incidence of acute rejection episodes was seen after the initiation of C2 monitoring (3% vs 1.2%). In general, these results are similar to data in other countries. The number of transplants performed must be increased to meet the current demand, and the cadaveric source of donation is the obvious way to do so. C2 monitoring is an example of technical improvements directed to optimize available resources.

  11. Follow-up of patients with systemic lupus erythematosus: what is not found in the guidelines.

    PubMed

    Jiménez-Alonso, J; Vargas-Hitos, J A; Navarrete-Navarrete, N; Zamora-Pasadas, M; Aguilar-Huergo, S; Jáimez, L; Sabio, J M

    2013-12-01

    A series of measures in the management of patients with systemic lupus erythematosus (SLE) which usually are not found in the lupus guidelines are discussed. In the lupus patient who has been well-controlled in the long term, the dose of hydroxychloroquine should be progressively reduced, without decreasing more than approximately 600 mg per week. We recommend taking this drug in the morning in patients with insomnia, at night in those with dyspepsia and to separate the intake of the drug from the shower (and the water should be as cool as possible) in those patients with aquagenic pruritus. We do not use prednisone on alternate days and exceptionally divide the dose into ¾ before breakfast and ¼ before dinner. Twenty to 30 min should be used per patient in every scheduled visit to assure a good clinical and human practice. We analyzed the follow-up of 112 consecutive patients from our systemic disease unit and found that 71.4% of them had symptoms that were unexplained by lupus and we only referred 8.9% of them to other specialists, probably because of our general training as internal medicine doctors. We suggest that knowing the views of SLE specialists might be of interest since, well-designed studies that would allow to progress in the understanding of this disease could be performed based on their experience.

  12. Teacher Education Follow-up Surveys: Variables Related to Response Rate.

    ERIC Educational Resources Information Center

    Boser, Judith A.

    This study of teacher education graduate follow-up surveys examined the relationship between response rate and number of graduates, questionnaire length, and follow-up contacts. Also, the study investigated survey practices differentiating between surveys which had high and low return rates in such areas as number of follow-up contacts,…

  13. Postoperative Mortality after Hip Fracture Surgery: A 3 Years Follow Up

    PubMed Central

    Un, Canan; Sacan, Ozlem; Gamli, Mehmet; Baskan, Semih; Baydar, Mustafa

    2016-01-01

    Background and Aims To determine mortality rates and predisposing factors in patients operated for a hip fracture in a 3-year follow-up period. Methods The study included patients who underwent primary surgery for a hip fracture.The inclusion criteria were traumatic, non-traumatic, osteoporotic and pathological hip fractures requiring surgery in all age groups and both genders. Patients with periprosthetic fractures or previous contralateral hip fracture surgery and patients who could not be contacted by telephone were excluded. At 36 months after surgery, evaluation was made using a structured telephone interview and a detailed examination of the hospital medical records, especially the documents written during anesthesia by the anesthesiologists and the documents written at the time of follow-up visits by the orthopaedic surgeons. A total of 124 cases were analyzed and 4 patients were excluded due to exclusion criteria. The collected data included demographics, type of fracture, co-morbidities, American Society of Anesthesiologists (ASA) scores, anesthesia techniques, operation type (intramedullary nailing or arthroplasty; cemented-noncemented), peroperative complications, refracture during the follow-up period, survival period and mortality causes. Results The total 120 patients evaluated comprised 74 females(61.7%) and 46 males(38.3%) with a mean age of 76.9±12.8 years (range 23–95 years). The ASA scores were ASA I (0.8%), ASA II (21.7%), ASA III (53.3%) and ASA IV (24.2%). Mortality was seen in 44 patients (36.7%) and 76 patients (63.3%) survived during the 36-month follow-up period. Of the surviving patients, 59.1% were female and 40.9% were male.The survival period ranged between 1–1190 days. The cumulative mortality rate in the first, second and third years were 29.17%, 33.33% and 36.67% respectively. The factors associated with mortality were determined as increasing age, high ASA score, coronary artery disease, congestive heart failure, Alzheimer

  14. Sleep patterns in school-age children with Asperger syndrome or high-functioning autism: a follow-up study.

    PubMed

    Allik, Hiie; Larsson, Jan-Olov; Smedje, Hans

    2008-10-01

    The course of sleep patterns over 2-3 years was compared between 16 school-age children with Asperger syndrome (AS) or high-functioning autism (HFA) and 16 age- and gender-matched typically developing children, using 1-week actigraphy at baseline and follow-up. At baseline (mean age 11.1 years), children with AS/HFA had longer sleep latency and lower sleep efficiency during school days, but earlier sleep start and sleep end during weekends. At follow-up (mean age 13.7 years), children with AS/HFA had longer night wakings and lower sleep efficiency during weekends than the controls. The overall change of sleep patterns, however, is similar in children with AS/HFA and typically developing controls over a 2 to 3-year period.

  15. Two Years Follow up of Domain Specific Cognitive Training in Relapsing Remitting Multiple Sclerosis: A Randomized Clinical Trial

    PubMed Central

    Mattioli, Flavia; Bellomi, Fabio; Stampatori, Chiara; Provinciali, Leandro; Compagnucci, Laura; Uccelli, Antonio; Pardini, Matteo; Santuccio, Giuseppe; Fregonese, Giuditta; Pattini, Marianna; Allegri, Beatrice; Clerici, Raffaella; Lattuada, Annalisa; Montomoli, Cristina; Corso, Barbara; Gallo, Paolo; Riccardi, Alice; Ghezzi, Angelo; Roscio, Marco; Tola, Maria Rosaria; Calanca, Chiara; Baldini, Daria; Trafficante, Debora; Capra, Ruggero

    2016-01-01

    Cognitive rehabilitation in multiple sclerosis (MS) has been reported to induce neuropsychological improvements, but the persistence of these effects has been scarcely investigated over long follow ups. Here, the results of a multicenter randomized clinical trial are reported, in which the efficacy of 15 week domain specific cognitive training was evaluated at 2 years follow up in 41 patients. Included patients were randomly assigned either to domain specific cognitive rehabilitation, or to aspecific psychological intervention. Patients who still resulted to be cognitively impaired at 1 year follow up were resubmitted to the same treatment, whereas the recovered ones were not. Neuropsychological tests and functional scales were administered at 2 years follow up to all the patients. Results revealed that both at 1 and at 2 years follow up more patients in the aspecific group (18/19, 94% and 13/17, 76% respectively) than in the specific group (11/22, 50% and 5/15, 33% respectively) resulted to be cognitively impaired. Furthermore patients belonging to the specific group showed significantly less impaired tests compared with the aspecific group ones (p = 0.02) and a significant amelioration in the majority of the tests. On the contrary patients in the aspecific group did not change. The specific group subjects also perceived a subjective improvement in their cognitive performance, while the aspecific group patients did not. These results showed that short time domain specific cognitive rehabilitation is a useful treatment for patients with MS, shows very long lasting effects, compared to aspecific psychological interventions. Also subjective cognitive amelioration was found in patients submitted to domain specific treatment after 2 years. PMID:26941630

  16. Micro-Bypass Implantation for Primary Open-Angle Glaucoma Combined with Phacoemulsification: 4-Year Follow-Up

    PubMed Central

    Fea, Antonio Maria; Consolandi, Giulia; Zola, Marta; Pignata, Giulia; Cannizzo, Paola; Lavia, Carlo; Rolle, Teresa; Grignolo, Federico Maria

    2015-01-01

    Purpose. To report the long-term follow-up results in patients with cataract and primary open-angle glaucoma (POAG) randomly assigned to cataract surgery combined with micro-bypass stent implantation or phacoemulsification alone. Methods. 36 subjects with cataract and POAG were randomized in a 1 : 2 ratio to either iStent implantation and cataract surgery (combined group) or cataract surgery alone (control group). 24 subjects agreed to be evaluated again 48 months after surgery. Patients returned one month later for unmedicated washout assessment. Results. At the long-term follow-up visit we reported a mean IOP of 15,9 ± 2,3 mmHg in the iStent group and 17 ± 2,5 mmHg in the control group (p = NS). After washout, a 14,2% between group difference in favour of the combined group was statistically significant (p = 0,02) for mean IOP reduction. A significant reduction in the mean number of medications was observed in both groups compared to baseline values (p = 0,005 in the combined group and p = 0,01 in the control group). Conclusion. Patients in the combined group maintained low IOP levels after long-term follow-up. Cataract surgery alone showed a loss of efficacy in controlling IOP over time. Both treatments reduced the number of ocular hypotensive medications prescribed. This trial is registered with: NCT00847158. PMID:26587282

  17. Cardiovascular risk factors in children after kidney transplantation--from short-term to long-term follow-up.

    PubMed

    Kaidar, Maital; Berant, Michael; Krauze, Irit; Cleper, Roxana; Mor, Eitan; Bar-Nathan, Nathan; Davidovits, Miriam

    2014-02-01

    Cardiovascular-related mortality is 100-fold higher in pediatric renal transplant recipients than in the age-matched general population. Seventy-seven post-renal transplant children's charts were reviewed for cardiovascular risk factors at two and six months after transplantation (short term) and at two yr after transplantation and the last follow-up visit (mean 7.14 ± 3.5 yr) (long term). Significant reduction was seen in cardiovascular risk factors prevalence from two months after transplantation to last follow-up respectively: Hypertension from 52.1% to 14%, hypercholesterolemia from 48.7% to 33%, hypertriglyceridemia from 50% to 12.5%, anemia from 29.6% to 18.3%, hyperparathyroidism from 32% to 18.3% and hyperglycemia from 11.7% to 10%, and left ventricular hypertrophy from 25.8% at short term to 15%. There was an increase in the prevalence of obesity from 1.5% to 3.9% and of CKD 3-5 from 4.75% to 24%. The need for antihypertensive treatment decreased from 54% to 42%, and the percentage of patients controlled by one medication rose from 26% to 34%, whereas the percentage controlled by 2, 3, and 4 medications decreased from 21.9%, 5.5%, and 1.4% to 6%, 2%, and 0. Children after renal transplantation appear to have high rates of cardiovascular risk factors, mainly on short-term follow-up.

  18. Optimisation of breast cancer patients' follow-up - potential way to improve cancer care in transitional countries.

    PubMed

    Bošković, L; Gašparić, M; Petrić Miše, B; Petković, M; Gugić, D; Ban, M; Jazvić, M; Dabelić, N; Belac Lovasić, I; Vrdoljak, E

    2016-05-05

    The aim of this analysis was to evaluate adherence of Croatian oncologists to follow-up criteria as suggested by the current national and international guidelines for women with breast cancer receiving adjuvant endocrine therapy. The use of clinical and diagnostic methods was documented in this prospective, non-interventional, multicenter study. A total of 438 post-menopausal patients receiving adjuvant endocrine treatment with non-steroidal aromatase inhibitors were included. Average annual frequency for each clinical and diagnostic method was calculated. Median adjuvant endocrine treatment duration before study recruitment was 10.5 months (interquartile 4.7-26.6). Patients were followed up for an average 23.5 ± 4.9 months. Average number of oncological visits was 5.3. Mammograms were performed at mean annual frequency of 0.7, chest radiographs at 0.5, abdominal ultrasounds at 0.9, breast ultrasounds at 1.2, complete blood counts and chemistry panels at 1.7, carcinoembryonic antigen at 0.8, cancer antigen 15-3 at 1.6, gynaecological examination at 0.3, and densitometry at mean annual frequency of 0.3. In conclusion, among post-menopausal women with breast cancer receiving adjuvant endocrine therapy in this study, more unnecessary and unproven follow-up procedures were done compared to the guidelines' recommendations.

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

    PubMed Central

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

    2016-01-01

    Abstract Proactive attitude of hypertensive patients seeking follow-up services (FUS) lies at the core of self-efficacy. However, few evidence have shown the activeness of seeking FUS in the context of blood pressure control among hypertensive patients. Improvements in follow-up visits may not just by services itself cause better control of blood pressure among hypertensive patients, rather due to the patient's pro-active attitude of the patient in seeking FUS. A cross-sectional study was carried out in selected rural regions of China to explore the association between blood pressure control and sociodemographic and economic variables and activeness of hypertensive patients in seeking FUS. The primary clinical outcome for this study was blood pressure control (systolic blood pressure <140 mmHg or diastolic blood pressure <90 mmHg) Out of the total 2321 participants with hypertension aged 35 years or older participated in this survey. Number of proactive FUS seekers were 3.17 times greater than those of passive seekers (odds ratio [OR] = 3.17, 95% confidence interval [CI] = 2.56–3.93, P < 0.001). In all subgroups, hypertensive patients who were seeking FUS actively were more likely to control blood pressure better than those seeking FUS passively. Proactive attitude of seeking follow-up services can improve blood pressure control among hypertensive patients. PMID:27057859

  20. Methods for successful follow-up of elusive urban populations: an ethnographic approach with homeless men.

    PubMed Central

    Conover, S.; Berkman, A.; Gheith, A.; Jahiel, R.; Stanley, D.; Geller, P. A.; Valencia, E.; Susser, E.

    1997-01-01

    Public health is paying increasing attention to elusive urban populations such as the homeless, street drug users, and illegal immigrants. Yet, valid data on the health of these populations remain scarce; longitudinal research, in particular, has been hampered by poor follow-up rates. This paper reports on the follow-up methods used in two randomized clinical trials among one such population, namely, homeless men with mental illness. Each of the two trials achieved virtually complete follow-up over 18 months. The authors describe the ethnographic approach to follow-up used in these trials and elaborate its application to four components of the follow-up: training interviewers, tracking participants, administering the research office, and conducting assessments. The ethnographic follow-up method is adaptable to other studies and other settings, and may provide a replicable model for achieving high follow-up rates in urban epidemiologic studies. PMID:9211004

  1. Follow up of patients who start treatment with antidepressants: treatment satisfaction, treatment compliance, efficacy and safety

    PubMed Central

    2013-01-01

    Background Measuring satisfaction with treatment has proved useful to ascertain the treatment features that are most important to the patients, and to explain increased treatment compliance. However, there are few studies that relate satisfaction to other clinical or self-perceived health status indicators. Recent studies have shown the close relationship between satisfaction with treatment, treatment compliance, and effectiveness. This study attempts to design and validate a scale to evaluate satisfaction with antidepressant drug therapy, assess treatment compliance (self-reported, validated questionnaire, drug accountability and electronic monitorization system), assess efficacy in reducing depressive symptoms and safety in patients who initiate antidepressant drug therapy, as well as to establish predictors of satisfaction, compliance and effectiveness with these drugs. Methods/design This is an observational longitudinal study with a cohort of adults initiating treatment with antidepressant drugs. A multi-centre study will be performed in which 20 Primary Care practices from Castilla-La Mancha are expected to participate. An initial interview and follow-up visits at 15 days, 1, 3, 6, 9 and 12 months will be conducted with all study participants. 706 subjects will be studied (95% confidence interval, precision ± 3%, expected rate of non-compliance 50%, expected non-responders and lost to follow up rate 15%). The following measurements will be performed: development and validation of a scale of satisfaction with antidepressant therapy, participant and antidepressant characteristics, treatment compliance evaluation (Haynes-Sackett Test, Morisky-Green Test, drug accountability and Medication Event Monitoring System), depression symptom reduction (Hamilton Depression Rating Scale and Montgomery-Asberg Depression Rating Scale), observation of adverse effects, and beliefs about treatment (The Beliefs about Medicines Questionnaire). Discussion Antidepressant drugs are

  2. PTA of Infrapopliteal Arteries: Long-term Clinical Follow-up and Analysis of Factors Influencing Clinical Outcome

    SciTech Connect

    Peregrin, Jan H. Koznar, Boris; Kovac, Josef; Lastovickova, Jarmila; Novotny, Jiri; Vedlich, Daniel; Skibova, Jelena

    2010-08-15

    This study was a retrospective analysis of patients with CLI who underwent infrapopliteal percutaneous transluminal angioplasty (PTA). The main goal was to evaluate clinical and morphological factors that influence the clinical outcome of PTA in long-term follow-up. A total of 1,445 PTA procedures were performed in 1,268 patients. Main indications for PTA included gangrene, nonhealing ulcers, or rest pain. The mean number of treated arteries was 1.77 artery/limb, and the majority of lesions were type TASC D. The technical success rate of PTA was 89% of intended-to-treat arteries. The main criterion of clinical success was functional limb salvage (LS). One-year follow-up involved 1,069 limbs. Primary and secondary 1-year LS rates were 76.1 and 84.4%, respectively. The effect of clinical and morphological parameters on the 1-year LS was that the only associated disease with an adverse effect on LS rate was DM combined with dialysis. Regarding limb preprocedural status, gangrene was clearly a negative predictor. The most important factor affecting LS was the number of patent arteries post-PTA: patients with 0, 1, 2, and 3 patent arteries had 1-year primary LS rates of 56.4, 73.1, 80.4, and 83%, respectively. Long-term follow-up of LS rates demonstrated secondary LS rates of 84.4, 78.8, and 73.3% at 1, 5, and 10 years. Every effort should be made to perform PTA for as many arteries as possible, even if TASC D type, to improve clinical outcome. Our study shows that repeat PTA is capable of keeping the long-term LS rate close to 75%.

  3. Pediatric familial neuromyelitis optica in two sisters with long term follow-up.

    PubMed

    Chuquilin, Miguel; Mullaguri, Naresh; Weinshenker, Brian

    2016-07-01

    Neuromyelitis optica causes bilateral optic neuritis and longitudinal extensive transverse myelitis. Although usually sporadic, 3% of cases of neuromyelitis optica are familial. The interval over which attacks continue and the long term prognosis for pediatric-onset neuromyelitis optica are not well defined. We describe two patients with pediatric familial neuromyelitis optica with the longest clinical follow-up of a pediatric case reported in the literature to our knowledge. One woman developed blindness with bilateral eye involvement within a few weeks at age 3. This was followed by transverse myelitis with paraparesis at age 19 leading to diagnosis of neuromyelitis optica. Her serum anti-aquaporin 4 antibody was later found to be positive. She continued with sporadic myelitis-related relapses but remained ambulant until age 40 when she had a more severe relapse. There was evidence of longitudinal extensive T2 hyperintensity in the thoracic spinal cord. Her sister also developed blindness at age 3.5 followed by myelitis 1year later with multiple relapses of gait impairment until her death from pneumonia at age 21. These patients represent the rare occurrence of neuromyelitis optica in children within the same family and show that this disease can have prolonged periods of remission but a continued tendency to relapse, supporting the need for lifelong immunosuppression.

  4. Ligneous conjunctivitis in a plasminogen-deficient dog: clinical management and 2-year follow-up.

    PubMed

    Torres, María-Dolores; Leiva, Marta; Tabar, María-Dolores; Naranjo, Carolina; Pastor, Josep; Peña, Teresa

    2009-01-01

    A 1-year-old-female Yorkshire Terrier was referred to the Veterinary Teaching Hospital of the Autonomous University of Barcelona (VTH-UAB) (Spain) with a 6-month history of unilateral chronic proliferative conjunctivitis and intermittent vomiting and cough. Several medical and surgical treatment efforts to manage conjunctival lesions had resulted in no improvement of the clinical signs. Complete general and ophthalmic examinations revealed several proliferative 'wood-like' masses in the conjunctiva, oral cavity and an interscapular subcutaneous nodule. Conjunctival and buccal biopsies were performed as diagnostic procedures. A diagnosis of ligneous conjunctivitis was made on the basis of histopathology findings and clinical presentation. The only biochemical abnormalities found were severe proteinuria and low plasminogen activity in plasma. No other analytical abnormalities were observed. Topical treatment with heparin and anti-inflammatory and immunosuppressive drugs have controlled the ophthalmological clinical signs. To our knowledge, this is the first case report of a dog with plasminogen deficiency and ligneous conjunctivitis with a long survival period and 2-year follow-up.

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

    SciTech Connect

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

    2007-06-15

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

  6. Covered Stents in the Treatment of Peripheral Arterial Aneurysms: Procedural Results and Midterm Follow-Up

    SciTech Connect

    Beregi, Jean-Paul; Prat, Alain; Willoteaux, Serge; Vasseur, Marc-Antoine; Boularand, Valerie; Desmoucelle, Frederic

    1999-01-15

    Purpose: To evaluate initial and midterm results of percutaneous treatment of peripheral aneurysms using covered stents. Methods: Between June 1994 and December 1997 we used covered stents (EndoPro System or Passager) on 19 patients with peripheral aneurysms (7 iliac, 5 subclavian, 3 femoral, 3 popliteal, 1 carotid). Results: Successful aneurysm exclusion was achieved in 18 of 19 patients (95%). In the short term (<30 days), one patient died of puncture site hemorrhage complicated by myocardial infarction; two femoral stents were surgically removed because of leakage. At subsequent follow-up (mean 20 months) two further unrelated deaths occurred. At 1 year (intention-to-treat) the stent was patent in 13 of 19 patients (68%) and the aneurysm was excluded in 17 of 19 (89%). Conclusion: Treatment of peripheral aneurysms with covered stents has a high rate of immediate procedural success. Continued exclusion of the aneurysms is achieved in a large proportion of patients but there is a relatively high rate of stent thrombosis.

  7. Evaluation of a residential nutrition rehabilitation center in rural Bolivia: Short-term effectiveness and follow-up results

    PubMed Central

    Rebolledo, Paulina A.; Huamani, Katherine Foy; Mues, Katherine E.; Ramakrishnan, Usha; Leon, Juan S.

    2015-01-01

    Background Nutrition rehabilitation centers (NRCs) have shown mixed results in reducing morbidity and mortality among undernourished children in the developing world. Follow-up on children after leaving these programs remains undocumented. Objective To assess the nutritional improvement of children attending the Centro de Rehabilitación Infantil Nutricional (CRIN), a residential NRC in rural Bolivia, from entrance to exit and to a household follow-up visit 1 month to 6 years later, and to identify factors associated with nutritional improvement. Methods A retrospective analysis was conducted of clinical records collected by CRIN staff from 135 children under 3 years of age attending CRIN in rural Cochabamba, Bolivia, from 2003 to 2009, and of clinical records of household follow-up measurements on a subset of 26 children that were taken between 1 month and 6 years postexit. Nutritional status was evaluated by calculating z-scores for weight-for-height (WHZ), weight-for-age (WAZ), and height-for-age (HAZ). Children with z-scores < − 2 were considered to be wasted, underweight, or stunted, respectively. Results The prevalence of wasting decreased significantly, while the prevalence of stunting did not change significantly between entrance and exit from the program. From entrance to exit, the mean changes in WHZ (0.79) and WAZ (1.08) were statistically significant, while the mean change in HAZ (− 0.02) was not significant. Linear regression analysis suggested that nutritional status and diarrhea at entrance had the greatest effect on WHZ and HAZ changes between entrance and exit. Children maintained their nutritional gains from the program between exit and follow-up and showed statistically significant improvement in WAZ (but not HAZ). Conclusions CRIN is effective at rehabilitating nutritional deficits associated with wasting, but not those associated with stunting. PMID:25076769

  8. One-Year Follow-Up Evaluation of the Sexually Transmitted Disease/Human Immunodeficiency Virus Intervention Program in a Marine Corps Sample

    DTIC Science & Technology

    2000-01-01

    programs, most of them have focused on civilian populations. There is a clear need to develop and evaluated sexually transmitted diseases ( STD )/HIV...known as the STD /HIV Intervention Program (SHIP) would have a sustained positive impact on the behavior of a sample of Marines. A 1-year follow-up

  9. Testing Mediators Hypothesized to Account for the Effects of a Dissonance-Based Eating Disorder Prevention Program over Longer Term Follow-Up

    ERIC Educational Resources Information Center

    Stice, Eric; Marti, C. Nathan; Rohde, Paul; Shaw, Heather

    2011-01-01

    Objective: Test the hypothesis that reductions in thin-ideal internalization and body dissatisfaction mediate the effects of a dissonance-based eating disorder prevention program on reductions in eating disorder symptoms over 1-year follow-up. Method: Data were drawn from a randomized effectiveness trial in which 306 female high school students…

  10. Two-year follow-up of bibliotherapy and individual cognitive therapy for depressed older adults.

    PubMed

    Floyd, Mark; Rohen, Noelle; Shackelford, Jodie A M; Hubbard, Karen L; Parnell, Marsha B; Scogin, Forrest; Coates, Adriana

    2006-05-01

    This study examined the stability of treatment gains after receiving either cognitive bibliotherapy or individual cognitive psychotherapy for depression in older adults. A 2-year follow-up of 23 participants from Floyd, Scogin, McKendree-Smith, Floyd, and Rokke (2004) was conducted by comparing pre-and posttreatment scores with follow-up scores on the Hamilton Rating Scale for Depression (HRSD) and the Geriatric Depression Scale (GDS). Results indicated that treatment gains from baseline to the 2-year follow-up period were maintained on the HRSD and GDS, and there was not a significant decline from posttreatment to follow-up. There were no significant differences between the treatments on the GDS or HRSD at the 2-year follow-up; however, bibliotherapy participants had significantly more recurrences of depression during the follow-up period.

  11. The siblings of childhood cancer patients need early support: a follow up study over the first year

    PubMed Central

    Lahteenmaki, P; Sjoblom, J; Korhonen, T; Salmi, T

    2004-01-01

    Background and methods: In a 1 year follow up study, we assessed the life situation of 33 siblings of childhood cancer patients and 357 healthy controls. The hypothesis was that siblings have more behavioural and health related problems just after the cancer diagnosis. Validated assessment methods were used. Results: Siblings below school age tended to have conduct problems, psychosomatic problems, and a mixed group of other behavioural problems, when assessed 3 months after the cancer diagnosis. These symptoms became less evident during follow up. Among the school aged siblings, however, conduct problems, learning problems, psychosomatic problems, impulsive-hyperactive symptoms, and other behavioural symptoms remained unchanged during follow up. In their self assessments, the school aged siblings showed both state and trait anxiety more often than controls at the first assessment, but later these symptoms settled to the same level as the controls. The overall Children's Depression Inventory (CDI) depression scores did not show differences between the study groups. Conclusions: The ratings of the parents were in keeping with the self assessment of the school aged siblings only in a few aspects; the emphasis of findings can be changed when proxies are used. The siblings have symptoms and adverse feelings which probably could be relieved by targeted, early information about the illness, and possibly by group discussions or activities, soon after the cancer diagnosis. In order to obtain necessary support for the siblings with educational problems, school personnel need to be informed about the sibling distress. PMID:15499052

  12. Treatment of gingival recession using enamel matrix proteins: a case report with 4-year follow-up.

    PubMed

    Kuru, Bahar; Yilmaz, Selçuk; Noyan, Ulkü

    2007-05-01

    Obtaining predictable and optimal coverage of exposed root surfaces and correction of corresponding gingival recessions have become important goals of periodontal plastic surgery. Various surgical techniques have been proposed for coverage of root surfaces. A therapeutic advantage may be gained if periodontal regeneration is obtained in addition to coverage of root with gingiva. In this case report, surgical recession coverage was performed as the bilaterally pedicled lateral sliding flap technique with the adjunctive use of enamel matrix derivative bioactive material (Emdogain). A female patient with gingival recession on maxillary central incisors is presented with 4-year follow-up observation. The surgical procedure used in this clinical pilot case study produced a marked reduction in gingival recession that was maintained for 4 years. Initial gingival recession averaged 4.25 mm with a probing depth of 1.25 mm. The 4-year follow-up demonstrated no significant changes in the degree of postoperative results obtained after 1 year. At the 4-year follow-up, a mean of 3.75 mm of root coverage was observed (93.8% root coverage). Probing depth averaged 0.75 mm, indicating a total of 4.25 mm gain of clinical attachment. Within the limits of this case, the results demonstrated the possibility of treating human buccal recessions by means of enamel matrix protein derivative together with the laterally repositioned flap technique, with a predictable reduction in recession and clinical gain in attachment.

  13. Supplement: Localization and broadband follow-up of the gravitational-wave transient GW150914

    DOE PAGES

    Abbott, B. P.

    2016-07-20

    This Supplement provides supporting material for arXiv:1602.08492 . We briefly summarize past electromagnetic (EM) follow-up efforts as well as the organization and policy of the current EM follow-up program. Here, we compare the four probability sky maps produced for the gravitational-wave transient GW150914, and provide additional details of the EM follow-up observations that were performed in the different bands.

  14. Evaluation of Orthopedic Trauma Surgery Follow-up and Impact of a Routine Callback Program.

    PubMed

    Casp, Aaron J; Wells, Jodi; Holzgrefe, Russell; Weiss, David; Kahler, David; Yarboro, Seth R

    2017-01-05

    A high rate of patients lost to follow-up is a common problem in orthopedic trauma surgery. This adversely affects the ability to produce accurate clinical outcomes research. The purpose of this project was to (1) evaluate the rate of loss to follow-up at an academic level I trauma center; (2) identify the patient-reported reasons for loss to follow-up; and (3) evaluate the efficacy of a routine patient callback program. All patients who underwent surgery in the orthopedic trauma division of the University of Virginia Medical Center from April 1, 2014, to September 30, 2014, and did not complete their postoperative clinic follow-up were analyzed. The characteristics of these patients were evaluated, and the primary reason for not completing the recommended follow-up was identified. All patients were then offered additional orthopedic follow-up at the time of contact. Of the 480 patients who met the inclusion criteria, 41 (8.5%) failed to complete the recommended postoperative follow-up course. The most common reason for being lost to follow-up was feeling well and not having the need to be seen (46.3%). Only 6 (14.6%) of the 41 patients requested follow-up care at the time of contact. The lost to follow-up rate in this study, 8.5%, was considerably lower than that previously reported, but patient characteristics were consistent with those of prior studies on this subject. The low lost to follow-up rate may reflect a difference in geographic location or patient population. The patient callback program had a low yield of patients requesting additional follow-up after being contacted. [Orthopedics. 201x; xx(x):xx-xx.].

  15. Visit-to-Visit Blood Pressure Variability Is a Novel Risk Factor for the Development and Progression of Diabetic Nephropathy in Patients With Type 2 Diabetes

    PubMed Central

    Okada, Hiroshi; Fukui, Michiaki; Tanaka, Muhei; Matsumoto, Shinobu; Mineoka, Yusuke; Nakanishi, Naoko; Asano, Mai; Yamazaki, Masahiro; Hasegawa, Goji; Nakamura, Naoto

    2013-01-01

    OBJECTIVE Recent study has suggested that not only the presence of hypertension but also the variability in systolic blood pressure (SBP) are risk factors for vascular disease and organ damage. The aim of this study was to investigate the relationship between visit-to-visit variability in SBP and change in urinary albumin excretion (UAE) or development of albuminuria in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS We measured SBP in 354 consecutive patients at every visit during 1 year and calculated the coefficient of variation (CV) of SBP. We performed a follow-up study to assess change in UAE or development of albuminuria, the mean interval of which was 3.76 ± 0.71 years. Then, we evaluated relationships of variability of SBP to diabetic nephropathy using multiple regression analysis and multiple Cox regression model. RESULTS Multiple regression analysis demonstrated that CV of SBP was independently associated with change in UAE (β = 0.1758; P = 0.0108). Adjusted Cox regression analyses demonstrated that CV of SBP was associated with an increased hazard of development of albuminuria; hazard ratio was 1.143 (95% CI 1.008–1.302). CONCLUSIONS Visit-to-visit variability in SBP could be a novel risk factor for the development and progression of diabetic nephropathy in patients with type 2 diabetes. PMID:23340892

  16. Stability, Survival, and Tolerability of an Auditory Osseointegrated Implant for Bone Conduction Hearing: Long-Term Follow-Up of a Randomized Controlled Trial

    PubMed Central

    den Besten, Christine A.; Stalfors, Joacim; Wigren, Stina; Blechert, Johan Ivarsson; Flynn, Mark; Eeg-Olofsson, Måns; Aggarwal, Rohini; Green, Kevin; Nelissen, Rik C.; Mylanus, Emmanuel A. M.; Hol, Myrthe K. S.

    2016-01-01

    Objective: To compare implant stability, survival, and soft tissue reactions for a novel (test) and previous generation (control) percutaneous auditory osseointegrated implant for bone conduction hearing at long-term follow-up of 5 years. Study Design: Single follow-up visit of a previously completed multicenter, randomized, controlled trial. Patients: Fifty-seven of the 77 participants of a completed randomized controlled trial on a new auditory osseointegrated implant underwent a single follow-up visit 5 years after implantation, which comprised implant stability measurements and collection of Holgers scores. Additionally, implant survival was recorded for all 77 patients from the original trial. Results: The test implant showed significantly higher implant stability quotient (ISQ) values compared with the control implant throughout the 5-year follow-up. Mean area under the curve of ISQ high from baseline to 5 years was 71.6 (standard deviation [SD] ±2.0) and 66.7 (SD ±3.4) for the test and control implant, respectively (p < 0.0001). For both implants, the mean ISQ value recorded at 5 years was higher compared with implantation (test group +2.03 [SD ±2.55, within group p < 0.0001] and control group +2.25 [SD ±4.95, within group p = 0.12]). No difference was noticed in increase from baseline between groups (p = 0.64). Furthermore, evaluation of soft tissue reactions continued to show superiority of the test implant. At the 5-year follow-up visit, one patient (2.5%) presented with a Holgers grade 2 in the test group, compared with four patients (23.5%) in the control group (p = 0.048); no patient presented with more severe soft tissue reactions. Excluding explantations, the survival rate was 95.8% for the test group and 95.0% for the control group. The corresponding rates including explantations were 93.9 and 90.0%. Conclusion: The test implant showed superiority in terms of higher mean ISQ values and less adverse soft tissue reactions, both

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

    PubMed

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

    2014-09-01

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

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

    PubMed Central

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

    2014-01-01

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

  19. A large prospective European cohort study of patients treated with strontium ranelate and followed up over 3 years.

    PubMed

    Audran, M; Jakob, F J; Palacios, S; Brandi, M-L; Bröll, H; Hamdy, N A T; McCloskey, E V

    2013-09-01

    Strontium ranelate has been available as an osteoporosis treatment in Europe since 2004. This article describes a large European observational survey of the use of strontium ranelate in clinical daily practice. A retrospective observational registry included 32,446 women consulting for postmenopausal osteoporosis in seven countries. Within the registry, 12,046 women were receiving strontium ranelate and were followed up over 3 years. The baseline characteristics of the follow-up cohort were similar to those of the whole registry cohort (age, 68.9 ± 10.3 years; body mass index, 25.6 ± 4.3 kg/m(2); lumbar spine T-score, -2.57 ± 0.85 SD; femoral neck T-score, -2.11 ± 0.86 SD). At baseline, 77 % of patients had at least one risk factor for osteoporosis, and 46 % had a previous history of osteoporotic fracture. Mean duration of follow-up was 32.0 ± 9.7 months, and treatment duration was 25.2 ± 13.7 months (24,956 patient-years of treatment). Persistence with strontium ranelate was 80 % at 1 year, 68 % at 2 years, and 64 % at 32 months; most patients (about 80 %) reported rarely omitting a dose. At least one emergent adverse event was reported in 2,674 (22 %) patients, most frequently gastrointestinal side effects. The crude incidence of venous thromboembolic events was 2.1/1,000 patient-years. No cases of hypersensitivity reactions, such as drug rash with eosinophilia and systemic symptoms (DRESS), Steven-Johnson syndrome, or toxic epidermal necrolysis, were reported. During follow-up, a fracture occurred in 890 patients (7 %); 429 of the fractures were nonvertebral fractures. Our observational survey over 32 months indicated good rates of adherence with strontium ranelate and confirmed its good safety profile in the management of postmenopausal osteoporosis.

  20. Efficacy of two interventions on the discontinuation of benzodiazepines in long-term users: 36-month follow-up of a cluster randomised trial in primary care

    PubMed Central

    Vicens, Caterina; Sempere, Ermengol; Bejarano, Ferrán; Socias, Isabel; Mateu, Catalina; Fiol, Francisca; Palop, Vicente; Mengual, Marta; Folch, Silvia; Lera, Guillem; Basora, Josep; Leiva, Alfonso

    2016-01-01

    Background Primary care interventions that promote cessation of benzodiazepine (BZD) use in long-term users are effective at 1 year, but their efficacy at 3 years is uncertain. Aim To assess the 3-year efficacy of two primary care interventions delivered by GPs on cessation of BZD use in long-term users. Design and setting Multicentre, three-arm, cluster randomised, controlled trial, with random allocation at the GP level. Method Seventy-five GPs and 532 patients were randomly allocated to three groups: usual care (control), structured intervention with stepped-dose reduction and follow-up visits (SIF), or structured intervention with written stepped-dose reduction (SIW). The primary outcome was BZD use at 36 months. Results At 36 months, 66/168 patients (39.2%) in the SIW group, 79/191 patients (41.3%) in the SIF group, and 45/173 patients (26.0%) in the control group had discontinued BZD use. The relative risks (RR) adjusted by cluster were 1.51 (95% CI = 1.10 to 2.05; P = 0.009) in the SIW group and 1.59 (95% CI = 1.15 to 2.19; P = 0.005) in the SIF group. A total of 131/188 patients (69.7%) who successfully discontinued BZD use at 12 months remained abstinent at 36 months. The groups showed no significant differences in anxiety, depression, or sleep dissatisfaction at 36 months. Conclusion The interventions were effective on cessation of BZD use; most patients who discontinued at 12 months remained abstinent at 3 years. Discontinuation of BZD use did not have a significant effect on anxiety, depression, or sleep quality. PMID:26823269

  1. The role of personality in the prediction of treatment outcome in pathological gamblers: a follow-up study.

    PubMed

    Ramos-Grille, Irene; Gomà-i-Freixanet, Montserrat; Aragay, Nùria; Valero, Sergi; Vallès, Vicenç

    2013-06-01

    The aim of the present study was to determine which domains in NEO Personality Inventory-Revised would predict relapse and dropout in treatment-seeking slot-machine pathological gamblers after 1-year follow-up. The NEO PI-R was completed by 73 consecutive treatment-seeking outpatients before they began an open program of individual cognitive-behavioral therapy. Twelve months after starting treatment, patients were categorized in groups as abstinent versus relapsed or completers versus dropouts. At 1-year follow-up, 29% of patients were abstinent, and 48% had completed treatment. Those who had relapsed showed higher significant scores on Neuroticism and lower scores on Conscientiousness. The dropout group scored significantly higher on Neuroticism and lower on Agreeableness and Conscientiousness than the completer group. Low scores on Conscientiousness emerged as a significant predictor of relapse; while low scores on Conscientiousness and Agreeableness were significant predictors of dropout. It seems as if low Conscientiousness could be considered as a predictor of treatment failure measured by either relapses or dropouts, whereas, low Agreeableness seems to be a prognostic domain specifically for dropouts. Pathological gamblers with lower Conscientiousness and lower Agreeableness seem to be at risk of prematurely dropping out of treatment. Our findings support the importance of individual differences in personality on therapy outcomes. The NEO PI-R may constitute an important tool to identify treatment-seeking pathological gamblers who may be at risk of relapsing or dropping out of treatment.

  2. Analyzing how radiologists recommend follow-up: toward development of an automated tracking and feedback system for clinical, laboratory, and radiologic studies

    NASA Astrophysics Data System (ADS)

    Cook, T. S.; Itri, J. N.; Boonn, W. W.; Kim, W.

    2010-03-01

    Radiologists often recommend further imaging, laboratory or clinical follow-up as part of a study interpretation, but rarely receive feedback as to the results of these additional tests. In most cases, the radiologist has to actively pursue this information by searching through the multiple electronic medical records at our institution. In this work, we seek to determine if it would be possible to automate the feedback process by analyzing how radiologists phrase recommendations for clinical, laboratory or radiologic follow-up. We surveyed a dozen attending radiologists to create a set of phrases conventionally used to indicate the need for follow-up. Next, we mined dictated reports over a 1-year period to quantify the appearance of each of these phrases. We are able to isolate 5 phrases that appear in over 21,000 studies performed during the 1-year period, and classify them by modality. We also validated the query by evaluating one day's worth of reports for follow-up recommendations and assessing the comparative performance of the follow-up query. By automatically mining imaging reports for these key phrases and tracking these patients' electronic medical records for additional imaging or pathology, we can begin to provide radiologists with automated feedback regarding studies they have interpreted. Furthermore, we can analyze how often these recommendations lead to a definitive diagnosis and enable radiologists to adjust their practice and decision-making accordingly and ultimately improve patient care.

  3. Dysphagia and health-related quality of life in patients with eosinophilic esophagitis: a long-term follow-up.

    PubMed

    Larsson, Helen; Bergman, Karin; Finizia, Caterina; Johansson, Leif; Bove, Mogens; Bergquist, Henrik

    2015-12-01

    Eosinophilic esophagitis (EoE) is a chronic immune/antigen-mediated disease, with dysphagia as the main symptom. The aim of this study was to survey symptoms and health-related quality of life in adult patients with EoE at least 1 year after diagnosis and a 2-month course of topical corticosteroids. Forty-seven consecutive patients [79 % males, mean age 49 years (range 18-90 years)] were evaluated using three different questionnaires at three different occasions: the Watson Dysphagia Scale (WDS), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Oesophageal Module 18 (EORTC QLQ-OES18) and the Short Form-36 (SF-36). The median time from diagnosis to the long-term follow-up was 23 months (range 12-34 months). The WDS scores and the EORTC QLQ-OES18 Dysphagia and Eating scale scores were improved after 2 months of treatment (p = 0.00007, p = 0.01, p = 0.004, respectively), as were the long-term follow-up scores (p = 0.01, p = 0.03, p = 0.005, respectively), relative to the scores at diagnosis. In addition, the EORTC QLQ-OES18 Choking scores were improved after the steroid course (p = 0.003) but not after the long-term follow-up. No significant differences were detected with respect to the SF-36 scores. In summary, EoE seems to be associated with a substantial burden of symptoms that improve significantly after treatment. A partial remission persists more than 1 year after diagnosis and the discontinuation of medication. The WDS and the EORTC QLQ-OES18 appear to be sensitive instruments appropriate for surveillance in these patients.

  4. A Telemedicine system based on Internet and short message service as a new approach in the follow-up of patients with gestational diabetes.

    PubMed

    Pérez-Ferre, Natalia; Galindo, Mercedes; Fernández, M Dolores; Velasco, Victoria; de la Cruz, M José; Martín, Patricia; del Valle, Laura; Calle-Pascual, Alfonso L

    2010-02-01

    To evaluate the feasibility of a Telemedicine system based on Internet and short message service in the follow-up of patients with gestational diabetes. Compared to control group, Telemedicine group reduced 62% the number of unscheduled face-to-face visits, and 82.7% in the subgroup of insulin-treated patients, improving patient satisfaction, and achieving similar pregnancy and new born outcomes.

  5. Two-Year Follow-Up of Bibliotherapy and Individual Cognitive Therapy for Depressed Older Adults

    ERIC Educational Resources Information Center

    Floyd, Mark; Rohen, Noelle; Shackelford, Jodie A. M.; Hubbard, Karen L.; Parnell, Marsha B.; Scogin, Forrest; Coates, Adriana

    2006-01-01

    This study examined the stability of treatment gains after receiving either cognitive bibliotherapy or individual cognitive psychotherapy for depression in older adults. A 2-year follow-up of 23 participants from Floyd, Scogin, McKendree-Smith, Floyd, and Rokke (2004) was conducted by comparing pre- and posttreatment scores with follow-up scores…

  6. Men with Intellectual Disabilities Who Have Attended Sex Offender Treatment Groups: A Follow-up

    ERIC Educational Resources Information Center

    Heaton, Kathryn M.; Murphy, Glynis H.

    2013-01-01

    Background: There have been a number of studies of treatment for men with intellectual disabilities and sexually abusive behaviour but few follow-up studies. Our aim was to follow up men with intellectual disabilities who had attended group cognitive behavioural treatment (CBT) for sexually abusive behaviour. Method Thirty-four men (from seven…

  7. 48 CFR 2427.305-2 - Follow-up by contractor.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  8. Laboratory guidelines for the diagnosis and follow-up of patients with monoclonal gammopathies.

    PubMed

    Bravo García-Morato, M; Padilla-Merlano, B; Nozal, P; Espiño, M; Juárez, C; Villar, L M; López-Trascasa, M

    2016-04-01

    We present guidelines from the Immunochemistry group of the Spanish Society for Immunology that are designed to provide a practical tool for the diagnosis and follow-up of monoclonal gammopathies. We review the clinical and analytical features of various monoclonal gammopathies, international consensus guidelines and techniques used to detect and follow-up monoclonal components.

  9. How Do Mode and Timing of Follow-up Surveys Affect Evaluation Success?

    ERIC Educational Resources Information Center

    Koundinya, Vikram; Klink, Jenna; Deming, Philip; Meyers, Andrew; Erb, Kevin

    2016-01-01

    This article presents the analysis of evaluation methods used in a well-designed and comprehensive evaluation effort of a significant Extension program. The evaluation data collection methods were analyzed by questionnaire mode and timing of follow-up surveys. Response rates from the short- and long-term follow-ups and different questionnaire…

  10. 48 CFR 2027.305-3 - Follow-up by Government.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Follow-up by Government... GENERAL CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Patent Rights Under Government Contracts 2027.305-3 Follow-up by Government. (a) The contracting officer shall, as a part of the closeout of...

  11. Follow Up Study of Non College Bound Somerset County High School Graduates June 1990, New Jersey.

    ERIC Educational Resources Information Center

    Doty, Charles R.

    A follow-up study sought to determine what happened to the 1990 noncollege-bound graduates of all the high schools in Somerset County, New Jersey. Data were gathered through a mailed survey and telephone follow-up (approximately 45 percent response) of the 408 graduates of the 12 of 13 high schools providing names. Some of the findings from…

  12. [Secondary ambulatory prophylaxis of venous thromboembolism: outcome of patients who were lost to follow-up].

    PubMed

    Wawrzyńska, L; Hajduk, B; Kober, J; Filipecki, S

    1998-01-01

    We have attempted to determine the outcome of 87 out-patients who were lost from follow-up. Several factors have been assessed: causes of lost from follow-up duration of oral anticoagulation, recurrent venous thromboembolic events, cause of death (if applicable).

  13. Barriers to Follow-Up for Abnormal Papanicolaou Smears among Female Sex Workers in Lima, Peru

    PubMed Central

    Aharon, Devora; Calderon, Martha; Solari, Vicky; Alarcon, Patricia; Zunt, Joseph

    2017-01-01

    Background Cervical cancer is the most prevalent cancer among Peruvian women. Female sex workers (FSW) in Peru are at elevated risk for HPV infection, and receive annual Papanicolaou screening. The objective of this study was to identify barriers to follow-up for abnormal Pap smears among FSW in Peru. Methods 97 FSW attending the Alberto Barton Health Center in Lima were surveyed regarding their STI screening history. 17 women with a history of an abnormal Pap smear were interviewed about their experiences regarding follow-up care. Results Of the 27 HPV-positive women, only 8 (30%) received follow-up treatment. Of the 19 women who did not receive follow-up, 7 (37%) had not been informed of their abnormal result. Qualitative interviews revealed that the major barrier to follow-up was lack of knowledge about HPV and potential health consequences of an abnormal Pap smear. Conclusion HPV infection is highly prevalent in Peruvian FSW, yet only 30% of FSW with abnormal Pap smears receive follow-up care. The predominant barriers to follow-up were lack of standardization in recording and communicating results and insufficient FSW knowledge regarding health consequences of HPV infection. Standardization of record-keeping and distribution of educational pamphlets have been implemented to improve follow-up for HPV. PMID:28060937

  14. Compilation of Case Studies: Exemplary Placement and Follow-Up Studies.

    ERIC Educational Resources Information Center

    Dale, Jack

    Examples of placement and follow-up conceptual models developed for a program of vocational education (kindergarten through university) are presented. Section 1 contains a historical overview of placement and follow-up activities in Florida and describes a comprehensive model. Section 2, describing a model for utilizing community resources for the…

  15. A Research on Students' Needs for Follow-Up Curriculum of College English

    ERIC Educational Resources Information Center

    Jin, Jie; Liu, Hengying; Zhang, Yan

    2015-01-01

    Increased universities and colleges offer the undergraduates with more follow-up courses with the further reform in college English education in China. An investigation on self-evaluation, difficulty, and willingness of undergraduates in learning English further was made in order to design more appropriate and adaptable follow-up courses. This…

  16. Documentation for the 2008-09 Teacher Follow-up Survey. NCES 2011-304

    ERIC Educational Resources Information Center

    Graham, Shawna; Parmer, Randall; Chambers, Lisa; Tourkin, Steven; Lyter, Deanna M.

    2011-01-01

    The Teacher Follow-up Survey (TFS) is sponsored by the National Center for Education Statistics (NCES) on behalf of the U.S. Department of Education and is conducted by the U.S. Census Bureau. TFS is a follow-up survey of selected elementary and secondary school teachers who participated in the Schools and Staffing Survey (SASS). SASS is the…

  17. Utility of Follow-Up Skeletal Surveys in Suspected Child Physical Abuse Evaluations

    ERIC Educational Resources Information Center

    Zimmerman, Stephanie; Makoroff, Kathi; Care, Marguerite; Thomas, Amy; Shapiro, Robert

    2005-01-01

    Objective: To evaluate the utility of a follow-up skeletal survey in suspected child physical abuse evaluations. Methods: In this prospective study, follow-up skeletal surveys were recommended for 74 children who, after an initial skeletal survey and evaluation by the Child Abuse Team, were suspected victims of physical abuse. The number and…

  18. Effect on Mail Survey Return Rates of Including Questionnaires With Follow-Up Letters.

    ERIC Educational Resources Information Center

    Futrell, Charles M.; Lamb, Charles W., Jr.

    1981-01-01

    Two thousand questionnaires were mailed to respondents allocated among seven treatments. Controls received an initial mailing (questionnaire and cover letter) only. The remaining six treatments varied by number of follow-up mailings and whether another questionnaire copy was included. Results suggest more than one follow-up letter with a…

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  20. Testicular Microlithiasis: Patient Compliance in a Two-Year Follow-Up Program

    PubMed Central

    Pedersen, M. R.; Osther, P. J. S.; Soerensen, F. B.; Rafaelsen, S. R.

    2016-01-01

    Introduction: We present a retrospective 2-year follow-up cohort of 103 men with testicular microlithiasis (TML) and discuss patient compliance and the value of surveillance. Methods: A retrospective analysis of patients examined with scrotal ultrasonography (US) in the period from 2008 through 2010 was performed. A total of 103 men with TML were diagnosed and offered US follow-up every 6 months for 2 years. They were retrospectively analyzed regarding demographics and follow-up details, including the development of any kind of malignancy until March 2015, using the Danish Electronic Pathology Registry. Results: The prevalence of TML was 10.3%. Of the 103 men with TML, 23 (22.3%) had TML in the left testicle, 38 (36.9%) in the right (p=0.002), and 42 (40.8%) had bilateral TML. Patient compliance was low with 11.7% participating in all US follow-up examinations. 5 men presented risk factors (testicular atrophy (N=1) and previous testicular cancer (N=4)), but no cases of testicular malignancy were found in the follow-up period. Conclusion: The low patient compliance conflicts with the ESUR Scrotal Imaging Subcommittee guidelines that recommend scrotal US follow-up annually for TML until the age of 55 years. The fact that no cancers were found during follow-up using the pathology registry calls the value of follow-up into question. PMID:27921092

  1. Vitamin D Intake and Status in 6-Year-Old Icelandic Children Followed up from Infancy

    PubMed Central

    Thorisdottir, Birna; Gunnarsdottir, Ingibjorg; Steingrimsdottir, Laufey; Palsson, Gestur I.; Birgisdottir, Bryndis E.; Thorsdottir, Inga

    2016-01-01

    High serum 25-hydroxyvitamin D (25(OH)D) levels have been observed in infants in Nordic countries, likely due to vitamin D supplement use. Internationally, little is known about tracking vitamin D status from infancy to childhood. Following up 1-year-old infants in our national longitudinal cohort, our aims were to study vitamin D intake and status in healthy 6-year-old Icelandic children (n = 139) and to track vitamin D status from one year of age. At six years, the mean 25(OH)D level was 56.5 nmol/L (SD 17.9) and 64% of children were vitamin D sufficient (25(OH)D ≥ 50 nmol/L). A logistic regression model adjusted for gender and breastfeeding showed that higher total vitamin D intake (Odds ratio (OR) = 1.27, 95% confidence interval (CI) = 1.08–1.49), blood samples collected in summer (OR = 8.88, 95% CI = 1.83–43.23) or autumn (OR = 5.64, 95% CI = 1.16–27.32) compared to winter/spring, and 25(OH)D at age one (OR = 1.02, 95% CI = 1.002–1.04) were independently associated with vitamin D sufficiency at age six. The correlation between 25(OH)D at age one and six was 0.34 (p = 0.003). Our findings suggest that vitamin D status in infancy, current vitamin D intake and season are predictors of vitamin D status in early school age children. Our finding of vitamin D status tracking from infancy to childhood provides motivation for further studies on tracking and its clinical significance. PMID:26861385

  2. Survival, haemodynamics and cardiac remodelling follow up in mice after myocardial infarction.

    PubMed

    Pons, S; Fornes, P; Hagege, A A; Heudes, D; Giudicelli, J-F; Richer, C

    2003-01-01

    1. In the present study, the time-course, over a 1 year period, of postischaemic dilated cardiomyopathy and/or development of congestive heart failure was investigated in mice in terms of survival and cardiac functional and structural characteristics. 2. C57BL/6 mice with myocardial infarction (MI mice; coronary ligation n = 78) or sham-operated animals (n = 45) were used and echocardiographic, haemodynamic and histomorphometric parameters were assessed at 3, 6 and 12 months post-MI. 3. At 12 months, the survival rate was 70% in MI mice. Left ventricular dysfunction was evidenced by a strong decrease in ejection fraction (EF; -48 and -53% at 6 and 12 months, respectively; both P < 0.05) and an increase in left ventricular end-diastolic pressure (+100% at both 6 and 12 months; both P < 0.05). There was no major worsening in cardiac function between 6 and 12 months, suggesting strong compensatory mechanisms. Cardiac remodelling was observed, characterized by strong left ventricular hypertrophy (+38 and +62% at 6 and 12 months, respectively; both P < 0.05) and dilatation (+53% at 6 months; P < 0.05), but collagen was not significantly increased. Significant correlations were found between EF (echocardiography) and dP/dtmax, between end-diastolic volume (echocardiography) and left ventricular internal perimeter (histomorphometry) and between left ventricular mass (echocardiography) and weight. 4. In conclusion, despite a high survival rate, the MI mouse model displays most of the hallmarks of postischaemic dilated cardiomyopathy and/or congestive heart failure, thus affording the necessary background for the subsequent evaluation of gene manipulation and/or drug effects. In addition, two-dimensional echocardiography appears to be a suitable tool for the long-term follow up of cardiac function and remodelling in this model.

  3. Vitamin D Intake and Status in 6-Year-Old Icelandic Children Followed up from Infancy.

    PubMed

    Thorisdottir, Birna; Gunnarsdottir, Ingibjorg; Steingrimsdottir, Laufey; Palsson, Gestur I; Birgisdottir, Bryndis E; Thorsdottir, Inga

    2016-02-04

    High serum 25-hydroxyvitamin D (25(OH)D) levels have been observed in infants in Nordic countries, likely due to vitamin D supplement use. Internationally, little is known about tracking vitamin D status from infancy to childhood. Following up 1-year-old infants in our national longitudinal cohort, our aims were to study vitamin D intake and status in healthy 6-year-old Icelandic children (n = 139) and to track vitamin D status from one year of age. At six years, the mean 25(OH)D level was 56.5 nmol/L (SD 17.9) and 64% of children were vitamin D sufficient (25(OH)D ≥ 50 nmol/L). A logistic regression model adjusted for gender and breastfeeding showed that higher total vitamin D intake (Odds ratio (OR) = 1.27, 95% confidence interval (CI) = 1.08-1.49), blood samples collected in summer (OR = 8.88, 95% CI = 1.83-43.23) or autumn (OR = 5.64, 95% CI = 1.16-27.32) compared to winter/spring, and 25(OH)D at age one (OR = 1.02, 95% CI = 1.002-1.04) were independently associated with vitamin D sufficiency at age six. The correlation between 25(OH)D at age one and six was 0.34 (p = 0.003). Our findings suggest that vitamin D status in infancy, current vitamin D intake and season are predictors of vitamin D status in early school age children. Our finding of vitamin D status tracking from infancy to childhood provides motivation for further studies on tracking and its clinical significance.

  4. Manipulation under anaesthesia post total knee replacement: long term follow up.

    PubMed

    Yeoh, David; Nicolaou, Nick; Goddard, Richard; Willmott, Henry; Miles, Kim; East, Debra; Hinves, Barry; Shepperd, John; Butler-Manuel, Adrian

    2012-08-01

    A reduced range of motion post total knee replacement (TKR) is a recognised problem. Manipulation under anaesthesia (MUA) is commonly performed in the stiff post-operative TKR. Long-term results are variable in the literature. We retrospectively reviewed, prospectively collected data on 48 patients followed up since 1996 from one centre, over an average of 7.5 years, (range 1 to 10 years) and report on the long-term results. During the study period 2.3% of TKRs underwent MUA. The mean time to MUA post TKR was 12.3 weeks (range 3 to 48). Pre MUA, the mean flexion was 53°. The mean immediate passive flexion post MUA was 97°, an improvement of 44° (Range 10° to 90°, p<0.05). By 1year, the mean flexion was 87°, an improvement of 34°, (range -15° to 70°, p<0.05). At 10 years the mean flexion was 86°, (range 55° to 100°, p<0.05). We found no difference in the gain in range of motion (ROM) between knees manipulated before or after 12 weeks. Additionally, the gain was no different in stiff knees with a pre TKR ROM <90°, compared to a pre TKR ROM >90°. There were no complications as a result of MUA. However, one patient was eventually revised at 2 years secondary to low grade infection. Our findings show that MUA is a safe and effective method at improving the ROM in a stiff post-operative TKR. The improvement is maintained in the long term irrespective of time to MUA and range of motion pre TKR.

  5. Neonatal and infantile erythroderma: a clinical and follow-up study of 42 cases.

    PubMed

    Al-Dhalimi, Muhsin A A

    2007-05-01

    Erythroderma in neonates and infants is a frequently encountered problem in the daily practice of pediatric dermatology. The objective of this study was to determine the frequency of various causes of this clinical entity, as well as which clinical and laboratory findings are useful in the differentiation of these causes, and to assess the evolution of this disease in this age group. Forty-two patients with erythroderma under 1 year of age were included in this study. A follow-up period of 3-5 years was completed. The study was performed in the Department of Dermatology, Al-Sadr and Alhakeem teaching hospitals and a private section in Najaf governorate, Iraq during the period 1998-2006. The diagnosis was made at an average of 3 months after the onset of the disease. The underlying causes included seborrheic dermatitis in 21.4%, atopic dermatitis in 14.3%, different types of Ichthyoses in 31.5%, psoriasis in 4.7%, pityriasis rubra pilaris in 2.4%, Staphylococcal scalded skin syndrome in 7.14%, Netherton syndrome in 4.7%, immune deficiency syndromes in 4.8% and undetermined erythroderma in 9.5% of the patients. Of 29 cases, histopathological examination of skin biopsy showed non-specific features in 58.7% and could confirm the diagnosis in 41.3% cases. The prognosis was poor with a mortality rate of 26.2% and severe dermatoses persisted in 60% of the survivors. It is difficult to make the etiological diagnosis of neonatal erythroderma from the first examination. Associated immune deficiency should be suspected if the condition associated with skin indurations, severe alopecia, failure to thrive and/or have infectious complications. The prognosis is poor especially in those with immune deficiency or a chronic persistent course.

  6. Non-systemic vasculitic neuropathy: single-center follow-up of 60 patients.

    PubMed

    Üçeyler, Nurcan; Geng, Anna; Reiners, Karlheinz; Toyka, Klaus V; Sommer, Claudia

    2015-09-01

    The objective of this study is to report the clinical presentation and long-term outcome of patients with non-systemic vasculitic neuropathy (NSVN) seen at our neuromuscular center. In this retrospective analysis, we assessed medical records of 60 patients with biopsy-proven NSVN (39 men, 21 women; median age: 64 years, 24-80), who were seen at our department between 1999 and 2008 and were followed up until 2014. The initial neurological findings, laboratory and neurophysiological data, treatment regimens, and outcome were analyzed in all patients. NSVN was mostly asymmetric (48/60, 80%), sensorimotor (45/60, 75%), and painful (38/60, 63%), with walking impairment as one major sign (51/60, 85%). No compound action potentials could be recorded in 29/60 (48%) sural nerves (later biopsied side) and in 6/60 (10%) tibial (motor) nerves. Pathology of sural nerve was informative in all cases irrespective of neurophysiological findings and prior immunosuppression. After initial treatment with i.v. methylprednisolone, all patients reported overall improvement. Of the 46 patients who were followed for >1 year, those with mild to moderate affliction were stable with azathioprine (19/46, 41%), while 18/46 (39%) patients were treated with cyclophosphamide and other immunosuppressants due to progression or relapse. At 4 years, 24/46 (52%) patients had either discontinued (n = 21) or had primarily refused immunosuppressive treatment (n = 3) without relapse. Age younger than the group median of 64 years was associated with better outcome. No patient evolved to systemic vasculitis. NSVN is a potentially treatable disorder of the peripheral nervous system.

  7. Follow-Up 92. Minnesota High School Follow-Up. Class of 1991--One Year Later. Trend Data: 1978-1991.

    ERIC Educational Resources Information Center

    Sedey, John M.

    A study examined the educational and employment activities of members of Minnesota's high school class of 1991. Data regarding 12,270 students (11,674 graduates, 218 dropouts, and 378 students school leavers not classified as dropouts) were collected from 107 high schools participating in the Minnesota Secondary School Follow-up System and from…

  8. Follow-Up 91. Minnesota High School Follow-Up. Class of 1990--One Year Later. Trend Data: 1978-1990.

    ERIC Educational Resources Information Center

    Sedey, John M.

    A study examined the educational and employment activities of members of Minnesota's high school class of 1990. Data regarding 12,458 students (11,814 graduates, 356 dropouts, and 288 students school leavers not classified as dropouts) were collected from 90 high schools participating in the Minnesota Secondary School Follow-up System and from 926…

  9. Follow-Up 90. Minnesota High School Follow-Up. Class of 1989: One Year Later. Trend Data: 1978-1989.

    ERIC Educational Resources Information Center

    Sedey, John M.

    A study examined the educational and employment activities of members of Minnesota's high school class of 1989. Data regarding 14,636 students (14,024 graduates, 324 dropouts, and 288 students school leavers not classified as dropouts) were collected from 97 high schools participating in the Minnesota Secondary School Follow-up System and from 853…

  10. Follow-Up 89. Minnesota High School Follow-Up. Class of 1988: One Year Later. Trend Data: 1978-1988.

    ERIC Educational Resources Information Center

    Sedey, John M.

    A study examined the educational and employment activities of members of Minnesota's high school class of 1988. Data regarding 15,232 students (14,151 graduates, 503 dropouts, and 578 students school leavers not classified as dropouts) were collected from 87 high schools participating in the Minnesota Secondary School Follow-up System and from 966…

  11. A 1-year follow-up study with C-VEMPs, O-VEMPs and video head impulse testing in vestibular neuritis.

    PubMed

    Magliulo, Giuseppe; Iannella, Giannicola; Gagliardi, Silvia; Re, Massimo

    2015-11-01

    The aim of this paper was to evaluate prospectively, in a group of patients affected by VN, a diagnostic protocol employing C-VEMPs, O-VEMPs and vHIT together. The diagnosis of vestibular neurolabyrinthitis was based on the clinical history, absence of associated auditory or neurological symptoms, and a neuro-otological examination with an evaluation of lateral semicircular canal function using the Fitzgerald-Hallpike caloric vestibular test and ice test. Our series revealed an incidence of 55% of superior and inferior vestibular neurolabyrinthitis, 40% of superior vestibular neurolabyrinthitis and 5% of inferior vestibular neurolabyrinthitis. These data, however, comprised different degrees of vestibular involvement considering the evaluation of each single vestibular end-organ with potential different prognosis. Four patients had only deficits of the horizontal and superior semicircular canals or their ampullary nerves. The implementation of C-VEMPs, O-VEMPs and vHIT in a vestibular diagnostic protocol has made possible to observe patients with ampullary VN, unidentifiable with other types of vestibular exams. The effect of age seems to have some impact on the recovery. When recovery firstly involves the utricular and saccular nerves and subsequently the ampullary nerves, it may be reasonable to expect a more favorable and successful outcome.

  12. Active or passive physiotherapy for occupational cervicobrachial disorders? A comparison of two treatment methods with a 1-year follow-up.

    PubMed

    Levoska, S; Keinänen-Kiukaanniemi, S

    1993-04-01

    In this study 169 female office employees were interviewed and examined to determine the occurrence and severity of neck and shoulder symptoms. Forty-seven of those with symptoms who fulfilled the criteria taken as indicating need for treatment were enrolled in a controlled clinical trial and divided into two groups. One group participated in dynamic muscle training of neck and shoulder muscles (active physiotherapy). The other patients were treated by means of surface heat, massage, and stretching (passive physiotherapy). Pain in the neck and shoulder regions disappeared significantly more often just after active treatment as compared to passive treatment. Symptoms returned within three months in both groups. However, after 12 months, the incidence of headache was significantly less in the group that had received active physiotherapy. Maximal isometric muscle strength in relation to cervical lateral flexion and extension and grip strength and endurance force of shoulder muscles improved significantly after active physiotherapy, but only maximal isometric extension force increased significantly after passive physiotherapy. Numbers of tender points in neck and shoulder muscles decreased significantly after both types of physiotherapy. Pressure threshold levels increased but not significantly in both groups during treatment.

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

    SciTech Connect

    Appiah-Opoku, Seth; Bryan, Hobson C.

    2013-07-15

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

  14. Ultrasound pleural effusion sign as a useful marker for identifying heart failure worsening in established heart failure patients during follow-up.

    PubMed

    Kataoka, Hajime

    2012-01-01

    Clinical significance of UltraSound Pleural Effusion (US-PLE) and test characteristics of this sign for identifying worsening heart failure (HF) during follow-up of HF patients are unclear. Clinical records of 83 established HF patients were examined. The diagnosis of worsening HF was classified as "highly certain,"probable,"uncertain," or "no" based on the combination of the changes in symptoms/signs and B-type natriuretic peptide (BNP). Routine test included searching for the US-PLE sign. During a follow-up of 652±456 days, 1826 visits were evaluated. Among the 83 study patients, 78 had at least one of the following: worsening symptom(s), HF-related sign(s), and/or elevated BNP levels (≥3-fold increase) at one or more clinic visits. The US-PLE sign was present at 83 visits of 49 study patients. Its appearance was associated with the presence of HF-related symptom(s)/sign(s) and BNP elevation (odds ratio, 53-177, P<.0001 each). The test characteristics of the US-PLE sign for diagnosis of high possibility of worsening HF status fulfilling the "highly certain" or "probable" criteria were: sensitivity (76.6%), specificity (98.6%), positive predictive value (71.1%), and negative predictive value (99.0%). The US-PLE sign has high diagnostic accuracy for identifying worsening HF, including asymptomatic events, in HF patients during follow-up.

  15. Quality of cancer follow-up care: a focus on Latina breast cancer survivors

    PubMed Central

    Ashing, Kimlin; Napoles, Anna

    2014-01-01

    Introduction Receiving quality cancer follow-up care influences survivorship outcomes. Among Latinas, breast cancer is the number one cause of cancer death; yet Latinas do not receive adequate follow-up care. This study examined quality of cancer follow-up care among Latina breast cancer survivors (BCS) and whether it differs by participant language and healthcare system variables (provider specialty, and medical setting). Methods Two hundred thirty-two (95 English-speaking Latina and 137 Spanish-speaking) Latina BCS were recruited from the California Cancer Registry, hospital cancer registries, and community agencies. Results English-speaking Latina BCS were more likely to report receiving cancer follow-up care at a doctor’s office (p<0.001). BCS without a regular place for cancer follow-up care were more likely to report not seeing a primary care provider (p<0.05) or cancer specialist (p<0.001) in the past 12 months. English-speaking Latina BCS (p<0.001), BCS who saw a cancer specialist in the past 12 months (p<0.001), and received follow-up care at a doctor’s office (p<0.05) reported higher quality of care. Speaking English, having seen a cancer specialist, and receiving follow-up care at a doctor’s office were independently associated with higher quality of care, explaining 44 % of the variance. Conclusions Our study findings suggest that examining the influence of ethnic and linguistic factors on quality of cancer follow-up care is necessary to address health disparities. Improved access to cancer follow-up care for Spanish-speaking Latina BCS is of particular concern. Implication of Cancer Survivors Identifying follow-up care needs of Latina BCS may contribute to providing high-quality care and improved survivorship outcomes. PMID:24563169

  16. Medical follow up after bariatric surgery: nutritional and drug issues. General recommendations for the prevention and treatment of nutritional deficiencies.

    PubMed

    Ziegler, O; Sirveaux, M A; Brunaud, L; Reibel, N; Quilliot, D

    2009-12-01

    This review is an update of the long-term follow-up of nutritional and metabolic issues following bariatric surgery, and also discusses the most recent guidelines for the three most common procedures: adjustable gastric bands (AGB); sleeve gastrectomy (SG); and roux-en-Y gastric bypass (GBP). The risk of nutritional deficiencies depends on the percentage of weight loss and the type of surgical procedure performed. Purely restrictive procedures (AGB, SG), for example, can induce digestive symptoms, food intolerance or maladaptative eating behaviours due to pre- or postsurgical eating disorders. GBP also has a minor malabsorptive component. Iron deficiency is common with the three types of bariatric surgery, especially in menstruating women, and GBP is also associated with an increased risk of calcium, vitamin D and vitamin B12 deficiencies. Rare deficiencies can lead to serious complications such as encephalopathy or protein-energy malnutrition. Long-term problems such as changes in bone metabolism or neurological complications need to be carefully monitored. In addition, routine nutritional screening, recommendations for appropriate supplements and monitoring compliance are imperative, whatever the bariatric procedure. Key points are: (1) virtually routine mineral and multivitamin supplementation; (2) prevention of gallstone formation with the use of ursodeoxycholic acid during the first 6 months; and (3) regular, life-long, follow-up of all patients. Pre- and postoperative therapeutic patient education (TPE) programmes, involving a new multidisciplinary approach based on patient-centred education, may be useful for increasing patients'long-term compliance, which is often poor. The role of the general practitioner has also to be emphasized: clinical visits and follow-ups should be monitored and coordinated with the bariatric team, including the surgeon, the obesity specialist, the dietitian and mental health professionals.

  17. Six year follow-up after catheter ablation of atrial fibrillation: a palliation more than a true cure.

    PubMed

    Sorgente, Antonio; Tung, Patricia; Wylie, Jack; Josephson, Mark E

    2012-04-15

    Long-term outcomes after pulmonary vein isolation for atrial fibrillation (AF) remain uncertain. In particular, the influence of rigorous arrhythmia monitoring on outcomes is not yet clear. In this study, 103 patients with symptomatic AF who underwent catheter ablation at a single academic medical center from 2002 to 2006 were evaluated, with a median follow-up time of 6 years. The primary end point was the success rate of catheter ablation, defined as the absence of any atrial arrhythmia recurrence lasting >10 seconds at the clinical visit and electrocardiographic or long-term cardiac rhythm recording after a single procedure and after the last procedure. In all, 153 procedures were performed, with a median of 1 (interquartile range 1 to 2) per patient as follows: 61 had 1, 35 had 2, 6 had 3, and 1 had 4 catheter ablations. Freedom from all atrial arrhythmias was present in 23% of patients at 6 years after a single procedure and in 39% of patients after the last procedure. No clinical predictors of AF recurrence were recognized after a single procedure, whereas after the last procedure, in univariate and multivariate Cox regression analysis, only nonparoxysmal AF (hazard ratio 1.92, 95% confidence interval 1.07 to 3.47, p = 0.02) was a predictor of recurrence. In conclusion, AF recurrence at 6-year follow-up after catheter ablation in a selected group of patients with symptomatic drug-refractory AF was relatively high, with 2/3 of AF relapses occurring in the first year of follow-up. Strict clinical surveillance after catheter ablation should be considered to help guide clinical decisions.

  18. Effects of Frequency of Follow-Up on Quality of Life of Type 2 Diabetes Patients on Oral Hypoglycemics

    PubMed Central

    Hu, Ming; Zhou, Zhiguang; Zeng, Fang

    2012-01-01

    Abstract Background Poor quality of life (QoL) in diabetes patients is reportedly associated with adverse outcomes. In the present study, we assessed the effects of frequency of follow-up on clinical indicators as well as QoL of type 2 diabetes patients taking hypoglycemic agents. Subjects and Methods In total, 155 type 2 diabetes patients were randomly assigned to two groups, which only differed in the frequency of follow-up visits. In both therapy groups, the patients were taking oral hypoglycemic agents. QoL was measured with a QoL Scale for Diabetes Mellitus (DMQLS) at study entry and months 3, 6, 9, and 12. Based on the drugs used, the patients were divided in three medication groups: glimepiride group, metformin group, and glimepiride+metformin group. Results Repeated-measures analysis of variance revealed that compared with the conventional therapy group, the intensive therapy group showed significant improvement in the Disease, Psychology, and Satisfaction domain scores of the DMQLS, the overall DMQLS score, and clinical indicator values (fasting blood glucose, 2-h postprandial blood glucose, and glycosylated hemoglobin). Correlation analyses showed that the changes in Disease, Physiology, Psychology, and Satisfaction domain scores of the DMQLS and in the overall DMQLS score were negatively correlated with changes in clinical indicator values. Conclusions Intensive frequency of follow-up is associated with improved QOL and clinical indicators and thus may be a preferred approach for type 2 diabetes patients on oral hypoglycemic agents. As QoL is negatively correlated with clinical indicators, it could be used as a comprehensive indicator of therapeutic effects on type 2 diabetes patients. PMID:22731794

  19. Quality of life in the follow-up of uveal melanoma patients after CyberKnife treatment.

    PubMed

    Klingenstein, Annemarie; Fürweger, Christoph; Nentwich, Martin M; Schaller, Ulrich C; Foerster, Paul I; Wowra, Berndt; Muacevic, Alexander; Eibl, Kirsten H

    2013-12-01

    To assess quality of life in uveal melanoma patients within the first and second year after CyberKnife radiosurgery. Overall, 91 uveal melanoma patients were evaluated for quality of life through the Short-form (SF-12) Health Survey at baseline and at every follow-up visit over 2 years after CyberKnife radiosurgery. Statistical analysis was carried out using SF Health Outcomes Scoring Software and included subgroup analysis of patients developing secondary glaucoma and of patients maintaining a best corrected visual acuity (BCVA) of the treated eye of 0.5 log(MAR) or better. Analysis of variance, Greenhouse-Geisser correction, Student's t-test, and Fisher's exact test were used to determine statistical significance. Physical Functioning (PF) and Role Physical (RP) showed a significant decrease after CyberKnife radiosurgery, whereas Mental Health (MH) improved (P=0.007, P<0.0001 and P=0.023). MH and Social Functioning (SF) increased significantly (P=0.0003 and 0.026) in the no glaucoma group, MH being higher compared with glaucoma patients (P=0.02). PF and RP were significantly higher in patients with higher BCVA at the second follow-up (P=0.02). RP decreased in patients with BCVA<0.5 log(MAR) (P=0.013). Vitality (VT) increased significantly in patients whose BCVA could be preserved (P=0.031). Neither tumor localization nor size influenced the development of secondary glaucoma or change in BCVA. Although PF and RP decreased over time, MH improved continuously. Prevention of secondary glaucoma has a significant influence on both SF and MH, whereas preservation of BCVA affects VT. Emotional stability throughout follow-up contributes positively toward overall quality of life. CyberKnife radiosurgery may contribute to attenuation of emotional distress in uveal melanoma patients.

  20. Using technology to deliver cancer follow-up: a systematic review

    PubMed Central

    2014-01-01

    Background People with cancer receive regular structured follow up after initial treatment, usually by a specialist in a cancer centre. Increasing numbers of cancer survivors prompts interest in alternative structured follow-up models. There is worldwide evidence of increasing interest in delivering cancer follow-up using technology. This review sough evidence supporting the use of technology in cancer follow-up from good quality randomised controlled trials. Method A search strategy was developed to identify randomised controlled trials and reviews of randomised trials of interventions delivering some aspect of structured cancer follow-up using new technologies. Databases searched were: All EBM Reviews; Embase; Medline (No Revisions); Medline (Non-Indexed Citations), and CAB Abstracts. Included articles were published in English between 2000 and 2014. Key words were generated by the research question. Papers were read independently and appraised using a standardised checklist by two researchers, with differences being resolved by consensus [J Epidemiol Community Health, 52:377–384, 1998]. Information was collected on the purpose, process, results and limitations of each study. All outcomes were considered, but particular attention paid to areas under consideration in the review question. Results The search strategy generated 22879 titles. Following removal of duplicates and abstract review 17 full papers pertaining to 13 randomised controlled studies were reviewed. Studies varied in technologies used and the elements of follow-up delivered, length of follow-up, tumour type and numbers participating. Most studies employed only standard telephone follow-up. Most studies involved women with breast cancer and included telephone follow-up. Together the results suggest that interventions comprising technology had not compromised patient satisfaction or safety, as measured by symptoms, health related quality of life or psychological distress. There was insufficient

  1. Observed changes in cardiovascular risk factors among high-risk middle-aged men who received lifestyle counselling: a 5-year follow-up

    PubMed Central

    Siren, Reijo; Eriksson, Johan G.; Vanhanen, Hannu

    2016-01-01

    Objective To examine the long-term impact of health counselling among middle-aged men at high risk of CVD. Design An observational study with a 5-year follow-up. Setting and intervention All men aged 40 years in Helsinki have been invited to a visit to evaluate CVD risk from 2006 onwards. A modified version of the North Karelia project risk tool (CVD risk score) served to assess the risk. High-risk men received lifestyle counselling based on their individual risk profile in 2006 and were invited to a follow-up visit in 2011. Subjects Of the 389 originally high-risk men, 159 participated in the follow-up visits in 2011. Based on their follow-up in relation the further risk communication, we divided the participants into three groups: primary health care, occupational health care and no control visits. Main outcome measures Lifestyle and CVD risk score change. Results All groups showed improvements in lifestyles. The CVD risk score decreased the most in the group that continued the risk communication visits in their primary health care centre (6.1 to 4.8 [95% CI −1.6 to −0.6]) compared to those who continued risk communication visits in their occupational health care (6.0 to 5.4 [95% CI −1.3 to 0.3]), and to those with no risk communication visits (6.0 to 5.9 [95% CI −0.5 to 0.4]). Conclusions These findings indicate that individualized lifestyle counselling improves health behaviour and reduces total CVD risk among middle-aged men at high risk of CVD. Sustained improvement in risk factor status requires ongoing risk communication with health care providers. KEY POINTSStudies of short duration have shown that lifestyle changes reduce the risk of cardiovascular disease among high-risk individuals.Sustaining these lifestyle changes and maintaining the lower disease risk attained can prove challenging.Cardiovascular disease (CVD) risk assessment and individualized health counselling for high-risk men, when implemented in primary health care, have the potential

  2. Adherence to Follow-Up Recommendations by Triathlon Competitors Receiving Event Medical Care

    PubMed Central

    Lloyd, Jarem B.; Copeli, Nikoli

    2017-01-01

    Introduction. We sought to investigate triathlete adherence to recommendations for follow-up for participants who received event medical care. Methods. Participants of the 2011 Ironman Syracuse 70.3 (Syracuse, NY) who sought evaluation and care at the designated finish line medical tent were contacted by telephone approximately 3 months after the initial encounter to measure adherence with the recommendation to seek follow-up care after event. Results. Out of 750 race participants, 35 (4.6%) athletes received event medical care. Of these 35, twenty-eight (28/35; 80%) consented to participate in the study and 17 (61%) were available on telephone follow-up. Of these 17 athletes, 11 (11/17; 65%) of participants reported that they had not followed up with a medical professional since the race. Only 5 (5/17; 29%) confirmed that they had seen a medical provider in some fashion since the race; of these, only 2 (2/17; 12%) sought formal medical follow-up resulting from the recommendation whereas the remaining athletes merely saw their medical providers coincidentally or as part of routine care. Conclusion. Only 2 (2/17; 12%) of athletes who received event medical care obtained postrace follow-up within a one-month time period following the race. Event medical care providers must be aware of potential nonadherence to follow-up recommendations. PMID:28203462

  3. Obesity, Gynecological Factors, and Abnormal Mammography Follow-Up in Minority and Medically Underserved Women

    PubMed Central

    Wujcik, Debra; Lin, Jin-Mann S.; Grau, Ana; Wilson, Veronica; Champion, Victoria; Zheng, Wei; Egan, Kathleen M.

    2009-01-01

    Abstract Background The relationship between obesity and screening mammography adherence has been examined previously, yet few studies have investigated obesity as a potential mediator of timely follow-up of abnormal (Breast Imaging Reporting and Data System [BIRADS-0]) mammography results in minority and medically underserved patients. Methods We conducted a retrospective cohort study of 35 women who did not return for follow-up >6 months from index abnormal mammography and 41 who returned for follow-up ≤6 months in Nashville, Tennessee. Patients with a BIRADS-0 mammography event in 2003–2004 were identified by chart review. Breast cancer risk factors were collected by telephone interview. Multivariate logistic regression was performed on selected factors with return for diagnostic follow-up. Results Obesity and gynecological history were significant predictors of abnormal mammography resolution. A significantly higher frequency of obese women delayed return for mammography resolution compared with nonobese women (64.7% vs. 35.3%). A greater number of hysterectomized women returned for diagnostic follow-up compared with their counterparts without a hysterectomy (77.8% vs. 22.2%). Obese patients were more likely to delay follow-up >6 months (adjusted OR 4.09, p = 0.02). Conversely, hysterectomized women were significantly more likely to return for timely mammography follow-up ≤6 months (adjusted OR 7.95, p = 0.007). Conclusions Study results suggest that weight status and gynecological history influence patients' decisions to participate in mammography follow-up studies. Strategies are necessary to reduce weight-related barriers to mammography follow-up in the healthcare system including provider training related to mammography screening of obese women. PMID:19558307

  4. Language Barriers, Location of Care and Delays in Follow-up of Abnormal Mammograms

    PubMed Central

    Karliner, LS; Ma, L; Hofmann, M; Kerlikowske, K

    2013-01-01

    Background Breast cancer is frequently diagnosed after an abnormal mammography result. Language barriers can complicate communication of those results. Objectives We evaluated the association of non-English language with delay in follow-up. Methods: Retrospective cohort study of women at three mammography facilities participating in the San Francisco Mammography Registry (SFMR) with an abnormal mammogram result from 1997-2008. We measured median time from report of abnormal result to first follow-up test. Results Of 13,014 women with 16,109 abnormal mammograms, 4,027 (31%) had a non-English patient language. Clinical facilities differed in proportion of non-English-speakers and in time to first follow-up test: facility A (38%; 25 days), facility B (18%; 14 days), facility C (51%; 41 days). Most (67%) mammography examinations had BIRADS 0 (incomplete) assessment, requiring radiographic follow-up. At 30 days of follow-up 67% of all English speakers with incomplete assessments had a follow-up exam compared with 50% of all non-English speakers (p<.0001). The facility with the least delay and the lowest proportion of non-English speakers, had the biggest difference by language; compared to English speakers and adjusting for education, non-English speakers had twice the odds of >30 day delay in follow-up (OR 2.3; 95 CI 1.4-3.9). Conclusions There are considerable differences among facilities in delays in diagnostic follow-up of abnormal mammography results. More attention must be paid to understanding mammography facility factors, such as wait time to schedule diagnostic mammography and radiology workload, in order to improve rates of timely follow-up, particularly for those facilities disproportionately serving vulnerable non-English speaking patients. PMID:21993060

  5. Pi of the Sky involvement in LSC-Virgo electromagnetic follow-up project

    NASA Astrophysics Data System (ADS)

    ZadroŻny, Adam; Sokołowski, Marcin; Mankiewicz, Lech; Żarnecki, Aleksander Filip

    2016-09-01

    Pi of the Sky took part in LSC-Virgo's Electromagnetic (EM) Follow-up project during first science run of Advanced LIGO detectors between September 2015 and January 2016. More than 60 astronomical teams have signed Memorandum-of-Understanding with LSC-Virgo for EM Follow-up project. LSC-Virgo's EM Follow-up is aimed for searching electromagnetic counterparts to gravitational wave transient candidates. Observing an event both in EM and gravitational wave band might be a important step forward to multi-messenger astronomy. The aim of this paper is to show algorithms used by Pi of the Sky for analysing data taken during the science runs.

  6. Scheduled Follow-Up Referrals and Simple Prevention Kits Including Counseling to Improve Post-Discharge Outcomes Among Children in Uganda: A Proof-of-Concept Study

    PubMed Central

    Wiens, Matthew O; Kumbakumba, Elias; Larson, Charles P; Moschovis, Peter P; Barigye, Celestine; Kabakyenga, Jerome; Ndamira, Andrew; English, Lacey; Kissoon, Niranjan; Zhou, Guohai; Ansermino, J Mark

    2016-01-01

    ABSTRACT Background: Recurrent illness following hospital discharge is a major contributor to childhood mortality in resource-poor countries. Yet post-discharge care is largely ignored by health care workers and policy makers due to a lack of resources to identify children with recurrent illness and a lack of cohesive systems to provide care. The purpose of this proof-of-concept study was to evaluate the effectiveness of a bundle of interventions at discharge to improve health outcomes during the vulnerable post-discharge period. Methods: The study was conducted between December 2014 and April 2015. Eligible children were between ages 6 months and 5 years who were admitted with a suspected or proven infectious disease to one of two hospitals in Mbarara, Uganda. A bundle of interventions was provided at the time of discharge. This bundle included post-discharge referrals for follow-up visits and a discharge kit. The post-discharge referral was to ensure follow-up with a nearby health care provider on days 2, 7, and 14 following discharge. The discharge kit included brief educational counseling along with simple preventive items as incentives (soap, a mosquito net, and oral rehydration salts) to reinforce the education. The primary study outcome was the number of post-discharge referral visits completed. Secondary study outcomes included satisfaction with the intervention, rates of readmission after 60 days, and post-discharge mortality rates. In addition, outcomes were compared with a historical control group, enrolled using the same inclusion criteria and outcome-ascertainment methods. Results: During the study, 216 children were admitted, of whom 14 died during hospitalization. Of the 202 children discharged, 85% completed at least 1 of the 3 follow-up referral visits, with 48% completing all 3 visits. Within 60 days after discharge, 22 children were readmitted at least once and 5 children (2.5%) died. Twelve (43%) readmissions occurred during a scheduled follow-up

  7. Social Development: 1 Year Olds

    MedlinePlus

    ... Stages Listen Español Text Size Email Print Share Social Development: 1 Year Olds Page Content Article Body During his second year, your toddler will develop a very specific image of his social world, friends, and acquaintances. He ...

  8. Moebius syndrome. Case report was a 30-year follow-up.

    PubMed

    Morello, D C; Converse, J M

    1977-09-01

    Moebius syndrome is uncommon, as reported in the literature. A patient with Moebius syndrome is reported, showing a 30-year follow-up after initial surgical treatment by bilateral partial transfers of the Masseter muscles.

  9. Using Structured Telephone Follow-up Assessments to Improve Suicide-related Adverse Event Detection

    PubMed Central

    Arias, Sarah A.; Zhang, Zi; Hillerns, Carla; Sullivan, Ashley F.; Boudreaux, Edwin D.; Miller, Ivan; Camargo, Carlos A.

    2014-01-01

    Adverse event (AE) detection and reporting practices were compared during the first phase of the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE), a suicide intervention study. Data were collected using a combination of chart reviews and structured telephone follow-up assessments post-enrollment. Beyond chart reviews, structured telephone follow-up assessments identified 45% of the total AEs in our study. Notably, detection of suicide attempts significantly varied by approach with 53 (18%) detected by chart review, 173 (59%) by structured telephone follow-up assessments, and 69 (23%) marked as duplicates. Findings provide support for utilizing multiple methods for more robust AE detection in suicide research. PMID:24588679

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

    Cancer.gov

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

  11. Did successfully treated pulmonary tuberculosis patients undergo all follow-up sputum smear examinations?

    PubMed

    Satyanarayana, S; Nagaraja, S B; Kelamane, S; Jaju, J; Chadha, S S; Chander, K; Vishnu, H; Wilson, N C; Harries, A D

    2011-12-21

    To assess response to anti-tuberculosis treatment as per national guidelines, a retrospective record review was undertaken in four districts of Andhra Pradesh, India, in December 2009 to determine whether pulmonary tuberculosis (PTB) patients reported as successfully treated (cured or treatment completed) underwent all scheduled follow-up sputum smear examinations. In a quarterly cohort of 3000 PTB patients reported as successfully treated, 1847 (61.5%) underwent all follow-up sputum examinations, with a higher proportion of new cases (65%) than retreatment cases (45%). The mid-continuation phase follow-up sputum examinations were commonly missed, and 11% patients had not undergone end-of-treatment follow-up sputum examinations.

  12. Dormaier and Chester Butte 2007 Follow-up Habitat Evaluation Procedures Report.

    SciTech Connect

    Ashley, Paul R.

    2008-01-01

    Follow-up habitat evaluation procedures (HEP) analyses were conducted on the Dormaier and Chester Butte wildlife mitigation sites in April 2007 to determine the number of additional habitat units to credit Bonneville Power Administration (BPA) for providing funds to enhance, and maintain the project sites as partial mitigation for habitat losses associated with construction of Grand Coulee Dam. The Dormaier follow-up HEP survey generated 482.92 habitat units (HU) or 1.51 HUs per acre for an increase of 34.92 HUs over baseline credits. Likewise, 2,949.06 HUs (1.45 HUs/acre) were generated from the Chester Butte follow-up HEP analysis for an increase of 1,511.29 habitat units above baseline survey results. Combined, BPA will be credited with an additional 1,546.21 follow-up habitat units from the Dormaier and Chester Butte parcels.

  13. Benefits of and barriers to SEA follow-up - Theory and practice

    SciTech Connect

    Gachechiladze-Bozhesku, M.; Fischer, T.B.

    2012-04-15

    If SEA is to facilitate 'strategic' changes, it needs to focus on shaping the ways in which strategic initiatives are implemented, not just formulated. This is why follow-up which refers to postdecisional activities of SEA and strategic initiatives is increasingly seen as crucial. However, to date follow-up has only received limited attention in the SEA literature, as well as in practical guidance. The key reasons for why post decision activities are often overlooked are the lack of understanding of its actual benefits and purportedly multiple problems with its accomplishment. This paper reports on the results of a comprehensive literature review and an international e-survey on the topic, as well as an in-depth analysis of six SEA follow-up cases from England and Canada. Practically encountered and perceived benefits of, and obstacles to SEA follow-up are identified and discussed.

  14. Assault history and follow-up contact of women survivors of recent sexual assault.

    PubMed

    Boykins, Anita D; Mynatt, Sarah

    2007-08-01

    The purpose of this comparative descriptive study is to describe and examine differences in assault characteristics and the issues surrounding follow-up contact of women survivors of a recent sexual assault. This study identified assault characteristics: half of the assaults were by strangers; approximately one-third of the assaults occurred in the victim's home; 29% of the victims were abducted; weapons and physical force were used in over half of the cases; 63% were vaginal assaults; and 86% involved penile penetration. Three months after the assault and the initial examination, only 23% (n = 18) of the study participants could be contacted by telephone for follow-up. The study's findings provide not only data regarding the characteristics of sexual assault, but also the difficulties in contacting adult female survivors for follow-up services. Recommendations outline the importance of thorough, individualized examinations and the need for improved, timely, follow-up services for sexual assault victims.

  15. Notification: Follow-up on a Framework for Developing Tribal Capacity

    EPA Pesticide Factsheets

    Project #OA-FY12-0333, March 1, 2012. We plan to follow-up on the 2008 report Framework for Developing Tribal Capacity Needed in the Indian General Assistance Program. and the Agency’s corrective actions.

  16. Primary-care-based episodes of care and their costs in a three-month follow-up in Finland

    PubMed Central

    Heinonen, J.; Koskela, T.H.; Soini, E.; Ryynänen, O.P.

    2015-01-01

    Objective To explore patient characteristics, resource use, and costs related to different episodes of care (EOC) in Finnish health care. Design Data were collected during a three-month prospective, non-randomized follow-up study (Effective Health Centre) using questionnaires and an electronic health record. Setting Three primary health care practices in Pirkanmaa, Finland. Subjects Altogether 622 patients were recruited during a one-week period. Inclusion criteria: the patient had a doctor’s or nurse’s appointment on the recruiting day and agreed to participate. Exclusion criteria: patients visiting a specialized health guidance clinic for pregnant women, children, and mothers. Main outcome measures Patient characteristics, resource use, and costs based on the ICPC-2 EOC classification. Results On average, the patients had 1.22 EOCs during the three months. Patient characteristics and resource use differed between the EOC chapters. Chapter L, “Musculoskeletal”, had the most episodes (17%). The most common (8%) single EOC was “upper respiratory infection”. The mean cost of an episode (COE) was €389.56 (standard error 61.11) and the median COE was €165.00 (interquartile range €118.46–288.56) during the three-month follow-up. The most expensive chapter was K, “Circulatory”, with a mean COE of €909.85. The most expensive single COE was in chapter K, €32 545.56. The most expensive 1% of the COEs summed up covered 36% of the total COEs. Conclusion Patient characteristics, resource use, and costs differed between the ICPC-2 chapters, which could be taken into account in service planning and pricing. Future studies should incorporate more specific diagnoses, larger data sets, and longer follow-up times.Key pointsThe most common episodes were under the ICPC-2 “Musculoskeletal” chapter, but the highest mean and single-episode costs were related to the “Circulatory” chapter.The mean (median) cost of episodes that started in primary care

  17. Medication persistence over 2 years of follow-up in a cohort of early rheumatoid arthritis patients: associated factors and relationship with disease activity and with disability

    PubMed Central

    Pascual-Ramos, Virginia; Contreras-Yáñez, Irazú; Villa, Antonio R; Cabiedes, Javier; Rull-Gabayet, Marina

    2009-01-01

    Introduction Aggressive treatment with disease-modifying antirheumatic drugs (DMARDs) plays a major role in improving early rheumatoid arthritis (RA) patient outcomes. Persistence and adherence with medication occurs variably (20% to 70%). The objectives of the study were to determine medication persistence (MP) in early RA patients over 13 consecutive visits each 2 months apart, to investigate the relationship between MP and disease activity, disability and structural damage, and to identify baseline prognosticators. Methods Charts from 75 patients of an early RA cohort were reviewed. At each visit, a rheumatologist interviewed patients regarding therapy, scored disease activity with the 28-joint disease activity score (DAS28) and disability with the health assessment questionnaire (HAQ), and recorded comorbidities and treatment. A complete medical history was obtained at baseline. MP was defined as the duration of time from initiation to discontinuation of at least one DMARD and/or corticosteroids for at least 1 week and was reported as a dichotomous variable at consecutive evaluations. Structural damage was defined by detection of new erosions on radiography. Descriptive statistics, Student's t test, the chi-squared test, and logistic regression analyses were used. Results The proportion of MP patients decreased from 98% at 2 months to 34% at 2 years. MP patients (n = 32) had similar DAS28 to non-MP patients (n = 53) at initial visits, lower DAS28 and greater DAS28 improvements at follow-ups (P ≤ 0.05 at visits 4, 6, 7 and 9) and reached sustained remission (≥ 3 consecutive visits with DAS28 < 2.6) more frequently (82.8% versus 46.5%, P = 0.003) and earlier (7.7 ± 4.6 versus 13.6 ± 5.7 months, P = 0.001) than non-MP patients. MP patients had similar baseline HAQ scores, but lower HAQ scores at follow-up (P ≤ 0.05 at visits 3, 5, 6, 7, 9, 10 and 13). More non-MP patients developed erosive disease than MP patients (26.8% versus 17.9%, P = 0.56). Older age

  18. Estimated cost of a factitious disorder with 6-year follow-up.

    PubMed

    Hoertel, Nicolas; Lavaud, Pierre; Le Strat, Yann; Gorwood, Philip

    2012-12-30

    Long-term follow up is rarely described for patients with Factitious Disorder, mainly because of the lack of access to patient's confidential information. In addition, the financial burden of multiple uses of health care system has not been examined so far. We report a 6-year follow-up for a patient with Factitious Disorder who first reported neurological then psychiatric symptoms, and investigate the cost of his detected hospitalizations.

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

    PubMed Central

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

    2013-01-01

    Abstract Background Intervention in early childhood development as one of the social determinants of health, is important for reducing social gap and inequity. In spite of increasingly developing intensive neonatal care wards and decreasing neonatal mortality rate, there is no follow up program in Iran. This study was carreid out to design high risk infants follow up care program with the practical aim of creating an model action for whole country, in 2012. Methods This qualitative study has been done by the Neonatal Department of the Deputy of Public Health in cooperation with Pediatrics Health Research Center of Tabriz University of Medical Sciences, Iran. After study of international documents, consensus agreement about adapted program for Iran has been accomplished by focus group discussion and attended Delphi agreement technique. After compiling primary draft included evidence based guidelines and executive plan, 14 sessions including expert panels were hold to finalize the program. Results After finalizing the program, high risk infants follow up care service package has been designed in 3 chapters: Evidence based clinical guidelines; eighteen main clinical guidelines and thirteen subsidiaries clinical guidelines, executive plan; 6 general, 6 following up and 5 backup processes. Education program including general and especial courses for care givers and follow up team, and family education processes. Conclusion We designed and finalized high risk infants follow up care service package. It seems to open a way to extend it to whole country. PMID:26171344

  20. Radiology-led Follow-up System for IVC Filters: Effects on Retrieval Rates and Times

    SciTech Connect

    Lee, L.; Taylor, J.; Munneke, G.; Morgan, R.; Belli, A.-M.

    2012-04-15

    Purpose: Successful IVC filter retrieval rates fall with time. Serious complications have been reported following attempts to remove filters after 3-18 months. Failed retrieval may be associated with adverse clinical sequelae. This study explored whether retrieval rates are improved if interventional radiologists organize patient follow-up, rather than relying on the referring clinicians. Methods: Proactive follow-up of patients who undergo filter placement was implemented in May 2008. At the time of filter placement, a report was issued to the referring consultant notifying them of the advised timeframe for filter retrieval. Clinicians were contacted to arrange retrieval within 30 days. We compared this with our practice for the preceding year. Results: The numbers of filters inserted during the two time periods was similar, as were the numbers of retrieval attempts and the time scale at which they occurred. The rate of successful retrievals increased but not significantly. The major changes were better documentation of filter types and better clinical follow-up. After the change in practice, only one patient was lost to follow-up compared with six the preceding year. Conclusions: Although there was no significant improvement in retrieval rates, the proactive, radiology-led approach improved follow-up and documentation, ensuring that a clinical decision was made about how long the filter was required and whether retrieval should be attempted and ensuring that patients were not lost to follow-up.

  1. Use of an extended INR follow-up interval for Veteran patients in an anticoagulation clinic.

    PubMed

    Porter, Andrea L; Margolis, Amanda R; Schoen, Rebecca R; Staresinic, Carla E; Ray, Cheryl A; Fletcher, Christopher D

    2017-04-01

    A prospective, single-arm study of 50 participants evaluated an extended INR follow-up interval to determine the implementation feasibility and safety of an extended interval in Veterans on a stable dose of warfarin. A protocol was designed to allow for a rigorous, yet pragmatic evaluation of a 12-week INR follow-up interval. Feasibility was determined by study enrollment, retention, and participant achievement rates for the extended INR interval. Safety was determined by bleeding and thromboembolism rates. Participants were monitored for 6 months. Despite the long-term stability of participants prior to enrollment, only 56% achieved a 12-week follow-up interval and only 34% of enrolled participants maintained a 12-week interval. Sixteen percent of participants were never eligible for an extension of their INR follow-up interval despite meeting initial enrollment criteria. There were two major bleeding events and one participant who experienced a thromboembolic event. Implementation of an extended interval of INR follow-up appears feasible as participant enrollment goals were met and pharmacists were able to follow the study protocol. However, a lower than expected proportion of participants were able to achieve and maintain an extended INR follow-up interval. Future evaluations are needed to confirm the safety of an extended INR interval.

  2. Comfort monitoring? Environmental assessment follow-up under community-industry negotiated environmental agreements

    SciTech Connect

    Noble, Bram; Birk, Jasmine

    2011-01-15

    Negotiated environmental agreements are becoming common practice in the mining industry. In principle, negotiated environmental agreements are said to respond to many of the shortcomings of environmental impact assessment by providing for improved follow-up of project impacts through, among other things, data provision, engaging stakeholders in the monitoring and management of project impacts, and building capacity at the local level to deal with project-induced environmental change. In practice, however, little is known about the efficacy of follow-up under negotiated environmental agreements between proponents and communities and the demonstrated value added to project impact management. This paper examines follow-up practice under negotiated environmental agreements with a view to understanding whether and how community-based monitoring under privatized agreements actually contributes to improved follow-up and impact management. Based on lessons emerging from recent experiences with environmental agreements in Canada's uranium industry, we show that follow-up under negotiated agreements may be described as 'comfort monitoring'. While such monitoring does improve community-industry relations and enhance corporate image, it does little to support effects-based management. If follow-up under negotiated agreements is to be credible over the long term, there is a need to ensure that monitoring results are useful for, and integrated with, regulatory-based monitoring and project impact management practices.

  3. Cohort profile of the Japan Collaborative Cohort Study at final follow-up.

    PubMed

    Tamakoshi, Akiko; Ozasa, Kotaro; Fujino, Yoshihisa; Suzuki, Koji; Sakata, Kiyomi; Mori, Mitsuru; Kikuchi, Shogo; Iso, Hiroyasu; Sakauchi, Fumio; Motohashi, Yutaka; Tsuji, Ichiro; Nakamura, Yosikazu; Mikami, Haruo; Kurosawa, Michiko; Hoshiyama, Yoshiharu; Tanabe, Naohito; Tamakoshi, Koji; Wakai, Kenji; Tokudome, Shinkan; Hashimoto, Shuji; Wada, Yasuhiko; Kawamura, Takashi; Watanabe, Yoshiyuki; Miki, Tsuneharu; Date, Chigusa; Kurozawa, Yoichi; Yoshimura, Takesumi; Shibata, Akira; Okamoto, Naoyuki; Shio, Hideo

    2013-01-01

    The Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study) was established in the late 1980s to evaluate the risk impact of lifestyle factors and levels of serum components on human health. During the 20-year follow-up period, the results of the study have been published in almost 200 original articles in peer-reviewed English-language journals. However, continued follow-up of the study subjects became difficult because of the retirements of principal researchers, city mergers throughout Japan in the year 2000, and reduced funding. Thus, we decided to terminate the JACC Study follow-up at the end of 2009. As a final point of interest, we reviewed the population registry information of survivors. A total of 207 (0.19%) subjects were ineligible, leaving 110 585 eligible participants (46 395 men and 64 190 women). Moreover, errors in coding date of birth and sex were found in 356 (0.32%) and 59 (0.05%) cases, respectively, during routine follow-up and final review. Although such errors were unexpected, their impact is believed to be negligible because of the small numbers relative to the large total study population. Here, we describe the final cohort profile at the end of the JACC Study along with selected characteristics of the participants and their status at the final follow-up. Although follow-up of the JACC Study participants is finished, we will continue to analyze and publish study results.

  4. Chronic central serous chorioretinopathy: long-term follow-up and vision-related quality of life

    PubMed Central

    Breukink, Myrte B; Dingemans, Alexander JM; den Hollander, Anneke I; Keunen, Jan EE; MacLaren, Robert E; Fauser, Sascha; Querques, Giuseppe; Hoyng, Carel B; Downes, Susan M; Boon, Camiel JF

    2017-01-01

    Purpose To describe the clinical findings and long-term outcome of patients with chronic central serous chorioretinopathy (cCSC). Materials and methods This was a retrospective case series in 52 eyes of 36 patients with a follow-up period of at least 1 year. Extensive ophthalmic examination and a validated questionnaire concerning vision-related quality of life (National Eye Institute Visual Function Questionnaire [NEI-VFQ]-39) were analyzed. Results Mean visual acuity showed a significant decline over time of 0.16 logarithm of minimum angle of resolution ([logMAR] range: −0.22 to 1.3; P=0.009) after a mean follow-up period of 10.6 years. Also, patients reported lower vision-related quality of life based on the NEI-VFQ-39 for almost all categories compared to healthy controls. Macular atrophy was diagnosed more often on optical coherence tomography compared to other diagnostic entities. Retinal pigment epithelium detachments in the macula were documented on optical coherence tomography in 56% of the patients. A significant thinning of foveal thickness was measured over time compared to unaffected fellow eyes (P=0.002). On long-term follow-up, 13 eyes (37%) showed an increase in number of hot spots on fluorescein angiography. Conclusion This study indicates that cCSC is a progressive disease in many patients, causing a progressive decline in visual acuity, accompanied by lower reported vision-related quality of life. In deciding whether or not to treat, the progressive nature of cCSC should be taken into account in this relatively young and often still professionally active patient group. PMID:28053499

  5. One decade follow up after nucleoplasty in the management of degenerative disc disease causing low back pain and radiculopathy

    PubMed Central

    Cincu, Rafael; Lorente, Francisco de Asis; Gomez, Joaquin; Eiras, Jose; Agrawal, Amit

    2015-01-01

    Objectives: Nucleoplasty is a minimally invasive procedure that is developed to treat patients with symptomatic, but contained disc herniations or bulging discs. The purpose of this study was to evaluate a decade follow-up of coblation nucleoplasty treatment for protruded lumbar intervertebral disc. Methods: In this retrospective study there a total 50 patients who underwent intradiscal coblation therapy for symptomatic, but contained lumbar degenerative disc disease were included. Relief of low back pain, leg pain and numbness after the operation were assessed by visual analog pain scale (VAS). Function of lower limb and daily living of patients were evaluated by the Oswestry disability index (ODI) and subjective global rating of overall satisfaction were recorded and analyzed. Results: There were 27 male and 23 female with followup mean follow up of 115 months (range 105–130 months) with a mean age was 52 years (range 26–74 years). Analgesic consumption was reduced or stopped in 90% of these cases after 1 year. At 24 months follow up VAS was four points and ODI was 7.2. In three patients, we repeated the cool ablation after 36 months, at L3–4 level in two cases. Ten patients continue to be asymptomatic after 114 months of intervention. There were no complications with the procedure including nerve root injury, discitis or allergic reactions. Conclusions: Nucleoplasty may provide intermittent relief in contained disc herniation without significant complications and minimal morbidity. In accordance with the literature the evidence for intradiscal coablation therapy is moderate in managing chronic discogenic low back pain; nucleoplasty appears to be safe and effective. PMID:25767571

  6. Outcome of Successful Versus Unsuccessful Percutaneous Coronary Intervention in Chronic Total Occlusions in One Year Follow-Up

    PubMed Central

    Sohrabi, Bahram; Ghaffari, Samad; Habibzadeh, Afshin; Chaichi, Parastoo; Kamalifar, Amir

    2013-01-01

    Background Chronic total occlusions (CTO) comprises already one-third of percutaneous coronary interventions (PCIs). There is controversy in PCI results considering short-term and long-term outcomes. We aim to compare efficacy and outcome of successful versus unsuccessful PCI in CTO in 1 year follow-up. Methods In this retrospective study we choose 330 consecutive patients undergone PCI on a CTO of a native coronary artery (163 successful and 167 unsuccessful) in Madani Heart Hospital, Tabriz, Iran. Patients were followed for a mean period of about 15 ± 3 months. Major adverse cardiac events (MACE) in hospital and in follow-up were recorded comprising death, acute myocardial infarction, and need for repeat revascularization. Results Patients with unsuccessful PCI compared to successful PCI were mainly male (87.4% vs. 77.3%; P < 0.02), had a higher incidence of diabetes mellitus (31.1% vs. 20.9%; P < 0.04) and hypertension (53.3% vs. 42.3%; P < 0.04). Most patients in successful group had single vessel disease (63.4% vs. 46.7%; P < 0.001) and less three-vessel disease (11.8% vs. 22.8%) compared to unsuccessful group. In-hospital MACE was insignificantly higher in unsuccessful PCI (17.4% vs. 11%). Unsuccessful PCI was significantly associated with higher rate of 12 months MACE (43.7% vs. 30.1%, P = 0.01), especially revascularization (41.3% vs. 25.2%, P = 0.02). Conclusion Although in hospital outcome was the same between groups, patients with successful PCI of CTO had a better one year follow-up outcome than unsuccessful PCI. However mortality rate was the same and main complications were due to revascularization.

  7. Post-Stroke Epilepsy in Young Adults: A Long-Term Follow-Up Study

    PubMed Central

    Arntz, Renate; Rutten-Jacobs, Loes; Maaijwee, Noortje; Schoonderwaldt, Hennie; Dorresteijn, Lucille; van Dijk, Ewoud; de Leeuw, Frank-Erik

    2013-01-01

    Background Little is known about the incidence and risk of seizures after stroke in young adults. Especially in the young seizures might dramatically influence prognosis and quality of life. We therefore investigated the long-term incidence and risk of post-stroke epilepsy in young adults with a transient ischemic attack (TIA), ischemic stroke (IS) or intracerebral hemorrhage (ICH). Methods and Findings We performed a prospective cohort study among 697 consecutive patients with a first-ever TIA, IS or ICH, aged 18–50 years, admitted to our hospital between 1-1-1980 till 1-11-2010. The occurrence of epilepsy was assessed by standardized questionnaires and verified by a neurologist. Cumulative risks were estimated with Kaplan-Meier analysis. Cox proportional hazard models were used to calculate relative risks. After mean follow-up of 9.1 years (SD 8.2), 79 (11.3%) patients developed post-stroke epilepsy and 39 patients (5.6%) developed epilepsy with recurrent seizures. Patients with an initial late seizure more often developed recurrent seizures than patients with an initial early seizure. Cumulative risk of epilepsy was 31%, 16% and 5% for patients with an ICH, IS and TIA respectively (Logrank test ICH and IS versus TIA p<0.001). Cumulative risk of epilepsy with recurrent seizures was 23%, 8% and 4% respectively (Logrank ICH versus IS p = 0.05, ICH versus TIA p<0.001, IS versus TIA p = 0.01). In addition a high NIHSS was a significant predictor of both epilepsy and epilepsy with recurrent seizures (HR 1.07, 95% CI 1.03–1.11 and 1.08, 95% CI 1.02–1.14). Conclusions Post-stroke epilepsy is much more common than previously thought. Especially patients with an ICH and a high NIHSS are at high risk. This calls upon the question whether a subgroup could be identified which benefits from the use of prophylactic antiepileptic medication. Future studies should be executed to investigate risk factors and the effect of post-stroke epilepsy on quality of life

  8. Response to hydroxycarbamide in pediatric β-thalassemia intermedia: 8 years' follow-up in Egypt.

    PubMed

    El-Beshlawy, Amal; El-Ghamrawy, Mona; EL-Ela, Mona Abou; Said, Fadwa; Adolf, Sonia; Abdel-Razek, Abdel-Rahman Ahmed; Magdy, Rania Ismail; Abdel-Salam, Amina

    2014-12-01

    Hydroxycarbamide (hydroxyurea or HU) has been shown to increase fetal hemoglobin (HbF) in patients with β-thalassemia intermedia (TI). The reported effects of HU in increasing the total hemoglobin (Hb) have been inconsistent. Studies of long-term therapy with HU in pediatric TI are rather uncommon. A retrospective observational study was carried out to evaluate the clinical responses to HU in Egyptian patients with β-TI. One hundred patients; children (n = 82, mean age 9.9 ± 4.1 years) and adults (n = 18) were studied for the mean Hb, HbF%, median serum ferritin, transfusion history, and splenic size before and after HU therapy (mean dose 20.0 ± 4.2 mg/kg/day, range 10-29 mg/kg/day) over a follow-up period 4 to 96 months (mean 35.4 ± 19.2 months). Molecular studies were also done for group of patients (n = 42). The overall response rate to HU was 79 %; 46 % were minor responders (with a reduction in transfusion rate by 50 % or more and/or an increase in their total hemoglobin level by 1-2 g/dl) and 33 % major responders (becoming transfusion-free and/or having an increase in total hemoglobin level by >2 g/dl). Mean hemoglobin increased among responders from 6.9 ± 0.9 g/dl to 8.3 ± 1.4 g/dl (p < 0.001). A significant rise in mean HbF (27.0 vs. 42.5 %; p < 0.011) and a decrease in median serum ferritin (800 vs. 644 ng/ml; p < 0.001) were also observed among responders (n = 45). Transfusions stopped in 44 % of pretreatment frequently transfused responders (n = 11/25). Splenic size decreased in 37 % of patients (n = 30/81). The predominant β-thalassemia mutation was 1-6 (T > C) in 32/42 (76 %) of studied patients; 28/32 were responders. Bivariate analysis showed no predictors of response as regards sex, pediatric and adult age, splenic status, or genotype. Hydroxycarbamide is a good therapeutic modality in the management of pediatric as in adult TI patients. It can minimize the need for blood transfusion, concomitant iron overload, and blood-born viral

  9. Surgical correction of Madelung's deformity by combined corrective radioulnar osteotomy: 14 cases with four-year minimum follow-up.

    PubMed

    Laffosse, Jean-Michel; Abid, Abdelaziz; Accadbled, Frank; Knör, Gorka; Sales de Gauzy, Jérôme; Cahuzac, Jean-Philippe

    2009-12-01

    Fourteen wrists in 11 girls, mean age 13.3 years (range 9-16) at surgery, were treated for Madelung's deformity. The presenting complaint was incapacitating pain. All were treated by radial closing wedge osteotomy and ulnar shortening osteotomy. The dorsal retinaculum was also surgically repaired in six cases. At a mean follow-up of 5.1 years (range 4-8.75), we observed improved range of motion in both flexion/extension and pronation/supination and absence of pain during daily activity. Radiographically, positioning of the distal radial articular surface and lunate subsidence were improved. Union was obtained after all osteotomies without secondary procedures. Posterior displacement of the ulnar head persisted in two wrists. Combined radioulnar osteotomy restored the anatomy to as near normal as possible. This technique provides satisfactory and encouraging results and does not compromise the surgical future of the wrist. However, longer follow-up is required to assess recurrence or possible long-term degenerative consequences.

  10. Neurological Manifestations of Mycoplasma pneumoniae Infection in Hospitalized Children and Their Long-Term Follow-Up.

    PubMed

    Kammer, Jessica; Ziesing, Stefan; Davila, Lukas Aguirre; Bültmann, Eva; Illsinger, Sabine; Das, Anibh M; Haffner, Dieter; Hartmann, Hans

    2016-10-01

    Objective In this retrospective study, we aimed to assess frequency, types, and long-term outcome of neurological disease during acute Mycoplasma pneumoniae (M. pneumoniae) infection in pediatric patients. Materials and Methods Medical records of patients hospitalized with acute M. pneumoniae infection were reviewed. Possible risk factors were analyzed by uni- and multivariate regression. Patients with neurological symptoms were followed up by expanded disability status score (EDSS) and the cognitive problems in children and adolescents (KOPKJ) scale. Results Out of 89 patients, 22 suffered from neurological symptoms and signs. Neurological disorders were diagnosed in 11 patients: (meningo-) encephalitis (n = 6), aseptic meningitis (n = 3), transverse myelitis (n = 1), and vestibular neuritis (n = 1), 11 patients had nonspecific neurological symptoms and signs. Multivariate logistic regression identified lower respiratory tract symptoms as a negative predictor (odds ratio [OR] = 0.1, p < 0.001), a preexisting immune deficit was associated with a trend for a decreased risk (OR = 0.12, p = 0.058). Long-term follow-up after a median of 5.1 years (range, 0.6-13 years) showed ongoing neurological deficits in the EDSS in 8/18, and in the KOPKJ in 7/17. Conclusion Neurological symptoms occurred in 25% of hospitalized pediatric patients with M. pneumoniae infection. Outcome was often favorable, but significant sequels were reported by 45%.

  11. Posttraumatic stress disorder after motor vehicle accidents: 3-year follow-up of a prospective longitudinal study.

    PubMed

    Mayou, R A; Ehlers, A; Bryant, B

    2002-06-01

    The paper presents a 3-year follow-up of a prospective longitudinal study of posttraumatic stress disorder (PTSD) after motor vehicle accidents (J. Abnormal Psychol., 107 (1998) 508). Participants were 546 patients who had been assessed when attending an emergency clinic shortly after a motor vehicle accident, and at 3 months and 1 year afterwards. The prevalence of posttraumatic stress disorder PTSD at 3 years was 11%. Maintaining psychological factors, i.e. negative interpretation of intrusions, rumination, thought suppression and anger cognitions, were important in predicting the persistence of PTSD at 3 years, as were persistent health and financial problems after the accident. Other predictors were female sex, hospital admission for injuries, perceived threat and dissociation during the accident, and litigation.

  12. Defense mechanisms after brief cognitive-behavior group therapy for panic disorder: one-year follow-up.

    PubMed

    Heldt, Elizeth; Blaya, Carolina; Kipper, Leticia; Salum, Giovanni A; Otto, Michael W; Manfro, Gisele G

    2007-06-01

    Changes in defense mechanisms have been shown in long-term psychodynamic treatment. The aim of this study was to examine the changes that occurred after brief cognitive-behavior group therapy in the defense style of panic disorder patients that had failed to respond to pharmacotherapy. Forty-seven patients participated in the study and severity of panic disorder was evaluated by Clinical Global Impression. Defense mechanisms were evaluated by the Defense Style Questionnaire. Patients decreased the use of maladaptive defenses after cognitive-behavior group therapy, and the change in immature defenses was maintained at 1-year follow-up evaluation (p = 0.022). These modifications were associated with reduction of symptoms (F = 0.359; p = 0.047). These findings are consistent with the hypothesis that defense styles are malleable in short-term treatment and are, at least partially, symptom-state dependent.

  13. Preparing for LSST with the LCOGT NEO Follow-up Network

    NASA Astrophysics Data System (ADS)

    Greenstreet, Sarah; Lister, Tim; Gomez, Edward

    2016-10-01

    The Las Cumbres Observatory Global Telescope Network (LCOGT) provides an ideal platform for follow-up and characterization of Solar System objects (e.g. asteroids, Kuiper Belt Objects, comets, Near-Earth Objects (NEOs)) and ultimately for the discovery of new objects. The LCOGT NEO Follow-up Network is using the LCOGT telescope network in addition to a web-based system developed to perform prioritized target selection, scheduling, and data reduction to confirm NEO candidates and characterize radar-targeted known NEOs.In order to determine how to maximize our NEO follow-up efforts, we must first define our goals for the LCOGT NEO Follow-up Network. This means answering the following questions. Should we follow-up all objects brighter than some magnitude limit? Should we only focus on the brightest objects or push to the limits of our capabilities by observing the faintest objects we think we can see and risk not finding the objects in our data? Do we (and how do we) prioritize objects somewhere in the middle of our observable magnitude range? If we want to push to faint objects, how do we minimize the amount of data in which the signal-to-noise ratio is too low to see the object? And how do we find a balance between performing follow-up and characterization observations?To help answer these questions, we have developed a LCOGT NEO Follow-up Network simulator that allows us to test our prioritization algorithms for target selection, confirm signal-to-noise predictions, and determine ideal block lengths and exposure times for observing NEO candidates. We will present our results from the simulator and progress on our NEO follow-up efforts.In the era of LSST, developing/utilizing infrastructure, such as the LCOGT NEO Follow-up Network and our web-based platform for selecting, scheduling, and reducing NEO observations, capable of handling the large number of detections expected to be produced on a daily basis by LSST will be critical to follow-up efforts. We hope our

  14. Does routine follow up after head injury help? A randomised controlled trial.

    PubMed Central

    Wade, D T; Crawford, S; Wenden, F J; King, N S; Moss, N E

    1997-01-01

    OBJECTIVE: To evaluate the Medical Disability Society's 1988 recommendation that "every patient attending hospital after a head injury should be registered and offered an outpatient follow up appointment" by determining whether offering a routine follow up service to patients presenting to hospital with a head injury of any severity affects outcome six months later. DESIGN: A randomised controlled trial design with masked assessment of outcome. SETTING: A mixed rural and urban health district with a population of about 560000. PATIENTS: 1156 consecutive patients resident in Oxfordshire aged between 16 and 65 years presenting over 13 months to accident and emergency departments or admitted to hospital and diagnosed as having a head injury of any severity, including those with other injuries. INTERVENTIONS: Patients were registered and randomised to one of two groups. Both groups continued to receive the standard service offered by the hospitals. The early follow up group were approached at 7-10 days after injury and offered additional information, advice, support, and further intervention as needed. All randomised patients were approached for follow up assessment six months after injury by independent clinicians blind to their group. MAIN OUTCOME MEASURES: Validated questionnaires were used to elicit ratings of post-concussion symptoms (the Rivermead postconcussion symptoms questionnaire), and changes in work, relationships, leisure, social, and domestic activities (the Rivermead head injury follow up questionnaire). RESULTS: The two groups were comparable at randomisation. Data was obtained at six months on 226 of 577 "control" patients and 252 of 579 "trial" patients (59% were lost to follow up). There were no significant differences overall between the trial and control groups at follow up, but subgroup analysis of the patients with moderate or severe head injuries (posttraumatic amnesia > or = one hour, or admitted to hospital), showed that those in the early

  15. Implant success rates in full-arch rehabilitations supported by upright and tilted implants: a retrospective investigation with up to five years of follow-up

    PubMed Central

    2015-01-01

    Purpose The aim of this retrospective study was to investigate the cumulative success rate, the implant survival rate, and the occurrence of biological complications in implants supporting full-arch immediately loaded rehabilitations supported by upright and tilted implants. Methods The clinical records and periapical radiographs of patients who attended follow-up visits were collected, and information was recorded regarding marginal bone loss resorption, the occurrence of peri-implant infectious diseases, and the implant survival rate. Implants were classified as successful or not successful according to two distinct classifications for implant success. Results A total of 53 maxillary and mandibular restorations including 212 implants were analysed, of which 56 implants were studied over the full five-year follow-up period. After five years, the cumulative success rate was 76.04% according to the Misch classification and 56.34% according to the Albrektsson classification. The cumulative implant survival rate was 100%, although one implant was found to be affected by peri-implantitis at the second follow-up visit. Conclusions The cumulative success rate of the implants dropped over time, corresponding to the progression of marginal bone resorption. The prevalence of peri-implantitis was very low, and the implant survival rate was not found to be related to the cumulative success rate. PMID:26734491

  16. Unexpected Return for Follow-up During the First Year of Multidisciplinary Care May Be Predictive of Rapid Deterioration of Renal Function.

    PubMed

    Tsai, Ming-Hsien; Fang, Yu-Weil; Wang, Li Hui; You, Xiang Gin; Leu, Jyh-Gang

    2015-10-01

    Multidisciplinary predialysis education and team care (MDC) may slow the decline in renal function in patients with chronic kidney disease (CKD). However, associations between unexpected return during MDC and progression of renal dysfunction have not been characterized in patients with CKD. Our study aimed to determine the association between exacerbation of renal dysfunction and the frequency of unexpected return during follow-up.A total of 437 patients with CKD receiving multidisciplinary care between January 2009 and June 2013 at the Shin-Kong Wu Ho-Su Memorial Hospital were included in this retrospective observational cohort study, and multiple imputations were performed for missing data. The predictor was the frequency of unexpected return for follow-up during the first year after entering MDC. Main outcome was monthly declines in estimated glomerular filtration rates (eGFR). Moreover, the demographic data, comorbidities, history of medication, and routine laboratory data for patients with CKD were collected.Among all patients, 59.7% were male, the mean age at initiation of MDC was 69.4 ± 13.2 years, and the duration of follow-up was 21.4 ± 3.3 months. The subjects were divided into 2 groups according to frequencies of follow-up (≤4 and > 4 visits) during the 1st year of MDC. The patients with CKD were regularly followed up every 3 months as a part of MDC in our hospital, and patients who returned for more than 4 follow-up visits were included in the unexpected return group. In crude regression analyses, unexpected return was significantly associated with higher monthly declines of eGFR (β = 0.092, 95% confidence interval, 0.014-0.170). This association remained after adjustments for multiple variables, and subgroup analyses of unexpected return showed that male gender, older age, CKD stage 1 to 3, hypertension, history of coronary artery disease, and use of renin-angiotensin system blockade were significantly associated with declines in

  17. Quality of life after laparoscopic gastric banding: Prospective study (152 cases) with a follow-up of 2 years.

    PubMed

    Champault, Axèle; Duwat, Olivier; Polliand, Claude; Rizk, Nabil; Champault, Gérard G

    2006-06-01

    To evaluate influence of laparoscopic gastric banding (LGB) on quality of life (QOL) in patients with morbid obesity. Laparoscopic adjustable gastric banding is a popular bariatric operation in Europe. The objectives of surgical therapy in patients with morbid obesity are reduction of body weight, and a positive influence on the obesity-related comorbidity as well the concomitant psychologic and social restrictions of these patients. In a prospective clinical trial, development of the individual patient QOL was analyzed, after LGB in patients with morbid obesity. From October 1999 to January 2001, 152 patients [119 women, 33 men, mean age 38.4 y (range 24 to 62), mean body mass index 44.3 (range 38 to 63)] underwent evaluation for LGB according the following protocol: history of obesity; concise counseling of patients and relative on nonsurgical treatment alternatives, risk of surgery, psychologic testing, questionnaire for eating habits, necessity of lifestyle change after surgery; medical evaluation including endocrinologic and nutritionist work-up, upper GI endoscopy, evaluation of QOL using the Gastro Intestinal Quality of Life Index (GIQLI). Decision for surgery was a multidisciplinary consensus. This group was follow-up at least 2 years, focusing on weight loss and QOL. Mean operative time was 82 minutes; mean hospital stay was 2.3 days and the mean follow-up period was 34 months. The BMI dropped from 44.3 to 29.6 kg/m and all comorbid conditions improved markedly: diabetes melitus resolved in 71% of the patients, hypertension in 33%, and sleep apnea in 90%. However, 26 patients (17%) had late complications requiring reoperation. Preoperative global GIQLI score was 95 (range 56 to 140), significant different of the healthy volunteers score (120) (70 to 140) P < 0.001. Correlated with weight loss (percentage loss of overweight and BMI), the global score of the group increased to 100 at 3 months, 104 at 6, 111 at 1 year to reach 119 at 2 years which is no

  18. Management and outcome of recurrent adult craniopharyngiomas: an analysis of 42 cases with long-term follow-up.

    PubMed

    Turel, Mazda K; Tsermoulas, Georgios; Gonen, Lior; Klironomos, George; Almeida, Joao Paulo; Zadeh, Gelareh; Gentili, Fred

    2016-12-01

    OBJECTIVE The treatment of recurrent and residual craniopharyngiomas is challenging. In this study the authors describe their experience with these tumors and make recommendations on their management. METHODS The authors performed an observational study of adult patients (≥ 18 years) with recurrent or residual craniopharyngiomas that were managed at their tertiary center. Retrospective data were collected on demographics and clinical, imaging, and treatment characteristics from patients who had a minimum 2-year follow-up. Descriptive statistics were used and the data were analyzed. RESULTS There were 42 patients (27 male, 15 female) with a mean age of 46.3 ± 14.3 years. The average tumor size was 3.1 ± 1.1 cm. The average time to first recurrence was 3.6 ± 5.5 years (range 0.2-27 years). One in 5 patients (8/42) with residual/recurrent tumors did not require any active treatment. Of the 34 patients who underwent repeat treatment, 12 (35.3%) had surgery only (transcranial, endoscopic, or both), 9 (26.5%) underwent surgery followed by adjuvant radiation therapy (RT), and 13 (38.2%) received RT alone. Eighty-six percent (18/21) had a gross-total (n = 4) or near-total (n = 14) resection of the recurrent/residual tumors and had good local control at last follow-up. One of 5 patients (7/34) who underwent repeat treatment had further treatment for a second recurrence. The total duration of follow-up was 8.6 ± 7.1 years. The average Karnofsky Performance Scale score at last follow-up was 80 (range 40-90). There was 1 death. CONCLUSIONS Based on this experience and in the absence of guidelines, the authors recommend an individualized approach for the treatment of symptomatic or growing tumors. This study has shown that 1 in 5 patients does not require repeat treatment of their recurrent/residual disease and can be managed with a "scan and watch" approach. On the other hand, 1 in 5 patients who had repeat treatment for their recurrence in the form of surgery and

  19. Language Development: 1 Year Olds

    MedlinePlus

    ... Stages Listen Español Text Size Email Print Share Language Development: 1 Year Olds Page Content Article Body ... assured, it’s not your imagination. He’s developing his language and comprehension skills right on schedule. This giant ...

  20. Comparing Effectiveness of Active and Passive Client Follow-Up Approaches in Sustaining the Continued Use of Long Acting Reversible Contraceptives (LARC) in Rural Punjab: A Multicentre, Non-Inferiority Trial

    PubMed Central

    Hameed, Waqas; Azmat, Syed Khurram; Ali, Moazzam; Ishaque, Muhammad; Abbas, Ghazunfer; Munroe, Erik; Harrison, Rebecca; Shamsi, Wajahat Hussain; Mustafa, Ghulam; Khan, Omar Farooq; Ali, Safdar; Ahmed, Aftab

    2016-01-01

    -based follow-up; 89.1% (95% CI 85.7, 91.8) who received telephone-based follow-up; and 83.8% (95% CI 79.8 to 87.1) who were in the passive or needs-based follow-up group. The probability of continuation among women who were actively followed-up by field health educators—either through home-based visit or telephone-based follow-up was, 88.3% (95% CI 85.9 to 90.0). An adjusted risk difference of -4.1 (95% CI -7.8 to -0.28; p-value = 0.035) was estimated between active and passive follow-up. Whereas, within the active client follow-up, the telephone-based follow-up was found to be as effective as the home-based follow-up with an adjusted risk difference of 1.8 (95% CI -2.7 to 6.4; p-value = 0.431). Conclusion A passive follow-up approach was 5% inferior to an active follow-up approach; whereas telephone-based follow-up was as effective as the home-based visits in sustaining the use of LARC, and was far more resource efficient. Therefore, active follow-up could improve method continuation especially in the critical post-insertion period. PMID:27584088

  1. Long-term follow-up of echolalia and question answering.

    PubMed

    Foxx, R M; Faw, G D

    1990-01-01

    A long-term follow-up of echolalia and correct question answering was conducted for 6 subjects from three previously published studies. The follow-up periods ranged from 26 to 57 months. In a training site follow-up, subjects were exposed to baseline/posttraining conditions in which the original trainer and/or a novel person(s) presented trained and untrained questions. Four subjects displayed echolalia below baseline levels, and another did so in some assessments. Overall, echolalia was lower than in baseline in 80.6% of the follow-ups. Five subjects displayed correct responding above baseline levels. No clear differences were noted in correct responding or echolalia between the trainer and novel-person presentations or between trained and untrained questions. In a follow-up in a natural environment conducted by a novel person, lower than baseline levels of echolalia were displayed by 3 subjects; 2 subjects displayed lower than baseline levels in some assessments. Two subjects consistently displayed correct responding above baseline, and 3 did so occasionally. Issues related to the study of maintenance are discussed.

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

    PubMed

    Meyenburg, Bernd; Kröger, Anne; Neugebauer, Rebecca

    2015-01-01

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

  3. Parental Involvement in Cognitive Behavior Therapy for Children with Anxiety Disorders: 3-Year Follow-Up.

    PubMed

    Walczak, Monika; Esbjørn, Barbara H; Breinholst, Sonja; Reinholdt-Dunne, Marie Louise

    2016-07-12

    Parental factors have been linked to childhood anxiety, hence, parental involvement in cognitive behavioral therapy (CBT) for anxious children has been examined. However, findings do not consistently show added effects of parent-enhanced CBT, longitudinal investigations are scarce and long-term effects unclear. In the present study, 40 out of 54 families who, 3 years previously, completed one of two types of CBT treatment: with limited or active parental involvement, were assessed using semi-structured diagnostic interviews. Diagnostic status at 3-years follow-up was compared between groups. Changes in diagnostic status across assessment points: posttreatment, 6-month and 3-year follow-up were analyzed within groups. Diagnostic change from 6-month to 3-year follow-up was compared between groups. Intent-to-treat analyses revealed no significant difference in diagnostic status between groups at 3-year follow-up. Nonetheless, children whose parents actively participated in treatment showed significantly more remission from 6-month to 3-year follow-up than children with limited parental participation.

  4. Therapeutic approaches and long-term follow-up for prenatal hydronephrosis

    PubMed Central

    Aydogdu, Bahattin; Tireli, Gulay; Demirali, Oyhan; Guvenc, Unal; Besik, Cemile; Sander, Serdar; Kiyak, Aysel

    2016-01-01

    Objective: This study summarises the outcomes of 149 patients who underwent surgery for antenatally diagnosed unilateral hydronephrosis. Methods: The medical records of such patients over a 23-year period were reviewed retrospectively. Age at the time of operation, preoperative and postoperative mean pelvic diameter on ultrasound, split renal function, washout patterns on scintigraphy, and early and late complications were recorded. Results: The mean preoperative follow-up period was five months (range: 1–66 months). One patient was operated on after 12 months and two patients after five years of follow-up. Mean preoperative pelvic diameter and renal function were 30.8 mm and 38.6%, respectively; all patients had an obstructive wash-out pattern. In the postoperative period, the corresponding measurements were 11.7 mm and 39.2%, with 111 non-obstructive, 24 partially obstructive, and 14 obstructive wash-out patterns. Three patients with severe caliectasis and low renal function underwent surgery despite mild hydronephrosis. The mean postoperative follow-up period was six (range 4–11) years. Complications developed in 14 (9.3%) patients. Conclusion: Patients with antenatal hydronephrosis may need surgery even after a follow-up period of six years. Because of the potential late development of complications, postoperative follow-up should be continued for 10 years. PMID:27375711

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

    PubMed

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

    2017-03-01

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

  6. Real life cancer comorbidity in Greek patients with diabetes mellitus followed up at a single diabetes center: an unappreciated new diabetes complication.

    PubMed

    Thanopoulou, Anastasia; Pectasides, Demetrios

    2014-01-01

    We determined cancer comorbidity in patients with diabetes followed up at a single Greek academic clinic and investigated the potential related factors. Cancer comorbidity was prospectively recorded for all patients with type 2 (T2DM, n = 759) or type 1 (T1DM, n = 134) diabetes of at least 10-year duration examined during one year. Patient characteristics, diabetes age of onset, duration, treatment, control, and complication rates were compared between subjects with and without cancer. Moreover, a retrospective collection of data from similar patients examined for the first time during the last 25 years, but lost to follow-up, after at least one-year's regular visits, was performed. In regularly followed-up T2DM patients cancer comorbidity was 12.6%. Patients with cancer were older and more frequently smokers. Prostate cancer was the most frequent (24.0%) type. In T1DM cancer comorbidity was 3.0%. Similar rates of comorbidity and types of cancer were observed in lost to follow-up patients. In conclusion, our patients with T2DM of at least 10-year' duration show high cancer comorbidity. No specific characteristics discriminate patients with cancer. Therefore presymptomatic cancer detection and prevention strategies may have to be incorporated into the annual systematic evaluation of our patients.

  7. [Neurodevelopmental follow-up of premature children in Lausanne and Geneva].

    PubMed

    Bickle Graz, M; Cevey-Macherel, M; Forcada-Guex, M; Truttmann, A; Ha-Vinh Leuchter, R; Sizonenko, S; Huppi, P S; Borradori Tolsa, C

    2011-02-23

    Preterm children born before 32 weeks of gestation represent 1% of the annual births in Switzerland, and are the most at risk of neurodevelopmental disabilities. A neurological surveillance is thus implemented in the neonatal units, and multidisciplinary neurodevelopmental follow-up is offered to all our preterm patients. The follow-up clinics of the University hospitals in Lausanne and Geneva follow the Swiss guidelines for follow-up. An extended history and neurological examination is taken at each appointment, and a standardized test of development is performed. These examinations, which take place between the ages of 3 months and 9 years old, allow the early identification and treatment of developmental disorders frequent in this population, such as motor, cognitive or behavioral disorders, as well as the monitoring of the quality of neonatal care.

  8. Long-Term Follow-Up of a Revascularized Immature Necrotic Tooth Evaluated by CBCT

    PubMed Central

    She, C. M. L.; Cheung, G. S. P.; Zhang, C. F.

    2016-01-01

    This case study reports the successful treatment of an immature upper premolar with periapical pathosis and sinus tract using revascularization technique. Clinical and radiographic examination demonstrated the recovery of vitality, continued root development, and periapical healing at the 7-month follow-up. In addition, severe calcification of the canal was noted at the 36-month follow-up. At the 66-month follow-up, cone-beam computed tomography (CBCT) revealed complete periapical healing, apical closure, increase in root length and thickness of dentin, and severe calcification of the root canal. Even though the nature of tissue within the root canal is unknown, revascularization appears to give good clinical and radiographic success. This case report highlights that severe calcification of the canal is one of the long-term outcomes of revascularized root canals. PMID:26949550

  9. A multidisciplinary follow-up clinic after patients' discharge from ITU.

    PubMed

    Crocker, Cheryl

    Follow-up clinics following discharge from intensive care are not a new phenomenon - Whiston Hospital in Liverpool has been running a clinic since 1990. Its pioneering work has set a precedent and has inspired Nottingham City Hospital to set up its own clinic. The Department of Health (2000) recommended that all NHS trusts 'review the provision of follow-up services and ensure there is appropriate provision for those patients who will benefit'. Nottingham City Hospital set up a multidisciplinary follow-up clinic without funding, with great success, over a year ago. This service has been extremely valuable to patients and their carers and has helped staff understand the needs of patients once they have left intensive care. This article will describe the clinic's work and case studies are utilized in order to illustrate key points.

  10. Reactive attachment disorder in maltreated twins follow-up: from 18 months to 8 years.

    PubMed

    Heller, Sherryl Scott; Boris, Neil W; Fuselier, Sarah-Hinshaw; Page, Timothy; Koren-Karie, Nina; Miron, Devi

    2006-03-01

    The best means for the diagnosis and treatment of reactive attachment disorder of infancy and early childhood have not been established. Though some longitudinal data on institutionalized children is available, reports of maltreated young children who are followed over time and assessed with measures of attachment are lacking. This paper presents the clinical course of a set of maltreated fraternal twins who were assessed and treated from 19 months to 30 months of age and then seen in follow-up at 3 and 8 years of age. A summary of the early assessment and course is provided and findings from follow-up assessments of the cognitive, behavioral, and interpersonal functioning of each child is analysed. Follow-up measures, chosen to capture social-cognitive processing of these children from an attachment perspective, are highlighted. Finally, findings from the case are discussed from nosological and theoretical perspectives.

  11. [Testicular cancer: a model to optimize the radiological follow-up].

    PubMed

    Stebler, V; Pauchard, B; Schmidt, S; Valerio, M; De Bari, B; Berthold, D

    2015-05-20

    Despite being rare cancers, testicular seminoma and non-seminoma play an important role in oncology: they represent a model on how to optimize radiological follow-up, aiming at a lowest possible radiation exposure and secondary cancer risk. Males diagnosed with testicular cancer undergo frequently prolonged follow-up with CT-scans with potential toxic side effects, in particular secondary cancers. To reduce the risks linked to ionizing radiation, precise follow-up protocols have been developed. The number of recommended CT-scanners has been significantly reduced over the last 10 years. The CT scanners have evolved technically and new acquisition protocols have the potential to reduce the radiation exposure further.

  12. Pi of the Sky preparations for LSC-Virgo's electromagnetic follow-up project

    NASA Astrophysics Data System (ADS)

    ZadroŻny, Adam; Sokołowski, Marcin; Majcher, Ariel; Opiela, Rafał; Obara, Łukasz

    2015-09-01

    The presentation focuses on plans of the Pi of the Sky collaboration to participate in the future LSC-Virgo's Electromagnetic (EM) Follow-up campaigns. Pi of the Sky telescope participated in the first "EM Follow-up project", called Looc-Up1-3 2009-2010 organized by LSC-Virgo collaboration. Pi of the Sky brought to the project an instrument with the biggest field of view and with a very high time resolution. Recently Pi of the Sky has signed an Memorandum of Understanding (MOU) with LSC-Virgo for EM Follow-up observations in the Advanced Detector Era (ADE). Plans of the Pi of the Sky telescope for joint observations with advanced LIGO and Virgo detectors will be also outlined.

  13. [Clinical and paraclinical follow-up after radiotherapy for head and neck cancer].

    PubMed

    Clément-Colmou, K; Troussier, I; Bardet, É; Lapeyre, M

    2015-10-01

    Head and neck cancer management often involves heavy multimodal treatments including radiotherapy. Despite the improvement of intensity-modulated radiation therapy, acute and late toxicities remain important. After such treatment, patients have to face different potential problems, depending on the post-therapeutic delay. In this way, short-term follow-up permits to appreciate the healing of acute toxicities and response to treatment. Long-term follow-up aims to recognize second primitive tumours and distant failure, and to detect and manage late toxicities. Medical and psychosocial supportive cares are essential, even after several years of complete remission. The objective of this article is to review the modalities of short-term and long-term follow-up of patients who receive a radiotherapy for head and neck cancer.

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

    PubMed Central

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

    2009-01-01

    This is the first prospective study to investigate psychosocial adjustment in male and female former child soldiers (n=156, 12% female). The study began in Sierra Leone in 2002 and was designed to examine both risk and protective factors in psychosocial adjustment. Over the two-year period of follow up, youth who had wounded or killed others during the war demonstrated increases in hostility. Youth who survived rape had higher levels of anxiety and hostility, but also demonstrated greater confidence and prosocial attitudes at follow up. Of the potential protective resources examined, improved community acceptance was associated with reduced depression at follow up and improved confidence and prosocial attitudes regardless of levels of violence exposure. Retention in school was also associated with greater prosocial attitudes. PMID:20636683

  15. Influence of body mass index on the choice of therapy for depression and follow-up care

    PubMed Central

    Boudreau, Denise M.; Arterburn, David; Bogart, Andy; Haneuse, Sebastien; Theis, Mary Kay; Westbrook, Emily; Simon, Greg

    2012-01-01

    Overweight and obese patients commonly suffer from depression and choice of depression therapy may alter weight. We conducted a cohort study to investigate whether obesity is associated with treatment choices for depression; and whether obesity is associated with appropriate duration of depression treatment and receipt of follow-up visits. Adults with a diagnosis of depression between January 1, 2006 and March 31, 2010 who had 1+ new episodes of an antidepressant medication and/or psychotherapy were eligible. Medication use, encounters, diagnoses, height, and weight were collected from health plan databases. We modeled receipt of the different therapies (medication and psychotherapy) by BMI and BMI trajectory during the 9-months prior to initiation of therapy using logistic regression models that accommodated correlation within provider and adjusted for covariates. We modeled BMI via a restricted cubic spline. Fluoxetine was the reference treatment option in the medication models. Lower BMI was associated with greater use of mirtazapine, and a declining BMI prior to treatment was associated with greater odds of initiating mirtazapine and paroxetine. Higher BMI was associated with greater odds of initiating bupropion even after adjustment for smoking status. Obese patients were less likely to receive psychotherapy and less likely to receive appropriate duration (180-days) of depression treatment compared to normal weight subjects. Our study provides evidence that BMI is considered when choosing therapy but associations were weak. Our results should prompt discussion about recommending and choosing depression treatment plans that optimize depression care and weight management concurrently. Differences in care and follow-up by BMI warrant additional research. PMID:23404891

  16. Refractive, Topographic, and Aberrometric Results at 2-Year Follow-Up for Accelerated Corneal Cross-Link for Progressive Keratoconus

    PubMed Central

    Bozkurt, Ercüment; Akcay, Betul Ilkay Sezgin; Kurt, Tugba; Yildirim, Yusuf; Günaydin, Zehra Karaagaç; Demirok, Ahmet

    2017-01-01

    Purpose. To report the visual, refractive, and corneal topography and wavefront aberration results of accelerated corneal cross-linking (CXL) during a 24-month follow-up. Methods. Forty-seven eyes underwent riboflavin-ultraviolet A-induced accelerated CXL treatment (30 mW/cm2 with a total dose of 7.2 joules/cm2). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical and cylindrical values, keratometry (K) measurements (Ksteep, Kflat, Kavg, and Kapex), central corneal thickness, and anterior corneal aberrometric analyses including total wavefront error (WFE), total high order aberration (HOA), astigmatism, trefoil, coma, quadrafoil, secondary astigmatism, and spherical aberration were evaluated. Results. The mean UDVA and CDVA were significantly improved at 1 (p = 0.003 and p = 0.004, resp.) and 2 years after treatment (p = 0.001 and p = 0.001, resp.). The mean Ksteep, Kflat, Kaverage, and Kapex values were significantly lower than baseline at 12 months (p = 0.008, p = 0.024, p = 0.001, and p = 0.014, resp.) and 24 months (p = 0.014, p = 0.017, p = 0.001, and p = 0.012, resp.). Corneal thickness showed a significant decrease at 1 month. Total HOA and coma decreased significantly at the 12-month (p = 0.001 and p = 0.009, resp.) and 24-month visits (p = 0.001 and p = 0.007, resp.). Conclusion. Accelerated CXL (30 mW/cm2) was found to be effective in improving UDVA, CDVA, corneal topography readings, total HOA, and coma aberrations during the 24-month follow-up. PMID:28197339

  17. A predictive scoring instrument for tuberculosis lost to follow-up outcome

    PubMed Central

    2012-01-01

    Background Adherence to tuberculosis (TB) treatment is troublesome, due to long therapy duration, quick therapeutic response which allows the patient to disregard about the rest of their treatment and the lack of motivation on behalf of the patient for improved. The objective of this study was to develop and validate a scoring system to predict the probability of lost to follow-up outcome in TB patients as a way to identify patients suitable for directly observed treatments (DOT) and other interventions to improve adherence. Methods Two prospective cohorts, were used to develop and validate a logistic regression model. A scoring system was constructed, based on the coefficients of factors associated with a lost to follow-up outcome. The probability of lost to follow-up outcome associated with each score was calculated. Predictions in both cohorts were tested using receiver operating characteristic curves (ROC). Results The best model to predict lost to follow-up outcome included the following characteristics: immigration (1 point value), living alone (1 point) or in an institution (2 points), previous anti-TB treatment (2 points), poor patient understanding (2 points), intravenous drugs use (IDU) (4 points) or unknown IDU status (1 point). Scores of 0, 1, 2, 3, 4 and 5 points were associated with a lost to follow-up probability of 2,2% 5,4% 9,9%, 16,4%, 15%, and 28%, respectively. The ROC curve for the validation group demonstrated a good fit (AUC: 0,67 [95% CI; 0,65-0,70]). Conclusion This model has a good capacity to predict a lost to follow-up outcome. Its use could help TB Programs to determine which patients are good candidates for DOT and other strategies to improve TB treatment adherence. PMID:22938040

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

    PubMed

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

    2010-12-01

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

  19. Association of black race with follow-up of an abnormal prostate-specific antigen test.

    PubMed

    Turner, Barbara J; Mavandadi, Shahrzad; Weiner, Mark G

    2011-02-01

    Delayed evaluation after a clearly abnormal prostate-specific antigen (PSA) result may contribute to more advanced prostate cancer at diagnosis in black men. In 46 primary care practices over a period of 4.5 years, we studied men aged more than 50 years without known prostate cancer who had a PSA of at least 10.0 ng/mL for the first time. PSA follow-up included: a urology appointment, a new prostate diagnosis, or repeat PSA test. Cox proportional hazards models assessed time to follow-up, adjusting for demographic, clinical, and health care factors with censoring at a time that represents excessive delay (200 days). Among all 724 study men (27% black), delay until PSA follow-up averaged 115.2 days (+/- 79.7 d) and the unadjusted hazard ratio (HR) for follow-up was shorter for black men than nonblack men (HR, 1.23; 95% CI, 1.00-1.51). However, black men were more likely to have had prior urology care and had higher index PSA levels than other men; both factors were associated with shorter follow-up. After adjustment, delay did not differ for black vs nonblack race (HR, 1.05; 95% Cl, 0.78-1.43) but men aged at least 75 years had a longer delay than men aged 74 years or less (HR, 0.72; 95% CI, 0.59-0.89). Despite black men having greater risk of advanced prostate disease at diagnosis and better linkage to urologic care, follow-up was delayed, on average, by more than 3 months and did not differ by race. These results reveal a potentially important, remediable factor to improve prostate cancer prevention and care for black men.

  20. Follow-up Actions on Electronic Referral Communicationin a Multispecialty Outpatient Setting

    PubMed Central

    Esquivel, Adol; Sittig, Dean F.; Murphy, Daniel; Kadiyala, Himabindu; Schiesser, Rachel; Espadas, Donna; Petersen, Laura A.

    2010-01-01

    ABSTRACT OBJECTIVES Electronic health records (EHR) enable transmission and tracking of referrals between primary-care practitioners (PCPs) and subspecialists. We used an EHR to examine follow-up actions on electronic referral communication in a large multispecialty VA facility. METHODS We retrieved outpatient referrals to five subspecialties between October 2006 and December 2007, and queried the EHR to determine their status: completed, discontinued (returned to PCP), or unresolved (no action taken by subspecialist). All unresolved referrals, and random samples of discontinued and completed referrals were reviewed to determine whether subspecialists took follow-up actions (i.e., schedule appointments anytime in the future) within 30 days of referral-receipt. For referrals without timely follow-up, we determined whether inaction was supported by any predetermined justifiable reasons or associated with certain referral characteristics. We also reviewed if PCPs took the required action on returned information. RESULTS Of 61,931 referrals, 22,535 were discontinued (36.4%), and 474 were unresolved (0.8%). We selected 412 discontinued referrals randomly for review. Of these, 52% lacked follow-up actions within 30 days. Appropriate justifications for inaction were documented in 69.8% (150/215) of those without action and included lack of prerequisite testing by the PCP and subspecialist opinion that no intervention was required despite referral. We estimated that at 30 days, 6.3% of all referrals were associated with an unexplained lack of follow-up actions by subspecialists. Conversely, 7.4% of discontinued referrals returned to PCPs were associated with an unexplained lack of follow-up. CONCLUSIONS Although the EHR facilitates transmission of valuable information at the PCP-subspecialist interface, unexplained communication breakdowns in the referral process persist in a subset of cases. PMID:20848235