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Sample records for 12-month follow-up visits

  1. 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

  2. 12-Month Follow-Up of Fluoxetine and Cognitive Behavioral Therapy for Binge Eating Disorder

    ERIC Educational Resources Information Center

    Grilo, Carlos M.; Crosby, Ross D.; Wilson, G. Terence; Masheb, Robin M.

    2012-01-01

    Objective: The longer term efficacy of medication treatments for binge-eating disorder (BED) remains unknown. This study examined the longer term effects of fluoxetine and cognitive behavioral therapy (CBT) either with fluoxetine (CBT + fluoxetine) or with placebo (CBT + placebo) for BED through 12-month follow-up after completing treatments.…

  3. Mindfulness meditation and cognitive behavioral therapy for insomnia: a naturalistic 12-month follow-up.

    PubMed

    Ong, Jason C; Shapiro, Shauna L; Manber, Rachel

    2009-01-01

    A unique intervention combining mindfulness meditation with cognitive behavioral therapy for insomnia (CBT-I) has been shown to have acute benefits at posttreatment in an open label study. The aim of the present study was to examine the long-term effects of this integrated intervention on measures of sleep and sleep-related distress in an attempt to characterize the natural course of insomnia following this treatment and to identify predictors of poor long-term outcome. Analyses were conducted on 21 participants, who provided follow-up data at six and 12 months posttreatment. At each time point, participants completed one week of sleep and meditation diaries and questionnaires related to mindfulness, sleep, and sleep-related distress, including the Pre-Sleep Arousal Scale, the Glasgow Sleep Effort Scale, the Kentucky Inventory of Mindfulness Skills, and the Insomnia Episode Questionnaire. Analyses examining the pattern of change across time (baseline, end of treatment, six months, and 12 months) revealed that several sleep-related benefits were maintained during the 12-month follow-up period. Participants who reported at least one insomnia episode (>or=1 month) during the follow-up period had higher scores on the Pre-Sleep Arousal Scale (P < .05) and the Glasgow Sleep Effort Scale (P < .05) at end of treatment compared with those with no insomnia episodes. Correlations between mindfulness skills and insomnia symptoms revealed significant negative correlations (P < .05) between mindfulness skills and daytime sleepiness at each of the three time points but not with nocturnal symptoms of insomnia. These results suggest that most sleep-related benefits of an intervention combining CBT-I and mindfulness meditation were maintained during the 12-month follow-up period, with indications that higher presleep arousal and sleep effort at end of treatment constitute a risk for occurrence of insomnia during the 12 months following treatment.

  4. Day Hospital Treatment for Anorexia Nervosa: A 12-Month Follow-up Study.

    PubMed

    Abbate-Daga, Giovanni; Marzola, Enrica; De-Bacco, Carlotta; Buzzichelli, Sara; Brustolin, Annalisa; Campisi, Stefania; Amianto, Federico; Migliaretti, Giuseppe; Fassino, Secondo

    2015-09-01

    Day hospitals (DHs) represent a treatment option for anorexia nervosa (AN), a mental disorder that is difficult to treat and has no evidence-based treatments available. We aimed to determine the effectiveness of a DH treatment that was specifically focused on the emotions of severe AN patients. Body mass index and eating psychopathology were the primary outcome measures. Fifty-six adult patients with AN were assessed upon admission, at the end of treatment (EOT) and at a 12-month follow-up evaluation (T18) using Eating Disorders Inventory-2, Beck Depression Inventory, Hamilton Rating Scale for Anxiety and Brief Social Phobia Scale. All participants received a multidisciplinary treatment programme that focused on psychodynamic psychotherapy. Seventy-eight per cent of participants reported positive outcomes at EOT and 68% at T18. Moreover, 82.1% and 65.4% of long-standing patients showed positive outcomes at EOT and T18, respectively. All measures of psychopathology were significantly improved at EOT and were maintained at follow-up. Our DH was effective at treating severe AN patients; however, further investigations of the processes of change are warranted.

  5. 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

  6. Postpartum Varicose Veins: Supplementation with Pycnogenol or Elastic Compression-A 12-Month Follow-Up.

    PubMed

    Belcaro, Gianni; Dugall, Mark; Luzzi, Roberta; Ippolito, Edmondo; Cesarone, M Rosaria

    2017-03-01

    This open registry aimed to evaluate the clinical evolution of postpartum varicose veins (VVs), in healthy women after the second pregnancy, how these veins regain shape and competence, and possible treatments. The registry included two groups of women: (1) those who used elastic compression stockings, and (2) who used an oral venotonic agent (Pycnogenol, 100 mg/d). A total of 12 evaluation targets were established. Minor symptoms were scored in an analogue scale line. A visual analogue scale line evaluated the overall satisfaction relative to elastic compression or Pycnogenol. Overall 133 women completed the registry evaluation with at least 3 months of follow-up. The resulting two registry groups were comparable. At 3 and 6 months in the Pycnogenol group the number of veins and incompetent sites were lower. At 6 months there were 13.3% of patients with edema in controls versus 3.2% in the Pycnogenol group. Spider veins decreased in Pycnogenol patients. Cramps and other minor symptoms were less common in the Pycnogenol group. In both groups there was a significant improvement at 6 months with better results in the Pycnogenol group. The need for treatment was limited with a decreased need for sclerotherapy, surgery, and conservative treatments in the Pycnogenol group. The overall satisfaction was higher among Pycnogenol patients, and compliance was optimal. Re-evaluation at 12 months indicated that the variations in VVs and spider vein clusters and the associated symptoms did not change. Most remodeling appeared to happen within 6 months after the pregnancy. It was concluded that the use of Pycnogenol improves signs/symptoms of postpartum VVs, and venous function and shape seem to return faster to prepartum, physiological pattern with its use.

  7. Physical outcomes of patients with burn injuries--a 12 month follow-up.

    PubMed

    Jarrett, Mark; McMahon, Margaret; Stiller, Kathy

    2008-01-01

    There is only limited research documenting functional ability, physical fitness, and health related quality of life after burn injury. The objective of this study was to measure a comprehensive range of physiotherapy-related outcomes over a 12-month period for patients with significant burn injuries. A prospective study was performed on consecutive patients admitted to the Royal Adelaide Hospital over a 12-month period. Outcomes were measured at admission and discharge from hospital and at 1, 3, 6, and 12 months, and comprised the: Medical Outcomes Study 36-Item Short Form Health Survey, Quick Disabilities of the Arm, Shoulder and Hand questionnaire, Lower Extremity Functional Scale questionnaire, shuttle walk test, grip strength and scar appearance using the Matching Assessment with Photographs of Scars. A total of 86 patients (74 male, mean age 38 years) participated. There was a significant deterioration in all outcomes in the first few months after burn injury, with most outcomes improving towards baseline levels by 6 months. However, lower limb function (Lower Extremity Functional Scale) remained significantly reduced at 12 months and functional exercise capacity (shuttle walk test) was still markedly reduced at 6 months compared with predicted normal values. The total burn surface area significantly affected many of the outcomes. In conclusion, for this sample of patients after burn injury, there was an acceptable rate of recovery for physiotherapy-related outcomes, in that most measures had returned to near baseline levels by 6 months postinjury, with the exception of lower limb function and functional exercise capacity.

  8. Post-thoracotomy pain syndrome and sensory disturbances following thoracotomy at 6- and 12-month follow-ups

    PubMed Central

    Hetmann, Fredrik; Kongsgaard, Ulf E; Sandvik, Leiv; Schou-Bredal, Inger

    2017-01-01

    Background Persistent pain affects a large proportion of patients after thoracotomy and is associated with sensory disturbances. The objective of this prospective study was to investigate the time course of pain and sensory disturbances over a 12-month period. Methods Patients scheduled for thoracotomy were recruited. Data were collected on the day before surgery, including baseline characteristics and the presence of any preoperative pain. At 6- and 12-month follow-ups, data on pain were collected using the Brief Pain Inventory-Short Form, and perceived sensory disturbances around the thoracotomy scar were recorded from a self-exploration test. Results At 12 months after surgery, 97 patients had complete data including baseline and 6-and 12-month measurements. Almost half of the patients reported post-thoracotomy pain at the follow-ups. However, 20% of the patients not reporting post-thoracotomy pain at 6 months did report it at 12 months. Between 40% and 60% of patients experienced some kind of sensory disturbance at 6 months. A small decline in some kind of sensory disturbance was reported by 20%–50% of patients at 12 months. Conclusion A proportion of patients experienced either resolved or delayed onset of pain. Sensory changes were strongly associated with post-thoracotomy pain syndrome, but were also present in a large proportion of patients without it. PMID:28356766

  9. The First Year Inventory: A Longitudinal Follow-Up of 12-Month-Old to 3-Year-Old Children

    ERIC Educational Resources Information Center

    Turner-Brown, Lauren M.; Baranek, Grace T.; Reznick, J Steven; Watson, Linda R.; Crais, Elizabeth R.

    2013-01-01

    The First Year Inventory is a parent-report measure designed to identify 12-month-old infants at risk for autism spectrum disorder. First Year Inventory taps behaviors that indicate risk in the developmental domains of sensory--regulatory and social--communication functioning. This longitudinal study is a follow-up of 699 children at 3 years of…

  10. A 12-Month Follow-Up of Homogeneous and Heterogeneous Anxiety Management Training.

    ERIC Educational Resources Information Center

    Deffenbacher, Jerry L.; Michaels, Ann C.

    1981-01-01

    A follow-up study found that both homogeneous and heterogeneous anxiety management training (AMT) led to continued reports of significantly less debilitating test or speech anxiety than the controls. The combined AMT group reported significantly less nontargeted anxiety than the combined control group on one of two nontargeted anxiety measures.…

  11. Beneficial effects of multisensory and cognitive stimulation in institutionalized elderly: 12-months follow-up.

    PubMed

    de Macedo, Liliane Dias E Dias; De Oliveira, Thaís Cristina Galdino; Soares, Fernanda Cabral; Bento-Torres, João; Bento-Torres, Natáli Valim Oliver; Anthony, Daniel Clive; Picanço-Diniz, Cristovam Wanderley

    2015-01-01

    We previously demonstrated the beneficial effects of a multisensory and cognitive stimulation program, consisting of 48 sessions, twice a week, to improve the cognition of elderly subjects living either in long-term care institutions (institutionalized - I) or in communities with their families (noninstitutionalized - NI). In the present study, we evaluated these subjects after the end of the intervention and compared the rate of age-related cognitive decline of those living in an enriched community environment (NI group, n=15, 74.1±3.9 years old) with those living in the impoverished environment of long-term care institutions (I group, n=20, 75.1±6.8 years old). Both groups participated fully in our stimulation program. Over 1 year, we conducted revaluations at five time points (2 months, 4 months, 6 months, 8 months, and 12 months) after the completion of the intervention. Both elderly groups were evaluated with the mini-mental state examination and selected language tests. Progressive cognitive decline was observed in both groups over the period. Indeed, it took only 4-6 months after the end of the stimulation program for significant reductions in language test scores to become apparent. However, earlier reductions in test scores were mainly associated with I group, and linguistic prosody test scores were significantly affected by institutionalization and time, two variables that interacted and reduced these scores. Moreover, I group reduced the Montréal cognitive assessment battery language tests scores 4 months before NI group. It remains to be investigated what mechanisms may explain the earlier and more intense language losses in institutionalized elderly.

  12. Beneficial effects of multisensory and cognitive stimulation in institutionalized elderly: 12-months follow-up

    PubMed Central

    Dias E Dias de Macedo, Liliane; De Oliveira, Thaís Cristina Galdino; Soares, Fernanda Cabral; Bento-Torres, João; Bento-Torres, Natáli Valim Oliver; Anthony, Daniel Clive; Picanço-Diniz, Cristovam Wanderley

    2015-01-01

    We previously demonstrated the beneficial effects of a multisensory and cognitive stimulation program, consisting of 48 sessions, twice a week, to improve the cognition of elderly subjects living either in long-term care institutions (institutionalized – I) or in communities with their families (noninstitutionalized – NI). In the present study, we evaluated these subjects after the end of the intervention and compared the rate of age-related cognitive decline of those living in an enriched community environment (NI group, n=15, 74.1±3.9 years old) with those living in the impoverished environment of long-term care institutions (I group, n=20, 75.1±6.8 years old). Both groups participated fully in our stimulation program. Over 1 year, we conducted revaluations at five time points (2 months, 4 months, 6 months, 8 months, and 12 months) after the completion of the intervention. Both elderly groups were evaluated with the mini-mental state examination and selected language tests. Progressive cognitive decline was observed in both groups over the period. Indeed, it took only 4–6 months after the end of the stimulation program for significant reductions in language test scores to become apparent. However, earlier reductions in test scores were mainly associated with I group, and linguistic prosody test scores were significantly affected by institutionalization and time, two variables that interacted and reduced these scores. Moreover, I group reduced the Montréal cognitive assessment battery language tests scores 4 months before NI group. It remains to be investigated what mechanisms may explain the earlier and more intense language losses in institutionalized elderly. PMID:26316730

  13. Miniscalpel-Needle versus Steroid Injection for Plantar Fasciitis: A Randomized Controlled Trial with a 12-Month Follow-Up

    PubMed Central

    Li, Shuming; Shen, Tong; Liang, Yongshan; Zhang, Ying; Bai, Bo

    2014-01-01

    Plantar fasciitis is the most common cause of heel pain in adults. A novel alternative medical instrument, the miniscalpel-needle (MSN), which is based on an acupuncture needle, has been recently developed in China. The objective of this study was to evaluate the effectiveness of the MSN release treatment versus that of traditional steroid injection for plantar fasciitis. Patients with plantar fasciitis were randomly assigned to 2 groups and followed up for 12 months, with 29 receiving MSN treatment and 25 receiving steroid injection treatment. The results showed that visual analog scale scores for morning pain, active pain, and overall heel pain all were decreased significantly in the MSN group from 1 to 12 months after treatment. In contrast, treatment with steroid injection showed a significant effect only at the 1-month follow-up but not at 6 or 12 months after treatment. Moreover, the MSN group achieved more rapid and sustained improvements than the steroid group throughout the duration of this study. No severe side effects were observed with MSN treatment. Our data suggest that the MSN release treatment is safe and has a significant benefit for plantar fasciitis compared to steroid injection. PMID:25114704

  14. Effects of Miniscalpel-Needle Release on Chronic Neck Pain: A Retrospective Analysis with 12-Month Follow-Up

    PubMed Central

    Li, Shuming; Shen, Tong; Liang, Yongshan; Zhang, Ying; Bai, Bo

    2015-01-01

    Objective Chronic neck pain is a highly prevalent condition, and is often treated with non-steroidal anti-inflammatory drugs. Limited clinical studies with short-term follow-up have shown promising efficacy of acupuncture as well as miniscalpel-needle (MSN) release. In this retrospective study, we examined whether MSN release could produce long-lasting relief in patients with chronic neck pain. Methods We retrieved the medical records of all patients receiving weekly MSN release treatment for chronic neck pain at this institution during a period from May 2012 to December 2013. Only cases with the following information at prior to, and 1, 6, and 12 months after the treatment, were included in the analysis: neck disability index (NDI), numerical pain rating scale (NPRS), and active cervical range of motion (CROM). The primary analysis of interest is comparison of the 12-month measures with the baseline. Patients who took analgesic drugs or massage within 2 weeks prior to assessment were excluded from the analysis. For MSN release, tender points were identified manually by an experienced physician, and did not necessarily follow the traditional acupuncture system. MSN was inserted vertically (parallel to the spine) until breaking through resistance and patient reporting of distention, soreness or heaviness. The depth of the needling ranged from 10 to 50 mm. The release was carried out by moving the MSN up and down 3–5 times without rotation. Results A total of 559 cases (patients receiving weekly MSN release treatment for chronic neck pain) were screened. The number of cases with complete information (NDI, NPRS, and CROM at baseline, 1, 6 and 12 months after last treatment) was 180. After excluding the cases with analgesic treatment or massage within 2 weeks of assessment (n = 53), a total of 127 cases were included in data analysis. The number of MSN release session was 7 (range: 4–11). At 12 months after the treatment, both NPRS and NDI were significantly lower

  15. Do patients with bipolar disorder and subsyndromal symptoms benefit from functional remediation? A 12-month follow-up study.

    PubMed

    Sanchez-Moreno, Jose; Bonnín, Caterina; González-Pinto, Ana; Amann, Benedikt L; Solé, Brisa; Balanzá-Martínez, Vicent; Arango, Celso; Jimenez, Esther; Tabarés-Seisdedos, Rafael; Garcia-Portilla, M Paz; Ibáñez, Angela; Crespo, Jose Manuel; Ayuso-Mateos, Jose Luis; Vieta, Eduard; Martinez-Aran, Anabel; Torrent, Carla

    2017-01-23

    We analyzed the efficacy of functional remediation, in a sample of patients with bipolar disorder who presented with subsyndromal symptoms. From a total sample of 239 patients with bipolar I and II disorder, according to DSM-IV-TR diagnostic criteria, entering a randomized clinical trial, those patients who presented with subsyndromal symptoms were selected based on a method already described by Berk and colleagues was applied. It consists of using the Clinical Global Impression-Bipolar version (CGI-BP) to establish the scores of the Hamilton Depression Rating Scale (HAM-D) and of the Young Mania Rating Scale (YMRS) that correspond with 1 in the CGI-BP. Functional outcome and mood symptoms were assessed at 6 and at 12-month follow-up. A total of 99 patients were selected for this post-hoc analysis, allocated as follows: functional remediation (n=33); psychoeducation (n=37) and treatment as usual (TAU,n=29). The repeated-measures analyses at 12-month follow-up revealed a significant group x time interaction in favour of the patients who received functional remediation when compared to psychoeducation and TAU (F=2.93; p=0.02) at improving psychosocial functioning. Finally, mood symptoms did not significantly change in any of the three groups at any time of follow-up, as shown by the non-significant group x time interaction effect in HAM-D scores (F=1.57; p=0.18) and YMRS scores (F=1.51; p=0.20). Bipolar patients with subsyndromal symptoms improve their functional outcome when exposed to functional remediation regardless of the persistence of mood symptomatology.

  16. Postoperative stability for surgery-first approach using intraoral vertical ramus osteotomy: 12 month follow-up.

    PubMed

    Kim, Jun-Young; Jung, Hwi-Dong; Kim, Sang Yoon; Park, Hyung-Sik; Jung, Young-Soo

    2014-07-01

    The aim of this study was to evaluate the postoperative stability of the surgery-first approach using intraoral vertical ramus osteotomy (IVRO). We retrospectively studied a sample derived from the patients who were treated by the surgery-first approach using a LeFort I osteotomy and IVRO for correction of class III dentofacial deformity from 2008 to 2012. Lateral cephalograms taken preoperatively and 2 days, 6 months, and 12 months postoperatively were traced, and the skeletal and dental variables at different time points were analysed. The study sample comprised 37 subjects, mean (SD) age 23 (4) years. The mean (SD) total duration of treatment including postoperative orthodontics was 14 (6) months, and surgical movement of the maxillary A point was 0.75 (1.3)mm anteriorly, and 0.21 (1.79)mm superiorly. The surgical change in the position of the maxillary first molar was 1.01 (1.57)mm superiorly. The mean (SD) movement of mandible was 11.15 (5.4)mm posteriorly at pogonion and 1.02 (1.79)mm inferiorly at menton. There were no significant change in maxillary skeletal variables during the first year postoperative period. The surgical relapse of mandible at pogonion was 0.63 (2.31) mm anteriorly (p=0.01), however, the relapse in superior direction at menton was 2.86 (1.39) mm with statistical significance (p=0.01). The total duration of orthodontic treatment with surgery-first was roughly 5 months shorter than conventional preoperative and postoperative orthodontic treatment. The surgery-first approach using IVRO is effective and predictable, and shortens the overall duration of treatment. Anterior relapse of the mandible was less than 1mm, and increased superior relapse can be compensated for with appropriate preoperative planning to provide a reliable outcome. This study was limited to 12 months' follow-up, and a long term follow-up study is indicated.

  17. The Primary Prevention of PTSD in Firefighters: Preliminary Results of an RCT with 12-Month Follow-Up

    PubMed Central

    Rees, Clare S.; Mazzucchelli, Trevor G.; Kane, Robert T.

    2016-01-01

    Aim To develop and evaluate an evidence-based and theory driven program for the primary prevention of Post-traumatic Stress Disorder (PTSD). Design A pre-intervention / post-intervention / follow up control group design with clustered random allocation of participants to groups was used. The “control” group received “Training as Usual” (TAU). Method Participants were 45 career recruits within the recruit school at the Department of Fire and Emergency Services (DFES) in Western Australia. The intervention group received a four-hour resilience training intervention (Mental Agility and Psychological Strength training) as part of their recruit training school curriculum. Data was collected at baseline and at 6- and 12-months post intervention. Results We found no evidence that the intervention was effective in the primary prevention of mental health issues, nor did we find any significant impact of MAPS training on social support or coping strategies. A significant difference across conditions in trauma knowledge is indicative of some impact of the MAPS program. Conclusion While the key hypotheses were not supported, this study is the first randomised control trial investigating the primary prevention of PTSD. Practical barriers around the implementation of this program, including constraints within the recruit school, may inform the design and implementation of similar programs in the future. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12615001362583 PMID:27382968

  18. Oral hygiene and gingival health in patients with fixed prosthodontic appliances--a 12-month follow-up.

    PubMed

    Ortolan, Sladana Milardović; Viskić, Josko; Stefancić, Sanja; Sitar, Ksenija Rener; Vojvodić, Denis; Mehulić, Ketij

    2012-03-01

    The aim of this study was to assess and observe the oral hygiene and gingival condition in patients before and after fixed prosthodontic therapy through a 12-month period in combination with oral hygiene instructions. It was also analysed how factors, such as type of fixed prosthodontic appliance, constructive material, the position of a fixed partial denture (FPD) in the mouth, age and gender influenced oral hygiene. The dental arches were divided into three segments each and teeth and gingiva were examined using the Plaque and Gingiva Index by Silness and Löe, and for the mineralized deposits assessment the Calculus Index by Green and Vermillion was employed. The preliminary examination was conducted before the prosthodontic therapy, and the reexaminations were carried out 14 days, 1, 6 and 12 months after crown and/or FPD placement. A total of 93 subjects from the original study group of 146 patients attended all clinical examinations, while the rest was excluded. The sample consisted of 60 women, 33 men at age between 21 and 95 (average 51.8). A total of 39 patients had single crowns (C), 50 FPDs and 5 C+FPD. The frequency of plaque found during the preliminary visit was higher than that found in the other periods (p < 0.001). Patients with C showed better oral hygiene levels than patients with FPDs or C+FPDs (p = 0.001). Our results revealed no significant difference in oral hygiene status among patients with FPDs made of different materials (p = 0.083). The worst hygiene levels were found in patients with fixed prosthodontic appliances in both jaws (p = 0.012). Younger patients showed better hygiene levels than the older ones (p = 0.002). Our research showed that appropriate educational and motivational measures can lead to improved oral hygiene, even after FPD placement. Presumably, the oral health in a group of adult patients can be kept acceptable by providing a prophylactic oral hygiene program.

  19. Controlled clinical trial addressing teeth whitening with hydrogen peroxide in adolescents: a 12-month follow-up

    PubMed Central

    Pinto, Marcelo Mendes; Gonçalves, Marcela Leticia Leal; da Mota, Ana Carolina Costa; Deana, Alessandro Melo; Olivan, Silvia Regina; Bortoletto, Carolina; de Godoy, Camila Haddad Leal; Vergilio, Katia Lumi Tanikawa; Altavista, Olga Maria; Motta, Lara J; Bussadori, Sandra Kalil

    2017-01-01

    OBJECTIVES: To evaluate the colorimetric change in incisors and canines of adolescents aged 12 to 20 years submitted to at-home whitening and to evaluate satisfaction, sensitivity and discomfort during the procedures through a questionnaire. METHOD: Thirty adolescents were randomly assigned to the following groups: 1) 6.0% hydrogen peroxide (White Class with calcium – FGM); 2) 7.5% hydrogen peroxide (White Class with calcium - FGM); 3) 10% hydrogen peroxide (Oral B 3D White – Oral-B); 4) Control group – placebo. Assessments were performed prior to treatment as well as at 7, 30, 180 and 360 days after treatment. Friedman’s ANOVA was used to analyze color. The Kruskal-Wallis test followed by Dunn’s post hoc test was used to compare the groups at the different evaluation times. Answers on the questionnaires were ranked, and non-parametrical tests were employed. The groups were compared in each period using the Kruskal-Wallis test followed by the Student-Newman-Keuls test. Categorical data were analyzed using Fisher's exact test, and the Wilcoxon test was used for the analysis of different periods. P-values were corrected using the Hyan-Holm step-down Bonferroni procedure. Clinicaltrials.gov: NCT01998386. RESULTS: Similar results were obtained one month after treatment with both tooth whitening gels and whitening strips. Patients were partially satisfied with the treatment after the first and second weeks and would recommend it. All products demonstrated color stability after 12 months of follow-up. CONCLUSIONS: The bleaching procedure was efficient, and the patients could perceive its result. Further investigations are needed to determine the effects of bleaching on young teeth. PMID:28355362

  20. Parental stress and child behavioral outcomes following substance abuse residential treatment. Follow-up at 6 and 12 months.

    PubMed

    Killeen, T; Brady, K T

    2000-07-01

    Residential treatment programs specifically designed for alcohol/drug-addicted women and their children have become a popular treatment modality across the United States. Outcome evaluation of these programs are beginning to show promising results. In this article, outcome data from a study of a residential substance abuse treatment program for women and young children in rural South Carolina will be presented. Data from 35 women and 23 children in the area of addiction severity, parenting and child emotional and behavioral development at 6 and 12 months following discharge from a substance abuse residential treatment program is examined. Results showed that women who completed treatment had better scores on addiction severity and parental stress, and their children had improved behavioral and emotional functioning at 6 and 12 months after discharge from the program. These results suggest that residential treatment has benefits for mothers and their children. This data adds to the growing body of evidence supporting intensive and inclusive care for certain groups of individuals with substance use disorders during critical periods.

  1. 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

  2. Parent-assessed quality of life among adolescents undergoing orthodontic treatment: a 12-month follow-up

    PubMed Central

    Abreu, Lucas Guimarães; Melgaço, Camilo Aquino; Abreu, Mauro Henrique Nogueira Guimaraes; Lages, Elizabeth Maria Bastos; Paiva, Saul Martins

    2015-01-01

    Objective: To assess parents' and caregivers' view of the first twelve months of adolescents' orthodontic treatment with fixed appliances and to assess the evaluative properties of the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ) in the orthodontic setting. Methods: Data from a sample of 96 parents and caregivers of adolescents undergoing orthodontic treatment with fixed appliances were collected by means of P-CPQ. Assessments were performed before banding and bracket bonding (T1) and 12 months after placement of fixed appliances (T2). Statistical analysis included Wilcoxon signed-rank test for the overall P-CPQ score and Bonferroni correction for P-CPQ subscales. The evaluative properties of the P-CPQ were assessed through responsiveness calculation and the minimally clinical important difference (MCID). Results: Among the 96 participants, 76 were mothers of patients, 16 were fathers, and four were other family members. Adolescents' mean age was 11.49 ± 0.50 years. Most families earned equal to or less than three times the Brazilian monthly minimum wage. There was significant improvement in the emotional and social well-being subscales (p < 0.001), which contributed to improve patient's overall quality of life (p< 0.001). Reductions in scores were associated with clinically meaningful moderate changes in the overall score as well as in the emotional and social well-being subscales. The MCID was 6.16 for the P-CPQ overall score. Conclusion: Parents and caregivers reported significant improvement in the quality of life of adolescents undergoing orthodontic treatment with fixed appliances. PMID:26560827

  3. Effects of Duchenne muscular dystrophy on muscle stiffness and response to electrically-induced muscle contraction: A 12-month follow-up.

    PubMed

    Lacourpaille, Lilian; Gross, Raphaël; Hug, François; Guével, Arnaud; Péréon, Yann; Magot, Armelle; Hogrel, Jean-Yves; Nordez, Antoine

    2017-03-01

    The present study aimed to assess the ability of muscle stiffness (shear modulus) and response to electrically-induced muscle contraction to detect changes in muscle properties over a 12-month period in children with Duchenne muscular dystrophy (DMD). Ten children with DMD and nine age-matched healthy male controls participated in two experimental sessions (T0 and T+12months) separated by 12.4 ± 0.9 months. Two contractions of the biceps brachii were electrically-induced during which an ultrasound probe was placed over the muscle. The resting shear modulus was measured using elastography from six muscles. Evoked maximal torque was increased at T+12months in controls (+11.2 ± 7.6%, P <0.001) but was not modified in children with DMD (P = 0.222). Electromechanical delay (+12.9 ± 11.3%, P <0.001) and its force transmission component (+10.1 ± 21.6%, P = 0.003) were significantly longer at T+12months than T0 for children with DMD. The results revealed an increase in muscle stiffness at T+12months in children with DMD for tibialis anterior (+75.1 ± 93.5%, P= 0.043), gastrocnemius medialis (+144.8 ± 180.6%, P= 0.050) and triceps brachii (+35.5 ± 32.2%, P= 0.005). This 12-month follow-up study demonstrates that electromechanical delay and elastography may help detect subtle muscle impairments in patients with DMD. These sensitive outcomes may improve the follow-up of innovative therapeutic interventions within the field of DMD.

  4. The effects of anti-depressants on depression symptom scores at 12 months follow-up in patients with cardiometabolic disease: Results from a large primary care cohort

    PubMed Central

    Jani, Bhautesh Dinesh; Purves, David; Barry, Sarah J. E.; McCowan, Colin; Cavanagh, Jonathan; Mair, Frances S.

    2015-01-01

    Background: Evidence on the long-term usefulness of anti-depressants in managing depression in cardiometabolic disease is limited. Aim: We examined the effects of anti-depressant prescribing on depressive symptoms at 12 months follow-up in patients with cardiometabolic disease and a positive depression screening result at baseline. Design and Setting: We retrospectively reviewed routine UK primary care data for patients with coronary heart disease, diabetes and previous stroke for the year 2008–2009. 35,537 patients with one of the three above diseases underwent depression screening using the Hospital Anxiety and Depression Scale (HADS-D). Of 7080 patients with a positive screening result (HADS-D ≥ 8), 3933 (55.5%) patients had a repeat HADS-D recorded at 12 months follow-up. Methods: We compared the change in HADS-D at follow-up and remission rate in those who were prescribed anti-depressants (n = 223) against those who were not (n = 3710). Results: The mean change in HADS-D from baseline, for the nonprescribed group was similar to the reduction observed in patients who were continuously prescribed (n = 93) with anti-depressants during follow-up. Patients who were prescribed intermittently (n = 72) or only one (n = 58) prescription during follow-up had a lower reduction in HADS-D compared to the nonprescribed group. There was no difference in remission rates between continuously prescribed and the nonprescribed group, but remission was lower in patients prescribed intermittently and single prescription. Conclusion: Improvement in depressive symptoms in patients with cardiometabolic disease at 12 months was not any better in patients prescribed with anti-depressants compared to the nonprescribed group. The role of anti-depressants in the management of depression in cardiometabolic disease merits further investigation. PMID:26286616

  5. Physical therapy plus general practitioners' care versus general practitioners' care alone for sciatica: a randomised clinical trial with a 12-month follow-up.

    PubMed

    Luijsterburg, Pim A J; Verhagen, Arianne P; Ostelo, Raymond W J G; van den Hoogen, Hans J M M; Peul, Wilco C; Avezaat, Cees J J; Koes, Bart W

    2008-04-01

    A randomised clinical trial in primary care with a 12-months follow-up period. About 135 patients with acute sciatica (recruited from May 2003 to November 2004) were randomised in two groups: (1) the intervention group received physical therapy (PT) added to the general practitioners' care, and (2) the control group with general practitioners' care only. To assess the effectiveness of PT additional to general practitioners' care compared to general practitioners' care alone, in patients with acute sciatica. There is a lack of knowledge concerning the effectiveness of PT in patients with sciatica. The primary outcome was patients' global perceived effect (GPE). Secondary outcomes were severity of leg and back pain, severity of disability, general health and absence from work. The outcomes were measured at 3, 6, 12 and 52 weeks after randomisation. At 3 months follow-up, 70% of the intervention group and 62% of the control group reported improvement (RR 1.1; 95% CI 0.9-1.5). At 12 months follow-up, 79% of the intervention group and 56% of the control group reported improvement (RR 1.4; 95% CI 1.1; 1.8). No significant differences regarding leg pain, functional status, fear of movement and health status were found at short-term or long-term follow-up. At 12 months follow-up, evidence was found that PT added to general practitioners' care is only more effective regarding GPE, and not more cost-effective in the treatment of patients with acute sciatica than general practitioners' care alone. There are indications that PT is especially effective regarding GPE in patients reporting severe disability at presentation.

  6. Bone Mass Outcomes in Patients With Osteoporosis Treated With Risedronate After Alendronate Failure: a 12-Month Follow-Up Study.

    PubMed

    Mendonça, Leonardo Teixeira; Pinheiro, Marcelo Medeiros; Szejnfeld, Vera Lúcia; Castro, Charlles Heldan de Moura

    Oral bisphosphonates are the drugs most frequently used for the treatment of osteoporosis. Clinicians usually switch between these drugs in clinical practice based on differences in efficacy. We aim to investigate the reasons associated with switching between oral bisphosphonates and to evaluate bone mass response and the incidence of fractures 12 mo after the exchange in a cohort of patients with osteoporosis seen at a tertiary hospital. Patients with osteoporosis who switched between oral bisphosphonates between January 2007 and December 2014 were included. Bone mass measured by dual-energy X-ray absorptiometry and the incidence of fracture were evaluated. A total of 112 patients (73.1 yr old on average, 95.5% women, 98% postmenopausal) were included. All patients were taking alendronate at the time of the switch to risedronate. In 91 patients (81.3%), the following reasons for the exchange of medication were identified: bone loss (59.8%), adverse events (11.6%), and recent fragility fracture (10.7%). One year after the switch, bone densitometry revealed bone loss in 51 patients (45.5%), bone mass maintenance in 34 (30.4%), and bone mass gain in 27 (24.1%). No new vertebral fracture was detected and no nonvertebral fracture was reported in 12 mo of follow-up. Bone mass outcomes (gain, loss, or maintenance) were not associated with the reason for switching between oral bisphosphonates. Similarly, none of the parameters evaluated could predict good densitometric response (gain or maintenance) in this scenario. Our findings suggest that the use of risedronate should not be recommended in the scenario of treatment failure or adverse events following the use of alendronate.

  7. Effect of vertebroplasty on pain relief, quality of life, and the incidence of new vertebral fractures: a 12-month randomized follow-up, controlled trial.

    PubMed

    Blasco, Jordi; Martinez-Ferrer, Angeles; Macho, Juan; San Roman, Luis; Pomés, Jaume; Carrasco, Josep; Monegal, Ana; Guañabens, Nuria; Peris, Pilar

    2012-05-01

    Uncertainty regarding the benefits of vertebroplasty (VP) for the treatment of acute osteoporotic vertebral fractures has recently arisen. A prospective, controlled, randomized single-center trial (ClinicalTrials.gov registration number NCT00994032) was designed to compare the effects of VP versus conservative treatment on the quality of life and pain in patients with painful osteoporotic vertebral fractures, new fractures and secondary adverse effects were also analyzed during a 12-month follow-up period. A total of 125 patients were randomly assigned to receive conservative treatment or VP. The primary end point was to compare the evolution of the quality of life (Quality of Life Questionnaire of the European Foundation for Osteoporosis [Qualeffo-41] and pain (Visual Analogue Scale [VAS]) during a 12 month follow-up. Secondary outcomes included comparison of analgesic consumption, clinical complications, and radiological vertebral fractures at the same time points. Both arms showed significant improvement in VAS scores at all time points, with greater improvement (p = 0.035) in the VP group at the 2-month follow-up. Significant improvement in Qualeffo total score was seen in the VP group throughout the study, whereas this was not seen in the conservative treatment arm until the 6-month follow-up. VP treatment was associated with a significantly increased incidence of vertebral fractures (odds ratio [OR], 2 · 78; 95% confidence interval [CI], 1.02-7.62, p = 0.0462). VP and conservative treatment are both associated with significant improvement in pain and quality of life in patients with painful osteoporotic vertebral fractures over a 1-year follow-up period. VP achieved faster pain relief with significant improvement in the pain score at the 2-month follow-up but was associated with a higher incidence in vertebral fractures.

  8. Reducing child conduct disordered behaviour and improving parent mental health in disadvantaged families: a 12-month follow-up and cost analysis of a parenting intervention.

    PubMed

    McGilloway, Sinead; NiMhaille, Grainne; Bywater, Tracey; Leckey, Yvonne; Kelly, Paul; Furlong, Mairead; Comiskey, Catherine; O'Neill, Donal; Donnelly, Michael

    2014-09-01

    The effectiveness of the Incredible Years Basic parent programme (IYBP) in reducing child conduct problems and improving parent competencies and mental health was examined in a 12-month follow-up. Pre- to post-intervention service use and related costs were also analysed. A total of 103 families and their children (aged 32-88 months), who previously participated in a randomised controlled trial of the IYBP, took part in a 12-month follow-up assessment. Child and parent behaviour and well-being were measured using psychometric and observational measures. An intention-to-treat analysis was carried out using a one-way repeated measures ANOVA. Pairwise comparisons were subsequently conducted to determine whether treatment outcomes were sustained 1 year post-baseline assessment. Results indicate that post-intervention improvements in child conduct problems, parenting behaviour and parental mental health were maintained. Service use and associated costs continued to decline. The results indicate that parent-focused interventions, implemented in the early years, can result in improvements in child and parent behaviour and well-being 12 months later. A reduced reliance on formal services is also indicated.

  9. Mid- and long-term effects of family constellation seminars in a general population sample: 8- and 12-month follow-up.

    PubMed

    Hunger, Christina; Weinhold, Jan; Bornhäuser, Annette; Link, Leoni; Schweitzer, Jochen

    2015-06-01

    In a previous randomized controlled trial (RCT), short-term efficacy of family constellation seminars (FCSs) in a general population sample was demonstrated. In this article, we examined mid- and long-term stability of these effects. Participants were 104 adults (M = 47 years; SD = 9; 84% female) who were part of the intervention group in the original RCT (3-day FCS; 64 active participants and 40 observing participants). FCSs were carried out according to manuals. It was predicted that FCSs would improve psychological functioning (Outcome Questionnaire OQ-45.2) at 8- and 12-month follow-up. Additionally, we assessed the effects of FCSs on psychological distress, motivational incongruence, individuals' experience in their personal social systems, and overall goal attainment. Participants yielded significant improvement in psychological functioning (d = 0.41 at 8-month follow-up, p = .000; d = 0.40 at 12-month follow-up, p = .000). Results were confirmed for psychological distress, motivational incongruence, the participants' experience in their personal social systems, and overall goal attainment. No adverse events were reported. This study provides first evidence for the mid- and long-term efficacy of FCSs in a nonclinical population. The implications of the findings are discussed.

  10. Long-term effects of a single course of nicotine treatment in acute ulcerative colitis: remission maintenance in a 12-month follow-up study.

    PubMed

    Guslandi, M

    1999-11-01

    Patients with mild to moderate active colitis who are treated with mesalazine plus transdermal nicotine reportedly suffer fewer relapses than patients treated with mesalazine plus oral prednisone. A long-term follow-up period was carried out to confirm this. Thirty patients with remission of distal colitis after therapy with the above treatment schedules were monitored for 12 months (Rachmilewitz' activity index plus endoscopy). Relapsed patients were retreated in a cross-over fashion. After 12 months recurrences were observed in 14 of 15 patients initially treated with steroids and in 7 of 15 subjects who were had received transdermal nicotine (P = 0.007, Fisher's test). A higher proportion of relapsed patients from the prednisone group, after successful retreatment with nicotine patches, remained in remission after 6 months (20%) than relapsed patients who switched to steroid treatment (57%). Our present results confirm the concept that nicotine-induced remission of ulcerative colitis lasts longer than that obtained by oral corticosteroids.

  11. The Impact of Screening, Brief Intervention and Referral for Treatment in Emergency Department Patients’ Alcohol Use: A 3-, 6- and 12-month Follow-up

    PubMed Central

    2010-01-01

    Aims: This study aims to determine the impact of Screening, Brief Intervention and Referral for Treatment (SBIRT) in reducing alcohol consumption in emergency department (ED) patients at 3, 6, and 12 months following exposure to the intervention. Methods: Patients drinking above the low-risk limits (at-risk to dependence), as defined by National Institute of Alcohol Abuse and Alcoholism (NIAAA), were recruited from 14 sites nationwide from April to August 2004. A quasi-experimental comparison group design included sequential recruitment of intervention and control patients at each site. Control patients received a written handout. The Intervention group received the handout and participated in a brief negotiated interview with direct referral for treatment if indicated. Follow-up surveys were conducted at 3, 6, and 12 months by telephone using an Interactive Voice Response (IVR) system. Results: Of the 1132 eligible patients consented and enrolled (581 control, 551 intervention), 699 (63%), 575 (52%) and 433 (38%) completed follow-up surveys via IVR at 3, 6, and 12 months, respectively. Regression analysis adjusting for the clustered sampling design and using multiple imputation procedures to account for subject attrition revealed that those receiving SBIRT reported roughly three drinks less per week than controls (B = −3.00, SE = 1.06, P < 0.05) and the level of maximum drinks per occasion was approximately three-fourths of a drink less than controls (B = -0.76, SE = 0.29, P < 0.05) at 3 months. At 6 and 12 months post-intervention, these effects had weakened considerably and were no longer statistically or substantively significant. Conclusion: SBIRT delivered by ED providers appears to have short-term effectiveness in reducing at-risk drinking, but multi-contact interventions or booster programs may be necessary to maintain long-term reductions in risky drinking. PMID:20876217

  12. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up.

    PubMed

    Rathleff, M S; Mølgaard, C M; Fredberg, U; Kaalund, S; Andersen, K B; Jensen, T T; Aaskov, S; Olesen, J L

    2015-06-01

    The aim of this study was to investigate the effectiveness of shoe inserts and plantar fascia-specific stretching vs shoe inserts and high-load strength training in patients with plantar fasciitis. Forty-eight patients with ultrasonography-verified plantar fasciitis were randomized to shoe inserts and daily plantar-specific stretching (the stretch group) or shoe inserts and high-load progressive strength training (the strength group) performed every second day. High-load strength training consisted of unilateral heel raises with a towel inserted under the toes. Primary outcome was the foot function index (FFI) at 3 months. Additional follow-ups were performed at 1, 6, and 12 months. At the primary endpoint, at 3 months, the strength group had a FFI that was 29 points lower [95% confidence interval (CI): 6-52, P = 0.016] compared with the stretch group. At 1, 6, and 12 months, there were no differences between groups (P > 0.34). At 12 months, the FFI was 22 points (95% CI: 9-36) in the strength group and 16 points (95% CI: 0-32) in the stretch group. There were no differences in any of the secondary outcomes. A simple progressive exercise protocol, performed every second day, resulted in superior self-reported outcome after 3 months compared with plantar-specific stretching. High-load strength training may aid in a quicker reduction in pain and improvements in function.

  13. Randomized study on the effect of single-implant versus two-implant retained overdentures on implant loss and muscle activity: a 12-month follow-up report.

    PubMed

    Alqutaibi, A Y; Kaddah, A F; Farouk, M

    2017-02-22

    The objective was to evaluate and compare single- and two-implant retained overdentures for the rehabilitation of the edentulous mandible. Fifty-six edentulous subjects were eligible for inclusion. Using a random sampling system, a single implant or two implants were placed in the mandible. After 3 months, locator attachments were connected to the implants and the denture delivered with the retentive components incorporated in the denture base. Implant failure and muscle activity were evaluated at the 3-, 6-, and 12-month follow-up examinations. The study sample comprised 56 patients (32 male, 24 female), with a mean age of 58.2 years. A total of 84 implants were placed (28 in the single-implant group and 56 in the two-implant group). All patients completed the 12 months of follow-up. No significant differences were found between subjects in the two groups with respect to implant failure. With regard to improvements in muscle activity, the two-implant group showed statistically significant but perhaps not clinically important differences. Single-implant mandibular overdentures may be suggested as an alternative treatment modality for the rehabilitation of edentulous patients who cannot afford the cost of a two-implant overdenture.

  14. Oral administration of a curcumin-phospholipid delivery system for the treatment of central serous chorioretinopathy: a 12-month follow-up study

    PubMed Central

    Mazzolani, Fabio; Togni, Stefano

    2013-01-01

    Background The therapeutic effects of Meriva®, a curcumin-phospholipid (lecithin) delivery system (formulated as Norflo® tablets), on visual acuity and retinal thickness in patients with acute and chronic central serous chorioretinopathy was previously investigated in a six-month open-label study. Methods In this follow-up study, visual acuity was again assessed by ophthalmologic evaluation and retinal thickness by optical coherence tomography (OCT). Norflo tablets were administered twice daily to patients with central serous chorioretinopathy. The study group consisted of 12 patients (total 18 eyes) who completed 12 months of follow-up. The primary endpoint was change in visual acuity before and after treatment with Norflo, and change in neuroretinal or retinal pigment epithelium detachment on OCT was the secondary endpoint. Results After 12 months of therapy, no eyes showed further reduction in visual acuity, 39% showed stabilization, and 61% showed statistically significant improvement (P = 0.0001 by Student’s t-test and P = 0.0005 by Wilcoxon signed rank test). Ninety-five percent of eyes showed a reduction in neuroretinal or retinal pigment epithelium detachment and 5% showed stabilization. The difference in retinal thickness after 12 months was statistically significant (P = 0.0001 by Student’s t-test and P = 0.0004 by Wilcoxon signed rank test). Conclusion These results, albeit preliminary, confirm our previous finding that this curcumin delivery system is effective in the management of central serous chorioretinopathy. When administered in a bioavailable formulation, curcumin is worth considering as a therapeutic agent for the management of inflammatory and degenerative eye conditions involving activation of retinal microglial cells. PMID:23723686

  15. 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

  16. Temperament and Behaviour of Infants Aged 4-12 Months on Admission to a Private Mother-Baby Unit and at 1- and 6-Month Follow-Up

    ERIC Educational Resources Information Center

    Fisher, Jane; Rowe, Heather; Feekery, Colin

    2004-01-01

    While infant behaviour is influenced by maternal care, infant crying and dysregulated sleep can reciprocally affect maternal mood. The temperament and behaviour of two 4-12-months-old infant cohorts admitted with their mothers to a residential parenting program were examined using behaviour charts and the Short Infant Temperament Questionnaire…

  17. In situ heart valve tissue engineering using a bioresorbable elastomeric implant - From material design to 12 months follow-up in sheep.

    PubMed

    Kluin, Jolanda; Talacua, Hanna; Smits, Anthal I P M; Emmert, Maximilian Y; Brugmans, Marieke C P; Fioretta, Emanuela S; Dijkman, Petra E; Söntjens, Serge H M; Duijvelshoff, Renée; Dekker, Sylvia; Janssen-van den Broek, Marloes W J T; Lintas, Valentina; Vink, Aryan; Hoerstrup, Simon P; Janssen, Henk M; Dankers, Patricia Y W; Baaijens, Frank P T; Bouten, Carlijn V C

    2017-05-01

    The creation of a living heart valve is a much-wanted alternative for current valve prostheses that suffer from limited durability and thromboembolic complications. Current strategies to create such valves, however, require the use of cells for in vitro culture, or decellularized human- or animal-derived donor tissue for in situ engineering. Here, we propose and demonstrate proof-of-concept of in situ heart valve tissue engineering using a synthetic approach, in which a cell-free, slow degrading elastomeric valvular implant is populated by endogenous cells to form new valvular tissue inside the heart. We designed a fibrous valvular scaffold, fabricated from a novel supramolecular elastomer, that enables endogenous cells to enter and produce matrix. Orthotopic implantations as pulmonary valve in sheep demonstrated sustained functionality up to 12 months, while the implant was gradually replaced by a layered collagen and elastic matrix in pace with cell-driven polymer resorption. Our results offer new perspectives for endogenous heart valve replacement starting from a readily-available synthetic graft that is compatible with surgical and transcatheter implantation procedures.

  18. Technology-assisted balance and gait training reduces falls in patients with Parkinson's disease: a randomized controlled trial with 12-month follow-up.

    PubMed

    Shen, Xia; Mak, Margaret K Y

    2015-02-01

    Objective. To examine the effects of technology-assisted balance and gait training on reducing falls in patients with Parkinson's disease (PD). Methods. Eligible subjects were randomly allocated to an experimental group given technology-assisted balance and gait training (BAL, n = 26) and an active control group undertaking strengthening exercises (CON, n = 25). The training in each group lasted for 3 months. The number of fallers and fall rate were used as primary outcomes, and single-leg-stance-time, latency of postural response to perturbation, self-selected gait velocity, and stride length as secondary outcomes. Fall incidence was recorded over 15 months after the baseline assessment (Pre). Other tests were performed at Pre, after 3-month intervention (Post(3m)), at 3 months (Post(6m)), and 12 months (Post(15m)) after treatment completion. Results. Forty-five subjects who completed the 3-month training were included in the data analysis. There were fewer fallers in the BAL than in the CON group at Post(3m), Post(6m), and Post(15m) (P < .05). In addition, the BAL group had lower fall rate than the CON group at Post(3m) and Post(6m) (incidence rate ratio: 0.111-0.188, P < .05), and marginally so at Post(15m) (incidence rate ratio: 0.407, P = .057). Compared with the CON subjects, the BAL subjects demonstrated greater reduction in the postural response latency and increase in the stride length against baseline at each assessment interval (P < .05), and marginally more increases of single-leg-stance-time at Post(3m) (P = .064), Post(6m) (P = .041) and Post(15m) (P = .087). Conclusions. Our positive findings provide evidence for the clinical use of technology-assisted balance and gait training in reducing falls in people with PD.

  19. Concurrent Heroin Use and Correlates among Methadone Maintenance Treatment Clients: A 12-Month Follow-up Study in Guangdong Province, China

    PubMed Central

    Luo, Xiaofeng; Zhao, Peizhen; Gong, Xiao; Zhang, Lei; Tang, Weiming; Zou, Xia; Chen, Wen; Ling, Li

    2016-01-01

    Objective: To assess concurrent heroin use and correlates among Methadone Maintenance Treatment (MMT) clients in Guangdong Province, China. Method: Demographic and drug use data were collected with a structured questionnaire, and MMT information was obtained from the MMT clinic registration system in Guangdong. Human immunodeficiency virus (HIV-) and hepatitis C virus (HCV) infected status and urine morphine results were obtained from laboratory tests. Logistic regressions were employed to investigate the factors associated with concurrent heroin use. Results: Among the 6848 participants, 75% continued using heroin more than once during the first 12 months after treatment initiation. Concurrent heroin use was associated with inharmonious family relationship (OR (odds ratio) = 1.49, 95% CI (confidence intervals): 1.24–1.78), HIV positivity (OR = 1.25, 95% CI: 1.01–1.55), having multiple sex partners (OR = 1.34, 95% CI: 1.07–1.69), having ever taken intravenous drugs (OR = 0.81, 95% CI: 0.69–0.95), higher maintenance dose (OR = 1.13, 95% CI: 1.01–1.28) and poorer MMT attendance (OR<20% = 1.32, 95% CI: 1.13–1.53; OR20%– = 1.33, 95% CI: 1.14–1.54; OR50%– = 1.69, 95% CI: 1.44–2.00). Among those who used heroin concurrently, the same factors, and additionally being older (OR35– = 1.26, 95% CI: 1.11–1.43; OR≥45 = 1.63, 95% CI: 1.30–2.05) and female (OR = 1.60, 95% CI: 1.28–2.00), contribute to a greater frequency of heroin use. Conclusions: Concurrent heroin use was prevalent among MMT participants in Guangdong, underscoring the urgent needs for tailored interventions and health education programs for this population. PMID:27005649

  20. 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- ...

  1. The shift from high to low turnover bone disease after parathyroidectomy is associated with the progression of vascular calcification in hemodialysis patients: A 12-month follow-up study.

    PubMed

    Hernandes, Fabiana Rodrigues; Canziani, Maria Eugênia Fernandes; Barreto, Fellype Carvalho; Santos, Rodrigo Oliveira; Moreira, Valéria de Melo; Rochitte, Carlos Eduardo; Carvalho, Aluizio Barbosa

    2017-01-01

    Parathyroidectomy (PTX) may cause low levels of PTH, leading to an excessive reduction of bone turnover, which is associated with poor outcomes in dialysis patients, including vascular calcification (VC). We aimed to prospectively investigate the impact of PTX on bone remodeling and its potential consequence on the progression of VC in hemodialysis patients. In this prospective study, 19 hemodialysis patients with severe secondary hyperparathyroidism (sHPT) were evaluated. All patients underwent laboratorial tests and coronary tomography at baseline and, 6 and 12 months after PTX; bone biopsy was performed at baseline and 12-month. At baseline, all patients had increased PTH levels up to 2500 pg/mL and high turnover bone disease in their bone biopsies. Fourteen (74%) patients had VC. During the follow-up, there was a significant decrease of PTH at 6 and 12-month. At 12-month, 90% of the patients evolved to low turnover bone disease. During the period of the hungry bone syndrome (first 6 months), no change of coronary calcium score was observed. However, calcium score increased significantly thereafter (12th month). There was an association between VC progression and the severity of low turnover bone disease. In conclusion, the shift from high to low turnover bone disease after PTX occurs in parallel to VC progression, contributing to the understanding of the complex pathophysiology involving mineral metabolism and cardiovascular disease in hemodialysis patients.

  2. 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

  3. 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.

  4. 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

  5. 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.

  6. The Majority of the Pre-Antiretroviral Population Who Were Lost to Follow-Up Stopped Their Care in Freetown, Sierra Leone: A 12-Month Prospective Cohort Study Starting with HIV Diagnosis

    PubMed Central

    Kelly, J. Daniel; Schlough, Gabriel Warren; Conteh, Sulaiman; Barrie, M. Bailor; Kargbo, Brima; Giordano, Thomas P.

    2016-01-01

    Background The heterogeneity of the pre-antiretroviral (pre-ART) population calls for more granular depictions of the cascade of HIV care. Methods We studied a prospective cohort of persons newly diagnosed with HIV infection from a single center in Freetown, Sierra Leone, over a 12-month period and then traced those persons who were lost to follow-up (LTFU) during pre-ART care (before ART initiation). ART eligibility was based on a CD4 cell count result of ≤ 350 mm/cells and/or WHO clinical stage 3 or 4. Persons who attended an appointment in the final three months were considered to be retained in care. Adherence to ART was measured using pharmacy refill dates. “Effective HIV care” was defined as completion of the cascade of care at 12-months regardless of whether patients are on ART. Tracing outcomes were obtained for those who were LTFU during pre-ART care. Results 408 persons newly diagnosed with HIV infection were screened, 338 were enrolled, and 255 persons were staged for ART. ART-ineligible persons had higher retention rates than ART-eligible persons (59.6% vs 41.8%, p = 0.03). 77 (22.8%) of 338 persons received effective HIV care. Most attrition (61.9%) occurred with persons during pre-ART care. 123 of 138 persons (89.1%) who were LTFU prior to ART initiation were found, and 91 of those 123 (74.0%) were alive. Of the 74 persons who were alive and described their engagement in care, 40 (54.1%) stopped care. Nearly half (42.5%) of those 40 stopped after assessment of ART-eligibility but before ART initiation. The main limitation of this study was the lack of tracing outcomes for those lost during ART care. Conclusions The majority of the pre-ART LTFU population stopped their care, particularly after ART-eligibility but before ART initiation. Interventions to hasten ART initiation and retain this at-risk group may have significant downstream impact on effective HIV care. PMID:26901765

  7. 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.

  8. 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

  9. 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

  10. Improvement of large-joint ultrasonographic synovitis is delayed in patients with newly diagnosed rheumatoid arthritis: results of a 12-month clinical and ultrasonographic follow-up study of a local cohort.

    PubMed

    Harman, Halil; Tekeoğlu, İbrahim; Takçı, Sibel; Kamanlı, Ayhan; Nas, Kemal; Harman, Sibel

    2015-08-01

    We analyzed the longitudinal changes in gray-scale ultrasonography (GSUS) and power Doppler ultrasonography (PDUS) parameters and correlated them with clinical, functional, and radiologic outcomes in patients with newly diagnosed rheumatoid arthritis (RA). GSUS and PDUS examinations, 44-joint disease activity score (DAS44) calculations, measurements of erythrocyte sedimentation rate, and C-reactive protein levels were performed in 68 RA patients at baseline and after 1, 3, 6, 9, and 12 months. Metacarpophalangeal joints, wrist, elbow, knee, ankle, metatarsophalangeal joints, and wrist and ankle tendons were examined by GSUS and PDUS. The laboratory and clinical findings began to decrease significantly at 1 month (P < 0.05). Improvement of the ultrasonography (US) variables began at 3 months. After 6 months, all of the joint synovitis scores, except those of the knee, elbow, and ankle joints, showed a statistically significant reduction compared to baseline scores (P < 0.001). DAS44 scores were lower in the very early RA group at 12 months compared to those whose symptom duration was greater than 3 months of RA (respectively, 1.53 ± 0.34; 1.80 ± 0.38; z = -2501, P = 0.012). The total modified Sharp scores at 12 months correlated with total PDUS synovitis scores at 12 months (r = 0.354, P = 0.003). Regression of US synovitis at large joints such as the knee, elbow, and ankle tended to be delayed compared to that at small joints. PD synovitis that is persistent despite disease-modifying anti-rheumatic drug therapy may cause radiographic bone erosions.

  11. Use of localized human growth hormone and testosterone injections in addition to manual therapy and exercise for lower back pain: a case series with 12-month follow-up

    PubMed Central

    Dubick, Marc N; Ravin, Thomas H; Michel, Yvonne; Morrisette, David C

    2015-01-01

    Objective The objective of this case series was to investigate the feasibility and safety of a novel method for the management of chronic lower back pain. Injections of recombinant human growth hormone and testosterone to the painful and dysfunctional areas in individuals with chronic lower back pain were used. In addition, the participants received manual therapies and exercise addressing physical impairments such as motor control, strength, endurance, pain, and loss of movement. Pain ratings and self-rated functional outcomes were assessed. Study design This is a case series involving consecutive patients with chronic lower back pain who received the intervention of injections of recombinant human growth hormone and testosterone, and attended chiropractic and/or physical therapy. Outcomes were measured at 12 months from the time of injection. Setting A community based hospital affiliated office, and a private practice block suite. Participants A total of 60 consecutive patients attending a pain management practice for chronic lower back pain were recruited for the experimental treatment. Most participants were private pay. Interventions Participants who provided informed consent and were determined not to have radicular pain received diagnostic blocks. Those who responded favorably to the diagnostic blocks received injections of recombinant human growth hormone and testosterone in the areas treated with the blocks. Participants also received manipulation- and impairment-based exercises. Outcome measures Outcomes were assessed at 12 months through pain ratings with the Mankowski Pain Scale and the Oswestry Disability Index. Results Of the 60 patients recruited, 49 provided informed consent, and 39 completed all aspects of the study. Those patients receiving the intervention reported a significant decrease in pain ratings (P<0.01) and a significant improvement in self-rated Oswestry Disability Index scores (P<0.01). In addition, in the Oswestry Disability Index

  12. The Irritable Bowel Syndrome Outcome Study (IBSOS): Rationale and design of a randomized, placebo-controlled trial with 12 month follow up of self- versus clinician-administered CBT for moderate to severe irritable bowel syndrome

    PubMed Central

    Lackner, Jeffrey M.; Keefer, Laurie; Jaccard, James; Firth, Rebecca; Brenner, Darren; Bratten, Jason; Dunlap, Laura J.; Byroads, Mark

    2012-01-01

    Irritable bowel syndrome is a common, oftentimes disabling, gastrointestinal disorder whose full range of symptoms has no satisfactory medical or dietary treatment. One of the few empirically validated treatments includes a specific psychological therapy called cognitive behavior therapy which, if available, is typically administered over several months by trained practitioners in tertiary care settings. There is an urgent need to develop more efficient versions of CBT that require minimal professional assistance but retain the efficacy profile of clinic based CBT. The Irritable Bowel Syndrome Outcome Study (IBSOS) is a multicenter, placebo-controlled randomized trial to evaluate whether a self-administered version of CBT is, at least as efficacious as standard CBT and more efficacious than an attention control in reducing core GI symptoms of IBS and its burden (e.g. distress, quality of life impairment, etc) in moderately to severely affected IBS patients. Additional goals are to assess, at quarterly intervals, the durability of treatment response over a 12 month period; to identify clinically useful patient characteristics associated with outcome as a way of gaining an understanding of subgroups of participants for whom CBT is most beneficial; to identify theory-based change mechanisms (active ingredients) that explain how and why CBT works; and evaluate the economic costs and benefits of CBT. Between August 2010 when IBSOS began recruiting subjects and February 2012, the IBSOS randomized 171 of 480 patients. Findings have the potential to improve the health of IBS patients, reduce its social and economic costs, conserve scarce health care resources, and inform evidence-based practice guidelines. PMID:22846389

  13. British Association for Sexual Health and HIV Scottish investigation 2010-2011: reasons for non-attendance in individuals lost to follow-up for HIV care for more than 12 months in Scotland.

    PubMed

    Cullen, B L; Codere, G; Wallace, L A; Baguley, S; Clutterbuck, D J

    2013-06-01

    As of 31 March 2011, 6696 HIV diagnoses had ever been reported in Scotland; of these, 1791 individuals had died, 3339 were attending specialist services, but the remainder had defaulted from specialist care; an investigation into their reasons for non-attendance, and the efforts of services to re-engage, was undertaken by British Association for Sexual Health and HIV Scottish branch using a web-based survey questionnaire. Twelve of the 13 Scottish HIV services returned information for 424 of 579 eligible cases; 112 of these 424 individuals were identified as genuine non-attendees. Findings indicate that the epidemiology of these non-attendees is similar to that of the whole Scottish HIV cohort. Three-quarters of individuals failed to attend a booked appointment following their last known attendance and very few attempts to contact non-attending individuals were successful. This survey has refocused attention on those lost to follow-up, while quality of the national data-set has improved, providing a clearer epidemiological picture of people living with HIV in Scotland.

  14. A comparative study of diode laser and plasmakinetic in transurethral enucleation of the prostate for treating large volume benign prostatic hyperplasia: a randomized clinical trial with 12-month follow-up.

    PubMed

    Wu, Gang; Hong, Zhe; Li, Chao; Bian, Cuidong; Huang, Shengsong; Wu, Denglong

    2016-05-01

    The objective of this study is to compare the efficacy and safety of diode laser enucleation of the prostate (DiLEP) with plasmakinetic enucleation of the prostate (PKEP) for symptomatic benign prostatic hyperplasia (BPH) patients with large prostate (volume > 80 ml). From January 2013 to June 2014, 80 consecutive patients were randomized treated with DiLEP (n = 40) or PKEP (n = 40). Perioperative and postoperative outcome data were assessed during a 1-year follow-up. There were no significant preoperative differences between the two surgical groups. The mean prostate volumes in the DiLEP and PKEP groups were 98.6 and 93.3 ml, respectively. DiLEP was equivalent to PKEP in improvement in International Prostate Symptom Score (IPSS), quality of life scores, and maximum flow rate. Compared with PKEP, patients treated with DiLEP showed a lower risk of blood loss (P < 0.01), shorter bladder irrigation and catheterization times (P < 0.01), as well as shorter hospital stays (P < 0.01). Moreover, the DiLEP group was significantly superior to bipolar plasmakinetic group in the irritative symptoms. However, the operation time of the DiLEP group was longer than that of PKEP group (P = 0.02). Both DiLEP and PKEP are safe and effective methods for the treatment of BPH in large prostates (volume > 80 ml). Compared with PKEP, DiLEP provides a decreased risk of hemorrhage, reduced bladder irrigation, and catheterization times, as well as shorter hospital stays.

  15. 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.

  16. 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.

  17. 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

  18. 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

  19. Developmental milestones record - 12 months

    MedlinePlus

    Normal childhood growth milestones - 12 months; Growth milestones for children - 12 months; Childhood growth milestones - 12 months ... care provider. PHYSICAL AND MOTOR SKILLS A 12-month-old child is expected to: Be 3 times ...

  20. 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.

  1. Medical Care and Your 8- to 12-Month-Old

    MedlinePlus

    ... Old Medical Care and Your 8- to 12-Month-Old KidsHealth > For Parents > Medical Care and Your 8- to 12-Month-Old A A A What's in this article? ... baby visits during this period, once at 9 months and again at 12 months . If you have ...

  2. 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

  3. 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.

  4. 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

  5. Recovery 3 and 12 months after hysterectomy

    PubMed Central

    Theunissen, Maurice; Peters, Madelon L.; Schepers, Jan; Maas, Jacques W.M.; Tournois, Fleur; van Suijlekom, Hans A.; Gramke, Hans-Fritz; Marcus, Marco A.E.

    2016-01-01

    Abstract Chronic postsurgical pain (CPSP) is 1 important aspect of surgical recovery. To improve perioperative care and postoperative recovery knowledge on predictors of impaired recovery is essential. The aim of this study is to assess predictors and epidemiological data of CPSP, physical functioning (SF-36PF, 0–100), and global surgical recovery (global surgical recovery index, 0–100%) 3 and 12 months after hysterectomy for benign indication. A prospective multicenter cohort study was performed. Sociodemographic, somatic, and psychosocial data were assessed in the week before surgery, postoperatively up to day 4, and at 3- and 12-month follow-up. Generalized linear model (CPSP) and linear-mixed model analyses (SF-36PF and global surgical recovery index) were used. Baseline data of 468 patients were collected, 412 (88%) patients provided data for 3-month evaluation and 376 (80%) patients for 12-month evaluation. After 3 and 12 months, prevalence of CPSP (numeric rating scale ≥ 4, scale 0–10) was 10.2% and 9.0%, respectively, SF-36PF means (SD) were 83.5 (20.0) and 85.9 (20.2), global surgical recovery index 88.1% (15.6) and 93.3% (13.4). Neuropathic pain was reported by 20 (5.0%) patients at 3 months and 14 (3.9%) patients at 12 months. Preoperative pain, surgery-related worries, acute postsurgical pain on day 4, and surgery-related infection were significant predictors of CPSP. Baseline level, participating center, general psychological robustness, indication, acute postsurgical pain, and surgery-related infection were significant predictors of SF-36PF. Predictors of global surgical recovery were baseline expectations, surgery-related worries, American Society of Anesthesiologists classification, type of anesthesia, acute postsurgical pain, and surgery-related infection. Several predictors were identified for CPSP, physical functioning, and global surgical recovery. Some of the identified factors are modifiable and optimization of patients’ preoperative

  6. Course of Depressive Symptoms Following a Workplace Injury: A 12-Month Follow-Up Update.

    PubMed

    Carnide, Nancy; Franche, Renée-Louise; Hogg-Johnson, Sheilah; Côté, Pierre; Breslin, F Curtis; Severin, Colette N; Bültmann, Ute; Krause, Niklas

    2016-06-01

    Introduction To estimate the prevalence, incidence and course of depressive symptoms, their relationship with return-to-work, and prevalence of depression diagnosis/treatment 12 months following a lost-time workplace musculoskeletal injury. Methods In a prospective cohort study, 332 workers' compensation claimants with a back or upper extremity musculoskeletal disorder completed interviews at 1, 6 and 12 months post-injury. Participants self-reported they had not received a depression diagnosis 1 year pre-injury. Cutoff of 16 on the CES-D defined a high level of depressive symptoms. Self-reported data on depression diagnosis and treatment and work status since injury were collected. Results Cumulative incidence of high depressive symptom levels over 12 months was 50.3 % (95 % CI 44.9-55.7 %). At 12 months, 24.7 % (95 % CI 20.1-29.3 %) of workers exhibited high levels. Over 12 months, 49.7 % (95 % CI 44.3-55.1 %) had low levels at all 3 interviews, 14.5 % (95 % CI 10.7-18.2 %) had persistently high levels, and 25.6 % (95 % CI 20.9-30.3 %) demonstrated improvements. Among workers with low baseline levels, incidence of high levels at 12 months was 6.0 % (95 % CI 2.7-9.3 %). For workers with high baseline levels, 36.1 % (95 % CI 27.9-44.3 %) exhibited persistent high symptoms at 6 and 12 months, while 38.4 % (95 % CI 30.1-46.6 %) experienced low levels at 6 and 12 months. Problematic RTW outcomes were common among workers with a poor depressive symptom course. Among workers with persistent high symptoms, 18.8 % (95 % CI 7.7-29.8 %) self-reported receiving a depression diagnosis by 12 months and 29.2 % (95 % CI 16.3-42.0 %) were receiving treatment at 12 months. Conclusions Depressive symptoms are common in the first year following a lost-time musculoskeletal injury and a poor depressive symptom course is associated with problematic RTW outcomes 12 months post-injury. While symptoms appear to improve over time, the first 6 months appear to be important in establishing future symptom levels and may represent a window of opportunity for early screening.

  7. 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.

  8. Your Child's Development: 1 Year (12 Months)

    MedlinePlus

    ... Year-Old Your Child’s Development: 1 Year (12 Months) KidsHealth > For Parents > Your Child’s Development: 1 Year (12 Months) A A A Your little one is now ... THIS TOPIC Your Child's Checkup: 1 Year (12 Months) Your Baby's Growth: 12 Months Your Baby's Hearing, ...

  9. 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.

  10. Factors Associated with Suicide Outcomes 12-months After Screening Positive for Suicide Risk in the Emergency Department

    PubMed Central

    Arias, Sarah A.; Miller, Ivan; Camargo, Carlos A.; Sullivan, Ashley F.; Goldstein, Amy B.; Allen, Michael H.; Manton, Anne P.; Boudreaux, Edwin D.

    2016-01-01

    Objective The main objective is to identify which patient characteristics have the strongest association with suicide outcomes during the 12-months after the index emergency department (ED) visit. Methods Data were analyzed from the first two phases of the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE). The ED-SAFE study, a quasi-experimental, interrupted time series design, involved participation from eight general medical EDs across the United States. Participants included adults presenting to the ED with active suicidal ideation or an attempt in the last week. Data collection included baseline interview; 6- and 12-month chart reviews; and 6-, 12-, 24-, 36-, and 52-week telephone follow-up assessments. Regression analyses were conducted. Results Among 874 participants, the median age was 37 years (interquartile range 27–47) with 56% female (n=488), 74% white (n=649), and 13% Hispanic (n=113). At baseline, 577 (66%) had suicidal ideation only while 297 (34%) had a suicide attempt in the past week. Data sufficient to determine outcomes were available for 782 (90%). In the 12-months after the index ED visit, 195 (25%) had documentation of at least one suicide attempt or suicide. High school education or less, an ED visit in the preceding 6 months, prior non-suicidal self-injury (NSSI), current alcohol misuse, and intent or plan were predictive of future suicidal behavior. Conclusions and Relevance Continuing to build an understanding of the factors associated with future suicide behaviors for this population will help guide design and implementation of improved suicide screening and interventions in the ED and allocation of scarce resources. PMID:26620285

  11. [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.

  12. BRAVISSIMO: 12-month results from a large scale prospective trial.

    PubMed

    Bosiers, M; Deloose, K; Callaert, J; Maene, L; Beelen, R; Keirse, K; Verbist, J; Peeters, P; Schroë, H; Lauwers, G; Lansink, W; Vanslembroeck, K; D'archambeau, O; Hendriks, J; Lauwers, P; Vermassen, F; Randon, C; Van Herzeele, I; De Ryck, F; De Letter, J; Lanckneus, M; Van Betsbrugge, M; Thomas, B; Deleersnijder, R; Vandekerkhof, J; Baeyens, I; Berghmans, T; Buttiens, J; Van Den Brande, P; Debing, E; Rabbia, C; Ruffino, A; Tealdi, D; Nano, G; Stegher, S; Gasparini, D; Piccoli, G; Coppi, G; Silingardi, R; Cataldi, V; Paroni, G; Palazzo, V; Stella, A; Gargiulo, M; Muccini, N; Nessi, F; Ferrero, E; Pratesi, C; Fargion, A; Chiesa, R; Marone, E; Bertoglio, L; Cremonesi, A; Dozza, L; Galzerano, G; De Donato, G; Setacci, C

    2013-04-01

    The BRAVISSIMO study is a prospective, non-randomized, multi-center, multi-national, monitored trial, conducted at 12 hospitals in Belgium and 11 hospitals in Italy. This manuscript reports the findings up to the 12-month follow-up time point for both the TASC A&B cohort and the TASC C&D cohort. The primary endpoint of the study is primary patency at 12 months, defined as a target lesion without a hemodynamically significant stenosis on Duplex ultrasound (>50%, systolic velocity ratio no greater than 2.0) and without target lesion revascularization (TLR) within 12 months. Between July 2009 and September 2010, 190 patients with TASC A or TASC B aortoiliac lesions and 135 patients with TASC C or TASC D aortoiliac lesions were included. The demographic data were comparable for the TASC A/B cohort and the TASC C/D cohort. The number of claudicants was significantly higher in the TASC A/B cohort, The TASC C/D cohort contains more CLI patients. The primary patency rate for the total patient population was 93.1%. The primary patency rates at 12 months for the TASC A, B, C and D lesions were 94.0%, 96.5%, 91.3% and 90.2% respectively. No statistical significant difference was shown when comparing these groups. Our findings confirm that endovascular therapy, and more specifically primary stenting, is the preferred treatment for patients with TASC A, B, C and D aortoiliac lesions. We notice similar endovascular results compared to surgery, however without the invasive character of surgery.

  13. Breastfeeding beyond 12 months. An historical perspective.

    PubMed

    Piovanetti, Y

    2001-02-01

    A decade ago, child psychiatrist Coello-Novello, in her term as Surgeon General of the United States, said, "It's the lucky baby, I feel, who continues to nurse until he's two." The accumulated evidence supports her statement. The understanding of the benefits of breastfeeding beyond 12 months should support the cultural change in which eventually prolonged breastfeeding becomes normal.

  14. Employment-based reinforcement of adherence to oral naltrexone in unemployed injection drug users: 12-month outcomes.

    PubMed

    Dunn, Kelly; DeFulio, Anthony; Everly, Jeffrey J; Donlin, Wendy D; Aklin, Will M; Nuzzo, Paul A; Leoutsakos, Jeannie-Marie S; Umbricht, Annie; Fingerhood, Michael; Bigelow, George E; Silverman, Kenneth

    2015-06-01

    Oral naltrexone could be a promising relapse-prevention pharmacotherapy for recently detoxified opioid-dependent patients; however, interventions are often needed to promote adherence with this treatment approach. We recently conducted a study to evaluate a 26-week employment-based reinforcement intervention of oral naltrexone in unemployed injection drug users (Dunn et al., 2013). Participants were randomly assigned into a contingency (n = 35) group required to ingest naltrexone under staff observation to gain entry into a therapeutic workplace or a prescription (n = 32) group given a take-home supply of oral naltrexone and access to the workplace without observed ingestion. Monthly urine samples were collected and analyzed for evidence for naltrexone adherence, opioid use, and cocaine use. As previously reported, contingency participants provided significantly more naltrexone-positive urine samples than prescription participants during the 26-week intervention period. The goal of this current study is to report the 12-month outcomes, which occurred 6 months after the intervention ended. Results at the 12-month visit showed no between-groups differences in naltrexone-positive, opioid-negative, or cocaine-negative urine samples and no participant self-reported using naltrexone at the follow-up visit. These results show that even after a period of successfully reinforced oral naltrexone adherence, longer-term naltrexone use is unlikely to be maintained after reinforcement contingencies are discontinued. (PsycINFO Database Record

  15. Employment-based Reinforcement of Adherence to Oral Naltrexone in Unemployed Injection Drug Users: 12-month Outcomes

    PubMed Central

    Dunn, Kelly; DeFulio, Anthony; Everly, Jeffrey J.; Donlin, Wendy D.; Aklin, Will M.; Nuzzo, Paul A.; Leoutsakos, Jeannie-Marie S.; Umbricht, Annie; Fingerhood, Michael; Bigelow, George E.; Silverman, Kenneth

    2015-01-01

    Oral naltrexone could be a promising relapse prevention pharmacotherapy for recently detoxified opioid-dependent patients, however interventions are often needed to promote adherence with this treatment approach. We recently conducted a study to evaluate a 26-week employment-based reinforcement intervention of oral naltrexone in unemployed injection drug users (Dunn et al., 2013). Participants were randomly assigned into a Contingency (n=35) group required to ingest naltrexone under staff observation to gain entry into a therapeutic workplace, or a Prescription (n=32) group given a take-home supply of oral naltrexone and access to the workplace without observed ingestion. Monthly urine samples were collected and analyzed for evidence for naltrexone adherence, opioid use, and cocaine use. As previously reported, Contingency participants provided significantly more naltrexone-positive urine samples than Prescription participants during the 26-week intervention period. The goal of this current study is to report the 12-month outcomes, which occurred 6 months after the intervention ended. Results at the 12-month visit showed no between-group differences in naltrexone-positive, opioid-negative, or cocaine-negative urine samples, and no participant self-reported using naltrexone at the follow-up visit. These results show that even after a period of successfully reinforced oral naltrexone adherence longer-term naltrexone use is unlikely to be maintained after reinforcement contingencies are discontinued. PMID:25134047

  16. 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.].

  17. Bimatoprost 0.01% vs bimatoprost 0.03%: a 12-month prospective trial of clinical and in vivo confocal microscopy in glaucoma patients

    PubMed Central

    Figus, M; Nardi, M; Piaggi, P; Sartini, M; Guidi, G; Martini, L; Lazzeri, S

    2014-01-01

    Purpose To evaluate the safety of two commercially available formulations of bimatoprost eye drops: 0.03 and 0.01% ophthalmic solutions. Methods This was a randomized, prospective, parallel-group, open-label, cohort study. A total of 60 glaucoma patients (60 eyes) under bimatoprost 0.03% monotherapy since at least 1 year were enrolled. Selected patients were randomized to receive a single drop of bimatoprost 0.01% (n=30) or bimatoprost 0.03% (n=30) ophthalmic solutions for 12 months. Statistical analysis was performed using paired t-test and repeated measures ANOVA test. Results Global clinical score (the sum of pruritus, stinging/burning, blurred vision, sticky eye sensation, eye dryness sensation, and foreign body sensation) significantly decreased in the bimatoprost 0.01% group from baseline 4.7±3.8 to 2.9±2.3 (P<0.001) and 2.5±2.0 (P<0.001) at 6-month and 12-month follow-ups, respectively. Comparison between groups showed differences at both follow-up visits (P=0.003 and P<0.001, respectively). In vivo confocal microscopy revealed a significant increase in goblet cell density in the bimatoprost 0.01% group compared with the bimatoprost 0.03% group (P<0.001 at both follow-up visits). All functional parameters and conjunctival hyperemia improved in the bimatoprost 0.01% group at each follow-up visit (P<0.05) and in comparison with bimatoprost 0.03% (P<0.05). Conclusion The results of this trial suggest that bimatoprost 0.01% eye drops seem to decrease the ocular discomfort with respect to bimatoprost 0.03% eye drops. PMID:24434659

  18. 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

    Background The use of long-acting reversible contraceptive (LARC) methods is very low in Pakistan with high discontinuation rates mainly attributed to method-related side effects. Mixed evidence is available on the effectiveness of different client follow-up approaches used to ensure method continuation. We compared the effectiveness of active and passive follow-up approaches in sustaining the use of LARC—and within ‘active’ follow-up, we further compared a telephone versus home-based approach in rural Punjab, Pakistan. Methods This was a 12-month multicentre non-inferiority trial conducted in twenty-two (16 rural- and 6 urban-based) franchised reproductive healthcare facilities in district Chakwal of Punjab province, between November 2013 and December 2014. The study comprised of three groups of LARC clients: a) home-based follow-up, b) telephone-based follow-up, and c) passive or needs-based follow-up. Participants in the first two study groups received counselling on scheduled follow-up from the field workers at 1, 3, 6, 9, and 12 month post-insertion whereas participants in the third group were asked to contact the health facility if in need of medical assistance relating to LARC method use. Study participants were recruited with equal allocation to each study group, but participants were not randomized. The analyses are based on 1,246 LARC (intra-uterine contraceptive device and implant) users that completed approximately 12-months of follow-up. The non-inferiority margin was kept at five percentage points for the comparison of active and passive follow-up and six percentage points for telephone and home-based approach. The primary outcome was cumulative probability of method continuation at 12-month among LARC users. Results Women recruited in home-based, telephone-based, and passive groups were 400, 419 and 427, respectively. The cumulative probability of LARC continuation at 12 month was 87.6% (95% CI 83.8 to 90.6) among women who received home

  19. Job stress as a risk factor for absences among manual workers: a 12-month follow-up study.

    PubMed

    Heo, Yong-Seok; Leem, Jong-Han; Park, Shin-Goo; Jung, Dal-Young; Kim, Hwan-Cheol

    2015-01-01

    This study was conducted to evaluate the impact of job stress on absence from work caused by illnesses and accidents through a prospective research design. A total of 2,349 manual workers were included in this analysis. In the first survey, job stress was determined using the Korean Occupational Stress Scale-Short Form. In the second survey, information on absence due to accidents or illnesses during the past one year was obtained through a questionnaire. The relationship was analyzed using a logistic regression model with multiple imputation. After adjusting for confounding variables for males, absence due to accidents was statistically associated with high job demand, insufficient job control, inadequate social support, and organizational injustice. In addition, high job demands and organizational injustice were related to increased absence due to illnesses in both genders. A lack of reward was associated with increased absence due to illnesses among female workers. We found that job stress was associated with a higher risk of absence caused by accidents or illnesses of manual workers.

  20. 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

  1. 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

  2. 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

  3. 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;

  4. 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

  5. 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.

  6. Senses and Your 8- to 12-Month-Old

    MedlinePlus

    ... TOPIC Feeding Your 8- to 12-Month-Old Sleep and Your 8- to 12-Month-Old Your Child's Vision Communication and Your 8- to 12-Month-Old Movement, Coordination, and Your 8- to 12-Month-Old Your Baby's Growth: 8 Months Your Child's Growth Learning, Play, and ...

  7. 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

  8. 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…

  9. 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.

  10. 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

  11. 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.

  12. 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…

  13. 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.

  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. 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.

  16. Emetic and Electric Shock Alcohol Aversion Therapy: Six- and Twelve-Month Follow-Up.

    ERIC Educational Resources Information Center

    Cannon, Dale S.; Baker, Timothy B.

    1981-01-01

    Follow-up data are presented for 6- and 12-months on male alcoholics (N=20) who received either a multifaceted inpatient alcoholism treatment program alone (controls) or emetic or shock aversion therapy in addition to that program. Both emetic and control subjects compiled more days of abstinence than shock subjects. (Author)

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. 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 ...

  2. 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

  3. 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)…

  4. Learning, Play, and Your 8- to 12-Month-Old

    MedlinePlus

    ... Old Learning, Play, and Your 8- to 12-Month-Old KidsHealth > For Parents > Learning, Play, and Your 8- to 12-Month-Old A A A What's in this article? ... baby becomes more mobile during these next few months. What Is My Child Learning? Your little one ...

  5. Feeding Your 8- to 12-Month-Old

    MedlinePlus

    ... 2-Year-Old Feeding Your 8- to 12-Month-Old KidsHealth > For Parents > Feeding Your 8- to 12-Month-Old A A A What's in this article? ... a 12 meses de edad By about 8 months old, most babies are pros at handling the ...

  6. Feeding Your 8- to 12-Month-Old

    MedlinePlus

    ... 2-Year-Old Feeding Your 8- to 12-Month-Old KidsHealth > For Parents > Feeding Your 8- to 12-Month-Old Print A A A What's in this ... a 12 meses de edad By about 8 months old, most babies are pros at handling the ...

  7. Learning, Play, and Your 8- to 12-Month-Old

    MedlinePlus

    ... Old Learning, Play, and Your 8- to 12-Month-Old KidsHealth > For Parents > Learning, Play, and Your 8- to 12-Month-Old Print A A A What's in this ... baby becomes more mobile during these next few months. What Is My Child Learning? Your little one ...

  8. 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

  9. [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.

  10. 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.

  11. 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…

  12. 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…

  13. 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…

  14. 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

  15. Perceptual learning: 12-month-olds' discrimination of monkey faces.

    PubMed

    Fair, Joseph; Flom, Ross; Jones, Jacob; Martin, Justin

    2012-11-01

    Six-month-olds reliably discriminate different monkey and human faces whereas 9-month-olds only discriminate different human faces. It is often falsely assumed that perceptual narrowing reflects a permanent change in perceptual abilities. In 3 experiments, ninety-six 12-month-olds' discrimination of unfamiliar monkey faces was examined. Following 20 s of familiarization, and two 5-s visual-paired comparison test trials, 12-month-olds failed to show discrimination. However, following 40 s of familiarization and two 10-s test trials, 12-month-olds showed reliable discrimination of novel monkey faces. A final experiment was performed demonstrating 12-month-olds' discrimination of the monkey face was due to the increased familiarization rather than increased time of visual comparison. Results are discussed in the context of perceptual narrowing, in particular the flexible nature of perceptual narrowing.

  16. Safety for Your Child: 6 to 12 Months

    MedlinePlus

    ... Share Safety for Your Child: 6 to 12 Months Page Content Article Body ​ Did you know that ... may climb before walking, or walk with support months before you expect. Your child will grasp at ...

  17. 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

  18. [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.

  19. 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.

  20. 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.

  1. 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.

  2. [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.

  3. Prosthetic Management of a Child with Hypohidrotic Ectodermal Dysplasia: 6-Year Follow-Up

    PubMed Central

    Conceição Pinto, Moara e Silva; Melo do Val, Cinthya; Costa Oliveira, Leonam; Costa de Aquino, Cristhyane

    2016-01-01

    Ectodermal dysplasia (ED) is a genetically heterogeneous condition resulting from clinical anomalies of structures derived from the ectoderm, such as the hair, nails, sweat glands, and teeth. This clinical report presents the case of a child diagnosed with hypohidrotic ED at 2 years of age; clinical and imaging evaluation was performed with 6-year follow-up, and we present details of the prosthetic dental care, with a 12-month follow-up. The patient's masticatory capacity had improved, leading to the child gaining 4 kg. In conclusion, prosthetic management was noninvasive and appeared to lead to developmental benefits for the patient. PMID:27822392

  4. Prevalence, correlates, and comorbidity of 12-Month tobacco dependence among ever-smokers in South Korea, during 1984-2001.

    PubMed

    Jeon, Hong Jin; Hahm, Bong-Jin; Lee, Hae-Woo; Hong, Jin Pyo; Bae, Jae-Nam; Park, Jong Ik; Kim, Jang-Kyu; Bae, Ahn; Park, Jong Han; Chung, Eun-Kee; Shin, Jong-Ho; Choi, Yong-Seoung; Chung, In-Won; Lee, Hyo Jung; Cho, Maeng Je

    2008-04-01

    The rate of dependence among ever-users of a drug indicates the risk of developing dependence once an individual has been exposed to the drug. This is the first study to investigate 12-month tobacco dependence (TD) among ever-smokers in a community-based population. Analyses were based on two national studies of representative samples aged 18-64 in 1984 (n=5,025) and in 2001 (n=6,275), conducted with household visits and face-to-face interviews. The rates of 12-month TD among ever-smokers in men showed no significant difference between 51.6% in 1984 and 50.6% in 2001. On the contrary, the rates in women significantly increased from 33.3% in 1984 to 52.8% in 2001. After adjusting for the sociodemographic variables, 'male gender' was significantly associated with 12-month TD among eversmokers in 1984, but not in 2001. 'Unmarried' was significantly associated in 2001 but not in 1984. 'Alcohol dependence' was the only psychiatric disorder associated with 12-month TD in both study years. In conclusion, 12-month TD was found in about 50% of ever-smokers, and gender differences between the rates of 12-month TD which was observed in 1984 disappeared in 2001. Individuals with 12-month TD showed higher comorbidity with alcohol dependence than ever-smokers without TD.

  5. Extracorporeal shock wave lithotripsy in infants less than 12-month old.

    PubMed

    Turna, Burak; Tekin, Ali; Yağmur, İsmail; Nazlı, Oktay

    2016-10-01

    There is a lack of literature on children compared to adults regarding the long-term effects of extracorporeal shock wave lithotripsy (SWL), specifically in infants. The aim of the present study was to analyze the efficacy and safety of SWL in infants and also evaluate its potential adverse effects in the mid-term. Between May 1999 and December 2013, 36 infants with 39 renal units underwent SWL treatment for kidney stones with an electrohydraulic lithotripter (Dornier MPL 9000/ELMED Multimed Classic). All children were less than 12-month old. The mid-term effects of SWL were examined at the last follow-up by measuring arterial blood pressure, random blood glucose level and ipsilateral kidney size. Evaluation of treatment and its consequences was based on clinical examination, blood tests and conventional imaging (plain abdominal radiography and ultrasound). Overall stone-free rate was 84.6 % after 3-month follow-up without any major complications. Mid-term follow-up was available in 20 of 36 children with a mean follow-up of 3.2 ± 2.8 years (range 0.5-15.3). None of the infants were found to develop new onset of hypertension or diabetes. All treated infant kidneys' sizes were in the normal percentile range. SWL for management of infant kidney stones is effective and safe in the mid-term.

  6. 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

  7. One-year treatment follow-up of plantar fasciitis: radial shockwaves vs. conventional physiotherapy

    PubMed Central

    Grecco, Marcus Vinicius; Brech, Guilherme Carlos; Greve, Júlia Maria D'Andrea

    2013-01-01

    OBJECTIVE: To compare radial shockwave treatment with conventional physiotherapy for plantar fasciitis after 12 months of follow-up. METHOD: This was a randomized, prospective, comparative clinical study. Forty patients with a diagnosis of plantar fasciitis were divided randomly into two treatment groups: group 1, with 20 patients who underwent ten physiotherapy sessions comprising ultrasound, kinesiotherapy and guidance for home-based stretching; and group 2, with 20 patients who underwent three applications of radial shockwaves, once a week, and guidance for home-based stretching. All patients were assessed regarding pain and functional abilities before treatment, immediately after and 12 months after treatment. The mean age was 49.6±11.8 years (range: 25-68 years), 85% were female, 88% were overweight, 63% were affected bilaterally, and 83% used analgesics regularly. RESULTS: At the 12-month follow-up, both treatments were effective for improving pain and functional ability among the patients with plantar fasciitis. The improvement with shockwaves was faster. CONCLUSION: Shockwave treatment was not more effective than conventional physiotherapy treatment 12 months after the end of the treatment. PMID:24037003

  8. 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%.

  9. 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

  10. Suicide attempts within 12 months of treatment for substance use disorders.

    PubMed

    Britton, Peter C; Conner, Kenneth R

    2010-02-01

    There are limited prospective data on suicide attempts (SA) during the months following treatment for substance use disorders (SUD), a period of high risk. In an analysis of the Drug Abuse Treatment Outcomes Study, a longitudinal naturalistic multisite study of treated SUDs, variables associated with SA in the 12 months following SUD treatment were examined. Participants included 2,966 patients with one or more SUDs. By 12 months, 77 (2.6%) subjects had attempted suicide. Multivariate logistic regression analyses were used to identify variables associated with SA. Variables collected at baseline that were associated with SA included lifetime histories of SA, suicidal ideation (SI), depression, cocaine as primary substance of use, outpatient methadone treatment, and short-term inpatient treatment. Male sex, older age, and minority race or ethnicity were associated with lower likelihood of SA. After controlling for baseline predictors, variables assessed at 12 months associated with SA included SI during follow-up and daily or more use of cocaine. The data contribute to a small but growing literature of prospective studies of SA among treated SUDs, and suggest that SUDs with cocaine use disorders in particular should be a focus of prevention efforts.

  11. 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.

  12. 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.

  13. 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

  14. 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

  15. 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.

  16. Walking and Eating Behavior of Toddlers at 12 Months Old

    ERIC Educational Resources Information Center

    Koda, Naoko; Akimoto, Yuko; Hirose, Toshiya; Hinobayashi, Toshihiko; Minami, Tetsuhiro

    2004-01-01

    Locomotive and eating behavior of 52 toddlers was observed at 12 months old in a nursery school and investigated in relation to the acquisition of independent walking. The toddlers who acquired walking ate more by themselves using the hands than the toddlers who did not start walking. This suggested that acquisition of walking was associated with…

  17. Perceptual Learning: 12-Month-Olds' Discrimination of Monkey Faces

    ERIC Educational Resources Information Center

    Fair, Joseph; Flom, Ross; Jones, Jacob; Martin, Justin

    2012-01-01

    Six-month-olds reliably discriminate different monkey and human faces whereas 9-month-olds only discriminate different human faces. It is often falsely assumed that perceptual narrowing reflects a permanent change in perceptual abilities. In 3 experiments, ninety-six 12-month-olds' discrimination of unfamiliar monkey faces was examined. Following…

  18. 12-Month-Olds Produce Others' Intended but Unfulfilled Acts

    ERIC Educational Resources Information Center

    Nielsen, Mark

    2009-01-01

    Following Meltzoff's (1995) behavioral reenactment paradigm, this study investigated the ability of 12-month-olds (N = 44) to reproduce a model's attempted-but-failed actions on objects. Testing was conducted using a novel set of objects designed to enable young infants to readily identify the potential outcome of the model's actions. Infants who…

  19. 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

  20. [The influence of anosognosia and depression on the perceived quality of life of patients with Alzheimer's disease: a 12 months follow-up].

    PubMed

    Portellano-Ortiz, Cristina; Turró-Garriga, Oriol; Gascón-Bayarri, Jordi; Piñán-Hernández, Sara; Moreno-Cordón, Laura; Viñas-Díez, Vanesa; Reñé-Ramírez, Ramón; Conde-Sala, Josep Lluís

    2014-09-01

    Introduccion. La anosognosia y la depresion pueden influir en la valoracion sobre la calidad de vida del paciente con enfermedad de Alzheimer. Objetivo. Explorar la evolucion de la calidad de vida del paciente con enfermedad de Alzheimer y la influencia de la anosognosia y la depresion en la percepcion de la calidad de vida de los pacientes y sus cuidadores. Pacientes y metodos. Estudio observacional, analitico y longitudinal de 12 meses. Muestra consecutiva de 221 pacientes atendidos ambulatoriamente. La media de edad fue de 77,8 ± 7,3 años y 140 fueron mujeres (63,3%). Instrumentos: Quality of Life in Alzheimer Disease, Anosognosia Questionnaire-Dementia, Geriatric Depression Scale, Disability Assessment for Dementia, Neuropsychiatric Inventory, Minimental State Examination y Global Deterioration Scale. Se calculo el tamaño del efecto en las diferencias entre dos medias y se realizo un analisis de regresion lineal con los factores asociados a la percepcion de la calidad de vida de los pacientes. Resultados. Los pacientes con anosognosia presentaron puntuaciones menores en depresion y mayores en la Quality of Life in Alzheimer Disease, al contrario que los pacientes sin anosognosia, e independientemente del tratamiento farmacologico antidepresivo. Los cuidadores puntuaron mas negativamente la calidad de vida de los pacientes. En la regresion lineal, las mayores discrepancias entre pacientes y cuidadores respecto a la calidad de vida se asociaron a la anosognosia, la depresion y la capacidad funcional (ß = –0,21; p < 0,001), que explicaban el 35,3, 7,9 y 11,3%, respectivamente, de la varianza. Conclusion. La anosognosia se asociaba a una menor depresion y mejor percepcion de la calidad de vida en los pacientes.

  1. 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.

  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. Wideband acoustic immittance measures: developmental characteristics (0 to 12 months).

    PubMed

    Kei, Joseph; Sanford, Chris A; Prieve, Beth A; Hunter, Lisa L

    2013-07-01

    Rapid developmental changes of the peripheral auditory system in normal infants occur in the first year of life. Specifically, the postnatal development of the external and middle ear affects all measures of external and middle ear function including wideband acoustic immittance(WAI). This article provides an overview of WAI studies in newborns and infants from a developmental perspective. Normative WAI data in newborns are fairly consistent across studies. However, there are discrepancies in some WAI measures between studies, possibly due to differences in sampling, methodology, and instrumentation. Accuracy of WAI measurements is compromised when a good probe seal cannot be maintained during testing or an inaccurate estimate of the cross-sectional area of the ear canal of newborns occurs. Comparison of WAI data between age groups from 0 to 12 months reveals maturation effects. Additional age-specific longitudinal and cross-sectional normative WAI data for infants from birth to 12 months are required to validate and consolidate existing data.

  4. 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.

  5. Aminoglycoside antibiotics for NIH category II chronic bacterial prostatitis: A single-cohort study with one-year follow-up

    PubMed Central

    Magri, Vittorio; Montanari, Emanuele; Marras, Emanuela; Perletti, Gianpaolo

    2016-01-01

    Although fluoroquinolones are first-line agents for the treatment of National Institutes of Health (NIH) category II chronic bacterial prostatitis (CBP), therapy with these agents is not always feasible due to the increasing worldwide resistance of causative uropathogens. New therapeutic options are urgently required, as drugs such as β-lactam antibiotics distribute poorly to prostatic sites of infection and trimethoprim therapy is often unfeasible due to high resistance rates. The present study aimed to analyze the efficacy of aminoglycosides, administered to a cohort of 78 patients affected by fluoroquinolone-resistant CBP, or excluded from fluoroquinolone therapy due to various contraindications. Patients received netilmicin (4.5 mg/kg, once-daily, intramuscular), combined or not with a β-lactam antibiotic, for 4 weeks. Follow-up visits were scheduled 6 and 12 months after the end of treatment. Fifty-five out of 70 patients (78.6%) showed eradication of the causative pathogen, and a significant reduction of the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) total score from a baseline median value of 21 to 14 at the end of therapy, and to 9 and 8 at 6-month and 12-month follow-up assessments, respectively. The pain, voiding and quality of life subdomains of the NIH-CPSI decreased accordingly. In 15 patients showing persistence of infection, NIH-CPSI total and subdomain scores did not decrease at the end of therapy. Additional clinical parameters, such as the urinary peak flow rate, percentage voided bladder, serum prostate-specific antigen concentration, International Prostate Symptom Score and prostate volume improved significantly only in the group of patients in which the infection was eradicated. Therapy was well tolerated, and genetic testing for deafness-predisposing mitochondrial mutations allowed safer administration of aminoglycosides. These results suggest that aminoglycosides may become a therapeutic alternative for the treatment of CBP. These

  6. Aminoglycoside antibiotics for NIH category II chronic bacterial prostatitis: A single-cohort study with one-year follow-up.

    PubMed

    Magri, Vittorio; Montanari, Emanuele; Marras, Emanuela; Perletti, Gianpaolo

    2016-10-01

    Although fluoroquinolones are first-line agents for the treatment of National Institutes of Health (NIH) category II chronic bacterial prostatitis (CBP), therapy with these agents is not always feasible due to the increasing worldwide resistance of causative uropathogens. New therapeutic options are urgently required, as drugs such as β-lactam antibiotics distribute poorly to prostatic sites of infection and trimethoprim therapy is often unfeasible due to high resistance rates. The present study aimed to analyze the efficacy of aminoglycosides, administered to a cohort of 78 patients affected by fluoroquinolone-resistant CBP, or excluded from fluoroquinolone therapy due to various contraindications. Patients received netilmicin (4.5 mg/kg, once-daily, intramuscular), combined or not with a β-lactam antibiotic, for 4 weeks. Follow-up visits were scheduled 6 and 12 months after the end of treatment. Fifty-five out of 70 patients (78.6%) showed eradication of the causative pathogen, and a significant reduction of the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) total score from a baseline median value of 21 to 14 at the end of therapy, and to 9 and 8 at 6-month and 12-month follow-up assessments, respectively. The pain, voiding and quality of life subdomains of the NIH-CPSI decreased accordingly. In 15 patients showing persistence of infection, NIH-CPSI total and subdomain scores did not decrease at the end of therapy. Additional clinical parameters, such as the urinary peak flow rate, percentage voided bladder, serum prostate-specific antigen concentration, International Prostate Symptom Score and prostate volume improved significantly only in the group of patients in which the infection was eradicated. Therapy was well tolerated, and genetic testing for deafness-predisposing mitochondrial mutations allowed safer administration of aminoglycosides. These results suggest that aminoglycosides may become a therapeutic alternative for the treatment of CBP. These

  7. Clinical outcomes of Single-Visit oral Prophylaxis: A practice-based randomised controlled trial

    PubMed Central

    2011-01-01

    Background Practice-based general dental practitioners routinely provide "scale and polish" or "oral prophylaxis" to patients attending their practices. Despite its routine provision, there is no evidence to support the clinical effectiveness of single-visit scale and polish, nor the frequency at which it should be provided. A recent systematic review recommended that future trials investigating scale and polish should involve dental practice patients. Methods A practice-based parallel randomised controlled trial with 24-month follow-up was conducted. Healthy adults (Basic Periodontal Examination [BPE] codes <3) were randomly assigned to 3 groups (6-month, 12-month, or 24-month interval between scale and polish). The primary outcome was gingival bleeding with the hypothesis that 6-monthly scale and polish would result in lower prevalence than 12-month or 24-month frequency. Follow-up measurements were recorded by examiners blinded to the allocation. 125, 122 and 122 participants were randomised to the 6-month, 12-month and 24-month groups respectively. Complete data set analyses were conducted for 307 participants: 107, 100, and 100 in the 6-month, 12-month and 24-month groups respectively. Chi-square test and ANOVA were used to compare treatment groups at follow-up. Logistic regression and ANCOVA were used to estimate the relationship between outcome and treatment group, adjusted for baseline values. Multiple imputation analyses were also carried out for participants with incomplete data sets. Results Prevalence of gingival bleeding at follow-up was 78.5% (6-month), 78% (12-month) and 82% (24-month) (p = 0.746). There were no statistically significant differences between groups with respect to follow-up prevalence of plaque and calculus. Statistically significant differences detected in the amount (millimetres) of calculus were too small to be clinically significant. Seventeen (4.6%) participants were withdrawn from the trial to receive additional treatment

  8. Laser Pulpotomy–An Effective Alternative to Conventional Techniques: A 12 Months Clinicoradiographic Study

    PubMed Central

    Rana, Vivek; Srivastava, Nikhil; Chandna, Preetika

    2015-01-01

    ABSTRACT Background: Vital pulpotomy is a single-stage procedure of surgical amputation of the coronal portion of exposed vital pulp, usually as a means of preserving the vitality and function of the remaining radicular portion. Aims and objectives: The aim of this study was to compare the clinical and radiographic success rates for ferric sulfate (FS), electrosurgery (ES) and laser pulpotomy in human primary molars. Materials and methods: In a randomized clinical trial, 30 primary molars indicated for pulpotomy in children aged 4 to 10 years were treated using either a FS (10 teeth), ES technique (10 teeth) and laser (10 teeth). Following the pulpotomy, the teeth were evaluated for clinical and radiographic success at 3, 6, 9 and 12 months on the basis of the presence of pain, sinus, mobility, internal and external resorption, periapical radiolucency, calcification in the canal and bone loss. Statistical analysis: The data were assessed with Chi-square test. Results: After 12 months of follow-up, both clinical and radiographic success rates were 100% in the laser group but only 80% in both ES and FS groups. There was statistically significant difference between the success rates of three groups (p < 0.05). Conclusion: Laser pulpotomy showed better clinical as well as radiographical results than ES and FS pulpotomy. Laser pulpotomy was also found superior in terms of operating time, patient cooperation, ease of use and pain. Although results of the study showed the failure rates for electrosurgical pulpotomy to be equal to those for FS pulpotomy, electrosurgical pulpotomy being a nonpharmacological technique considered more favorable. Further studies using larger sample size and longer evaluation periods are suggested. How to cite this article: Gupta G, Rana V, Srivastava N, Chandna P. Laser Pulpotomy–An Effective Alternative to Conventional Techniques: A 12 Months Clinicoradiographic Study. Int J Clin Pediatr Dent 2015;8(1):18-21. PMID:26124576

  9. Cost of Living with Parkinson's Disease over 12 Months in Australia: A Prospective Cohort Study

    PubMed Central

    Abimanyi-Ochom, Julie; Lane, Lisa; Murphy, Anna T.; Morris, Meg E.; Iansek, Robert

    2017-01-01

    Background. Parkinson disease (PD) is a costly chronic condition in terms of managing both motor and nonmotor symptoms. The burden of disease is high for individuals, caregivers, and the health system. The aim of this study is to estimate the annual cost of PD from the household, health system, and societal perspectives. Methods. A prospective cohort study of newly referred people with PD to a specialist PD clinic in Melbourne, Australia. Participants completed baseline and monthly health resource use questionnaires and Medicare data were collected over 12 months. Results. 87 patients completed the 12-month follow-up assessments. The mean annual cost per person to the health care system was $32,556 AUD. The burden to society was an additional $45,000 per annum per person with PD. The largest component of health system costs were for hospitalisation (69% of total costs). The costs for people with moderate to severe disease were almost 4 times those with mild PD ($63,569 versus $17,537 p < 0.001). Conclusion. PD is associated with significant costs to individuals and to society. Costs escalated with disease severity suggesting that the burden to society is likely to grow with the increasing disease prevalence that is associated with population ageing. PMID:28352490

  10. Psychosocial and neurocognitive functioning in unipolar and bipolar depression: a 12-month prospective study.

    PubMed

    Godard, Julie; Baruch, Philippe; Grondin, Simon; Lafleur, Martin F

    2012-03-30

    Previous studies have revealed psychosocial and cognitive impairments in patients during unipolar and bipolar depression, which persist even in subsyndromal and euthymic states. Currently, little is known about the nature and the extent of psychosocial and cognitive deficits during depression. The aim of the present study was to characterize psychosocial and cognitive profiles among unipolar (MDD) and bipolar (BD) patients during a major depressive episode and to compare the profiles of the patient groups. Depressed patients with MDD (n=13) and BD (n=11) were followed over a period of 12 months. Clinical, psychosocial and neuropsychological assessments were conducted at baseline and at 6-week, 4-month, 8-month and 12-month follow-ups. In the case of severe mood disorders, psychosocial and neurocognitive functioning seem similar among MDD and BD patients during a depressive episode. All MDD and BD patients had global psychosocial dysfunction, characterized by occupational and relational impairments. Furthermore, the neurocognitive profile was heterogeneous with regard to the nature and extent of cognitive deficits but attentional processes were frequently compromised. After 1 year of treatment, occupational and relational impairments, as well as neurocognitive dysfunction, persisted sufficiently to alter daily functioning.

  11. Cost of Living with Parkinson's Disease over 12 Months in Australia: A Prospective Cohort Study.

    PubMed

    Bohingamu Mudiyanselage, Shalika; Watts, Jennifer J; Abimanyi-Ochom, Julie; Lane, Lisa; Murphy, Anna T; Morris, Meg E; Iansek, Robert

    2017-01-01

    Background. Parkinson disease (PD) is a costly chronic condition in terms of managing both motor and nonmotor symptoms. The burden of disease is high for individuals, caregivers, and the health system. The aim of this study is to estimate the annual cost of PD from the household, health system, and societal perspectives. Methods. A prospective cohort study of newly referred people with PD to a specialist PD clinic in Melbourne, Australia. Participants completed baseline and monthly health resource use questionnaires and Medicare data were collected over 12 months. Results. 87 patients completed the 12-month follow-up assessments. The mean annual cost per person to the health care system was $32,556 AUD. The burden to society was an additional $45,000 per annum per person with PD. The largest component of health system costs were for hospitalisation (69% of total costs). The costs for people with moderate to severe disease were almost 4 times those with mild PD ($63,569 versus $17,537 p < 0.001). Conclusion. PD is associated with significant costs to individuals and to society. Costs escalated with disease severity suggesting that the burden to society is likely to grow with the increasing disease prevalence that is associated with population ageing.

  12. Five-Year Follow-Up of Army Personnel Potentially Exposed to Chemical Warfare Agents

    DTIC Science & Technology

    2005-12-01

    muscles or tendons 10.3 10.4 0.98 (0.83-1.15) Skin cancer 3.3 2.6 1.30 (0.94-1.79) Other cancer 1.0 1.4 0.67 (0.40-1.12) Eczema or psoriasis 10.5 9.5...response (31.0% vs. 31.9%) (Table IV). The percentage or doctor visits, or number of hospitalizations. Conversely, when distribution of number of days at...general health status of clinic or doctor visits made during the past 12 months because between exposed and unexposed veterans (p = 0.72; Table VII). of

  13. 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

  14. Social cognition in schizophrenia, Part 2: 12-month stability and prediction of functional outcome in first-episode patients.

    PubMed

    Horan, William P; Green, Michael F; DeGroot, Michael; Fiske, Alan; Hellemann, Gerhard; Kee, Kimmy; Kern, Robert S; Lee, Junghee; Sergi, Mark J; Subotnik, Kenneth L; Sugar, Catherine A; Ventura, Joseph; Nuechterlein, Keith H

    2012-06-01

    This study evaluated the longitudinal stability and functional correlates of social cognition during the early course of schizophrenia. Fifty-five first-episode schizophrenia patients completed baseline and 12-month follow-up assessments of 3 key domains of social cognition (emotional processing, theory of mind, and social/relationship perception), as well as clinical ratings of real-world functioning and symptoms. Scores on all 3 social cognitive tests demonstrated good longitudinal stability with test-retest correlations exceeding .70. Higher baseline and 12-month social cognition scores were both robustly associated with significantly better work functioning, independent living, and social functioning at the 12-month follow-up assessment. Furthermore, cross-lagged panel analyses were consistent with a causal model in which baseline social cognition drove later functional outcome in the domain of work, above and beyond the contribution of symptoms. Social cognitive impairments are relatively stable, functionally relevant features of early schizophrenia. These results extend findings from a companion study, which showed stable impairments across patients in prodromal, first-episode, and chronic phases of illness on the same measures. Social cognitive impairments may serve as useful vulnerability indicators and early clinical intervention targets.

  15. Maternal Antenatal Depression and Infant Disorganized Attachment at 12 months

    PubMed Central

    Hayes, Lisa J.; Goodman, Sherryl H.; Carlson, Elizabeth

    2012-01-01

    Although high rates of attachment disorganization have been observed in infants of depressed mothers, little is known about the role of antenatal depression as a precursor to infant attachment disorganization. The primary aim of this study was to examine associations between maternal antenatal depression and infant disorganization at 12 months in a sample of women (N = 79) at risk for perinatal depression. A secondary aim was to test the roles of maternal postpartum depression and maternal parenting quality as potential moderators of this predicted association. Among women with histories of major depressive episodes, maternal depressive symptoms were assessed at multiple times during pregnancy and the first year postpartum, maternal parenting quality was measured at 3 months postpartum, and attachment disorganization was assessed at 12 months postpartum. Results revealed that infants classified as disorganized had mothers with higher levels of depressive symptoms during pregnancy compared to infants classified as organized. Maternal parenting quality moderated this association, as exposure to higher levels of maternal depressive symptoms during pregnancy was only associated with higher rates of infant disorganized attachment when maternal parenting at 3 months was less optimal. These findings suggest that enhancing maternal parenting behaviors during this early period in development has the potential to alter pathways to disorganized attachment among infants exposed to antenatal maternal depressive symptoms, which could have enduring consequences for child wellbeing. PMID:23216358

  16. 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

  17. Correlation of serum KL-6 and CC16 levels with neurodevelopmental outcome in premature infants at 12 months corrected age

    PubMed Central

    Zhang, Zhiqun; Lu, Hui; Zhu, Yunxia; Xiang, Junhua; Huang, Xianmei

    2015-01-01

    The aim of this study was to evaluate KL-6 and CC16 levels and their correlation with neurodevelopmental outcome among very low birth weight pre-term infants at 12 months corrected age. This prospective cohort study was performed from 2011 to 2013 by enrolling pre-term neonates of gestational age ≤ 32 weeks and birth weight ≤ 1500 g. Serum KL-6 and CC16 levels were determined 7 days after birth and their correlation with neurodevelopment was evaluated using Gesell Mental Developmental Scales. Of the 86 eligible pre-term infants, 63 completed follow-up, of which 15 had bronchopulmonary dysplasia. At 12 months corrected age, 49 infants had favorable outcomes and 14 infants had poor neurodevelopmental outcome. KL-6 levels were higher and CC16 levels were lower in infants with poor neurodevelopmental outcome compared with those infants who had favourable neurodevelopmental outcome. Serum KL-6 levels less than 90.0 ng/ml and CC16 levels greater than 320.0 pg/ml at 7 days of life were found to be predictive of a favourable outcome at 12 months corrected age. These biological markers could predict neurodevelopmental outcome at 12 months corrected age in very low birth weight premature infants, and help the clinician plan early therapeutic interventions to minimize or avoid poor neurodevelopmental outcome. PMID:25631862

  18. Ethosuximide, Valproic Acid and Lamotrigine in Childhood Absence Epilepsy: Initial Monotherapy Outcomes at 12 months

    PubMed Central

    Glauser, Tracy A.; Cnaan, Avital; Shinnar, Shlomo; Hirtz, Deborah G.; Dlugos, Dennis; Masur, David; Clark, Peggy O.; Adamson, Peter C.

    2012-01-01

    Purpose Determine the optimal initial monotherapy for children with newly diagnosed childhood absence epilepsy based on 12 months of double blind therapy. Methods A double-blind, randomized controlled clinical trial compared the efficacy, tolerability and neuropsychological effects of ethosuximide, valproic acid and lamotrigine in children with newly diagnosed childhood absence epilepsy. Study medications were titrated to clinical response and subjects remained in the trial unless they reached a treatment failure criterion. Maximal target doses were ethosuximide 60 mg/kg/day or 2000 mg/day, valproic acid 60 mg/kg/day or 3000 mg/day and lamotrigine 12 mg/kg/day or 600 mg/day. Original primary outcome was at 16–20 weeks and included a video EEG assessment. For this report, the main effectiveness outcome was the freedom from failure rate 12 months after randomization and included a video EEG assessment; differential drug effects were determined by pairwise comparisons. The main cognitive outcome was the percentage of subjects experiencing attentional dysfunction at the Month 12 visit. Key Findings A total of 453 children were enrolled and randomized; seven were deemed ineligible and 446 subjects comprised the overall efficacy cohort. There were no demographic differences between the three cohorts. By 12 months after starting therapy, only 37% of all enrolled subjects were free from treatment failure on their first medication. At the Month 12 visit, the freedom-from-failure rates for ethosuximide and valproic acid were similar (45% and 44%, respectively; odds ratio with valproic acid vs. ethosuximide, 0.94; 95% confidence interval [CI], 0.60 to 1.48; P = 0.82) and were higher than the rate for lamotrigine (21%; odds ratio with ethosuximide vs. lamotrigine, 3.09; 95% CI, 1.86 to 5.13; odds ratio with valproic acid vs. lamotrigine, 2.90; 95% CI, 1.74 to 4.83; P<0.001 for both comparisons). The frequency of treatment failures due to lack of seizure control (p < 0

  19. Extracorporeal shock wave therapy vs cryoultrasound therapy in the treatment of chronic lateral epicondylitis. One year follow up study

    PubMed Central

    Vulpiani, Maria Chiara; Nusca, Sveva Maria; Vetrano, Mario; Ovidi, Serena; Baldini, Rossella; Piermattei, Cristina; Ferretti, Andrea; Saraceni, Vincenzo Maria

    2015-01-01

    Summary Background the purpose of this study is to compare the therapeutic effects of extracorporeal shock wave therapy (ESWT) to those of cryoultrasound (Cryo-US) therapy in chronic lateral epicondylitis during a 12-month period. Methods single-blinded, randomized, controlled study of 80 participants treated for chronic LE with 3 ESWT sessions at 48/72-hours intervals (n=40) or 12 Cryo-US therapy sessions (4 sessions per week) (n=40). VAS and satisfactory results, considered as the sum of excellent and good scores in the Roles and Maudsley score, were used as outcome measures at baseline and 3, 6 and 12 months post-treatment. Results the results show statistically significant differences in VAS between the two groups at 6 (p<0.001) and 12 months (p<0.001) in favour of the ESWT Group. At 12 months, a difference of more than 2 points in the VAS between the two groups is demonstrated in favour of the ESWT Group. Considering satisfactory results, significant differences between the two groups are observed at 6 (p=0.003) and 12 months (p <0.001) in favour of the ESWT Group where patients achieve a satisfactory rate over 50%. Conclusions ESWT has better clinical therapeutic results at 6- and 12-month follow-up as compared to Cryo-US therapy. Level of Evidence 1B. PMID:26605190

  20. Hypoglossal nerve stimulation improves obstructive sleep apnea: 12-month outcomes.

    PubMed

    Kezirian, Eric J; Goding, George S; Malhotra, Atul; O'Donoghue, Fergal J; Zammit, Gary; Wheatley, John R; Catcheside, Peter G; Smith, Philip L; Schwartz, Alan R; Walsh, Jennifer H; Maddison, Kathleen J; Claman, David M; Huntley, Tod; Park, Steven Y; Campbell, Matthew C; Palme, Carsten E; Iber, Conrad; Eastwood, Peter R; Hillman, David R; Barnes, Maree

    2014-02-01

    Reduced upper airway muscle activity during sleep is a key contributor to obstructive sleep apnea pathogenesis. Hypoglossal nerve stimulation activates upper airway dilator muscles, including the genioglossus, and has the potential to reduce obstructive sleep apnea severity. The objective of this study was to examine the safety, feasibility and efficacy of a novel hypoglossal nerve stimulation system (HGNS; Apnex Medical, St Paul, MN, USA) in treating obstructive sleep apnea at 12 months following implantation. Thirty-one subjects (35% female, age 52.4 ± 9.4 years) with moderate to severe obstructive sleep apnea and unable to tolerate positive airway pressure underwent surgical implantation and activation of the hypoglossal nerve stimulation system in a prospective single-arm interventional trial. Primary outcomes were changes in obstructive sleep apnea severity (apnea-hypopnea index, from in-laboratory polysomnogram) and sleep-related quality of life [Functional Outcomes of Sleep Questionnaire (FOSQ)]. Hypoglossal nerve stimulation was used on 86 ± 16% of nights for 5.4 ± 1.4 h per night. There was a significant improvement (P < 0.001) from baseline to 12 months in apnea-hypopnea index (45.4 ± 17.5 to 25.3 ± 20.6 events h(-1) ) and Functional Outcomes of Sleep Questionnaire score (14.2 ± 2.0 to 17.0 ± 2.4), as well as other polysomnogram and symptom measures. Outcomes were stable compared with 6 months following implantation. Three serious device-related adverse events occurred: an infection requiring device removal; and two stimulation lead cuff dislodgements requiring replacement. There were no significant adverse events with onset later than 6 months following implantation. Hypoglossal nerve stimulation demonstrated favourable safety, feasibility and efficacy.

  1. 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

  2. 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…

  3. Ultrasound-Guided Radiofrequency Thermal Ablation of Uterine Fibroids: Medium-Term Follow-Up

    SciTech Connect

    Carrafiello, Gianpaolo; Recaldini, Chiara Fontana, Federico; Ghezzi, Fabio; Cuffari, Salvatore; Lagana, Domenico; Fugazzola, Carlo

    2010-02-15

    Previous studies have shown that radiofrequency thermal ablation (RFA) of uterine fibroids through a percutaneous ultrasound (US)-guided procedure is an effective and safe minimally invasive treatment, with encouraging short-term results. The aim of this study was to assess the results in terms of volume reduction and clinical symptoms improvement in the midterm follow-up of fibroids with a diameter of up to 8 cm. Eleven premenopausal females affected by symptomatic fibroids underwent percutaneous US-guided RFA. Symptom severity and reduction in volume were evaluated at 1, 3, 6, 9, and 12 months. The mean symptom score (SSS) before the procedure was 50.30 (range 31.8-67.30), and the average quality of life (QOL) score value was 62 (range 37.20-86.00). The mean basal diameter was 5.5 cm (range 4.4-8) and the mean volume was 101.5 cm{sup 3} (range 44.58-278 cm{sup 3}). The mean follow-up was 9 months (range 3-12 months). The mean SSS value at the end of the follow-up was 13.38 (range 0-67.1) and the QOL 90.4 (range 43.8-100). At follow-up the mean diameter was 3.0 cm (range 1.20-4.5 cm), and the mean volume was 18 cm{sup 3} (range 0.90-47.6 cm{sup 3}). In 10 of 11 patients we obtained total or partial regression of symptoms. In one case the clinical manifestations persisted and it was thus considered unsuccessful. In conclusion, US-guided percutaneous RFA is a safe and effective treatment even for fibroids up to 8 cm.

  4. 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...

  5. Risk factors associated with high thyroglobulin level following radioactive iodine ablation, measured 12 months after treatment for papillary thyroid carcinoma

    PubMed Central

    Kim, Eun Young; Hyun, Kee Hoon; Park, Yong Lai; Park, Chan Heun

    2017-01-01

    Purpose The measurement of serum thyroglobulin (Tg) of papillary thyroid carcinoma patients, 12 months after total thyroidectomy and radioactive iodine (RAI) ablation following thyroxine hormone withdrawal (T4-off Tg) or recombinant human thyroid-stimulating hormone stimulation (rhTSH-Tg), is standard method for monitoring disease status. The aim of this study was to find predictive factors for detectable T4-off Tg during follow-up. Methods A retrospective review was conducted of 329 patients who underwent total thyroidectomy and RAI ablation between October 2008 and August 2012. Subjects were assigned to high (>1 ng/mL, n = 53) and low (≤1 ng/mL, n = 276) groups, based on T4-off Tg measured 12 months postoperatively. Demographic and clinicopathological characteristics at diagnosis and follow-up were compared between the 2 groups. Results The low and high T4-off Tg groups differed with respect to tumor size, preoperative Tg, ablative Tg, cervical lymph node metastasis, thyroglobulinemia out of proportion to results of diagnostic whole body scan, and American Thyroid Association 3-level stratification and restratification. Multivariate analysis confirmed that ablative Tg > 1.0 ng/mL (odds ratio [OR], 10.801; P = 0.001), more than 5 cervical lymph node metastasis (OR, 6.491; P = 0.003), and thyroglobulinemia out of proportion (OR, 9.221; P = 0.000) were risk factors. Conclusion Ablative Tg >1.0 ng/mL, more than 5 cervical lymph node metastasis, and thyroglobulinemia out of proportion were independent factors for T4-off Tg >1 ng/mL 12 months postoperative. In low-risk patients without these risk factors, the possible omission of Tg measurements could be considered during follow-up. PMID:28090499

  6. Peak Oxygen Uptake after Cardiac Rehabilitation: A Randomized Controlled Trial of a 12-Month Maintenance Program versus Usual Care

    PubMed Central

    Madssen, Erik; Arbo, Ingerid; Granøien, Ingrid; Walderhaug, Liv; Moholdt, Trine

    2014-01-01

    Background Exercise capacity is a strong predictor of survival in patients with coronary artery disease (CAD). Exercise capacity improves after cardiac rehabilitation exercise training, but previous studies have demonstrated a decline in peak oxygen uptake after ending a formal rehabilitation program. There is a lack of knowledge on how long-term exercise adherence can be achieved in CAD patients. We therefore assessed if a 12-month maintenance program following cardiac rehabilitation would lead to increased adherence to exercise and increased exercise capacity compared to usual care. Materials and Methods Two-centre, open, parallel randomized controlled trial with 12 months follow-up comparing usual care to a maintenance program. The maintenance program consisted of one monthly supervised high intensity interval training session, a written exercise program and exercise diary, and a maximum exercise test every third month during follow-up. Forty-nine patients (15 women) on optimal medical treatment were included following discharge from cardiac rehabilitation. The primary endpoint was change in peak oxygen uptake at follow-up; secondary endpoints were physical activity level, quality of life and blood markers of cardiovascular risk. Results There was no change in peak oxygen uptake from baseline to follow-up in either group (intervention group 27.9 (±4.7) to 28.8 (±5.6) mL·kg (-1) min (−1), control group 32.0 (±6.2) to 32.8 (±5.8) mL·kg (−1) min (−1), with no between-group difference, p = 0.22). Quality of life and blood biomarkers remained essentially unchanged, and both self-reported and measured physical activity levels were similar between groups after 12 months. Conclusions A maintenance exercise program for 12 months did not improve adherence to exercise or peak oxygen uptake in CAD patients after discharge from cardiac rehabilitation compared to usual care. This suggests that infrequent supervised high intensity interval training sessions are

  7. Patterns of mother-infant interaction from 3 to 12 months among dyads with substance abuse and psychiatric problems.

    PubMed

    Siqveland, Torill S; Haabrekke, Kristin; Wentzel-Larsen, Tore; Moe, Vibeke

    2014-11-01

    The aim of this study was to investigate the development of mother-infant interaction patterns from 3 to 12 months among three groups of mother-baby pairs recruited during pregnancy: one group from residential substance abuse treatment (n=28), a second group from psychiatric outpatient treatment (n=22), and a third group from well-baby clinics (n=30). The mother-infant interaction at 3 and 12 months was assessed by the Parent-Child Early Relational Assessment (PCERA), which consists of maternal, child and dyadic subscales (Clark, 2006). Linear mixed effects models were used to analyze group differences and the changes in mother-infant interaction from 3 to 12 months. At 3 months, pairwise comparisons showed that the group with psychiatric problems had significantly more difficulties in the mother-infant interaction than the two other groups. The group with substance abuse problems was not significantly different from the two other groups. At 12 months, the mother-infant pairs in the substance abuse group showed significantly more relational disturbances than the non-clinical pairs, as well as a poorer affective quality of interaction than the dyads in the group with psychiatric problems. Analysis of change from 3 to 12 months showed that difficulties in the interaction increased among the mother-baby pairs in the substance abuse group, while improvements were displayed in the two other groups. These results underline that mother-infant pairs at double risk due to maternal substance abuse and other non-optimal factors, are in need for long-term follow up in order to prevent the development of negative interactional patterns.

  8. Hyponatremia at discharge as a predictor of 12-month clinical outcomes in hospital survivors after acute myocardial infarction.

    PubMed

    Bae, Myung Hwan; Kim, Jae Hee; Jang, Se Yong; Park, Sun Hee; Lee, Jang Hoon; Yang, Dong Heon; Park, Hun Sik; Cho, Yongkeun; Chae, Shung Chull

    2017-02-01

    Hyponatremia in the early phase of acute myocardial infarction (AMI) is a well-known predictor of poor prognosis. However, little is known about the clinical implication of sodium levels at discharge in hospital survivors after AMI. The study included 1290 consecutive patients (64 ± 12 years; 877 men) who survived the index hospitalization after AMI. We determined the 12-month mortality rates of these patients. Patients who died during the 12-month follow-up had lower sodium levels at discharge than those who had survived (137 ± 6 vs. 139 ± 4 mmol/L; P < 0.014). Hyponatremia at discharge, defined as a serum sodium level ≤135 mmol/L, was present in 210 patients (16.3 %). In the Cox-proportional hazard model, hyponatremia at discharge (hazard ratio, 2.264; 95 % confidence interval, 1.119-4.579; P = 0.023) was an independent predictor of 12-month mortality. Moreover, hyponatremia at discharge had an incremental prognostic value over conventional risk factors (χ (2) = 7, P = 0.007), and conventional risk factors and log N-terminal Pro-B-type natriuretic peptide combined (χ (2) = 5, P = 0.021). In the subgroup analysis, the 12-month mortality of patients with hyponatremia at discharge was significantly higher than in those without, irrespective of age, Killip class, left ventricular ejection fraction, percutaneous coronary intervention at index hospitalization, and prescription of diuretics at discharge. Hyponatremia at discharge is an independent predictor of 12-month mortality in hospital survivors after AMI.

  9. Twelve-month follow-up of virtual reality and standard exposure therapies for the fear of flying.

    PubMed

    Rothbaum, Barbara Olasov; Hodges, Larry; Anderson, Page L; Price, Larry; Smith, Samantha

    2002-04-01

    This study reports the 12-month follow-up from patients with the fear of flying who were treated in a controlled study and randomly assigned (n = 49) to virtual reality exposure (VRE) therapy, standard exposure (SE) therapy, or to a wait-list control (WL). VRE and SE were equally superior to WL. At 12 months posttreatment, data were gathered on 24 of the 30 (80%) patients who were assigned to VRE or SE. Patients maintained their treatment gains, and 92% of VRE participants and 91% of SE participants had flown on a real airplane since the graduation flight. This is the 1st year-long follow-up of patients having been treated with VRE and indicates that short-term treatment can have lasting effects.

  10. Ospemifene 12-month safety and efficacy in postmenopausal women with vulvar and vaginal atrophy

    PubMed Central

    2014-01-01

    Objective Assessment of 12-month safety of ospemifene 60 mg/day for treatment of postmenopausal women with vulvar and vaginal atrophy (VVA). Methods In this 52-week, randomized, double-blind, placebo-controlled, parallel-group study, women 40–80 years with VVA and an intact uterus were randomized 6 : 1 to ospemifene 60 mg/day or placebo. The primary objective was 12-month safety, particularly endometrial; 12-week efficacy was assessed. Safety assessments included endometrial histology and thickness, and breast and gynecological examinations. Efficacy evaluations included changes from baseline to week 12 in percentage of superficial and parabasal cells and vaginal pH. Results Of 426 randomized subjects, 81.9% (n = 349) completed the study with adverse events the most common reason for discontinuation (ospemifene 9.5%; placebo 3.9%). Most (88%) treatment-emergent adverse events with ospemifene were considered mild or moderate. Three cases (1.0%) of active proliferation were observed in the ospemifene group. For one, active proliferation was seen at end of study week 52, and diagnosed as simple hyperplasia without atypia on follow-up biopsy 3 months after the last dose. This subsequently resolved with progestogen treatment and dilatation and curettage. In six subjects (five ospemifene (1.4%), one placebo (1.6%)) endometrial polyps were found (histopathology); however, only one (ospemifene) was confirmed as a true polyp during additional expert review. Endometrial histology showed no evidence of carcinoma. Statistically significant improvements were seen for all primary and secondary efficacy measures and were sustained through week 52 with ospemifene vs. placebo. Conclusions The findings of this 52-week study confirm the tolerance and efficacy of oral ospemifene previously reported in short- and long-term studies. PMID:23984673

  11. 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

  12. Gist extraction and sleep in 12-month-old infants.

    PubMed

    Konrad, Carolin; Herbert, Jane S; Schneider, Silvia; Seehagen, Sabine

    2016-10-01

    Gist extraction is the process of excerpting shared features from a pool of new items. The present study examined sleep and the consolidation of gist in 12-month-old infants using a deferred imitation paradigm. Sixty infants were randomly assigned to a nap, a no-nap or a baseline control condition. In the nap and no-nap conditions, infants watched demonstrations of the same target actions on three different hand puppets that shared some features. During a 4-h delay, infants in the nap condition took a naturally scheduled nap while infants in the no-nap condition naturally stayed awake. Afterwards, infants were exposed to a novel forth hand puppet that combined some of the features from the previously encountered puppets. Only those infants who took a nap after learning produced a significantly higher number of target actions than infants in the baseline control condition who had not seen any demonstrations of target actions. Infants in the nap condition also produced significantly more target actions than infants in the no-nap condition. Sleep appears to support the storage of gist, which aids infants in applying recently acquired knowledge to novel circumstances.

  13. Outcome of anthroposophic medication therapy in chronic disease: A 12-month prospective cohort study

    PubMed Central

    Hamre, Harald J; Witt, Claudia M; Glockmann, Anja; Ziegler, Renatus; Kienle, Gunver S; Willich, Stefan N; Kiene, Helmut

    2008-01-01

    Background Anthroposophic medications (AMED) are prescribed in 56 countries. Objective To study clinical outcomes in patients prescribed AMED for chronic disease. Design Prospective cohort study. Setting 110 medical practices in Germany. Participants 665 consecutive outpatients aged 1–71 years, prescribed AMED for mental, respiratory, musculoskeletal, neurological, genitourinary, and other chronic diseases. Main outcomes Disease and Symptom Scores (physicians’ and patients’ assessment, 0–10) and SF-36. Results During the first six months, an average of 1.5 AMED per patient was used, in total 652 different AMED. Origin of AMED was mineral (8.0% of 652 AMED), botanical (39.0%), zoological (7.2%), chemically defined (13.0%), and mixed (33.0%). From baseline to six-month-follow-up, all outcomes improved significantly: Disease Score improved by mean 3.15 points (95% confidence interval 2.97–3.34, p < 0.001), Symptom Score by 2.43 points (2.23–2.63, p < 0.001), SF-36 Physical Component Summary by 3.04 points (2.16–3.91, p < 0.001), and SF-36 Mental Component Summary by 5.75 points (4.59–6.92, p < 0.001). All improvements were maintained at 12-month follow-up. Improvements were similar in adult men and women, in children, and in patients not using adjunctive therapies. Conclusion Outpatients using AMED for chronic disease had long-term reduction of disease severity and improvement of quality of life. PMID:19920891

  14. Twelve months follow-up after retrograde recanalization of superficial femoral artery chronic total occlusion

    PubMed Central

    Wojtasik-Bakalarz, Joanna; Arif, Salech; Chyrchel, Michał; Rakowski, Tomasz; Bartuś, Krzysztof; Dudek, Dariusz

    2017-01-01

    Introduction Fifty percent of cases of peripheral artery disease are caused by chronic total occlusion (CTO) of the superficial femoral artery (SFA). Ten–fifteen percent of percutaneous SFA recanalization procedures are unsuccessful. In those cases the retrograde technique can increase the success rate of the procedure, but the long-term follow-up of such procedures is still unknown. Aim To assess the efficacy and clinical outcomes during long-term follow-up after retrograde recanalization of the SFA. Material and methods We included patients after at least one unsuccessful percutaneous antegrade recanalization of the SFA. Patients were evaluated for the procedural and clinical follow-up of mean time 13.9 months. Results The study included 17 patients (7 females, 10 males) who underwent percutaneous retrograde recanalization of the SFA from June 2011 to June 2015. The mean age of patients was 63 ±7 years. Retrograde puncture of the distal SFA was successful in all cases. A retrograde procedure was performed immediately after antegrade failure in 4 (23.5%) patients and after a previously failed attempt in 13 (76.5%) patients. The procedure was successful in 15 (88.2%) patients, and unsuccessful in 2 (11.8%) patients. Periprocedural complications included 1 peripheral distal embolization (successfully treated with aspiration thrombectomy), 1 bleeding event from the puncture site and 7 puncture site hematomas. During follow-up the all-cause mortality rate was 5.8% (1 patient, non-cardiac death). The primary patency rate at 12 months was 88.2% and secondary patency 100%. Conclusions The retrograde SFA puncture seems to be a safe and successful technique for CTO recanalization and is associated with a low rate of perioperative and long-term follow-up complications. PMID:28344617

  15. 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.

  16. 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

  17. 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.

  18. 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

  19. Outcomes of Hepatic Resection in Intrahepatic Cholangiocarcinoma Patients with Diabetes, Hypertension, and Dyslipidemia: Significance of Routine Follow-Up

    PubMed Central

    Nishioka, Takayoshi; Kubo, Shoji; Tanaka, Shogo; Wakasa, Kenichi; Takemura, Shigekazu; Kinoshita, Masahiko; Hamano, Genya; Kuwae, Yuko; Shibata, Toshihiko; Suehiro, Shigefumi

    2016-01-01

    Background The outcomes of hepatic resection in intrahepatic cholangiocarcinoma (ICC) patients with diabetes mellitus (DM), hypertension (HT), and dyslipidemia (DL) (metabolic components) remain unclear. Methods The outcomes of 43 ICC patients without known risk factors for ICC who underwent hepatic resection were retrospectively reviewed. These patients were divided into three groups: those followed-up for metabolic components at least every 6 months (follow-up group, n=16), those not followed-up for metabolic components (no follow-up group, n=14), and those without metabolic components (control group, n=13). Results In the follow-up group, 13 (81%) patients were further examined for ICC during follow-up because of abnormal screening results, such as elevated serum gamma-glutamyl transpeptidase and carbohydrate antigen 19-9 (CA19-9) concentrations or detection of hepatic tumor on ultrasonography and/or computed tomography, whereas most patients in the other two groups exhibited ICC-related symptoms. No patient in the follow-up group exhibited lymph node metastasis, whereas 43% of those in the no follow-up group and 46% in the control group had lymph node metastasis (p=0.005 and 0.004 vs. the follow-up group, respectively). All 16 patients in the follow-up group were diagnosed as International Union Against Cancer pathologic stage I or II (early stage). There were no significant differences in the incidence of postoperative recurrence between the three groups; however, the incidence of extrahepatic recurrence was lower in the follow-up group than in the no follow-up group and the control group (13% vs. 78% vs. 63%, p=0.0232). The 1-, 3-, and 5-year overall survivalrates in the follow-up group were better than those in the no follow-up and control groups (93/93/66% vs. 77/34/34% and 85/24/0%, p=0.034 and 0.001, respectively). Conclusions Routine measurement of serum gamma-glutamyl transpeptidase and/or CA19-9 levels and imaging examinations every 12 months (or 6

  20. 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…

  1. 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...

  2. 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…

  3. 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...

  4. 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...

  5. Efficacy and safety of dienogest in patients with endometriosis: A single-center observational study over 12 months

    PubMed Central

    Park, So Yun; Chae, Hee Dong; Kim, Chung-Hoon; Kang, Byung Moon

    2016-01-01

    Objective To evaluate the efficacy and safety of dienogest treatment in patients who had received dienogest for 12 months or more to treat endometriosis. Methods We analyzed the clinical data of 188 women with endometriosis who had been treated with 2 mg of dienogest once a day for 12 months or more at a single institute. We evaluated changes in endometriosis-associated pain and endometrioma size, recurrence rate, and adverse events following dienogest administration. Bone mineral density (BMD) was measured in patients who were prescribed dienogest for more than 18 months. Results Pain was significantly reduced at 12 months after dienogest medication. In those treated with dienogest due to recurrent endometrioma, the size of the endometrioma was significantly decreased at the 12-month and 18-month follow-ups. We found only one case of sonographic recurrence during dienogest administration among those who were treated postoperatively to prevent recurrence (1 of 114, 0.9%). The most common adverse drug reaction was uterine bleeding (3.2%), and other adverse events were generally tolerable and associated with low discontinuation rates (5.2%). Among the 50 patients in whom BMD was measured, 10 patients (20%) had a Z-score below the expected range for age. Conclusion The administration of dienogest for a year or more seems to be highly effective in preventing recurrence after surgery, reducing endometriosis-associated pain, and decreasing the size of recurrent endometrioma, with a favorable safety and tolerability profile. However, BMD should be checked in patients on long-term medication due to possible bone loss in some women. PMID:28090460

  6. Improving Physical Health in Patients with Chronic Mental Disorders: 12-Month Results from a Randomized Controlled Collaborative Care Trial

    PubMed Central

    Kilbourne, Amy M.; Barbaresso, Michelle M.; Lai, Zongshan; Nord, Kristina M.; Bramlet, Margretta; Goodrich, David E.; Post, Edward P.; Almirall, Daniel; Bauer, Mark S.

    2015-01-01

    Objective Persons with chronic mental disorders are disproportionately burdened with physical health conditions. We determined whether Life Goals Collaborative Care compared to usual care improves physical health in patients with mental disorders within 12 months. Method This single-blind randomized controlled effectiveness study of a collaborative care model was conducted at a mid-western Veterans Affairs urban outpatient mental health clinic. Patients (N=293 out of 474 eligible approached) with an ICD-9-CM diagnosis of schizophrenia, bipolar disorder, or major depressive disorder and at least one cardiovascular disease risk factor were consented and randomized (02/24/10 to 04/29/15) to Life Goals (N=146) or usual care (N=147). A total of 287 completed baseline assessments and 245 completed 12-month follow-up assessments. Life Goals included five weekly sessions that provided semi-structured guidance on managing physical and mental health symptoms through healthy behavior changes, augmented by ongoing care coordination. The primary outcome was change in physical health-related quality of life score (VR-12 physical health component score). Secondary outcomes included control of cardiovascular risk factors from baseline to 12 months (blood pressure, lipids, weight), mental health-related quality of life, and mental health symptoms. Results Among patients completing baseline and 12-month outcomes assessments (N=245), the mean age was 55.3 (SD=10.8; range 28-75 years) and 15.4% were female. Intent-to-treat analysis revealed that compared to those in usual care, patients randomized to Life Goals had slightly increased VR-12 physical health scores (coefficient=3.21;p=0.01). Conclusion Patients with chronic mental disorders and cardiovascular disease risk who received Life Goals had improved physical health-related quality of life. PMID:27780336

  7. 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

  8. Outcomes of ≤6-month versus 12-month dual antiplatelet therapy after drug-eluting stent implantation

    PubMed Central

    Villablanca, Pedro A.; Massera, Daniele; Mathew, Verghese; Bangalore, Sripal; Christia, Panagiota; Perez, Irving; Wan, Ningxin; Schulz-Schüpke, Stefanie; Briceno, David F.; Bortnick, Anna E.; Garcia, Mario J.; Lucariello, Richard; Menegus, Mark; Pyo, Robert; Wiley, Jose; Ramakrishna, Harish

    2016-01-01

    Abstract Background: The benefit of ≤6-month compared with 12-month dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) placement remains controversial. We performed a meta-analysis and meta-regression of ≤6-month versus 12-month DAPT in patients undergoing PCI with DES placement. Methods: We conducted electronic database searches of randomized controlled trials (RCTs) comparing DAPT durations after DES placement. For studies with longer follow-up, outcomes at 12 months were identified. Odds ratios and 95% confidence intervals were computed with the Mantel–Haenszel method. Fixed-effect models were used; if heterogeneity (I2) > 40 was identified, effects were obtained with random models. Results: Nine RCTs were included with total n = 19,224 patients. No significant differences were observed between ≤6-month compared with 12-month DAPT in all-cause mortality (OR 0.87; 95% confidence interval (CI): 0.69–1.11), cardiovascular (CV) mortality (OR 0.89; 95% CI: 0.66–1.21), non-CV mortality (OR 0.85; 95% 0.58–1.24), myocardial infarction (OR 1.10; 95% CI: 0.89–1.37), stroke (OR 0.97; 95% CI: 0.67–1.42), stent thrombosis (ST) (OR 1.37; 95% CI: 0.89–2.10), and target vessel revascularization (OR 0.95; 95% CI: 0.77–1.18). No significant difference in major bleeding (OR 0.72; 95% CI: 0.49–1.05) was observed, though the all-bleeding event rate was significantly lower in the ≤6-month DAPT group (OR 0.76; 95% CI: 0.59–0.96). In the meta-regression analysis, a significant association between bleeding events and non-CV mortality with 12-month DAPT was found, as well as between ST and mortality in addition to MI with ≤6-month DAPT. Conclusion: DAPT for ≤6 months is associated with similar mortality and ischemic outcomes but less bleeding events compared with 12-month DAPT after PCI with DES. PMID:28033306

  9. 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.

  10. 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

  11. 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.

  12. 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

  13. 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.

  14. Inhaled fluticasone in bronchiectasis: a 12 month study

    PubMed Central

    Tsang, K; Tan, K; Ho, P; Ooi, G; Ho, J; Mak, J; Tipoe, G; Ko, C; Yan, C; Lam, W; Chan-Yeung, M

    2005-01-01

    Background: The clinical efficacy of inhaled corticosteroid (ICS) treatment has not been evaluated in bronchiectasis, despite the presence of chronic airway inflammation. Methods: After three consecutive weekly visits, 86 patients were randomised to receive either fluticasone 500 µg twice daily (n = 43, 23F, mean (SD) age 57.7 (14.4) years) or matched placebo (n = 43, 34F, 59.2 (14.2) years) and reviewed regularly for 52 weeks in a double blind fashion. Results: 35 and 38 patients in the fluticasone and placebo groups completed the study. Significantly more patients on ICS than on placebo showed improvement in 24 hour sputum volume (OR 2.5, 95% CI 1.1 to 6.0, p = 0.03) but not in exacerbation frequency, forced expiratory volume in 1 second, forced vital capacity, or sputum purulence score. Significantly more patients with Pseudomonas aeruginosa infection receiving fluticasone showed improvement in 24 hour sputum volume (OR 13.5, 95% CI 1.8 to 100.2, p = 0.03) and exacerbation frequency (OR 13.3, 95% CI 1.8 to 100.2, p = 0.01) than those given placebo. Logistic regression models revealed a significantly better response in sputum volume with fluticasone treatment than with placebo among subgroups of patients with 24 hour sputum volume <30 ml (p = 0.04), exacerbation frequency ⩽2/year (p = 0.04), and sputum purulence score >5 (p = 0.03). Conclusions: ICS treatment is beneficial to patients with bronchiectasis, particularly those with P aerurginosa infection. PMID:15741443

  15. Long-Term Follow-Up of Percutaneous Balloon Angioplasty in Adult Aortic Coarctation

    SciTech Connect

    Paddon, Alex J.; Nicholson, Anthony A.; Ettles, Duncan F.; Travis, Simon J.; Dyet, John F.

    2000-09-15

    Purpose: To assess long-term outcomes following percutaneous transluminal angioplasty (PTA) of congenital aortic coarctation in adults.Methods: Seventeen patients underwent PTA for symptomatic adult coarctation of the aorta. Sixteen patients, with a mean age of 28 years (range 15-60 years), were reviewed at a mean interval after angioplasty of 7.3 years (range 1.5-11 years). Assessment included magnetic resonance imaging (MRI), Doppler echocardiography, and clinical examination. Current clinical measurements were compared with pre- and immediate post-angioplasty measurements.Results: At follow-up 16 patients were alive and well. The patient not included in follow-up had undergone surgical repair and excision of the coarctation segment following PTA. Mean brachial systolic blood pressure for the group decreased from 174 mmHg before angioplasty to 130 mmHg at follow-up (p 0.0001). The mean gradient had fallen significantly from 50.9 to 17.8 at follow-up (p = 0.001). The average number of antihypertensive drugs required per patient decreased from 0.56 to 0.31 (p = 0.234). No significant residual stenoses or restenoses were seen at MRI. Small but clinically insignificant residual pressure gradients were recorded in all patients using Doppler echocardiography. Complications included one transient ischemic attack at 5 days, one external iliac dissection requiring stent insertion, and a further patient who developed a false aneurysm close to the coarctation site at 12 months which subsequently required surgical excision.Conclusion: PTA of adult coarctation is safe and effective in the long term. Although primary stenting has recently been advocated in the treatment of this condition, our results suggest that PTA remains the treatment of choice.

  16. 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.

  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. 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

  5. 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

  6. Telemedicine Versus Standard Follow-Up Care for Diabetes-Related Foot Ulcers: Protocol for a Cluster Randomized Controlled Noninferiority Trial (DiaFOTo)

    PubMed Central

    Espehaug, Birgitte; Hausken, Marie F; Graue, Marit; Østbye, Truls; Skeie, Svein; Cooper, John G; Tell, Grethe S; Günther, Bodo Erhardt; Dale, Håvard; Smith-Strøm, Hilde; Kolltveit, Beate-Christin H; Kirkevold, Marit; Rokne, Berit

    2016-01-01

    foot ulcers. In addition, qualitative substudies are being performed to provide a more comprehensive evaluation of the ongoing processes during the trial with the patients in the intervention and control groups and those health care professionals either working in primary care or in specialist care delivering the intervention. Results The project has been funded. The inclusion of patients started in September 2012. Because recruitment goals were not met in the initial period, two more clinical sites have been included to meet sample size requirements. Patient recruitment will continue until June 2016. Data collection in the qualitative substudies has been completed. Conclusions This telemedicine trial operates in a novel setting and targets patients with diabetes-related foot ulcers during a 12-month follow-up period. The trial addresses whether integrated care using telemedicine between primary and specialist health care can be an equivalent alternative to standard outpatient care. Trial Registration ClinicalTrials.gov NCT01710774; https://clinicaltrials.gov/ct2/show/NCT01710774 (Archived by WebCite at http://www.webcitation.org/6im6KfFov). PMID:27430301

  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. 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

  9. 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

  10. Extracranial carotid angioplasty and stenting. Initial results and short-term follow-up.

    PubMed Central

    Vozzi, C R; Rodriguez, A O; Paolantonio, D; Smith, J A; Wholey, M H

    1997-01-01

    Carotid percutaneous transluminal angioplasty, with or without stent implantation, is becoming another therapeutic option for carotid revascularization. To evaluate the feasibility and effectiveness of the technique, from October of 1995 to March of 1997, we performed 24 percutaneous transluminal angioplasty procedures in 22 patients with severe extracranial carotid artery stenosis. Three common carotid and 21 internal carotid arteries were treated, and 19 procedures included stent implantation using nonarticulated PALMAZ stents (P154 and P204). Twelve patients were asymptomatic and 10 patients were symptomatic; 2 of the symptomatic patients had complete obstruction of the internal carotid artery that was successfully recanalized. Technical and angiographic success was achieved in 23 of 24 procedures, with the carotid artery obstruction diminishing from 85.6% +/- 8.5% to 5.7% +/- 3.2% (P < 0.001). Average stenosis length was 12.5 +/- 3.1 mm, and mean time of carotid occlusion during balloon inflation was 11.5 +/- 2.5 seconds. Three patients experienced transitory seizures during the procedure prior to dilation, 1 patient had a minor stroke with complete recovery within 72 hours, and 1 patient had a major stroke and died 45 days after the procedure. Clinical follow-up was achieved in all patients (mean, 10.5 +/- 7.2 months) and angiographic follow-up in 16 patients (mean, 6.3 +/- 1.2 months). The results obtained in this initial experience provide adequate support to continue further evaluation of this new therapeutic strategy. Images PMID:9339503

  11. 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

  12. 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.

  13. Mother’s Emotional and Posttraumatic Reactions after a Preterm Birth: The Mother-Infant Interaction Is at Stake 12 Months after Birth

    PubMed Central

    Petit, Anne-Cécile; Eutrope, Julien; Thierry, Aurore; Bednarek, Nathalie; Aupetit, Laurence; Saad, Stéphanie; Vulliez, Lauriane; Sibertin-Blanc, Daniel; Nezelof, Sylvie; Rolland, Anne-Catherine

    2016-01-01

    Objectives Very preterm infants are known to be at risk of developmental disabilities and behavioural disorders. This condition is supposed to alter mother-infant interactions. Here we hypothesize that the parental coping with the very preterm birth may greatly influence mother-infant interactions. Methods 100 dyads were included in 3 university hospitals in France. Preterm babies at higher risk of neurodevelopmental sequelae (PRI>10) were excluded to target the maternal determinants of mother-infant interaction. We report the follow-up of this cohort during 1 year after very preterm birth, with regular assessment of infant somatic state, mother psychological state and the assessment of mother-infant interaction at 12 months by validated scales (mPPQ, HADS, EPDS, PRI, DDST and PIPE). Results We show that the intensity of post-traumatic reaction of the mother 6 months after birth is negatively correlated with the quality of mother-infant interaction at 12 months. Moreover, the anxious and depressive symptoms of the mother 6 and 12 months after birth are also correlated with the quality of mother-infant interaction at 12 months. By contrast, this interaction is not influenced by the initial affective state of the mother in the 2 weeks following birth. In this particular population of infants at low risk of sequelae, we also show that the quality of mother-infant interaction is not correlated with the assessment of the infant in the neonatal period but is correlated with the fine motor skills of the baby 12 months after birth. Conclusions This study suggests that mothers’ psychological condition has to be monitored during the first year of very preterm infants’ follow-up. It also suggests that parental interventions have to be proposed when a post-traumatic, anxious or depressive reaction is suspected. PMID:27022953

  14. The effect of a micronutrient-fortified complementary food on micronutrient status, growth and development of 6- to 12-month-old disadvantaged urban South African infants.

    PubMed

    Oelofse, A; Van Raaij, J M A; Benade, A J S; Dhansay, M A; Tolboom, J J M; Hautvast, J G A J

    2003-09-01

    The study was conducted to look at the effectiveness of a multimicronutrient-fortified complementary food on the micronutrient status, linear growth and psychomotor development of 6- to 12-month-old infants from a black urban disadvantaged community in the Western Cape, South Africa. The study was designed as an intervention study. In both the experimental and control groups, serum retinol concentration showed a decline over the intervention period of 6 months. The decline was less pronounced in the experimental group. This resulted in a significantly (P<005) higher serum retinol concentration at 12 months in the experimental group (26.8+/-5.8 microg/dl) compared with the control group (21.4+/-5 microg/dl). Serum iron concentration also declined over the intervention period. The decline was less pronounced in the experimental group. No difference was observed in haemoglobin levels between the groups at 12 months. Serum zinc concentration did not differ significantly between the two groups at follow up. Weight gain over the 6 months period did not differ significantly between the experimental (2.1+/-0.9 kg) and control groups (2.1+/-1.2 kg). There was no difference in linear growth between the experimental (10.0+/-1.5 cm) and control group (10.1+/-2.1 cm) at the end of the follow-up period. Weight and length at 6 months significantly predicted weight and length at 12 months. No difference was observed in psychomotor developmental scores between the two groups after 6 months of intervention. Introducing a multimicronutrient-fortified complementary food into the diet of 6- to 12-month-old infants seemed to have an arresting effect on declining serum retinol and iron concentration in the experimental group. No benefit was observed in serum zinc concentration, linear growth and psychomotor development.

  15. Overgeneral autobiographical memory at baseline predicts depressive symptoms at follow-up in patients with first-episode depression.

    PubMed

    Liu, Yansong; Zhang, Fuquan; Wang, Zhiqiang; Cao, Leiming; Wang, Jun; Na, Aiguo; Sun, Yujun; Zhao, Xudong

    2016-09-30

    Previous studies have shown that overgeneral autobiographical memory (OGM) is a characteristic of depression. However, there are no studies to explore the association between baseline OGM and depressive symptoms at follow-up in patients with first-episode depression (FE). This study investigated whether baseline OGM predicts depressive symptoms at follow-up in patients with FE. We recruited 125 patients with FE. The participants were divided into remitted group and non-remitted group according to the severity of their depression at 12 months follow-up. The measures consisted of the 17-item Hamilton Depression Rating Scale, Ruminative Response Scale, and Autobiographical Memory Test. Hierarchical linear regression analyses and bootstrap mediation analyses were conducted. The results showed that non-remitted patients had more OGM at baseline. Baseline OGM predicted depressive symptoms at follow-up in patients with FE. Rumination mediated the relationship between baseline OGM and depressive symptoms at follow-up. Our findings highlight OGM as a vulnerability factor involved in the maintenance of depression in patients with FE.

  16. Clinical application and long-term follow-up study of porcine acellular dermal matrix combined with autoskin grafting.

    PubMed

    Jiong, Chen; Jiake, Chai; Chunmao, Han; Yingen, Pan; Qiuhe, Wu; Zhouxi, Fang; Xiangsheng, Feng

    2010-01-01

    The purpose of this study was to investigate the clinical effects of porcine acellular dermal matrix combined with autoskin grafting on full-thickness skin defects using long-term clinical follow-up study and histologic examination. One hundred fifty-two patients with deep burn or trauma hospitalized from February 2000 to July 2003 were repaired with porcine acellular dermal matrix and split-thickness autoskin graft. Take rate of the grafts was calculated on 1 week after operation. Scar hyperplasia was examined on 1, 3, 6, and 12 months after operation. At the same time, the contracture rates of grafted areas were also calculated. Skin biopsy was performed on five patients for histologic examination, as well as transmission electron microscopy 78 months after operation. The take rate of grafts of 116 patients (76.3%) was 100%, and the take rate of the rest of the patients (36 patients, 23.7%) was more than 95%. No one needed skin transplantation for the second time. One hundred twenty-seven patients were followed up on 1 month after operation; grafts showed mild contraction. There was slight cicatricle at skin junction with tender texture. There was no obvious pruritus and blister. One hundred one patients were followed up on 3 months after operation. The graft contraction showed obvious relief with good articular function. Eighty-two patients were followed up on 6 months after operation. The color and texture of the grafts were similar to normal skin without obvious cicatricial hyperplasia. Fifty-eight patients were followed up on 12 months after operation. The grafts were similar to normal skin without obvious rejection. There were no significant differences between the contracture rates at 3, 6, and 12 months and 1 month after the second surgery. Sixteen patients were followed up on 78 months after operation. The appearance of grafts was slightly dry compared with normal skin. Tissue structure of grafts was similar to normal skin with sweat gland-like structure

  17. 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.

  18. One year outcomes in patients with acute lung injury randomised to initial trophic or full enteral feeding: prospective follow-up of EDEN randomised trial

    PubMed Central

    Dinglas, Victor D; Bienvenu, O Joseph; Colantuoni, Elizabeth; Wozniak, Amy W; Rice, Todd W

    2013-01-01

    Objective To evaluate the effect of initial low energy permissive underfeeding (“trophic feeding”) versus full energy enteral feeding (“full feeding”) on physical function and secondary outcomes in patients with acute lung injury. Design Prospective longitudinal follow-up evaluation of the NHLBI ARDS Clinical Trials Network’s EDEN trial Setting 41hospitals in the United States. Participants 525 patients with acute lung injury. Interventions Randomised assignment to trophic or full feeding for up to six days; thereafter, all patients still receiving mechanical ventilation received full feeding. Measurements Blinded assessment of the age and sex adjusted physical function domain of the SF-36 instrument at 12 months after acute lung injury. Secondary outcome measures included survival; physical, psychological, and cognitive functioning; quality of life; and employment status at six and 12 months. Results After acute lung injury, patients had substantial physical, psychological, and cognitive impairments, reduced quality of life, and impaired return to work. Initial trophic versus full feeding did not affect mean SF-36 physical function at 12 months (55 (SD 33) v 55 (31), P=0.54), survival to 12 months (65% v 63%, P=0.63), or nearly all of the secondary outcomes. Conclusion In survivors of acute lung injury, there was no difference in physical function, survival, or multiple secondary outcomes at 6 and 12 month follow-up after initial trophic or full enteral feeding. Trial Registration NCT No 00719446 PMID:23512759

  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. 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.

  1. Correlation of EEG, CT, and MRI Brain with Neurological Outcome at 12 Months in Term Newborns with Hypoxic Ischemic Encephalopathy

    PubMed Central

    Jose, Annu; Matthai, John; Paul, Sarah

    2013-01-01

    Objective: To correlate electroencephalogram (EEG), computed tomography (CT), and magnetic resonance imaging (MRI) brain with neurological outcome at 12 months in term neonates with hypoxic ischemic encephalopathy. Design: Prospective observational study. Setting: Neonatal intensive care unit (NICU) in a tertiary care teaching hospital. Materials and Methods: The study was conducted between June 2010 and November 2011. Consecutive term neonates with perinatal asphyxia and hypoxic ischemic encephalopathy were the subjects. All babies were managed as per standard protocol. EEG was done as soon as the baby was stable and CT brain within 7 days. MRI was done at 3 months. Neurodevelpmental assessment was done at 12 months. Results: Of the 31 babies, four died and one was lost to follow-up. Neurodevelopmental at 12 months of age was normal in 15 babies. EEG was normal in six babies and all of them had a normal neurodevelopment. Thirteen of the 14 babies with burst suppression pattern were abnormal (P<0.001). CT brain was normal in 14 and all of them had normal neurodevelopment (P<0.001), while 11 of the 12 with cerebral edema had abnormal outcome (P<0.001). Of the 16 babies with normal MRI, 14 were normal, while all six babies with abnormal signals in the cortex and thalamus had abnormal outcome (P=0.002). Conclusions: A normal EEG and CT brain in a term newborn with hypoxic ischemic encephalopathy (HIE) is associated with good neurological outcome. Burst suppression pattern in EEG, bleeds, or hypodensities in the CT and involvement of basal ganglia/thalamus in the MRI are predictors of abnormal outcome. PMID:24251256

  2. 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

  3. Longitudinal follow-up of muscle echotexture in infants with congenital muscular torticollis

    PubMed Central

    Hu, Ching-Fang; Fu, Tieh-Cheng; Chen, Chung-Yao; Chen, Carl Pai-Chu; Lin, Yu-Ju; Hsu, Chih-Chin

    2017-01-01

    Abstract Unilateral fibrous contracture of the sternocleidomastoid (SCM) muscle is the major pathophysiology in infants with congenital muscular torticollis (CMT). Physical examination is not always sufficient to detect minimal muscle fibrosis in involved SCM muscles. A prospective study for SCM muscle fibrosis in CMT infants by quantifying echotexture and muscle thickness during the course of treatment is highlighted in the study. Convenience samples of 21 female and 29 male infants with CMT, who were 1 to 12 months old, underwent physiotherapy for at least 3 months and were followed for 4.7 ± 0.4 months. All infants had at least 2 clinical assessments and ultrasonographic examinations for bilateral SCM muscles during follow-up. The K value, derived from the difference in echo intensities between the involved and uninvolved SCM muscles on longitudinal sonograms, was used to represent the severity of muscle fibrosis. Bilateral SCM muscle thickness and ratio of involved to uninvolved muscle thickness (Ratio I/U) were obtained simultaneously. Clinical outcome was also recorded. No subjects underwent surgical intervention during follow-up. The K value decreased from 6.85 ± 0.58 to 1.30 ± 0.36 at the end of follow-up (P < 0.001), which reflected the decrease of muscle fibrosis. The Ratio I/U decreased from 1.11 ± 0.04 to 0.97 ± 0.02 during treatment, which was possibly related to the increased uninvolved SCM muscle thickness. In conclusion, echotexture is an efficient indicator for reflecting a wide degree of muscle fibrosis in infants with CMT and is informative during the treatment course. PMID:28178161

  4. Longitudinal follow-up of muscle echotexture in infants with congenital muscular torticollis.

    PubMed

    Hu, Ching-Fang; Fu, Tieh-Cheng; Chen, Chung-Yao; Chen, Carl Pai-Chu; Lin, Yu-Ju; Hsu, Chih-Chin

    2017-02-01

    Unilateral fibrous contracture of the sternocleidomastoid (SCM) muscle is the major pathophysiology in infants with congenital muscular torticollis (CMT). Physical examination is not always sufficient to detect minimal muscle fibrosis in involved SCM muscles.A prospective study for SCM muscle fibrosis in CMT infants by quantifying echotexture and muscle thickness during the course of treatment is highlighted in the study.Convenience samples of 21 female and 29 male infants with CMT, who were 1 to 12 months old, underwent physiotherapy for at least 3 months and were followed for 4.7 ± 0.4 months. All infants had at least 2 clinical assessments and ultrasonographic examinations for bilateral SCM muscles during follow-up. The K value, derived from the difference in echo intensities between the involved and uninvolved SCM muscles on longitudinal sonograms, was used to represent the severity of muscle fibrosis. Bilateral SCM muscle thickness and ratio of involved to uninvolved muscle thickness (Ratio I/U) were obtained simultaneously. Clinical outcome was also recorded.No subjects underwent surgical intervention during follow-up. The K value decreased from 6.85 ± 0.58 to 1.30 ± 0.36 at the end of follow-up (P < 0.001), which reflected the decrease of muscle fibrosis. The Ratio I/U decreased from 1.11 ± 0.04 to 0.97 ± 0.02 during treatment, which was possibly related to the increased uninvolved SCM muscle thickness.In conclusion, echotexture is an efficient indicator for reflecting a wide degree of muscle fibrosis in infants with CMT and is informative during the treatment course.

  5. 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.

  6. 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…

  7. 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…

  8. 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…

  9. 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,...

  10. 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,...

  11. 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,...

  12. 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,...

  13. 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,...

  14. 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. |

  15. 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…

  16. 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…

  17. 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…

  18. 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,…

  19. 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…

  20. 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…

  1. 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…

  2. 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.

  3. 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…

  4. 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…

  5. 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…

  6. 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

  7. 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…

  8. 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

  9. 26 CFR 1.443-1 - Returns for periods of less than 12 months.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... the short period is as follows: Taxable income exclusive of net long-term capital gain $40,000 Net long-term capital gain 10,000 Taxable income for short period before annualizing 50,000 Taxable income... term “12-month period” means the 12-month period ending at the close of the last day of the...

  10. The Development of Rational Imitation in 9- and 12-Month-Old Infants

    ERIC Educational Resources Information Center

    Zmyj, Norbert; Daum, Moritz M.; Aschersleben, Gisa

    2009-01-01

    Studies on rational imitation have provided evidence for the fact that infants as young as 12 months of age engage in rational imitation. However, the developmental onset of this ability is unclear. In this study, we investigated whether 9- and 12-month-olds detect voluntary and implicit as well as nonvoluntary and explicit constraints in the head…

  11. A Randomized Trial of Computerized vs. In-person Brief Intervention for Illicit Drug Use in Primary Care: Outcomes through 12 months

    PubMed Central

    Gryczynski, Jan; Mitchell, Shannon Gwin; Gonzales, Arturo; Moseley, Ana; Peterson, Thomas R.; Ondersma, Steven J.; O'Grady, Kevin E.; Schwartz, Robert P.

    2014-01-01

    This study examined outcomes through 12 months from a randomized trial comparing computerized brief intervention (CBI) vs. in-person brief intervention (IBI) delivered by behavioral health counselors for adult community health center patients with moderate-level drug misuse (N= 360). Data were collected at baseline, 3-, 6-, and 12-month follow-up, and included the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) and laboratory analysis of hair samples. Repeated measures analyses examined differential change over time. There were no significant differences in drug-positive hair tests over time or by condition. Global ASSIST scores decreased in both conditions (p< .001), but there were no significant differences between conditions in overall change across 12 months of follow-up (p= .13). CBI produced greater overall reductions in alcohol (p= .04) and cocaine (p= .02) ASSIST scores than IBI, with initial differences dissipating over time. Computerized brief interventions present a viable alternative to traditional in-person brief interventions. PMID:25282578

  12. 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

  13. Home-Based Psychiatric Outpatient Care Through Videoconferencing for Depression: A Randomized Controlled Follow-Up Trial

    PubMed Central

    Rössler, Wulf

    2016-01-01

    Background There is a tremendous opportunity for innovative mental health care solutions such as psychiatric care through videoconferencing to increase the number of people who have access to quality care. However, studies are needed to generate empirical evidence on the use of psychiatric outpatient care via videoconferencing, particularly in low- and middle-income countries and clinically unsupervised settings. Objective The objective of this study was to evaluate the effectiveness and feasibility of home-based treatment for mild depression through psychiatric consultations via videoconferencing. Methods A randomized controlled trial with a 6- and 12-month follow-up including adults with mild depression treated in an ambulatory setting was conducted. In total, 107 participants were randomly allocated to the videoconferencing intervention group (n=53) or the face-to-face group (F2F; n=54). The groups did not differ with respect to demographic characteristics at baseline. The F2F group completed monthly follow-up consultations in person. The videoconferencing group received monthly follow-up consultations with a psychiatrist through videoconferencing at home. At baseline and after 6 and 12 months, in-person assessments were conducted with all participants. Clinical outcomes (severity of depression, mental health status, medication course, and relapses), satisfaction with treatment, therapeutic relationship, treatment adherence (appointment compliance and dropouts), and medication adherence were assessed. Results The severity of depression decreased significantly over the 12-month follow-up in both the groups. There was a significant difference between groups regarding treatment outcomes throughout the follow-up period, with better results in the videoconferencing group. There were 4 relapses in the F2F group and only 1 in the videoconferencing group. No significant differences between groups regarding mental health status, satisfaction with treatment, therapeutic

  14. Non-pharmacological, multicomponent group therapy in patients with degenerative dementia: a 12-month randomzied, controlled trial

    PubMed Central

    2011-01-01

    Background Currently available pharmacological and non-pharmacological treatments have shown only modest effects in slowing the progression of dementia. Our objective was to assess the impact of a long-term non-pharmacological group intervention on cognitive function in dementia patients and on their ability to carry out activities of daily living compared to a control group receiving the usual care. Methods A randomized, controlled, single-blind longitudinal trial was conducted with 98 patients (follow-up: n = 61) with primary degenerative dementia in five nursing homes in Bavaria, Germany. The highly standardized intervention consisted of motor stimulation, practice in activities of daily living, and cognitive stimulation (acronym MAKS). It was conducted in groups of ten patients led by two therapists for 2 hours, 6 days a week for 12 months. Control patients received treatment as usual. Cognitive function was assessed using the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-Cog), and the ability to carry out activities of daily living using the Erlangen Test of Activities of Daily Living (E-ADL test) at baseline and after 12 months. Results Of the 553 individuals screened, 119 (21.5%) were eligible and 98 (17.7%) were ultimately included in the study. At 12 months, the results of the per protocol analysis (n = 61) showed that cognitive function and the ability to carry out activities of daily living had remained stable in the intervention group but had decreased in the control patients (ADAS-Cog: adjusted mean difference: -7.7, 95% CI -14.0 to -1.4, P = 0.018, Cohen's d = 0.45; E-ADL test: adjusted mean difference: 3.6, 95% CI 0.7 to 6.4, P = 0.015, Cohen's d = 0.50). The effect sizes for the intervention were greater in the subgroup of patients (n = 50) with mild to moderate disease (ADAS-Cog: Cohen's d = 0.67; E-ADL test: Cohen's d = 0.69). Conclusions A highly standardized, non-pharmacological, multicomponent group intervention conducted

  15. 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

  16. 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.

  17. 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.

  18. 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

  19. [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.

  20. [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.

  1. 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.

  2. 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)…

  3. 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…

  4. 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

  5. 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.

  6. 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

  7. 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

  8. 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.

  9. Feasibility, effectiveness and costs associated with a web-based follow-up assessment following total joint arthroplasty.

    PubMed

    Marsh, Jacquelyn D; Bryant, Dianne M; MacDonald, Steven J; Naudie, Douglas D R; McCalden, Richard W; Howard, James L; Bourne, Robert B; McAuley, James P

    2014-09-01

    The purpose of this study was to assess the feasibility, effectiveness and costs of a web-based follow-up compared to in-person assessment following primary total hip or total knee arthroplasty. Patients who were at least 12 months postoperative were randomized to follow-up method. We excluded patients who had revision surgery, osteolysis, complications or identified radiographic issues. 229 patients (118 Web, 111 in-person) completed the study. There were no patients who had an issue missed by the web-based follow-up. Patients in the web-based group travelled less (28.2km vs 103.7km, (P<0.01)), had lower associated costs ($10.45 vs $21.36, (P<0.01)) and took less time to complete (121.7min web vs 228.7min usual). Web-based follow-up is a feasible, clinically effective alternative with lower associated costs than in-person clinic assessment.

  10. 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.

  11. 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

  12. 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.

  13. Prognostic factors and course for successful clinical outcome quality of life and patients' perceived effect after a cognitive behavior therapy for chronic non-specific low back pain: A 12-months prospective study.

    PubMed

    Verkerk, Karin; Luijsterburg, Pim A J; Heymans, Martijn W; Ronchetti, Inge; Miedema, Harald S; Koes, Bart W; Pool-Goudzwaard, Annelies

    2015-02-01

    This study investigates the clinical course of and prognostic factors for quality of life (Short Form 36 items Health survey (SF-36)) and global perceived effect (GPE) in patients treated for chronic non-specific low back pain at 5 and 12-months follow-up. Data from a prospective cohort (n = 1760) of a rehabilitation center were used, where patients followed a 2-months cognitive behavior treatment. The outcome 'improvement in quality of life (SF-36)' was defined as a 10% increase in score on the SF-36 at follow-up compared with baseline. On the GPE scale, patients who indicated to be 'much improved' were coded as 'clinically improved'. Multivariable logistic regression analysis included 23 baseline characteristics. At 5-months follow-up, scores on the SF-36 Mental Component Scale (SF-36; MCS) and the Physical Component Scale (SF-36; PCS) had increased from 46.6 (SD 10.3) to 50.4 (SD 9.8) and from 31.9 (SD 7.1) to 46.6 (SD 10.3), respectively. At 5-months follow-up, 53.0% of the patients reported clinical improvement (GPE) which increased to 60.3% at 12-months follow-up. The 10% improvement in quality of life (SF-36 MCS) at 5-months follow-up was associated with patient characteristics and psychological factors. At 5-months follow-up, the 10% improvement in quality of life (SF-36 PCS) and GPE was associated with patient characteristics, physical examination, work-related factors and psychological factors; for GPE, an association was also found with clinical status. At 12-months follow-up GPE was associated with patient characteristics, clinical status, physical examination and work-related factors. The next phase in this prognostic research is external validation of these results.

  14. 12-month intravascular ultrasound observations from BiOSS® first-in-man studies.

    PubMed

    Gil, Robert J; Bil, Jacek; Costa, Ricardo A; Gil, Katarzyna E; Vassiliev, Dobrin

    2016-09-01

    The aim of this study was to analyze the difference in neointima pattern assessed by intravascular ultrasound (IVUS) between two dedicated bifurcation stents, BiOSS® Expert and BiOSS® LIM at 12-month follow-up. This manuscript reports IVUS findings obtained from the analysis of patients enrolled into first-in-man registries initially assessing the BiOSS Expert® (paclitaxel) and BiOSS LIM® (sirolimus) stents. Quantitative angiographic analysis was performed pre, post-stenting, and at follow-up. IVUS examination was performed at 12 months. There were analyzed 34 cases (BiOSS Expert® 11 patients, BiOSS LIM® 23 patients). Procedural characteristics in the two groups were similar, except for rates of main vessel predilatation and FKB/POT, which were higher in BiOSS® LIM group, 54.5 % vs 73.9 % (P < 0.05) and 0 % vs 39.1 % (P < 0.05), respectively. When comparing late lumen loss (LLL) for both stents there were significantly bigger values for main vessel and main branch in the BiOSS® Expert group, but not in side branch. Intravascular ultrasound examination showed that in the BiOSS LIM® group comparing with the BiOSS Expert® group there was lower neointima burden in the whole stent (24.7 ± 7.5 % vs 19.4 ± 8.6 %, P < 0.05) as well as in main vessel (22.8 ± 5.6 % vs 16.9 ± 6.1 %, P < 0.05) and main branch (36.1 ± 6.5 % vs 27.6 ± 8.7 %, P < 0.05), but not at the level of bifurcation (15.1 ± 3.8 % vs 13.6 ± 5.4 %, P = NS). In addition, we found that final kissing balloon/proximal optimization technique (FKB/POT) was associated with significantly smaller value of LLL in main vessel (0.24 ± 0.09 mm vs 0.32 ± 0.14 mm, P < 0.05), which in IVUS analysis resulted in smaller neointima burden in main vessel (13.7 ± 3.9 % vs 18.9 ± 4.45 %, P < 0.05) as well as at the bifurcation site (12.6 ± 4.1 % vs 14.1 ± 2.4 %, P < 0.05). The

  15. Self-Expandable Stent Placement in Infrapopliteal Arteries After Unsuccessful Angioplasty Failure: One-Year Follow-up

    SciTech Connect

    Peregrin, J. H. Smirova, S.; Koznar, B.; Novotny, J.; Kovac, J.; Lastovickova, J.; Skibova, J.

    2008-09-15

    The purpose of this prospective study was to evaluate whether stent placement in infrapopliteal arteries is helpful in failed percutaneous transluminal angioplasty (PTA). Infrapopliteal PTA was performed in 70 arteries of 66 patients with chronic critical lower limb ischemia. The group comprised 55 males and 11 females, with an average age of 63.4 (range, 42-82) years. Diabetes mellitus was present in 92.4% of patients. Only the palpable anterior tibial and posterior tibial arteries were evaluated. Stents (Xpert stent; Abbot Vascular, Redwood City, CA, USA) were placed in 16 arteries where PTA was not successful (the failure was defined as residual stenosis >30% after PTA). In 54 arteries simple PTA was performed and was technically successful. Twenty-four nondilated arteries with no significant stenosis served as a comparison group. The 12-month patency rate was evaluated according to a combination of palpation and Doppler ultrasound. In all cases stent placement restored the flow in the artery immediately after unsuccessful PTA. Twelve-month follow-up showed a patency rate of 82% in the PTA group, 78% in the stent group, and 69% in the comparison group. We conclude that stent placement in the case of unsuccessful infrapopliteal PTA changed technical failure to success and restored flow in the dilated artery. At 12-month follow-up the patency rate of infrapopliteal arteries stented for PTA failure did not differ significantly either from nonstented arteries with an optimal PTA result or from a comparison group of nonintervened arteries.

  16. 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

  17. Outcome for adult contacts of smear-positive pulmonary tuberculosis in the absence of X-ray follow-up: 2000-03.

    PubMed

    Ormerod, L P; Green, R M; Broadfield, E

    2004-06-01

    The effects of the policy change in X-ray follow-up of adult tuberculin-positive close contacts of sputum microscopy positive pulmonary tuberculosis made by the Joint Tuberculosis Committee of the British Thoracic Society in 2000 were monitored prospectively from late 2000 until the end of 2003. No cases in contacts that could have been detected by interval X-rays at three and 12 months were found. The data, on 291 cases, support the abandonment of X-ray follow-up in favour of an 'inform and advise' strategy after an initial normal chest X-ray in this category of tuberculosis contact.

  18. 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

  19. Long-Term Follow-Up of Cyclophosphamide Compared with Azathioprine for Initial Maintenance Therapy in ANCA-Associated Vasculitis

    PubMed Central

    Faurschou, Mikkel; Berden, Annelies; Flossmann, Oliver; Bajema, Ingeborg; Hoglund, Peter; Smith, Rona; Szpirt, Wladimir; Westman, Kerstin; Pusey, Charles D.; Jayne, David R.W.

    2014-01-01

    Background and objectives Treatment with azathioprine within 3 months of remission induction with cyclophosphamide is a common treatment strategy for patients with ANCA-associated vasculitis. This study comprised patients undergoing long-term follow-up who were randomly allocated to azathioprine after 3–6 months or after 12 months of cyclophosphamide treatment. Design, setting, participants, & measurements Patients from 39 European centers between 1995 and 1997 with a new diagnosis of ANCA-associated vasculitis that involved the kidneys or another vital organ were eligible. At the time of diagnosis, participants were randomly allocated to convert to azathioprine after 3–6 months (the azathioprine group) or after 12 months of cyclophosphamide (the cyclophosphamide group). Patients who did not achieve a remission within 6 months were excluded. This study assessed relapses, ESRD, and death during long-term follow-up. Results Patients were allocated to the azathioprine group (n=71) and the cyclophosphamide group (n=73). Of these patients, 63 (43.8%) developed a relapse, 35 (24.3%) developed a renal relapse, 13 (9.0%) developed ESRD, and 21 (14.6%) died. Although there were worse outcomes in the azathioprine group, none were statistically significant. The subdistribution hazard ratio [sHR] for relapse was 1.63 (95% confidence interval [95% CI], 0.99 to 2.71), the composite of relapse or death hazard ratio [HR] was 1.59 (95% CI, 1.00 to 2.54), the ESRD sHR was 1.71 (95% CI, 0.56 to 5.19), and the death HR was 0.75 (95% CI, 0.32 to 1.79). Conclusions It remains uncertain whether converting to azathioprine after 3–6 months of induction cyclophosphamide therapy is as effective as converting after 12 months. Outcomes are still poor for this group of patients and further research is required to determine the optimal timing of maintenance therapy. PMID:24970876

  20. 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

  1. 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…

  2. [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.

  3. One-year follow-up of neurological status of patients after cardiac arrest seen at the emergency room of a teaching hospital

    PubMed Central

    Vancini-Campanharo, Cássia Regina; Vancini, Rodrigo Luiz; de Lira, Claudio Andre Barbosa; Lopes, Maria Carolina Barbosa Teixeira; Okuno, Meiry Fernanda Pinto; Batista, Ruth Ester Assayag; Atallah, Álvaro Nagib; de Góis, Aécio Flávio Teixeira

    2015-01-01

    ABSTRACT Objective: To describe neurological status and associated factors of survivors after cardiac arrest, upon discharge, and at 6 and 12 month follow-up. Methods: A cohort, prospective, descriptive study conducted in an emergency room. Patients who suffered cardiac arrest and survived were included. A one-year consecutive sample, comprising 285 patients and survivors (n=16) followed up for one year after discharge. Neurological status was assessed by the Cerebral Performance Category before the cardiac arrest, upon discharge, and at 6 and 12 months after discharge. The following factors were investigated: comorbidities, presence of consciousness upon admission, previous cardiac arrest, witnessed cardiac arrest, location, cause and initial rhythm of cardiac arrest, number of cardiac arrests, interval between collapse and start of cardiopulmonary resuscitation, and between collapse and end of cardiopulmonary resuscitation, and duration of cardiopulmonary resuscitation. Results: Of the patients treated, 4.5% (n=13) survived after 6 and 12 months follow-up. Upon discharge, 50% of patients remained with previous Cerebral Performance Category of the cardiac arrest and 50% had worsening of Cerebral Performance Category. After 6 months, 53.8% remained in the same Cerebral Performance Category and 46.2% improved as compared to discharge. After 12 months, all patients remained in the same Cerebral Performance Category of the previous 6 months. There was no statistically significant association between neurological outcome during follow-up and the variables assessed. Conclusion: There was neurological worsening at discharge but improvement or stabilization in the course of a year. There was no association between Cerebral Performance Category and the variables assessed. PMID:26154538

  4. 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

  5. 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.

  6. 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

  7. 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

  8. [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.

  9. 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.

  10. Screening for High Blood Pressure in Adults During Ambulatory Nonprimary Care Visits: Opportunities to Improve Hypertension Recognition.

    PubMed

    Handler, Joel; Mohan, Yasmina; Kanter, Michael H; Reynolds, Kristi; Li, Xia; Nguyen, Miki; Young, Deborah R; Koebnick, Corinna

    2015-06-01

    Visits with nonprimary care providers such as optometrists may be missed opportunities for the detection of high blood pressure (BP). For this study, normotensive adults with at least 12 months of health plan membership on January 1, 2009 (n=1,075,522) were followed-up for high BP through March 14, 2011. Of 111,996 patients with a BP measurement ≥140/90 mm Hg, 82.7% were measured during primary care visits and 17.3% during nonprimary care visits. Individuals with a BP ≥140/90 mm Hg measured during nonprimary care visits were older and more likely to be male and non-Hispanic white. The proportion of patients with follow-up and false-positives were comparable between primary and nonprimary care. The main nonprimary care specialty to identify a first BP ≥140/90 mm Hg was ophthalmology/optometry with 24.5% of all patients. Results suggest that expanding screening for hypertension to nonprimary care settings may improve the detection of hypertension.

  11. 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

  12. 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.

  13. [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.

  14. 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.

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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.

  20. 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.

  1. 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

  2. New polyethylenes in total hip replacement: A ten- to 12-year follow-up study.

    PubMed

    García-Rey, E; García-Cimbrelo, E; Cruz-Pardos, A

    2013-03-01

    Between 1999 and 2001, 90 patients underwent total hip replacement using the same uncemented acetabular and femoral components with a 28 mm metallic femoral head but with prospective randomisation of the acetabular liner to either Durasul highly cross-linked polyethylene or nitrogen-sterilised Sulene polyethylene. We assessed 83 patients at a minimum follow-up of ten years. Linear penetration of the femoral head was estimated at six weeks, six and 12 months and annually thereafter, using the Dorr method, given the non-spherical shape of the acetabular component. There was no loosening of any component; only one hip in the Sulene group showed proximal femoral osteolysis. The mean penetration of the femoral head at six weeks was 0.08 mm (0.02 to 0.15) for the Durasul group and 0.16 mm (0.05 to 0.28) for the Sulene group (p = 0.001). The mean yearly linear penetration was 64.8% lower for the Durasul group at 0.05 mm/year (sd 0.035) for the Sulene group and 0.02 mm/year (sd 0.016) for the Durasul (p < 0.001). Mean linear femoral head penetration at ten years was 61% less in the Durasul than Sulene group. Highly cross-linked polyethylene gives excellent results at ten years.

  3. 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.

  4. 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.

  5. Long-Term Outcomes of Posterior Lumbar Interbody Fusion Using Stand-Alone Ray Threaded Cage for Degenerative Disk Disease: A 20-Year Follow-Up

    PubMed Central

    Medrano, Belen G.; Noriega, David C.

    2016-01-01

    Study Design Retrospective study. Purpose To analyze outcomes of posterior lumbar interbody fusion (PLIF) stand-alone cages. Overview of Literature PLIF for degenerative disk disease using stand-alone cages has lost its popularity owing to implant-related complications and pseudoarthrosis. Methods We analyzed the records of 45 patients (18 women, 27 men), operated between January 1994 and December 1996, with a mean follow-up of 18 years 3 months (20 years 3 months–22 years 3 months). Clinical outcomes were measured using visual analogue score (VAS), Oswestry disability index (ODI), Odom's criteria, and radiological measurements of fusion rate, Cobb angle, and implant-related complications conducted at the preoperative evaluation, hospital discharge, 12-month follow-up, and final follow-up. Results Preoperative mean VAS (back) was 6.9 and VAS (radicular) was 7.2, with mean improvements (p <0.05) of 2.9 and 3.1, respectively, at the final follow-up. Median preoperative ODI was 64.5, with a mean improvement to 34 and 42 at the 12-month and final follow-ups, respectively (p <0.05). Odom's criteria at the 12-month follow-up were excellent in 11.2% patients, good in 57.7%, fair in 31.1%, and poor in none of the patients; at the final follow-up, no patient was classified as excellent, 71.1% as good, 22.2% as fair, and 6.7% as poor (p <0.05). Pseudoarthrosis was observed in five patients (11.1%), of whom, three (6.6%) required re-operation. Preoperative disk height was 9.23 mm, which increased to 13.33 mm in the immediate postoperative evaluation and was maintained at 10.0 mm at the final follow-up (p <0.05). The preoperative mean L1–S1 Cobb angle was 34.7°, which changed to 44.7° in the immediate postoperative evaluation and dropped to 39.7° at the final follow-up (p <0.005). Conclusions PLIF stand-alone cages were associated with good clinical outcomes. Although the fusion rate was excellent, maintenance of disk heights and a lordotic alignment were not achieved

  6. 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

  7. Testosterone replacement therapy does not promote priapism in hypogonadal men with sickle cell disease: 12-month safety report.

    PubMed

    Morrison, B F; Reid, M; Madden, W; Burnett, A L

    2013-07-01

    Hypogonadism, which is highly prevalent in men with sickle cell disease (SCD), affects quality of life and causes great morbidity. The safety of testosterone replacement therapy (TRT) in SCD in relation to priapism episodes is relatively unknown. Our aim was to monitor the safety of TRT in a cohort of seven hypogonadal men with SCD. Testosterone undecanoate (Nebido) 1 g was administered intramuscularly to adult men with homozygous SCD (Hb SS) having hypogonadism [serum total testosterone ≤12.0 nmol/L (346 ng/dL), reference range 12.5-38.1 nmol/L (360-1098 ng/dL)] for 12 months. Serum total testosterone, haemoglobin, haematocrit, renal and liver function tests, glucose and PSA measurements were done at baseline and 12-month follow-up. Trough serum total testosterone, haemoglobin and haematocrit were measured three monthly. Priapism events and adverse drug events were assessed every 3 months. International Index of Erectile Function (IIEF), Androgen Deficiency in the Ageing Male (ADAM) and World Health Organization Quality of Life (WHOQOL) questionnaires were administered at baseline, 6 and 12 months. Seven men with a mean age of 34.4 years were treated. Median total testosterone increased from 10.6 to 11.2 nmol/L (p = 0.46). Median serum lactate dehydrogenase levels decreased from 1445 to 1143.5 IU/L (p < 0.05), while all other laboratory indices remained stable. Injection site pain was the most frequently reported adverse event, with no increases in painful crises, hypersensitivity or oedema. After TRT, there was no significant increase in priapism frequency. Median questionnaire scores were increased for the IIEF (46-68, p = 0.018), reduced for ADAM (5.0-2.0, p = 0.016) and unchanged for WHOQOL (98-103, p = 0.086). TRT using testosterone undecanoate with eugonadal intent for hypogonadism appears to be safe in men with SCD. This treatment does not appear to promote priapism occurrences and rather it possibly improves sexual function. Future prospective

  8. Low-dose budesonide for maintenance of clinical remission in collagenous colitis: a randomised, placebo-controlled, 12-month trial

    PubMed Central

    Münch, Andreas; Bohr, Johan; Miehlke, Stephan; Benoni, Cecilia; Olesen, Martin; Öst, Åke; Strandberg, Lars; Hellström, Per M; Hertervig, Erik; Armerding, Peter; Stehlik, Jiri; Lindberg, Greger; Björk, Jan; Lapidus, Annika; Löfberg, Robert; Bonderup, Ole; Avnström, Sören; Rössle, Martin; Dilger, Karin; Mueller, Ralph; Greinwald, Roland; Tysk, Curt; Ström, Magnus

    2016-01-01

    Objective This 1-year study aimed to assess low-dose budesonide therapy for maintenance of clinical remission in patients with collagenous colitis. Design A prospective, randomised, placebo-controlled study beginning with an 8-week open-label induction phase in which patients with histologically confirmed active collagenous colitis received budesonide (Budenofalk, 9 mg/day initially, tapered to 4.5 mg/day), after which 92 patients in clinical remission were randomised to budesonide (mean dose 4.5 mg/day; Budenofalk 3 mg capsules, two or one capsule on alternate days) or placebo in a 12-month double-blind phase with 6 months treatment-free follow-up. Primary endpoint was clinical remission throughout the double-blind phase. Results Clinical remission during open-label treatment was achieved by 84.5% (93/110 patients). The median time to remission was 10.5 days (95% CI (9.0 to 14.0 days)). The maintenance of clinical remission at 1 year was achieved by 61.4% (27/44 patients) in the budesonide group versus 16.7% (8/48 patients) receiving placebo (treatment difference 44.5% in favour of budesonide; 95% CI (26.9% to 62.7%), p<0.001). Health-related quality of life was maintained during the 12-month double-blind phase in budesonide-treated patients. During treatment-free follow-up, 82.1% (23/28 patients) formerly receiving budesonide relapsed after study drug discontinuation. Low-dose budesonide over 1 year resulted in few suspected adverse drug reactions (7/44 patients), all non-serious. Conclusions Budesonide at a mean dose of 4.5 mg/day maintained clinical remission for at least 1 year in the majority of patients with collagenous colitis and preserved health-related quality of life without safety concerns. Treatment extension with low-dose budesonide beyond 1 year may be beneficial given the high relapse rate after budesonide discontinuation. Trial registration numbers http://www.clinicaltrials.gov (NCT01278082) and http

  9. Surveillance of probably benign (BI-RADS 3) lesions in mammography: what is the right follow-up protocol?

    PubMed

    Buch, Karen A; Qureshi, Muhammad M; Carpentier, Bianca; Cunningham, Deborah A; Stone, Michael; Jaffe, Carl; Quinn, Marie; Gonzalez, Carlos; LaVoye, Justine; Hines, Neely; Bloch, Boris Nicolas

    2015-01-01

    BI-RADS-3 is a category in mammography for probably benign lesions and for which periodic follow-up with repeat imaging is recommended. At our institution repeated mammograms are performed at 6, 12, 18, and 24 months. The purpose of this study was to assess the significance of 18-month mammogram for evaluation of BI-RADS-3 lesions. Following IRB approval, electronic medical records and picture archiving and communications system were used to review 121,862 consecutive mammograms between February, 2002-May, 2009. A total of 8,400 patients with BI-RADS-3 mammograms were identified. Of these, 7,632 patients were followed until completion of 24 month mammogram or biopsy following an upgrade in their BI-RADS status. Over the follow-up, 197 patients received an upgrade in their BI-RADS status of which 179 were biopsied. Histopathologic results were reviewed. The majority of the BI-RADS-3 lesions were upgraded at 6-month mammogram (n = 150, 76.1%) followed by 32 (16.2%), 11 (5.6%), and 4 (2.0%) at 12, 18, and 24 month mammograms respectively. Thirty-four of 179 upgraded and biopsied lesions were found to be malignant. From these 27 (79.4%), 3 (8.8%), 3 (8.8%), and 1 (2.9%) lesions were identified at 6, 12, 18, and 24 month mammograms respectively. At the 18-month mammogram 3/7,632 lesions (0.04%) were found to be malignant. The vast majority of malignant lesions (88.2%) were detected within the first 12-months of follow-up. Only three of 179 biopsies (1.7%) were malignant at 18-month follow-up. Based on those results a 6-, 12-, and 24-month follow-up protocol for BI-RADS-3 lesions is sufficient.

  10. [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

  11. Diisocyanate-induced asthma in Switzerland: long-term course and patients’ self-assessment after a 12-year follow-up

    PubMed Central

    2014-01-01

    Background Isocyanates are among the most common causes of occupational asthma (OA) in Switzerland. Patients with OA have been shown to have unfavourable medical, socioeconomic and psychological outcomes. We investigated long-term asthma and the socio-economic outcomes of diisocyanate-induced asthma (DIA) in Switzerland. Patients and methods We conducted an observational study on 49 patients with DIA and followed 35 of these patients over a mean exposure-free interval of 12 ± 0.5 (range 11.0-13.0) years. At the initial and follow-up examinations, we recorded data on respiratory symptoms and asthma medication; measured the lung function; and tested for bronchial hyperreactivity. We allowed the patients to assess their state of health and overall satisfaction using a visual analogue scale (VAS) at these visits. Results The 35 patients whom we could follow had a median symptomatic exposure time of 12 months, interquartile range (IQR) 26 months and a median overall exposure time of 51 (IQR 104) months. Their subjective symptoms (p < 0.001) and the use of asthma medication (p = 0.002), particularly the use of inhaled corticosteroids (p < 0.001), decreased by nearly 50%. At the same time, the self-assessment of the patients’ state of health and overall satisfaction increased considerably according to both symptomatology and income. In contrast, slight reductions in terms of FVC% predicted from 102% to 96% (p = 0.04), of FEV1% predicted from 91% to 87% (p = 0.06) and of the FEV1/FVC ratio of 3%; (p = 0.01) were observed while NSBHR positivity did not change significantly. In univariate as well as multivariate logistic analyses we showed significant associations between age, duration of exposure and FEV1/FVC ratio with persistent asthma symptoms and NSBHR. Conclusions We found that the patients’ symptoms, the extent of their therapy and the decrease in their lung volumes during the follow-up period were similar to the findings in the

  12. [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.

  13. 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.

  14. 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.

  15. [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.

  16. 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.

  17. 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.

  18. 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

  19. 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

  20. 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.

  1. [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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. Education and training in the paediatric senior house officer grade: analysis of RCPCH hospital/child health visits reports, 1997–2001

    PubMed Central

    Smith, C; Anderson, J

    2003-01-01

    Methods: Retrospective audit of visits reports (1997–2001) against the RCPCH criteria for general professional training. Hospital and/or community child health departments who were responsible for training paediatric senior house officers were visited to assess whether RCPCH criteria of education were being met. Follow up visits were undertaken where limited education and training approval was given. Reports were received from 214 of 242 (88%) hospital and/or community based departments in England, Wales, and Northern Ireland. Results: Satisfactory achievement of the 12 training criteria by departments varied widely: 39–95% (median 66%) achieved. Follow up visits reported significant improvements in most departments. Criteria which departments struggled to achieve reasonable standards were: (1) ensuring SHOs were performing educationally appropriate duties (39% achieved); and (2) satisfactory outpatient experience (41% achieved). Twenty four per cent of hospital based departments did not have a paediatrician with 12 months or more experience of paediatrics resident on call. Conclusions: The visiting process highlighted areas of good practice, encouraged change to meet the criteria, and recommended increased resources and staffing where necessary to improve training and hence the service. The need for continuing approval for education and training in these departments encouraged significant efforts on the part of trainers and managers to meet the requirements, and consequently the quality of service to children has been enhanced. PMID:12716724

  8. 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

  9. 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

  10. Parents’ perceived treatment match and treatment retention over 12 months among youth in the LAMS study

    PubMed Central

    Young, Andrea S.; Horwitz, Sarah M.; Findling, Robert L.; Youngstrom, Eric A.; Arnold, L. Eugene; Fristad, Mary A.

    2015-01-01

    Objective The goal of these analyses was to describe the 12-month prevalence and identify predictors of mental health services retention for youth, ages 6–12 years, using data from the Longitudinal Assessment of Manic Symptoms (LAMS) study. Methods In a longitudinal cohort study, 416 children and their parents completed measures of mental health services use and parents’ perception of the services and semi-structured psychodiagnostic interviews at a baseline and 12-month assessment. Logistic regression analyses examined the effects of demographic and clinical variables and parents’ perception of how well their children’s treatment matched their needs on 12-month treatment retention. Results Sixty-nine percent of youth (n=289) continued to use services at 12 months. White race (p<.001) and greater functional impairment (p=.024) were associated with treatment retention; greater perceived treatment match at baseline significantly predicted retention above and beyond the effects of sociodemographic and clinical variables (p=.001). Conclusions White race and parents’ perceptions about appropriateness of treatment predict 12-month treatment retention. PMID:26522675

  11. Loss to follow-up of adults in public HIV care systems in Mozambique: Identifying obstacles to treatment

    PubMed Central

    Micek, Mark A; Gimbel-Sherr, Kenneth; Baptista, Alberto João; Matediana, Eduardo; Montoya, Pablo; Pfeiffer, James; Melo, Armando; Gimbel-Sherr, Sarah; Johnson, Wendy; Gloyd, Stephen

    2009-01-01

    Introduction Access to antiretroviral treatment (ART) has expanded dramatically in resource-limited settings. Evaluating loss to follow-up from HIV testing through post-ART care can help identify obstacles to care. Methods Routine data was analyzed for adults receiving services in two public HIV care systems in central Mozambique. The proportion of people passing through the following steps was determined: (1) HIV testing, (2) enrollment at an ART clinic, (3) CD4 testing, (4) starting ART if eligible, and (5) adhering to ART. Results During the 12-month study period (2004–2005), an estimated 23,430 adults were tested for HIV, and 7,005 (29.9%) were HIV-positive. Only 3,956 (56.5%) of those HIV-positive enrolled at an ART clinic ≤30 days after testing. CD4 testing was obtained in 77.1% ≤30 days of enrollment. Of 1,506 eligible for ART, 471 (31.3%) started ART ≤90 days after CD4 testing. Of 382 with ≥180 days of potential follow-up time on ART, 317 (83.0%) had pharmacy-based adherence rates ≥90%. Discussion Substantial drop-offs were observed for each step between HIV testing and treatment, but were highest for referral from HIV testing to treatment sites and for starting ART. Interventions are needed to improve follow-up and ensure that people benefit from available HIV services. PMID:19550350

  12. Computed Tomography and Ultrasounds for the Follow-up of Hepatocellular Carcinoma Ablation: What You Need to Know

    PubMed Central

    Kelekis, Alexios; Filippiadis, Dimitrios

    2016-01-01

    Image-guided tumor ablation provides curative treatment in properly selected patients or appropriate therapeutic options whenever surgical techniques are precluded. Tumor response assessment post ablation is important in determining treatment success and future therapy. Accurate interpretation of post-ablation imaging findings is crucial for therapeutic and follow-up strategies. Computed Tomography (CT) and Ultrasound (US) play important roles in patients’ follow-up post liver thermal ablation therapies. Contrast-enhanced ultrasound (CEUS) can provide valuable information on the ablation effects faster and at a lower cost than computed tomography or magnetic resonance imaging. However, a disadvantage is that the technique cannot examine total liver parenchyma for disease progression as CT and Magnetic Resonance (MR) imaging can. Follow-up strategies for assessment of tumor response includes contrast enhanced multiphasic (non-contrast, arterial, portal, delayed phases) imaging with Computed Tomography at three, six, and 12 months post ablation session and annually ever since in order to prove sustained effectiveness of the ablation or detect progression. PMID:26861398

  13. The influence of maternal optimality and infant temperament on parenting stress at 12 months among mothers with substance abuse and psychiatric problems.

    PubMed

    Siqveland, Torill S; Olafsen, Kåre S; Moe, Vibeke

    2013-10-01

    The present prospective longitudinal study aimed to investigate the long-term impact of maternal optimality assessed during pregnancy on parenting stress at infant age 12 months. In this study the concept of optimality was utilized to investigate maternal variations regarding resources during pregnancy in relation to later parenting stress, among three different groups of mothers that were recruited from substance abuse treatment, psychiatric outpatient treatment and well-baby clinics respectively. The influence of infant temperament on parenting stress was also examined. All mothers were interviewed during pregnancy. At 12 months, infant temperament (Colorado Childhood Temperament Inventory; Rowe & Plomin, 1977) and stress in the parent and child domain (Parenting Stress Index; Abidin, 1955) were assessed. Results demonstrated higher levels of parenting stress among mothers in the clinical groups, compared to the non-clinical group. Furthermore, it was the maternal psychiatric optimality index in combination with child temperament characteristics (child emotionality) that contributed uniquely to stress in the parent domain, while stress in the child domain was significantly associated only with child temperament characteristics (both child emotionality and soothability). The association between maternal psychiatric optimality assessed in pregnancy, infant temperament and parenting stress when the infants were 12 months old, points to the importance of simultaneously addressing the mothers' own psychological distress, and to support positive mother-infant interactions. Each woman's individual optimality profile may be used to display needs of follow-up in order to prevent enduring effects of non-optimality on parenting stress.

  14. 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.

  15. 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

  16. 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

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. [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.

  3. [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.

  4. 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.

  5. 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. %

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. Breastfeeding practices in military families: a 12-month prospective population-based study in the national capital region.

    PubMed

    Mao, Chad Y; Narang, Sandeep; Lopreiato, Joseph

    2012-02-01

    Breastfeeding practices in military families have not been widely investigated. The objective of this study was to measure the prevalence and duration of breastfeeding among uniformed families and identify factors associated with breastfeeding. We conducted a prospective study of 253 mothers of new infants from July to December 2004. Initial information gathered included demographic data, feeding choices, and intended duration of breastfeeding. Follow-up surveys were conducted until 12 months postpartum. 51% of mothers were breastfeeding at 6 months and 25% at 1 year. Mothers on active duty were equally likely to breastfeed than non-active duty mothers. Officer mothers were 3 times more likely to breastfeed compared to enlisted mothers (p = 0.005). Mothers with higher education were twice as likely to breastfeed longer (p = 0.015). Families participating in Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) were 2.5 times less likely to breastfed at 1 year (p < 0.001). Our study shows a higher percentage of women initiating and maintaining breastfeeding compared to national data, but still less than current American Academy of Pediatrics guidelines. Our study suggests that to improve breastfeeding rates among uniformed families, more attention may need to be directed to younger, enlisted mothers and those families in a lower socioeconomic status or receiving WIC assistance.

  12. Echocardiographic Follow-Up of Patent Foramen Ovale and the Factors Affecting Spontaneous Closure

    PubMed Central

    Yildirim, Ali; Aydin, Alperen; Demir, Tevfik; Aydin, Fatma; Ucar, Birsen; Kilic, Zubeyir

    2016-01-01

    Background The aim of the present study was to evaluate the echocardiographic follow-up of patent foramen ovale, which is considered a potential etiological factor in various diseases, and to determine the factors affecting spontaneous closure. Methods Between January 2000 and June 2012, records of 918 patients with patent foramen ovale were retrospectively reviewed. Patency of less than 3 mm around the fossa ovalis is called patent foramen ovale. Patients with cyanotic congenital heart diseases, severe heart valve disorders and severe hemodynamic left to right shunts were excluded from the study. The patients were divided into three groups based on age; 1 day-1 month in group 1, 1 month-12 months in group 2, and more than 12 months in group 3. Results Of the 918 patients, 564 (61.4%) had spontaneous closure, 328 (35.8%) had patent foramen ovale continued, 15 (1.6%) patients had patent foramen ovale enlarged to 3-5 mm, 6 patients were enlarged to 5-8 mm, and in one patient patent foramen ovale reached to more than 8 mm size. Defect was spontaneously closed in 65.9% of the patients in group 1, 66.7% of the patients in group 2, and 52.3% of the patients in group 3. There was a negative correlation between the age of diagnosis and spontaneous closure (p < 0.05). Gender, prematurity and coexisting malformations such as patent ductus arteriosus and atrial septal aneurysm did not have any effect on spontaneous closure of patent foramen ovale (p > 0.05). However, ventricular septal defect and spontaneous closure of patent foramen ovale had a positive correlation (p < 0.01). No correlation was noted between the existence of atrial septal aneurysm, prematurity, and maturity of the patients. Conclusions The present study demonstrated that spontaneous closure rate of patent foramen ovale is high. Furthermore, a positive correlation was found between spontaneous closure of patent foramen ovale with early diagnosis and small defect size. PMID:27899861

  13. 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

  14. 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.

  15. 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

  16. 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

  17. 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

  18. Gestational trophoblastic diseases - clinical guidelines for diagnosis, treatment, follow-up, and counselling.

    PubMed

    Niemann, Isa; Vejerslev, Lars O; Frøding, Ligita; Blaakær, Jan; Maroun, Lisa Leth; Hansen, Estrid Stæhr; Grove, Anni; Lund, Helle; Havsteen, Hanne; Sunde, Lone

    2015-11-01

    Hydatidiform mole is treated with surgical uterine evacuation with suction and blunt curettage (D). Medical uterine evacuation should not be used (C). On clinical suspicion of hydatidiform mole, one representative sample of the evacuated tissue is fixed for histopathologic investigation and one is forwarded unfixed for genetic analysis (D). Serum hCG is measured on suspicion of hydatidiform mole. At the time of the uterine evacuation, the initial hCG is measured (A). After a hydatidiform mole that is both triploid and partial, serum hCG is measured weekly until there are two consecutive undetectable values (< 1 or < 2), after which the patient can be discharged from follow-up (C). After a diploid hydatidiform mole, a complete mole, or a hydatidiform mole without valid ploidy determination, serum hCG is measured weekly until the value is undetectable (< 1 or < 2). If serum hCG is undetectable within 56 days after evacuation, the patient can be discharged from follow-up after an additional four monthly measurements. If serum hCG is first normalised after 56 days, the patient is follow-up with monthly serum hCG measurement for six months. Safe contraception should be used during the follow-up period (A). If hCG stagnates (less than 10% fall over three measurements), increases, or if hCG can be demonstrated for longer than 6 months, the patient by definition has persistent trophoblastic disease (PTD). A chest X-ray should be taken and a gynaecologic ultrasound scanning performed. The patient is referred to oncologic treatment (A). Uterine re-evacuation as a treatment for PTD can, in general, not be recommended because the rate of remission is low, and there is the risk of perforation of the uterus (C). In all following pregnancies, the woman is offered an early ultrasound scan, e.g. in gestational week eight (D). Eight weeks after termination of all future pregnancies, serum hCG is measured (D). In PTD and invasive hydatidiform mole, the primary treatment is MTX

  19. Diagnoses behind patients with hard-to-classify tremor and normal DaT-SPECT: a clinical follow up study

    PubMed Central

    Menéndez-González, Manuel; Tavares, Francisco; Zeidan, Nahla; Salas-Pacheco, José M.; Arias-Carrión, Oscar

    2014-01-01

    The [123I]ioflupane—a dopamine transporter radioligand—SPECT (DaT-SPECT) has proven to be useful in the differential diagnosis of tremor. Here, we investigate the diagnoses behind patients with hard-to-classify tremor and normal DaT-SPECT. Therefore, 30 patients with tremor and normal DaT-SPECT were followed up for 2 years. In 18 cases we were able to make a diagnosis. The residual 12 patients underwent a second DaT-SPECT, were then followed for additional 12 months and thereafter the diagnosis was reconsidered again. The final diagnoses included cases of essential tremor, dystonic tremor, multisystem atrophy, vascular parkinsonism, progressive supranuclear palsy, corticobasal degeneration, fragile X–associated tremor ataxia syndrome, psychogenic parkinsonism, iatrogenic parkinsonism and Parkinson's disease. However, for 6 patients the diagnosis remained uncertain. Larger series are needed to better establish the relative frequency of the different conditions behind these cases. PMID:24744729

  20. A follow-up study of posttraumatic stress disorder, anxiety, and depression in Australian victims of domestic violence.

    PubMed

    Mertin, P; Mohr, P B

    2001-12-01

    Although posttraumatic stress disorder (PTSD), anxiety, and depression are acknowledged consequences of domestic violence, little information is available on the course of recovery over time and factors that may mediate positive outcome. Fifty-nine women were assessed for the presence of PTSD and levels of anxiety and depression at time of shelter residence and again one year later. Results at follow-up indicated a significant reduction in the incidence of PTSD, although a substantial number of women continued to report a range of posttrauma symptoms. There were also significant reductions in the levels of anxiety and depression over the 12-month period. Findings indicated the particular importance of safety and the presence of social support as prerequisites for recovery.

  1. KTP laser stapedotomy with a self-crimping, thermal shape memory Nitinol piston: follow-up study reporting intermediate-term hearing.

    PubMed

    Gerlinger, Imre; Bakó, Péter; Piski, Zalán; Révész, Péter; Ráth, Gábor; Karosi, Tamás; Lujber, László

    2014-12-01

    The aim of this study was an evaluation of the mid-term hearing results after the implantation of a self-crimping heat memory Nitinol piston in stapes surgery. The 12-month postoperative results were compared with those at a minimum of 3 years (maximum 6.7, average 4.4 years). The medical records of all 44 patients who underwent surgery with a Nitinol piston for stapes fixation between November 2005 and January 2007 were evaluated retrospectively. The prostheses used in all cases measured either 4.5 or 4.75 × 0.6 mm. We hypothesized that the 12-month postoperative hearing results would be permanent after an average follow-up of 4.4 years. Thirty-two of the 44 consecutive patients were females and 12 were males. Their mean age was 40.4 years (range 27-69). All underwent a 12-month postoperative audiometric evaluation. 38 (30 females, 8 males, average age 45, range 28-77 years) of the 44 were available for mid-term 4.4-year (minimum 3 years, maximum 6.7 years) postoperative audiometric evaluation. The mean air-bone gap (ABG) for the frequencies 0.5, 1, 2 and 3 kHz at the 12-month postoperative follow-up was 11 dB (SD 4.1) and that after an average 4.4-year postoperative evaluation was 6.4 dB (SD 3.6). The mean decrease in ABG after 12 months was 19.5 dB, and that after the average 4.4 years was 21.3 dB. ABG closure within 10 dB was achieved in 77.2 % after 12 months and in 89.5 % after the average 4.4 years. No patient with an ABG > 20 dB was recorded after the average 4.4 years. The mean air conduction threshold at 4 kHz was examined pre and postoperatively so as to indicate any possible inner ear damage. At the 12-month follow-up, the difference between the pre and postoperative values was -2.5 dB, whereas after the average 4.4 years the difference was surprisingly +13 dB. The individual AC improvements were also demonstrated with the use of Amsterdam Hearing Evaluation Plots (AHEPs). The Nitinol prosthesis allowed excellent intraoperative handling and no

  2. Change in sexual activity 12 months after ART initiation among HIV-positive Mozambicans.

    PubMed

    Pearson, Cynthia R; Cassels, Susan; Kurth, Ann E; Montoya, Pablo; Micek, Mark A; Gloyd, Stephen S

    2011-05-01

    We assessed sexual behaviors before and 12-months after ART initiation among 277 Mozambicans attending an HIV clinic. Measured behaviors included the number of sexual partners, condom use, concurrent relationships, disclosure of HIV status, alcohol use, and partners' serostatus. Compared to before ART initiation, increases were seen 12 months after ART in the proportion of participants who were sexually active (48% vs. 64% respondents, P < 0.001) and the proportion of participants with HIV-negative or unknown serostatus partners (45% vs. 80%, P < 0.001). Almost all (96%) concurrent partnerships reported at 12 months formed after ART initiation. Although reported correct and consist condom use increased, the number of unprotected sexual relationships remained the same (n = 45). Non-disclosure of HIV-serostatus to sexual partners was the only significant predictor of practicing unprotected sex with partners of HIV-negative or unknown serostatus. Sexual activity among HIV-positive persons on ART increased 12 months after ART initiation. Ongoing secondary transmission prevention programs addressing sexual activity with multiple partners, disclosure to partners and consistent condom use with serodisconcordant partners must be incorporated throughout HIV care programs.

  3. FedEx Express Gasoline Hybrid Electric Delivery Truck Evaluation: 12-Month Report

    SciTech Connect

    Barnitt, R.

    2011-01-01

    This report summarizes the data obtained in a 12-month comparison of three gasoline hybrid electric delivery vehicles with three comparable diesel vehicles. The data show that there was no statistical difference between operating cost per mile of the two groups of vehicles. As expected, tailpipe emissions were considerably lower across all drive cycles for the gHEV than for the diesel vehicle.

  4. Change in Sexual Activity 12 Months After ART Initiation Among HIV-Positive Mozambicans

    PubMed Central

    Cassels, Susan; Kurth, Ann E.; Montoya, Pablo; Micek, Mark A.; Gloyd, Stephen S.

    2012-01-01

    We assessed sexual behaviors before and 12-months after ART initiation among 277 Mozambicans attending an HIV clinic. Measured behaviors included the number of sexual partners, condom use, concurrent relationships, disclosure of HIV status, alcohol use, and partners’ serostatus. Compared to before ART initiation, increases were seen 12 months after ART in the proportion of participants who were sexually active (48% vs. 64% respondents, P < 0.001) and the proportion of participants with HIV-negative or unknown serostatus partners (45% vs. 80%, P < 0.001). Almost all (96%) concurrent partnerships reported at 12 months formed after ART initiation. Although reported correct and consist condom use increased, the number of unprotected sexual relationships remained the same (n = 45). Non-disclosure of HIV-serostatus to sexual partners was the only significant predictor of practicing unprotected sex with partners of HIV-negative or unknown serostatus. Sexual activity among HIV-positive persons on ART increased 12 months after ART initiation. Ongoing secondary transmission prevention programs addressing sexual activity with multiple partners, disclosure to partners and consistent condom use with serodisconcordant partners must be incorporated throughout HIV care programs. PMID:21082338

  5. Metacognitive functioning predicts positive and negative symptoms over 12 months in first episode psychosis.

    PubMed

    McLeod, Hamish J; Gumley, Andrew I; Macbeth, Angus; Schwannauer, Matthias; Lysaker, Paul H

    2014-07-01

    The negative symptoms of schizophrenia are a major source of impairment and distress but both pharmacological and psychological treatment options provide only modest benefit. Developing more effective psychological treatments for negative symptoms will require a more sophisticated understanding of the psychological processes that are implicated in their development and maintenance. We extended previous work by demonstrating that metacognitive functioning is related to negative symptom expression across the first 12 months of first episode psychosis (FEP). Previous studies in this area have either been cross-sectional or have used much older participants with long-standing symptoms. In this study, forty-five FEP participants were assessed three times over 12 months and provided data on PANSS rated symptoms, premorbid adjustment, metacognitive functioning, and DUP. Step-wise linear regression showed that adding metacognition scores to known predictors of negative symptoms (baseline symptom severity, gender, DUP, and premorbid academic and social adjustment) accounted for 62% of the variance in PANSS negative symptom scores at six months and 38% at 12 months. The same predictors also explained 47% of the variance in positive symptoms at both six and 12 months. However, exploration of the simple correlations between PANSS symptom scores and metacognition suggests a stronger univariate relationship between metacognition and negative symptoms. Overall, the results indicate that problems with mental state processing may be important determinants of negative symptom expression from the very early stages of psychosis. These results provide further evidence that metacognitive functioning is a potentially relevant target for psychological interventions.

  6. Case Study Analyses of Play Behaviors of 12-Month-Old Infants Later Diagnosed with Autism

    ERIC Educational Resources Information Center

    Mulligan, Shelley

    2015-01-01

    Case study research methodology was used to describe the play behaviors of three infants at 12 months of age, who were later diagnosed with an autism spectrum disorder. Data included standardized test scores, and analyses of video footage of semi-structured play sessions from infants identified as high risk for autism, because of having a sibling…

  7. Vowel Production in 7- to 12-Month-Old Infants with Hearing Loss

    ERIC Educational Resources Information Center

    Nelson, Rebecca; Yoshinaga-Itano, Christine; Rothpletz, Ann; Sedey, Allison

    2007-01-01

    The purpose of this study was to examine vowel production in 7- to 12-month-old infants with hearing loss. Fifty-four infants were divided into three groups according to degree of hearing loss (mild-to-moderate, moderately severe-to-severe, profound), and their vocalizations were phonetically transcribed from 30-minute videotaped samples. These…

  8. Atypical Object Exploration at 12 Months of Age Is Associated with Autism in a Prospective Sample

    ERIC Educational Resources Information Center

    Ozonoff, Sally; Macari, Suzanne; Young, Gregory S.; Goldring, Stacy; Thompson, Meagan; Rogers, Sally J.

    2008-01-01

    This prospective study examined object exploration behavior in 66 12-month-old infants, of whom nine were subsequently diagnosed with an autism spectrum disorder. Previous investigations differ on when the repetitive behaviors characteristic of autism are first present in early development. A task was developed that afforded specific opportunities…

  9. Suicide Attempts within 12 Months of Treatment for Substance Use Disorders

    ERIC Educational Resources Information Center

    Britton, Peter C.; Conner, Kenneth R.

    2010-01-01

    There are limited prospective data on suicide attempts (SA) during the months following treatment for substance use disorders (SUD), a period of high risk. In an analysis of the Drug Abuse Treatment Outcomes Study, a longitudinal naturalistic multisite study of treated SUDs, variables associated with SA in the 12 months following SUD treatment…

  10. Upper limb module in non-ambulant patients with spinal muscular atrophy: 12 month changes.

    PubMed

    Sivo, Serena; Mazzone, Elena; Antonaci, Laura; De Sanctis, Roberto; Fanelli, Lavinia; Palermo, Concetta; Montes, Jacqueline; Pane, Marika; Mercuri, Eugenio

    2015-03-01

    Recent studies have suggested that in non-ambulant patients affected by spinal muscular atrophy the Upper Limb Module can increase the range of activities assessed by the Hammersmith Functional Motor Scale Expanded. The aim of this study was to establish 12-month changes in the Upper Limb Module in a cohort of non-ambulant spinal muscular atrophy patients and their correlation with changes on the Hammersmith Functional Motor Scale Expanded. The Upper Limb Module scores ranged between 0 and 17 (mean 10.23, SD 4.81) at baseline and between 1 and 17 at 12 months (mean 10.27, SD 4.74). The Hammersmith Functional Motor Scale Expanded scores ranged between 0 and 34 (mean 12.43, SD 9.13) at baseline and between 0 and 34 at 12 months (mean 12.08, SD 9.21). The correlation betweeen the two scales was 0.65 at baseline and 0.72 on the 12 month changes. Our results confirm that the Upper Limb Module can capture functional changes in non-ambulant spinal muscular atrophy patients not otherwise captured by the other scale and that the combination of the two measures allows to capture changes in different subgroups of patients in whom baseline scores and functional changes may be influenced by several variables such as age.

  11. Evidence for a Unitary Goal Concept in 12-Month-Old Infants

    ERIC Educational Resources Information Center

    Biro, Szilvia; Verschoor, Stephan; Coenen, Lot

    2011-01-01

    We investigated whether infants can transfer their goal attribution between situations that contain different types of information about the goal. We found that 12-month-olds who had attributed a goal based on the causal efficacy of a means-end action generated expectations about the actor's action in another scenario in which the actor could…

  12. Class Matters: 12-Month-Olds' Word-Object Associations Privilege Content over Function Words

    ERIC Educational Resources Information Center

    MacKenzie, Heather; Curtin, Suzanne; Graham, Susan A.

    2012-01-01

    A fundamental step in learning words is the development of an association between a sound pattern and an element in the environment. Here we explore the nature of this associative ability in 12-month-olds, examining whether it is constrained to privilege particular word forms over others. Forty-eight infants were presented with sets of novel…

  13. The Flexibility of 12-Month-Olds' Preferences for Phonologically Appropriate Object Labels

    ERIC Educational Resources Information Center

    MacKenzie, Heather K.; Graham, Susan A.; Curtin, Suzanne; Archer, Stephanie L.

    2014-01-01

    We explored 12-month-olds' flexibility in accepting phonotactically illegal or ill-formed word forms in a modified associative-learning task. Sixty-four English-learning infants were presented with a training phase that either clarified the purpose of a sound--object association task or left the task ambiguous. Infants were then habituated to sets…

  14. Auditory Temporal Pattern Perception in 6- and 12-Month-Old Infants.

    ERIC Educational Resources Information Center

    Morrongiello, Barbara A.

    1984-01-01

    A go/no-go conditioned head-turn paradigm was used to examine the abilities of 6- and 12-month-olds to discriminate changes in temporal grouping and their perception of absolute and relative timing information when listening to patterns of white-noise bursts. (Author/RH)

  15. Speech Production in 12-Month-Old Children with and without Hearing Loss

    ERIC Educational Resources Information Center

    McGowan, Richard S.; Nittrouer, Susan; Chenausky, Karen

    2008-01-01

    Purpose: The purpose of this study was to compare speech production at 12 months of age for children with hearing loss (HL) who were identified and received intervention before 6 months of age with those of children with normal hearing (NH). Method: The speech production of 10 children with NH was compared with that of 10 children with HL whose…

  16. Adherence to Glaucoma Medications Over 12 Months in Two US Community Pharmacy Chains

    PubMed Central

    Feehan, Michael; Munger, Mark A.; Cooper, Daniel K.; Hess, Kyle T.; Durante, Richard; Jones, Gregory J.; Montuoro, Jaime; Morrison, Margaux A.; Clegg, Daniel; Crandall, Alan S.; DeAngelis, Margaret M.

    2016-01-01

    This study determined the degree of adherence to medications for glaucoma among patients refilling prescriptions in community pharmacies. Methods: Data abstracted from the dispensing records for 3615 adult patients (18 years or older, predominantly over 45) receiving glaucoma medications from two retail pharmacy chains (64 stores in total) were analyzed. From a 24-month historic data capture period, the 12-month levels of adherence were determined using standard metrics, the proportion of days covered (PDC) and the medication possession ratio (MPR). The overall 12-month mean PDC was only 57%, and the mean MPR was 71%. Using a criterion by which 80% coverage was considered satisfactory adherence, only 30% had satisfactory overall 12-month PDC coverage, and only 37% had satisfactory overall 12-month MPR coverage. Refill adherence increased with age and was highest in the 65-and-older age group (p < 0.001). Differential adherence was found across medication classes, with the highest satisfactory coverage seen for those taking alpha2-adrenergic agonists (PDC = 36.0%; MPR = 47.6%) down to those taking direct cholinergic agonists (PDC = 25.0%; MPR = 31.2%) and combination products (PDC = 22.7%; MPR = 31.0%). Adherence to glaucoma medications in the community setting, as measured by pharmacy refill data, is very poor and represents a critical target for intervention. Community pharmacists are well positioned to monitor and reinforce adherence in this population. PMID:27618115

  17. 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.

  18. 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.

  19. Skeletal findings in the first 12 months following initiation of glucocorticoid therapy for pediatric nephrotic syndrome

    PubMed Central

    Phan, V; Blydt-Hansen, T; Feber, J; Alos, N; Arora, S; Atkinson, S; Bell, L; Clarson, C; Couch, R; Cummings, EA; Filler, G; Grant, RM; Grimmer, J; Hebert, D; Lentle, B; Ma, J; Matzinger, M; Midgley, J; Pinsk, M; Rodd, C; Shenouda, N; Stein, R; Stephure, D; Taback, S; Williams, K; Rauch, F; Siminoski, K; Ward, LM

    2014-01-01

    Introduction Vertebral fracture (VF) incidence following glucocorticoid (GC) initiation has not been previously reported in pediatric nephrotic syndrome. Methods VF were assessed on radiographs (Genant method); lumbar spine bone mineral density (LS BMD) was evaluated by dual-energy x-ray absorptiometry. Results Sixty-five children were followed to 12 months post-GC initiation (median age: 5.4 years, range 2.3 to 17.9). Three of 54 children with radiographs (6%, 95% CI 2 to 15%) had incident VF at 1 year. The mean LS BMD Z-score was below the healthy average at baseline (mean ± SD −0.5 ± 1.1 p=0.001) and at 3 months (−0.6 ± 1.1 p<0.001), but not at 6 months (−0.3 ± 1.3, p=0.066) or 12 months (−0.3 ± 1.2, p=0.066). Mixed effect modeling showed a significant increase in LS BMD Z-scores between 3 and 12 months (0.22 SD, 95% CI 0.08 to 0.36, p=0.003). A sub-group (N=16; 25%) had LS BMD Z-scores that were ≤ −1.0 at 12 months. In these children, each additional 1000 mg/m2 of GC received in the first 3 months was associated with a decrease in LS BMD Z-score by 0.39 at 12 months (95% CI, −0.71 to −0.07; p=0.017). Conclusions The incidence of VF at 1 year was low and LS BMD Z-scores improved by 12 months in the majority. Twenty-five percent of children had LS BMD Z-scores ≤ −1.0 at 12 months. In these children, LS BMD Z-scores were inversely associated with early GC exposure, despite similar GC exposure compared to the rest of the cohort. PMID:23948876

  20. 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

    evidence of tumor recurrence which was corrected surgically. Two masses did show some mild enhancement on CT 6 months post operatively, biopsies showed no evidence of tumor with fibrosis. Of the patients with follow up of greater than 12 months 75% had decreasing size of the lesion, 25% had no change in size. No complications were seen. CONCLUSIONS: Radiofrequency ablation of renal tumors is a feasible alternative for patients that have imperative indication for nephron sparing surgery or those that have significant co-morbidities. The procedure is expedient, efficacious and carries minimal morbidity. It is of extreme importance to follow these patients closely with imaging of the lesion on a frequent basis.

  1. Noninvasive Transcutaneous Monitoring in Long-Term Follow-Up of Patients With Thromboangiitis Obliterans Treated With Intravenous Iloprost.

    PubMed

    Melillo, Elio; Grigoratos, Chrysanthos; Sanctis, Francesco De; Spontoni, Paolo; Nuti, Marco; Dell'Omodarme, Matteo; Ferrari, Mauro; Balbarini, Alberto

    2015-07-01

    We evaluated the effectiveness of intravenous iloprost (IVI) in outpatients with thromboangiitis obliterans (TAO) and lower limb noninvasive transcutaneous monitoring (TCM) at follow-up (FU). Ten consecutive patients with TAO underwent IVI therapy. Transcutaneous oxygen (TcPo 2) and carbon dioxide (TcPco 2) determination and laser Doppler flowmetry (LDF) were performed before and after IVI at 3, 6, and 12 months of FU. Clinical response was positive in 7 patients, whereas 3 nonresponders underwent a second IVI cycle with 1 showing a late positive clinical response. After 12 months of FU, all patients were alive without amputations. Supine and dependent TcP2 levels significantly improved (P < .005). Hallux LDF values showed significant change with the maximal hyperemic test at 44°C (P < .005). Forefoot maximal hyperemic test at 44°C LDF (P < .005) and improved venous arterial reflex (P < .05) showed statistically significant time evolution. We demonstrated some degree of IVI effectiveness and evaluated TCM in patients with TAO.

  2. 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

  3. 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

  4. 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

  5. Predictors of loss to follow-up in antiretroviral treatment for adult patients in the Oromia region, Ethiopia

    PubMed Central

    Megerso, Abebe; Garoma, Sileshi; Eticha, Tolosa; Workineh, Tilaye; Daba, Shallo; Tarekegn, Mihretu; Habtamu, Zelalem

    2016-01-01

    Purpose It is known that antiretroviral treatment (ART) reduces mortality from acquired immunodeficiency syndrome related causes. Patient’s lost to follow-up (LTFU) in this treatment poses a paramount problem to the public and health care services. Information on predictors of loss to follow-up is scarce in this study area and similar settings. Therefore, this study aimed at identifying correlates of loss to follow-up in ART among adult patients in the Oromia region of Ethiopia. Methods A case–control study was conducted between February 2015 and April 2015 using medical records. The stratified sampling technique was used to select health facilities. The number of patient records to be included in the study was proportionally allocated to each stratum based on their patient proportion in the regional data. Specific health facilities from which to include the records were randomly selected from a list of the health facilities per stratum. All adult patient records registered as LTFU (416) in the selected health facilities during the 12-month period prior to the data collection date, and 832 patients with good adherence to ART were included. Data were double-entered into Epi Info 7 and analyzed using SPSS 20. Descriptive statistics and binary logistic regression were used to report the results. Qualitative data were thematically analyzed using open code computer software. Results Age 15–24 years (adjusted odds ratio [AOR], 19.82 95% CI: 6.80, 57.73); day laborers (AOR, 5.36; 95% confidence interval [CI]: 3.23, 8.89), rural residents (AOR, 2.35; 95% CI: 1.45, 3.89), World Health Organization clinical stage IV (AOR, 2.29; 95% CI: 1.45, 3.62), baseline CD4 <350 cells/mL (AOR, 2.06; 95% CI: 1.36, 3.13), suboptimal adherence to ART (AOR, 7.42; 95% CI: 1.87, 29.41), were factors which increased the risk of loss to follow-up in ART. Conclusion Multiple risk factors, both socioeconomic and clinical, were associated with loss to follow-up. Attention is required to

  6. Retention of a Flowable Composite Resin in Comparison to a Conventional Resin-Based Sealant: One-year Follow-up

    PubMed Central

    Jafarzadeh, M.; Malekafzali, B.; Tadayon, N.; Fallahi, S.

    2010-01-01

    Objective: Long-term retention of pit and fissure sealants is crucial for their success. This clinical study evaluated the retention rate of a flowable composite resin (Filtek Supreme XT Flowable Restorative) compared to a conventional resin-based sealant (Concise Light Cure White Sealant) over 12 months. Materials and Methods: Forty subjects aged 6 to 9 years were included in the study. Using a half-mouth design, a total of 80 first permanent molars were sealed with conventional fissure sealant on one side of the mouth and flowable composite on the contralateral side. Clinical evaluation was performed at 3, 6, and 12 months by a single blind examiner and the retention was classified as complete retention, partial loss, or total loss. Results: For both materials, there was no total loss of sealants over 12 months. Partial loss of both materials was observed in one sealant after 3 months. After 6 months, 36 teeth sealed with conventional fissure sealant were intact compared with 37 sealed with a flowable composite, and after 12 months, 33 teeth sealed with conventional fissure sealant were intact compared with 35 that were sealed with a flowable composite. There were no statistically significant difference (P>0.05) between the two materials regarding the retention rate at each follow-up period. Conclusion: As flowable composite resulted in comparable sealant retention rates, this material could be a good choice for fissure sealant. PMID:21998768

  7. 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

  8. Effect of recent spinal cord injury on wnt signaling antagonists (sclerostin and dkk-1) and their relationship with bone loss. A 12-month prospective study.

    PubMed

    Gifre, Laia; Vidal, Joan; Carrasco, Josep L; Filella, Xavier; Ruiz-Gaspà, Silvia; Muxi, Africa; Portell, Enric; Monegal, Ana; Guañabens, Nuria; Peris, Pilar

    2015-06-01

    Spinal cord injury (SCI) has been associated with a marked increase in bone loss and bone remodeling, especially short-term after injury. The absence of mechanical load, mediated by osteocyte mechanosensory function, seems to be a causative factor related to bone loss in this condition. However, the pathogenesis and clinical management of this process remain unclear. Therefore, the aim of the study was to analyze the effect of recent SCI on the Wnt pathway antagonists, sclerostin and Dickkopf (Dkk-1), and their relationship with bone turnover and bone mineral density (BMD) evolution. Forty-two patients (aged 35 ± 14yrs) with a recent (<6months) complete SCI were prospectively included. Sclerostin and Dkk-1, bone turnover markers (bone formation: PINP, bone ALP; resorption: sCTx) and BMD (lumbar spine, proximal femur, total body and lower extremities [DXA]) were assessed at baseline and at 6 and 12 months. The results were compared with a healthy control group. 22/42 patients completed the 12-month follow-up. At baseline, SCI patients showed a marked increase in bone markers (PINP and sCTx), remaining significantly increased at up to 6 months of follow-up. Additionally, they presented significantly increased Dkk-1 values throughout the study, whereas sclerostin values did not significantly change. BMD markedly decreased at the proximal femur (-20.2 ± 5.4%, p < 0.01), total body (-5.7 ± 2.2%, p = 0.02) and lower extremities (-13.1 ± 4.5%, p = 0.01) at 12 months. Consequently, 59% of patients developed densitometric osteoporosis at 12 months. Patients with higher Dkk-1 values (>58 pmol/L) at baseline showed higher sublesional BMD loss. In conclusion, this study shows that short-term after SCI there is a marked increase in bone turnover and bone loss, the latter associated with an increase in Dkk-1 serum levels. The persistence of increased levels of this Wnt antagonist throughout the study and their relationship with the magnitude of

  9. Computerized Working-Memory Training for Children Following Arterial Ischemic Stroke: A Pilot Study With Long-Term Follow-Up.

    PubMed

    Eve, Megan; O'Keeffe, Fiadhnait; Jhuty, Simren; Ganesan, Vijeya; Brown, Gary; Murphy, Tara

    2016-01-01

    Cognitive deficits in the domains of working memory (WM) and executive function are well documented following childhood arterial ischemic stroke (AIS). However, there are currently no evidence-based cognitive interventions for this population. Computerized, implicit WM training has been demonstrated to generate generalized cognitive gains for children with WM and attention deficits and for adults following brain injury. This study used a pilot design to investigate the efficacy and feasibility of such an intervention program (Cogmed WM Training) for a childhood AIS population. Outcomes were measured via psychometric assessment at preintervention and postintervention and again at 1-year follow-up. At longitudinal follow-up, participants were found to have significant and persistent cognitive difficulties, particularly with attention and response inhibition. Following the computerized, implicit WM intervention, a significant improvement in phonological-loop WM was seen; however, this improvement was not maintained after 12 months. No additional significant improvements on standardized psychometric outcome measures were seen either immediately or at 12-month follow-up. Findings of this pilot study therefore do not currently support Cogmed as an effective intervention for children with AIS but highlight the need for further research, including randomized, controlled trials, to investigate cognitive interventions for the childhood AIS population.

  10. Early insulin resistance predicts weight gain and waist circumference increase in first-episode psychosis--A one year follow-up study.

    PubMed

    Keinänen, Jaakko; Mantere, Outi; Kieseppä, Tuula; Mäntylä, Teemu; Torniainen, Minna; Lindgren, Maija; Sundvall, Jouko; Suvisaari, Jaana

    2015-12-01

    First-episode psychosis (FEP) is associated with weight gain during the first year of treatment, and risk of abdominal obesity is particularly increased. To identify early risk markers of weight gain and abdominal obesity, we investigated baseline metabolic differences in 60 FEP patients and 27 controls, and longitudinal changes during the first year of treatment in patients. Compared to controls at baseline, patients had higher low-density lipoprotein, triglyceride and apolipoprotein B levels, and lower levels of high-density lipoprotein and apolipoprotein A-I but no difference in body mass index or waist circumference. At 12-month follow-up, 60.6% of patients were overweight or obese and 58.8% had abdominal obesity. No significant increase during follow-up was seen in markers of glucose and lipid metabolism or blood pressure, but increase in C-reactive protein between baseline and 12-month follow-up was statistically significant. Weight increase was predicted by baseline insulin resistance and olanzapine use, while increase in waist circumference was predicted by baseline insulin resistance only. In conclusion, insulin resistance may be an early marker of increased vulnerability to weight gain and abdominal obesity in young adults with FEP. Olanzapine should be avoided as a first-line treatment in FEP due to the substantial weight increase it causes. In addition, the increase in the prevalence of overweight and abdominal obesity was accompanied by the emergence of low-grade systemic inflammation.

  11. Long term follow-up study to evaluate immunogenicity and safety of a single dose of live attenuated hepatitis a vaccine in children.

    PubMed

    Mitra, Monjori; Shah, Nitin; Faridi, Mma; Ghosh, Apurba; Sankaranarayanan, V S; Aggarwal, Anju; Chatterjee, Suparna; Bhattacharyya, Nisha; Kadhe, Ganesh; Vishnoi, Gaurav; Mane, Amey

    2015-01-01

    Worldwide, viral hepatitis continues to be a cause of considerable morbidity and mortality. Mass immunization with a single dose of live attenuated HAV has been shown to significantly reduce disease burden in the community. This was a phase IV, 5-year follow up study carried out at 4 centers (Kolkata, Delhi, Mumbai and Chennai) across India. The subjects with antibody titer <20 mIU/mL at baseline were evaluated for long term immunogenicity. Of the 503 subjects enrolled, 349 subjects were baseline seronegative with an anti-HAV antibody titer <20 mIU/mL. Overall, 343 subjects could be followed up at some point of time during this 5 y post vaccination period. In the last year (60 months) of follow-up, 108 subjects (97.3%) of 111 subjects (who came for follow-up at the end of 5 y) had a protective antibody titer (anti-HAV antibody titer >20 mIU/mL). The seroconversion rates considering seroprotection levels of anti-HAV antibody titer >20 mIU/mL, following vaccination starting from 6 weeks, 6 months, 12 months, 24 months, 36 months, 48 months and 60 months were 95.1%, 97.9%, 98.3%, 96.2%, 97.8%, 92.6% and 97.3%, respectively. The geometric mean concentration (GMC) over the years increased from 64.9 mIU/mL at 6 weeks to 38.1 mIU/mL and 135.2 mIU/mL at 6 months and 12 months, respectively and was maintained at 127.1 mIU/mL at 60 months. In conclusion, the result of this 5-year follow up study showed that the single dose of live attenuated vaccine is well tolerated and provides long-term immunogenicity in healthy Indian children.

  12. MOTHER-INFANT INTERACTION AT 12 MONTHS IN PRENATALLY COCAINE-EXPOSED CHILDREN

    PubMed Central

    Ukeje, Ikechukwu; Bendersky, Margaret; Lewis, Michael

    2006-01-01

    This study examined mother-infant interactions of 12-month-old African-American prenatally cocaine-exposed infants and their mothers. Videotaped observations were made during a free-play dyadic interaction, a brief separation, and a reunion period. Videotapes were coded for maternal and child behaviors during each phase of the procedure. Although there were few differences in interactive behaviors between prenatally cocaine-exposed and nonexposed children and their mothers, children who were prenatally exposed to cocaine ignored their mother’s departure (odds ratio [OR] = 3.0, p < .05) during separation significantly more often than nonexposed subjects. In addition, mothers who abused cocaine engaged in significantly more verbal behavior (F(2,104) = 7.00, p < .001) with their children than mothers of nonexposed children. These findings indicate that women who used cocaine during pregnancy may not differ from nonusers in their interactions with their 12-month-old infants. PMID:11417936

  13. Language Differences at 12 Months in Infants Who Develop Autism Spectrum Disorder.

    PubMed

    Lazenby, DeWayne C; Sideridis, Georgios D; Huntington, Noelle; Prante, Matthew; Dale, Philip S; Curtin, Suzanne; Henkel, Lisa; Iverson, Jana M; Carver, Leslie; Dobkins, Karen; Akshoomoff, Natacha; Tagavi, Daina; Nelson, Charles A; Tager-Flusberg, Helen

    2016-03-01

    Little is known about early language development in infants who later develop autism spectrum disorder (ASD). We analyzed prospective data from 346 infants, some of whom were at high risk for developing ASD, to determine if language differences could be detected at 12 months of age in the infants who later were diagnosed with ASD. Analyses revealed lower receptive and expressive language scores in infants who later were diagnosed with ASD. Controlling for overall ability to understand and produce single words, a Rasch analysis indicated that infants who later developed ASD had a higher degree of statistically unexpected word understanding and production. At 12 months of age, quantitative and qualitative language patterns distinguished infants who later developed ASD from those who did not.

  14. Lifetime and 12-Month Nonsuicidal Self-Injury and Academic Performance in College Freshmen.

    PubMed

    Kiekens, Glenn; Claes, Laurence; Demyttenaere, Koen; Auerbach, Randy P; Green, Jennifer G; Kessler, Ronald C; Mortier, Philippe; Nock, Matthew K; Bruffaerts, Ronny

    2016-10-01

    We examined whether nonsuicidal self-injury (NSSI) is associated with academic performance in college freshmen, using census-based web surveys (N = 7,527; response = 65.4%). NSSI was assessed with items from the Self-Injurious Thoughts and Behaviors Interview and subsequently linked with the administratively recorded academic year percentage (AYP). Freshmen with lifetime and 12-month NSSI showed a reduction in AYP of 3.4% and 5.9%, respectively. The college environment was found to moderate the effect of 12-month NSSI, with more strongly reduced AYPs in departments with higher-than-average mean departmental AYPs. The findings suggest that overall stress and test anxiety are underlying processes between NSSI membership and academic performance.

  15. Atypical object exploration at 12 months of age is associated with autism in a prospective sample.

    PubMed

    Ozonoff, Sally; Macari, Suzanne; Young, Gregory S; Goldring, Stacy; Thompson, Meagan; Rogers, Sally J

    2008-09-01

    This prospective study examined object exploration behavior in 66 12-month-old infants, of whom nine were subsequently diagnosed with an autism spectrum disorder. Previous investigations differ on when the repetitive behaviors characteristic of autism are first present in early development. A task was developed that afforded specific opportunities for a range of repetitive uses of objects and was coded blind to outcome status. The autism/ASD outcome group displayed significantly more spinning, rotating, and unusual visual exploration of objects than two comparison groups. The average unusual visual exploration score of the autism/ASD group was over four standard deviations above the mean of the group with no concerns at outcome. Repetitive behaviors at 12 months were significantly related to cognitive and symptomatic status at 36 month outcome. These results suggest that repetitive or stereotyped behaviors may be present earlier than initially thought in very young children developing the autism phenotype.

  16. The relationship between attention and deferred imitation in 12-month-old infants.

    PubMed

    Zmyj, Norbert; Schölmerich, Axel; Daum, Moritz M

    2017-03-01

    Imitation is a frequent behavior in the first years of life, and serves both a social function (e.g., to interact with others) and a cognitive function (e.g., to learn a new skill). Infants differ in their temperament, and temperament might be related to the dominance of one function of imitation. In this study, we investigated whether temperament and deferred imitation are related in 12-month-old infants. Temperament was measured via the Infant Behavior Questionnaire Revised (IBQ-R) and parts of the Laboratory Temperament Assessment Battery (Lab-TAB). Deferred imitation was measured via the Frankfurt Imitation Test for 12-month-olds (FIT-12). Regression analyses revealed that the duration of orienting (IBQ-R) and the latency of the first look away in the Task Orientation task (Lab-TAB) predicted the infants' imitation score. These results suggest that attention-related processes may play a major role when infants start to imitate.

  17. Outcome of oral dysplasia: a retrospective hospital-based study of 207 patients with a long follow-up.

    PubMed

    Arduino, Paolo G; Surace, Antonio; Carbone, Mario; Elia, Alessandra; Massolini, Gianluca; Gandolfo, Sergio; Broccoletti, Roberto

    2009-07-01

    The aim of this retrospective hospital-based study was to review and evaluate the long-term outcome of patients with oral epithelial dysplasia (OED), with or without surgical intervention, to identify factors affecting clinical course and malignant evolution. Patients with a follow-up of at least 12 months were included. Data collected were statistically analyzed. The mean age was 63.58 years for women (n = 100) and 64.17 years for men (n = 107). One hundred and thirty-five of the patients had lesions with histopathological features of mild OED, 50 had moderate OED and 22 had severe OED. Gender and risk factors seemed not to be related with the development of OED. One hundred and thirty-three patients underwent active treatment. During the period considered, 39.4% of the 207 lesions disappeared; 19.66% remained stable and 33.7% of the total cases showed a new dysplastic event after treatment. Fifteen (7.24%) out of 207 developed a squamous cell carcinoma during follow-up. Our data showed that speckled lesions are more often associated with high histological grade. The risk of malignant development does not seem to be predictable. Surrounded by the limitations of the retrospective designs, we have showed that there is no eminent benefit of surgical intervention of OED in preventing recurrences and malignant development.

  18. Factors that can predict pain with walking, 12 months after total knee arthroplasty

    PubMed Central

    Lindberg, Maren Falch; Miaskowski, Christine; RustøEn, Tone; Rosseland, Leiv Arne; Cooper, Bruce A; Lerdal, Anners

    2016-01-01

    Background and purpose — Functional limitations after total knee arthroplasty (TKA) are common. In this longitudinal study, we wanted to identify subgroups of patients with distinct trajectories of pain-related interference with walking during the first year after TKA and to determine which demographic, clinical, symptom-related, and psychological characteristics were associated with being part of this subgroup. Patients and methods — Patients scheduled for primary TKA for osteoarthritis (n = 202) completed questionnaires that evaluated perception of pain, fatigue, anxiety, depression, and illness on the day before surgery. Clinical characteristics were obtained from the medical records. Interference of pain with walking was assessed preoperatively, on postoperative day 4, and at 6 weeks, 3 months, and 12 months after TKA. Results — Using growth mixture modeling, 2 subgroups of patients were identified with distinct trajectories of pain-related interference with walking over time. Patients in the Continuous Improvement class (n = 157, 78%) had lower preoperative interference scores and reported a gradual decline in pain-related interference with walking over the first 12 months after TKA. Patients in the Recurrent Interference class (n = 45, 22%) reported a high degree of preoperative pain-related interference with walking, initial improvement during the first 3 months after TKA, and then a gradual increase—returning to preoperative levels at 12 months. Patients in the Recurrent Interference class had higher preoperative pain, fatigue, and depression scores, and poorer perception of illness than the Continuous Improvement class. Interpretation — 1 in 5 patients did not improve in pain-related interference with walking at 12 months after TKA. Future studies should test the efficacy of interventions designed to modify preoperative characteristics. PMID:27658970

  19. Factors that can predict pain with walking, 12 months after total knee arthroplasty.

    PubMed

    Lindberg, Maren Falch; Miaskowski, Christine; RustøEn, Tone; Rosseland, Leiv Arne; Cooper, Bruce A; Lerdal, Anners

    2016-12-01

    Background and purpose - Functional limitations after total knee arthroplasty (TKA) are common. In this longitudinal study, we wanted to identify subgroups of patients with distinct trajectories of pain-related interference with walking during the first year after TKA and to determine which demographic, clinical, symptom-related, and psychological characteristics were associated with being part of this subgroup. Patients and methods - Patients scheduled for primary TKA for osteoarthritis (n = 202) completed questionnaires that evaluated perception of pain, fatigue, anxiety, depression, and illness on the day before surgery. Clinical characteristics were obtained from the medical records. Interference of pain with walking was assessed preoperatively, on postoperative day 4, and at 6 weeks, 3 months, and 12 months after TKA. Results - Using growth mixture modeling, 2 subgroups of patients were identified with distinct trajectories of pain-related interference with walking over time. Patients in the Continuous Improvement class (n = 157, 78%) had lower preoperative interference scores and reported a gradual decline in pain-related interference with walking over the first 12 months after TKA. Patients in the Recurrent Interference class (n = 45, 22%) reported a high degree of preoperative pain-related interference with walking, initial improvement during the first 3 months after TKA, and then a gradual increase-returning to preoperative levels at 12 months. Patients in the Recurrent Interference class had higher preoperative pain, fatigue, and depression scores, and poorer perception of illness than the Continuous Improvement class. Interpretation - 1 in 5 patients did not improve in pain-related interference with walking at 12 months after TKA. Future studies should test the efficacy of interventions designed to modify preoperative characteristics.

  20. 6 Minute Walk Test in Duchenne MD Patients with Different Mutations: 12 Month Changes

    PubMed Central

    Pane, Marika; Mazzone, Elena S.; Sormani, Maria Pia; Messina, Sonia; Vita, Gian Luca; Fanelli, Lavinia; Berardinelli, Angela; Torrente, Yvan; D'Amico, Adele; Lanzillotta, Valentina; Viggiano, Emanuela; D'Ambrosio, Paola; Cavallaro, Filippo; Frosini, Silvia; Bello, Luca; Bonfiglio, Serena; Scalise, Roberta; De Sanctis, Roberto; Rolle, Enrica; Bianco, Flaviana; Van der Haawue, Marlene; Magri, Francesca; Palermo, Concetta; Rossi, Francesca; Donati, Maria Alice; Alfonsi, Chiara; Sacchini, Michele; Arnoldi, Maria Teresa; Baranello, Giovanni; Mongini, Tiziana; Pini, Antonella; Battini, Roberta; Pegoraro, Elena; Previtali, Stefano C.; Napolitano, Sara; Bruno, Claudio; Politano, Luisa; Comi, Giacomo P.; Bertini, Enrico; Morandi, Lucia; Gualandi, Francesca; Ferlini, Alessandra; Goemans, Nathalie; Mercuri, Eugenio

    2014-01-01

    Objective In the last few years some of the therapeutical approaches for Duchenne muscular dystrophy (DMD) are specifically targeting distinct groups of mutations, such as deletions eligible for skipping of individual exons. The aim of this observational study was to establish whether patients with distinct groups of mutations have different profiles of changes on the 6 minute walk test (6MWT) over a 12 month period. Methods The 6MWT was performed in 191 ambulant DMD boys at baseline and 12 months later. The results were analysed using a test for heterogeneity in order to establish possible differences among different types of mutations (deletions, duplications, point mutations) and among subgroups of deletions eligible to skip individual exons. Results At baseline the 6MWD ranged between 180 and 560,80 metres (mean 378,06, SD 74,13). The 12 month changes ranged between −325 and 175 (mean −10.8 meters, SD 69.2). Although boys with duplications had better results than those with the other types of mutations, the difference was not significant. Similarly, boys eligible for skipping of the exon 44 had better baseline results and less drastic changes than those eligible for skipping exon 45 or 53, but the difference was not significant. Conclusions even if there are some differences among subgroups, the mean 12 month changes in each subgroup were all within a narrow Range: from the mean of the whole DMD cohort. This information will be of help at the time of designing clinical trials with small numbers of eligible patients. PMID:24421885

  1. 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

  2. Meaning in life and non-suicidal self-injury: A follow-up study with participants with Borderline Personality Disorder.

    PubMed

    Marco, José H; Garcia-Alandete, Joaquín; Pérez, Sandra; Guillen, Verónica; Jorquera, Mercedes; Espallargas, Pilar; Botella, Cristina

    2015-12-15

    Non-suicidal self-injury (NSSI) is considered one of the defining features of people diagnosed with Borderline Personality Disorder (BPD). Longitudinal studies are needed to identify factors predicting future NSSI in BPD participants. Several studies have shown that low meaning in life is associated with mental health problems, addiction problems, depression, hopelessness, and suicide. The purpose of this paper is to examine whether meaning in life predicts the frequency of NSSI behaviors during the one-year follow-up. The sample was composed up of 80 participants with a BPD diagnosis. We assessed the frequency of NSSI behaviors over a 12-month follow-up period. The results suggest that the participants who had low meaning in life had more frequency of NSSI, depression, and hopelessness at baseline, and more frequency of NSSI during the follow-up, than participants with high meaning in life. The predictor variables: Frequency of NSSI at base line, depression, hopelessness, and meaning in life, significantly predicted the frequency of NSSI during the one-year follow-up. Therefore, meaning in life was the only predictor of NSSI during the follow-up period.

  3. Static or dynamic predictors of physical activity (PA)? A tracking study based on 12- and 38-month follow-ups in older adults.

    PubMed

    de Souto Barreto, Philipe; Ferrandez, Anne-Marie

    2014-01-01

    Studies that investigated stability of PA in older populations are scarce. Moreover, no studies used dynamic indicators to predict PA trajectories. The purpose of the present study were to investigate PA stability overtime, and to examine if changes in self-reported physical function (dynamic indicator) are better predictors of trajectories of PA than baseline measures of physical function (static indicator). This is a prospective postal survey with two time-point follow-ups: 12 and 38 months. Participants were older adults aged ≥ 60 years, and members of the medical insurance scheme of the French national education system. They responded to a self-report questionnaire on PA and general health status at three different times: baseline, 12- and 38-month follow-ups (n=243 for the 12-month follow-up; n=164 for the 38-month follow-up). Overtime analyses of PA showed a moderate-to-good stability with regard to both duration and volume of PA; however, a decrease in stability for vigorous PA was found between 12- and 38-month follow-ups. Both baseline measure and changes in physical function predicted PA trajectories, but magnitudes of associations were stronger for the dynamic indicator. Moreover, change in physical function was the only predictor of both becoming active compared with Inactive (reduced probability) and becoming inactive compared to Active (increased probability). In conclusion, a dynamic indicator of physical function is a better predictor of PA variation than static indicators.

  4. 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

  5. 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.

  6. 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

  7. Improved asthma control in patients with severe, persistent allergic asthma after 12 months of nightly temperature-controlled laminar airflow: an observational study with retrospective comparisons

    PubMed Central

    Schauer, Uwe; Bergmann, Karl-Christian; Gerstlauer, Michael; Lehmann, Sylvia; Gappa, Monika; Brenneken, Amelie; Schulz, Christian; Ahrens, Peter; Schreiber, Jens; Wittmann, Michael; Hamelmann, Eckard

    2015-01-01

    Introduction Continuous or episodic allergen exposure is a major risk factor of frequent symptoms and exacerbations for patients with allergic asthma. It has been shown that temperature-controlled laminar airflow (TLA) significantly reduced allergen exposure and airway inflammation and improved quality of life of patients with poorly controlled allergic asthma. Objective The objective was to evaluate the effects of nighttime TLA when used during real-life conditions for 12 consecutive months in addition to the patients’ regular medication. Methods This multicenter, pre- and postretrospective observational study included patients with inadequately controlled moderate-to-severe allergic asthma who received add-on treatment with TLA for 12 consecutive months. Data on medication use, asthma control, asthma symptoms, lung function, use of hospital resources, and exacerbations were collected after 4 and 12 months and compared with corresponding data collected retrospectively from medical records during the year prior to inclusion in the study. Results Data from 30 patients (mean age 28; range 8–70) completing 4 months and 27 patients completing 12 months of TLA use are presented. The mean number of exacerbations was reduced from 3.6 to 1.3 (p<0.0001), and the ratio of asthma-related emergency room visits or hospitalizations diminished from 72.4 to 23.3% (p=0.001) or from 44.8 to 20.0% (p<0.05), respectively, after 12 months of TLA use. The Asthma Control Test index increased from 14.1 to 18.5 (p<0.0001). After 4 months of TLA use, clear improvements can be shown for most variables in line with the data collected after 12 months. Conclusions The addition of TLA to the patients’ regular medication significantly reduced exacerbations, asthma symptoms, and the utilization of hospital resources. The data support that TLA may be an important new non-pharmacological approach in the management of poorly controlled allergic asthma. PMID:26557252

  8. 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

  9. Immunization of babies born to HBsAg positive mothers: An audit on the delivery and completeness of follow up in Norfolk and Suffolk, United Kingdom.

    PubMed

    Keeble, Stuart; Quested, Jane; Barker, Deborah; Varadarajan, Abina; Shankar, Ananda Giri

    2015-01-01

    Perinatal transmission of hepatitis B infection has increased in the UK over the last decade. Routine antenatal screening of pregnant mothers (based on HBsAg) provides an effective means to identify 'at risk' babies. Follow up of babies born to infected mothers involves 4 doses of vaccination and/or a single dose of HBIG at birth. In this study we report the outcome of follow up of babies born to infected mothers over a 5 y period. One hundred sixty-three babies born to HBsAg positive mothers were followed up to ascertain the completeness for immunization and serological testing. Vaccination completion was 99.4% (162 of babies) at birth (1st dose), 95.6% (152 babies) for the second dose (at 1st month), 94.3 % (148 babies) for the 3rd dose (at 2nd month) and 83.4% (106 babies) for the 4th dose (at 12 months). Additionally, at 12 months 29.9% (38) of babies had their blood tested serologically to ascertain infection status; all babies receiving antigen testing were HBsAg negative. The overall vaccination coverage was good, although there is scope to improve the coverage of 4th dose. However, the proportion of children who were serologically tested for surface antigen at 12 months was considerably lower and there is a greater need to test babies concurrently at the time of giving the 4(th) dose. The proposed dried blood spot testing which will be rolled out from September 2014 should address this issue.

  10. Long-term outcomes of anthroposophic therapy for chronic low back pain: A two-year follow-up analysis

    PubMed Central

    Hamre, Harald J; Witt, Claudia M; Kienle, Gunver S; Glockmann, Anja; Ziegler, Renatus; Willich, Stefan N; Kiene, Helmut

    2009-01-01

    Background Anthroposophic treatment for chronic low back pain (LBP) includes special artistic and physical therapies and special medications. In a previously published prospective cohort study, anthroposophic treatment for chronic LBP was associated with improvements of pain, back function, and quality of life at 12-month follow-up. These improvements were at least comparable to improvements in a control group receiving conventional care. We conducted a two-year follow-up analysis of the anthroposophic therapy group with a larger sample size. Methods Seventy-five consecutive adult outpatients in Germany, starting anthroposophic treatment for discogenic or non-specific LBP of ≥6 weeks’ duration participated in a prospective cohort study. Main outcomes were Hanover Functional Ability Questionnaire (HFAQ; 0–100), LBP Rating Scale Pain Score (LBPRS; 0–100), Symptom Score (0–10), and SF-36 after 24 months. Results Eighty-five percent of patients were women. Mean age was 49.0 years. From baseline to 24-month follow-up all outcomes improved significantly; average improvements were: HFAQ 11.1 points (95% confidence interval [CI]: 5.5–16.6; p < 0.001), LBPRS 8.7 (95% CI: 4.4–13.0; p < 0.001), Symptom Score 2.0 (95% CI: 1.3–2.8; p < 0.001), SF-36 Physical Component Summary 6.0 (95% CI: 2.9–9.1; p < 0.001), and SF-36 Mental Component Summary 4.0 (95% CI: 1.1–6.8; p = 0.007). Conclusion Patients with chronic LBP receiving anthroposophic treatment had sustained improvements of symptoms, back function, and quality of life, suggesting that larger multicenter rigorous studies may be worthwhile. PMID:21197296

  11. 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.

  12. Recurrence Incidence in Differentiated Thyroid Cancers and the Importance of Diagnostic Iodine-131 Scintigraphy in Clinical Follow-up

    PubMed Central

    Hatipoğlu, Filiz; Karapolat, İnanç; Ömür, Özgür; Akgün, Ayşegül; Yanarateş, Ahmet; Kumanlıoğlu, Kamil

    2016-01-01

    Objective: Differentiated thyroid cancers (DTC) are tumors with good prognosis. However, local recurrence or distant metastasis can be observed. In our study, we aimed to investigate the incidence of recurrence and the importance of diagnostic iodine-131 whole body scan (WBS) in clinical follow-up in patients with DTC. Methods: The clinical data of 217 patients with DTC who were followed-up more than 3 years were reviewed retrospectively. The incidence of recurrence was investigated in a group of patients who had radioactive iodine (RAI) treatment and showed no sign of residual thyroid tissue or metastasis with diagnostic WBS that was performed at 6-12 months after therapy and had a thyroglobulin (Tg) level lower than 2 ng/dl. Results: At the time of diagnosis, ten cases had thyroid capsule invasion, 25 cases had extra-thyroid soft tissue invasion, 11 patients showed lymph node metastasis and four patients had distant organ metastasis. One hundred forty-five patients had RAI treatment at ablation dose (75-100 mCi), whereas 35 patients had RAI treatment at metastasis dose (150-200 mCi). Thirty-seven patients with papillary microcarcinoma did not receive RAI treatment. In 12 (%7.5) of the 160 patients who were considered as “successful ablation”, a recurrence was identified. Recurrence was detected by diagnostic WBS in all cases and stimulated Tg level was <2 ng/dL with the exception of the two cases who had distant metastasis. Conclusion: Identification of pathological findings with WBS in patients who developed local recurrence in the absence of elevated Tg highlights the importance of diagnostic WBS in clinical follow-up. PMID:27277325

  13. 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…

  14. One-year follow-up of mud-bath therapy in patients with bilateral knee osteoarthritis: a randomized, single-blind controlled trial

    NASA Astrophysics Data System (ADS)

    Fioravanti, A.; Bacaro, G.; Giannitti, C.; Tenti, S.; Cheleschi, S.; Guidelli, G. M.; Pascarelli, N. A.; Galeazzi, M.

    2015-09-01

    The objective of this prospective parallel randomized single-blind study was to assess that a cycle of mud-bath therapy (MBT) provides any benefits over usual treatment in patients with bilateral knee osteoarthritis (OA). Patients with symptomatic primary bilateral knee OA, according to ACR criteria, were included in the study and randomized to one of two groups: one group received a cycle of MBT at spa center of Chianciano Terme (Italy) in addition to the usual treatment, and one group continued their regular care routine alone. Clinical assessments were performed 7 days before enrollment (screening visit), at the time of enrollment (basal time), after 2 weeks, and after 3, 6, 9, and 12 months after the beginning of the study. All assessments were conducted by two researchers blinded to treatment allocation. The primary efficacy outcomes were the global pain score evaluated by Visual Analog Scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) subscore for physical function (W-TPFS). Of the 235 patients screened, 103 met the inclusion criteria: 53 patients were included in the MBT group and 50 in the control group. In the group of patients treated with MBT, we observed a statistically significant ( p < 0.001) reduction of VAS and W-TPFS score at the end of the treatment; this improvement was significant ( p < 0.05) also at 3 months of follow-up. The control group did not show significant differences between baseline time and all other times. The differences between one group were significant for both primary parameters already from the 15th day and persisted up to the 9th month. This beneficial effect was confirmed by the significant reduction of symptomatic drug consumption. Tolerability of MBT seemed to be good, with light and transitory side effects. Our results confirm that a cycle of MBT added to usual treatment provides a beneficial effect on the painful symptoms and functional capacities in patients with knee OA that

  15. 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.

  16. A 12-month, open-label, comparative study of quetiapine and risperidone in the acute and long-term treatment of schizophrenia.

    PubMed

    Perez, Victor; Cañas, Fernando; Tafalla, Monica

    2008-05-01

    This multicentre, observational, prospective, nonrandomized study compared the effectiveness and tolerability of quetiapine and risperidone in the acute and long-term treatment of schizophrenia in a clinical setting. Patients admitted to an acute unit with schizophrenia, schizophreniform or schizoaffective disorder (DSM-IV), who were prescribed quetiapine or risperidone (3 : 1 ratio) within the first week of treatment, according to the physician's usual practice, were recruited. In total, 492 patients (quetiapine: 367; risperidone: 125) were followed up at weeks 1 and 2, discharge and 6 and 12 months thereafter. Mean doses at 12 months were: quetiapine 718.5 mg/day and risperidone 7.0 mg/day. Efficacy measures (Brief Psychiatric Rating Scale, Clinical Global Impression Severity of Illness and Improvement) indicated similar results for both agents. No difference was found in rehospitalization rate with either drug. In terms of tolerability, orthostatic hypotension was more frequent with quetiapine, but extrapyramidal symptoms and male sexual dysfunction were more frequent with risperidone. In conclusion, quetiapine and risperidone had comparable effectiveness, but there were differences between treatments in their side effect profile.

  17. 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

  18. 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.

  19. 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.

  20. CUMULATIVE TRAUMAS AND RISK THRESHOLDS: 12-MONTH PTSD IN THE WORLD MENTAL HEALTH (WMH) SURVEYS

    PubMed Central

    Karam, Elie G.; Friedman, Matthew J.; Hill, Eric D.; Kessler, Ronald C.; McLaughlin, Katie A.; Petukhova, Maria; Sampson, Laura; Shahly, Victoria; Angermeyer, Matthias C.; Bromet, Evelyn J.; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Ferry, Finola; Florescu, Silvia E.; Haro, Josep Maria; He, Yanling; Karam, Aimee N.; Kawakami, Norito; Kovess-Masfety, Viviane; Medina-Mora, María Elena; Browne, Mark A. Oakley; Posada-Villa, José A.; Shalev, Arieh Y.; Stein, Dan J.; Viana, Maria Carmen; Zarkov, Zahari; Koenen, Karestan C.

    2014-01-01

    Background Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue. Methods Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts. Results 19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyper-arousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs. Conclusions A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more “complex” clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. Depression and Anxiety 31:130–142, 2014. PMID:23983056

  1. Language development at 18 months is related to multimodal communicative strategies at 12 months.

    PubMed

    Igualada, Alfonso; Bosch, Laura; Prieto, Pilar

    2015-05-01

    The present study investigated the degree to which an infants' use of simultaneous gesture-speech combinations during controlled social interactions predicts later language development. Nineteen infants participated in a declarative pointing task involving three different social conditions: two experimental conditions (a) available, when the adult was visually attending to the infant but did not attend to the object of reference jointly with the child, and (b) unavailable, when the adult was not visually attending to neither the infant nor the object; and (c) a baseline condition, when the adult jointly engaged with the infant's object of reference. At 12 months of age measures related to infants' speech-only productions, pointing-only gestures, and simultaneous pointing-speech combinations were obtained in each of the three social conditions. Each child's lexical and grammatical output was assessed at 18 months of age through parental report. Results revealed a significant interaction between social condition and type of communicative production. Specifically, only simultaneous pointing-speech combinations increased in frequency during the available condition compared to baseline, while no differences were found for speech-only and pointing-only productions. Moreover, simultaneous pointing-speech combinations in the available condition at 12 months positively correlated with lexical and grammatical development at 18 months of age. The ability to selectively use this multimodal communicative strategy to engage the adult in joint attention by drawing his attention toward an unseen event or object reveals 12-month-olds' clear understanding of referential cues that are relevant for language development. This strategy to successfully initiate and maintain joint attention is related to language development as it increases learning opportunities from social interactions.

  2. Risks and Benefits of Dual Antiplatelet Therapy Beyond 12 Months After Coronary Stenting

    PubMed Central

    Dadjou, Yahya; Safavi, Salar; Kojuri, Javad

    2016-01-01

    Abstract The optimal duration of dual antiplatelet therapy (DAT) after coronary stenting remains poorly define. The aim of this study was to evaluate the impact of longer than 24 months DAT in patients who received drug-eluting and bare-metal stents. A total of 1010 individuals who underwent elective, urgent or emergency coronary angioplasty with intended stent implantation at reference or specialized cardiac hospitals were randomized to receive long-term and short-term DAT to determine the benefits and adverse effects of long-term DAT. Total of 508 patients were randomized to long-term and 502 patients to <1 year DAT, and all of them were followed for more than 36 months for major adverse cardiac and cerebvascular events and bleeding major adverse cardiac and cerebvascular events (MACCE) Mean age of the 1010 patients (364 women and 646 men) was 60 years. Stent reocclusion occurred in 15 patients. Mean Syntax score was 23.00 ± 5.08 for whole samples, 25.00 ± 5.27 in 28 patients with MACCE and 23 ± 5.00 in 982 patients without MACCE (P = 0.057). According to all specified bleeding definitions, clopidogrel therapy for >12 months was not associated with a greater risk of hemorrhage. A regimen of >12 months of clopidogrel therapy in patients who had received drug-eluting or bare-metal stents did not differ significantly from a regimen of <12 months on clopidogrel with regard to MACCE. Long-term DAT might not significantly affect the reduction in the risk of death from any cause, myocardial infarction, or stroke, and not associated with minor or major bleeding events. PMID:27258494

  3. Socio-demographic inequalities and teeth extraction in the last 12 months in Italy

    PubMed Central

    La Torre, Giuseppe; Romeo, Umberto; Iarocci, Gianluca; Brugnoletti, Orlando; Semyonov, Leda; Galanakis, Alexandros; Barbato, Ersilia

    2014-01-01

    Summary Aims Teeth loss represents a major concern for the global oral health status of a population. The aim of this study was to describe the prevalence of teeth extraction among the Italian adult population, analyzing the association between teeth extraction in the last 12 months and socio-demographic characteristics. Methods This cross-sectional study is based on the national survey ‘Health Conditions and Healthcare Services Use’, carried out by the Italian National Centre of Statistics (ISTAT) in 2005. A univariate analysis was performed to investigate the association between the dependent and the independent variables (teeth extraction Vs socio-demographic characteristics). Multiple logistic regression analysis was conducted to assess the influence on the outcome (teeth extraction Yes/No). Results The present study highlights the relationship between teeth extraction and socio-demographic factors. Out of 128,040 individuals, the sampled population consisted of 124,677 subjects, representing 56,400,323 individuals in the Italian population. The prevalence of teeth extraction in the last 12 months was 8.2%. Subjects who underwent teeth extraction in the last 12 months were prevalent female (8.6%), smokers (10.4%), with a primary education (9.2%), married (9.2%), in poor health conditions (9.3%), age category of 55–64 years (11.1%), from Northeast of Italy (8.5%), with scarce household income (8.4%). The multivariate analysis confirmed most of the results of the univariate analysis. Conclusions Inequalities in health among groups of various socioeconomic status constitute one of the main challenges for public health; these inequalities might be reduced by improving educational opportunities, income distribution, health-related behaviour, or accessibility to health care. PMID:25774248

  4. 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,…

  5. 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

  6. Sustained safety and performance of the second-generation drug-eluting absorbable metal scaffold in patients with de novo coronary lesions: 12-month clinical results and angiographic findings of the BIOSOLVE-II first-in-man trial

    PubMed Central

    Haude, Michael; Ince, Hüseyin; Abizaid, Alexandre; Toelg, Ralph; Lemos, Pedro Alves; von Birgelen, Clemens; Christiansen, Evald Høj; Wijns, William; Neumann, Franz-Josef; Kaiser, Christoph; Eeckhout, Eric; Lim, Soo Teik; Escaned, Javier; Onuma, Yoshinobu; Garcia-Garcia, Hector M.; Waksman, Ron

    2016-01-01

    Aims Metal absorbable scaffolds constitute a conceptually attractive alternative to polymeric scaffolds. Promising 6-month outcomes of a second-generation drug-eluting absorbable metal scaffold (DREAMS 2G), consisting of an absorbable magnesium scaffold backbone, have been reported. We assessed the 12-month safety and performance of this novel device. Methods and results The prospective, international, multi-centre, first-in-man BIOSOLVE-II trial enrolled 123 patients with up to two de novo lesions with a reference diameter between 2.2 and 3.7 mm. All patients were scheduled for angiographic follow-up at 6 months, and—if subjects consented—at 12 months. Dual antiplatelet therapy was recommended for 6 months. Quantitative coronary angiography (QCA) parameters remained stable from 6 to 12 months [paired data of 42 patients: in-segment late lumen loss 0.20 ± 0.21 mm vs. 0.25 ± 0.22 mm, P = 0.117, Δ 0.05 ± 0.21 mm (95% CI: −0.01;0.12); in-scaffold late lumen loss 0.37 ± 0.25 mm vs. 0.39 ± 0.27 mm, P = 0.446, Δ 0.03 ± 0.22 (95% CI: −0.04;0.10), respectively]. Intravascular ultrasound and optical coherence tomography findings corroborated the QCA results. Target lesion failure occurred in four patients (3.4%), consisting of one death of unknown cause, one target-vessel myocardial infarction, and two clinically driven target lesion revascularization. No additional event occurred beyond the 6-month follow-up. During the entire follow-up of 12 months, none of the patients experienced a definite or probable scaffold thrombosis. Conclusion The novel drug-eluting metal absorbable scaffold DREAMS 2G showed a continuous favourable safety profile up to 12 months and stable angiographic parameters between 6 and 12 months. ClinicalTrials.gov identifier NCT01960504. PMID:27190094

  7. 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.

  8. 20 CFR 404.251 - Subsequent entitlement to benefits less than 12 months after entitlement to disability benefits...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Subsequent entitlement to benefits less than 12 months after entitlement to disability benefits ended. 404.251 Section 404.251 Employees' Benefits... Subsequent entitlement to benefits less than 12 months after entitlement to disability benefits ended....

  9. The 12-Month Prevalence of DSM-IV Anxiety Disorders among Nigerian Secondary School Adolescents Aged 13-18 Years

    ERIC Educational Resources Information Center

    Adewuya, Abiodun O.; Ola, Bola A.; Adewumi, Tomi A.

    2007-01-01

    Aims: To estimate the 12-month prevalence of DSM-IV-specific anxiety disorders among Nigerian secondary school adolescents aged 13-18 years. Method: A representative sample of adolescents (n=1090) from senior secondary schools in a semi-urban town in Nigeria was assessed for the 12-month prevalence of DSM-IV-specific anxiety. Results: The 12-month…

  10. Identification of Infants at Risk for Autism Spectrum Disorder and Developmental Language Delay Prior to 12 Months

    ERIC Educational Resources Information Center

    Samango-Sprouse, Carole A.; Stapleton, Emily J.; Aliabadi, Farhad; Graw, Robert; Vickers, Rebecca; Haskell, Kathryn; Sadeghin, Teresa; Jameson, Robert; Parmele, Charles L.; Gropman, Andrea L.

    2015-01-01

    Studies have shown an increased head circumference and the absence of the head tilt reflex as possible risk factors for autism spectrum disorder, allowing for early detection at 12 months in typically developing population of infants. Our aim was to develop a screening tool to identify infants prior to 12 months at risk for autism spectrum…

  11. 77 FR 27386 - Endangered and Threatened Wildlife and Plants; 12-Month Finding on a Petition To List the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-10

    ... Fish and Wildlife Service 50 CFR Part 17 Endangered and Threatened Wildlife and Plants; 12-Month... Wildlife and Plants. Upon publication of this 12-month petition finding, we will add the Arapahoe snowfly... to revise the Federal Lists of Threatened and Endangered Wildlife and Plants that...

  12. Cytology and Human Papillomavirus Testing 6 to 12 Months after ASCUS or LSIL Cytology in Organized Screening To Predict High-Grade Cervical Neoplasia between Screening Rounds

    PubMed Central

    Sjøborg, Katrine D.; Nygård, Mari; Røysland, Kjetil; Campbell, Suzanne; Alfsen, G. Cecilie; Jonassen, Christine M.

    2012-01-01

    We carried out a prospective study comparing the performance of human papillomavirus (HPV) E6/E7 mRNA (PreTect HPV-Proofer; NorChip, Klokkarstua, Norway) and DNA (Amplicor HPV test; Roche Diagnostics, Basel, Switzerland) triage testing of women 6 to 12 months after atypical-squamous-cells-of-undetermined-significance (ASCUS) or low-grade-squamous-intraepithelial-lesion (LSIL) cytology in organized screening to predict high-grade cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) between screening rounds. Between January 2005 and April 2008, 692 study women with screening-detected ASCUS/LSIL cytology 6 to 12 months earlier returned for HPV mRNA and DNA testing and repeat cytology. The median follow-up time was 3 years, using existing health care facilities. Follow-up test results were available for 625 women. Of the 145 CIN2+ cases detected during the study period, 95 (65.5%) were HPV mRNA positive 6 to 12 months after screening-detected ASCUS/LSIL, 44 (30.4%) were HPV mRNA negative, and 6 (4.1%) were invalid. The corresponding HPV DNA results were 139 (95.9%), 5 (3.4%), and 1 (0.7%), respectively. The cumulative incidences of CIN2+ 3 years after a negative HPV mRNA and DNA test were 10.3% (95% confidence interval [CI], 7.2 to 13.3%) and 1.8% (95% CI, 0.0 to 3.6%), respectively. The cumulative incidences of CIN2+ 3 years after positive HPV mRNA and DNA tests were 52.8% (95% CI, 40.1 to 60.1%) and 41.3% (95% CI, 35.5 to 46.6%), respectively. In conclusion, both positive HPV mRNA and DNA test results have a high enough long-term prediction of CIN2+ risk to consider referral to colposcopy as good practice when performed in delayed triage of women with ASCUS/LSIL cytology. In addition, the low CIN2+ risk among women with a negative Amplicor HPV test in our study confirms its safe use in a clinical setting. PMID:22518869

  13. Effects of a 12-Month Pedometer-Based Walking Intervention in Women of Low Socioeconomic Status

    PubMed Central

    Hornbuckle, Lyndsey M.; Kingsley, J. Derek; Kushnick, Michael R.; Moffatt, Robert J.; Haymes, Emily M.; Miles, Rebecca; Toole, Tonya; Panton, Lynn B.

    2016-01-01

    This study examined the effects of a 12-month walking intervention in overweight/obese, low socioeconomic women. Forty-six women (48.2 ± 8.0 years) entered the study. Outcomes included weight, waist and hip circumferences, body mass index (BMI), blood pressure, glycosylated hemoglobin, blood lipids, fibrinogen, and high-sensitivity C-reactive protein (hsCRP). Both intention-to-treat analyses in all participants and group analyses in study completers only (3K group = increased steps/day by ≥3,000; No Δ group = did not increase steps/day by ≥3,000) were conducted. Group × time ANOVA was used. In study completers, 3K significantly increased steps/day (6,903 ± 3,328 to 12,323 ± 5,736) compared to No Δ (4,926 ± 3,374 to 5,174 ± 3,095) from baseline to 12 months. There was a significant time effect for weight (P = 0.030), BMI (P = 0.029), and hsCRP (P = 0.044). Low socioeconomic women who adhere to a long-term, pedometer-based walking intervention significantly increased steps/day and may improve body weight, BMI, and hsCRP. This could help reduce health disparities in this population over time. PMID:27746679

  14. Does contingency in adults' responding influence 12-month-old infants' social referencing?

    PubMed

    Stenberg, Gunilla

    2016-12-07

    In two experiments we examined the influence of contingent versus non-contingent responding on infant social referencing behavior. EXPERIMENT 1: Forty 12-month-old infants were exposed to an ambiguous toy in a social referencing situation. In one condition an unfamiliar adult who in a previous play situation had responded contingently to the infant's looks gave the infant positive information about the toy. In the other condition an unfamiliar adult who previously had not responded contingently delivered the positive information. EXPERIMENT 2: Forty-eight 12-month-old infants participated in Experiment 2. In this experiment it was examined whether the familiarity of the adult influences infants' reactions to contingency in responding. In one condition a parent who previously had responded contingently to the infant's looks provided positive information about the ambiguous toy, and in the other condition a parent who previously had not responded contingently provided the positive information. The infants looked more at the contingent experimenter in Experimenter 1, and also played more with the toy after receiving positive information from the contingent experimenter. No differences in looking at the parent and in playing with the toy were found in Experiment 2. The results indicate that contingency in responding, as well as the familiarity of the adult, influence infants' social referencing behavior.

  15. Long-term memory, forgetting, and deferred imitation in 12-month-old infants

    PubMed Central

    Klein, Pamela J.; Meltzoff, Andrew N.

    2013-01-01

    Long-term recall memory, as indexed by deferred imitation, was assessed in 12-month-old infants. Independent groups of infants were tested after retention intervals of 3 min, 1 week and 4 weeks. Deferred imitation was assessed using the ‘observation-only’ procedure in which infants were not allowed motor practice on the tasks before the delay was imposed. Thus, the memory could not have been based on re-accessing a motor habit, because none was formed in the first place. After the delay, memory was assessed either in the same or a different environmental context from the one in which the adult had originally demonstrated the acts. In Experiments 1 and 3, infants observed the target acts while in an unusual environment (an orange and white polka-dot tent), and recall memory was tested in an ordinary room. In Experiment 2, infants observed the target acts in their homes and were tested for memory in a university room. The results showed recall memory after all retention intervals, including the 4 week delay, with no effect of context change. Interestingly, the forgetting function showed that the bulk of the forgetting occurred during the first week. The findings of recall memory without motor practice support the view that infants as young as 12 months old use a declarative (nonprocedural) memory system to span delay intervals as long as 4 weeks. PMID:25147475

  16. Replicating Reducing the Risk: 12-Month Impacts of a Cluster Randomized Controlled Trial

    PubMed Central

    Blocklin, Michelle; Layzer, Jean; Price, Cristofer; Juras, Randall; Freiman, Lesley

    2016-01-01

    Objectives. To test the effectiveness of Reducing the Risk, an evidence-based sexual health curriculum designed to help prevent adolescent pregnancy and sexually transmitted infections, on youth sexual behavior and intermediate outcomes thought to lead to these behaviors. Methods. Classes within schools in St. Louis, Missouri; Austin, Texas; and San Diego, California; were randomly assigned to receive Reducing the Risk or “business as usual.” Youths completed Web-based surveys at baseline (preintervention, August 2012–January 2014) and 12 months later (August 2013–January 2015). Intent-to-treat analyses were conducted across sites; we tested for differences in impacts between sites and other subgroups. Results. The program had no overall impact on sexual behaviors. However, at 1 site, program participants were significantly less likely to have engaged in recent sexual intercourse than were control group members. There were positive overall impacts on intermediate outcomes (e.g., knowledge, attitudes). Conclusions. After 12 months, Reducing the Risk was unsuccessful at changing sexual behaviors. Other results were mixed, but promising evidence (e.g., behavioral impacts at 1 site, impacts on intermediate outcomes) suggests potential for more widespread behavioral impacts over a longer term. PMID:27689492

  17. Recanalization of Acute and Subacute Femoropopliteal Artery Occlusions with the Rotarex Catheter: One Year Follow-up, Single Center Experience

    SciTech Connect

    Duc, Sylvain R. Schoch, Eric; Pfyffer, Markus; Jenelten, Regula; Zollikofer, Christoph L.

    2005-06-15

    Purpose:To assess the efficacy and safety of a new rotational catheter for percutaneous removal of fresh and organized thrombi in the femoropopliteal artery.Methods:Forty-one limbs in 38 patients (age 56-90 years, mean 75.6 years) with acute, subacute or chronic femoropopliteal occlusions of 1-180 days' duration (mean 31.6 days) were treated with the Rotarex device. The Fontaine stage was mainly IIB (Rutherford 2-3, 22 patients) or III (Rutherford 4, 14 patients). The length of occlusion varied from 2 to 35 cm (mean 13.1 cm). After recanalization percutaneous transluminal angioplasty (PTA) was performed if there was a residual stenosis of >25%. Patients were followed up with color Doppler ultrasound at 48 hr and clinically with Doppler pressures and oscillometry at 3, 6, and 12 months.Results:After an average of two passages with the Rotarex catheter all but two limbs required PTA for residual stenosis >25%. Five patients needed additional stenting. Major complications were one groin hematoma requiring blood transfusion and one arteriovenous fistula spontaneously thrombosing after unsuccessful primary prolonged balloon dilation. Distal embolizations occurred in 10 patients; 6 clinically relevant emboli were aspirated. All occlusions were technically successfully recanalised there were 2 early reocclusions after 1 day and two at 2 weeks. Brachial-ankle indices improved from an average of 0.41 before to 0.93 after recanalization. Primary and secondary patency rates were 62% / 84% after 6 months and 39% / 68% after 1 year. The amputation-free survival at 12 months was 100%.Conclusion:The Rotarex mechanical thrombectomy device is an efficient, quick, easy to handle, and safe tool for the treatment of acute, subacute or even chronic peripheral arterial thromboembolic occlusions. It can be used for short or long occlusions with equal success, provided the obstruction is not heavily calcified and has been safely passed with a guidewire first.

  18. Ultrasound-guided foam sclerotherapy of great saphenous vein with 2% polidocanol – one-year follow-up results

    PubMed Central

    Osęka, Marcin; Tworus, Robert; Gałązka, Zbigniew

    2016-01-01

    Introduction Ultrasound-guided foam sclerotherapy (UGFS) of varicose veins is a useful treatment option. It is a relatively safe method in the case of limited, small varicose veins. In theory, a justified concern could be raised that the injection of an active drug into the large superficial venous vessels may potentially cause life-threatening consequences. Aim To assess the safety and efficacy of UGFS using a 2% solution of polidocanol (Aethoxysklerol 2%) in the case of great saphenous vein incompetence. Material and methods Fifty-two patients with great saphenous vein incompetence underwent ultrasound-guided foam sclerotherapy. The efficacy criterion was the elimination of reflux measured ultrasonographically and withdrawal or decrease of complaints: 1 week, and 1, 3, 6 and 12 months after the treatment. Complications of sclerotherapy were reported during follow-up. Results Decrease or withdrawal of complaints of chronic venous insufficiency was reported in 96% of cases (50 patients). Disappearance or decrease of varicose veins was noted in all patients (100%). During examination after 12 months, full success of ultrasound was achieved in 38 (73%) cases, and 11 (21%) patients presented a partial desired effect according to the consensus from Tegernsee. Persistence of reflux longer than 1 s in the treated great saphenous vein was reported in 3 (6%) cases. Serious complications, such as deep vein thrombosis, pulmonary embolism, dyspnea, anaphylaxis, or neurological abnormalities, were not recorded. Conclusions Ultrasound-guided foam sclerotherapy of incompetent great saphenous vein and varicosities with 2% polidocanol was found to be an effective and safe method of treatment during 1 year of observation. However, longer observation is necessary. PMID:27458485

  19. 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

  20. 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.

  1. 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.

  2. 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

  3. 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

  4. Short-term imaging follow-up of patients with concordant benign breast core needle biopsies: is it really worth it?

    PubMed Central

    Adams, Michelle C.; Falcon, Shannon; Mooney, Blaise P.; Laronga, Christine; Chau, Alec; Drukteinis, Jennifer S.

    2014-01-01

    PURPOSE Women with histologically proven concordant benign breast disease are often followed closely after biopsy for a period of two years, and they are considered to be at high-risk for cancer development. Our goal was to evaluate the utility of short-term (six-month) imaging follow-up and determine the incidence of breast cancer development in this population. METHODS Retrospective review of concordant benign breast pathology was performed in 558 patients who underwent multi-modality breast core biopsy. A total of 339 patients (60.7%) with 393 biopsies qualified for the study. The six-, 12-, and 24-month incidence rates of breast cancer development were estimated with 95% confidence intervals (CI), using the exact method binomial proportions. RESULTS No cancer was detected in 285 of 339 patients (84.1%) returning for the six-month follow-up. No cancer was detected in 271 of 339 patients (79.9%) returning for the 12-month follow-up. Among 207 follow-up exams (61.1%) performed at 24 months, three patients were detected to have cancer in the ipsilateral breast (1.45% [95% CI, 0.30%–4.18%]) and two patients were detected to have cancer in the contralateral breast (0.97% [95% CI, 0.12%–3.45%]). Subsequent patient biopsy rate was 30 of 339 (8.85%, [95% CI, 6.05%–12.39%]). Three ipsilateral biopsies occurred as a sole result of the six-month follow-up of 285 patients (1.05%, [95% CI, 0.22%–3.05%]). CONCLUSION Short-term imaging follow-up did not contribute to improved breast cancer detection, as all subsequent cancers were detected on annual mammography. Annual diagnostic mammography after benign breast biopsy may be sufficient. PMID:25205024

  5. Coping and Parenting: Mediators of 12-Month Outcomes of a Family Group Cognitive-Behavioral Preventive Intervention with Families of Depressed Parents

    PubMed Central

    Compas, Bruce E.; Champion, Jennifer E.; Forehand, Rex; Cole, David A.; Reeslund, Kristen L.; Fear, Jessica; Hardcastle, Emily J.; Keller, Gary; Rakow, Aaron; Garai, Emily; Merchant, Mary Jane; Roberts, Lorinda

    2011-01-01

    In a randomized clinical trial with 111 families of parents with a history of major depressive disorder (86% mothers; 86% Caucasian), changes in adolescents’ (mean age 11 years; 42% female) coping and parents’ parenting skills were examined as mediators of the effects of a family group cognitive behavioral preventive intervention on adolescents’ internalizing and externalizing symptoms. Changes in hypothesized mediators were assessed at 6-months and changes in adolescents’ symptoms were measured at 12-month follow-up. Significant differences favoring the family intervention as compared with a written information comparison condition were found for changes in composite measures of parent-adolescent reports of adolescents’ use of secondary control coping skills and direct observations of parents’ positive parenting skills. Changes in adolescents’ secondary control coping and positive parenting mediated the effects of the intervention on depressive, internalizing and externalizing symptoms accounting for approximately half of the effect of the intervention on the outcomes. Further, reciprocal relations between children’s internalizing symptoms and parenting were found from baseline to 6-month follow-up. Implications for the prevention of psychopathology in offspring of depressed parents are highlighted. PMID:20873898

  6. Effects of changing from non-accelerated to accelerated MRI for follow-up in brain atrophy measurement.

    PubMed

    Leung, Kelvin K; Malone, Ian M; Ourselin, Sebastien; Gunter, Jeffrey L; Bernstein, Matt A; Thompson, Paul M; Jack, Clifford R; Weiner, Michael W; Fox, Nick C

    2015-02-15

    Stable MR acquisition is essential for reliable measurement of brain atrophy in longitudinal studies. One attractive recent advance in MRI is to speed up acquisition using parallel imaging (e.g. reducing volumetric T1-weighted acquisition scan times from around 9 to 5 min). In some studies, a decision to change to an accelerated acquisition may have been deliberately taken, while in others repeat scans may occasionally be accidentally acquired with an accelerated acquisition. In ADNI, non-accelerated and accelerated scans were acquired in the same scanning session on each individual. We investigated the impact on brain atrophy as measured by k-means normalized boundary shift integral (KN-BSI) and deformation-based morphometry when changing from non-accelerated to accelerated MRI acquisitions over a 12-month interval using scans of 422 subjects from ADNI. KN-BSIs were calculated using both a non-accelerated baseline scan and non-accelerated 12-month scans (i.e. consistent acquisition), and a non-accelerated baseline scan and an accelerated 12-month scan (i.e. changed acquisition). Fluid-based non-rigid registration was also performed on those scans to estimate the brain atrophy rate. We found that the effect on KN-BSI and fluid-based non-rigid registration depended on the scanner manufacturer. For KN-BSI, in Philips and Siemens scanners, the change had very little impact on the measured atrophy rate (increase of 0.051% in Philips and -0.035% in Siemens from consistent acquisition to changed acquisition), whereas, in GE, the change caused a mean reduction of 0.65% in the brain atrophy rate. This is likely due to the difference in tissue contrast between gray matter and cerebrospinal fluid in the non-accelerated and accelerated scans in GE, which uses IR-FSPGR instead of MP-RAGE. For fluid-based non-rigid registration, the change caused a mean increase of 0.29% in the brain atrophy rate in the changed acquisition compared with consistent acquisition in Philips

  7. Triangular Titanium Implants for Minimally Invasive Sacroiliac Joint Fusion: 2-Year Follow-Up from a Prospective Multicenter Trial

    PubMed Central

    Bitan, Fabien; Lockstadt, Harry; Kovalsky, Don; Cher, Daniel; Hillen, Travis

    2016-01-01

    Background Sacroiliac joint (SIJ) dysfunction is an underdiagnosed condition. Several published cohorts have reported favorable mid-term outcomes after SIJ fusion using titanium implants placed across the SIJ. Herein we report long-term (24-month) results from a prospective multicenter clinical trial. Methods One hundred and seventy-two subjects at 26 US sites with SI joint dysfunction were enrolled and underwent minimally invasive SI joint fusion with triangular titanium implants. Subjects underwent structured assessments preoperatively and at 1, 3, 6, 12, 18 and 24 months postoperatively, including SIJ pain ratings (0-100 visual analog scale), Oswestry Disability Index (ODI), Short Form-36 (SF-36), EuroQOL-5D (EQ-5D), and patient satisfaction. Adverse events were collected throughout follow-up. All participating patients underwent a high-resolution pelvic CT scan at 1 year. Results Mean subject age was 50.9 years and 69.8% were women. SIJ pain was present for an average of 5.1 years prior to surgical treatment. SIJ pain decreased from 79.8 at baseline to 30.4 at 12 months and remained low at 26.0 at 24 months (p<.0001 for change from baseline). ODI decreased from 55.2 at baseline to 31.5 at 12 months and remained low at 30.9 at 24 months (p<.0001 for change from baseline). Quality of life (SF-36 and EQ-5D) improvements seen at 12 months were sustained at 24 months. The proportion of subjects taking opioids for SIJ or low back pain decreased from 76.2% at baseline to 55.0% at 24 months (p <.0001). To date, 8 subjects (4.7%) have undergone one or more revision SIJ surgeries. 7 device-related adverse events occurred. CT scan at one year showed a high rate (97%) of bone adherence to at least 2 implants on both the iliac and sacral sides with modest rates of bone growth across the SIJ. Conclusions In this study of patients with SIJ dysfunction, minimally invasive SI joint fusion using triangular titanium implants showed marked improvements in pain, disability and

  8. Severity of 12-Month DSM-IV Disorders in the National Comorbidity Survey Replication Adolescent Supplement

    PubMed Central

    Kessler, Ronald C.; Avenevoli, Shelli; Costello, Jane; Green, Jennifer Greif; Gruber, Michael J.; McLaughlin, Katie A.; Petukhova, Maria; Sampson, Nancy A.; Zaslavsky, Alan M.; Merikangas, Kathleen Ries

    2012-01-01

    Context Estimates of DSM-IV disorder prevalence are high; stringent criteria to define need for services are desired. Objective To present US national data on the prevalence and sociodemographic correlates of 12-month serious emotional disturbance (SED), defined by the US Substance Abuse and Mental Health Services Administration, from the National Comorbidity Survey Replication Adolescent Supplement. Design The National Comorbidity Survey Replication Adolescent Supplement is a national survey of DSM-IV anxiety, mood, behavior, and substance disorders among US adolescents. Setting Dual-frame household and school samples of US adolescents. Participants Total of 6483 pairs of adolescents aged 13 to 17 (interviews) and parents (questionnaires). Main Outcome Measures The DSM-IV disorders were assessed with the World Health Organization Composite International Diagnostic Interview and validated with blinded clinical interviews based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Serious emotional disturbance was operationalized as a DSM-IV/Composite International Diagnostic Interview disorder with a score of 50 or less on the Children’s Global Assessment Scale (ie, moderate impairment in most areas of functioning or severe impairment in at least 1 area). Concordance of Composite International Diagnostic Interview SED diagnoses with blinded Schedule for Affective Disorders and Schizophrenia for School-Age Children diagnoses was good. Results The estimated prevalence of SED was 8.0%. Most SEDs were due to behavior (54.5%) or mood (31.4%) disorders. Although respondents with 3 or more disorders made up only 29.0% of those with 12-month DSM-IV/Composite International Diagnostic Interview disorders, they constituted 63.5% of SEDs. Predictive effects of high comorbidity were significantly greater than the product of their disorder-specific odds ratios and consistent across disorder types. Associations of sociodemographic variables with SED

  9. Is there a role of pulsed electromagnetic fields in management of patellofemoral pain syndrome? Randomized controlled study at one year follow-up.

    PubMed

    Servodio Iammarrone, Clemente; Cadossi, Matteo; Sambri, Andrea; Grosso, Eugenio; Corrado, Bruno; Servodio Iammarrone, Fernanda

    2016-02-01

    Patellofemoral pain syndrome (PFPS) is a common cause of recurrent or chronic knee pain in young adults, generally located in the retropatellar region. Etiology is controversial and includes several factors, such as anatomical defects, muscular imbalance, or joint overuse. Good results have been reported with exercise therapy, including home exercise program (HEP). Joint inflammation with increase of pro-inflammatory cytokines levels in the synovial fluid might be seen especially when chondromalacia becomes evident. Biophysical stimulation with pulsed electromagnetic fields (PEMFs) has shown anti-inflammatory effects and anabolic chondrocyte activity. The purpose of this randomized controlled study was to evaluate if the combination of HEP with PEMFs was more effective than HEP alone in PFPS treatment. Thirty-one PFPS patients were enrolled in this study. All patients were instructed to train with HEP. Patients in the PEMFs group associated HEP with PEMFs. Function and pain were assessed with Victorian Institute of Sport Assessment score (VISA), Visual Analog Scale (VAS), and Feller's Patella Score at baseline at 2, 6, and 12 months of follow-up. Drug assumption was also recorded. Increase in VISA score was significantly higher in PEMFs group compared to controls at 6 and 12 months, as well as the increase in the Feller's Patella Score at 12 months. VAS score became significantly lower in the PEMFs group with respect to control group since 6 month follow-up. Pain reduction obtained with PEMFs enhanced practicing therapeutic exercises leading to a better recovery process; this is extremely important in addressing the expectations of young patients, who wish to return to sporting activities.

  10. 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

  11. Automated 3D mapping of baseline and 12-month associations between three verbal memory measures and hippocampal atrophy in 490 ADNI subjects.

    PubMed

    Apostolova, Liana G; Morra, Jonathan H; Green, Amity E; Hwang, Kristy S; Avedissian, Christina; Woo, Ellen; Cummings, Jeffrey L; Toga, Arthur W; Jack, Clifford R; Weiner, Michael W; Thompson, Paul M

    2010-05-15

    We used a previously validated automated machine learning algorithm based on adaptive boosting to segment the hippocampi in baseline and 12-month follow-up 3D T1-weighted brain MRIs of 150 cognitively normal elderly (NC), 245 mild cognitive impairment (MCI) and 97 Dementia of the Alzheimer's type (DAT) ADNI subjects. Using the radial distance mapping technique, we examined the hippocampal correlates of delayed recall performance on three well-established verbal memory tests--ADAScog delayed recall (ADAScog-DR), the Rey Auditory Verbal Learning Test -DR (AVLT-DR) and Wechsler Logical Memory II-DR (LM II-DR). We observed no significant correlations between delayed recall performance and hippocampal radial distance on any of the three verbal memory measures in NC. All three measures were associated with hippocampal volumes and radial distance in the full sample and in the MCI group at baseline and at follow-up. In DAT we observed stronger left-sided associations between hippocampal radial distance, LM II-DR and ADAScog-DR both at baseline and at follow-up. The strongest linkage between memory performance and hippocampal atrophy in the MCI sample was observed with the most challenging verbal memory test-the AVLT-DR, as opposed to the DAT sample where the least challenging test the ADAScog-DR showed strongest associations with the hippocampal structure. After controlling for baseline hippocampal atrophy, memory performance showed regionally specific associations with hippocampal radial distance in predominantly CA1 but also in subicular distribution.

  12. Gender and discipline in 5-12-month-old infants: a longitudinal study.

    PubMed

    Ahl, Richard Evan; Fausto-Sterling, Anne; García-Coll, Cynthia; Seifer, Ronald

    2013-04-01

    We examined the effects of infant age and gender on the behaviors of infants and mothers during discipline interactions using longitudinal, naturalistic, home-based, taped observations of 16 mother-infant dyads (eight males and eight females). These observations were conducted between the child ages of 5 and 12 months and used a devised Maternal Discipline Coding System to code for the occurrence of discipline events. During discipline interactions, mothers vocalized longer, used harsher tones, and used more explanations with older compared to younger infants. Male infants were more likely than female infants to cry or whine during discipline events. Mothers of male infants used longer vocalizations, more words, and more affectionate terms than mothers of female infants. Male infants were more difficult during discipline interactions than female infants, but it appeared that mothers of males responded to this difficulty by using milder discipline techniques.

  13. Proteomic characterization of human milk fat globule membrane proteins during a 12 month lactation period.

    PubMed

    Liao, Yalin; Alvarado, Rudy; Phinney, Brett; Lönnerdal, Bo

    2011-08-05

    The milk fat globule membrane (MFGM) contains proteins which have been implicated in a variety of health benefits. Milk fat globule membrane proteins were isolated from human milk during a 12 month lactation period and subjected to in-solution digestion and liquid chromatography tandem mass spectrometry analysis. Data were pooled, and our results showed that 191 proteins were identified. Relative quantification of the identified MFGM proteins during the course of lactation was performed by label free spectral counting and differentiation expression analysis, which showed some proteins decreasing during the course of lactation whereas some increased or remained at a relatively constant level. The human MFGM proteins are distributed between intracellular, extracellular, and membrane-associated proteins, and they are mainly involved in cell communication and signal transduction, immune function, metabolism and energy production. This study provides more insights into the dynamic composition of human MFGM proteins, which in turn will enhance our understanding of the physiological significance of MFGM proteins.

  14. The role of verbal labels on flexible memory retrieval at 12-months of age.

    PubMed

    Taylor, Gemma; Liu, Hao; Herbert, Jane S

    2016-11-01

    The provision of verbal labels enhances 12-month-old infants' memory flexibility across a form change in a puppet imitation task (Herbert, 2011), although the mechanisms for this effect remain unclear. Here we investigate whether verbal labels can scaffold flexible memory retrieval when task difficulty increases and consider the mechanism responsible for the effect of language cues on early memory flexibility. Twelve-month-old infants were provided with English, Chinese, or empty language cues during a difficult imitation task, a combined change in the puppet's colour and form at the test (Hayne et al., 1997). Imitation performance by infants in the English language condition only exceeded baseline performance after the 10-min delay. Thus, verbal labels facilitated flexible memory retrieval on this task. There were no correlations between infants' language comprehension and imitation performance. Thus, it is likely that verbal labels facilitate both attention and categorisation during encoding and retrieval.

  15. Factors associated with parental perception of child vulnerability 12 months after abnormal newborn screening results.

    PubMed

    Tluczek, Audrey; McKechnie, Anne Chevalier; Brown, Roger L

    2011-10-01

    We identified factors associated with elevated parental perceptions of child vulnerability (PPCV) 12 months after newborn screening (NBS) of 136 children: healthy, normal results (H, n = 37), cystic fibrosis carriers (CF-C, n = 40), congenital hypothyroidism (CH, n = 36), and cystic fibrosis (CF, n = 23). Controlling for infant and parent characteristics, mixed logit structural equation modeling showed direct paths to elevated PPCV included parent female sex, CF diagnosis, and high documented illness frequency. PPCV was positively associated with maternal parenting stress. Infants with CF and CF carriers had significantly more documented illness frequency than H group infants. The CH group did not differ significantly from the H group and had no paths to PPCV. Unexpectedly high documented illness frequency among infants who are CF carriers warrants further investigation.

  16. Factors associated with recurrent tuberculosis more than 12 months after treatment completion

    PubMed Central

    Kim, Lindsay; Moonan, Patrick K.; Heilig, Charles M.; Yelk Woodruff, Rachel S.; Kammerer, J. Steve; Haddad, Maryam B.

    2016-01-01

    SUMMARY Setting Even in persons with complete treatment of their first tuberculosis (TB) episode, patients with a TB history are at higher risk for having TB. Objective Describe factors from the initial TB episode associated with recurrent TB among patients who completed treatment and remained free of TB for at least 12 months. Design US TB cases, stratified by birth origin, during 1993–2006 were examined. Cox proportional hazards regression was employed to assess the association of factors during the initial episode with recurrence at least 12 months after treatment completion. Results Among 632 US-born patients, TB recurrence was associated with age 25–44 (adjusted hazard ratio [aHR] 1.77, 99% confidence interval [CI] 1.02–3.09, attributable fraction [AF] 1%–34%), substance use (aHR 1.57, 99%CI 1.23–2.02, AF 8%–22%), and treatment supervised by health departments (aHR 1.42, 99%CI 1.03–1.97, AF 2%–28%). Among 211 foreign-born patients, recurrence was associated with HIV infection (aHR 2.24, 99%CI 1.27–3.98, AF 2%–9%) and smear-positive TB (aHR 1.56, 99%CI 1.06–2.30, AF 3%–33%). Conclusion Factors associated with recurrence differed by birth origin and might be useful for anticipating greater risk for recurrent TB among certain patients with a TB history. PMID:26688528

  17. Weight loss effects from vegetable intake: a 12-month randomised controlled trial

    PubMed Central

    Tapsell, L C; Batterham, M J; Thorne, R L; O'Shea, J E; Grafenauer, S J; Probst, Y C

    2014-01-01

    Background/Objectives: Direct evidence for the effects of vegetable intake on weight loss is qualified. The study aimed to assess the effect of higher vegetable consumption on weight loss. Subjects/Methods: A single blind parallel controlled trial was conducted with 120 overweight adults (mean body mass index=29.98 kg/m2) randomised to two energy deficit healthy diet advice groups differing only by doubling the serving (portion) sizes of vegetables in the comparator group. Data were analysed as intention-to-treat using a linear mixed model. Spearmans rho bivariate was used to explore relationships between percentage energy from vegetables and weight loss. Results: After 12 months, the study sample lost 6.5±5.2 kg (P<0.001 time) with no difference between groups (P>0.05 interaction). Both groups increased vegetable intake and lost weight in the first 3 months, and the change in weight was significantly correlated with higher proportions of energy consumed as vegetables (rho=–0.217, P=0.024). Fasting glucose, insulin and triglyceride levels decreased (P<0.001 time) and high-density lipoprotein cholesterol levels increased (P<0.001 time), with no difference between groups. Weight loss was sustained for 12 months by both groups, but the comparator group reported greater hunger satisfaction (P=0.005). Conclusions: Advice to consume a healthy low-energy diet leads to sustained weight loss, with reductions in cardiovascular disease risk factors regardless of an emphasis on more vegetables. In the short term, consuming a higher proportion of the dietary energy as vegetables may support a greater weight loss and the dietary pattern appears sustainable. PMID:24667750

  18. Mild pituitary phenotype in 3- and 12-month-old Aip-deficient male mice.

    PubMed

    Lecoq, Anne-Lise; Zizzari, Philippe; Hage, Mirella; Decourtye, Lyvianne; Adam, Clovis; Viengchareun, Say; Veldhuis, Johannes D; Geoffroy, Valérie; Lombès, Marc; Tolle, Virginie; Guillou, Anne; Karhu, Auli; Kappeler, Laurent; Chanson, Philippe; Kamenický, Peter

    2016-10-01

    Germline mutations in the aryl hydrocarbon receptor-interacting protein (AIP) gene predispose humans to pituitary adenomas, particularly of the somatotroph lineage. Mice with global heterozygous inactivation of Aip (Aip(+/-)) also develop pituitary adenomas but differ from AIP-mutated patients by the high penetrance of pituitary disease. The endocrine phenotype of these mice is unknown. The aim of this study was to determine the endocrine phenotype of Aip(+/-) mice by assessing the somatic growth, ultradian pattern of GH secretion and IGF1 concentrations of longitudinally followed male mice at 3 and 12 months of age. As the early stages of pituitary tumorigenesis are controversial, we also studied the pituitary histology and somatotroph cell proliferation in these mice. Aip(+/-) mice did not develop gigantism but exhibited a leaner phenotype than wild-type mice. Analysis of GH pulsatility by deconvolution in 12-month-old Aip(+/-) mice showed a mild increase in total GH secretion, a conserved GH pulsatility pattern, but a normal IGF1 concentration. No pituitary adenomas were detected up to 12 months of age. An increased ex vivo response to GHRH of pituitary explants from 3-month-old Aip(+/-) mice, together with areas of enlarged acini identified on reticulin staining in the pituitary of some Aip(+/-) mice, was suggestive of somatotroph hyperplasia. Global heterozygous Aip deficiency in mice is accompanied by subtle increase in GH secretion, which does not result in gigantism. The absence of pituitary adenomas in 12-month-old Aip(+/-) mice in our experimental conditions demonstrates the important phenotypic variability of this congenic mouse model.

  19. Association Between Blood Transfusions and 12-Month Mortality After Transcatheter Aortic Valve Implantation.

    PubMed

    Kleczynski, Pawel; Dziewierz, Artur; Bagienski, Maciej; Rzeszutko, Lukasz; Sorysz, Danuta; Trebacz, Jaroslaw; Sobczynski, Robert; Tomala, Marek; Stapor, Maciej; Dudek, Dariusz

    2017-02-07

    Blood transfusions are considered as an important predictor of adverse outcome in patients with severe aortic (AS) undergoing transcatheter aortic valve implantation (TAVI). We sought to investigate the association between blood transfusions and mortality after TAVI. We enrolled 101 consecutive patients with severe AS undergoing TAVI. Patients who required transfusion were defined as patients in whom at least one unit of packed red blood cells (PRBCs) was transfused in the perioperative period. Twelve-month outcomes were assessed based on Valve Academic Research Consortium definitions. A total of 28 (27.7%) patients required blood transfusion after TAVI. Baseline characteristics of the patients with and without a transfusion were similar. Median amount of PRBCs was 2 (interquartile range, 2-4). Twelvemonth all-cause mortality was higher in patients with than without a blood transfusion (39.3% versus 9.6%; P = 0.001). Importantly, the need for a blood transfusion after TAVI was an independent predictor of higher mortality rates after 12 months (hazard ratio (HR) 2.84 95%CI (1.06-7.63); P = 0.039; (HR for incomplete coronary revascularization 10.86, 95%CI 3.72-31.73; P < 0.001; HR for a history of stroke/TIA 3.93, 95%CI 1.39-11.07; P < 0.001). The duration of inhospital stay was longer in patients requiring transfusion (16.0 (14.0-22.0) versus 7.0 (7.0-11.5) days; P = 0.014). In conclusion, blood transfusions after TAVI were associated with higher mortality rates after 12 months, longer in-hospital stay, and were identified as an independent predictor of impaired clinical outcome.

  20. 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

  1. The Origins of 12-Month Attachment: A Microanalysis of 4-Month Mother-Infant Interaction

    PubMed Central

    Beebe, Beatrice; Jaffe, Joseph; Markese, Sara; Buck, Karen; Chen, Henian; Cohen, Patricia; Bahrick, Lorraine; Andrews, Howard; Feldstein, Stanley

    2013-01-01

    A detailed microanalysis of 4-month mother-infant face-to-face communication revealed a fine-grained specification of essential communication processes that predicted 12-month insecure attachment outcomes, particularly resistant and disorganized classifications. An urban community sample of 84 dyads were videotaped at 4 months during a face-to-face interaction, and at 12 months during the Ainsworth Strange Situation. Four-month mother and infant communication modalities of attention, affect, touch, and spatial orientation were coded from split-screen videotape on a 1s time base; mother and infant facial-visual “engagement” variables were constructed. We used contingency measures (multi-level time-series modeling) to examine the dyadic temporal process over time, and specific rates of qualitative features of behavior to examine the content of behavior. Self-contingency (auto-correlation) measured the degree of stability/lability within an individual’s own rhythms of behavior; interactive contingency (lagged cross-correlation) measured adjustments of the individual’s behavior that were correlated with the partner’s previous behavior. We documented that both self- and interactive contingency, as well as specific qualitative features, of mother and infant behavior were mechanisms of attachment formation by 4 months, distinguishing 12-month insecure, resistant, and disorganized attachment classifications from secure; avoidant were too few to test. All communication modalities made unique contributions. The separate analysis of different communication modalities identified intermodal discrepancies or conflict, both intrapersonal and interpersonal, that characterized insecure dyads. Contrary to dominant theories in the literature on face-to-face interaction, measures of maternal contingent coordination with infant yielded the fewest associations with 12-month attachment, whereas mother and infant self-contingency, and infant contingent coordination with mother

  2. The origins of 12-month attachment: a microanalysis of 4-month mother-infant interaction.

    PubMed

    Beebe, Beatrice; Jaffe, Joseph; Markese, Sara; Buck, Karen; Chen, Henian; Cohen, Patricia; Bahrick, Lorraine; Andrews, Howard; Feldstein, Stanley

    2010-01-01

    A microanalysis of 4-month mother-infant face-to-face communication revealed a fine-grained specification of communication processes that predicted 12-month insecure attachment outcomes, particularly resistant and disorganized classifications. An urban community sample of 84 dyads were videotaped at 4 months during a face-to-face interaction, and at 12 months during the Ainsworth Strange Situation. Four-month mother and infant communication modalities of attention, affect, touch, and spatial orientation were coded from split-screen videotape on a 1 s time base; mother and infant facial-visual "engagement" variables were constructed. We used contingency measures (multi-level time-series modeling) to examine the dyadic temporal process over time, and specific rates of qualitative features of behavior to examine the content of behavior. Self-contingency (auto-correlation) measured the degree of stability/lability within an individual's own rhythms of behavior; interactive contingency (lagged cross-correlation) measured adjustments of the individual's behavior that were correlated with the partner's previous behavior. We documented that both self- and interactive contingency, as well as specific qualitative features, of mother and infant behavior were mechanisms of attachment formation by 4 months, distinguishing 12-month insecure, resistant, and disorganized attachment classifications from secure; avoidant were too few to test. All communication modalities made unique contributions. The separate analysis of different communication modalities identified intermodal discrepancies or conflict, both intrapersonal and interpersonal, that characterized insecure dyads. Contrary to dominant theories in the literature on face-to-face interaction, measures of maternal contingent coordination with infant yielded the fewest associations with 12-month attachment, whereas mother and infant self-contingency, and infant contingent coordination with mother, yielded comparable numbers

  3. Impact of Exhaled Breath Acetone in the Prognosis of Patients with Heart Failure with Reduced Ejection Fraction (HFrEF). One Year of Clinical Follow-up

    PubMed Central

    Saldiva, Paulo H. N.; Mangini, Sandrigo; Issa, Victor S.; Ayub-Ferreira, Silvia M.; Bocchi, Edimar A.

    2016-01-01

    Background The identification of new biomarkers of heart failure (HF) could help in its treatment. Previously, our group studied 89 patients with HF and showed that exhaled breath acetone (EBA) is a new noninvasive biomarker of HF diagnosis. However, there is no data about the relevance of EBA as a biomarker of prognosis. Objectives To evaluate whether EBA could give prognostic information in patients with heart failure with reduced ejection fraction (HFrEF). Methods After breath collection and analysis by gas chromatography-mass spectrometry and by spectrophotometry, the 89 patients referred before were followed by one year. Study physicians, blind to the results of cardiac biomarker testing, ascertained vital status of each study participant at 12 months. Results The composite endpoint death and heart transplantation (HT) were observed in 35 patients (39.3%): 29 patients (32.6%) died and 6 (6.7%) were submitted to HT within 12 months after study enrollment. High levels of EBA (≥3.7μg/L, 50th percentile) were associated with a progressively worse prognosis in 12-month follow-up (log-rank = 11.06, p = 0.001). Concentrations of EBA above 3.7μg/L increased the risk of death or HT in 3.26 times (HR = 3.26, 95%CI = 1.56–6.80, p = 0.002) within 12 months. In a multivariable cox regression model, the independent predictors of all-cause mortality were systolic blood pressure, respiratory rate and EBA levels. Conclusions High EBA levels could be associated to poor prognosis in HFrEF patients. PMID:28030609

  4. 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.

  5. 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.

  6. 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.].

  7. 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

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

    PubMed Central

    Allegri, Pia; Mastromarino, Antonio; Neri, Piergiorgio

    2010-01-01

    Curcumin has been successfully applied to treat inflammatory conditions in experimental research and in clinical trials. The purpose of our study is to evaluate the efficacy of an adjunctive-to-traditional treatment with Norflo tablets (curcumin-phosphatidylcholine complex; Meriva) administered twice a day in recurrent anterior uveitis of different etiologies. The study group consisted of 106 patients who completed a 12-month follow-up therapeutic period. We divided the patients into three main groups of different uveitis origin: group 1 (autoimmune uveitis), group 2 (herpetic uveitis), and group 3 (different etiologies of uveitis). The primary end point of our work was the evaluation of relapse frequency in all treated patients, before and after Norflo treatment, followed by the number of relapses in the three etiological groups. Wilcoxon signed-rank test showed a P < 0.001 in all groups. The secondary end points were the evaluation of relapse severity and of the overall quality of life. The results showed that Norflo was well tolerated and could reduce eye discomfort symptoms and signs after a few weeks of treatment in more than 80% of patients. In conclusion, our study is the first to report the potential therapeutic role of curcumin and its efficacy in eye relapsing diseases, such as anterior uveitis, and points out other promising curcumin-related benefits in eye inflammatory and degenerative conditions, such as dry eye, maculopathy, glaucoma, and diabetic retinopathy. PMID:21060672

  9. 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.

  10. African American community members sustain favorable blood pressure outcomes through 12-month telephone motivational interviewing (MI) maintenance

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Community approaches offer promise for addressing disparities experienced by African Americans in hypertension prevalence, treatment, and control. HUB City Steps, a community-based participatory research lifestyle intervention, tracked participants through a 12-month MI maintenance phase following a...

  11. 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

  12. Outcomes in Adenomyosis Treated with Uterine Artery Embolization Are Associated with Lesion Vascularity: A Long-Term Follow-Up Study of 252 Cases

    PubMed Central

    Zhou, Jing; He, Li; Liu, Ping; Duan, Hui; Zhang, Hanze; Li, Weili; Gong, Shipeng; Su, Guidong; Chen, Chunlin

    2016-01-01

    Purpose To study the therapeutic effects of uterine artery embolization (UAE) on adenomyosis and to investigate the association between uterine blood supply and artery embolization treatment outcomes. Methods Using digital subtraction angiography (DSA) imaging data, we retrospectively evaluated the vascular features of 252 adenomyosis patients treated with UAE. The cases were classified based on the equality of uterine blood supply (equal and unequal subgroups) and the degree of vascularity at the adenomyosis lesion site (hypervascular, isovascular and hypovascular subgroups). Patients were followed-up for 5 years after UAE. Improvements in dysmenorrhea and menorrhagia were evaluated based on the relief of the patients’ symptoms. The improvement rates among the different subgroups were analyzed and compared. Results The improvement rates of dysmenorrhea and menorrhagia were 74.0% and 70.9%, respectively, at the short-term (12-month) follow-up and 70.4% and 68.8%, respectively, at the long-term (5-year) follow-up. No statistically significant differences were observed in the improvement rates for dysmenorrhea or menorrhagia between the equal and unequal blood supply subgroups at either the short- or long-term follow-up. The improvement rates for dysmenorrhea among the hypervascular, isovascular and hypovascular subgroups were 86.5%, 71.8% and 58.8%, respectively, at the short-term follow-up (p = 0.002) and 83.6%, 67.3% and 52.8%, respectively, at the long-term follow-up (p = 0.005). The improvement rates for menorrhagia in the hypervascular, isovascular and hypovascular subgroups were 81.0%, 68.3% and 60.7%, respectively, at the short-term follow-up (p = 0.024) and 79.4%, 61.4% and 62.2%, respectively, at the long-term follow-up (p = 0.052). Conclusion UAE is effective in treating patients with adenomyosis in both the short and long term. The outcomes of patients with adenomyosis were significantly correlated with lesion vascularity. PMID:27806072

  13. 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.

  14. 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.

  15. Efficacy and safety of concentration-controlled everolimus with reduced-dose cyclosporine in Japanese de novo renal transplant patients: 12-month results

    PubMed Central

    2013-01-01

    Background No study to date has evaluated the efficacy and safety of everolimus with reduced-exposure cyclosporine in Japanese de-novo renal transplant (RTx) patients. Methods This 12-month, multicenter, open-label study randomized (1:1) 122 Japanese de-novo RTx patients to either an everolimus regimen (1.5 mg/day starting dose (target trough: 3 to 8 ng/ml) + reduced-dose cyclosporine) or a mycophenolate mofetil (MMF) regimen (2 g/day + standard dose cyclosporine). All patients received basiliximab and corticosteroids. Key endpoints at month 12 were composite efficacy failure (treated biopsy-proven acute rejection, graft loss, death, or loss to follow-up) and renal function (estimated glomerular filtration rate; Modification of Diet in Renal Disease-4). Results Clear cyclosporine exposure reduction was achieved in the everolimus group throughout the study (52% reduction at month 12). Month 12 efficacy failure rates showed everolimus 1.5 mg to be non-inferior to MMF (11.5% vs. 11.5%). The median estimated glomerular filtration rate at month 12 was 58.00 ml/minute/1.73 m2 in the everolimus group versus 55.25 ml/minute/1.73 m2 in the MMF group (P = 0.063). Overall, the incidence of adverse events was comparable between the groups with some differences in line with the known safety profile of the treatments. The everolimus group had a higher incidence of wound healing events and edema, whereas a higher rate of cytomegalovirus infections was reported in the MMF group. Conclusions This study confirmed the efficacy of everolimus 1.5 mg/day (target trough: 3 to 8 ng/ml) in Japanese RTx patients for preventing acute rejection, while allowing for substantial cyclosporine sparing. Renal function and safety findings were comparable with previous reports from other RTx populations. Trial registration ClinicalTrials.gov number: NCT00658320 PMID:23866828

  16. 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…

  17. 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…

  18. 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...

  19. 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.

  20. 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…

  1. 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...

  2. 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…

  3. [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).

  4. 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

  5. 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…

  6. 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…

  7. 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…

  8. Utility of Follow-Up Skeletal Surveys in Suspected Child Physical Abuse Evaluations

    ERI