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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. Efficacy of transepithelial corneal collagen crosslinking for keratoconus: 12-month follow-up

    PubMed Central

    Heikal, Mohamed A; Soliman, Tarek Tawfik; Fayed, Ayser; Hamed, Abdelmonem M

    2017-01-01

    Purpose To evaluate the efficacy of transepithelial corneal collagen crosslinking (TE-CXL) in patients with progressive keratoconus. Patients and methods This is a prospective interventional consecutive study carried out on 30 eyes of 18 patients with progressive keratoconus who underwent TE-CLX using both ParaCel™ (riboflavin 0.25%, hydroxy propyl methyl cellulose, NaCl, ethylenediaminetetraacetic acid [EDTA], Tris, and benzalkonium chloride) and vibeX-Xtra (riboflavin 0.22%, phosphate-buffered saline solution). The procedure was carried out at Ebsar Eye Center in Egypt in the period from 2012 to 2014. The follow-up visits were scheduled on days 1, 3, 6, and 12 months after treatment. Results There were statistically significant improvements (P<0.001) in the mean best-corrected visual acuity (0.54±0.22 preoperatively vs 0.61±0.19 at 12 months postoperatively), the mean manifest refraction spherical equivalent (MRSE; −6.16±3.90 diopters [D] preoperatively and −5.91±3.72 D at 12 months postoperatively), and the mean preoperative corneal astigmatism (−3.39±2.11 D preoperatively and −2.46±2.60 D at 12 months postoperatively). Conclusion TE-CXL could halt the progression of keratoconus in adult patients. TE-CXL resulted in a statistically significant improvement in best-corrected visual acuity, manifest refraction, refractive and corneal astigmatism and K values in keratoconus patients at the 12-month follow-up. Larger sample sizes and longer follow-ups are required in order to make meaningful conclusions. PMID:28461739

  3. Micropulse diode laser trabeculoplasty (MDLT): A phase II clinical study with 12 months follow-up

    PubMed Central

    Fea, Antonio Maria; Bosone, Alex; Rolle, Teresa; Brogliatti, Beatrice; Grignolo, Federico Maria

    2008-01-01

    Objective This pilot study evaluates the pressure lowering potential of subthreshold micropulse diode laser trabeculoplasty (MDLT) for a clinically meaningful duration in patients with medically uncontrolled open angle glaucoma (OAG). Design prospective interventional case series. Participants Thirty-two eyes of 20 consecutive patients with uncontrolled OAG (12 bilateral and 8 unilateral). Methods Confluent subthreshold laser applications over the inferior 180° of the anterior TM using an 810 nm diode laser in a micropulse operating mode. The intraocular pressure (IOP) was measured at baseline and at 1 hour, 1 day, 1 week, 3, 6, 9, and 12 months post-treatment. Flare was measured with a Kowa FM 500 flare-meter at baseline and at 3 hours, 1 day, 1 week, and 12 months post-treatment. After treatment, the patients were maintained on their pre-treatment drug regimen. Main outcome measures Criteria for treatment response were IOP reduction ≥3 mm Hg and IOP ≤21 mm Hg within the first week after MDLT. Eyes not complying to the above criteria during the follow-up were considered treatment failure. Mean IOP change and percentage of IOP reduction during the follow-up were calculated. Results One eye was analyzed for bilateral patients. A total of 20 eyes were thus included. Four eyes (20%) did not respond to treatment during the first week. One additional eye failed at the 6 month visit. The treatment was successful in 15 eyes (75%) at 12 months. The IOP was significantly lower throughout follow-up (p < 0.01). At 12 months, the mean percentage of IOP reduction in the 15 respondent eyes was 22.1% and 12 eyes (60%) had IOP reduction higher than 20%. During the first two postoperative days, one eye with pigmentary glaucoma experienced a significant increase of flare associated with an IOP spike (34 mm Hg) that was controlled with systemic drugs; afterwards it qualified as a respondent and completed the study. No increase of flare was found in any other patient. No

  4. Psychological adjustment in children after traumatic disfiguring injuries: a 12-month follow-up.

    PubMed

    Rusch, M D; Grunert, B K; Sanger, J R; Dzwierzynski, W W; Matloub, H S

    2000-12-01

    The psychological adjustment of 57 children (age range, 3 to 12 years) who sustained mutilating traumatic injuries to the face or upper or lower extremities was assessed over a 12-month interval. The injuries had occurred as a result of boating, lawn mower, or home accidents or dog bites. Within 5 days of the traumatic event, 98 percent of the children were symptomatic for posttraumatic stress disorder, depression, or anxiety. One month after the injury, 82 percent were symptomatic. Symptom frequency had declined by the time of the 3-month and 6-month evaluations, but 44 percent of the children continued to report symptoms at 12-month follow-up visits, and 21 percent met the diagnostic criteria for posttraumatic stress disorder. Typical symptoms included flashbacks, fear of re-injury, mood disorders, body-image changes secondary to disfigurement, sleep disturbances, and anxiety. These findings support the importance of psychological evaluation and treatment of children who suffer mutilating injuries that require the attention of plastic surgeons.

  5. 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.…

  6. 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.…

  7. Depression after stroke at 12-month follow-up: a multicenter study.

    PubMed

    Limampai, Patchara; Wongsrithep, Wanpen; Kuptniratsaikul, Vilai

    2017-10-01

    To study the prevalence of depression at 12 months after stroke and to analyze factors associated with depression. This prospective cross-sectional study was conducted among nine tertiary hospitals in Thailand. Stroke patients from the Thai Stroke Rehabilitation Registry who were admitted in inpatient rehabilitation wards were recruited for evaluation at the 12-month follow-up time point. Hospital Anxiety and Depression Scale (HADS) was used to evaluate depression in stroke. A score of ≥11 was considered as having depression. Univariate and multivariate analysis was used to investigate factors related with depression in stroke. Two hundred stroke patients with a mean age of 62.1±12.5 years were recruited. Approximately 60% were male. The number of stroke patients with depression at the 12-month follow-up was 42 (21.0%, 95%CI 15.9%-27.2%). Mean HADS score at 12-month follow-up was not significantly different from those at discharge. However, 28 (16.5%) stroke patients who did not have depression at discharge developed depression during the 12-month period. From multivariate analysis, complications and urinary incontinence were found to be significantly associated with depression after stroke with adjusted odds ratio of 3.65 (95%CI 1.11-12.06) and 4.82 (95%CI 1.74-13.38), respectively. Depression is a common complication after stroke. This study found one-fifth of stroke survivors developed depression at the 12-month follow-up. Complications at discharge and urinary incontinence were significantly correlated with depression in multivariate analysis. Further study concerning interventions in decreasing depression should be performed in order to improve the quality of life of those stroke patients.

  8. 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.

  9. Mindfulness Meditation and CBT for Insomnia: A Naturalistic 12-Month Follow-up

    PubMed Central

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

    2016-01-01

    A unique intervention combining mindfulness meditation with cognitive behavioral therapy for insomnia (CBT-I) has been shown to have acute benefits at post-treatment 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 6 and 12 months post treatment. 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 (PSAS), Glasgow Sleep Effort Scale (GSES), Kentucky Inventory of Mindfulness Skills (KIMS), and the Insomnia Episode Questionnaire. Analyses examining the pattern of change across time (baseline, end-of-treatment, 6 month, and 12 month) revealed that several sleep-related benefits were maintained during the 12-month follow-up period. Participants who reported at least one insomnia episode (≥ 1 month) during the follow-up period had higher scores on the PSAS (p < .05) and GSES (p < .05) at end-of-treatment compared to 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 pre-sleep arousal and sleep effort at end-of-treatment constitute a risk for occurrence of insomnia during the 12 months following treatment. PMID:19114261

  10. Self-assessment of drinking on the Internet--3-, 6- and 12-month follow-ups.

    PubMed

    Koski-Jännes, Anja; Cunningham, John; Tolonen, Kari

    2009-01-01

    The aim of this work was to report on the results of a pilot study of a web-based self-assessment service (DHT) for Finnish drinkers (www.paihdelinkki.fi/testaa/juomatapatesti). During the 7-month recruitment period in 2004 altogether 22,536 anonymous self-assessments were recorded in the database of this service. The study sample was recruited from the 1598 service users who also participated to a survey evaluating the DHT. Those who consented by providing required baseline data and their e-mail address (n = 343) were sent a message asking them to fill in the follow-up questions 3, 6 and 12 months later. Their self-reported use of alcohol and drinking-related problems served as the main outcome variables in this single-group follow-up study. At 3, 6 and 12 months, 78%, 69% and 61% of the study participants, respectively, responded to the follow-up. The intention-to-treat (ITT) results revealed significant reductions (P < 0.001) in all the outcome measures. The reductions occurred during the first 3 months, after which the changes were non-significant. The results are in line with previous studies with mostly shorter follow-up periods suggesting that Internet-based self-assessment services can be useful tools in reducing excessive drinking. A randomized controlled trial would, however, increase our certainty about the causes of the observed changes.

  11. Meralgia paraesthetica: Ultrasound-guided injection at multiple levels with 12-month follow-up.

    PubMed

    Klauser, Andrea S; Abd Ellah, Mohamed M H; Halpern, Ethan J; Sporer, Isabella; Martinoli, Carlo; Tagliafico, Alberto; Sojer, Martin; Taljanovic, Mihra S; Jaschke, Werner R

    2016-03-01

    To evaluate the efficacy of ultrasound (US)-guided injections around the lateral femoral cutaneous nerve (LFCN) at different levels in meralgia paraesthetica (MP) patients. The study was approved by the university ethics committee and informed oral and written consent were obtained from all patients. Between June 2008 and August 2013, 20 patients with symptoms of MP, including nine men (mean age, 61.33 years) and 11 women (mean age 61.18 years), were treated with US-guided injection of steroids along the LFCN at three different levels in a mean of 2.25 sessions. A visual analogue scale (VAS) was used to measure symptoms before, immediately after and 12 months after treatment. Complete resolution of symptoms was documented in 15/20 patients (mean VAS decreased from 82 to 0), and partial resolution in the remaining five (mean VAS decreased from 92 to 42), which was confirmed at 12-month follow-up. By using the different levels of injection approach overall significantly better symptom relief was obtained (p < 0.05). The outcome of US-guided injection along the LFCN can be further improved by injections at different levels (p < 0.05), which was confirmed at 12-month long-term follow-up. Meralgia paraesthetica is an entrapment neuropathy of the lateral femoral cutaneous nerve. Ultrasound proved effective in diagnosis and in guiding injection therapy. Injection at the anterior superior iliac spine has been used previously. Multiple injections along the nerve course were used in this study. Long-term follow-up (12 months) confirmed the results.

  12. [Angioplasty of the renal arteries. Our experience with a 12-month follow-up].

    PubMed

    Simonetti, G; Rossi, P; Passariello, R; Pesce, B; Rovasio, S S; Urigo, F; Canalis, G C; Tomiselli, A

    1983-09-01

    We have treated 56 stenoses of renal arteries in 50 patients in which a renin assay indicated renovascular hypertension. In this paper we refer only to 40 cases of renal arteries angioplasty in 37 patients (3 cases of bilateral stenoses) with a clinical follow-up of 12 months. 25 lesions were of arteriosclerotic nature, while 15 were due to fibromuscular displasia. Results demonstrated that angioplasty resolved hypertensive conditions (either with or without medical therapy) in 82% of the cases of arteriosclerotic lesions and in 86% of the stenoses due to fibromuscular displasia. Although extremely rare, the complications that may occur with this procedure are very serious (arterial rupture, acute thrombosis, peripheral embolization). Out of utmost importance is a close collaboration with a vascular surgeon. Without doubt angioplasty will bring about radical changes in the preparation of therapeutical protocol and in some selected cases to improve renal function.

  13. 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.

  14. 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

  15. [Results of a psychotherapeutic program for smoking after 12 months of follow-up].

    PubMed

    Vellisco García, A; Alvarez Gutiérrez, F J; Elías Hernández, T; Romero, J; Toral Marín, J; Bordoy Sánchez, C; Castillo Gómez, J

    2001-01-01

    To compare the efficacy of psychological counseling for smokers in a cessation program in comparison with treatment based only on providing information about damage caused by tobacco and advice for quitting, and to determine the reasons patients started to smoke. We studied 249 patients who came to a preliminary interview; 226 began treatment for smoking cessation. The average level of dependence, quantified the Fagerstrom test was 7.26 +/- 1.85 points. Two treatment groups were formed: the first patients seen made up the control group (n = 37), which received information about the dangers of tobacco and strategies for quitting, and the psychological counseling group (n = 189). Follow-up examinations were performed three, six and twelve months after treatment, with abstinence checked by measurement of CO in exhaled air. Only patients with CO levels less than 5 ppm (particles per million) in exhaled air were considered non-smokers. Most patients of both sexes named social pressure as the reason for starting to smoke. The rate of abstinence in the information and strategies group was 8.1% at all three follow-up visits, whereas the rate was 37%, 25.4% and 24.3% at three, six and twelve months, respectively, in the group receiving counseling. The differences between the two groups were significant at all visits. Social pressure is the main reason for starting to smoke. We observed a success rate of 24.3% after one year of follow-up after psychological treatment only, a rate that was significantly higher than that of the group that received only information. We believe that psychological counseling is an effective alternative for smokers who want to quit.

  16. 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.

  17. The role of illness perceptions in predicting outcome after acute whiplash trauma: a multicenter 12-month follow-up study.

    PubMed

    Gehrt, Tine B; Wisbech Carstensen, Tina Birgitte; Ørnbøl, Eva; Fink, Per K; Kasch, Helge; Frostholm, Lisbeth

    2015-01-01

    To examine (1) whether the patients' perceptions of their symptoms immediately after the accident and at 3-month follow-up predict working ability and neck pain at 12-month follow-up and (2) the possible changes in patients' illness perceptions during the follow-up period. A total of 740 consecutive patients exposed to acute whiplash trauma consulting emergency units and general practitioners in 4 Danish counties from 2001 to 2003. The patients completed questionnaires at baseline, 3-, and 12-month follow-up. Illness perceptions were measured using a condensed version of the Illness Perception Questionnaire and a 1-item question concerning return to work expectation. Neck pain was measured using an 11-point box scale, and working ability was measured by self-report at 12-month follow-up. Multiple logistic regression analyses were applied controlling for possible confounders. Patients with pessimistic illness perceptions at baseline and 3-month follow-up were more likely to experience neck pain and affected working ability at 12 months compared with patients with optimistic illness perceptions. Negative return-to-work expectation predicted affected working ability at 12 months. Furthermore, patients with high neck pain intensity or affected working ability report more changes in their illness perceptions during follow-up than patients with low neck pain intensity or unaffected working ability. The findings are in line with the common-sense model of illness and previous research demonstrating that patient's expectations for recovery and illness perceptions might influence the course after whiplash injury. Illness perceptions and expectations may provide a useful starting point for future interventions and be targeted in the prevention of chronicity.

  18. A 12-month exercise intervention decreased stress symptoms and increased mental resources among working adults - Results perceived after a 12-month follow-up.

    PubMed

    Kettunen, Oili; Vuorimaa, Timo; Vasankari, Tommi

    2015-01-01

    This study evaluated the effect of a 12-month physical exercise intervention accompanied by a 12-month followup evaluating stress symptoms (SS), mental resources (MR) and cardiorespiratory fitness (CRF) in healthy, working adults. We hypothesized that the stress symptoms would decrease and mental resources would increase during the intervention and that these results are associated with changes in CRF. The study group included healthy adults (N = 371). Three hundred thirty eight participants (212 women, 126 men) were allocated in the exercise group and 33 in the control group (17 women and 16 men). For the analysis, the exercise group was divided into subgroups according to the baseline SS and MR. Stress symptoms and MR were measured using the Occupational Stress Questionnaire. During the 12-month exercise intervention, SS decreased by 16% (p < 0.0001), MR increased by 8% (p < 0.0001) and CRF increased by 7% (p < 0.0001) in the exercise group, while no changes occurred in the control group (ANCOVA, p < 0.01). In the exercise group, the results (SS, MR, and CRF) remained improved during the follow-up. There was a positive correlation between the change in SS and the change in CRF (r = 0.19, p < 0.01). In the subgroup having the highest SS at baseline, SS during the intervention decreased most (26%) (ANCOVA, p < 0.0001). One year physical exercise intervention improved mental well-being among working adults and this was associated with an improvement in cardiorespiratory fitness. The positive changes remained after the 12-month follow-up. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  19. 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…

  20. 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…

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

    PubMed

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

    2017-01-01

    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. 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. 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. 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.

  2. 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

  3. Hazardous Alcohol Drinking as Predictor of Smoking Relapse (3-, 6-, and 12-Months Follow-Up) by Gender.

    PubMed

    Rodríguez-Cano, Rubén; López-Durán, Ana; Martínez-Vispo, Carmela; Martínez, Úrsula; Fernández Del Río, Elena; Becoña, Elisardo

    2016-12-01

    Diverse studies have found a relation between alcohol consumption and smoking relapse. Few studies have analyzed the relation of smoking relapse with pretreatment alcohol consumption and gender differences. The main purpose of this study is to analyze the influence of alcohol consumption in smoking relapse over 12 months (3-, 6-, and 12-months follow-up) and to determine possible gender differences. The sample included 374 smokers who quit smoking by participating in a psychological smoking cessation treatment. We assessed hazardous pretreatment alcohol drinking (AUDIT), cigarette consumption (FTND; number of cigarettes) and sociodemographic variables. Higher scores on hazardous pretreatment alcohol drinking predict smoking relapse at 3-, 6-, and 12-months after smoking cessation. In males, higher scores on hazardous pretreatment alcohol drinking predict relapse at 6 and at 12 months. In females, higher scores on hazardous pretreatment alcohol drinking predict tobacco relapse at 3 months. Hazardous pretreatment alcohol drinking predicts relapse at all intervals after smoking cessation (3-, 6-, and 12-months follow-up). However, the influence of hazardous pretreatment alcohol drinking on smoking relapse differs as a function of gender, as it is a short-term predictor in women (3 months) and a long-term predictor in men (6 and 12 months). Copyright © 2016 Elsevier Inc. All rights reserved.

  4. 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.…

  5. 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.

  6. 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

  7. The effectiveness of an improved multidisciplinary pain management programme: a 6- and 12-month follow-up study.

    PubMed

    Dysvik, Elin; Kvaløy, Jan Terje; Natvig, Gerd Karin

    2012-05-01

      This article is a report of a Norwegian-revised study on the effectiveness of a follow-up multidisciplinary management programme for chronic pain to investigate the change processes associated with treatment.   Substantial evidence supports the use of Cognitive Behavioural Therapy approaches to chronic pain. As relapse is often reported, follow-up sessions should be included.   A follow-up quasi-experimental design was performed, and a previous control group was used. The study initially included 117 participants, and 104 of the sample completed the 6- and 12-month follow-up programme. The 6-month follow-up consisted of therapeutic dialogue and education combined with physical activity. At the 12-month follow-up, a telephonic consultation was conducted. The data collection period was between September 2006 and January 2008. The statistical and clinical significance were considered.   Findings suggest that this follow-up programme can potentially maintain the positive results of the basic programme in terms of reduced pain perception, improved health-related quality of life, and movement towards self-management.   These results are consistent with the ultimate goal of Cognitive Behavioural Therapy approaches, which is to help patients with chronic pain to cope more effectively and to improve their health-related quality of life and functioning. To maintain treatment improvements and advance nursing, there is a clear need for research that tests the efficacy of follow-up interventions that are designed to prevent drop out and relapse. © 2011 Blackwell Publishing Ltd.

  8. Outcome after major trauma: 12-month and 18-month follow-up results from the Trauma Recovery Project.

    PubMed

    Holbrook, T L; Anderson, J P; Sieber, W J; Browner, D; Hoyt, D B

    1999-05-01

    The importance of outcome after major injury has continued to gain attention in light of the ongoing development of sophisticated trauma care systems in the United States. The Trauma Recovery Project (TRP) is a large prospective epidemiologic study designed to examine multiple outcomes after major trauma in adults aged 18 years and older, including quality of life, functional outcome, and psychologic sequelae such as depression and posttraumatic stress disorder (PTSD). Patient outcomes were assessed at discharge and at 6, 12, and 18 months after discharge. The specific objectives of the present report are to describe functional outcomes at the 12-month and 18-month follow-ups in the TRP population and to examine the association of putative risk factors with functional outcome. Between December 1, 1993, and September 1, 1996, 1,048 eligible trauma patients triaged to four participating trauma center hospitals in the San Diego Regionalized Trauma System were enrolled in the TRP study. The admission criteria for patients were as follows: (1) age 18 years or older; (2) Glasgow Coma Scale score on admission of 12 or greater; and (3) length of stay greater than 24 hours. Functional outcome after trauma was measured before and after injury using the Quality of Well-Being (QWB) Scale, an index sensitive to the well end of the functioning continuum (0 = death, 1.000 = optimum functioning). Follow-up at 12 months after discharge was completed for 806 patients (79%), and follow-up at 18 months was completed for 780 patients (74%). Follow-up contact at any of the study time points (6, 12, or 18 months) was achieved for 926 (88%) patients. The mean age was 36 +/- 14.8 years, and 70% of the patients were male; 52% were white, 30% were Hispanic, and 18% were black or other. Less than 40% of study participants were married or living together. The mean Injury Severity Score was 13 +/- 8.5, with 85% blunt injuries and a mean length of stay of 7 +/- 9.2 days. QWB scores before injury

  9. Chemo-mechanical caries removal with Papacarie™: case series with 84 reports and 12 months of follow-up.

    PubMed

    Bussadori, Sandra Kalil; Godoy, Camila Haddad Leal de; Alfaya, Thays Almeida; Fernandes, Kristianne Porta Santos; Mesquita-Ferrari, Raquel Agnelli; Motta, Lara Jansiski

    2014-03-01

    The aim of the present study was to determine the success rate after 12 months of follow-up in a series of cases in which chemo-mechanical caries removal (CMCR) was performed with Papacarie(TM), followed by restoration with glass ionomer cement. The development of conservative techniques for carious tissue removal and improvements in dental restoration materials have allowed better preservation of dental structures in the treatment of decayed teeth. Chemo-mechanical caries removal (CMCR) is a conservative atraumatic treatment option. Papacarie(TM) is a papain-based material developed to act only on the carious dentin, allowing its easy removal with a blunt curette. The study involved a total of 84 deciduous posterior teeth with occlusal dentinal caries. Only teeth without risk of pulp exposure were studied. After a period of 12 months, the restorations were evaluated based on criteria employed in previous studies. The radiographic evaluation revealed resorption and calcification of the affected teeth. The data were submitted to descriptive statistical analysis with the aid of the XLSTAT program. The success rate was 88.1% and 98.8% based on the clinical and radiographic evaluations, respectively. The difference between the success and failure rates was statistically significant (p < 0.0001). Papacarie(TM) is an effective product for CMCR on occlusal dentinal tissue in deciduous teeth, demonstrating a high clinical and radiographic success rate after 12 months of follow-up.

  10. 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

  11. Quality of life in persons living with HIV in Burkina Faso: a follow-up over 12 months.

    PubMed

    Bakiono, Fidèle; Guiguimdé, Patrice Wendpouiré Laurent; Sanou, Mahamoudou; Ouédraogo, Laurent; Robert, Annie

    2015-11-13

    In Burkina Faso, very little is known about the quality of life of persons living with HIV through their routine follow- up. This study aimed to assess the quality of life of persons living with HIV, and its change over a 1-year period. Four hundred and twenty four (424) persons living with HIV were monitored during twelve (12) months from September 2012 to September 2013 in Ouagadougou, the capital city of Burkina Faso. Three interviews were conducted in order to assess the quality of life of patients and its change over time, using the World Health Organization Quality of Life assessment brief scale in patients with Human Immunodeficiency Virus infection (WHOQOL HIV-BREF). The Friedman test was used to assess significant differences in quantitative variables at each of the three follow-up interviews. Groups at baseline, at 6 months and at 12 months were compared using Wilcoxon signed rank test for quantitative data and McNemar test for qualitative variables. Pearson Chi(2) was used when needed. Multivariable logistic regression models were fit to estimate adjusted odds ratio (OR) and 95% confidence intervals (95% CI). Trends in global quality of life score and subgroups (status related to Highly Active Anti Retroviral Treatment (HAART) using univariate repeated measures analysis of variance were assessed. A p-value less than 0.05 was considered significant. At baseline, quality of life scores were highest in the domain of spirituality, religion and personal beliefs (SRPB) and lowest in the environmental domain. This trend was maintained during the 12-month follow-up. The global score increased significantly from the beginning up to the twelfth month of follow-up. Over the 12 months, the baseline factors that were likely to predict an increase in the global quality of life score were: not having support from relatives for medical care (P = 0.04), being under HAART (P = 0.001), being self-perceived as healthy (P = 0.03), and having a global quality of life score

  12. The Acupuncture on Hot Flashes Among Menopausal Women study: observational follow-up results at 6 and 12 months.

    PubMed

    Borud, Einar Kristian; Alraek, Terje; White, Adrian; Grimsgaard, Sameline

    2010-03-01

    The previously published Acupuncture on Hot Flashes Among Menopausal Women study compared the effectiveness of individualized acupuncture treatment plus self-care versus self-care alone on hot flashes and health-related quality of life in postmenopausal women. This article reports on the observational follow-up results at 6 and 12 months. The Acupuncture on Hot Flashes Among Menopausal Women study was a pragmatic, multicenter randomized controlled trial with two parallel arms, conducted in 2006 to 2007. The 267 participants were postmenopausal women experiencing, on average, 12.6 hot flashes per 24 h. The acupuncture group received 10 individualized acupuncture treatments during 12 weeks and advice on self-care, whereas the control group received only advice on self-care. Hot flash frequency and intensity (0-10 scale) and hours of sleep per night were registered in a diary. Health-related quality of life was assessed by the Women's Health Questionnaire. From baseline to 6 months, the mean reduction in hot flash frequency per 24 hours was 5.3 in the acupuncture group and 5.0 in the control group, a nonsignificant difference of 0.3. At 12 months, the mean reduction in hot flash frequency was 6.0 in the acupuncture group and 5.8 in the control group, a nonsignificant difference of 0.2. Differences in quality-of-life scores were not statistically significant at 6 and 12 months. The statistically significant differences between the study groups found at 12 weeks were no longer present at 6 and 12 months. Acupuncture can contribute to a more rapid reduction in vasomotor symptoms and increase in health-related quality of life in postmenopausal women but probably has no long-term effects.

  13. 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

  14. 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

    2017-04-01

    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. Copyright © 2017 Elsevier B.V. and ECNP. All rights reserved.

  15. 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.

  16. Effect of Brazil nut supplementation on plasma levels of selenium in hemodialysis patients: 12 months of follow-up.

    PubMed

    Stockler-Pinto, Milena B; Lobo, Julie; Moraes, Cristiane; Leal, Viviane O; Farage, Najla E; Rocha, Ariana V; Boaventura, Gilson T; Cozzolino, Silvia M F; Malm, Olaf; Mafra, Denise

    2012-07-01

    Large amounts of reactive oxygen species are produced in hemodialysis (HD) patients, and, at higher concentrations, reactive oxygen species are thought to be involved in the pathogenesis of cardiovascular disease. It has been proposed that selenium (Se) may exert an antiatherogenic influence by reducing oxidative stress. The richest known food source of Se is the Brazil nut (Bertholletia excelsa, family Lecythidaceae), found in the Amazon region. The objective of this work was to determine if Se plasma levels in HD patients submitted to a program of supplementation during 3 months with 1 Brazil nut by day could be sustained after 12 months. A total of 21 HD patients (54.2 ± 15.2 years old; average time on dialysis, 82.3 ± 51.6 months; body mass index, 24.4 ± 3.8 kg/m(2)) from the RenalCor Clinic in Rio de Janeiro, Brazil, were followed up 12 months after the supplementation study ended. The Se plasma levels were determined by atomic absorption spectrophotometry with hydride generation. The Se Plasma levels (17.3 ± 19.9 μg/L) were below the normal range (60 to 120 μg/L) before nut supplementation, and after 3 months of supplementation, the levels increased to 106.8 ± 50.3 μg/L (P < .0001). Twelve months after supplementation, the plasma Se levels decreased to 31.9 ± 14.8 μg/L (P < .0001). The data showed that these patients were Se deficient and that the consumption of Brazil nut was effective to increase the Se parameters of nutritional status. Se levels 12 months after the supplementation period were not as low as presupplementation levels but yet significantly lower, and we needed to motivate patients to adopt different dietary intake patterns. Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  17. Efficacy and Stability of Two in-Office Bleaching Agents in Adolescents: 12 Months Follow-Up.

    PubMed

    Bacaksiz, Ayca; Tulunoglu, Ozlem; Tulunoglu, Ibrahim

    2016-01-01

    Although there are several clinical studies on in office vital bleaching in adults, there are no Randomized Clinical Trials for the efficacy of this application in adolescents. The aim the study was to evaluate the efficiency of two bleaching systems on adolescents for twelve-months follow-up. Twenty-eight volunteers, aged between 13-18, randomly divided into two groups. Two commercial in-office bleaching systems were used: G1 (n=14): Zoom2 25 % HP with UV light and G2 (n=14): Beaming White 36% HP with LED light in a single 3 x 15 minute procedure. The color assessment was made with a spectrophometer; before and after bleaching; 48 hours; 1, 6 and 12 months later. Color enhancement and maintenance of two techniques over 12 months were compared by two ways ANOVA and Student's t test. Sensitivity was evaluated on a scale with Wilcoxon test. Both groups demonstrated similar and significant tooth color enhancement and did not reveal any statistically significant differences between them. However, a relapse of the tooth shade was observed with the low concentration agent/ultraviolet light system. No sensitivity was observed in any patients. Two in-office bleaching systems can be used successfully on young permanent teeth. For long-term successful results, high concentration/LED light may be more effective.

  18. QL-10NEURO-ONCOLOGY TELEMEDICINE FOLLOW-UP VISITS

    PubMed Central

    Green, Richard; Woyshner, Emily

    2014-01-01

    We report our 18 month experience with the use of a videoconferencing system to perform neuro-oncology follow-up visits. The Neuro-oncology Program at the Kaiser Permanente-Los Angeles Medical center serves the majority of Kaiser HMO patients in the Southern California region. We installed a videoconferencing system (Cisco TelePresence EX90, Cisco Systems, San Jose, CA) in our office in Los Angeles and in a medical office building in Anaheim, CA at a distance of 35 miles. Established neuro-oncology patients from Orange County chose between in-person and remote visits. Patients were seated in an examination room and the neuro-oncology provider alerted by text page. A focused history and physical examination was performed, followed by desktop sharing of clinical and laboratory data using an electronic medical record (Epic Systems Corporation, Verona, WI) and of neuroimages (Phillips iSite PACS, Andover, MA). Patients were asked, but not required, to complete an anonymous online 16 question satisfaction survey after each visit. Visits were performed by either a neuro-oncologist (179) or a Physician's Assistant (12). Of the 191 visits, 174 included evaluation of neuroimaging and 77 included evaluation of response to ongoing chemotherapy. During 12 visits chemotherapy was initiated, and during 15 visits the chemotherapy regimen was changed based on imaging findings. One-hundred and eleven surveys (58% of visits) were completed. Patients reported a high level of satisfaction with the visits (average 9.6, on a 1-10 scale). The average estimated travel time saved was 118 minutes per visit. Four surveys reported technical problems and 1 indicated a preference for an in-person visit. No adverse events could be attributed to use of the telemedicine system. These data suggest that neuro-oncology follow-up visits can be practiced safely and effectively using a telemedicine system, with high levels of patient satisfaction.

  19. The Impact of Vaccine Refusal on Physician Office Visits During the Subsequent 12 Months.

    PubMed

    Jones, Milissa U; Carter, Cassandra G; Cameron, Kenneth L; Smith, Tyler K

    2017-09-01

    We hypothesized that families who are nonadherent to the routine vaccination schedule (RVS) present less frequently for physician visits. We conducted a retrospective chart review to compare the number of visits made over the subsequent 12-month period by families that refused the RVS versus those who were adherent. Subjects were aged 0 to 4 years, enrolled to Keller Army Hospital, and had a diagnosis indicating the RVS was refused. Age-matched controls, who were adherent to the RVS, were randomly chosen for each case. Subjects made significantly more total visits than CASES: 7 (interquartile range [IQR] = 1-20) versus 6 (IQR = 2-17), p = 0.0049. When each visit type was compared independently, there was no significant difference in the number of acute (p = 0.494) or emergency department (p = 0.077) visits between groups. However, subjects who refused to follow the RVS made significantly fewer routine care visits during the 1-year follow-up period compared to those that adhered to the RVS (p < 0.001). Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  20. 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

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

    PubMed

    Skeffington, Petra M; Rees, Clare S; Mazzucchelli, Trevor G; Kane, Robert T

    2016-01-01

    To develop and evaluate an evidence-based and theory driven program for the primary prevention of Post-traumatic Stress Disorder (PTSD). 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). 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. 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. 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. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12615001362583.

  2. Outcomes after foot surgery in people with a diabetic foot ulcer and a 12-month follow-up.

    PubMed

    Lenselink, E; Holloway, S; Eefting, D

    2017-05-02

    The aim of this study was to retrospectively measure the outcomes of foot-sparing surgery at one year follow-up for patients with diabetic foot ulcers (DFUs). We assessed wound healing and the need for further surgery in relation to the variables that influence healing. Data were retrospectively collected by reviewing the electronic files of patients attending the Wound Expert Clinic (WEC). Outcomes of surgical debridement, toe, ray and transmetatarsal amputations were assessed. A total of 129 cases in 121 patients were identified for inclusion. The results demonstrated that complete wound healing was reached in 52% (61/117) of the patients within 12 months. The need for additional surgery or for major amputation was 56% (n=72/129) and 30% (n=39/129) respectively. The need for an additional procedure was particularly high after surgical debridement (75%, 33/44) and transmetatarsal amputation (64%, 7/11). Risk factors for non-healing or for a major amputation were: infection (p=0.01), ischaemia (p=0.01), a history of peripheral arterial occlusive disease (p<0.01) and smoking (p=0.01). Additional findings were that not all patients underwent vascular assessment and in half of the patients there was a delay in undergoing revascularisation. The results of the study reveal some areas for improvement including timely revascularisation and performance of multiple debridement procedures if needed in order to save a limb.

  3. 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.

  4. Conventional vs. Daylight Photodynamic Therapy for patients with actinic keratosis on face and scalp: 12-month follow-up results of a randomized, intraindividual comparative analysis.

    PubMed

    Sotiriou, Elena; Evagelou, George; Papadavid, Evangelia; Apalla, Zoe; Vrani, Fotini; Vakirlis, Efstratios; Panagiotou, Maro; Stefanidou, Maria; Pombou, Tsampikos; Krasagakis, Konstantinos; Rigopoulos, Dimitrios; Ioannides, Demetrios

    2017-10-03

    Daylight PDT (DLPDT) is a new PDT procedure. Several trials demonstrate that DLPDT achieves similar response rates with conventional PDT (CPDT) in the treatment of nonhyperkeratotic actinic keratoses (AKs) in a nearly painless way. It seems that DLPDT represents a more convenient and equally effective treatment modality. Data on long-term efficacy of DLPDT are limited. To compare short- and long-term efficacy, safety and tolerability of DLPDT with that of CPDT in face and scalp AKs. The study, an intraindividual right-left comparison study, was conducted in 3 centers in North, Center and South Greece. Eligible patients received either DLPDT or CPDT randomly allocated to alternate sides of face or scalp. Patients were evaluated at baseline, 3 and 12 months after treatment. Assessments included lesion response at 3 and 12 months, PDT associated pain during PDT session, local skin reactions 3 days after treatment as well as patients' preference 3 months after treatment. A total of 46 patients completed the study. Three months after treatment the overall lesion complete response rate was 78% for DLPDT and 80.6% for CPDT. At the 12-months follow-up response rate decreased to 71.8% and 73.7% for DLPDT and CPDT accordingly. Regarding response based on lesion grade, response rates obtained in grade I lesions were higher with DLPDT, while treatment with CPDT resulted to higher rates of cured grade II lesions at both follow-up visits. Results were not supported by statistical significance. DLPDT was associated with significantly lower pain and reduced severity of local skin reactions. Patients' preference favored DLPDT. Our study demonstrated that DLPDT is similar to CPDT in terms of long-term efficacy and recurrence rates in the treatment of face and scalp AKs. DLPDT demonstrated a better tolerability profile as it was associated with lower pain and less severe adverse events. This article is protected by copyright. All rights reserved. This article is protected by

  5. Clinical and biometrical 12-month follow-up in patients after reconstruction of the sural nerve biopsy defect by the collagen-based nerve guide Neuromaix.

    PubMed

    Bozkurt, Ahmet; Claeys, Kristl G; Schrading, Simone; Rödler, Jana V; Altinova, Haktan; Schulz, Jörg B; Weis, Joachim; Pallua, Norbert; van Neerven, Sabien G A

    2017-09-22

    Many new strategies for the reconstruction of peripheral nerve injuries have been explored for their effectiveness in supporting nerve regeneration. However only a few of these materials were actually clinically evaluated and approved for human use. This open, mono-center, non-randomized clinical study summarizes the 12-month follow-up of patients receiving reconstruction of the sural nerve biopsy defect by the collagen-based nerve guide Neuromaix. Neuromaix was implanted as a micro-structured, two-component scaffold bridging 20-40 mm nerve defects after sural nerve biopsy in twenty patients (eighteen evaluated, two lost in follow-up). Safety of the material was evaluated by clinical examination of wound healing. Performance was assessed by sensory testing of modalities, pain assessment, and palpation for the Hoffmann-Tinel's sign as well as demarcating the asensitive area at each follow-up visit. Every patient demonstrated uneventful wound healing during the complete 12-month time course of the study. Two patients reported complete return of sensation, whereas eleven out of eighteen patients reported a positive Hoffmann-Tinel's sign at the lower leg with simultaneous reduction of the asensitive area by 12 months. Our data show that Neuromaix can be implanted safely in humans to bridge sural nerve gaps. No procedure-related, adverse events, or severe adverse events were reported. These first clinical data on Neuromaix provide promising perspectives for the bridging of larger nerve gaps in combined nerves, which should be investigated more through extensive, multi-center clinical trials in the near future.

  6. 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

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

    PubMed

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

    2017-03-01

    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. 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. 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. 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.

  8. Fatigue Following Traumatic Brain Injury in Children and Adolescents: A Longitudinal Follow-Up 6 to 12 Months After Injury.

    PubMed

    Crichton, Alison; Anderson, Vicki; Oakley, Ed; Greenham, Mardee; Hearps, Stephen; Delzoppo, Carmel; Beauchamp, Miriam H; Hutchison, James S; Guerguerian, Anne-Marie; Boutis, Kathy; Babl, Franz E

    2017-09-18

    Longitudinal fatigue data in children suffering from traumatic brain injury (TBI) are lacking. To examine the effects of time postinjury (6-12 months) and injury severity on fatigue after childhood TBI. Secondarily, we compared fatigue 12 months postinjury against published control data. Three tertiary children's hospitals across Australia (n = 1) and Canada (n = 2). Parents (n = 109) of children (mean [M] = 9.9 years at injury; range, 1.0-16.9 years) admitted to one of 3 participating hospitals with mild (n = 69) or moderate/severe (n = 37) TBI. Longitudinal prospective study. Primary: Pediatric Quality of Life Multidimensional Fatigue Scale (total, general, sleep/rest, and cognitive), rated by parents 6 and 12 months postinjury. Secondary: Pediatric Injury Functional Outcome Scale (fatigue and sleep items, rated on recruitment and 6 and 12 months postinjury). Demographic and children data were collected at recruitment. Mixed-models analysis demonstrated nonsignificant effects of time (6 vs 12 months postinjury) on multidimensional fatigue scores. Cognitive fatigue worsened over time. Moderate/severe TBI was associated with worse fatigue 12 months postinjury (general, P = .03; cognitive, P = .02). Across all severities, fatigue 12 months postinjury was significantly worse compared with control data (total fatigue, P < .001; all domains, all Ps < .025). Fatigue remains significant at 12 months since injury, particularly for those with moderate/severe TBI.

  9. A 12-month follow-up study of people with dementia referred to general hospital liaison psychiatry services.

    PubMed

    Sheehan, Bart; Lall, Ranjit; Gage, Heather; Holland, Caroline; Katz, Jeanne; Mitchell, Kate

    2013-11-01

    new services for patients with dementia in general hospitals are being widely developed. Little is known of outcomes after hospital for such patients. to establish outcomes for patients with dementia referred to general hospital psychiatric services. prospective cohort study. two UK general hospitals. referrals with dementia to liaison psychiatric services. eligible referrals (n = 112), and their carers, were assessed during admission, and at 6 and 12 months, using battery of health measurements. mortality at 6 months was 31% and at 12 months 40%. At baseline, 13% lived in a care home, rising to 84% by 6 months. Quality of life scores remained stable over 12 months, while carer stress fell significantly. Baseline clinical and demographic variables did not predict quality of life or carer stress at 6 and 12 months. dementia liaison services in general hospitals currently focus on poor outcome cases.

  10. Internet-based screening and brief intervention for illicit drug users: a randomized controlled trial with 12-month follow-up.

    PubMed

    Sinadinovic, Kristina; Wennberg, Peter; Berman, Anne H

    2014-03-01

    This trial investigated the effects of access to an Internet-based screening and brief intervention site for illicit drug users. This article adds to previously published results from the 3- and 6-month follow-ups by extending the follow-up period to 12 months and reporting changes in substance use between the 6- and 12-month follow-ups. In total, 202 Internet help-seekers with illicit drug use, 15-70 years old, were randomly assigned to either an intervention group that received Internet-based screening and brief intervention via eScreen.se or to an assessment-only control group. The primary outcome measure was the Drug Use Disorders Identification Test consumption questions (DUDIT-C) score, and secondary outcome measures were the DUDIT, Alcohol Use Disorders Identification Test consumption questions (AUDIT-C), and AUDIT scores, as well as the proportion of drug abstainers and participants making a clinically significant change in their alcohol and other drug use. DUDIT-C, DUDIT, AUDIT-C, and AUDIT scores remained stable between the 6- and 12-month follow-ups. However, 12 months after recruitment, 34.3% of those who used eScreen.se had changed their alcohol use to a clinically lower level compared with the 21.8% of the controls. Also, none of the eScreen.se users increased their level of alcohol use during this 12-month period, whereas 5.0% in the control group did so. Despite no changes in illicit drug use from the 6- to 12-month follow-up for both the intervention and control group, eScreen.se seems to be more effective than assessment only for reducing alcohol use among illicit drug users over a 12-month period.

  11. Improving adherence and clinical outcomes in self-guided internet treatment for anxiety and depression: a 12-month follow-up of a randomised controlled trial.

    PubMed

    Titov, Nickolai; Dear, Blake F; Johnston, Luke; McEvoy, Peter M; Wootton, Bethany; Terides, Matthew D; Gandy, Milena; Fogliati, Vincent; Kayrouz, Rony; Rapee, Ronald M

    2014-01-01

    A recent paper reported the outcomes of a study examining a new self-guided internet-delivered treatment, the Wellbeing Course, for symptoms of anxiety or depression. This study found the intervention resulted in significant symptom reductions. It also found that automated emails increased treatment completion and clinical improvements in a subsample with elevated anxiety and depression. To examine the clinical outcomes and the effect of automated emails at 12 months post-treatment. Participants, who were randomly allocated to a Treatment Plus Automated Emails Group (TEG; n = 100), a standard Treatment Group (TG; n = 106) or delayed-treatment Waitlist Control Group (Control; n = 51), were followed up at 12 months post-treatment. Eighty-one percent, 78% and 87% of participants in the TEG, TG and treated Waitlist Control Group provided symptom data at 12-month follow-up, respectively. The primary outcome measures were the Patient Health Questionnaire-9 Item Scale (PHQ-9) and the Generalized Anxiety Disorder-7 Item Scale (GAD-7). Significant improvements in symptoms of anxiety and depression were observed over time in both the TEG and TG (Fs >69, ps <.001) these were sustained from post-treatment to 12-month follow-up (ps >.05), and were associated with large effect sizes. No statistically significant differences in symptoms were found between the TEG and TG at post-treatment, 3-month or 12-month follow-up. Previously reported symptom differences between TEG and TG participants with comorbid symptoms were no longer present at 12-month follow-up (ps >.70). The overall benefits of the Wellbeing Course were sustained at 12-month follow-up. Although automated emails facilitated Course completion and reductions in symptoms for participants with comorbid anxiety and depression from pre-post treatment, these differences were no longer observed at 12-month follow-up. The results indicate that automated emails promote more rapid treatment response for people with elevated and

  12. Improving Adherence and Clinical Outcomes in Self-Guided Internet Treatment for Anxiety and Depression: A 12-Month Follow-Up of a Randomised Controlled Trial

    PubMed Central

    Titov, Nickolai; Dear, Blake F.; Johnston, Luke; McEvoy, Peter M.; Wootton, Bethany; Terides, Matthew D.; Gandy, Milena; Fogliati, Vincent; Kayrouz, Rony; Rapee, Ronald M.

    2014-01-01

    Background A recent paper reported the outcomes of a study examining a new self-guided internet-delivered treatment, the Wellbeing Course, for symptoms of anxiety or depression. This study found the intervention resulted in significant symptom reductions. It also found that automated emails increased treatment completion and clinical improvements in a subsample with elevated anxiety and depression. Aims To examine the clinical outcomes and the effect of automated emails at 12 months post-treatment. Method Participants, who were randomly allocated to a Treatment Plus Automated Emails Group (TEG; n = 100), a standard Treatment Group (TG; n = 106) or delayed-treatment Waitlist Control Group (Control; n = 51), were followed up at 12 months post-treatment. Eighty-one percent, 78% and 87% of participants in the TEG, TG and treated Waitlist Control Group provided symptom data at 12-month follow-up, respectively. The primary outcome measures were the Patient Health Questionnaire-9 Item Scale (PHQ-9) and the Generalized Anxiety Disorder-7 Item Scale (GAD-7). Results Significant improvements in symptoms of anxiety and depression were observed over time in both the TEG and TG (Fs >69, ps <.001) these were sustained from post-treatment to 12-month follow-up (ps >.05), and were associated with large effect sizes. No statistically significant differences in symptoms were found between the TEG and TG at post-treatment, 3-month or 12-month follow-up. Previously reported symptom differences between TEG and TG participants with comorbid symptoms were no longer present at 12-month follow-up (ps >.70). Conclusions The overall benefits of the Wellbeing Course were sustained at 12-month follow-up. Although automated emails facilitated Course completion and reductions in symptoms for participants with comorbid anxiety and depression from pre-post treatment, these differences were no longer observed at 12-month follow-up. The results indicate that automated emails promote more

  13. Predictors of physical activity at 12 month follow-up after a supervised exercise intervention in postmenopausal women.

    PubMed

    Aparicio-Ting, Fabiola E; Farris, Megan; Courneya, Kerry S; Schiller, Ashley; Friedenreich, Christine M

    2015-05-05

    Few studies have examined recreational physical activity (RPA) after participating in a structured exercise intervention. More specifically, little is known about the long-term effects of exercise interventions in post-menopausal women. This study had two objectives: 1) To compare RPA in postmenopausal women in the exercise group and the control group 12 months after the end of the Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial; and 2) To apply the Theory of Planned Behaviour (TPB) to identify predictors of RPA 12 months post-intervention among women in the exercise group. Self-reported RPA 12-months post-intervention from a validated questionnaire was used to estimate RPA levels for control group (118/160, 74% response) and exercise group participants (126/160, 79% response). Bivariate analysis was used to compare RPA between exercise and control group participants and to identify TPB variables for multivariate analysis. Logistic regression was applied to TPB data collected from self- administered questionnaires at end of trial by exercise group participants (126/160, 79% response) to identify predictors of long-term RPA. At 12 months post-intervention, 62% of women in the exercise group were active compared to 58% of controls (p = 0.52). Of the TPB constructs examined, self-efficacy (OR =2.98 (1.08-8.20)) and behavioural beliefs (OR = 1.46 (1.03-2.06)) were identified as predictors of RPA for exercise group participants. Levels of RPA in the exercise and control groups were comparable 12 months post intervention, indicating that participation in the ALPHA trial was associated with increased physical activity in previously inactive women, regardless of randomization into either the exercise group or in the control group. Exercise interventions that promote self-efficacy and positive behavioural beliefs have the potential to have long-term impacts on physical activity behaviour, although further research is needed to examine additional

  14. Impact of thulium VapoEnucleation of the prostate on erectile function: a prospective analysis of 72 patients at 12-month follow-up.

    PubMed

    Tiburtius, Christian; Knipper, Sophie; Gross, Andreas J; Netsch, Christopher

    2014-01-01

    To evaluate changes in erectile function after thulium VapoEnucleation of the prostate (ThuVEP) for the treatment of benign prostatic obstruction at 12-month follow-up. We prospectively evaluated 72 patients who underwent ThuVEP between January and July 2011. Preoperative evaluation included maximum urinary flow rate (Qmax), international prostate symptom score (IPSS), quality of life (QoL), postvoiding residual urine (PVR), and the Erectile function domain of the International Index of Erectile Function (IIEF-EF). According to preoperative IIEF-EF score, patients were classified into subgroup A (IIEF-EF ≥19, n = 38) and subgroup B (IIEF-EF <19, n = 34). All complications during the perioperative period were noted and classified according to the modified Clavien classification system. All patients were reassessed at 12-month follow-up by Qmax, IPSS, QoL, PVR, and IIEF-EF score. Patient data were expressed as median (interquartile range). Median patient age was 70 (65-73) years, and the median prostate volume was 52.5 (39.75-72) mL, respectively. At 12-month follow-up, IPSS (20 vs 4), QoL (4 vs 1), Qmax (9.7 vs 22.15 mL/s), and PVR (100 vs 15 mL) improved significantly in comparison with preoperative assessment (P ≤.001) without differences between subgroup A and B. A slight but not statistically significant increase of the IIEF-EF domain score was reported at 12-month follow-up (19.5 vs 20), which could be shown in subgroup A (25 vs 26) and B (6 vs 8). ThuVEP is a safe and effective procedure for the treatment of benign prostatic obstruction. At 12-month follow-up, marginal nonsignificant erectile function improvement was reported after surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. 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.

  16. Severely Aggressive Children Receiving Stimulant Medication Versus Stimulant and Risperidone: 12-Month Follow-Up of the TOSCA Trial.

    PubMed

    Gadow, Kenneth D; Brown, Nicole V; Arnold, L Eugene; Buchan-Page, Kristin A; Bukstein, Oscar G; Butter, Eric; Farmer, Cristan A; Findling, Robert L; Kolko, David J; Molina, Brooke S G; Rice, Robert R; Schneider, Jayne; Aman, Michael G

    2016-06-01

    The objective of this study was to evaluate 52-week clinical outcomes of children with co-occurring attention-deficit/hyperactivity disorder (ADHD), disruptive behavior disorder, and serious physical aggression who participated in a prospective, longitudinal study that began with a controlled, 9-week clinical trial comparing the relative efficacy of parent training + stimulant medication + placebo (Basic; n = 84) versus parent training + stimulant + risperidone (Augmented; n = 84). Almost two-thirds (n = 108; 64%) of families in the 9-week study participated in week 52 follow-ups (Basic, n = 55; Augmented, n = 53) and were representative of the initial study sample. The assessment battery included caregiver and clinician ratings and laboratory tests. Only 43% of participants in the Augmented group and 36% in the Basic group still adhered to their assigned regimen (not significant [NS]); 23% of those in the Augmented group and 11% in the Basic group were taking no medication (NS). Both randomized groups improved baseline to follow-up, but the 3 primary parent-reported behavioral outcomes showed no significant between-group differences. Exploratory analyses indicated that participants in the Augmented group (65%) were more likely (p = .02) to have a Clinical Global Impressions (CGI) severity score of 1 to 3 (i.e., normal to mildly ill) at follow-up than those in the Basic group (42%). Parents rated 45% of children as impaired often or very often from ADHD, noncompliant, or aggressive behavior. The Augmented group had elevated prolactin levels, and the Basic group had decreased weight over time. Findings were generally similar whether groups were defined by randomized assignment or follow-up treatment status. Both treatment strategies were associated with clinical improvement at follow-up, and primary behavioral outcomes did not differ significantly. Many children evidenced lingering mental health concerns, suggesting the need for additional research into

  17. Radiographic Fractal and Clinical Resonance Frequency Analyses of Posterior Mandibular Dental Implants: Their Possible Association With Mandibular Cortical Index With 12-Month Follow-up.

    PubMed

    Tözüm, Tolga F; Dursun, Erhan; Uysal, Serdar

    2016-12-01

    The aim of the present study was to investigate whether the mandibular cortical index (MCI) has a relationship with fractal dimension of bone and/or implant stability, and to justify the possible association between MCI, fractal dimension, and stability. Eighty-two subjects who received dental implants to replace missing mandibular premolar/molar sites were selected. Three months after surgical placement, implants were restored with fixed ceramic fused metal crowns. MCI was evaluated at baseline; fractal dimensions were measured with fractal analysis (FA) and implant stability quotient (ISQ) with resonance frequency analysis immediately after surgery and 12-month follow-up. FA at mesial and distal regions for Class 1, Class 2, and Class 3 MCI resulted with significant increases at 12-month follow-up compared to baseline. The ISQ in patients with Class 2 and Class 3 MCI resulted with a significant decrease compared to Class 1 MCI at baseline and at 12 months. All MCI classes evaluated with ISQ and FA at baseline values resulted with significant increases at 12 months. Significant correlations were considered for all mandibular posterior implants between baseline and 12-month measurements for ISQ and FA evaluations. Fractal analysis may be a useful method for understanding the healing process around implants and implant stability quotient values. Mandibular cortical index evaluations should be considered before implant procedures, which may provide a presurgical treatment plan and may provide information about the mandibular bone quality.

  18. Changes in health-related quality of life in people with morbid obesity attending a learning and mastery course. A longitudinal study with 12-months follow-up.

    PubMed

    Andenæs, Randi; Fagermoen, May S; Eide, Hilde; Lerdal, Anners

    2012-08-18

    Severe obesity is a complex condition that is associated with a wide range of serious health complications and reduced health-related quality of life (HRQoL). In addition to physiological factors, activity and participation, environmental factors, and personal factors are related to an individual's overall quality of life HRQoL. In Norway, a course based on cognitive behavioral principles is offered to people seeking medical treatment for weight management. The aim is to assist participants to achieve a healthier lifestyle and thereby improve their HRQoL. We therefore investigated changes in HRQoL in participants after they attended this learning and mastery course, and explored how well sociodemographic variables, paid work, social support, personal factors, and surgery predicted HRQoL at 12-month follow-up. A single-group longitudinal study was conducted. Data were collected by self-reported questionnaires. This article reports on those who had completed the questionnaire at the 12-month (n = 69) follow-up. HRQoL was assessed with the EQ-5D. Other standardized instruments measured employment, social support, self-efficacy, and surgery. At the 12-month follow-up, participants scored higher on all dimensions of the EQ-5D and on the EQ-VAS. Generalized linear model showed that having paid work, and social support were statistically significant predictors of HRQoL at the 12-month follow-up. Sex, self-efficacy, and surgery were not statistically significant associated with HRQoL. Participation in paid work, and receiving social support from persons with whom they had a close relationship were strongly related to HRQoL in obese people 12 months after participating in a learning and mastery course. The study is registered in Clinical Trials: NCT01336725.

  19. 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

  20. Outcomes of biodegradable polymer sirolimus-eluting PROLIM stent in patients with coronary artery disease. Results of 12-month follow-up of prospective registry.

    PubMed

    Roleder, Tomasz; Smolka, Grzegorz; Podolecka, Ewa; Chudek, Jolanta; Dworowy, Sebastian; Żelazowska, Katarzyna; Wojakowski, Wojciech; Ochała, Andrzej

    Data from clinical trials suggested that biodegradable-polymer-based drug-eluting stents (DES) might improve long-term clinical outcomes. PROLIM (Balton, Warsaw, Poland) DES is based on a stainless steel platform with a closed cell design releasing sirolimus from biodegradable copolymer (lactic and glycolic acid) in eight weeks. In the present study the safety and the efficacy of a PROLIM stent was assessed in patients with de novo coronary lesions in 12-month clinical follow-up. It was a single-centre, observational, prospective registry to assess the safety and efficacy of a PROLIM stent implantation in all consecutive patients with de novo coronary artery lesions treated with percutaneous coronary intervention (PCI). The primary study endpoint was a composite safety (cardiac death, non-fatal myocardial infarction), and the second study endpoint was the efficacy of PROLIM implantation-clinically driven target vessel revascularisation (TVR) assessed at 12-month follow-up. One hundred patients were enrolled into the study and 118 PROLIM stents were implanted. Thirty-two (32%) patients had diabetes, 46 (46%) patients were prior PCI, and 17 (17%) patients had coronary artery bypass grafting. 67% of stented lesions were complex ones (B2/C) and 17% were bifurcations. During the 12-month follow-up primary study endpoints occurred in five (5%) patients. Two (2%) cardiac deaths were reported and three (3%) TVRs were performed, of which one was related to in-PROLIM stent restenosis. PCI with biodegradable-polymer PROLIM DES seems to be safe and effective in 12-month follow-up. A larger trial is warranted to assess clinical outcomes post PROLIM stent implantation.

  1. 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.

  2. Risk factors for depression at 12-month follow-up in adult primary health care patients with major depression: an international prospective study.

    PubMed

    Barkow, Katrin; Maier, Wolfgang; Ustün, T Bedirhan; Gänsicke, Michael; Wittchen, Hans-Ulrich; Heun, Reinhard

    2003-09-01

    The aim of this study was to identify internationally relevant risk factors for the persistence of depression in primary care. None of the previous studies examining primary care patients could examine an equivalently large international sample. The findings from the WHO Collaborative Study on 'Psychological Problems in General Health Care' might be generalised to different cultural environments. A primary care sample of depressed subjects (ICD-10) (n=725) from 15 centres from all over the world was reinvestigated for the presence of depression after 12 months. Logistic regression analysis was used to determine the relationship of sociodemographic variables, characteristics of mental illness, and social disability with depression at follow-up. 33.5% of the subjects met ICD-10 criteria for a current depressive episode at the 12-month follow-up. Logistic regression analysis revealed that years of formal education, unemployment, depression severity, antidepressant use, abdominal pain as the main reason for consulting the general practitioner, and 'Repeated suicidal thoughts' were related to depression after 1 year. We have only poor information about details of the actual course of patients between the two assessments. Our findings of significant variables are generally comparable to results of previously conducted studies. Sociodemographic and disease-specific variables play an important role in the prediction of depression at the 12-month follow-up. General practitioners must be careful in the consideration of these variables but also of individual patient characteristics.

  3. [Previous abstinence time as a predictive factor at 12 months follow-up in a multi-component smoking cessation program].

    PubMed

    Moreno-Arnedillo, J J; Morante-Benadero, M E; Sánchez-Vegazo-Sánchez, E

    2014-01-01

    The objective of this study is to analyze the length of the longest period of previous abstinence time as a predictor of the results of a smoking cessation program at 12 months follow-up. A cross-sectional study was conducted on a sample of 475 smokers who had participated in a multi-component smoking cessation group therapy program. The independent variable is the longest abstinence time passed, measured in weeks, before the current treatment. Success was defined as self-reported abstinence. Bivariate analyses were applied to the independent variable and to other variables in order to determine the factors that would be part of a logistic regression model using contrasts Student t or χ(2) comparisons, as appropriate. Those that showed statistical significance were entered into a multivariate logistic regression model. Within the studied variables, previous abstinence time and sex were the only predictive variables of success at 12 month follow-up. The probability of being abstinent at 12 months follow-up was significantly associated with the length of the previous longest period of abstinence, and this is the best of the predictors considered. Successful cessation programs depend more on the relationship with the consumer biographical aspects than with biological factors. The history of previous attempts is a more valuable source of information for designing treatments than others traditionally considered. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  4. 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.

  5. 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

  6. 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.

  7. 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

  8. Supervised training and home-based rehabilitation in patients with stabilized ankylosing spondylitis on TNF inhibitor treatment: a controlled clinical trial with a 12-month follow-up.

    PubMed

    Masiero, Stefano; Poli, Patrizia; Bonaldo, Lara; Pigatto, Maurizia; Ramonda, Roberta; Lubrano, Ennio; Punzi, Leonardo; Maffulli, Nicola

    2014-06-01

    To assess the 12-month's follow-up effects on pain, mobility, and physical function outcomes of a supervised training and home-based rehabilitation for ankylosing spondylitis patients stabilized with TNF-inhibitor therapy. Controlled clinical trial (sequentially determined allocation) with 12-months' follow-up. Patients' homes. A total of 69 subjects were allocated to either a rehabilitation programme (rehabilitation group, n = 22), an educational-behavioural programme (educational group, n = 24), and to neither programme (control group, n = 23). Rehabilitation programme included supervised training and home exercises (stretching, strengthening, aerobic, chest, and spine/hip joint flexibility exercises); educational-behavioural programme included information on ankylosing spondylitis, pain and stress mechanisms, and control. Spinal pain intensity, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index, chest expansion, and cervical and lumbar spine active range of motion measured by a pocket goniometer. At baseline, the three groups exhibited comparable demographic characteristics and basal evaluations. Intra-group changes in the rehabilitation group from baseline to 12 months yielded statistically significant gains (p < 0.05) for all outcomes. At 12-months follow-up, compared with the control and educational-behavioural, the rehabilitation group exhibited significant differences in chest expansion (p = 0.001 and p < 0.001), Bath Ankylosing Spondylitis Disease Activity Index (p = 0.012 and p = 0.050), and in some goniometric measurements as cervical rotation (p = 0.007 and p = 0.014), toraco-lumbar rotation (p = 0.009 and p = 0.050), and total cervical movements (p = 0.009 and p = 0.001). In comparison with the educational-behavioural programme or no intervention, supervised training and home exercises improved long-term outcome in patients with ankylosing spondylitis. © The

  9. 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.

  10. Does Internet-based cognitive behavioral therapy (iCBT) prevent major depressive episode for workers? A 12-month follow-up of a randomized controlled trial.

    PubMed

    Imamura, K; Kawakami, N; Furukawa, T A; Matsuyama, Y; Shimazu, A; Umanodan, R; Kawakami, S; Kasai, K

    2015-07-01

    In this study we investigated whether an Internet-based computerized cognitive behavioral therapy (iCBT) program can decrease the risk of DSM-IV-TR major depressive episodes (MDE) during a 12-month follow-up of a randomized controlled trial of Japanese workers. Participants were recruited from one company and three departments of another company. Those participants who did not experience MDE in the past month were randomly allocated to intervention or control groups (n = 381 for each). A 6-week, six-lesson iCBT program was provided to the intervention group. While the control group only received the usual preventive mental health service for the first 6 months, the control group was given a chance to undertake the iCBT program after a 6-month follow-up. The primary outcome was a new onset of DSM-IV-TR MDE during the 12-month follow-up, as assessed by means of the web version of the WHO Composite International Diagnostic Interview (CIDI), version 3.0 depression section. The intervention group had a significantly lower incidence of MDE at the 12-month follow-up than the control group (Log-rank χ2 = 7.04, p < 0.01). The hazard ratio for the intervention group was 0.22 (95% confidence interval 0.06-0.75), when estimated by the Cox proportional hazard model. The present study demonstrates that an iCBT program is effective in preventing MDE in the working population. However, it should be noted that MDE was measured by self-report, while the CIDI can measure the episodes more strictly following DSM-IV criteria.

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. Self-help smoking cessation and maintenance programs: a comparative study with 12-month follow-up by the American Lung Association.

    PubMed Central

    Davis, A L; Faust, R; Ordentlich, M

    1984-01-01

    One thousand two hundred thirty seven smokers responding to lung association announcements in five geographic areas were randomly assigned to one of four groups and mailed American Lung Association materials: 1) leaflets (L); 2) leaflets plus maintenance manual (L + M); 3) cessation manual (C); and 4) cessation and maintenance manuals (C + M). Five telephone interviews over one year achieved a 95 per cent follow-up completion rate. Nonrespondents as well as exclusive cigar and pipe users were classified as smokers. Twenty per cent quit initially, with 5 per cent continually abstinent in (C + M) at 12 months vs 2 per cent in (L) (p less than .05). Nonsmoking prevalence rates (no tobacco smoking in the past month), on the other hand, gradually increased after six months; at 12 months those with the maintenance component, (L + M) and (C + M), had higher rates (18 per cent) than (L) (12 per cent) or (C) (15 per cent). Leaflets and manual alone were least cost effective. Rising nonsmoking prevalence rates observed in all groups suggest that successful attempts to quit increased over time and that a contributing factor might have been the follow-up method. Although achieving lower quit rates than methods requiring attendance at a course, the self-help intervention has the advantages of greater availability, flexibility, and in some instances lower cost. PMID:6437257

  16. Replantation of a maxillary second molar after removal of a third molar with a dentigerous cyst: Case report and 12-month follow-up

    PubMed Central

    Peñarrocha-Diago, María A.; Peñarrocha-Oltra, David; Peñarrocha-Diago, Miguel

    2014-01-01

    The aim of this study was to describe the replantation of a maxillary second right molar, which had been removed for surgical reasons in order to remove a dentigerous cyst associated with the adjacent third molar, and the case’s 12-month follow-up. A 51-year-old man presented swelling in the right maxillary area. Radiographic examination showed a large radiolucency in close proximity to the third molar, suggesting a follicular cyst. The third molar was extracted and the cyst underwent curettage. The second molar had to be extracted to enable complete removal of the cyst and to achieve primary closure of the wound, which would have been impossible without repositioning the molar. With this objective, extraoral endodontic treatment was performed, the root-end was resected and prepared with ultrasonic retrotips, and root-end filling was accomplished with MTA before the molar was replanted. At the 12-month follow-up, the tooth showed no clinical signs or symptoms, probing depth was no greater than 3 mm and radiographic examination showed no evidence of root resorption or periapical lesion. Key words:Replantation, maxillary molar, follicular cyst, dentigerous cyst. PMID:24790721

  17. 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.

  18. Body composition and weight gain in new users of the three-monthly injectable contraceptive, depot-medroxyprogesterone acetate, after 12 months of follow-up.

    PubMed

    dos Santos, Priscilla de Nazaré Silva; Modesto, Waleska Oliveira; Dal'Ava, Nathalia; Bahamondes, Maria Valéria; Pavin, Elizabeth João; Fernandes, Arlete

    2014-12-01

    To evaluate weight gain and body composition (BC) in new users of depot-medroxyprogesterone acetate (DMPA) as a contraceptive. This cohort study followed up 20 DMPA users and 20 copper intrauterine device (TCu380A IUD) users, paired for age (± 1 year) and body mass index (BMI ± 1 kg/m(2)), during 12-months. Healthy, non-obese women aged 18 to 40 years, unaffected by conditions that could influence their body weight, were enrolled. Socio-demographic variables, habits, weight, BMI, BC using dual-energy X-ray absorptiometry, circumferences, skinfold thickness, body fat percentage and waist-to-hip ratio were evaluated. All participants were encouraged to adopt healthy habits. At baseline, median age was 29 and 30.5 years, and mean BMI was 24.8 and 24.5 kg/m(2) in the DMPA and IUD groups, respectively. At 12 months, an increase was observed in waist and hip circumference in the DMPA users and 8/20 of them had a weight gain ≥ 5% (mean 4.6 kg) with accumulation of fat centrally. There were no differences in weight gain or in BC measurements between the groups; nevertheless 40% of women in the DMPA group had larger weight gain and accumulation of fat centrally. The duration of follow-up may have been insufficient to detect differences between the groups.

  19. 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.

  20. In-office endometrial ablation using a third-generation uterine balloon therapy system: 12-month prospective follow-up on menstrual patterns and dysmenorrhea impact.

    PubMed

    Chapa, Hector O; Venegas, Gonzalo; Antonetti, Alfred G; Van Duyne, Charles P; Sandate, Jeffrey; Bakker, Ken

    2009-01-01

    To evaluate the efficiency of in-office Thermachoice III (Ethicon, Somerville, New Jersey) endometrial ablations in resolving menstrual abnormalities as well as dysmenorrhea at 12 months after the procedure. This was a prospective, single arm, cohort study of women from an inner city, community based, physician group medical/ surgical clinic. Diagnostic hysteroscopy, dilation and curettage, and Thermachoice III endometrial ablation were performed under local analgesia. At baseline, N = 148. At 12 months, 23 patients were lost to follow-up, leaving 125 for the evaluable cohort. The largest resulting patient category was amenorrhea, with 66.4% (83 of 125 evaluable), followed by hypomenorrhea at 31% (39 of 125 evaluable). Three patients (2.4%) were considered clinical failures. These 3 patients initially were designated as having hypomenorrhea at 3 months. Dysmenorrhea reduction was statistically significant (p < 0.05) at 6 months and 12 months as compared to baseline. At 1 year after the procedure, the efficiency of in-office Thermachoice III was observed, with high amenorrhea rates as well as persistently decreased dysmenorrhea.

  1. Silicon Matrix Calcium Phosphate as a Bone Substitute: Early Clinical and Radiological Results in a Prospective Study With 12-Month Follow-up

    PubMed Central

    Pesántez, Carlos Fernando Arias; Oliveira, Leonardo

    2008-01-01

    Introduction Autograft has been the “gold standard” for orthopedic bone grafting applications, but with some clinical challenges. Here we present the rationale and clinical outcomes supporting the use of a bone substitute material that consists of a mixture of two calcium phosphates (HA and ß-TCP), which are integrated into a silicon xerogel matrix, promoting nanocrystalline apatite layers on the surface of the material following implantation into a physiological environment. Methods Twenty-four patients with a median age of 53.80 (36–81) years underwent lumbar spinal fusion for degenerative disease, selected by clinical presentation, X-rays, and MRI findings. Subjects were evaluated preoperatively and postoperatively at 1, 3, 6, and 12 months. The outcome assessment consisted of visual analog scale (VAS), Oswestry Disability Index (ODI), and radiological assessment analyzing the state of fusion on X-ray and CT evaluation by 3 independent radiologists. Results All patients completed 12-month follow-up. The mean VAS decreased from 9.3 (± 0.9) to 2.4 (± 1.6) and the mean ODI decreased from 55.0 (± 9.2) to 19.3 (± 11.4) at 12-month follow-up. Three months after surgery, 10 patients (41.67%) had solid fusion based on analysis of CT scans and dynamic radiographs. At 6 months postoperatively, the fusion rate had increased to 75% (18 patients). Twelve months after surgery, 95.83% of patients had solid fusion (23 patients). Conclusions The clinical results from this study of silicon matrix calcium phosphate are consistent with previous in vitro studies indicating that this material stimulates formation of a bioactive layer and provides an effective bone graft material for lumbar fusion applications. In comparison with previous studies involving rhBMP-2, silicon matrix calcium phosphate provided a lower fusion rate at 3- and 6-month follow-up points, but after 12 months, the fusion rate was similar, with no statistical differences and lower overall costs. No

  2. 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

  3. Online mindfulness as a promising method to improve exercise capacity in heart disease: 12-month follow-up of a randomized controlled trial.

    PubMed

    Gotink, Rinske A; Younge, John O; Wery, Machteld F; Utens, Elisabeth M W J; Michels, Michelle; Rizopoulos, Dimitris; van Rossum, Liesbeth F C; Roos-Hesselink, Jolien W; Hunink, Myriam M G

    2017-01-01

    There is increasing evidence that mindfulness can reduce stress, and thereby affect other psychological and physiological outcomes as well. Earlier, we reported the direct 3-month results of an online modified mindfulness-based stress reduction training in patients with heart disease, and now we evaluate the effect at 12-month follow-up. 324 patients (mean age 43.2 years, 53.7% male) were randomized in a 2:1 ratio to additional 3-month online mindfulness training or to usual care alone. The primary outcome was exercise capacity measured with the 6 minute walk test (6MWT). Secondary outcomes were blood pressure, heart rate, respiratory rate, NT-proBNP, cortisol levels (scalp hair sample), mental and physical functioning (SF-36), anxiety and depression (HADS), perceived stress (PSS), and social support (PSSS12). Differences between groups on the repeated outcome measures were analyzed with linear mixed models. At 12-months follow-up, participants showed a trend significant improvement exercise capacity (6MWT: 17.9 meters, p = 0.055) compared to UC. Cohen's D showed significant but small improvement on exercise capacity (d = 0.22; 95%CI 0.05 to 0.39), systolic blood pressure (d = 0.19; 95%CI 0.03 to 0.36), mental functioning (d = 0.22; 95%CI 0.05 to 0.38) and depressive symptomatology (d = 0.18; 95%CI 0.02 to 0.35). All other outcome measures did not change statistically significantly. In the as-treated analysis, systolic blood pressure decreased significantly with 5.5 mmHg (p = 0.045; d = 0.23 (95%CI 0.05-0.41)). Online mindfulness training shows favorable albeit small long-term effects on exercise capacity, systolic blood pressure, mental functioning, and depressive symptomatology in patients with heart disease and might therefore be a beneficial addition to current clinical care. www.trialregister.nl NTR3453.

  4. Handgrip strength is associated with, but poorly predicts, disability in older women with acute low back pain: A 12-month follow-up study.

    PubMed

    Felício, Diogo Carvalho; Diz, Juliano Bergamaschine Mata; Pereira, Daniele Sirineu; Queiroz, Bárbara Zille de; Silva, Juscélio Pereira de; Moreira, Bruno de Souza; Oliveira, Vinícius Cunha; Pereira, Leani Souza Máximo

    2017-10-01

    Older women with low back pain (LBP) constitute a special subpopulation at risk of severe and permanent disability. It is important to identify factors limiting functionality in this population in order to reduce costs and improve both prevention and intervention. Handgrip strength (HGS) is a biomarker of aging associated with several adverse health outcomes, but long-term associations with disability in older patients with LBP are not known. To examine whether HGS predicts disability in older women with acute low back pain (LBP). Longitudinal analyses were conducted with a sample of 135 older women from the international multicenter study Back Complaints in the Elders (BACE-Brazil). Women aged 60 years and over with a new episode of acute LBP were included. HGS was assessed with Jamar(®) dynamometer, and disability was assessed using the Roland Morris questionnaire and gait speed test. Variables were assessed at baseline and at 12-month follow-up. Linear regression models explored associations between HGS and disability measures. Significant association was found between HGS at baseline and gait speed at 12-month follow-up (r=-0.24; p=0.004). A multivariable-adjusted model showed that this association was independent of age, body mass index, and pain intensity (adjusted R(2)=0.13; p<0.001). A final prediction model showed an incremental difference of only 2.1% in gait speed after inclusion of HGS as an independent variable. No association was found between HGS and score on the Roland Morris questionnaire. Caution is needed regarding the use of HGS as a predictive measure of disability in older women with acute LBP. Changes in gait speed were very small and unlikely to be of clinical relevance. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Thought Field Therapy Compared to Cognitive Behavioral Therapy and Wait-List for Agoraphobia: A Randomized, Controlled Study with a 12-Month Follow-up

    PubMed Central

    Irgens, Audun C.; Hoffart, Asle; Nysæter, Tor E.; Haaland, Vegard Ø.; Borge, Finn-Magnus; Pripp, Are H.; Martinsen, Egil W.; Dammen, Toril

    2017-01-01

    Background: Thought field therapy (TFT) is used for many psychiatric conditions, but its efficacy has not been sufficiently documented. Hence, there is a need for studies comparing TFT to well-established treatments. This study compares the efficacy of TFT and cognitive behavioral therapy (CBT) for patients with agoraphobia. Methods: Seventy-two patients were randomized to CBT (N = 24), TFT (N = 24) or a wait-list condition (WLC) (N = 24) after a diagnostic procedure including the MINI PLUS that was performed before treatment or WLC. Following a 3 months waiting period, the WL patients were randomized to CBT (n = 12) or TFT (n = 12), and all patients were reassessed after treatment or waiting period and at 12 months follow-up. At first we compared the three groups CBT, TFT, and WL. After the post WL randomization, we compared CBT (N = 12 + 24 = 36) to TFT (N = 12 + 24 = 36), applying the pre-treatment scores as baseline for all patients. The primary outcome measure was a symptom score from the Anxiety Disorders Interview Scale that was performed by an interviewer blinded to the treatment condition. For statistical comparisons, we used the independent sample’s t-test, the Fisher’s exact test and the ANOVA and ANCOVA tests. Results: Both CBT and TFT showed better results than the WLC (p < 0.001) at post-treatment. Post-treatment and at the 12-month follow-up, there were not significant differences between CBT and TFT (p = 0.33 and p = 0.90, respectively). Conclusion: This paper reports the first study comparing TFT to CBT for any disorder. The study indicated that TFT may be an efficient treatment for patients with agoraphobia. Trial Registration: https://clinicaltrials.gov/, identifier NCT00932919. PMID:28676782

  6. Predictive significance of the overvaluation of shape/weight in obese patients with binge eating disorder: findings from a randomized controlled trial with 12-month follow-up

    PubMed Central

    Grilo, C. M.; White, M. A.; Gueorguieva, R.; Wilson, G. T.; Masheb, R. M.

    2013-01-01

    Background Undue influence of body shape or weight on self-evaluation – referred to as overvaluation – is considered a core feature across eating disorders, but is not a diagnostic requirement for binge eating disorder (BED). This study examined the concurrent and predictive significance of overvaluation of shape/weight in obese patients with BED participating in a randomized clinical trial testing cognitive behavioral therapy (CBT) and behavioral weight loss (BWL). Method A total of 90 participants were randomly assigned to 6-month group treatments of CBT or BWL. Assessments were performed at baseline, throughout- and post-treatment, and at 6- and 12-month follow-ups after completing treatments with reliably administered semi-structured interviews and established measures. Results Participants categorized with overvaluation (n=52, 58%) versus without overvaluation (n=38, 42%) did not differ significantly in demographic features (age, gender and ethnicity), psychiatric co-morbidity, body mass index or binge eating frequency. The overvaluation group had significantly greater levels of eating disorder psychopathology and poorer psychological functioning (higher depression and lower self-esteem) than the non-overvaluation group. Overvaluation of shape/weight significantly predicted non-remission from binge eating and higher frequency of binge eating at the 12-month follow-up, even after adjusting for group differences in depression and self-esteem levels. Conclusions Our findings suggest that overvaluation does not simply reflect concern commensurate with being obese or more frequent binge eating, but also is strongly associated with heightened eating-related psychopathology and psychological distress, and has negative prognostic significance for longer-term treatment outcomes. Overvaluation of shape/weight warrants consideration as a diagnostic specifier for BED as it provides important information about severity and treatment outcome. PMID:22967857

  7. Transient physical and psychosocial activities increase the risk of nonpersistent and persistent low back pain: a case-crossover study with 12 months follow-up.

    PubMed

    Machado, Gustavo C; Ferreira, Paulo H; Maher, Chris G; Latimer, Jane; Steffens, Daniel; Koes, Bart W; Li, Qiang; Ferreira, Manuela L

    2016-12-01

    A previous study has shown that transient physical and psychosocial activities increased the risk of developing low back pain. However, the link between these factors in triggering nonpersistent or persistent episodes remains unclear. We aimed to investigate the association of transient exposures to physical and psychosocial activities with the development of nonpersistent or persistent low back pain. This was a case-crossover study with 12 months follow-up. We included 999 consecutive participants seeking care for a sudden onset of low back pain. Development of low back pain was the outcome measure. At baseline, participants reported transient exposures to 12 predefined activities over the 4 days preceding pain onset. After 12 months, participants were asked whether they had recovered and the date of recovery. Exposures in the 2-hour period preceding pain onset (case window) were compared with the 2-hour period, 24 hours before pain onset (control window) in a case-crossover design for all participants. Conditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CI), and interaction analyses were used to compare estimates of nonpersistent (i.e., <6 weeks duration) and persistent cases. This study received funding from Australia's National Health and Medical Research Council (APP1003608). There were 832 participants (83%) who completed the 12 months follow-up successfully. Of these, 430 participants had nonpersistent low back pain (<6 weeks duration), whereas 352 reported persistent symptoms (≥6 weeks duration). Exposure to several transient activities, such as manual tasks involving heavy loads, awkward postures, live people or animals, moderate or vigorous physical activity, and being fatigued or tired during a task or activity, significantly increased the risk of both nonpersistent and persistent low back pain, with ORs ranging from 2.9 to 11.7. Overall, the risk of developing a persistent or a nonpersistent episode of

  8. Post-discharge follow-up visits and hospital utilization by Medicare patients, 2007-2010.

    PubMed

    DeLia, Derek; Tong, Jian; Gaboda, Dorothy; Casalino, Lawrence P

    2014-01-01

    Document trends in time to post-discharge follow-up visit for Medicare patients with an index admission for heart failure (HF), acute myocardial infarction (AMI), or community-acquired pneumonia (CAP). Determine factors predicting whether the first post-discharge utilization event is a follow-up visit, treat-and-release emergency department (ED) visit, or readmission. Using Medicare claims data from 2007-2010, we plotted annual cumulative incidence functions for the time frame post-discharge to follow-up visit, accounting for competing risks with censoring at 30 days. We used multinomial probit regression to determine factors predicting the probability of first-occurring post-discharge utilization events within 30 days. For each cohort, the cumulative incidence of follow-up visits increased during the study period. For example, in 2010, 54.6% of HF patients had a follow-up visit within 10 days of discharge compared to 47.9% in 2007. Within each cohort, the largest increase in follow-up visits took place between 2008 and 2009. Follow-up visits were less likely for patients who were Black, Hispanic, and enrolled in Medicaid or Medicare Advantage, and they were more likely for patients with greater comorbidities and prior procedures as well as those with private or supplemental Medicare coverage. There were no changes in 30-day readmission rates. Although increases in follow-up visits may have been influenced by the introduction of publicly reported readmission rates in 2009, these increases did not continue in 2010 and were not associated with a change in readmissions. Patients who were Black, Hispanic, and/or enrolled in Medicaid or Medicare Advantage were less likely to have follow-up visits.

  9. Post-Discharge Follow-Up Visits and Hospital Utilization by Medicare Patients, 2007–2010

    PubMed Central

    DeLia, Derek; Tong, Jian; Gaboda, Dorothy; Casalino, Lawrence P

    2014-01-01

    Objective Document trends in time to post-discharge follow-up visit for Medicare patients with an index admission for heart failure (HF), acute myocardial infarction (AMI), or community-acquired pneumonia (CAP). Determine factors predicting whether the first post-discharge utilization event is a follow-up visit, treat-and-release emergency department (ED) visit, or readmission. Methods Using Medicare claims data from 2007–2010, we plotted annual cumulative incidence functions for the time frame post-discharge to follow-up visit, accounting for competing risks with censoring at 30 days. We used multinomial probit regression to determine factors predicting the probability of first-occurring post-discharge utilization events within 30 days. Results For each cohort, the cumulative incidence of follow-up visits increased during the study period. For example, in 2010, 54.6% of HF patients had a follow-up visit within 10 days of discharge compared to 47.9% in 2007. Within each cohort, the largest increase in follow-up visits took place between 2008 and 2009. Follow-up visits were less likely for patients who were Black, Hispanic, and enrolled in Medicaid or Medicare Advantage, and they were more likely for patients with greater comorbidities and prior procedures as well as those with private or supplemental Medicare coverage. There were no changes in 30-day readmission rates. Discussion Although increases in follow-up visits may have been inf luenced by the introduction of publicly reported readmission rates in 2009, these increases did not continue in 2010 and were not associated with a change in readmissions. Patients who were Black, Hispanic, and/or enrolled in Medicaid or Medicare Advantage were less likely to have follow-up visits. PMID:24949226

  10. Socioeconomic position and participation in baseline and follow-up visits: the Inter99 study.

    PubMed

    Bender, Anne M; Jørgensen, Torben; Helbech, Bodil; Linneberg, Allan; Pisinger, Charlotta

    2014-07-01

    The aim of this paper was to identify the extent of socioeconomic inequality in participation at baseline and follow-up visits. The Inter99 study is a randomized intervention with the aim of investigating the effects of an individualized lifestyle consultation on ischaemic heart disease (IHD). The study comprised 61,301 persons of which 13,016 were assigned to the intervention group. The rest formed the control group. All those in the intervention group were invited to participate in health examinations, risk assessments, and lifestyle consultations. Participants at high risk of IHD were invited to follow-up visits after 1, 3, and 5 years. Data on five socioeconomic factors were retrieved from nationwide registers. For each socioeconomic factor we estimated the relative risks and relative index of inequality of participation at the baseline visit and among high-risk participants at follow-up visits. In addition, we conducted analyses of trends in socioeconomic inequality in participation across follow-up visits. Participation rates were 53% at baseline and 61-65% at the three follow-up visits. There was strong socioeconomic inequality in participation at baseline, with increasing probability of participation found with increasing level of socioeconomic position. This was smaller at follow-up visits. Except for education and housing tenure, there was an increase in socioeconomic inequality in participation across follow-up visits. We found strong socioeconomic inequality in participation at baseline and follow-up visits. Effort should be made to increase participation in individualized lifestyle interventions among persons of low socioeconomic position. Otherwise, the consequence may be increased socioeconomic inequality in IHD. © The European Society of Cardiology 2012 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  11. Efficacy and safety of porcine collagen filler for nasolabial fold correction in Asians: a prospective multicenter, 12 months follow-up study.

    PubMed

    Lee, Jung Ho; Choi, Yong Sung; Kim, Sue Min; Kim, Young Jin; Rhie, Jong Won; Jun, Young Joon

    2014-11-01

    Recently, injectable dermal fillers have become important alternatives to surgical procedures for the correction of facial wrinkles. Bovine collagen is the first approved material for filler injection, and several studies have shown its efficacy. However, the risk of developing an allergic reaction and xenogenic transmission of bovine spongiform encephalopathy remain among its disadvantages. In this randomized, double-blinded, split-face study, we compared the efficacy and safety of a porcine collagen filler (TheraFill®) with that of a bovine collagen filler (KOKEN®) for nasolabial fold correction. A total of sixty one patients with mild to severe nasolabial fold were randomized to receive TheraFill® and KOKEN® on contralateral sides of the face. During the 12-month follow-up period, improvement in the Wrinkle-Severity Rating Scale score was slightly higher in TheraFill® group than KOKEN® group, although the difference was not statistically significant. No serious adverse reactions were observed and both materials were tolerable in most cases. In conclusion, the long-term effect of TheraFill® on nasolabial fold correction was comparable to that of KOKEN®, and it may be a good alternative to bovine collagen filler.

  12. Cardiac surgery patients' evaluation of the quality of theatre nurse postoperative follow-up visit.

    PubMed

    Falk-Brynhildsen, Karin; Nilsson, Ulrica

    2009-06-01

    Theatre nurses at the Department of Cardiothoracic Surgery in Orebro, Sweden, have since 2001 routinely conducted a follow-up visit to postoperative cardiac patients. A model with a standardized information part and an individual-caring conversation including both a retrospective and a prospective part designed the visit. The purpose of this study was to evaluate the quality of the postoperative follow-up visit conducted by the theatre nurses and find out if the quality was related to gender or type of admission. The method was prospective and explorative, including 74 cardiac surgery patients who had had a postoperative follow-up visit by a theatre nurse in Sweden. The instrument measuring quality, from the patient's perspective, measured the quality of the visit, and consisted of 16 items modified to suit the study. The results showed an overall high quality rating, with statistically significant higher scores for six items between patients who had undergone emergency surgery, in comparison with elective patients. When comparing gender, women had statistically significant higher scores in two items. In conclusion, this postoperative follow-up visit by the theatre nurse was a valuable and useful tool especially for the patients who had undergone emergency surgery. In the follow-up visit the theatre nurse creates a caring relationship by meeting the patient as an individual with his/her own experience and needs for information about the surgery, intra and postoperative care, and recovery.

  13. Double-blind, 12 month follow-up, placebo-controlled trial of mifepristone on cognition in alcoholics: the MIFCOG trial protocol.

    PubMed

    Donoghue, Kim; Rose, Abigail; Coulton, Simon; Milward, Joanna; Reed, Kylie; Drummond, Colin; Little, Hilary

    2016-02-24

    Increased levels of cortisol during acute alcohol withdrawal have been linked to cognitive deficits and depression. Preclinical research found that the glucocorticoid Type II receptor antagonist, mifepristone, prevented some of the neurotoxic effects of withdrawal and memory loss. Clinical trials have shown mifepristone effective in the treatment of depression. This study aims to examine the extent to which the glucocorticoid Type II receptor antagonist, mifepristone, when given to alcohol dependent males during the acute phase of alcohol withdrawal, will protect against the subsequent memory loss and depressive symptoms during abstinence from alcohol. The study is a Phase 4 therapeutic use, "Proof of Concept" trial. The trial is a double-blind randomised controlled clinical trial of mifepristone versus inactive placebo. The trial aims to recruit 120 participants referred for an inpatient alcohol detoxification from community alcohol teams, who meet the inclusion criteria; 1) Male, 2) Aged 18-60 inclusive, 3) alcohol dependent for 5 or more years. A screening appointment will take place prior to admission to inpatient alcohol treatment units to ensure that the individual is suitable for inclusion in the trial in accordance with the inclusion and exclusion criteria. On admission participants are randomised to receive 600 mg a day of mifepristone (200 mg morning, afternoon and evening) for 7 days and 400 mg for the subsequent 7 days (200 mg morning and evening) or the equivalent number of placebo tablets for 14 days. Participants will remain in the trial for 4 weeks (at least 2 weeks as an inpatient) and will be followed up at 3, 6 and 12 months post randomisation. Primary outcome measures are cognitive function at week 3 and 4 after cessation of drinking and symptoms of depression over the 4 weeks after cession of drinking, measured using the Cambridge Neuropsychological Test Automated battery and Beck Depression Inventory, respectively. Secondary outcome measures

  14. Improving the use of early follow-up care after emergency department visits. A randomized trial.

    PubMed

    Nelson, E W; Van Cleve, S; Swartz, M K; Kessen, W; McCarthy, P L

    1991-04-01

    To test the hypothesis that the appropriateness of parents' use of early follow-up care after emergency department (ED) visits can be improved by postvisit support from a nurse practitioner. Randomized controlled trial, single blinded. Urban university hospital ED linked to hospital's primary care center. Parents of 190 children younger than 8 years who sought care in the ED for acute illnesses and who were treated as outpatients with primary care center follow-up at the discretion of ED clinicians. Parents in the experimental group were called by a nurse practitioner who offered both individualized guidance regarding follow-up and access to a nurse practitioner for further help as needed. The control group received "usual" follow-up advice during ED visits. In the week after the ED visits, parents in the experimental group, compared with parents in the control group, were more compliant with instructions regarding follow-up (79% vs 61%), less apt to miss appointments (15% vs 31%), and less apt to "shop" elsewhere for care (2% vs 9%). Appropriateness of follow-up was assessed in "blinded" fashion using preestablished guidelines. Inappropriate use of follow-up care was significantly reduced among experimental group subjects (10% vs 20%). The nurse practitioner's intervention improved parents' use of follow-up care in our sample. Overall care for episodic ED users might be improved by similar interventions.

  15. Predictors of Change in Physical Activity and Fruit and Vegetable Intake in a Multiethnic Population in Hawaii at 6 and 12 Months Follow-up

    PubMed Central

    Galloway, Joy C.; Nigg, Claudio R.; Liu, Min; Banna, Jinan C.

    2016-01-01

    Health-promoting behaviors have been shown to co-exist, but it is unknown if decisional balance with regards to one health behavior may predict change in another behavior. The objective of this study was to examine the relationship between benefits (pros) and costs (cons) of fruit and vegetable (FV) intake and physical activity (PA) and behavior over time, both within behaviors and transbehaviorally. This longitudinal study was conducted in multiethnic adults in Hawaii (n = 700; 63% female; mean age = 47 years; mean BMI = 25.9; mean education = 14.5 years, average household income = $45,000/year). Questionnaires assessed PA and FV pros/cons on a 5-point Likert Scale, PA (MET-min/wk), and FV intake (servings/day). Multiple regression was used to examine the relationship between pros/cons for PA and FV intake and behavior at 6- and 12-month follow-up. At baseline, average FV pros were 4.08 (.91), and average FV cons were 1.88 (.90). Average baseline PA pros were 4.07 (.89), and average PA cons were 1.71 (.77). Multiple regressions revealed that baseline FV pros and cons predicted FV intake, FV cons also predicted PA, and PA pros and cons were not predictive of PA or of FV intake. Study findings provide some support for decisional balance as a useful core construct used in leading theories of behavior change. Improving decisional balance for FV intake may have a beneficial effect on FV intake and potentially PA, indicating a potential gateway effect of decisional balance for FV intake on other behaviors. PMID:27525198

  16. Determining the rate of follow-up after hospital emergency department visits for dental conditions.

    PubMed

    Meyer, Beau; Adkins, Eric; Finnerty, Nathan M; Robinson, Fonda G

    2016-01-01

    Emergency department (ED) visits for dental reasons continue to impact EDs nationwide. This investigation determined the rate of follow-up in an emergency dental clinic (EDC) after hospital ED visits for nontraumatic dental conditions. This prospective investigation reports the number of patients who presented to an ED for nontraumatic dental conditions and the rate of follow-up at an EDC. Upon ED discharge, patients were provided instructions to follow-up for low-cost care at the EDC. Telephone contact was attempted following failed referrals. Descriptive statistics were reported for comparing referral sources and demographic trends. Two hundred and forty-seven referrals were made and 31% followed up for definitive treatment at the EDC. More referrals were made on weekends than on weekdays. Failed referrals were unreachable by telephone in 75% of cases. Tooth extraction was the most common treatment rendered in the EDC. Of the ED patients who accessed EDC care, 14% became comprehensive patients in the EDC's regular dental clinic. Less than one-third of ED referrals to the EDC followed up for definitive care when provided an opportunity to do so, and 75% of referrals were unreachable by telephone in the week following the ED dental visit.

  17. Determining the rate of follow-up after hospital emergency department visits for dental conditions

    PubMed Central

    Meyer, Beau; Adkins, Eric; Finnerty, Nathan M; Robinson, Fonda G

    2016-01-01

    Background Emergency department (ED) visits for dental reasons continue to impact EDs nationwide. This investigation determined the rate of follow-up in an emergency dental clinic (EDC) after hospital ED visits for nontraumatic dental conditions. Methods This prospective investigation reports the number of patients who presented to an ED for nontraumatic dental conditions and the rate of follow-up at an EDC. Upon ED discharge, patients were provided instructions to follow-up for low-cost care at the EDC. Telephone contact was attempted following failed referrals. Descriptive statistics were reported for comparing referral sources and demographic trends. Results Two hundred and forty-seven referrals were made and 31% followed up for definitive treatment at the EDC. More referrals were made on weekends than on weekdays. Failed referrals were unreachable by telephone in 75% of cases. Tooth extraction was the most common treatment rendered in the EDC. Of the ED patients who accessed EDC care, 14% became comprehensive patients in the EDC’s regular dental clinic. Conclusion Less than one-third of ED referrals to the EDC followed up for definitive care when provided an opportunity to do so, and 75% of referrals were unreachable by telephone in the week following the ED dental visit. PMID:27099530

  18. 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…

  19. 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…

  20. A randomized comparison of home visits and hospital-based group follow-up visits after early postpartum discharge.

    PubMed

    Escobar, G J; Braveman, P A; Ackerson, L; Odouli, R; Coleman-Phox, K; Capra, A M; Wong, C; Lieu, T A

    2001-09-01

    Short postpartum stays are common. Current guidelines provide scant guidance on how routine follow-up of newly discharged mother-infant pairs should be performed. We aimed to compare 2 short-term (within 72 hours of discharge) follow-up strategies for low-risk mother-infant pairs with postpartum length of stay (LOS) of <48 hours: home visits by a nurse and hospital-based follow-up anchored in group visits. We used a randomized clinical trial design with intention-to-treat analysis in an integrated managed care setting that serves a largely middle class population. Mother-infant pairs that met LOS and risk criteria were randomized to the control arm (hospital-based follow-up) or to the intervention arm (home nurse visit). Clinical utilization and costs were studied using computerized databases and chart review. Breastfeeding continuation, maternal depressive symptoms, and maternal satisfaction were assessed by means of telephone interviews at 2 weeks postpartum. During a 17-month period in 1998 to 1999, we enrolled and randomized 1014 mother-infant pairs (506 to the control group and 508 to the intervention group). There were no significant differences between the study groups with respect to maternal age, race, education, household income, parity, previous breastfeeding experience, early initiation of prenatal care, or postpartum LOS. There were no differences with respect to neonatal LOS or Apgar scores. In the control group, 264 mother-infant pairs had an individual visit only, 157 had a group visit only, 64 had both a group and an individual visit, 4 had a home health and a hospital-based follow-up, 13 had no follow-up within 72 hours, and 4 were lost to follow-up. With respect to outcomes within 2 weeks after discharge, there were no significant differences in newborn or maternal hospitalizations or urgent care visits, breastfeeding discontinuation, maternal depressive symptoms, or a combined clinical outcome measure indicating whether a mother-infant pair had

  1. 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

  2. Patients visiting the emergency room for seizures: insurance status and clinic follow-up.

    PubMed

    Farhidvash, Fariba; Singh, Pradumna; Abou-Khalil, Bassel; Arain, Amir

    2009-11-01

    Epilepsy is a chronic condition that is best treated in the outpatient clinic setting. However, many epilepsy patients use the hospital emergency room (ER) as a primary resource for seizure management. We studied characteristics of these patients in comparison with patients attending an epilepsy clinic. We reviewed ER data of patients seen in 2002 and 2003 for seizures, in Vanderbilt University Hospital (VUH) and Metro Nashville General Hospital (MNGH), seeking to identify patients who had visited the emergency room more than once. We collected demographic and insurance information on these patients and identified those who followed up in the epilepsy clinic. There were 1005 patients who visited the VUH ER and 205 the MNGH ER for seizures. Patients visiting the ER for seizures were less likely to be insured than epilepsy patients followed in the clinic, in both institutions. The proportion of patients visiting the ER more than once was 15.2% at VUH and 29.2% at MNGH. Among these patients, 3.2% at VUH and 26.7% at MNGH were uninsured. Clinic follow-up occurred in 68.6% of VUH and 13.3% of MNGH repeat ER visitors. Combining institutions, insured patients were much more likely to follow-up in the clinic. Repeated use of the ER for seizures was more common in the county hospital, where the proportion of uninsured patients was also higher. Patients visiting the county hospital ER repeatedly tend not to follow-up in the neurology clinic. This element of disparity of care requires further attention.

  3. Simplified follow-up after early medical abortion: 12-month experience of a telephone call and self-performed low-sensitivity urine pregnancy test.

    PubMed

    Michie, Lucy; Cameron, Sharon T

    2014-05-01

    The objective was to determine if simplified follow-up after early medical abortion, consisting of a telephone call 2 weeks after the procedure plus a self-performed low-sensitivity urine pregnancy (LSUP) test, was successful for screening for ongoing pregnancies in the year following its introduction as standard service. A retrospective computerized database review of 1084 women at a hospital abortion service in Edinburgh, UK, who had a medical abortion (≤9 weeks) and went home to expel the pregnancy was performed. Women who screened 'positive' at telephone follow-up on the basis of ongoing pregnancy symptoms, scant bleeding or LSUP test result were scheduled for an ultrasound. The main outcome measures were the proportion of women scheduled for telephone follow-up successfully contacted and the proportion of ongoing pregnancies detected. A total of 943 women were scheduled for telephone follow-up. Ten women presented to the hospital before the time of the follow-up call. Of the remaining 933 women, 656 [70%, 95% confidence interval (CI) 67.7-73.2] were successfully contacted. Five hundred seventy-three (87%, 95% CI 84.5-89.7) of those contacted screened 'negative'; no false negatives occurred. Eighty-three (13%, 95% CI 10.2-15.5) screened 'positive,' and of those, three had ongoing pregnancies. Of the 277 (30%, 95% CI 26.7-32.7) who were not contacted, two ongoing pregnancies occurred. The sensitivity of telephone follow-up with LSUP to detect ongoing pregnancy was 100% (95% CI 30.9%-100%), and specificity was 88% (95% CI 84.9%-90.1%). The negative predictive value was 100% (95% CI 99.1%-100%), and positive predictive value was 3.6% (95% CI 0.9%-10.9%). A telephone call and LSUP test at 2 weeks are suitable as a standard method of follow-up for screening for ongoing pregnancy after early medical abortion. For most women, a routine clinic follow-up after early medical abortion (to exclude ongoing pregnancy) can be replaced with a telephone call and a self

  4. Predictors of changes in physical, psychosocial, sexual quality of life, and comfort with food after obesity surgery: a 12-month follow-up study.

    PubMed

    Brunault, Paul; Frammery, Julie; Couet, Charles; Delbachian, Irène; Bourbao-Tournois, Céline; Objois, Martine; Cosson, Patricia; Réveillère, Christian; Ballon, Nicolas

    2015-02-01

    Although obesity surgery provides significant postoperative improvement in quality of life (QoL), it is still unclear which factors might predict improvement in QoL after surgery. We aimed to determine which factors might predict changes in physical, psychosocial, sexual QoL, and comfort with food 12 months after surgery, by putting to the test a QoL model based on Wilson and Cleary's model. We included 126 obese patients (48.4% had gastric banding, 34.1% had sleeve gastrectomy, and 17.5% had gastric bypass). At baseline, we assessed QoL (Quality of Life, Obesity and Dietetics rating scale), BMI, depression (Beck Depression Inventory), and binge eating (Bulimic Investigatory Test, Edinburgh). At 12 months, we assessed QoL and BMI. To determine the predictors for changes in each QoL dimension after surgery, we used linear mixed models adjusted for preoperative age, BMI, time, type of surgery, preoperative binge eating severity, and preoperative depression severity. After 12 months, we found significant improvement in physical, psychosocial, sexual QoL, but not in comfort with food. Increased weight loss was associated with better improvement in physical and psychosocial QoL. Higher preoperative depression severity predicted poorer improvement in physical, psychosocial, and sexual QoL. Higher preoperative binge eating severity predicted poorer improvement in psychosocial, sexual QoL, and comfort with food. In addition to weight loss, preoperative levels of binge eating and depression should be considered as important predictors for QoL changes after bariatric surgery. Screening and treatment for preoperative depression and binge eating might improve QoL after bariatric surgery.

  5. Body composition, resting energy expenditure and inflammatory markers: impact in users of depot medroxyprogesterone acetate after 12 months follow-up.

    PubMed

    Batista, Gisele Almeida; Souza, Aglécio Luiz de; Marin, Daniela Miguel; Sider, Marina; Melhado, Vaneska Carvalho; Fernandes, Arlete Maria; Alegre, Sarah Monte

    2017-01-01

    The aim of this study was to evaluate for 12 months the changes of body weight using Depot Medroxyprogesterone Acetate (DMPA) and if these changes are related to inflammatory markers. Twenty women of childbearing age who chose the DMPA, without previous use of this method, BMI < 30 kg/m2, and 17 women using IUD TCu 380A, participated in the study. At the baseline and after one year, changes in weight gain, body composition by the bioimpedance electric method, resting energy expenditure (REE) by the indirect calorimetry method, inflammatory markers and HOMA-IR were assessed. After 12 months of evaluation, we could observe a significant increase in the DMPA group in weight (3,01 kg) and BMI, while the IUD group's only significant increase was observed in the BMI. Relative to REE there was an increase of basal metabolic rate (BMR) in both groups after one year. The sub-group DMPA that gained < 3 kg had increased significant weight, BMI and body surface (BS) with respiratory quotient (RQ) reduction, while the sub-group that gained ≥ 3 kg had a significant increase in weight, BMI, BS, fat-free mass, fat mass, BMR, Leptin, HOMA-IR and waist circumference, with RQ significantly reduced. Our study found significant changes in weight, body composition and metabolic profile of the population studied in the first 12 months of contraceptive use. These changes mainly increased body weight, leptin levels and HOMA-IR which can contribute to the development of some chronic complications, including obesity, insulin resistance and diabetes mellitus.

  6. Distance to clinic and follow-up visit compliance in adolescent gastric bypass cohort.

    PubMed

    Jenkins, Todd M; Xanthakos, Stavra A; Zeller, Meg H; Barnett, Sean J; Inge, Thomas H

    2011-01-01

    Regular follow-up after bariatric surgery is important to assess the clinical status. Various factors could influence retention (i.e., compliance with clinical follow-up). The present analysis tested the hypothesis that the distance from the center will influence clinical retention for adolescent bariatric surgery patients. Our aim was to determine whether the distance to the clinic, and other patient characteristics, would predict clinical follow-up compliance. The present study was conducted at a tertiary care, free-standing children's hospital. The Follow-up of Adolescent Bariatric Surgery (FABS) study is a single-center cohort study collecting demographic and clinical information. The subjects' addresses were geocoded, and the distance to the clinic was calculated. A generalized estimating equations model was used to examine follow-up visit compliance. A total of 71 subjects underwent Roux-en-Y gastric bypass surgery (RYGB), with a mean body mass index of 59 kg/m(2). The average distance to the clinic was 98 miles. Retention declined over time (6 mo, 94%; 1 yr, 89%; 2 yr, 69%; P < .01); however, distance was not associated with retention (P = .68). Age at surgery was inversely related to retention (P = .04). Compliance with clinical follow-up decreased 1 and 2 years after RYGB in adolescents. The distance from the center was not associated with follow-up regimen compliance. However, increasing age was associated with decreased retention. Additional research should focus on determining the modifiable factors that influence retention. Copyright © 2011. Published by Elsevier Inc.

  7. Distance to clinic and follow-up visit compliance in adolescent gastric bypass cohort

    PubMed Central

    Jenkins, Todd M.; Xanthakos, Stavra A.; Zeller, Meg H.; Barnett, Sean J.; Inge, Thomas H.

    2015-01-01

    Background Regular follow-up after bariatric surgery is important to assess the clinical status. Various factors could influence retention (i.e., compliance with clinical follow-up). The present analysis tested the hypothesis that the distance from the center will influence clinical retention for adolescent bariatric surgery patients. Our aim was to determine whether the distance to the clinic, and other patient characteristics, would predict clinical follow-up compliance. The present study was conducted at a tertiary care, free-standing children’s hospital. Methods The Follow-up of Adolescent Bariatric Surgery (FABS) study is a single-center cohort study collecting demographic and clinical information. The subjects’ addresses were geocoded, and the distance to the clinic was calculated. A generalized estimating equations model was used to examine follow-up visit compliance. Results A total of 71 subjects underwent Roux-en-Y gastric bypass surgery (RYGB), with a mean body mass index of 59 kg/m2. The average distance to the clinic was 98 miles. Retention declined over time (6 mo, 94%; 1 yr, 89%; 2 yr, 69%; P < .01); however, distance was not associated with retention (P = .68). Age at surgery was inversely related to retention (P = .04). Conclusion Compliance with clinical follow-up decreased 1 and 2 years after RYGB in adolescents. The distance from the center was not associated with follow-up regimen compliance. However, increasing age was associated with decreased retention. Additional research should focus on determining the modifiable factors that influence retention. PMID:21511537

  8. Levonorgestrel-releasing intrauterine device in the treatment of abnormal uterine bleeding: a 6- and 12-month morphological and clinical follow-up.

    PubMed

    Palmara, Vittorio; Sturlese, Emanuele; Villari, Daniela; Giacobbe, Valentina; Retto, Annalisa; Santoro, Giuseppe

    2013-08-01

    Abnormal uterine bleeding is defined as any alteration in the pattern or volume of menstrual blood flow, and it is preferably treated using hysterectomy, endometrial destruction or the levonorgestrel-releasing intrauterine system (Mirena(®) ). Recently, it has been demonstrated that studies of Mirena(®) were generally small and consequently imprecise. Our study was aimed at assessing the effects of a slow-release levonorgestrel (20 μg/day) intrauterine device in fertile and postmenopausal women experiencing abnormal uterine bleeding that did not respond to traditional medical management. A total of 40 women, of whom 24 were of reproductive capacity and 16 were postmenopausal, were enrolled in the trial. Removal of the intrauterine device was required for only 2 of the 24 fertile women and for only 3 of the 16 postmenopausal women. After 6 and 12 months of treatment, the remaining women were clinically evaluated and underwent ultrasound and hysteroscopy using biopsy specimens as a control. The EuroQol Group EQ-5D questionnaire was used for evaluation of quality of life. The device showed good tolerability and efficacy. It resulted in a reduction in the endometrial mucosal thickness with a regression of bleeding and collateral effects, which were more evident after 12 months of treatment. A positive effect of the device on the woman's quality of life was demonstrated. The slow-release levonorgestrel intrauterine device may be a valid therapeutic tool for treating basic symptomatology and increasing quality of life in women with abnormal uterine bleeding. © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  9. Follow-up after a pediatric emergency department visit: telephone versus e-mail?

    PubMed

    Goldman, Ran D; Mehrotra, Shruti; Pinto, Tanya R; Mounstephen, William

    2004-10-01

    The Internet has become in recent years an unlimited source of health-related information and revolutionized health information access. Follow-up after an emergency department (ED) visit is important for continuity of care but is difficult to achieve. We conducted this study to determine whether e-mail could become a method for a follow-up contact after leaving the pediatric ED. Over a 2-month period, parents who had a telephone line and e-mail access and whose child was discharged from the ED at the Hospital for Sick Children in Toronto were randomized to receive an e-mail or a telephone follow-up. Main outcome measure was the response rates by parents to the telephone or e-mail. A total of 265 (79%) of the 337 families who were approached had Internet access, and the majority (75%) check e-mails at least once a day. Eighty-seven percent (85 of 98) and 53% (53 of 100) of the families who were contacted by telephone or e-mail, respectively, were reached within an average of 17 and 46 hours, respectively. Fourteen percent of families from the study population were unreachable either by telephone or by e-mail. Most (57%) parents who did not respond to the e-mail did not check or did not remember reading the e-mail or had trouble with access. Ten percent of the e-mails were undeliverable. The telephone is better than e-mail as a follow-up channel with families of children who visit the pediatric ED. The main reason for not responding to e-mails is "technical problems." E-mail could be a mean for follow-up contact for part of our patient population, especially for nonurgent purposes.

  10. Rural Medicare Beneficiaries Have Fewer Follow-up Visits and Greater Emergency Department Use Postdischarge.

    PubMed

    Toth, Matthew; Holmes, Mark; Van Houtven, Courtney; Toles, Mark; Weinberger, Morris; Silberman, Pam

    2015-09-01

    Hospitals are focused on improving postdischarge services for older adults, such as early follow-up care after hospitalization to reduce readmissions and unnecessary emergency department (ED) use. Rural Medicare beneficiaries face many barriers to receiving quality care, but little is known about their postdischarge care and outcomes. We hypothesize that rural Medicare beneficiaries compared with urban beneficiaries, will have fewer follow-up visits, and a greater likelihood of readmission and ED use. We conducted a retrospective analysis of elderly Medicare beneficiaries discharged home using the Medicare Current Beneficiary Survey, Cost and Use files, 2000-2010. Multivariate Cox proportional hazard models were used to assess the risk of rural residency on readmission, ED use, and follow-up care up to 30 days' postdischarge. Covariates include demographic, health, and hospital-level characteristics. Compared with urban beneficiaries, Medicare beneficiaries living in isolated rural settings had a lower rate of follow-up care [hazard ratio (HR)=0.81, P<0.001]. Beneficiaries in large and small rural settings had a greater risk of an ED visit compared with urban beneficiaries (HR=1.44, P<0.001; HR=1.52, P<0.01). Rural beneficiaries did not have a greater risk of readmission, though risk of readmission was higher for beneficiaries discharged from hospitals in large and small rural settings (HR=1.33, P<0.05; HR=1.42, P<0.05). This study provides evidence of lower quality postdischarge care for Medicare beneficiaries in rural settings. As readmission penalties expand, hospitals serving rural beneficiaries may be disproportionately affected. This suggests a need for policies that increase follow-up care in rural settings.

  11. Randomized controlled trial of a computer-tailored multiple health behaviour intervention in general practice: 12-month follow-up results.

    PubMed

    Parekh, Sanjoti; King, David; Boyle, Frances M; Vandelanotte, Corneel

    2014-03-19

    Effective strategies to address risk factors of non-communicable diseases are required to curtail the expanding costs of health care. This trial tested the effectiveness over one year of a minimal intervention targeting multiple health behaviours (diet, physical activity, alcohol and smoking) in a general practice setting, through the provision of personalised, computer-tailored feedback. Patients who had attended a general practice in the previous 6 months were recruited from 21 general practitioners in Brisbane, Australia. Baseline data were collected using self-reports on adherence to ten health behaviours and summarised into a health score from 0 to 10. This randomised controlled trial used a 2×2 factorial design, with one arm randomising subjects to the intervention or control group. The other arm was either feedback at baseline (single contact) or an additional assessment with feedback at 3 months (dual contact). As such, 4 study groups created were, to which participants were randomised blindly: A. Intervention with single contact; B. Intervention with dual contact; C. Control with single contact and D. Control with dual contact. All participants were assessed again at 12 months. Of the 4676 participants randomised, 3065 completed questionnaires at 12 months. Both single and dual contact groups improved their 10 item health scores (+0.31 and +0.49 respectively) relative to control group outcomes (+0.02; p<0.01). Improvement in adherence to guidelines for fish intake, type of milk consumed, vegetable and fruit intake, and alcohol intake were observed in single and dual contact intervention groups (p<0.01). Both intervention groups showed greater improvement than controls for individual health behaviours, apart from red meat intake, smoking behaviour, physical activity and body weight. Interestingly, there was an improvement in reported non-smoking rates in both intervention and control groups (3% single contact; 4.5% dual contact). Small but meaningful long

  12. 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. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Long-term adherence to the New Nordic Diet and the effects on body weight, anthropometry and blood pressure: a 12-month follow-up study.

    PubMed

    Poulsen, Sanne Kellebjerg; Crone, Charlotte; Astrup, Arne; Larsen, Thomas Meinert

    2015-02-01

    The New Nordic Diet (NND) has induced weight loss in a 26-week controlled intervention. We aim to investigate whether high compliance and satisfaction can be maintained after the active intervention is discontinued thereby maintaining the health effects. After 26 weeks of intervention with NND or Average Danish Diet (ADD), 147 participants (mean age 43 years and mean BMI 29.1 kg/m²) were followed for further 52 weeks. All participants were encouraged to follow NND but without further guidance. The study is registered with ClinicalTrials.gov, study id NCT01195610. One hundred and ten participants (75%) completed the follow-up. Among participants previously randomised to NND (NND group), dietary compliance and satisfaction decreased from 4.3 to 3.0 and from 4.8 to 4.0, respectively (both p < 0.0001) (1-5 point scale). Among those originally randomised to ADD (ADD group), satisfaction with NND was significantly higher than with ADD during follow-up (3.3 vs. 2.5, p = 0.026). Weight losses during intervention of -6.2 kg and -3.0 kg were followed by regains of 4.6 kg (SE 0.5) and 1.1 kg (SE 0.7) for the NND group and ADD group, respectively [adjusted difference; mean (95 % CI): 1.8 kg (0.1-3.4), p = 0.041]. Across diet groups, every 1 score higher in compliance with NND was associated with 0.90 kg less body weight regain (p = 0.026) and those who increased physical activity regained 3.4 kg less compared to those who did not (p < 0.0001). NND provides higher satisfaction, and body weight regain is reduced with higher compliance with NND and increased physical activity.

  14. Impact of newborn follow-up visit timing on subsequent ED visits and hospital readmissions: an instrumental variable analysis.

    PubMed

    O'Donnell, Heather C; Colman, Gregory; Trachtman, Rebecca A; Velazco, Nerissa; Racine, Andrew D

    2014-01-01

    To determine whether newborn first outpatient visit (FOV) within 3 days of discharge is associated with reduced rates of emergency department (ED) visits and hospital readmissions. Retrospective cohort analysis was performed of all newborns who were born and had outpatient follow-up within a large academic medical center to determine whether they had ED visits or hospital readmission within 2 weeks after hospital discharge. Multivariable regression using an instrumental variable for timing of FOV was conducted to estimate the relationship between FOV within 3 days of discharge and ED visits and hospital readmissions within 2 weeks of discharge, adjusting for potential confounders. Stratified analyses assessed this relationship in subpopulations with medical or social risk factors. Of 3282 newborns, 178 (5%) had 1 or more ED visits or hospital readmissions within 2 weeks of hospital discharge. FOV within 3 days was not significantly associated with ED visits and readmissions in the instrumental variable analysis (IVA) (-0.035, P = .11) or the ordinary least squares analysis (OLS) (0.006, P = .52). The difference in coefficients between these analyses, however, suggests that IVA successfully adjusted for some unmeasured bias. In stratified analyses, only newborns born to African American mothers or discharged by family medicine providers demonstrated a significant relationship between FOV within 3 days and reduced odds of ED visits and readmissions. No significant relationship between outpatient visit timing and ED visits and hospital readmissions was found. Further study is needed to assess the impact of early outpatient visits on other newborn outcomes. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  15. 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.

  16. 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

  17. Durability of treatment effects of the Sleep Position Trainer versus oral appliance therapy in positional OSA: 12-month follow-up of a randomized controlled trial.

    PubMed

    de Ruiter, Maurits H T; Benoist, Linda B L; de Vries, Nico; de Lange, Jan

    2017-09-15

    The Sleep Position Trainer (SPT) is a new option for treating patients with positional obstructive sleep apnea (POSA). This study investigated long-term efficacy, adherence, and quality of life during use of the SPT device compared with oral appliance therapy (OAT) in patients with POSA. This prospective, multicenter trial randomized patients with mild to moderate POSA (apnea-hypopnea index [AHI] 5-30/h) to SPT or OAT. Polysomnography was performed at baseline and after 3 and 12 months' follow-up. The primary endpoint was OSA severity; adherence, quality of life, and adverse events were also assessed. Ninety-nine patients were randomized and 58 completed the study (29 in each group). Median AHI in the SPT group decreased from 13.2/h at baseline to 7.1/h after 12 months (P < 0.001); corresponding values in the OAT group were 13.4/h and 5.0/h (P < 0.001), with no significant between-group difference (P = 1.000). Improvements throughout the study were maintained at 12 months. Long-term median adherence was also similar in the two treatment groups; the proportion of patients who used their device for ≥ 4 h for 5 days in a week was 100% in the SPT group and 97.0% in the OAT group (P = 0.598). The efficacy of SPT therapy was maintained over 12 months and was comparable to that of OAT in patients with mild to moderate POSA. Adherence was relatively high, and similar in the two groups. www.clinicaltrials.gov (NCT02045576).

  18. Alternatives to a routine follow-up visit for early medical abortion.

    PubMed

    Clark, Wesley; Bracken, Hillary; Tanenhaus, Jini; Schweikert, Suzanne; Lichtenberg, E Steve; Winikoff, Beverly

    2010-02-01

    To evaluate the ability of women and their providers to assess abortion outcome without the routine use of ultrasonography. This multicenter trial enrolled 4,484 women seeking medical abortion at 10 clinics in the United States. Women received the standard medical abortion care with mifepristone-misoprostol in those clinics and blinded clinical assessments before follow-up ultrasonography. Data were collected prospectively on abortion outcomes, receipt of additional treatment, and clinical, laboratory, and ultrasound assessments associated with the procedure. We constructed five model algorithms for evaluating women's postabortion status, each using a different assortment of data. Four of the algorithms (algorithms 1-4) rely on data collected by the woman and on the results of the low-sensitivity pregnancy test. Algorithm 5 relies on the woman's assessment, the results of the pregnancy test, and follow-up physician assessment (sometimes including bimanual or speculum examination). A total of 3,054 women received medical abortion and had adequate data for evaluation. Twenty women (0.7%) had an ongoing pregnancy; 26 (0.9%) received curettage for retained tissue, empiric treatment for possible infection, or both; and 55 (1.8%) received additional uterotonics or other medical abortion-related care. Screening algorithms including patient-observed outcomes, a low-sensitivity pregnancy test, and nonsonographic clinical evaluation were as effective as sonography in identifying women who received interventions at or after the follow-up visit. Relying on women's observations, a low-sensitivity pregnancy test, and clinical examination, women and their providers can accurately assess whether follow-up care is required after medical abortion without routine ultrasonography. ClinicalTrials.gov, www.clinicaltrials.gov, NCT00120224. II.

  19. 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.

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

    PubMed Central

    Hill, Brett; Moulin, Dwight

    2017-01-01

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

  1. Pulmonary vein isolation and left atrial complex-fractionated atrial electrograms ablation for persistent atrial fibrillation with phased radio frequency energy and multi-electrode catheters: efficacy and safety during 12 months follow-up.

    PubMed

    Mulder, Anton A W; Wijffels, Maurits C E F; Wever, Eric F D; Boersma, Lucas V A

    2011-12-01

    Ablation for persistent atrial fibrillation (AF) remains a difficult and time-consuming procedure with varying degrees of success. We evaluated the long-term effects of a novel approach for ablation of persistent AF using multi-electrode catheters. In 89 patients with longstanding persistent AF (>1 year), multi-electrode ablation was performed with a pulmonary vein ablation catheter (PVAC), a multi-array septal catheter (MASC), and a multi-array ablation catheter (MAAC) for ablation of complex-fractionated atrial electrograms (CFAE) at the septum, left atrial (LA) roof, floor, posterior wall, and mitral isthmus. Follow-up was performed at 6 and 12 months with electrocardiogram, 7 days Holter, and occasionally ambulant event recordings. Average procedure and fluoroscopy times were 112 ± 32 and 21 ± 10 min. The pre-specified endpoint of pulmonary vein isolation and LA CFAE ablation was reached in all patients. No procedural complications were observed. At 12 months after a single treatment 44 of 89 (49%) remained in sinus rhythm, including direct current cardioversion in 12 patients. At 12 months, after a redo PVAC/MASC/MAAC, an additional 6 of 15 patients (40%) were free of AF. In 18 of 89 (20%) patients AF was changed to paroxysmal. In this single centre study, ablation for longstanding persistent AF with the PVAC/MASC/MAAC resulted in 56% freedom of AF at 1 year after 1.2 ± 0.4 procedures. This approach is time efficient and has a favourable safety profile.

  2. High Blood Pressure Increases the Risk of Poor Outcome at Discharge and 12-month Follow-up in Patients with Symptomatic Intracranial Large Artery Stenosis and Occlusions: Subgroup analysis of the CICAS Study.

    PubMed

    Yu, Dan-Dan; Pu, Yue-Hua; Pan, Yue-Song; Zou, Xin-Ying; Soo, Yannie; Leung, Thomas; Liu, Li-Ping; Wang, David Z; Wong, Ka-Sing; Wang, Yi-Long; Wang, Yong-Jun

    2015-06-01

    The purpose of this study was to discuss the relationship between blood pressure and prognosis of patients with symptomatic intracranial arterial stenosis. Data on 2426 patients with symptomatic intracranial large artery stenosis and occlusion who participated in the Chinese Intracranial Atherosclerosis (CICAS) study were analyzed. According to the JNC 7 criteria, blood pressure of all patients was classified into one of the four subgroups: normal, prehypertension, hypertension stage I, and hypertension stage II. Poor outcomes were defined as death and functional dependency (mRS 3-5) at discharge or at 1 year. For patients with intracranial stenosis of 70% to 99%, the rate of poor outcome at discharge was 19.3%, 23.5%, 26.8%, and 39.8% (P = 0.001) for each blood pressure subgroup. For patients with intracranial large artery occlusion, the rates were 17.6%, 22.1%, 29.5%, and 49.8%, respectively (P < 0.0001). The rate of poor outcome at 12-month follow-up was 12.6%, 15.3%, 28.5%, and 27.9% (P = 0.0038) in patients with stenosis of 70% to 99% for each blood pressure subgroup and 11.6%, 21.5%, 23.9%, 35.1% (P < 0.0001) in patients with occlusion. For patients with severe intracranial arterial stenosis or occlusion, higher hypertension stages are associated with an increased risk of poor outcome at discharge and 12-month follow-up. © 2015 The Authors. CNS Neuroscience & Therapeutics Published by John Wiley & Sons Ltd.

  3. Long-term (6 and 12 months) follow-up of two prospective, randomized, controlled phase III trials of photodynamic therapy with BF-200 ALA and methyl aminolaevulinate for the treatment of actinic keratosis

    PubMed Central

    Dirschka, T; Radny, P; Dominicus, R; Mensing, H; Brüning, H; Jenne, L; Karl, L; Sebastian, M; Oster-Schmidt, C; Klövekorn, W; Reinhold, U; Tanner, M; Gröne, D; Deichmann, M; Simon, M; Hübinger, F; Hofbauer, G; Krähn-Senftleben, G; Borrosch, F; Reich, K; Berking, C; Wolf, P; Lehmann, P; Moers-Carpi, M; Hönigsmann, H; Wernicke-Panten, K; Hahn, S; Pabst, G; Voss, D; Foguet, M; Schmitz, B; Lübbert, H; Szeimies, R-M

    2013-01-01

    Background Two phase III trials of photodynamic therapy (PDT) with BF-200 ALA, a recently approved nanoemulsion formulation of 5-aminolaevulinic acid (ALA) demonstrated high clearance rates in mild-to-moderate actinic keratosis (AK). The comparison to a registered methyl aminolaevulinate (MAL) cream demonstrated significantly superior total patient clearance rates. Objectives To evaluate long-term efficacy and safety of PDT for AK 6 and 12 months after the last PDT with BF-200 ALA, MAL or placebo. Methods The follow-up phase (FUP) was performed with patients of two phase III studies. Both studies compared BF-200 ALA with placebo, one of the studies additionally with MAL. Overall recurrence rates and various subgroups (light source, lesion severity, lesion location, complete responders after first PDT) were assessed 6 and 12 months after the last PDT. Results Recurrence rates were similar for BF-200 ALA and MAL, with a tendency to lower recurrence rates for BF-200 ALA. The proportion of patients who were fully cleared during PDT and remained completely clear for at least 12 months after PDT were 47% for BF-200 ALA (both studies) and 36% for MAL treatment. The subgroup that was illuminated with narrow wavelength LED lamps reached 69% and 53% for BF-200 ALA (both studies, respectively) and 41% for MAL. No safety concerns were reported. Conclusions The FUP data confirmed the high efficacy and safety of PDT with BF-200 ALA. The slightly lower recurrence rates after BF-200 ALA treatment compared with MAL treatment enhanced the better treatment outcome due to the significantly superior efficacy. PMID:23252768

  4. Long-term (6 and 12 months) follow-up of two prospective, randomized, controlled phase III trials of photodynamic therapy with BF-200 ALA and methyl aminolaevulinate for the treatment of actinic keratosis.

    PubMed

    Dirschka, T; Radny, P; Dominicus, R; Mensing, H; Brüning, H; Jenne, L; Karl, L; Sebastian, M; Oster-Schmidt, C; Klövekorn, W; Reinhold, U; Tanner, M; Gröne, D; Deichmann, M; Simon, M; Hübinger, F; Hofbauer, G; Krähn-Senftleben, G; Borrosch, F; Reich, K; Berking, C; Wolf, P; Lehmann, P; Moers-Carpi, M; Hönigsmann, H; Wernicke-Panten, K; Hahn, S; Pabst, G; Voss, D; Foguet, M; Schmitz, B; Lübbert, H; Szeimies, R-M

    2013-04-01

    Two phase III trials of photodynamic therapy (PDT) with BF-200 ALA, a recently approved nanoemulsion formulation of 5-aminolaevulinic acid (ALA) demonstrated high clearance rates in mild-to-moderate actinic keratosis (AK). The comparison to a registered methyl aminolaevulinate (MAL) cream demonstrated significantly superior total patient clearance rates. To evaluate long-term efficacy and safety of PDT for AK 6 and 12 months after the last PDT with BF-200 ALA, MAL or placebo. The follow-up phase (FUP) was performed with patients of two phase III studies. Both studies compared BF-200 ALA with placebo, one of the studies additionally with MAL. Overall recurrence rates and various subgroups (light source, lesion severity, lesion location, complete responders after first PDT) were assessed 6 and 12 months after the last PDT. Recurrence rates were similar for BF-200 ALA and MAL, with a tendency to lower recurrence rates for BF-200 ALA. The proportion of patients who were fully cleared during PDT and remained completely clear for at least 12 months after PDT were 47% for BF-200 ALA (both studies) and 36% for MAL treatment. The subgroup that was illuminated with narrow wavelength LED lamps reached 69% and 53% for BF-200 ALA (both studies, respectively) and 41% for MAL. No safety concerns were reported. The FUP data confirmed the high efficacy and safety of PDT with BF-200 ALA. The slightly lower recurrence rates after BF-200 ALA treatment compared with MAL treatment enhanced the better treatment outcome due to the significantly superior efficacy. © 2012 Biofrontera Bioscience GmbH BJD © 2012 British Association of Dermatologists.

  5. A randomized controlled trial of a resilience-based intervention on psychosocial well-being of children affected by HIV/AIDS: Effects at 6- and 12-month follow-up.

    PubMed

    Li, Xiaoming; Harrison, Sayward E; Fairchild, Amanda J; Chi, Peilian; Zhao, Junfeng; Zhao, Guoxiang

    2017-10-01

    Global literature suggests that resilience-based interventions may yield improvements in psychosocial well-being for vulnerable children, but limited data are available regarding the efficacy of such interventions among children affected by parental HIV/AIDS. To evaluate initial efficacy of a multi-level resilience-based intervention among children affected by parental HIV/AIDS in China in improving children's psychosocial well-being and resilience-related outcomes. Seven hundred-ninety children, 6-17 years of age, were recruited from rural China. Children were either AIDS orphans or were living with one or two parents infected with HIV/AIDS. Children and primary caregivers were randomly assigned to participate in a 4-arm trial to evaluate the Child-Caregiver-Advocacy Resilience (ChildCARE) intervention. This resilience-based psychosocial intervention provides programming at three levels (child, caregiver, community). Survey data were collected at baseline, 6-months, and 12-months in order to examine efficacy of the child-only and child + caregiver arms in improving children's psychological resilience. Intervention groups displayed improvements in several resilience-related outcomes at 6- and 12-month follow-ups, including self-reported coping, hopefulness, emotional regulation, and self-control. The child-only intervention arm showed some fading of intervention effects by 12-months. Preliminary findings suggest that the ChildCARE intervention is efficacious in promoting psychosocial well-being of children affected by parental HIV/AIDS in rural China. Targeting both children and caregivers for psychosocial intervention may be effective in improving children's resilience. Additional evaluation and modifications, including the inclusion of booster sessions, should be considered to further strengthen the program. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Sustained effectiveness and cost-effectiveness of the Healthy Activity Programme, a brief psychological treatment for depression delivered by lay counsellors in primary care: 12-month follow-up of a randomised controlled trial.

    PubMed

    Weobong, Benedict; Weiss, Helen A; McDaid, David; Singla, Daisy R; Hollon, Steven D; Nadkarni, Abhijit; Park, A-La; Bhat, Bhargav; Katti, Basavraj; Anand, Arpita; Dimidjian, Sona; Araya, Ricardo; King, Michael; Vijayakumar, Lakshmi; Wilson, G Terence; Velleman, Richard; Kirkwood, Betty R; Fairburn, Christopher G; Patel, Vikram

    2017-09-01

    The Healthy Activity Programme (HAP), a brief behavioural intervention delivered by lay counsellors, enhanced remission over 3 months among primary care attendees with depression in peri-urban and rural settings in India. We evaluated the sustainability of the effects after treatment termination, the cost-effectiveness of HAP over 12 months, and the effects of the hypothesized mediator of activation on clinical outcomes. Primary care attendees aged 18-65 years screened with moderately severe to severe depression on the Patient Health Questionnaire 9 (PHQ-9) were randomised to either HAP plus enhanced usual care (EUC) (n = 247) or EUC alone (n = 248), of whom 95% completed assessments at 3 months, and 91% at 12 months. Primary outcomes were severity on the Beck Depression Inventory-II (BDI-II) and remission on the PHQ-9. HAP participants maintained the gains they showed at the end of treatment through the 12-month follow-up (difference in mean BDI-II score between 3 and 12 months = -0.34; 95% CI -2.37, 1.69; p = 0.74), with lower symptom severity scores than participants who received EUC alone (adjusted mean difference in BDI-II score = -4.45; 95% CI -7.26, -1.63; p = 0.002) and higher rates of remission (adjusted prevalence ratio [aPR] = 1.36; 95% CI 1.15, 1.61; p < 0.009). They also fared better on most secondary outcomes, including recovery (aPR = 1.98; 95% CI 1.29, 3.03; p = 0.002), any response over time (aPR = 1.45; 95% CI 1.27, 1.66; p < 0.001), higher likelihood of reporting a minimal clinically important difference (aPR = 1.42; 95% CI 1.17, 1.71; p < 0.001), and lower likelihood of reporting suicidal behaviour (aPR = 0.71; 95% CI 0.51, 1.01; p = 0.06). HAP plus EUC also had a marginal effect on WHO Disability Assessment Schedule score at 12 months (aPR = -1.58; 95% CI -3.33, 0.17; p = 0.08); other outcomes (days unable to work, intimate partner violence toward females) did not statistically significantly differ between the two arms. Economic analyses

  7. Sustained effectiveness and cost-effectiveness of the Healthy Activity Programme, a brief psychological treatment for depression delivered by lay counsellors in primary care: 12-month follow-up of a randomised controlled trial

    PubMed Central

    Weobong, Benedict; Singla, Daisy R.; Hollon, Steven D.; Nadkarni, Abhijit; Park, A-La; Bhat, Bhargav; Anand, Arpita; Dimidjian, Sona; King, Michael; Vijayakumar, Lakshmi; Wilson, G. Terence; Velleman, Richard

    2017-01-01

    Background The Healthy Activity Programme (HAP), a brief behavioural intervention delivered by lay counsellors, enhanced remission over 3 months among primary care attendees with depression in peri-urban and rural settings in India. We evaluated the sustainability of the effects after treatment termination, the cost-effectiveness of HAP over 12 months, and the effects of the hypothesized mediator of activation on clinical outcomes. Methods and findings Primary care attendees aged 18–65 years screened with moderately severe to severe depression on the Patient Health Questionnaire 9 (PHQ-9) were randomised to either HAP plus enhanced usual care (EUC) (n = 247) or EUC alone (n = 248), of whom 95% completed assessments at 3 months, and 91% at 12 months. Primary outcomes were severity on the Beck Depression Inventory–II (BDI-II) and remission on the PHQ-9. HAP participants maintained the gains they showed at the end of treatment through the 12-month follow-up (difference in mean BDI-II score between 3 and 12 months = −0.34; 95% CI −2.37, 1.69; p = 0.74), with lower symptom severity scores than participants who received EUC alone (adjusted mean difference in BDI-II score = −4.45; 95% CI −7.26, −1.63; p = 0.002) and higher rates of remission (adjusted prevalence ratio [aPR] = 1.36; 95% CI 1.15, 1.61; p < 0.009). They also fared better on most secondary outcomes, including recovery (aPR = 1.98; 95% CI 1.29, 3.03; p = 0.002), any response over time (aPR = 1.45; 95% CI 1.27, 1.66; p < 0.001), higher likelihood of reporting a minimal clinically important difference (aPR = 1.42; 95% CI 1.17, 1.71; p < 0.001), and lower likelihood of reporting suicidal behaviour (aPR = 0.71; 95% CI 0.51, 1.01; p = 0.06). HAP plus EUC also had a marginal effect on WHO Disability Assessment Schedule score at 12 months (aPR = −1.58; 95% CI −3.33, 0.17; p = 0.08); other outcomes (days unable to work, intimate partner violence toward females) did not statistically significantly

  8. Sustained effectiveness and cost-effectiveness of Counselling for Alcohol Problems, a brief psychological treatment for harmful drinking in men, delivered by lay counsellors in primary care: 12-month follow-up of a randomised controlled trial.

    PubMed

    Nadkarni, Abhijit; Weiss, Helen A; Weobong, Benedict; McDaid, David; Singla, Daisy R; Park, A-La; Bhat, Bhargav; Katti, Basavaraj; McCambridge, Jim; Murthy, Pratima; King, Michael; Wilson, G Terence; Kirkwood, Betty; Fairburn, Christopher G; Velleman, Richard; Patel, Vikram

    2017-09-01

    Counselling for Alcohol Problems (CAP), a brief intervention delivered by lay counsellors, enhanced remission and abstinence over 3 months among male primary care attendees with harmful drinking in a setting in India. We evaluated the sustainability of the effects after treatment termination, the cost-effectiveness of CAP over 12 months, and the effects of the hypothesized mediator 'readiness to change' on clinical outcomes. Male primary care attendees aged 18-65 years screening with harmful drinking on the Alcohol Use Disorders Identification Test (AUDIT) were randomised to either CAP plus enhanced usual care (EUC) (n = 188) or EUC alone (n = 189), of whom 89% completed assessments at 3 months, and 84% at 12 months. Primary outcomes were remission and mean standard ethanol consumed in the past 14 days, and the proposed mediating variable was readiness to change at 3 months. CAP participants maintained the gains they showed at the end of treatment through the 12-month follow-up, with the proportion with remission (AUDIT score < 8: 54.3% versus 31.9%; adjusted prevalence ratio [aPR] 1.71 [95% CI 1.32, 2.22]; p < 0.001) and abstinence in the past 14 days (45.1% versus 26.4%; adjusted odds ratio 1.92 [95% CI 1.19, 3.10]; p = 0.008) being significantly higher in the CAP plus EUC arm than in the EUC alone arm. CAP participants also fared better on secondary outcomes including recovery (AUDIT score < 8 at 3 and 12 months: 27.4% versus 15.1%; aPR 1.90 [95% CI 1.21, 3.00]; p = 0.006) and percent of days abstinent (mean percent [SD] 71.0% [38.2] versus 55.0% [39.8]; adjusted mean difference 16.1 [95% CI 7.1, 25.0]; p = 0.001). The intervention effect for remission was higher at 12 months than at 3 months (aPR 1.50 [95% CI 1.09, 2.07]). There was no evidence of an intervention effect on Patient Health Questionnaire 9 score, suicidal behaviour, percentage of days of heavy drinking, Short Inventory of Problems score, WHO Disability Assessment Schedule 2.0 score, days unable to

  9. Sustained effectiveness and cost-effectiveness of Counselling for Alcohol Problems, a brief psychological treatment for harmful drinking in men, delivered by lay counsellors in primary care: 12-month follow-up of a randomised controlled trial

    PubMed Central

    Nadkarni, Abhijit; Weobong, Benedict; Singla, Daisy R.; Park, A-La; Bhat, Bhargav; Katti, Basavaraj; Murthy, Pratima; King, Michael; Wilson, G. Terence; Fairburn, Christopher G.; Velleman, Richard

    2017-01-01

    Background Counselling for Alcohol Problems (CAP), a brief intervention delivered by lay counsellors, enhanced remission and abstinence over 3 months among male primary care attendees with harmful drinking in a setting in India. We evaluated the sustainability of the effects after treatment termination, the cost-effectiveness of CAP over 12 months, and the effects of the hypothesized mediator ‘readiness to change’ on clinical outcomes. Methods and findings Male primary care attendees aged 18–65 years screening with harmful drinking on the Alcohol Use Disorders Identification Test (AUDIT) were randomised to either CAP plus enhanced usual care (EUC) (n = 188) or EUC alone (n = 189), of whom 89% completed assessments at 3 months, and 84% at 12 months. Primary outcomes were remission and mean standard ethanol consumed in the past 14 days, and the proposed mediating variable was readiness to change at 3 months. CAP participants maintained the gains they showed at the end of treatment through the 12-month follow-up, with the proportion with remission (AUDIT score < 8: 54.3% versus 31.9%; adjusted prevalence ratio [aPR] 1.71 [95% CI 1.32, 2.22]; p < 0.001) and abstinence in the past 14 days (45.1% versus 26.4%; adjusted odds ratio 1.92 [95% CI 1.19, 3.10]; p = 0.008) being significantly higher in the CAP plus EUC arm than in the EUC alone arm. CAP participants also fared better on secondary outcomes including recovery (AUDIT score < 8 at 3 and 12 months: 27.4% versus 15.1%; aPR 1.90 [95% CI 1.21, 3.00]; p = 0.006) and percent of days abstinent (mean percent [SD] 71.0% [38.2] versus 55.0% [39.8]; adjusted mean difference 16.1 [95% CI 7.1, 25.0]; p = 0.001). The intervention effect for remission was higher at 12 months than at 3 months (aPR 1.50 [95% CI 1.09, 2.07]). There was no evidence of an intervention effect on Patient Health Questionnaire 9 score, suicidal behaviour, percentage of days of heavy drinking, Short Inventory of Problems score, WHO Disability

  10. Effectiveness of a motivational interviewing intervention on weight loss, physical activity and cardiovascular disease risk factors: a randomised controlled trial with a 12-month post-intervention follow-up

    PubMed Central

    2013-01-01

    Background Intensive diet and physical activity interventions have been found to reduce cardiovascular disease (CVD) risk, but are resource intensive. The American Heart Association recently recommended motivational interviewing (MI) as an effective approach for low-intensity interventions to promote health-related outcomes such as weight loss. However, there is limited research evaluating the long-term effectiveness of MI-based interventions on health-related outcomes associated with CVD risk. The current research evaluated the effectiveness of a six-month low-intensity MI intervention in a UK primary-care setting in maintaining reductions in CVD risk factors at12 months post-intervention. Methods Primary-care patients were randomised to an intervention group that received standard exercise and nutrition information plus up to five face-to-face MI sessions, delivered by a physical activity specialist and registered dietician over a 6-month period, or to a minimal intervention comparison group that received the standard information only. Follow-up measures of behavioural (vigorous and moderate physical activity, walking, physical activity stage-of-change, fruit and vegetable intake, and dietary fat intake) and biomedical (weight, body mass index [BMI], blood pressure, cholesterol) outcomes were taken immediately post-intervention and at a 12-month follow-up occasion. Results Intent-to-treat analyses revealed significant differences between groups for walking and cholesterol. Obese and hypercholesterolemic patients at baseline exhibited significant improvements in BMI and cholesterol respectively among those allocated to the intervention group compared to the comparison group. Post-intervention improvements in other health-related outcomes including blood pressure, weight, and BMI were not maintained. Conclusions The present study suggests that a low-intensity MI counselling intervention is effective in bringing about long-term changes in some, but not all, health

  11. Polymer-Free Biolimus A9-Coated Stents in the Treatment of De Novo Coronary Lesions: 4- and 12-Month Angiographic Follow-Up and Final 5-Year Clinical Outcomes of the Prospective, Multicenter BioFreedom FIM Clinical Trial.

    PubMed

    Costa, Ricardo A; Abizaid, Alexandre; Mehran, Roxana; Schofer, Joachim; Schuler, Gerhard C; Hauptmann, Karl E; Magalhães, Marco A; Parise, Helen; Grube, Eberhard

    2016-01-11

    The purpose of this study was to evaluate the efficacy and long-term outcomes of a novel polymer/carrier-free drug-coated stent (DCS) in patients with de novo coronary lesions. The BioFreedom (BFD) DCS incorporates a low-profile, stainless-steel platform, with a surface that has been modified to create a selectively microstructured abluminal surface that allows adhesion and further release of Biolimus A9 (Biosensors Europe SA, Morges, Switzerland). A total of 182 patients (183 lesions) were randomized into a 1:1:1 ratio for treatment with BFD "standard dose" (BFD) or BFD "low dose" (BFD-LD) versus first-generation paclitaxel-eluting stents (PES) at 4 sites in Germany. Baseline and procedural characteristics were well matched. At 4-month angiographic follow-up (Cohort 1, n = 75), in-stent late lumen loss (LLL) was significantly lower with BFD and BFD-LD versus PES (0.08 and 0.12 mm vs. 0.37 mm, respectively; p < 0.0001 for BFD vs. PES, and p = 0.002 for BFD-LD vs. PES). At 12 months (Cohort 2, n = 107), in-stent LLL (primary endpoint) was 0.17 mm in BFD versus 0.35 mm in PES (p = 0.001 for noninferiority; p = 0.11 for superiority); however, the BFD-LD (0.22 mm) did not reach noninferiority (p = 0.21). At 5 years (175 of 182), there were no significant differences in major adverse cardiac events (23.8%, 26.4%, and 20.3%) and clinically indicated target lesion revascularization (10.8%, 13.4%, and 10.2%) for BFD, BFD-LD, and PES, respectively; also, there was no definite/probable stent thrombosis reported. The BFD, but not the BFD-LD, demonstrated noninferiority versus PES in terms of in-stent LLL, a surrogate of neointimal hyperplasia, at 12-month follow-up. At 5 years, clinical event rates were similar, without occurrence of stent thrombosis in all groups. (BioFreedom FIM Clinical Trial; NCT01172119). Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  12. Changes in hip and ankle range of motion and hip muscle strength in 8–11 year old novice female ballet dancers and controls: a 12 month follow up study

    PubMed Central

    Bennell, K; Khan, K; Matthews, B; Singleton, C

    2001-01-01

    Objectives—To evaluate in a 12 month longitudinal study changes in hip and ankle range of motion and hip muscle strength in young female novice ballet dancers. Methods—Fifty three of the original 77 (69%) female dancers aged 8–11 years and 40 of the original 49 (82%) controls returned for follow up measurements one year later. Supine right active hip external (ER) and internal (IR) rotation were measured using an inclinometer. A turnout protractor was used to assess standing active turnout range. Range of right weight bearing ankle dorsiflexion and calf muscle length were measured in a standing lunge position using an inclinometer. A manual muscle tester was used to assess right hip flexor, IR, ER, abductor and adductor strength. Results—The mean (SD) 12 month change in hip ER did not differ between dancers (11.7 (11.3)°) and controls (8.1 (17.6)°). Dancers gained 12.5 (13.5)° hip IR which was significantly greater than controls (0.5 (13.9)°). Greater IR change was associated with improved IR strength (r = 0.34, p<0.001). Dancers increased total turnout (12.0 (16.7)°) significantly more than controls (2.2 (20.0)°). There was no significant change in ankle dorsiflexion range in either group. Dancers and controls increased in all measures of hip muscle strength (p<0.001) and dancers achieved significantly greater gains in three out of five muscle groups (all, p<0.05). Conclusions—Total hip range of motion increased in both ballet students and controls at this young age. However, ankle dorsiflexion did not, which is probably due to this movement being blocked by bony apposition, rather than soft tissue stretch. This has implications for ballet teachers, as it has long been accepted that this movement could be improved with training. Dancers had greater increases in hip strength after 12 months compared with controls in muscles specific for ballet, suggesting that hip strength can be trained at this young age. Whether these gains are permanent requires

  13. TUGENDHAT: a pilot randomized study on effects of biventricular pacing in patients with bradycardia pacing indication and normal systolic function on heart failure, atrial fibrillation and quality of life (results of 12 month follow-up).

    PubMed

    Taborsky, M; Rihova, D; Mraz, T; Mandysova, E; Vlasinova, J; Kamenik, L; Novak, M; Neuzil, P; Jarkovsky, J; Littnerova, S

    2013-01-01

    Since the late 1990s, a growing number of clinical studies have indicated that long-term permanent right ventricular (RV) apical pacing will induce severe complications such as development of heart failure, increased burden of atrial fibrillation leading to decreased quality of life. To investigate whether cardiac resynchronization therapy (CRT) using biventricular (BiV) pacing can prevent the development of left ventricular (LV) dysfunction, LV remodelling, worsening of the clinical status and quality of life in chronically RV paced patients with normal LV ejection fraction (EF). A total of 127 patients with Class I indication for permanent cardiac pacing and without established indication for CRT were subjected to 6 months of RV and BiV pacing in a patient-blinded, randomized crossover trial. Treatment effects of BiV pacing were evaluated for LV function, LV remodelling and clinical status. As compared with RV pacing, BiV pacing did not significantly prevent the decrease of LV function [LVEF 61.0 % (36.0; 68.0) vs 60.5 % (38.5; 67.5) in RV pacing], did not change the functional class according to the New York Heart Association [52 % in Class II vs 53.9 % in Class II in RV pacing, and 3.9 % in Class III vs 6.9 % in Class III in RV pacing], and did not present any changes in quality of life [32.5 (18.0; 80.0) vs 32.0 (21.0; 47.0) indexes in RV pacing]. BiV pacing, compared to RV pacing, did not change LV function and quality of life in patients with the absence of LV dysfunction or remodelling, standard bradycardia pacing indications in a pilot phase (12- month follow-up) of the TUGENDHAT trial. The final report will be published after 60-month follow-up termination (Tab. 5, Fig. 3, Ref. 30).

  14. 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.

  15. 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

  16. Brief Intervention and Follow-Up for Suicidal Patients With Repeat Emergency Department Visits Enhances Treatment Engagement

    PubMed Central

    Brown, Gregory K.; Currier, Glenn W.; Lyons, Chelsea; Chesin, Megan; Knox, Kerry L.

    2015-01-01

    We implemented an innovative, brief, easy-to-administer 2-part intervention to enhance coping and treatment engagement. The intervention consisted of safety planning and structured telephone follow-up postdischarge with 95 veterans who had 2 or more emergency department (ED) visits within 6 months for suicide-related concerns (i.e., suicide ideation or behavior). The intervention significantly increased behavioral health treatment attendance 3 months after intervention, compared with treatment attendance in the 3 months after a previous ED visit without intervention. The trend was for a decreasing hospitalization rate. PMID:26066951

  17. Feasibility, acceptability and outcomes at a 12-month follow-up of a novel community-based intervention to prevent type 2 diabetes in adults at high risk: mixed methods pilot study

    PubMed Central

    Penn, Linda; Ryan, Vicky; White, Martin

    2013-01-01

    Objectives and design Lifestyle interventions can prevent type 2 diabetes (T2D) in adults with impaired glucose tolerance. In a mixed methods pilot study, we aimed to assess the feasibility, acceptability and outcomes at a 12-month follow-up of a behavioural intervention for adults at risk of T2D. Participants Adults aged 45–65 years with a Finnish Diabetes Risk Score (FINDRISC) ≥11. Setting The intervention was delivered in leisure and community settings in a local authority that ranks in the 10 most socioeconomically deprived in England. Intervention A 10-week supported programme to promote increased physical activity (PA), healthy eating and weight loss was delivered by fitness trainers as twice-weekly group PA or cookery sessions, each followed by behavioural counselling with support to 12 months. Outcome measures We assessed feasibility and acceptability of the intervention, and change in behavioural and health-related outcomes at 6 and 12 months. Results From 367 registers of interest, 218 participants were recruited to the programme with baseline mean (SD): age 53.6 (6) years, FINDRISC 13.9 (3.1), body mass index 33.5 (5.9) kg/m2, waist circumference 108.1 (13.7) cm, PA levels (self-report): daily total 49.1 (5.9) metabolic-equivalent (MET) h/day. Follow-up at 12 months was completed by 134 (61%) participants, with an estimated mean (95% CI) change from baseline in weight −5.7 (−7.8 to −2.8); −2.8 (−3.8 to −1.9) kg, waist circumference −7.2 (−9.2 to −5.2); −6.0 (−7.1 to −5.0) cm, and PA level 7.9 (5.8 to 10.1); 6.7 (5.2 to 8.2) MET h/day equivalent, for men and women, respectively (from covariance pattern mixed models). Participants reported an enjoyable, sociable and supportive intervention experience. Conclusions Participants’ views indicated a high level of intervention acceptability. High retention and positive outcomes at 12 months provide encouraging indications of the feasibility and potential effectiveness

  18. Replacing ambulatory surgical follow-up visits with mobile app home monitoring: modeling cost-effective scenarios.

    PubMed

    Armstrong, Kathleen A; Semple, John L; Coyte, Peter C

    2014-09-22

    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. 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. 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. 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 health care system costs alone, in

  19. 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

  20. 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. © The Author 2014. Published by Oxford University Press on behalf of the International Epidemiological Association.

  1. Paedodontic general anaesthesia and compliance with follow-up visits at a tertiary oral and dental hospital, South Africa.

    PubMed

    Kolisa, Y; Ayo-Yusuf, O A; Makobe, D C

    2013-06-01

    The study aimed to describe the demographic profile of children receiving dental general anaesthesia (DGA) at the Pretoria Oral-and-Dental Hospital, South Africa, the type of treatment received and the level of compliance with the six-month preventive follow-up visit. Retrospective review of records of children treated under DGA between January 2009 and December 2010. The study group contained 78-children. Of these, 79.5% were between one and four years of age (mean 3.7-years; SD: 2.01), and 54% were female. The parents of more than half the sample (56.4%) were unemployed. The majority (55.2%) recorded no medical condition prior to undergoing DGA. Of the treatments performed, 63% were extractions (mean = 4.7 teeth/child), 51% involved placement of composite restorations (mean = 3.4 teeth) and 18% were fitting of stainless steel crowns (mean = 2.1 teeth). No preventive treatment was performed under DGA. Only 14 children (18%) returned within 15-months for follow-ups. Seven returnees were re-booked for a second DGA appointment for severely carious teeth; the rest received preventive treatment. Female children (Odds Ratio (OR): 0.28; p = 0.04) and children with no medical-condition (OR: 0.20; p = 0.03) were less likely to return for a follow-up visit. Children with employed parents were more likely (OR: 3.50; p = 0.09) to return for follow-ups. This study highlights the importance of preventive treatment prior to and during DGA, especially in a setting where the caries disease burden and unemployment are high.

  2. Motivation to take part in integrated care-an assessment of follow-up home visits to elderly persons.

    PubMed

    Hjelmar, Ulf; Hendriksen, Carsten; Hansen, Kirsten

    2011-07-01

    The aim of follow-up visits by the general practitioner and district nurse (within a week after discharge from hospital) is to reduce hospital readmissions and improve the overall wellbeing of the patient. There is strong evidence that these programmes are effective, but are difficult to implement because of a number of organizational obstacles, including co-ordination between the organizations involved in the process. In this paper we look at the factors that affect motivation to participate in a cross-sectoral programme in Copenhagen, Denmark, implementing follow-up home visits to elderly persons. The analysis is based on inter-organizational network theory in an attempt to explain the role of motivation in network formation between organizational systems. The empirical findings are based on focus groups and in-depth interviews with hospital staff, general practitioners, and district nurses. Care providers are motivated to collaborate by a number of factors. The focus of collaboration needs to be clearly defined and agreed upon, there needs to be a high degree of equality between the professionals involved, and there has to be a will to co-operate based on a shared understanding of values and learning potentials. The study concludes that we need to focus on specific care fields and actors to reduce complexity in the area and more fully understand what motivates care providers to participate in cross-sectoral activities, such as a follow-up home visit programme. One lesson for current policy is that motivational factors need to be addressed in future collaborative programmes in order to fully exploit the potential health benefits.

  3. The Role of Radiographs and Office Visits in the Follow-Up of Healed Intertrochanteric Hip Fractures: An Economic Analysis.

    PubMed

    Kempegowda, Harish; Richard, Raveesh; Borade, Amrut; Tawari, Akhil; Howenstein, Abby M; Kubiak, Erik N; Suk, Michael; Horwitz, Daniel S

    2016-12-01

    The purpose of this study was to evaluate the role and the necessity of radiographs and office visits obtained during follow-up of intertrochanteric hip injuries. Retrospective study. Two level I trauma centers. Four hundred sixty-five elderly patients who were surgically treated for an intertrochanteric fracture of the femur at 2 level I trauma centers between January 2009 and August 2014 were retrospectively identified from orthopaedic trauma databases. Analysis of all healed intertrochanteric hip fractures, including demographic characteristics, quality of reduction, time of healing, number of office visits, number of radiographs obtained, and each radiograph for fracture alignment, implant position or any pathological changes. The surgical fixation of 465 fractures included 155 short nails (33%), 232 long nails (50%), 69 sliding hip screw devices (15%), 7 trochanteric stabilizing plates (1.5%), and 2 proximal femur locking plates (0.5%). The average fracture healing time was 12.8 weeks and the average follow-up was 81.2 weeks. Radiographs of any patient obtained after the fracture had healed did not reveal any changes, including fracture alignment or implant position and hardware failure. In 9 patients, pathological changes, including arthritis (3), avascular necrosis (3), and ectopic ossification (3) were noted. The average number of elective office visits and radiographs obtained after the fracture had healed were 2.8 (range: 1-8) and 2.6 (range: 1-8), respectively. According to Medicare payments to the institution, these radiographs and office visits account for a direct cost of $360.81 and $192, respectively, per patient. The current study strongly suggests that there is a negligible role for radiographs and office visits during the follow-up of a well-healed hip fracture when there is documented evidence of radiographic and clinical healing with acceptable fracture alignment and implant position. Implementation of this simple measure will help in reducing

  4. 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.

  5. 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.

  6. Impact of a pharmacist-directed educational program on the long-term knowledge and use of folic acid among college women: a 12-month follow-up study.

    PubMed

    Murphy, Bethany L; Dipietro, Natalie A

    2012-04-01

    Few studies have examined the impact of educational interventions on participants' long-term knowledge and use of folic acid for prevention of neural tube defects (NTD). The objective of this pilot study was to evaluate changes in knowledge and behaviors in a sample of college women one year after such a program. Female students of a residential college campus voluntarily attended the event, which was advertised to the campus community as a women's health seminar. Participants completed a multiple-choice test assessing knowledge of folic acid and NTD and frequency of multivitamin use before and immediately after a 30-minute oral presentation. Following 3 reminder messages sent via email or mail, knowledge and multivitamin use were re-assessed 1-month and 12-months post-intervention. Thirty-two college women participated in the educational intervention; 27 (84%) completed the 12-month post-test. At 12 months, statistically significant increases in knowledge from baseline remained for questions pertaining to food high in folic acid (p=0.023); completion of spinal column (p=0.011); and 2 questions on NTD prevention (p=0.044). Increases in knowledge regarding recommended daily allowance of folic acid (p=0.817) and difficulty in receiving adequate folic acid from diet alone (p=0.617) were not statistically significant from baseline. Regular multivitamin use (≥4 times per week) was not statistically significantly increased from baseline (p=0.592). Although it was encouraging that the women retained much of the information learned during the program, it appears that the changes in multivitamin use seen at 1-month were not sustained at 12-months. Further study with larger groups of college women is recommended.

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

    PubMed Central

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

    1997-01-01

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

  8. Increased emergency room visits or hospital admissions in females after 12-month MMR vaccination, but no difference after vaccinations given at a younger age.

    PubMed

    Wilson, Kumanan; Ducharme, Robin; Ward, Brian; Hawken, Steven

    2014-02-26

    Previous studies have suggested that a child's sex may be a predictor of vaccine reactions. We used a self-controlled case series design, an extension of retrospective cohort methodology which controls for fixed confounders using a conditional Poisson modeling approach. We compared a risk period immediately following vaccination to a control period farther removed from vaccination in each child and estimated the relative incidence of emergency room visits and/or hospital admissions following the 2-, 4-, 6-, and 12-month vaccinations to investigate the effect of sex on relative incidence. All infants born in Ontario, Canada between April 1, 2002 and March 31, 2009 were eligible for study inclusion. In analyses combining immunizations at 2, 4 and 6 months and examining these vaccinations separately, there was no significant relationship between the relative incidence of an event and sex of the child. At 12 months, we observed a significant effect of sex, with female sex being associated with a significantly higher relative incidence of events (P=0.0027). The relative incidence ratio (95% CI) comparing females to males following the 12-month vaccination was 1.08 (1.03 to 1.14), which translates to 192 excess events per 100,000 females vaccinated compared to the number of events that would have occurred in 100,000 males vaccinated. As the MMR vaccine is given at 12 months of age in Ontario, our findings suggest that girls may have an increased reactogenicity to the MMR vaccine which may be indicative of general sex differences in the responses to the measles virus. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Dental therapists' expanded scope of practice in Australia: a 12-month follow-up of an educational bridging program to facilitate the provision of oral health care to patients 26+ years.

    PubMed

    Hopcraft, Matthew; Martin-Kerry, Jacqueline M; Calache, Hanny

    2015-01-01

    Prior to 2009, dental therapists' scope of clinical practice in Victoria was limited to patients 25 years or younger. However, increases in dental demand by adults 26+ years required an alternative approach to service delivery. This paper outlines the self-reported confidence and knowledge level of dental therapists at 3, 6, and 12 months postcompletion of an educational program aimed at providing them with the skills to treat adults aged 26+ years. The study also surveyed dentists in the practice about the dental therapists' knowledge and the impact of their extended scope of practice on the clinics' operation. After completion of their educational program, the dental therapists who participated were surveyed at 3, 6, and 12 months postcompletion to assess their self-reported confidence levels and knowledge. Senior dentists at the clinic were surveyed to understand the impact of the subsequent change in practice of the dental therapists who undertook this training, as well as any concerns of perceived educational gaps. Surveys showed increased self-reported confidence levels by the dental therapists at 3, 6, and 12 months after completion of the program. Dental therapists and mentoring dentists identified that further education was needed in areas such as oral medicine, pathology, medically compromised patients, medications, prosthodontics, and referrals. Dental therapists felt confident and knowledgeable postprogram to treat patients 26+ years, within their scope of practice. Dentists generally felt that dental therapists, after completing the educational program, were confident and knowledgeable. Educational areas to focus on in future programs were identified. © 2015 American Association of Public Health Dentistry.

  10. 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

  11. Er:YAG ablative fractional laser-primed photodynamic therapy with methyl aminolevulinate as an alternative treatment option for patients with thin nodular basal cell carcinoma: 12-month follow-up results of a randomized, prospective, comparative trial.

    PubMed

    Choi, S H; Kim, K H; Song, K H

    2016-05-01

    Surgical excision is conventionally regarded as the treatment of choice for nodular basal cell carcinoma (nBCC), and methyl aminolevulinate photodynamic therapy (MAL-PDT) has relatively low efficacy for nBCC. However, Er:YAG ablative fractional laser (AFL)-primed MAL-PDT (Er:YAG AFL-PDT) may offer enhanced efficacy for nBCC, especially thin nBCC (thickness ≤2 mm). We compared Er:YAG AFL-PDT with conventional MAL-PDT for thin facial nBCC in Korean patients. Thirty-nine patients (42 lesions) with primary, histologically proven thin nBCCs were randomized to Er:YAG AFL-PDT (single session, n = 20) or conventional MAL-PDT (two sessions, 7 days apart, n = 19). Efficacy, recurrence rate, cosmetic outcomes and safety were assessed 1 week, 3 months and 12 months after the last treatment. Three months after the final treatment, overall complete response rates were 84.2% with Er:YAG AFL-PDT and 50% with MAL-PDT (P = 0.026). The recurrence rate was significantly lower with Er:YAG AFL-PDT (6.3%) than with MAL-PDT (55.6%) at 12 months (P = 0.006). Er:YAG AFL-PDT and MAL-PDT did not differ significantly with respect to cosmetic outcomes or safety. Er:YAG AFL-PDT can be used as an alternative treatment option for patients who have thin nBCC and are not suitable for surgical treatment. © 2015 European Academy of Dermatology and Venereology.

  12. 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

  13. Lack of stability at more than 12 months of follow-up after anterior cruciate ligament reconstruction using all-inside quadruple-stranded semitendinosus graft with adjustable cortical button fixation in both femoral and tibial sides.

    PubMed

    Bressy, G; Brun, V; Ferrier, A; Dujardin, D; Oubaya, N; Morel, N; Fontanin, N; Ohl, X

    2016-11-01

    The use of the semitendinosus tendon alone for anterior cruciate ligament reconstruction keeps the gracilis muscle intact and decreases anterior pain in comparison with the use of the patellar tendon. Recently, Lubowitz described a new all-inside technique with an ST4 tendon fixed with a cortical button in both femoral and tibial sides. We hypothesized that this type of graft with cortical button fixation provides well-controlled residual anterior tibial translation (<3mm). The aim of this study was to assess the results obtained with this technique in terms of laxity and IKDC score at more than 1 year of follow-up. We performed a prospective single-center study to evaluate the results with this procedure with at least 1 year of follow-up. The primary endpoint was the objective IKDC score and side-to-side anterior tibial translation difference. The secondary endpoint was the subjective assessment using the subjective IKDC and Lysholm scores. Tunnel positioning was assessed using the Aglietti criteria. Thirty-five patients were included and reviewed with a mean follow-up of 19.7 months. Sixty-three percent of the patients were male and the mean age at the procedure was 28 years. The IKDC score was A or B in 43% of the patients and C or D in 57%; 54% of the patients had a residual side-to-side anterior tibial translation difference less than 3mm and 29% presented significant pivot shift (grade C or D). Five patients underwent revision surgery, including one for rupture of the ACL reconstruction. The meniscal status did not influence postoperative laxity and the IKDC grade. Our hypothesis was not verified and the postoperative stability of the knee was insufficient. Postoperative side-to-side anterior tibial translation difference remained greater than 3mm for 16 patients and the analysis seems to indicate that the distal cortical fixation of the graft with an adjusted loop is insufficient. Prospective study - Level IV. Copyright © 2016 Elsevier Masson SAS. All

  14. Systolic Blood Pressure Visit-to-Visit Variability and Major Adverse Outcomes in Atrial Fibrillation: The AFFIRM Study (Atrial Fibrillation Follow-Up Investigation of Rhythm Management).

    PubMed

    Proietti, Marco; Romiti, Giulio Francesco; Olshansky, Brian; Lip, Gregory Y H

    2017-11-01

    Hypertension and atrial fibrillation predict major adverse events independently. Visit-to-visit variability (VVV) in systolic blood pressure (SBP) predicts outcomes beyond SBP itself, but risk associated with SBP-VVV in atrial fibrillation remains uncertain. We evaluated relationships between SBP-VVV, quality of oral anticoagulation control, and outcomes in patients with atrial fibrillation. Data from the AFFIRM trial (atrial fibrillation follow-up investigation of rhythm management) were analyzed. SBP-VVV was defined according to SD of SBP (SBP-SD) during follow-up. SBP-VVV was categorized by quartiles (1st, <10.09; 2nd, 10.09-13.85; 3rd, 13.86-17.33; and 4th, ≥17.34 mm Hg) and as a continuous variable. Among the original cohort, 3843 (94.7%) patients were eligible. Time in therapeutic range and percentage of international normalized ratio in range were progressively lower by quartiles (both P<0.001). An inverse linear association existed between SBP-SD and time in therapeutic range/percentage of international normalized ratio in range (P<0.001). After a median (interquartile range) follow-up of 3.6 (2.7-4.6) years, stroke and major bleeding rates progressively increased by SBP-VVV quartile (both P<0.001). Patients in the 4th quartile had the highest rate of cardiovascular and all-cause death (P=0.005 and P<0.001). A Cox multivariate analysis confirmed that 3rd and 4th quartiles were associated independently with a higher risk for stroke (P=0.042 and P=0.004) and major bleeding (P=0.009 and P<0.001). Patients in 4th quartile had also a higher risk for all-cause death (P=0.048). SBP-SD as a continuous variable was associated with increased risk for all outcomes. In conclusion, SBP-VVV is inversely associated with quality of anticoagulation control and independently predicts major adverse outcomes. Management of blood pressure variability may improve outcomes in atrial fibrillation. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000556. © 2017

  15. The effectiveness and predictors of response to antipsychotic agents to treat impaired quality of life in schizophrenia: A 12-month naturalistic follow-up study with implications for confounding factors, antidepressants, anxiolytics, and mood stabilizers.

    PubMed

    Ritsner, Michael S; Gibel, Anatoly

    2006-12-30

    This study examined specific predictors of the efficacy of risperidone (RP), olanzapine (OL) and first-generation antipsychotic agents (FGAs), the role of confounding factors, and concomitant agents such as antidepressants, anxiolytics, and mood stabilizers in the treatment of health related quality of life (HRQL) impairment of schizophrenia patients. This was a community-based, open label, parallel group naturalistic study of 124 schizophrenia outpatients who received either RP, OL, FGA, or combined agents (CA). Evaluations were performed at baseline and 12 months later. They included the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), the Positive and Negative Syndrome Scale (PANSS), the Distress Scale for Adverse Symptoms, and inventories for the assessment of distress severity, subjective tolerability, and self-efficacy. OL was found to be superior to RP, FGAs and CA in terms of quality of life. FGAs revealed greater therapeutic benefit than RP, which was more beneficial than combined therapy. Improvement in Q-LES-Q was revealed in patients who received antidepressants and anxiolytics, but not mood stabilizers, or anti-Parkinson drugs. This effect was independent of treatment groups and gender. Regression models revealed that changes in emotional distress and side effects were common predictors for HRQL changes across treatment groups. Specific predictors of HRQL efficacy included self-efficacy for OL, negative and positive symptoms for RP, dysphoric mood and positive symptoms, daily doses and self-efficacy for FGA treated patients. These findings suggest that OL is beneficial in the treatment of HRQL impairment in schizophrenia compared with RP, FGAs and CA. Special attention should be paid to specific predictors of HRQL efficacy for each antipsychotic agent, and to concomitant treatment with antidepressants and anxiolytics.

  16. 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

  17. 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

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

    2012-11-01

    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. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. 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.

  19. Comparative assessment of three drug eluting stents with different platforms but with the same biodegradable polymer and the drug based on quantitative coronary angiography and optical coherence tomography at 12-month follow-up.

    PubMed

    Gil, Robert J; Bil, Jacek; Legutko, Jacek; Pawłowski, Tomasz; Gil, Katarzyna E; Dudek, Dariusz; Costa, Ricardo A

    2017-09-30

    The aim of this study was to compare neointima proliferation in three drug-eluting stents (DES) produced by the same company (Balton, Poland) which are covered with a biodegradable polymer and elute sirolimus (concentration: 1.0 and 1.2 µg/mm(2)), but have different stent platforms and strut thickness: stainless steel Prolim(®) (115 µm) and BiOSS LIM(®) (120 µm) and cobalt-chromium Alex(®) (70 µm). We analyzed data of patients with quantitative coronary angiography (QCA) and optical coherence tomography (OCT) at 12 months from BiOSS LIM Registry, Prolim Registry and Alex OCT clinical trial. There were 56 patients enrolled, in whom 29 Prolim(®) stents were deployed, in 11-BiOSS LIM(®) and in 16-Alex stents. The late lumen loss was the smallest in Prolim(®) subgroup (0.26 ± 0.17 mm) and did not differ from Alex(®) subgroup (0.28 ± 0.47 mm). This parameter was significantly bigger in BiOSS(®) subgroup (0.38 ± 0.19 mm; p < 0.05). In OCT analysis there was no statistically significant difference between Prolim(®) and Alex(®) subgroups in terms of mean neointima burden (24.6 ± 8.6 vs. 19.27 ± 8.11%) and neointima volume (28.16 ± 15.10 vs. 24.51 ± 17.64 mm(3)). In BiOSS(®) group mean neointima burden (30.9 ± 6.2%) and mean neointima volume (44.9 ± 4.9 mm(3)) were significantly larger. The morphological analysis revealed that in most cases in all groups the neointima was homogenous with plaque presence only around stent struts. In the QCA and OCT analysis regular DES (Prolim(®) and Alex(®)) obtained similar results, whereas more pronounced response from the vessel wall was found in the BiOSS(®) subgroup.

  20. 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.

  1. Cardiac rehabilitation after acute coronary syndrome comparing adherence and risk factor modification in a community-based shared care model versus hospital-based care in a randomised controlled trial with 12 months of follow-up.

    PubMed

    Bertelsen, Jannik B; Refsgaard, Jens; Kanstrup, Helle; Johnsen, Søren P; Qvist, Ina; Christensen, Bo; Christensen, Kent L

    2017-04-01

    To investigate whether phase II cardiac rehabilitation (CR) conducted by a community model of shared care CR (SC-CR) including health care centres and general practice was feasible and provided acceptable results and to compare SC-CR to hospital-based CR (H-CR) in a randomised controlled trial. Patients were randomised to H-CR or SC-CR after admission for acute coronary syndrome. In SC-CR, the general practitioner took over the responsibility of the remaining rehabilitation, pharmacological treatment and risk factor management after the initial visit to the hospital outpatient clinic. The Municipal Health Care Centres provided courses on smoking cessation, nutrition, and exercise training and contributed to disease education and psychosocial support. The main endpoint was adherence to the CR programme and compliance with lifestyle modifications. In total, 1364 patients were screened, 327 (24%) were eligible, and 212 (65%) accepted participation. Phase II CR was completed by 192 (91%) of the participants. Full adherence to the CR programme was seen in 53% in SC-CR versus 54% in H-CR (relative risk (RR): 0.98, 95% confidence interval: 0.73-1.32). In H-CR, patients had higher rates of adherence to dietary advice and health education. In SC-CR, 12% of patients did not attend the risk factor evaluation and clinical assessment with their general practitioner. No difference in risk factor improvement was found. Exercise training was declined by 25% in both groups. Adherence to phase II CR was high in both groups. SC-CR did not improve adherence and efficacy, but had comparable effects on medication and risk factors. Thus, SC-CR was safe and effective.

  2. Visit-to-Visit Glucose Variability Predicts the Development of End-Stage Renal Disease in Type 2 Diabetes: 10-Year Follow-Up of Taiwan Diabetes Study.

    PubMed

    Yang, Ya-Fei; Li, Tsai-Chung; Li, Chia-Ing; Liu, Chiu-Shong; Lin, Wen-Yuan; Yang, Sing-Yu; Chiang, Jen-Huai; Huang, Chiu-Ching; Sung, Fung-Chang; Lin, Cheng-Chieh

    2015-11-01

    The purpose of this study was to examine the association of glucose variability using coefficient of variation of fasting plasma glucose (FPG-CV) and coefficient of variation of glycated hemoglobin (HbA1c-CV) to end-stage renal disease (ESRD) in 31,841 Chinese patients with type 2 diabetes.Patients with type 2 diabetes enrolled in National Diabetes Care Management Program, aged ≧30 years, and free of ESRD (n = 31,841) in January 1, 2002 to December 31, 2004 were included. Extended Cox proportional hazards regression models with competing risk of all-cause mortality were used to evaluate risk factors on ESRD incidence. Patients were followed till 2012.After a median follow-up period of 8.23 years, 1642 patients developed ESRD, giving a crude incidence rate of 6.27/1000 person-years (6.36 for men, 6.19 for women). After the multivariate adjustment, both FPG-CV and HbA1c-CV were independent predictors of ESRD with corresponding hazard ratios of 1.20 (95% confidence interval [CI] 1.01, 1.41), 1.24 (95% CI 1.05, 1.46) in HbA1c-CV from fourth to fifth quintile and 1.23 (95% CI 1.03, 1.47) in FPG-CV from fifth quintile.One-year visit-to-visit glucose variability expressed by FPG-CV and HbA1c-CV predicted development of ESRD in patients with type 2 diabetes, suggesting therapeutic strategies toward a goal to minimize glucose fluctuation.

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

    PubMed

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

    2011-02-01

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

  4. Male involvement in PMTCT and associated factors among men whom their wives had ANC visit 12 months prior to the study in Gondar town, North west Ethiopia, December, 2014.

    PubMed

    Amano, Abdella; Musa, Abdulbasit

    2016-01-01

    Globally, male involvement has been recognized as a priority focus area to be strengthened in PMTCT but, testing male partners for HIV in the context of preventing mother-to-child transmission remains a challenge in most low- and middle-income countries including Ethiopia. In Ethiopia even though male involvement is one of the guiding principle in testing and counseling of HIV, the magnitude of male involvement in PMTCT is not well known. The objective was to assess the magnitude of male involvement in PMTCT and associated factors among men whom their wives have ANC visit 12 months prior to the study in Gondar town, North west Ethiopia. A community-based cross-sectional survey was conducted from December 1- 20, 2014 among men whose wives had ANC follow up in the last 12 months prior to study period in Gondar town. Cluster sampling was used to get the total of 802 participants. From all participants, only 20.9% of men had high involvement index in prevention of mother to child transmission of HIV/AIDS. Men with secondary and post secondary education (AOR=3.59, 95%CI: 1.36, 9.44), government employment by occupation (AOR=2.23, 95%CI: 1.53, 4.02) men who were married and in union (AOR=4.37, 95%CI: 1.85, 10.32), and men who have heard about PMTCT (AOR=1.74, 95%CI=1.21, 2.49) were more likely to have high involvement index in PMTCT. Male involvement in PMTCT programme was low in the study area. Having information about PMTCT, attending Secondary and post secondary education, being government employer and living in union with partner were factors significantly associated with male involvement in PMTCT. Improving male involvement by creating husband's awareness regarding benefit of PMTCT through provision of balanced information for all male partners is recommended.

  5. 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.

  6. [Factors determining irregular attendance to follow-up visits among human immunodeficiency virus patients: results of the hospital survey of patients infected with human immunodeficiency virus].

    PubMed

    Diaz, Asuncion; Ten, Alicia; Marcos, Henar; Gutiérrez, Gonzalo; González-García, Juan; Moreno, Santiago; Barrios, Ana María; Arponen, Sari; Portillo, Álvaro; Serrano, Regino; García, Maria Teresa; Pérez, José Luis; Toledo, Javier; Royo, Maria Carmen; González, Gustavo; Izquierdo, Ana; Viloria, Luis Javier; López, Irene; Elizalde, Lázaro; Martínez, Eva; Castrillejo, Daniel; Aranguren, Rosa; Redondo, Caridad; Diez, Mercedes

    2015-05-01

    To describe the occurrence of non-regular attendance to follow-up visits among HIV patients and to analyze the determining factors. One-day survey carried out annually (2002-2012) in public hospitals. Epidemiological, clinical and behavioral data are collected in all HIV-infected inpatients and outpatients receiving HIV-related care on the day of the survey. "Non-regular attendance to a follow-up visit" was defined as sporadic attendance to the medical appointments, according to the judgment of the attending physician. Descriptive and bivariate analyses were performed, and factors associated to non-regular attendance to follow-up visits were estimated using logistic regression. A total of 7,304 subjects were included, of whom 13.7% did not attend medical appointments regularly. Factors directly associated with non-regular attendance were: age between 25-49 years; birth in Sub-Saharan Africa or Latin-America; low educational level; being homeless or in prison; living alone or in closed institutions; being unemployed or retired; being an intravenous drug user; not using a condom at last sexual encounter, and injecting drugs in the last 30 days. Conversely, HIV diagnosis within the last year and being men who have sex with men were factors inversely associated with non-regular attendance to follow-up visits. In spite of health care beings free of charge for everyone in Spain, social factors can act as barriers to regular attendance to medical appointments, which, in turn, can endanger treatment effectiveness in some population groups. This should be taken into account when planning HIV policies in Spain. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  7. 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

  8. Establishment of a family-centred care programme with follow-up home visits: implications for clinical care and economic characteristics.

    PubMed

    Hüning, B M; Reimann, M; Beerenberg, U; Stein, A; Schmidt, A; Felderhoff-Müser, U

    2012-11-01

    Elternberatung Frühstart is a family-centred care programme for very preterm infants and seriously ill neonates and their parents. The uniqueness of this programme is in its consistency and continuity in parental counselling from pregnancy at risk to follow-up home visits. Family-centred care is provided by specialised nurses, a social education worker, a case manager, a psychologist and neonatologists. They give support and information to parents and facilitate transition to home including co-ordination of health care services and support networks. The programme starts with information for parents at risk of preterm delivery to lessen their anxieties and worries. After birth, parental bonding is encouraged and parents are involved in daily care procedures. The following weeks focus on communication, information and education in order to enhance parental competence. Discharge planning and coordinated follow-up visits involve the family doctor and several members of the welfare and health care system. One of the key objectives is to prevent re-hospitalisation. Over a 4 year period 330 families participated. Funding is provided by: 1) the hospital, from admission to discharge equivalent to one full-time nursing staff, 2) charity donations for follow-up visits and 3) health care insurance for social medical aftercare (Bunter Kreis) following §43, 2 SGB V in severe cases. As a result of this programme, the median length of stay was reduced by 24 days; the number of patients that stayed longer than average were reduced by 64% in the group of patients born < 1 500 g. At the same time the patient throughput increased from 243 to 413. To conclude, a family-centred care programme with coordinated follow-up increases parental satisfaction, reduces the length of the hospital stay and is therefore profitable. © Georg Thieme Verlag KG Stuttgart · New York.

  9. 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

  10. Clinical outcome following stringent discontinuation of dual antiplatelet therapy after 12 months in real-world patients treated with second-generation zotarolimus-eluting resolute and everolimus-eluting Xience V stents: 2-year follow-up of the randomized TWENTE trial.

    PubMed

    Tandjung, Kenneth; Sen, Hanim; Lam, Ming Kai; Basalus, Mounir W Z; Louwerenburg, J Hans W; Stoel, Martin G; van Houwelingen, K Gert; de Man, Frits H A F; Linssen, Gerard C M; Saïd, Salah A M; Nienhuis, Mark B; Löwik, Marije M; Verhorst, Patrick M J; van der Palen, Job; von Birgelen, Clemens

    2013-06-18

    The aim of this study was to assess the safety and efficacy of the implantation of Resolute zotarolimus-eluting stents (ZES) (Medtronic Inc., Santa Rosa, California) and Xience V everolimus-eluting stents (EES) (Abbott Vascular, Santa Clara, California) following strict discontinuation of dual antiplatelet therapy (DAPT) after 12 months. Only limited long-term follow-up data are available from head-to-head comparisons of second-generation drug-eluting stents. The randomized TWENTE (The Real-World Endeavor Resolute Versus Xience V Drug-Eluting Stent Study in Twente) trial is an investigator-initiated study performed in a population with many complex patients and lesions and only limited exclusion criteria. Patients were randomly assigned 1:1 to ZES (n = 697) or EES (n = 694). Two-year follow-up information was available on all patients. The rate of continuation of DAPT beyond 12 months was very low (5.4%). The primary endpoint of target vessel failure, a composite of cardiac death, target vessel-related myocardial infarction, and target vessel revascularization, did not differ between ZES and EES (10.8% vs. 11.6, p = 0.65), despite fewer target lesion revascularizations in patients with EES (2.6% vs. 4.9%, p = 0.03). The patient-oriented composite endpoint was similar (16.4% vs. 17.1%, p = 0.75). Two-year rates of definite or probable stent thrombosis were 1.2% and 1.4%, respectively (p = 0.63). Very late definite or probable stent thrombosis occurred only in 2 patients in each study arm (0.3% vs. 0.3%, p = 1.00). After 2 years of follow-up and stringent discontinuation of DAPT beyond 12 months, Resolute ZES and Xience V EES showed similar results in terms of safety and efficacy for treating patients with a majority of complex lesions and off-label indications for drug-eluting stents. (The Real-World Endeavor Resolute Versus Xience V Drug-Eluting Stent Study in Twente [TWENTE]; NCT01066650). Copyright © 2013 American College of Cardiology Foundation

  11. Oral information about side effects of endocrine therapy for early breast cancer patients at initial consultation and first follow-up visit: an online survey.

    PubMed

    Luschin, Gero; Habersack, Marion

    2014-01-01

    This study was initiated to identify how physicians inform women about specific side effects of endocrine therapy for early breast cancer. It is recommended that women with early breast cancer receive endocrine treatment for at least 5 years. Although this medication is an important step in curing breast cancer, continued application by patients is far below 100%; 30-50% of all women prematurely end their prescribed therapy. In an online survey, physicians specializing in treating breast cancer (members of the Austrian Breast and Colorectal Cancer Study Group, ABCSG) were asked about their practice of informing patients about potential side effects of endocrine therapy for breast cancer. Two hundred and five members of the ABCSG completed the online questionnaire. The physicians indicated that patients were primarily informed regarding joint pain/muscle pain and flushes/sleep disturbances during the initial consultation as well as during the first follow-up visit. Patients were informed considerably less regarding side effects that influence quality-of-life areas, such as pain during intercourse, reduced orgasm capability, and hair loss. During the initial consultation, and during first follow-up visit, patients are not uniformly and are insufficiently informed about substantial side effects of endocrine therapy.

  12. Long-term effects of nurse home visitation on children's criminal and antisocial behavior: 15-year follow-up of a randomized controlled trial.

    PubMed

    Olds, D; Henderson, C R; Cole, R; Eckenrode, J; Kitzman, H; Luckey, D; Pettitt, L; Sidora, K; Morris, P; Powers, J

    1998-10-14

    A program of home visitation by nurses has been shown to affect the rates of maternal welfare dependence, criminality, problems due to use of substances, and child abuse and neglect. However, the long-term effects of this program on children's antisocial behavior have not been examined. To examine the long-term effects of a program of prenatal and early childhood home visitation by nurses on children's antisocial behavior. Fifteen-year follow-up of a randomized trial. Interviews were conducted with the adolescents and their biological mothers or custodial parents. Semirural community in New York. Between April 1978 and September 1980, 500 consecutive pregnant women with no previous live births were recruited, and 400 were enrolled. A total of 315 adolescent offspring participated in a follow-up study when they were 15 years old; 280 (89%) were born to white mothers, 195 (62%) to unmarried mothers, 151 (48%) to mothers younger than 19 years, and 186 (59%) to mothers from households of low socioeconomic status at the time of registration during pregnancy. Families in the groups that received home visits had an average of 9 (range, 0-16) home visits during pregnancy and 23 (range, 0-59) home visits from birth through the child's second birthday. The control groups received standard prenatal and well-child care in a clinic. Children's self-reports of running away, arrests, convictions, being sentenced to youth corrections, initiation of sexual intercourse, number of sex partners, and use of illegal substances; school records of suspensions; teachers' reports of children's disruptive behavior in school; and parents' reports of the children's arrests and behavioral problems related to the children's use of alcohol and other drugs. Adolescents born to women who received nurse visits during pregnancy and postnatally and who were unmarried and from households of low socioeconomic status (risk factors for antisocial behavior), in contrast with those in the comparison groups

  13. The evaluation of anxiety and panic agarophobia scores in patients with benign paroxysmal positional vertigo on initial presentation and at the follow-up visit.

    PubMed

    Kahraman, Serif Samil; Arli, Cengiz; Copoglu, Umit Sertan; Kokacya, Mehmet Hanifi; Colak, Sait

    2017-05-01

    Patients with BPPV experienced short but intense anxiety and/or panic disorder, especially at the initial visit, but most patients recovered without medication with successful treatment. Recent studies have shown that people with dizziness report some psychological problems such as panic and agoraphobia and anxiety. The aim of this study was to evaluate anxiety and panic agorophobia levels in patients with benign paroxysmal positional vertigo on initial presentation and at the follow-up visit and compare the scores with the control group. All the 32 patients in the study had a diagnosis of BPPV confirmed by their history, typical subjective symptom reports, and characteristic positional nystagmus during the Dix-Hallpike test and/or Roll test. The patients were instructed to complete the standard forms of Beck anxiety inventory and panic agoraphobia scale questionnaire before and at 7 and 14 days after the canalith repositioning treatment. The validity scores of panic agoraphobia were statistically significantly higher in patients with BPPV than in the control group in each period (p < .001) and the validity scores of the Beck anxiety inventory were statistically significantly higher in patients with BPPV than in the control group at the first and second evaluation (p < .001).

  14. Your Baby's Growth: 12 Months

    MedlinePlus

    ... Games, and the Internet Your Baby's Growth: 12 Months KidsHealth > For Parents > Your Baby's Growth: 12 Months Print A A A What's in this article? ... Child's Growth Your Child's Checkup: 1 Year (12 Months) Learning, Play, and Your 8- to 12-Month- ...

  15. 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.

  16. Universal versus conditional three-day follow up visit for children with uncomplicated fever at the community level: design of a cluster-randomized, community-based, non-inferiority trial in Tanganyika, Democratic Republic of Congo.

    PubMed

    van Boetzelaer, Elburg; Ho, Lara S; Gutman, Julie R; Steinhardt, Laura C; Wittcoff, Alison; Barbera, Yolanda; Ngoy, Pascal; Harvey, Steven A; Mullany, Luke C

    2017-01-26

    The current recommendation within integrated Community Case Management guidelines that all children presenting with uncomplicated fever and no danger signs be followed up after three days may not be necessary. Such fevers often resolve rapidly (usually within 48-96 h), and previous studies suggest that expectant home care for uncomplicated fever can be safely recommended. We aim to determine the non-inferiority of a conditional versus a universal follow-up visit for these children. We are conducting a cluster-randomized, community-based, non-inferiority trial enrolling ~4300 children (ages 2-59 months) presenting to community health workers (CHWs) with uncomplicated fever in Tanganyika Province, Democratic Republic of the Congo. Clusters (n = 28) of CHWs are randomized to advise caretakers of such children to either 1) return for a follow-up visit on Day 3 following the initial consultation (Day 1), regardless of illness resolution (as per current guidelines) or 2) return for a follow-up visit on Day 3 only if the child's signs have not resolved. Enrolled children are followed up at Day 7 for a repeat assessment and recording of the primary outcome of the study, "failure", which is defined as having fever, diarrhea, pneumonia or decline of health status (e.g. hospitalization, presenting danger signs, or death). The results of this trial will be interpreted in conjunction with a similarly designed trial currently ongoing in Ethiopia. If a follow-up visit conditional on continued illness is shown to be non-inferior to current guidelines stipulating universal follow-up, appropriate updating of such guidelines could reduce time and human resource pressures on both providers and caregivers throughout communities of sub-Saharan Africa and South Asia. This trial was registered at ClinicalTrials.gov ( NCT02595827 ) on November 2nd, 2015.

  17. Developmental milestones record - 12 months

    MedlinePlus

    ... Sing songs. Have a play date with a child of a similar age. Avoid television and other screen time until age 2. Try using a transitional object to help with separation anxiety. Alternative ... milestones - 12 months; Growth milestones for children - 12 months; Childhood growth milestones - 12 months; Well ...

  18. 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 ...

  19. Impact of clinic follow-up visits on body weight control in people with prediabetes or diabetes mellitus: Japanese nonelderly cohort study.

    PubMed

    Ono, Sachiko; Ono, Yosuke; Matsui, Hiroki; Yasunaga, Hideo

    2017-09-01

    Body weight control is considered essential for the management of diabetes mellitus. Clinicians have an important role in educating and guiding patients with diabetes to control their body weight. The aim of the present study was to clarify if clinic visits influenced body weight control of people with prediabetes or diabetes mellitus. To examine whether individuals with diabetes mellitus who visit clinics show better weight control. We used a large Japanese database (Japan Medical Data Center, Tokyo, Japan) of screening for lifestyle disease linked with administrative claim data to retrospectively identify people with prediabetes or diabetes mellitus based on their fasting plasma glucose and glycated haemoglobin (HbA1c) concentration. We collected data on their baseline characteristics (including age, sex, body mass index and disease history) and their lifestyles. We used propensity-score inverse probability of treatment weighted generalized estimating equations to examine the association between clinic visits and change in body mass index. Between 2013 and 2014, we identified 11004 individuals with prediabetes or diabetes. The proportions visiting clinics after the first diagnosis made at screening was 27.8%. Clinic visit was significantly associated with lower body mass index after adjustment for baseline patient characteristics a year after first screening (-0.17 kg/m2; 95% confidence interval, -0.22 to -0.12). In Japanese people found to have prediabetes or diabetes during an annual health screen, those who visited clinics after their first diagnosis were likely to have better body weight control.

  20. Visiting the cinema, concerts, museums or art exhibitions as determinant of survival: a Swedish fourteen-year cohort follow-up.

    PubMed

    Konlaan, B B; Bygren, L O; Johansson, S E

    2000-09-01

    The aim of this study was to ascertain the possible influence of attending various kinds of cultural events or visiting cultural institutions as a determinant of survival. A cohort of individuals aged 25-74 years from a random sample were interviewed by trained non-medical interviewers in 1982 and 1983. The interviews covered standard-of-living variables. Our independent variables covered visiting cultural institutions and attendance at cultural events, reading books or periodicals, and music making. The non-response rate was about 25%. The cohort was followed with respect to survival for 14 years up to 31st December 1996. The background covariates that were used for control purposes were age, sex, cash buffer, educational standard, long-term disease, smoking, and physical exercise. Our setting was the Swedish survey of living conditions among the adult Swedish population aged 25-74 years. About 10,609 individuals were interviewed in 1982 and 1983. The outcome measure was survival until 31st December 1996. In all, 916 men and 600 women died during this period. We found a higher mortality risk for those people who rarely visited the cinema, concerts, museums, or art exhibitions compared with those visiting them most often. The significant relative risks ranging between RR 1.14 (95% CI. 1.01-1.31) of attending art exhibitions, and RR 1.42 (CI. 1.25-1.60) of attending museums, when adjusting for the nine other variables. Visits to the cinema and concerts gave significant RR in between. We could not discern any beneficial effect of attending the theatre, church service or sports event as a spectator or any effect of reading or music making. Our conclusion is that attendance at certain kinds of cultural events may have a beneficial effect on longevity.

  1. Long-term effects of prenatal and infancy nurse home visitation on the life course of youths: 19-year follow-up of a randomized trial.

    PubMed

    Eckenrode, John; Campa, Mary; Luckey, Dennis W; Henderson, Charles R; Cole, Robert; Kitzman, Harriet; Anson, Elizabeth; Sidora-Arcoleo, Kimberly; Powers, Jane; Olds, David

    2010-01-01

    To examine the effect of prenatal and infancy nurse home visitation on the life course development of 19-year-old youths whose mothers participated in the program. Randomized trial. Semirural community in New York. Three hundred ten youths from the 400 families enrolled in the Elmira Nurse-Family Partnership program. Intervention Families received a mean of 9 home visits (range, 0-16) during pregnancy and 23 (range, 0-59) from birth through the child's second birthday. Youth self-reports of educational achievement, reproductive behaviors, welfare use, and criminal involvement. Relative to the comparison group, girls in the pregnancy and infancy nurse-visited group were less likely to have been arrested (10% vs 30%; relative risk [RR], 0.33; 95% confidence interval [CI], 0.13-0.82) and convicted (4% vs 20%; 0.20; 0.05-0.85) and had fewer lifetime arrests (mean: 0.10 vs 0.54; incidence RR [IRR], 0.18; 95% CI, 0.06-0.54) and convictions (0.04 vs 0.37; 0.11; 0.02-0.51). Nurse-visited girls born to unmarried and low-income mothers had fewer children (11% vs 30%; RR, 0.35; 95% CI, 0.12-1.02) and less Medicaid use (18% vs 45%; 0.40; 0.18-0.87) than their comparison group counterparts. Prenatal and infancy home visitation reduced the proportion of girls entering the criminal justice system. For girls born to high-risk mothers, there were additional positive program effects consistent with results from earlier phases of this trial. There were few program effects for boys.

  2. Can municipality-based post-discharge follow-up visits including a general practitioner reduce early readmission among the fragile elderly (65+ years old)? A randomized controlled trial

    PubMed Central

    Thygesen, Lau Caspar; Fokdal, Sara; Gjørup, Thomas; Taylor, Rod S.

    2015-01-01

    Objective. To evaluate how municipality-based post-discharge follow-up visits including a general practitioner and municipal nurse affect early readmission among high-risk older people discharged from a hospital department of internal medicine. Design and setting. Centrally randomized single-centre pragmatic controlled trial comparing intervention and usual care with investigator-blinded outcome assessment. Intervention. The intervention was home visits with a general practitioner and municipal nurse within seven days of discharge focusing on medication, rehabilitation plan, functional level, and need for further health care initiatives. The visit was concluded by planning one or two further visits. Controls received standard health care services. Patients. People aged 65 + years discharged from Holbæk University Hospital, Denmark, in 2012 considered at high risk of readmission. Main outcome measures. The primary outcome was readmission within 30 days. Secondary outcomes at 30 and 180 days included readmission, primary health care, and municipal services. Outcomes were register-based and analysis used the intention-to-treat principle. Results. A total of 270 and 261 patients were randomized to intervention and control groups, respectively. The groups were similar in baseline characteristics. In all 149 planned discharge follow-up visits were carried out (55%). Within 30 days, 24% of the intervention group and 23% of the control group were readmitted (p = 0.93). No significant differences were found for any other secondary outcomes except that the intervention group received more municipal nursing services. Conclusion. This municipality-based follow-up intervention was only feasible in half the planned visits. The intervention as delivered had no effect on readmission or subsequent use of primary or secondary health care services. PMID:26059872

  3. Enduring effects of prenatal and infancy home visiting by nurses on children: follow-up of a randomized trial among children at age 12 years.

    PubMed

    Kitzman, Harriet J; Olds, David L; Cole, Robert E; Hanks, Carole A; Anson, Elizabeth A; Arcoleo, Kimberly J; Luckey, Dennis W; Knudtson, Michael D; Henderson, Charles R; Holmberg, John R

    2010-05-01

    To test the effect of prenatal and infancy home visits by nurses on 12-year-old, firstborn children's use of substances, behavioral adjustment, and academic achievement. Randomized controlled trial. Public system of obstetric and pediatric care in Memphis, Tennessee. We studied 12-year-old, firstborn children (n = 613) of primarily African American, economically disadvantaged women (743 randomized during pregnancy). Program of prenatal and infancy home visits by nurses. Use of cigarettes, alcohol, and marijuana; internalizing, externalizing, and total behavioral problems; and academic achievement. By the time the firstborn child was 12 years of age, those visited by nurses, compared with those in the control group, reported fewer days of having used cigarettes, alcohol, and marijuana during the 30-day period before the 12-year interview (0.03 vs 0.18, P = .02) and were less likely to report having internalizing disorders that met the borderline or clinical threshold (22.1% vs 30.9%, P = .04). Nurse-visited children born to mothers with low psychological resources, compared with their control group counterparts, scored higher on the Peabody Individual Achievement Tests in reading and math (88.78 vs 85.70, P = .009) and, during their first 6 years of education, scored higher on group-administered standardized tests of math and reading achievement (40.52 vs 34.85, P = .02). No statistically significant program effects were found on children's externalizing or total behavioral problems. Through age 12, the program reduced children's use of substances and internalizing mental health problems and improved the academic achievement of children born to mothers with low psychological resources.

  4. 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.

  5. 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

  6. Effectiveness of Multidisciplinary Group-Based Intervention versus Individual Physiotherapy for Improving Chronic Low Back Pain in Nursing Staff: A Clinical Trial with 3- and 6-Month Follow-Up Visits from Tehran, Iran.

    PubMed

    Ghadyani, Leila; Tavafian, Sedigheh Sadat; Kazemnejad, Anoshirvan; Wagner, Joan

    2017-06-01

    Clinical trial. To evaluate the effectiveness of a multidisciplinary group-based intervention on improving pain and disability among Iranian nurses with chronic low back pain in Tehran, Iran. Although low back pain (LBP) is one of the most important health problems, the challenge remains on how to find an effective intervention to reduce pain and related disabilities. Overall, 136 eligible nurses with chronic mechanical LBP were classified into two groups. The intervention group (n=66 participants) participated in a physiotherapy educational program (for 120 minutes) plus a health educational program based on predictive constructs of the social cognitive theory (for 120 minutes). These interventions were delivered by a physiotherapist and a health education specialist. The control group (n=70 participants) participated in a physiotherapy educational program (for 120 minutes). Disability rate, pain severity, and back pain prevention behavior were measured initially and at 3- and 6-month follow-up visits using the visual analogue scale, Roland-Morris Disability, and Nursing Low Back Pain Preventive Behaviors Questionnaire. Data were analyzed by SPSS ver. 16. There were statistically significant differences between the two groups in the main outcome measures immediately after the educational program and at 3- and 6-month follow-up visits. Preventive behaviors of participants in the intervention group were improved at 3- and 6- month follow-up visits (p<0.001). The mean scores of predictive constructs regarding LBP preventive behaviors in the intervention group were improved after 3 and 6 months (p<0.001). Finally, in the intervention group, pain severity and disability were decreased significantly. This study showed that a multidisciplinary educational program intervention can be an effective approach for reducing LBP and related disabilities among nurses.

  7. Patient satisfaction with nurse-led telephone follow-up after curative treatment for breast cancer

    PubMed Central

    2010-01-01

    Background Current frequent follow-up after treatment for breast cancer does not meet its intended aims, but does depend on expensive and scarce specialized knowledge for routine history taking and physical examinations. The study described in this paper compared patient satisfaction with a reduced follow-up strategy, i.e. nurse-led telephone follow-up, to satisfaction with traditional hospital follow-up. Methods Patient satisfaction was assessed among patients (n = 299) who were participants of a randomized controlled trial investigating the cost-effectiveness of several follow-up strategies in the first year after treatment for breast cancer. Data on patient satisfaction were collected at baseline, three, six and 12 months after treatment, using the Dutch version of Ware's Patient Satisfaction Questionnaire III (PSQ III). In addition to general satisfaction, the PSQ III reports on satisfaction scores for technical competence, interpersonal aspects, and access of care. Regression analysis was used to predict satisfaction scores from whether or not nurse-led telephone follow-up was received. Results Nurse-led telephone follow-up had no statistically significant influence on general patient satisfaction (p = 0.379), satisfaction with technical competence (p = 0.249), and satisfaction with interpersonal aspects (p = 0.662). Regarding access of care, patient satisfaction scores were significantly higher for patients receiving telephone follow-up (p = 0.015). However, a mean difference at 12 months of 3.1 points was judged to be not clinically relevant. Conclusions No meaningful differences were found in satisfaction scores between nurse-led telephone and hospital follow-up in the first year after breast cancer treatment. With high satisfaction scores and the potential to substantially reduce clinic visits, nurse-led telephone follow-up may be an acceptable alternative to traditional hospital follow-up. Trial registration number ISRCTN 74071417. PMID:20429948

  8. 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

  9. 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.

  10. 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

  11. 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, ...

  12. 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.

  13. Quit and Smoking Reduction Rates in Vape Shop Consumers: A Prospective 12-Month Survey

    PubMed Central

    Polosa, Riccardo; Caponnetto, Pasquale; Cibella, Fabio; Le-Houezec, Jacques

    2015-01-01

    Aims: Here, we present results from a prospective pilot study that was aimed at surveying changes in daily cigarette consumption in smokers making their first purchase at vape shops. Modifications in products purchase were also noted. Design: Participants were instructed how to charge, fill, activate and use their e-cigarettes (e-cigs). Participants were encouraged to use these products in the anticipation of reducing the number of cig/day smoked. Settings: Staff from LIAF contacted 10 vape shops in the province of the city of Catania (Italy) that acted as sponsors to the 2013 No Tobacco Day. Participants: 71 adult smokers (≥18 years old) making their first purchase at local participating vape shops were asked by professional retail staff to complete a form. Measurements: Their cigarette consumption was followed-up prospectively at 6 and 12 months. Details of products purchase (i.e., e-cigs hardware, e-liquid nicotine strengths and flavours) were also noted. Findings: Retention rate was elevated, with 69% of participants attending their final follow-up visit. At 12 month, 40.8% subjects could be classified as quitters, 25.4% as reducers and 33.8% as failures. Switching from standard refillables (initial choice) to more advanced devices (MODs) was observed in this study (from 8.5% at baseline to 18.4% at 12 month) as well as a trend in decreasing the e-liquid nicotine strength, with more participants adopting low nicotine strength (from 49.3% at baseline to 57.1% at 12 month). Conclusions: We have found that smokers purchasing e-cigarettes from vape shops with professional advice and support can achieve high success rates. PMID:25811767

  14. Uterine Leiomyomas: Safety and Efficacy of US-guided Suprapubic Transvaginal Radiofrequency Ablation at 1-year Follow-up.

    PubMed

    Wu, Xiang-Jun; Guo, Qing; Cao, Bing-Sheng; Tan, Li-Xia; Zhang, Hong-Yu; Cai, Yu-Ru; Gao, Bu-Lang

    2016-06-01

    Purpose To assess the safety and efficacy of ultrasonography (US)-guided suprapubic transvaginal (ST) radiofrequency ablation (RFA) in the treatment of symptomatic uterine leiomyomas at 1-year follow-up. Materials and Methods The institutional review board approved this prospective study, and all patients provided informed consent. ST RFA was performed as an outpatient procedure 3 days after menstruation in 51 women (age range, 32-52 years; mean age, 42.2 years) with 62 leiomyomas. The leiomyomas were assessed with conventional and contrast material-enhanced US before and after ST RFA for leiomyoma size, location, and blood flow. All patients were evaluated for postoperative complications, including abdominal pain, injury to surrounding tissues and organs, vaginal bleeding, increased vaginal discharge, fever, dyspnea, and menorrhagia, after ST RFA and at follow-up visits. The leiomyoma volumes, improvement in leiomyoma-related symptoms, effect on quality of life (QOL), and patient satisfaction were assessed and compared before and after ST RFA and at follow-up visits by using statistical analyses. Results Sixty-two leiomyomas were successfully treated with ST RFA until 90% of the leiomyoma was echogenic. At 1-month follow-up, 46 (74%) leiomyomas had no contrast enhancement, five (8%) had peripheral enhancement, eight (13%) had focal enhancement, and three (5%) had scattered enhancement at contrast-enhanced US. At 6-month follow-up, the number of leiomyomas that had no enhancement, peripheral enhancement, focal enhancement, or scattered enhancement was 43 (69%), seven (11%), nine (15%), and three (5%), respectively. The leiomyoma volumes were significantly (P < .05) reduced at 1-, 3-, 6-, and 12-month follow-up (from 33.0 cm(3) ± 25.1 [standard deviation] before treatment to 6.8 cm(3) ± 7.7 at 12-month follow-up). The mean percentage volume reduction at 1-, 3-, 6-, and 12-month follow-up was 28%, 57%, 63%, and 78%, respectively. The scores for symptoms and QOL

  15. Performance of Pap smear and human papilloma virus testing in the follow-up of women with cervical intraepithelial neoplasia grade 1 managed conservatively.

    PubMed

    Santos, André Luis Ferreira; Derchain, Sophie Françoise Mauricette; Sarian, Luis Otávio; Martins, Marcos Roberto; Morais, Sirlei Siani; Syrjänen, Kari Juhani

    2006-01-01

    Conservative management (follow-up) of cervical intraepithelial neoplasia grade 1 (CIN1) is acceptable, but evidence on performance of follow-up tools, such as Pap smear and human papilloma virus (HPV) test, is still needed. A cohort of 78 women with histologically confirmed CIN1, referred because of atypical squamous cell or low-grade squamous intraepithelial lesion in their Pap smear, was enrolled between August 2000 and September 2002 and was prospectively followed-up at 6 and 12 months, until September 2003. Follow-up examinations included Pap test and Hybrid Capture II (HCII) with high-risk HPV, colposcopy, and cervical biopsies in patients with persistent abnormalities. Odds ratios and performance indicators (with 95% confidence interval) were calculated for HPV and Pap test results in detecting biopsy-confirmed CIN during the follow-up. Thirty-seven (47%) of the women were HPV-positive at baseline. At first follow-up visit, 30 women had persistent CIN1 and one woman progressed to CIN2; 15 patients had CIN1 and one patient CIN2 at the second follow-up visit. Women with persistent CIN1 (or progression) during follow-up had a significantly higher HPV detection rate and abnormal Pap tests, compared to women with regressive disease. Cytology had a far better sensitivity in detecting CIN than HCII at the first follow-up visit (81 versus 52%, respectively), whereas both examinations had equivalent sensitivities at the second follow-up visit (69 and 56%, respectively). Cytology had a superior negative predictive value at the first follow-up visit and better positive predictive value, in addition, at the second visit. Because cytological abnormalities correlated generally better with the persistence of biopsy-confirmed CIN1 in this follow-up protocol, HCII test is the second-hand option to Pap test, but the use of both Pap and HCII together seems an unnecessary waste of resources.

  16. 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.

  17. Preoperative predictors of adherence to multidisciplinary follow-up care postbariatric surgery.

    PubMed

    Larjani, Soroush; Spivak, Israel; Hao Guo, Ming; Aliarzadeh, Babak; Wang, Wei; Robinson, Sandra; Sockalingam, Sanjeev; Aarts, Mary-Anne

    2016-02-01

    Long-term multidisciplinary care after bariatric surgery is important for weight maintenance and management of co-morbidities. Despite this, the rate of attendance to follow-up appointments is universally low. To identify patient factors that contribute to adherence to follow-up care after bariatric surgery. Three university-affiliated hospitals in Canada A cohort study of 388 patients who underwent bariatric surgery from January 2011 to December 2011 was performed. This program mandates multidisciplinary follow-up care at 3, 6, and 12 months, and annually thereafter. Patients' socioeconomic, psychosocial, and medical and psychiatric co-morbidities were recorded prospectively. Adherence to follow-up care was defined as having attended the majority of clinic visits (3 or 4 out of 4); all other patients were considered nonadherent. The mean age of patients was 45.0 years, 81.2% were female, and the majority underwent a gastric bypass (91.8%) versus a sleeve gastrectomy (8.2%); 62.1% of patients were adherent to follow-up appointments. Patients older than 25 years had a higher adherence rate than those who were younger (63.2% versus 37.5%, P = .040). Patients with full-time or part-time employment had a significantly higher adherence rate than those who were unemployed or retired (65.6% versus 50.0%, P = .017, odds ratio 1.9). Patients with obstructive sleep apnea (OSA) before surgery had higher follow-up adherence than those without OSA (62.2% versus 37.8%, P = .044). In multivariate analysis, employment remained an independent predictor of follow-up adherence (P = .017). Employment was the strongest predictor of attendance to follow-up clinic. Patients with OSA and older patients were also more likely to return consistently for scheduled follow-up. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  18. 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

  19. Variability of bacterial vaginosis over 6- to 12-month intervals.

    PubMed

    Ness, Roberta B; Kip, Kevin E; Soper, David E; Stamm, Carol A; Rice, Peter; Richter, Holly E

    2006-06-01

    To examine variability in bacterial vaginosis (BV) over 6- to 12-month intervals. One thousand one hundred ninety-three women were followed for a median of 3 years with serial vaginal swab Gram stains for BV. Discrete time hazard models were fit to identify independent risk factors for BV. Women with BV at study entry were categorized as having normal flora at the next visit 20% of the time, and women with normal flora at study entry were categorized as having BV at the next visit 20% of the time. Among women with initially normal flora, factors associated with BV were black race, lower education, a history of BV, a history of chlamydial/gonococcal cervicitis, and lack of monogamy. About one fifth of women with normal flora develop BV over a given 6- to 12-month interval, and the modifiable risk factors of cervicitis and lack of monogamy contribute to the development of BV.

  20. Quarterly vs. yearly clinical follow-up of remotely monitored recipients of prophylactic implantable cardioverter-defibrillators: results of the REFORM trial

    PubMed Central

    Hindricks, Gerhard; Elsner, Christian; Piorkowski, Christopher; Taborsky, Milos; Geller, Jan Christoph; Schumacher, Burghard; Bytesnik, Jan; Kottkamp, Hans

    2014-01-01

    Aims The rapidly increasing number of patients with implantable cardioverter-defibrillators (ICD) places a large burden on follow-up providers. This study investigated the possibility of longer in-office follow-up intervals in primary prevention ICD patients under remote monitoring with automatic daily data transmissions from the implant memory. Methods and results Conducted in 155 ICD recipients with MADIT II indications, the study compared the burden of scheduled and unscheduled ICD follow-up visits, quality of life (SF-36), and clinical outcomes in patients randomized to either 3- or 12-month follow-up intervals in the period between 3 and 27 months after implantation. Remote monitoring (Biotronik Home Monitoring) was used equally in all patients. In contrast to previous clinical studies, no calendar-based remote data checks were performed between scheduled in-office visits. Compared with the 3-month follow-up interval, the 12-month interval resulted in a minor increase in the number of unscheduled follow-ups (0.64 vs. 0.27 per patient-year; P = 0.03) and in a major reduction in the total number of in-office ICD follow-ups (1.60 vs. 3.85 per patient-year; P < 0.001). No significant difference was found in mortality, hospitalization rate, or hospitalization length during the 2-year observation period, but more patients were lost to follow-up in the 12-month group (10 vs. 3; P = 0.04). The SF-36 scores favoured the 12-month intervals in the domains ‘social functioning’ and ‘mental health’. Conclusion In prophylactic ICD recipients under automatic daily remote monitoring, the extension of the 3-month in-office follow-up interval to 12 months appeared to safely reduce the ICD follow-up burden during 27 months after implantation. ClinicalTrials.gov Identifier NCT00401466 (http://www.clinicaltrials.gov/ct2/show/NCT00401466). PMID:23868932

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

    MedlinePlus

    ... Child Too Busy? Helping Your Child Adjust to Preschool School Lunches Kids and Food: 10 Tips for Parents Healthy Habits for TV, Video Games, and the Internet Your Child’s Development: 1 Year (12 Months) KidsHealth > For Parents > Your ...

  2. 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.

  3. 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.

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

    PubMed

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

    2016-01-01

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

  5. 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

  6. 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

  7. 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.

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

    PubMed Central

    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. PMID:26212413

  9. [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.

  10. Postpartum follow-up rates before and after the postpartum follow-up initiative at Queen Emma Clinic.

    PubMed

    Tsai, Pai-Jong Stacy; Nakashima, Laurie; Yamamoto, Jan; Ngo, Lynn; Kaneshiro, Bliss

    2011-03-01

    To study postpartum follow-up rates, as well as counseling opportunities, among Queen Emma Clinic patients before and after the implementation of the Queen Emma Clinic Postpartum Follow-up Initiative. This was a retrospective chart review of 221 women who received prenatal care at the Queen Emma Clinic and gave birth between April 2006 and April 2008. In April 2007 the postpartum initiative was started. The primary outcome was the number of postpartum follow-up visits. Secondary outcomes included breastfeeding, contraceptive use, depression screening and referral, follow-up screening for patien ts with gestational diabetes and subsequent pregnancy. Postpartum follow-up rates were significantly higher after the Postpartum Follow-up Initiative (86.1% compared with 71.7%, P =.012). When comparing timing of follow-up, the first postpartum visit occurred approximately one week sooner in the post intervention group (2.96 weeks compared with 3.73 weeks, P=0.38) with no difference in timing of the second postpartum visit (6.62 weeks compared with 6.42 weeks, P=.72). In the post intervention group there were more patients breastfeeding at the first postpartum visit (28.7% compared with 16%, P=.015), as well as the second postpartum visit (28.7% compared with 12.3%, P=0.01). There were also more women using contraception in the post intervention group (84.3% compared with 71.7%, P=.009). There was no difference in depression screening or referral, follow-up screening for gestational diabetes, or timing of subsequent pregnancies. The Postpartum Follow-Up Initiative improved postpartum follow-up rates, as well as breastfeeding, and contraceptive use. Hawaii Medical Journal Copyright 2011.

  11. Postpartum Follow-up Rates Before and After the Postpartum Follow-up Initiative at Queen Emma Clinic

    PubMed Central

    Nakashima, Laurie; Yamamoto, Jan; Ngo, Lynn; Kaneshiro, Bliss

    2011-01-01

    Objective To study postpartum follow-up rates, as well as counseling opportunities, among Queen Emma Clinic patients before and after the implementation of the Queen Emma Clinic Postpartum Follow-up Initiative. Methods This was a retrospective chart review of 221 women who received prenatal care at the Queen Emma Clinic and gave birth between April 2006 and April 2008. In April 2007 the postpartum initiative was started. The primary outcome was the number of postpartum follow-up visits. Secondary outcomes included breastfeeding, contraceptive use, depression screening and referral, follow-up screening for patients with gestational diabetes and subsequent pregnancy. Results Postpartum follow-up rates were signifificantly higher after the Postpartum Follow-up Initiative (86.1% compared with 71.7%, P=.012). When comparing timing of follow-up, the first postpartum visit occurred approximately one week sooner in the post intervention group (2.96 weeks compared with 3.73 weeks, P= 0.38) with no difference in timing of the second postpartum visit (6.62 weeks compared with 6.42 weeks, P=.72). In the post intervention group there were more patients breastfeeding at the first postpartum visit (28.7% compared with 16%, P=.015), as well as the second postpartum visit (28.7% compared with 12.3%, P= 0.01). There were also more women using contraception in the post intervention group (84.3% compared with 71.7%, P=.009). There was no difference in depression screening or referral, follow-up screening for gestational diabetes, or timing of subsequent pregnancies. Conclusion The Postpartum Follow-Up Initiative improved postpartum follow-up rates, as well as breastfeeding, and contraceptive use. PMID:21365543

  12. 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

  13. [Acceptance of preventive home visits among frail elderly persons : Participants an non-participants in a Follow-up after 2 and 4 years within the LUCAS longitudinal study].

    PubMed

    Pröfener, F; Anders, J; Dapp, U; Minder, C E; Golgert, S; von Renteln-Kruse, W

    2016-10-01

    The objective of preventive home visits (PHV) is to support independent living of elderly people. The target group is a matter of discussion and acceptance so far seems to have been low. The target group favored in studies were persons with functional impairments living independently; therefore, acceptance of this offer by frail persons and characteristics of participants and non-participants were studied. All participants classified as frail in the longitudinal urban cohort ageing study (LUCAS; BMBF Fkz 01ET0708-13/01, ET1002A-D/01EL1407) were randomized (RCT) in 2007/2008 into an intervention group (174 persons) and a control group (379 persons). Participants in the intervention group were offered the option of a PHV. Sociodemographic and health-related characteristics were compared between the participants with a PHV, non-participants and controls at baseline and after 2 and 4 years. Non-participants who refused the offer of the PHV were asked about their reasons. There were 64 persons (36.8 %) in the intervention group classified as frail who accepted the offer of a PHV. Of these, significantly more lived alone, tended to be female with a higher educational level and with less need of care. After 2 years significantly more persons in the group without PHV had died and after 4 years more participants with PHV reported a depressive mood. There were no other significant differences between the groups. Half of the reasons not to accept the PHV that were reported by the non-participants were because of health-related or psychological problems and one third because of lack of interest or need for PHV. The offer of PHV to frail elderly persons with an unlimited age was associated with a relatively high acceptance. The high number of refusals by non-participants with functional impairments is remarkable and needs further investigation.

  14. 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.].

  15. 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

  16. 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

  17. Cervical neoplasia after diagnosis and follow-up of women with atypical squamous cells of undetermined significance.

    PubMed

    Murta, E F C; Da Silva, C S; Vieira, J B; Khabbaz, K M; Adad, S J

    2007-01-01

    Although the cytological finding of atypical squamous cells of undetermined significance (ASCUS) occurs in around 5% of women undergoing cytological screening, the clinical evolution is unknown. The objective of this study was to evaluate women with a diagnosis of ASCUS and compare the histological findings and clinical evolution over six and 12 months. 1244 patients with ASCUS (two diagnostic cytologists) were evaluated in this study with Pap Smears and colposcopy (biopsy if necessary) at the first visit, and thereafter at second and third visits (6 and 12 months after the first visit). Comparisons were made between cytological findings and histological diagnoses at every visit during the study and during evolution. At the first visit, 60.3% of the biopsied patients presented histological findings of CIN I, 17.46% CIN II/III and 6.3% invasive neoplasia. At the second visit, 48.3% of the biopsied patients presented CIN I, 24.1% CIN II/III and none invasive neoplasia. At the third visit, 68.9% of the biopsied patients presented CIN I, 13.8% CIN II/III and none invasive carcinoma. If we consider all visits, a total of 213 colposcopy-guided biopsies were performed, representing 17.1% of all the patients included. Of these, 164 (13.2%) presented a histological diagnosis of cervical intraepithelial neoplasia (CIN) and eight (0.6%) presented with invasive carcinoma. We conclude that CIN or invasive lesions frequently occur in women with a diagnosis of ASCUS. Immediate review of the thin sections, new cytological tests or colposcopy and rigorous follow-up should be considered when making a diagnosis of ASCUS.

  18. 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

  19. 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 ...

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

    DTIC Science & Technology

    1961-01-21

    nutrtion , Ecuador 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF 18. NUMBER 19a. NAME OF RESPONSIBLE PERSON a. REPORT b. ABSTRACT c. THIS PAGE ABSTRACT OF... food composition tables for Central and Latin American countries. Miss Pazmino is scheduled to attend the INCAP School of Dietetics within the near...so that the exact intake of the nutrients involved.can be estimated, Questions regarding the Food Composition Tables of INNE from Dr. W. T. WuLeung

  1. 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;

  2. What factors influence follow-up in orthopedic trauma surgery?

    PubMed

    Whiting, Paul S; Greenberg, Sarah E; Thakore, Rachel V; Alamanda, Vignesh K; Ehrenfeld, Jesse M; Obremskey, William T; Jahangir, Alex; Sethi, Manish K

    2015-03-01

    Among surgical patients, follow-up visits are essential for monitoring post-operative recovery and determining ongoing treatment plans. Non-adherence to clinic follow-up appointments has been associated with poorer outcomes in many different patient populations. We sought to identify factors associated with non-attendance at follow-up appointments for orthopedic trauma patients. A retrospective chart review at a level I trauma center identified 2,165 patients who underwent orthopedic trauma surgery from 2008 to 2009. Demographic data including age, sex, race, tobacco use, American Society of Anesthesiologist (ASA) score, insurance status, distance from the hospital, and follow-up time were collected. Injury characteristics including fracture type, anatomic location of the operation, length of hospital stay, living situation and employment status were recorded. Attendance at the first scheduled follow-up visit was recorded. Multivariable log-binomial regression analyses were used with statistical significance maintained at p < 0.05. Of the 2,165 patients included in the analysis, 1,449 (66.9 %) attended their first scheduled post-operative clinic visit. 33.1 % (717) were not compliant with keeping their first clinic appointment after surgery. Patients who used tobacco, lived more than 100 miles from the clinic site, did not have private insurance, had an ASA score >2, or had a fracture of the hip or pelvis were significantly less likely to follow-up. Age, sex, and race were not significantly associated with failure to follow-up. Follow-up appointments are essential for preventing complications among orthopedic trauma patients. By identifying patients at risk of failure to follow-up, orthopedic surgeons can appropriately design and implement long-term treatment plans specifically targeted for high-risk patients.

  3. QuickStats: Percentage* of Adults Aged 18-64 Years Who Had Visited or Talked to a Health Care Professional in the Past 12 Months,† by Race/Ethnicity§ - National Health Interview Survey, 2010 and 2015¶.

    PubMed

    2016-07-29

    From 2010 to 2015, there was an increase in the percentage of non-Hispanic white adults (82.5% to 84.0%) and non-Hispanic black adults (80.5% to 83.5%) aged 18-64 years who had seen or talked to a health care professional in the past 12 months. In 2010, non-Hispanic white adults aged 18-64 years were the most likely to have seen or talked to a health professional in the past 12 months, but there was no significant difference between non-Hispanic white and non-Hispanic black adults in 2015. In both 2010 and 2015, Hispanic adults aged 18-64 years were the least likely to have seen or talked to a health care professional in the past 12 months.

  4. Efficacy and utility of phone call follow-up after pediatric general surgery versus traditional clinic follow-up.

    PubMed

    Fischer, Kevin; Hogan, Virginia; Jager, Alesha; von Allmen, Daniel

    2015-01-01

    Typical follow-up for surgical procedures consists of an interim history and brief focused physical examination. These appointments occupy clinic resources, require a time investment by the family, and rarely identify problems. Previous studies have demonstrated the safety of a postoperative phone call. Compare a traditional in-person clinic postoperative visit with postoperative phone call follow-up regarding patient satisfaction, rate of successful follow-up, and clinic resource utilization in a large academic practice. A retrospective review of charts of patients who underwent select surgical procedures, along with a review of the clinic schedule for the same time period. Efficacy, patient/family satisfaction, and impact on the clinic. Families were contacted by telephone two weeks after select surgical procedures to assess for complications and questions. Cohorts of patients six months before and six months after implementation were assessed for main outcome measures. Before implementation, 55.5% of patients (427/769) who had one of the select surgical procedures were seen in the clinic postoperatively, and 62.6% (435/695) had a successful postoperative phone call follow-up. There were also 1090 overall scheduled postoperative appointments. Six months after implementation, overall postoperative appointments decreased 35.5% to 703. Overall, postoperative-scheduled visits decreased by 6% compared with new visits and other general follow-up visits, which each increased by 3%. A satisfaction survey revealed that 93% of patients (n = 231) were highly satisfied with the process. A hospital cost analysis suggested an 89% cost savings ($101.75 per patient for clinic visit vs $12.50 per patient for phone call follow-up). Postoperative phone call follow-up is an effective tool that improves patient and physician efficiency and satisfaction.

  5. Impairments, activity limitations and participation restrictions 6 and 12 months after breast cancer operation.

    PubMed

    Kärki, Anne; Simonen, Riitta; Mälkiä, Esko; Selfe, James

    2005-05-01

    To describe the impairments of upper body and limbs, activity limitations and participation restrictions 6 and 12 months after operation for breast cancer and to examine the impact of impairments on activity limitations. A prospective survey 6 and 12 months after operation. Ninety-six breast cancer patients. A questionnaire for assessing the impairments, activity limitations and participation restrictions was developed. The most common impairments 6 months after operation were breast and axilla scar tightness, axilla oedema and neck-shoulder pain. At 12-month follow-up the breast scar tightness (p=0.008) and axilla oedema (p=0.023) decreased, and limb ache (p=0.005) increased significantly. The most limiting impairments were axilla oedema and limb numbness 6 months after operation, and at 12-month follow-up axilla oedema. Lifting, carrying and reaching out caused worsening of impairments to more than half of the respondents at 6-month follow-up. Regression analysis showed that many impairments together were determinants of activity limitations and sleep impairment. Participation restrictions were constant. Respondents had not given up participation in activities in the home, but some had abandoned leisure activities and felt that their work ability had decreased. Impairments and their impact on activities were frequent and constant. There is an urgent need for developing rehabilitation protocols for breast cancer patients.

  6. One-year follow-up period after transumbilical thoracic sympathectomy for hyperhidrosis: outcomes and consequences.

    PubMed

    Zhu, Li-Huan; Du, Quan; Chen, Long; Yang, Shengsheng; Tu, Yuanrong; Chen, Shengping; Chen, Weisheng

    2014-01-01

    Thoracic sympathectomy is considered the most effective method to treat palmar hyperhidrosis. We developed a novel approach for thoracic sympathectomy in patients with palmar hyperhidrosis through the umbilicus, using an ultrathin gastroscope. The aim of this study was to evaluate the continuing efficacy and patient satisfaction of this innovative surgery. All procedures were performed under general anesthesia and the patients were intubated with a dual-lumen endotracheal tube. After a 5-mm umbilical incision, the muscular parts of the diaphragmatic dome were incised with a needle-knife and the nasal gastroscope was advanced into the thoracic cavity. The sympathetic chain was identified at the desired thoracic level and ablated with hot biopsy forceps. All patients were followed up for at least 1 year after the procedure through clinic visits or telephone/e-mail interviews. From April 2010 to August 2011, a total of 35 patients underwent a transumbilical thoracic sympathectomy. Fifty-seven percent were male patients, with a mean age of 21.2 years (range, 16-33 years). The success rate after 12 months was 97.1% (34 of 35) for isolated palmar hyperhidrosis and 72.2% (13 of 18) for axillary hyperhidrosis. Compensatory sweating was reported in 28.6% of patients at the 1-year follow-up evaluation. There was no mortality, no diaphragmatic hernia, and no Horner syndrome was observed. Quality of life related to hyperhidrosis improved substantially in 27 (77.1%) patients, and improved in 4 (11.4%) patients at 12 months after surgery. A total of 94.3% of patients were satisfied with the excellent cosmetic results of the surgical incision. Transumbilical thoracic sympathectomy is an efficacious alternative to the conventional approach. This technique avoided the chronic pain and chest wall paresthesia associated with the chest incision. In addition, this novel procedure afforded maximum cosmetic benefits. Copyright © 2014 The American Association for Thoracic Surgery

  7. 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

  8. 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.

  9. Effects of lay support for pregnant women with social risk factors on infant development and maternal psychological health at 12 months postpartum.

    PubMed

    Popo, Emma; Kenyon, Sara; Dann, Sophie-Anna; MacArthur, Christine; Blissett, Jacqueline

    2017-01-01

    The ELSIPS (Evaluation of Lay Support in Pregnant Women with Social Risk) RCT showed that lay support for women with social risk had a positive effect on maternal mental health and mother-infant bonding. This exploratory study examined whether these observed benefits would impact infant development at 1 year. A sub-sample of women whose infants were under one year who had participated in the ELSIPS RCT which randomised women to receive either standard care or the services of a Pregnancy Outreach Worker (POW), and who were contactable, were eligible to participate in the follow up. At home visits, the Bayley Scales of Infant Development (3rd Edition) and standardised measures of depression, self efficacy, mind-mindedness and bonding were completed. 486 women were eligible for follow up, of whom 154 agreed to participate. 61/273 were successfully followed up in the standard maternity care arm and 51/213 in the POW arm. Women who completed follow up were less depressed and had higher selfefficacy scores at 8-12 weeks postpartum than those who did not complete follow up. There were no significant differences in maternal outcomes, infant cognitive development, receptive communication, expressive communication, fine motor development or social/emotional functioning between groups at 12 month follow up. Infants of mothers who received the POW intervention had significantly better gross motor development than infants whose mothers received standard care (p<0.03). The provision of lay support to women with social risk may facilitate infant gross motor skill development at one year but there were no other demonstrable benefits. The effects of the intervention may be underestimated given that those women who completed follow up had better mental health than the original study sample. Controlled-Trials.com ISRCTN35027323.

  10. 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

  11. Impact of thrombolysis on stroke outcome at 12 months in a population: the Bern stroke project.

    PubMed

    Fischer, Urs; Mono, Marie-Luise; Zwahlen, Marcel; Nedeltchev, Krassen; Arnold, Marcel; Galimanis, Aekatarini; Bucher, Sabine; Findling, Oliver; Meier, Niklaus; Brekenfeld, Caspar; Gralla, Jan; Heller, Regula; Tschannen, Beatrice; Schaad, Heinz; Waldegg, Gabriel; Zehnder, Thomas; Ronsdorf, Anke; Oswald, Phillip; Brunner, Georg; Schroth, Gerhard; Mattle, Heinrich P

    2012-04-01

    Thrombolysis improves outcome of patients with acute ischemic stroke, but it is unknown whether thrombolysis has a measurable effect on long-term outcome in a defined population. We prospectively assessed demographic data, management, and outcome of acute ischemic stroke patients admitted within 48 hours to 18 primary care hospitals of the canton of Bern (969 299 inhabitants) during 12 months. Blinded follow-up was obtained at 3 and 12 months. Predictors of mortality and favorable outcome (modified Rankin Scale score ≤2) at 3 and 12 months using logistic regression were analyzed. From December 2007 to December 2008, 807 patients (mean age, 72 years) were included. Median National Institutes of Health Stroke Scale score on admission was 5; 107 patients (13%) received intravenous, intra-arterial, or mechanical thrombolysis. Estimated cumulative mortality at 3 months was 20.6% and at 12 months 27.4%. Age 75 years or older, higher National Institutes of Health Stroke Scale scores, and higher Charlson comorbidity index were independent predictors of mortality at 3 and 12 months. Estimated favorable outcome at 3 months was 48.2% and at 12 months was 44.6%. Thrombolysis was the only modifiable independent predictor of favorable outcome at 3 (relative risk, 1.49; 95% CI, 1.18-1.89) and 12 months (relative risk, 1.59; 95% CI, 1.24-2.04), whereas age younger than 75 years, male gender, National Institutes of Health Stroke Scale score <4, and lower Charlson comorbidity index were nonmodifiable predictors. Thirteen percent of acute ischemic stroke patients admitted within 48 hours to Bernese hospitals underwent thrombolysis, which exerted a measurable effect on 3-month outcome in this population. This effect was sustained at 12 months. Age, stroke severity, Charlson comorbidity index, and male gender were independent nonmodifiable predictors of outcome.

  12. 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…

  13. Prospect Follow Up Pays Dividends in Enrollment.

    ERIC Educational Resources Information Center

    Wassom, Julie

    1993-01-01

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

  14. Intravitreal bevacizumab treatment for choroidal neovascularization in pathologic myopia: 12-month results.

    PubMed

    Gharbiya, Magda; Allievi, Francesca; Mazzeo, Luigi; Gabrieli, Corrado Balacco

    2009-01-01

    To evaluate the short-term efficacy and safety of intravitreal bevacizumab for the treatment of myopic choroidal neovascularization (CNV). Prospective, nonrandomized, interventional case series. Twenty eyes from 20 patients with CNV secondary to pathologic myopia participated in this prospective nonrandomized interventional case series. All patients were scheduled for three monthly intravitreal bevacizumab 1.25 mg injections. Early Treatment Diabetic Retinopathy Study best-corrected visual acuity (BCVA), foveal center thickness (FCT) on optical coherence tomography (OCT), and fluorescein angiographic findings were examined before and after treatment. Patients were followed up for 12 months. The mean BCVA (+/- standard deviation [SD]) at baseline was 24.8 (+/- 11.86) letters (Snellen equivalent: 20/80). At 12 months after treatment, the mean BCVA (+/- SD) improved significantly (P = .000001) to 43 (+/- 12.38) letters (Snellen equivalent: 20/35). At 12 month follow-up, BCVA improved 10 letters or more in 18 (90%) out of 20 treated eyes and improved 15 letters or more in 14 (70%) out of 20 treated eyes. No treated eyes experienced a worsening of BCVA from baseline. The mean FCT (+/- SD) at baseline was 223 (+/- 47.43) microns. At 12 months after treatment, the mean FCT (+/- SD) reduced to 206 (+/- 50.87) microns. This reduction in FCT after treatment was not statistically significant (P = .11). At 12 months follow-up, absence of fluorescein leakage from the CNV was demonstrated in 19 (95%) out of 20 treated eyes and persistent leakage in one eye (5%). None of the 19 eyes that had CNV closure experienced recurrence at 12-month follow-up. No ocular or systemic adverse effects from treatment were encountered. These results of intravitreal bevacizumab in myopic CNV are very promising with no apparent short-term safety concerns. At 12 months, treated eyes had a significant improvement in visual acuity (VA). OCT findings, as well, showed a trend consistent with the

  15. Effect of antiretroviral therapy (ART) on change in fertility intentions of HIV positive women in Addis Ababa, Ethiopia: A prospective follow up study.

    PubMed

    Mekonnen, Hussen

    2017-07-16

    The study aimed to assess change in fertility intentions 12 months after ART initiation among HIV positive women in Addis Ababa, Ethiopia. Institution based follow up study was conducted, among 360 HIV positive women in Addis Ababa; from June 2012 to October 2013. Logistic regression model was used to assess the influence socio-demographic, reproductive health and clinical characteristics on the change in fertility intention of women. Overall, 41.0 % (147/360) of the women reported fertility intentions at the baseline, while 48.3 % (174/360) reported fertility intentions 12 months after follow up. The proportion of fertility intention 12 months after antiretroviral therapy (ART) initiation was higher among ART initiated 55.8% (106/190) than ART naïve 40% (68/170) women. The adjusted analysis indicated that change from the need of no more children at the baseline to the need more children 12 months after ART initiation was significantly associated with woman's ART use (AOR, 2.46, 95% CI, 1.20-5.20), marital status: single (AOR, 5.32, 95% CI, 1.10-25.92), married (AOR, 6.34 95% CI, 1.43-27.99), respectively more likely to report fertility intention than divorced/ widowed women. ART use is significant predictor of change in fertility intention between the baseline and follow up visit suggests that additional effort is necessary to avail integrated family planning and HIV services to address safe fertility goal of women living with HIV in the study area.

  16. Depression 12-months after coronary artery bypass graft is predicted by cortisol slope over the day.

    PubMed

    Poole, Lydia; Kidd, Tara; Ronaldson, Amy; Leigh, Elizabeth; Jahangiri, Marjan; Steptoe, Andrew

    2016-09-01

    Alterations in the diurnal profile of cortisol have been associated with depressed mood in patients with coronary heart disease. The relationship between cortisol output and depressed mood has not been investigated prospectively in coronary artery bypass graft (CABG) patients before. We aimed to study the relationship between cortisol measured pre- and post-operatively and depression symptoms measured 12 months after CABG surgery. We analysed data from 171 patients awaiting first-time, elective CABG surgery from the pre-assessment clinic at St. George's Hospital, London. The Beck Depression Inventory (BDI) was used to assess depression symptoms and saliva samples were collected to measure diurnal cortisol. Baseline assessments of depression and cortisol were obtained an average 29days before surgery, short-term follow-up of cortisol occurred 60days after surgery and long-term follow-up of depression was assessed 378days after surgery. Baseline cortisol slope was not associated with depression at 12-month follow-up. However, a steeper cortisol slope measured 60days after surgery predicted reduced odds of depression (BDI≥10) 12 months after surgery (odds ratio 0.661, 95% confidence interval 0.437-0.998, p=0.049) after controlling for covariates. These findings suggest interventions aimed at improving adaptation in the early recovery period may have long-term benefits in this patient group. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. [Telemedicine in pacemaker therapy and follow-up].

    PubMed

    Schuchert, A

    2009-12-01

    Present-day remote systems for cardiovascular implantable electronic devices (CIEDs) provide, in contrast to previous solutions, a broad range of data about the patient and the implanted device ("remote control"). Telemedicine includes remote monitoring as well as remote follow-up: Remote monitoring is the continual interrogation of the device to detect patient- or device-related adverse events earlier than with standard follow-up visits. Remote follow-up aims to replace scheduled and unscheduled face-to-face follow-up visits due to the interrogation of the automatic pacemaker functions. Currently available remote systems, such as Home Monitoring, CareLink, Merlin.net, and Latitude, have in common that they interrogate the device, send these data to a server, and provide the data to the physician on a secured web site. Automatic wireless interrogation of the device is the preferred solution; however, the devices must have been equipped with a micro-antenna, which is usually restricted to more recent pacemaker models. Knowledge about remote control in pacemaker patients is limited, because most remote applications were evaluated in ICD and CRT patients. While the most frequently reported clinical event in pacemaker patients is atrial fibrillation, the impact in routine clinical follow-up still has to be evaluated in detail. Device-related adverse events are rare. Large, long-term, randomized trials are comparing remote and conventional approaches with the aim of demonstrating the benefits of telemedicine in this patient group.

  18. 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.

  19. A prospective, split-face, randomized, comparative study of safety and 12-month longevity of three formulations of hyaluronic acid dermal filler for treatment of nasolabial folds.

    PubMed

    Prager, Welf; Wissmueller, Esther; Havermann, Isabel; Bee, Eva K; Howell, David J; Zschocke, Ina; Simon, Jeannette

    2012-07-01

    Data regarding several hyaluronic acids (HAs) used identically for facial tissue augmentation have heretofore been unavailable. This prospective, split-face, randomized, two-armed study sought to determine the long-term safety and effectiveness of three HAs (HA-1 (Belotero Basic/Balance), HA-2 (Restylane), and HA-3 (Juvéderm Ultra 3/Juvéderm Ultra Plus XC) in the treatment of nasolabial folds (NLFs). Twenty participants in Arm A received HA-1 in one NLF and HA-2 in the other. In Arm B, 20 participants received HA-1 in one NLF and HA-3 in the other. Injection was at visit 2, with follow-up visits at 1, 6, 9, and 12 months. Mean volume of HA was slightly <1.5 mL/NLF. Adverse events were unremarkable across all HAs, with injection site erythema being the most frequent adverse event. Mean pretreatment NLF severity rating for both arms was 2.3; at 12 months, mean posttreatment severity rating was 1.5 for HA-1/HA-2 and 1.6 for HA-1/HA-3. Although not statistically significant, participants tended to show a preference for HA-1. All three HAs provided essentially equivalent results, except for 4-week evenness results, which favored HA-1. Injection volumes of the three HAs were also similar. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

  20. Follow-up for cervical cancer: a Program in Evidence-Based Care systematic review and clinical practice guideline update

    PubMed Central

    Elit, L.; Kennedy, E.B.; Fyles, A.; Metser, U.

    2016-01-01

    Background In 2009, the Program in Evidence-based Care (pebc) of Cancer Care Ontario published a guideline on the follow-up of cervical cancer. In 2014, the pebc undertook an update of the systematic review and clinical practice guideline for women in this target population. Methods The literature from 2007 to August 2014 was searched using medline and embase [extended to 2000 for studies of human papillomavirus (hpv) dna testing]. Outcomes of interest were measures of survival, diagnostic accuracy, and quality of life. A working group evaluated the need for changes to the earlier guidelines and incorporated comments and feedback from internal and external reviewers. Results One systematic review and six individual studies were included. The working group concluded that the new evidence did not warrant changes to the 2009 recommendations, although hpv dna testing was added as a potentially more sensitive method of detecting recurrence in patients treated with radiotherapy. Comments from internal and external reviewers were incorporated. Recommendations Summary Follow-up care after primary treatment should be conducted and coordinated by a physician experienced in the surveillance of cancer patients. A reasonable follow-up strategy involves visits every 3–4 months within the first 2 years, and every 6–12 months during years 3–5. Visits should include a patient history and complete physical examination, with elicitation of relevant symptoms. Vaginal vault cytology examination should not be performed more frequently than annually. Combined positron-emission tomography and computed tomography, other imaging, and biomarker evaluation are not advocated; hpv dna testing could be useful as a method of detection of recurrence after radiotherapy. General recommendations for follow-up after 5 years are also provided. PMID:27122975

  1. [Early prediction of the neurological result at 12 months in newborns at neurological risk].

    PubMed

    Herbón, F; Garibotti, G; Moguilevsky, J

    2015-08-01

    The aim of this study was to evaluate the Amiel-Tison neurological examination (AT) and cranial ultrasound at term for predicting the neurological result at 12 months in newborns with neurological risk. The study included 89 newborns with high risk of neurological damage, who were discharged from the Neonatal Intensive Care of the Hospital Zonal Bariloche, Argentina. The assessment consisted of a neurological examination and cranial ultrasound at term, and neurological examination and evaluation of development at 12 months. The sensitivity, specificity, positive and negative predictor value was calculated. The relationship between perinatal factors and neurodevelopment at 12 month of age was also calculated using logistic regression models. Seventy children completed the follow-up. At 12 months of age, 14% had an abnormal neurological examination, and 17% abnormal development. The neurological examination and the cranial ultrasound at term had low sensitivity to predict abnormal neurodevelopment. At 12 months, 93% of newborns with normal AT showed normal neurological results, and 86% normal development. Among newborns with normal cranial ultrasound the percentages were 90 and 81%, respectively. Among children with three or more perinatal risk factors, the frequency of abnormalities in the neurological response was 5.4 times higher than among those with fewer risk factors, and abnormal development was 3.5 times more frequent. The neurological examination and cranial ultrasound at term had low sensitivity but high negative predictive value for the neurodevelopment at 12 months. Three or more perinatal risk factors were associated with neurodevelopment abnormalities at 12 months of age. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  2. Clinical Impact of Structured Follow-up After Pancreatic Surgery.

    PubMed

    Tjaden, Christine; Michalski, Christoph W; Strobel, Oliver; Giese, Nathalia; Hennche, Anne-Kathrin; Büchler, Markus W; Hackert, Thilo

    2016-07-01

    Structured follow-up after surgery for pancreatic ductal adenocarcinoma (PDAC) remains controversial and is currently not recommended due to a supposed lack of therapeutic consequences. Furthermore, it is not clear whether noncancer patients after pancreas resection need to be seen in the clinic on a regular basis. The present study analyzed how follow-up after pancreatic surgery affected postoperative treatment and long-term outcomes. Data of all postoperative visits in a specialized outpatient clinic for pancreatic diseases were analyzed for a 1-year period with regard to symptoms, diagnostic procedures, and therapeutic consequences. Six hundred eighteen patients underwent 940 postoperative follow-ups. Nearly half of them needed a change of medication due to altered pancreatic function. In 74 (40%) of 184 resected PDAC patients, recurrence (local or systemic) was detected during follow-up, although only 19 of these had shown associated symptoms (26%). In all patients with recurrence, a cancer-directed treatment was induced. Eleven (69%) of 16 patients with isolated local recurrence were referred for reresection. Follow-up examinations are a substantial part of the clinical management after pancreas resections. Follow-up is particularly important for PDAC because recurrence is often asymptomatic, but its detection allows for therapeutic interventions and potentially improved prognosis. This should be implemented in future guidelines.

  3. Nurse-led follow-up at home vs. conventional medical outpatient clinic follow-up in patients with incurable upper gastrointestinal cancer: a randomized study.

    PubMed

    Uitdehaag, Madeleen J; van Putten, Paul G; van Eijck, Casper H J; Verschuur, Els M L; van der Gaast, Ate; Pek, Chulja J; van der Rijt, Carin C D; de Man, Rob A; Steyerberg, Ewout W; Laheij, Robert J F; Siersema, Peter D; Spaander, Manon C W; Kuipers, Ernst J

    2014-03-01

    Upper gastrointestinal cancer is associated with a poor prognosis. The multidimensional problems of incurable patients require close monitoring and frequent support, which cannot sufficiently be provided during conventional one to two month follow-up visits to the outpatient clinic. To compare nurse-led follow-up at home with conventional medical follow-up in the outpatient clinic for patients with incurable primary or recurrent esophageal, pancreatic, or hepatobiliary cancer. Patients were randomized to nurse-led follow-up at home or conventional medical follow-up in the outpatient clinic. Outcome parameters were quality of life (QoL), patient satisfaction, and health care consumption, measured by different questionnaires at one and a half and four months after randomization. As well, cost analyses were done for both follow-up strategies in the first four months. In total, 138 patients were randomized, of which 66 (48%) were evaluable. At baseline, both groups were similar with respect to clinical and sociodemographic characteristics and health-related QoL. Patients in the nurse-led follow-up group were significantly more satisfied with the visits, whereas QoL and health care consumption within the first four months were comparable between the two groups. Nurse-led follow-up was less expensive than conventional medical follow-up. However, the total costs for the first four months of follow-up in this study were higher in the nurse-led follow-up group because of a higher frequency of visits. The results suggest that conventional medical follow-up is interchangeable with nurse-led follow-up. A cost utility study is necessary to determine the preferred frequency and duration of the home visits. Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  4. Outpatient follow-up of patients hospitalized for acute leptospirosis

    PubMed Central

    Spichler, Anne; Athanazio, Daniel; Seguro, Antonio C.; Vinetz, Joseph M.

    2011-01-01

    Summary Objective The outcome of leptospirosis after the resolution of acute disease, either spontaneously or after treatment, is not well described. The aim of this study was to assess the possible sequelae of acute leptospirosis after hospital discharge. Methods We report here a prospective study carried out in São Paulo, Brazil in which patients hospitalized for leptospirosis were followed in the outpatient setting. Results Forty-seven patients were serially assessed: 32 severe and 15 mild cases. Early and late complications were not common in either group, but subjective complaints were common in the first few weeks after hospital discharge (53% of severe cases, 40% of mild cases). Two patients had continuing complaints: one had profound general malaise and the other developed new onset panic disorder. The sample analyzed represented 26% of the patients hospitalized with leptospirosis in the city of São Paulo during the study period. The duration of follow-up was an average of approximately 20 days at the first visit, and approximately 40 days at the second visit. Forty-seven patients came for one follow-up visit and 22 of the same patients had two follow-up visits. Conclusions While two of 47 patients reported continuing symptoms after hospitalization for acute leptospirosis, no definitive, objective evidence of chronic sequelae due to this infection was proven. While preliminary, these observations point to the need for a prospective, rigorous and systematic study to definitively determine and characterize late complications and chronic disease after acute leptospirosis. PMID:21616696

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

    SciTech Connect

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

    2009-09-15

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

  6. Follow-up study for a disease management program for chronic heart failure 24 months after program commencement.

    PubMed

    Otsu, Haruka; Moriyama, Michiko

    2012-12-01

    There are few studies dealing with comprehensive chronic heart failure (CHF) disease management programs, which are based on self-management, in Japan. We developed and conducted a comprehensive educational program for CHF for 6 months that aimed to improve self-management and prevent the deterioration of outpatients with CHF. Our follow-up research focused on whether performance of self-management in the intervention group continued for 24 months after commencement. Participants were selected from patients who went for follow-up visits to one Japanese clinic, which specialized in cardiovascular internal medicine, that were diagnosed with CHF. During the first follow-up period, 7 to 12 months after program commencement, 47 participants in the intervention group and 47 participants in the control group were analyzed. During the second follow-up period, 13 to 24 months after program commencement, 41 participants in the intervention group were analyzed. Participants in the intervention group acquired self-management skills and activities and these continued up to 24 months after the program commencement. As a result, no deterioration in symptoms related to CHF was demonstrated. Meanwhile, quitting smoking and drinking depended on individual preference and it was difficult to improve. The educational program was effective in the long term and the program is significant for use in busy medical situations that do not offer sufficient follow-up support for patients. Regular intervention and ways that produce longer-lasting effects should be further developed. © 2011 The Authors. Japan Journal of Nursing Science © 2011 Japan Academy of Nursing Science.

  7. Five-Year Follow-Up of a 30-Month Trial of Stability of Silicone Band Frontalis Suspension for the Treatment of Severe Unilateral Upper Eyelid Ptosis in Infants.

    PubMed

    Nucci, Paolo; Lembo, Andrea; Santangelo, Elisabetta; Fogagnolo, Paolo; Serafino, Massimiliano

    2016-01-01

    To evaluate the five-year stability of frontalis suspension of the upper eyelid with a silicone band for the treatment of severe congenital ptosis in infants. Chart review of pediatric patients with a follow-up of five years after unilateral frontalis suspension with silicone band was reviewed. Margin-reflex distance (MRD) and corneal staining were measured at different follow-up visits. Data were analyzed by analysis of variance and t test for paired data. Twenty pediatric patients were included in this retrospective study. MRD was severely reduced before surgery in all cases: it ranged from -1 mm to -4 mm (-2.4 ± 0.8 mm). After surgery, MRD increased to 2.9 ± 0.3 mm, and then progressively decreased by 0.6 mm within the first three months (p < 0.001); a further reduction of 0.2 mm, occurring between three and 12 months after surgery, was not statistically significant (p < 0.001). Between the 12-month and the five-year follow-up visits (one visit every six months), no changes in MRD were found for any patient. After the five-years visit, no substantial changes were recorded in 18 patients (90%); in two patients, a second surgery to improve the deterioration was necessary. Corneal staining, which was present in five patients (25%) during the first two postoperative weeks, disappeared over five years of follow-up. During the five-year follow-up of this retrospective study, the frontalis suspension with a silicone band proved to be a stable procedure. After 30 months from the first observation, MRD values were stable, except for two patients that underwent a second surgery to stabilize the worsening ptosis.

  8. 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.

  9. A 12-Month Prospective Cohort Study of Symptoms of Common Mental Disorders Among European Professional Footballers.

    PubMed

    Gouttebarge, Vincent; Aoki, Haruhito; Verhagen, Evert A L M; Kerkhoffs, Gino M M J

    2017-09-01

    To determine the 12-month incidence and comorbidity of symptoms of common mental disorders (CMD) among European professional footballers and to explore the association of potential stressors with the health conditions under study among those European professional footballers. Observational prospective cohort study with a follow-up period of 12 months. Male professional footballers from 5 European countries (n = 384 at baseline). Adverse life events, conflicts with trainer/coach, and career dissatisfaction were explored by using validated questionnaires. Symptoms of distress, anxiety/depression, sleep disturbance, and adverse alcohol use were assessed using validated questionnaires. A total of 384 players (mean age of 27 years old; mean career duration of 8 years) were enrolled, of which 262 completed the follow-up period. The incidence of symptoms of CMD were 12% for distress, 37% for anxiety/depression, 19% for sleep disturbance, and 14% for adverse alcohol use. Over the follow-up period of 12 months, approximately 13% of the participants reported 2 symptoms, 5% three symptoms, and 3% four symptoms. Professional footballers reporting recent adverse life events, a conflict with trainer/coach, or career dissatisfaction were more likely to report symptoms of CMD, but statistically significant associations were not found. The 12-month incidence of symptoms of CMD among European professional footballers ranged from 12% for symptoms of distress to 37% for symptoms of anxiety/depression. A professional football team typically drawn from a squad of 25 players can expect symptoms of CMD to occur among at least 3 players in one season.

  10. Follow-up Cost Study. TEX-SIS FOLLOW-UP SC5.

    ERIC Educational Resources Information Center

    Baugh, Ronald C.

    This report presents data on the costs of follow-up studies, based on 29 separate follow-up studies conducted by eight public community/junior colleges in Texas. The purpose of this study, conducted by Navarro College as a subcontractor of Project FOLLOW-UP, was to provide data and information regarding the cost of follow-up studies that would be…

  11. 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…

  12. 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.

  13. 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…

  14. Long-term follow-up of psilocybin-facilitated smoking cessation.

    PubMed

    Johnson, Matthew W; Garcia-Romeu, Albert; Griffiths, Roland R

    2017-01-01

    A recent open-label pilot study (N = 15) found that two to three moderate to high doses (20 and 30 mg/70 kg) of the serotonin 2A receptor agonist, psilocybin, in combination with cognitive behavioral therapy (CBT) for smoking cessation, resulted in substantially higher 6-month smoking abstinence rates than are typically observed with other medications or CBT alone. To assess long-term effects of a psilocybin-facilitated smoking cessation program at ≥12 months after psilocybin administration. The present report describes biologically verified smoking abstinence outcomes of the previous pilot study at ≥12 months, and related data on subjective effects of psilocybin. All 15 participants completed a 12-month follow-up, and 12 (80%) returned for a long-term (≥16 months) follow-up, with a mean interval of 30 months (range = 16-57 months) between target-quit date (i.e., first psilocybin session) and long-term follow-up. At 12-month follow-up, 10 participants (67%) were confirmed as smoking abstinent. At long-term follow-up, nine participants (60%) were confirmed as smoking abstinent. At 12-month follow-up 13 participants (86.7%) rated their psilocybin experiences among the five most personally meaningful and spiritually significant experiences of their lives. These results suggest that in the context of a structured treatment program, psilocybin holds considerable promise in promoting long-term smoking abstinence. The present study adds to recent and historical evidence suggesting high success rates when using classic psychedelics in the treatment of addiction. Further research investigating psilocybin-facilitated treatment of substance use disorders is warranted.

  15. 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.

  16. 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 ...

  17. 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 ...

  18. 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 ...

  19. 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.

  20. Predictors of follow-up for overweight youth and parents.

    PubMed

    Pratt, Keeley J; Collier, David N; Walton, Nicole L; Lazorick, Suzanne; Lamson, Angela L

    2015-03-01

    Attrition is a significant problem for health care providers working with youth and parents involved in childhood obesity treatment. Barriers for families in childhood obesity treatment have been explored, but less is known about factors that may be associated with follow-up attendance. The purpose of this study is to explore youth and parent variables, pediatrician's evaluations of youth and parents' likelihood to change (LTC), and their association with attendance at follow-up. One hundred ninety-three youth and parent dyads were included in the sample; slightly more than half of the sample did not return for a follow up visit. Descriptive statistics, paired and independent t tests, and correlations were used to determine associations between youth and parent demographic factors, attendance at follow-up, and pediatricians' evaluation of likelihood to change. Evaluations of LTC and demographic factors did not significantly associate with follow-up appointment attendance. Single parents were more likely to be rated by pediatricians as likely to make changes. Implications for future research and clinical practice are discussed.

  1. Individualized follow up programme and early discharge in term neonates.

    PubMed

    De Carolis, Maria Pia; Cocca, Carmen; Valente, Elisabetta; Lacerenza, Serafina; Rubortone, Serena Antonia; Zuppa, Antonio Alberto; Romagnoli, Costantino

    2014-07-15

    Early discharge of mother/neonate dyad has become a common practice, and its effects are measured by readmission rates. We evaluated the safety of early discharge followed by an individualized Follow-up programme and the efficacy in promoting breastfeeding initiation and duration. During a nine-month period early discharge followed by an early targeted Follow-up was carried out in term neonates in the absence of weight loss <10% or hyperbilirubinaemia at risk of treatment. Follow-up visits were performed at different timepoints with a specific flow-chart according to both bilirubin levels and weight loss at discharge. During the study period early discharge was performed in 419 neonates and Follow-up was carried out in 408 neonates (97.4%). No neonates required readmission for hyperbilirubinaemia and dehydration during the first 28 days of life. Breastfeeding rate was 90.6%, 75.2%, 41.5% at 30, 90 and 180 days of life, respectively. A six-month phone interview was performed for 383 neonates (93.8%) and satisfaction of parents about early discharge was high in 345 cases (90.1%). Early discharge in association with an individualized Follow-up programme resulted safe for the neonate and effective for breastfeeding initation and duration.

  2. Robotic Follow-Up for Human Exploration

    NASA Technical Reports Server (NTRS)

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

    2010-01-01

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

  3. 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)

  4. Heart Valve Surgery Recovery and Follow Up

    MedlinePlus

    ... Disease Venous Thromboembolism Aortic Aneurysm More Heart Valve Surgery Recovery and Follow Up Updated:Sep 14,2016 ... Surgery Milestones • Personal Stories Video: Preparing For Your Surgery Find helpful tips from others who have successfully ...

  5. E3 Sample Follow-up Email

    EPA Pesticide Factsheets

    Sample follow-up email to assist in identifying and nominating those suppliers who you think could benefit most from joining the Green Suppliers Network; your role is to facilitate supplier selection and engagement.

  6. Feasibility of telephone follow-up after medical abortion.

    PubMed

    Perriera, Lisa K; Reeves, Matthew F; Chen, Beatrice A; Hohmann, Heather L; Hayes, Jennifer; Creinin, Mitchell D

    2010-02-01

    This study was conducted to assess the feasibility of using telephone calls combined with high-sensitivity urine pregnancy testing as a primary method of follow-up after medical abortion. We enrolled 139 women up to 63 days of gestation to receive mifepristone 200 mg orally and misoprostol 800 mcg vaginally or buccally, per their choice. Participants were contacted by phone one week after mifepristone administration and interviewed using standardized questions. If the subject or clinician thought the pregnancy was not expelled, the subject returned for an ultrasound examination. Otherwise, subjects performed high-sensitivity home urine pregnancy testing 30 days after the mifepristone and were called within 3 days of the test. Those with positive pregnancy tests returned for an ultrasound examination. Those with negative tests required no further follow-up. Six of the 139 (4.3%, 95% CI 1.6-9.1%) subjects presented prior to Phone Call 1 for an in-person visit. All 133 (100%, 95% CI 97.8-100%) subjects eligible for their first telephone follow-up were contacted. Eight of the 133 (6.1%, 95% CI 2.6-11.5%) women were asked to return for evaluation and all did so (100%, 95% CI 63.1-100%). Eight of the 133 women eligible for the 30 day phone call presented for an interim visit prior to the call. After 30 days, 116 of the 117 (99.1%, 95% CI 97.5-100%) eligible subjects were contacted. One subject was not reached for the day 30 phone call. Twenty-seven of the 116 (23.3%, 95% CI 15.6-31.0%) subjects had a positive pregnancy test and required follow-up. Two of these subjects (7.4%, 95% CI 1.0-24.2%) did not return for in-person follow-up. Two of the 116 (1.7%, 95% CI 0.2-6.1%) subjects had inconclusive pregnancy tests and were asked to return for follow-up. One of these subjects (50%, 95% CI 1.2-98.7%) did not return. Complete follow-up was achieved in 135 of the 139 subjects (97.1%, 95% CI 94.3-99.9%). None of the 26 women evaluated for a positive or inconclusive pregnancy

  7. 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.

  8. 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

  9. 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.

  10. 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)…

  11. 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)…

  12. VeClose trial 12-month outcomes of cyanoacrylate closure versus radiofrequency ablation for incompetent great saphenous veins.

    PubMed

    Morrison, Nick; Gibson, Kathleen; Vasquez, Michael; Weiss, Robert; Cher, Daniel; Madsen, Monte; Jones, Andrew

    2017-05-01

    Endovenous cyanoacrylate closure (CAC) is a new U.S. Food and Drug Administration-approved therapy for treatment of clinically symptomatic venous reflux in saphenous veins. The device is indicated for the permanent closure of lower extremity superficial truncal veins, such as the great saphenous vein (GSV). Early results from a randomized trial of CAC have been reported previously. Herein we report 1-year outcomes. There were 222 subjects with symptomatic GSV incompetence randomly assigned to receive either CAC (n = 108) or radiofrequency ablation (RFA; n = 114). After the month 3 visit, subjects could receive adjunctive therapies aimed at treating visible varicosities and incompetent tributaries. Vein closure was assessed at day 3 and months 1, 3, 6, and 12 using duplex ultrasound. Additional study visit assessments included the Venous Clinical Severity Score; Clinical, Etiology, Anatomy, and Pathophysiology classification; EuroQol-5 Dimension; and Aberdeen Varicose Vein Questionnaire. Both time to closure and time to first reopening of the target vein were evaluated using survival curve analysis. Adverse events were evaluated at each visit. Of 222 enrolled and randomized subjects, a 12-month follow-up was obtained for 192 (95 CAC and 97 RFA; total follow-up rate, 192/222 [86.5%]). By month 1, 100% of CAC subjects and 87% of RFA subjects demonstrated complete occlusion of the target vein. By month 12, the complete occlusion rate was nearly identical in both groups (97.2% in the CAC group and 97.0% in the RFA group). Twelve-month freedom from recanalization was similar in the CAC and RFA groups, although there was a trend toward greater freedom from recanalization in the CAC group (P = .08). Symptoms and quality of life improved equally in both groups. Most adverse events were mild to moderate and not related to the device or procedure. In patients with incompetent GSVs, treatment with both CAC and RFA results in high occlusion rates. Time to complete occlusion

  13. Emotional and Social Development: 8 to 12 Months

    MedlinePlus

    ... Feeding & Nutrition Preemie Sleep Teething & Tooth Care Toddler Preschool ... and Social Development: 8 to 12 Months Page Content Article Body During these months, your child sometimes may seem like two separate babies. First ...

  14. 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.

  15. Impact of an Intervention to Improve Contraceptive Use Through Follow-Up Phone Calls to Female Adolescent Clinic Patients

    PubMed Central

    Kirby, Douglas; Raine, Tina; Thrush, Greg; Yuen, Cora; Sokoloff, Abby; Potter, Susan C.

    2011-01-01

    CONTEXT Adolescent females often have questions or concerns about their contraceptive methods, and they may discontinue use if these questions are not answered. Little evidence exists on whether follow-up phone calls to address young women’s concerns can help sustain contraceptive use. METHODS Between 2005 and 2007, a total of 805 females aged 14–18 attending a reproductive health clinic in San Francisco were randomly assigned to receive either regular clinic services or regular clinic services plus nine follow-up phone calls over 12 months. The young women were surveyed at baseline and roughly six, 12 and 18 months later to measure condom and contraceptive use, rates of pregnancy and STDs, and other outcomes and mediators. Multiple linear and logistic regression repeated measures analyses were used to assess the program’s effects. RESULTS Clinic counselors completed only 2.7 calls per patient, and made 7.8 attempts for every completed call. Although contraceptive use increased from baseline to follow-up at six months in both groups, levels of condom and contraceptive use, and rates of pregnancy and STDs, did not differ between the intervention and control groups at any of the follow-up assessments. Moreover, the intervention did not improve clinic utilization or satisfaction or have consistent positive effects on participants’ attitudes. CONCLUSIONS Reaching young women by phone after a clinic visit for contraception is challenging and does not appear to provide significant benefits beyond those provided by basic clinic services. More intensive interventions may be needed to markedly change adolescent sexual and contraceptive behavior. PMID:21126301

  16. Family, Friends, and 12-month PTSD among African Americans

    PubMed Central

    Nguyen, Ann W.; Chatters, Linda M.; Taylor, Robert Joseph; Levine, Debra Siegel; Himle, Joseph A.

    2016-01-01

    Purpose Despite a growing literature on the influence of social support on mental health, little is known about the relationship between social support and specific psychiatric disorders for African Americans, such as PTSD. This study investigated the relationship between social support, negative interaction with family and 12-month PTSD among African Americans. Methods Analyses were based on a nationally representative sample of African Americans from the National Survey of American Life (n=3,315). Social support variables included emotional support from family, frequency of contact with family and friends, subjective closeness with family and friends, and negative interactions with family. Results Results indicated that emotional support from family is negatively associated with 12-month PTSD while negative interaction with family is predictive of 12-month PTSD. Additionally, a significant interaction indicated that high levels of subjective closeness to friends could offset the impact of negative family interactions on 12-month PTSD. Conclusions Overall, study results converged with previously established findings indicating that emotional support from family is associated with 12-month PTSD, while, negative interaction with family is associated with increased risk of 12-month PTSD. The findings are discussed in relation to prior research on the unique association between social support and mental health among African Americans. PMID:27189209

  17. Patients' expectations and preferences regarding cancer follow-up care.

    PubMed

    Brandenbarg, D; Berendsen, A J; de Bock, G H

    2017-07-05

    Most survivors of cancer enter a follow-up routine after their treatment, the aim of which is to detect recurrence, provide psychological support, monitor treatment-related side-effects, and to evaluate care. Due to rising numbers of people with cancer and better survival of these patients, current follow-up routines are under pressure. We reviewed the literature on patients' expectations and preferences regarding this care. We systematically searched the databases of Pubmed, CINAHL, and PsychInfo. Studies were screened and data extraction was double performed by three authors. Data were collected from quantitative and qualitative studies and described thematically. After screening, 12 full-text articles were included, comprising 849 patients aged from 28 to 90 years. Patients expect follow-up visits to detect recurrence of cancer. They want to undergo extensive testing to get reassurance. Furthermore, patients expect relevant information to be provided and to get advice about different aspects of their illness. Psychosocial support is also expected. Patients express a desire for consistency of care as well as continuity of care, and prefer long and intensive follow-up. After cancer, patients appear to lose confidence in their bodies and fear cancer recurrence after the end of treatment, which may lead to intensive screening wishes. This is not desirable, since care for cancer is already under pressure due to rising numbers of survivors. We have to ensure that follow-up routines are sustainable and effective. Patients should receive good information about the need for follow-up tests. Doctors should be trained to give this information. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Outpatient follow-up of patients hospitalized for acute leptospirosis.

    PubMed

    Spichler, Anne; Athanazio, Daniel; Seguro, Antonio C; Vinetz, Joseph M

    2011-07-01

    The outcome of leptospirosis after the resolution of acute disease, either spontaneously or after treatment, is not well described. The aim of this study was to assess the possible sequelae of acute leptospirosis after hospital discharge. We report here a prospective study carried out in São Paulo, Brazil in which patients hospitalized for leptospirosis were followed in the outpatient setting. Forty-seven patients were serially assessed: 32 severe and 15 mild cases. Early and late complications were not common in either group, but subjective complaints were common in the first few weeks after hospital discharge (53% of severe cases, 40% of mild cases). Two patients had continuing complaints: one had profound general malaise and the other developed new onset panic disorder. The sample analyzed represented 26% of the patients hospitalized with leptospirosis in the city of São Paulo during the study period. The duration of follow-up was an average of approximately 20 days at the first visit, and approximately 40 days at the second visit. Forty-seven patients came for one follow-up visit and 22 of the same patients had two follow-up visits. While two of 47 patients reported continuing symptoms after hospitalization for acute leptospirosis, no definitive, objective evidence of chronic sequelae due to this infection was proven. While preliminary, these observations point to the need for a prospective, rigorous and systematic study to definitively determine and characterize late complications and chronic disease after acute leptospirosis. Copyright © 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  19. 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

  20. [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.

  1. 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

  2. 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.

  3. Delayed Graft Function Phenotypes and 12-Month Kidney Transplant Outcomes.

    PubMed

    Hall, Isaac E; Reese, Peter P; Doshi, Mona D; Weng, Francis L; Schröppel, Bernd; Asch, William S; Ficek, Joseph; Thiessen-Philbrook, Heather; Parikh, Chirag R

    2017-08-01

    Ischemia-reperfusion injury (IRI) leading to delayed graft function (DGF), defined by the United Network for Organ Sharing as dialysis in the first week (UNOS-DGF), associates with poor kidney transplant outcomes. Controversies remain, however, about dialysis initiation thresholds and the utility for other criteria to denote less severe IRI, or slow graft function (SGF). Multicenter, prospective study of deceased-donor kidney recipients to compare UNOS-DGF to a definition that combines impaired creatinine reduction in the first 48 hours or greater than 1 dialysis session for predicting 12-month estimated glomerular filtration rate (eGFR). We also assessed 10 creatinine and urine output-based SGF definitions relative to 12-month eGFR. In 560 recipients, 215 (38%) had UNOS-DGF, 330 (59%) met the combined definition, 14 (3%) died, and 23 (4%) had death-censored graft failure by 12 months. Both DGF definitions were associated with lower adjusted 12-month eGFR (95% confidence interval)-by 7.3 (3.6-10.9) and 7.4 (3.8-11.0) mL/min per 1.73 m, respectively. Adjusted relative risks for 12-month eGFR less than 30 mL/min per 1.73 m were 1.9 (1.2-3.1) and 2.1 (1.1-3.7), with unadjusted areas under the curve of 0.618 and 0.627, respectively. For SGF definitions, postoperative day (POD) 7 creatinine had the strongest association with 12-month eGFR, and POD5 creatinine and creatinine reduction between POD1 and POD2 demonstrated modest separations in 12-month eGFR. Although UNOS-DGF does not adequately predict 12-month function on its own, our findings do not support changing the definition. Postoperative day 7 creatinine is correlated with 12-month eGFR, but large translational studies are needed to understand the biological link between IRI severity at transplant and longer-term outcomes.

  4. XMM-XXL Follow-up

    NASA Astrophysics Data System (ADS)

    Murray, Stephen

    2011-09-01

    XMM-XXL survey will cover 20 square degrees in two selected areas. Chandra follow-up observations of selected clusters identified with XMM will help to separate AGN emission from the cluster emission to improve estimates of cluster properties, especially the temperature and mass.

  5. 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…

  6. 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…

  7. 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…

  8. Cochlear implantation in children under 12 months of age.

    PubMed

    McKinney, Samantha

    2017-10-01

    Children with congenital hearing loss are being identified earlier, leading to earlier intervention. Current US Food and Drug Administration (FDA) criteria states a child must be 12 months or older for cochlear implantation. The purpose of this article is to review recent publications regarding the benefits of implanting infants under 12 months of age. Topics include: safety and efficacy of surgery, speech and language acquisition outcomes, audiologic components, and limitations. Since the early 1990s, the candidacy criteria evolved drastically. However, the FDA criteria for cochlear implantation in children has remained at 12 months of age or older since 2000. Recent research indicates implanting below 12 months of age a safe and effective procedure. Speech and language outcomes showed better speech and language advantages. In addition, infants implanted earlier showed normal auditory skills as early as 3 months post cochlear implant activation. This article will also address recent findings on the limitations of earlier implantation. Recent research demonstrates positive outcomes in children implanted under 12 months of age. Developing research on earlier implantation could lead to a change in the current FDA criteria allowing infants to reach their speech and hearing potential faster.

  9. 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.

  10. Alternative methods of follow up in breast cancer: a systematic review of the literature

    PubMed Central

    Montgomery, D A; Krupa, K; Cooke, T G

    2007-01-01

    Regular clinical follow up after breast cancer is a common practice. Evidence from retrospective reviews casts doubt on the efficacy of this practice and the various guidelines for follow up show little concordance. Our aim was to investigate what alternative follow-up methods (including reduced frequency of visits) have been subjected to controlled trial and to establish what evidence exists from controlled trials to advise the guidelines. The study involved systematic review of the literature using MEDLINE, Embase, CancerLit, Web of Sciences and EBM reviews as data sources. Methods included reviewing all randomised controlled trials comparing different follow-up frequencies or comparing an alternative method with clinical follow up after breast cancer. All outcome measures addressed in the trials were analysed. Two trials compared frequency of traditional follow up. Five trials assessed alternative methods. All were of inadequate power or duration to establish ideal frequency of clinic visits or safety of alternative follow-up methods. Alternative follow up had no detrimental effect on satisfaction or outcome. Few trials have been conducted, all of which are underpowered to establish safety of reducing or replacing clinic visits. Alternative methods of follow up are acceptable to patients and may be associated with other benefits. Larger trials are required. PMID:17486134

  11. 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

  12. Loss to follow-up in a randomized controlled trial study for pediatric weight management (EPOC).

    PubMed

    Warschburger, Petra; Kröller, Katja

    2016-11-14

    Attrition is a serious problem in intervention studies. The current study analyzed the attrition rate during follow-up in a randomized controlled pediatric weight management program (EPOC study) within a tertiary care setting. Five hundred twenty-three parents and their 7-13-year-old children with obesity participated in the randomized controlled intervention trial. Follow-up data were assessed 6 and 12 months after the end of treatment. Attrition was defined as providing no objective weight data. Demographic and psychological baseline characteristics were used to predict attrition at 6- and 12-month follow-up using multivariate logistic regression analyses. Objective weight data were available for 49.6 (67.0) % of the children 6 (12) months after the end of treatment. Completers and non-completers at the 6- and 12-month follow-up differed in the amount of weight loss during their inpatient stay, their initial BMI-SDS, educational level of the parents, and child's quality of life and well-being. Additionally, completers supported their child more than non-completers, and at the 12-month follow-up, families with a more structured eating environment were less likely to drop out. On a multivariate level, only educational background and structure of the eating environment remained significant. The minor differences between the completers and the non-completers suggest that our retention strategies were successful. Further research should focus on prevention of attrition in families with a lower educational background. Current Controlled Trials ISRCTN24655766 . Registered 06 September 2008, updated 16 May 2012.

  13. 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

  14. 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.

  15. Patients lost to follow-up in acromegaly: results of the ACROSPECT study.

    PubMed

    Delemer, B; Chanson, Ph; Foubert, L; Borson-Chazot, F; Chabre, O; Tabarin, A; Weryha, G; Cortet-Rudelli, C; Raingeard, I; Reznik, Y; Reines, C; Bisot-Locard, S; Castinetti, F

    2014-05-01

    The complex management of acromegaly has transformed this disease into a chronic condition, with the risk of patients being lost to follow-up. The objective of this study was to estimate the proportion of acromegalic patients lost to follow-up in France and to determine the impact that abandoning follow-up has on the disease and its management. ACROSPECT was a French national, multicentre, cross-sectional, observational study. Acromegalic patients were considered lost to follow-up if no new information had been entered in their hospital records during the previous 2 years. They were traced where possible, and data were collected by means of a recall visit or questionnaire. In the study population, 21% of the 2392 acromegalic patients initially followed in 25 tertiary endocrinology centres were lost to follow-up. At their last follow-up visit, 30% were uncontrolled, 33% were receiving medical therapy and 53% had residual tumour. Of the 362 traced, 62 had died and 77% were receiving follow-up elsewhere; the leading reason for abandoning follow-up was that they had not been informed that it was necessary. Our analysis of the questionnaires suggests that they were not receiving optimal follow-up. This study underlines the need to better inform acromegalic patients of the need for long-term follow-up, the absence of which could be detrimental to patients' health, and to develop shared care for what must now be regarded as a chronic disease.

  16. 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.

  17. [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.

  18. 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.

  19. 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.

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

    PubMed

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

    2017-05-11

    Although improved during the past few years, blood pressure control remains sub optimal. The impact of follow-up assessment on blood pressure control was evaluated in a group of patients of the HYT (HYperTension survey), treated with a combination of different dihydropyridine calcium-channel blockers (CCBs regimen) and inhibitors of renin-angiotensin-aldosterone system (RAAS) and with uncontrolled blood pressure. This was obtained assessing (a) the rate of blood pressure control at 3 and 6 months of follow-up in the whole group of patients, (b) the rate of blood pressure control and the average blood pressure values in subjects treated with different DHP-CCBs regimen. From the 4993 patients with uncontrolled blood pressure, (BP ≥ 140/90 or ≥140/85 in patients with diabetes), 3729 (mean age 61.2 ± 11.5 years), maintained CCBs regimen combined wih RAAS blockers and were evaluated at 3 and 6 months follow-up. At each visit BP (semiautomatic device, Omron-M6, 3 measurements), heart rate, adverse events and treatment persistence were collected. At 1st and 2nd follow-up the rate of controlled BP was 63.5 and 72.8% respectively (p < 0.05 vs 35.3% at baseline), whereas in diabetes was 32.5 and 37.9% respectively (p < 0.05 vs 20% at baseline). No differences in heart rate were observed. No differences in control rate were observed between the different CCBs regimen. The incidence of drugs related adverse events was 3.6%. These findings provide evidence that: (a) the follow-up of hypertensive patients under therapy increase the rate of blood pressure control; (b) there is no significant difference in the antihypertensive effect between different CCBs regimen; (c) lipophilic CCBs induce less ankle edema.

  1. 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.

  2. Rational Imitation in 12-Month-Old Infants

    ERIC Educational Resources Information Center

    Schwier, Christiane; van Maanen, Catharine; Carpenter, Malinda; Tomasello, Michael

    2006-01-01

    Gergely, Bekkering, and Kiraly (2002) demonstrated that 14-month-old infants engage in "rational imitation." To investigate the development and flexibility of this skill, we tested 12-month-olds on a different but analogous task. Infants watched as an adult made a toy animal use a particular action to get to an endpoint. In 1 condition there was a…

  3. 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…

  4. 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…

  5. 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…

  6. 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…

  7. Improving preterm infants' immunisation status: a follow-up audit.

    PubMed

    Crawford, Nigel W; Barfield, Charles; Hunt, Rod W; Pitcher, Helen; Buttery, Jim P

    2014-04-01

    Preterm infants are at increased risk of vaccine preventable diseases. An audit in 2007 identified suboptimal immunisation status of preterm infants. The aim of this study was to complete the 'audit loop', reviewing preterm infants' immunisation status at a single tertiary paediatric hospital. A retrospective follow-up immunisation audit was conducted at The Royal Children's Hospital, Melbourne, neonatal unit. The 'audit loop' included a preterm infants' reminder sticker and feedback of the original audit findings to Royal Children's Hospital health-care professionals. Immunisation status was determined using the Australian Childhood Immunisation Register record for all admitted preterm infants born <32 weeks gestation (July 2008-June 2009). Conducted in March 2011, the median age of participants (n = 57) was 2.5 years (range 1.7-3.1 years). Forty-four per cent (25/57) had a history of chronic lung disease, 86% (49/57) were <1500 g and 42% (24/57) <28 weeks gestation. The majority (96% (55/57)) were up to date with routine immunisations at 12 months of age. There was a 2.4-fold increase, compared with the original audit, for receipt of the additional recommended hepatitis B vaccine at 12 months of age, as well as influenza vaccine in infants with chronic lung disease. This study showed that a simple reminder combined with education strategies can improve vaccine delivery in special risk groups such as preterm infants. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  8. Circadian feeding patterns of 12-month-old infants.

    PubMed

    Wee, Poh Hui; Loy, See Ling; Toh, Jia Ying; Tham, Elaine Kwang Hsia; Cheung, Yin Bun; Godfrey, Keith M; Gluckman, Peter D; Saw, Seang Mei; Chong, Yap-Seng; Lek, Ngee; Chan, Jerry Kok Yen; Goh, Daniel Yam Thiam; Chong, Mary Foong-Fong; Yap, Fabian

    2017-06-01

    Early life nutrition and feeding practices are important modifiable determinants of subsequent obesity, yet little is known about the circadian feeding pattern of 12-month-old infants. We aimed to describe the 24-h feeding patterns of 12-month-old infants and examine their associations with maternal and infant characteristics. Mothers from a prospective birth cohort study (n 431) reported dietary intakes of their 12-month-old infants and respective feeding times using 24-h dietary recall. Based on their feeding times, infants were classified into post-midnight (00.00-05.59 hours) and pre-midnight (06.00-23.59 hours) feeders. Mean daily energy intake was 3234 (sd 950) kJ (773 (sd 227) kcal), comprising 51·8 (sd 7·8) % carbohydrate, 33·9 (sd 7·2) % fat and 14·4 (sd 3·2) % protein. Mean hourly energy intake and proportion of infants fed were lower during post-midnight than pre-midnight hours. There were 251 (58·2 %) pre-midnight and 180 (41·8 %) post-midnight feeders. Post-midnight feeders consumed higher daily energy, carbohydrate, fat and protein intakes than pre-midnight feeders (all P<0·001). The difference in energy intake originated from energy content consumed during the post-midnight period. Majority (n 173) of post-midnight feeders consumed formula milk during the post-midnight period. Using multivariate logistic regression with confounder adjustment, exclusively breast-feeding during the first 6 months of life was negatively associated with post-midnight feeding at 12 months (adjusted OR 0·31; 95 % CI 0·11, 0·82). This study provides new insights into the circadian pattern of energy intake during infancy. Our findings indicated that the timing of feeding at 12 months was associated with daily energy and macronutrient intakes, and feeding mode during early infancy.

  9. Office-based cryoablation of breast fibroadenomas: 12-month followup.

    PubMed

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

    2004-06-01

    Fibroadenomas comprise between 30% and 50% of all breast biopsies. Despite their benign nature, many women have their fibroadenomas surgically removed. We previously reported on a minimally invasive therapy using cryoablation to treat fibroadenomas. We now report on 12-month followup using this technique. A prospective, nonrandomized trial was initiated in June 2000 with IRB approval. The Visica Treatment System was used to cryoablate 70 biopsy-proved fibroadenomas in 57 patients using a freeze-thaw-freeze cycle lasting 6 to 30 minutes. Each patient was serially evaluated for safety, efficacy, and satisfaction. Fifty-seven fibroadenomas (mean 2.1 cm, range 0.8 to 4.2 cm) in 47 patients were followed for 12 months. At 1 year, with 89% median tumor volume reduction measured by ultrasonography, 75% of fibroadenomas were nonpalpable. There were no adverse events and only minor complications. Two patients (4%) had their lesions excised after 12 months; pathology revealed no viable fibroadenoma. Serial mammograms showed resorption of the fibroadenoma leaving minimal residual density without calcifications. Cosmesis was excellent with no volume deficit, as no tissue is removed. Ninety-one percent of patients were satisfied at 12 months. Cryoablation is safe and effective in treating breast fibroadenomas. It offers a nonsurgical, office-based treatment that is well tolerated by patients and accurately monitored with ultrasonographic guidance. At 12 months we found progressive tumor volume reduction and reduced palpability, with no volume deficit, excellent cosmesis, and satisfied patients. Ultrasonography-guided cryoablation is a preferred option for treatment of breast fibroadenomas without open surgery.

  10. [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.

  11. 12-month efficacy of a single radiofrequency ablation on autonomously functioning thyroid nodules.

    PubMed

    Bernardi, Stella; Stacul, Fulvio; Michelli, Andrea; Giudici, Fabiola; Zuolo, Giulia; de Manzini, Nicolò; Dobrinja, Chiara; Zanconati, Fabrizio; Fabris, Bruno

    2016-11-15

    Radiofrequency ablation has been advocated as an alternative to radioiodine and/or surgery for the treatment of autonomously functioning benign thyroid nodules. However, only a few studies have measured radiofrequency ablation efficacy on autonomously functioning benign thyroid nodules. The aim of this work was to evaluate the 12-month efficacy of a single session of radiofrequency ablation (performed with the moving shot technique) on solitary autonomously functioning benign thyroid nodules. Thirty patients with a single, benign autonomously functioning benign thyroid nodules, who were either unwilling or ineligible to undergo surgery and radioiodine, were treated with radiofrequency ablation between April 2012 and May 2015. All the patients underwent a single radiofrequency ablation, performed with the 18-gauge needle and the moving shot technique. Clinical, laboratory, and ultrasound evaluations were scheduled at baseline, and after 1, 3, 6, and 12 months from the procedure. A single radiofrequency ablation reduced thyroid nodule volume by 51, 63, 69, and 75 % after 1, 3, 6, and 12 months, respectively. This was associated with a significant improvement of local cervical discomfort and cosmetic score. As for thyroid function, 33 % of the patients went into remission after 3 months, 43 % after 6 months, and 50 % after 12 months from the procedure. This study demonstrates that a single radiofrequency ablation allowed us to withdraw anti-thyroid medication in 50 % of the patients, who remained euthyroid afterwards. This study shows that a single radiofrequency ablation was effective in 50 % of patients with autonomously functioning benign thyroid nodules. Patients responded gradually to the treatment. It is possible that longer follow-up studies might show greater response rates.

  12. 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

  13. 12-month Healing Rates after Endodontic Therapy Using the Novel GentleWave System: A Prospective Multicenter Clinical Study.

    PubMed

    Sigurdsson, Asgeir; Garland, Randy W; Le, Khang T; Woo, Stacey M

    2016-07-01

    This multicenter, prospective, nonsignificant risk clinical study evaluated healing rates for molars 12 months after endodontic therapy using the GentleWave System (Sonendo, Inc, Laguna Hills, CA). Eighty-nine patients needing endodontic therapy who met the inclusion criteria consented for this clinical study. All enrolled patients were treated with a standardized protocol consisting of conservative access, shaping of canals to #20/.07, GentleWave treatment, and warm vertical obturation. Six endodontists performed the clinical procedures and follow-up evaluations. Preoperative, intraoperative, and postoperative data were collected from the consented patients. Each patient was evaluated for clinical signs and symptoms. Two trained, blinded, and independent evaluators scored the subject's radiographs for signs of apical periodontitis using a periapical index. The teeth classified as healing or healed were considered as a success and accounted for the cumulative success rate of healing. Statistical analysis was performed by using the Fisher exact test, Pearson correlation, and multivariate logistic regression analyses of the preoperative prognostic factors at P = .05. Seventy-five teeth in 75 patients were evaluated at 12 months with a follow-up rate of 84.3%. The cumulative success of endodontic therapy was 97.3%. The success rates of necrotic and irreversible pulpitis were 92.9% and 98.4%, respectively; 3.8% of the patients experienced moderate postoperative pain within 2 days and no incidence of pain at 14 days, 6 months, and 12 months of initial therapy. Ten prognostic factors were identified using bivariate analyses. Using logistic analyses, the prognostic significant variable that was directly correlated to healing was the preoperative presence of lesions (P = .026). In this 12-month prospective multicenter clinical study, the GentleWave System showed a high level of success after a 12-month follow-up. Copyright © 2016 American Association of Endodontists

  14. 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

  15. 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

  16. 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%.

  17. [Safety and efficacy of classic ambulatory implantable cardioverter-defibrillator and resynchronisation systems follow-up compared to telemetric follow-up].

    PubMed

    Lelakowski, Jacek; Rydlewska, Anna; Piekarz, Justyna; Lelakowska-Pieła, Maria; Pudło, Joanna

    2016-03-01

    Telemetric follow-up (RM) after cardiac devices implantation is not only not inferior to classic follow-up, but also enables earlier clinical complications detection and stricter patient monitoring. of the study was to confirm safety and efficacy of RM in patients with implantable cardioverter-defibrillator (ICD) or cardioverterdefibrillator with resynchronisation therapy (CRT-D), compared to traditional follow-up in outpatient clinic. Group A (CRT-D+ICD) (retrospective, patients followed-up in outpatient clinic) was consisted with 273 patients (mean age 65±11 years, 230M). Group A included 128 patients after CRT-D implantation and 145 patients with ICD. Group B (RM group) (prospective, RM Medtronic CareLink follow-up) involved 89 patients (mean age 61±14 years, 73M). 11 patients had CRT-D and 78 had ICD implanted. Only patients with Medtronic equipment were included to group B. Follow-up of patients from group A - ambulatory visit in outpatient clinic: 1-3 months after implantation, then every 6 months. Follow-up of patients from group B - daily follow-up using RM system (Medtronic CareLink). Patient's clinical status, medications, frequency/ type of arrhythmias, device interventions were assessed in both groups. To assess presence of ventricular arrhythmia, device interventions, ICD and CRT-D programming changes, pharmacotherapy changes, a number of patients were randomly chosen from group A. They were similar in age, gender, LVEF value, NYHA class, comorbidities, time of follow-up (control group) to Group B (RM group). In the RM group, compared to control group, there were significantly less programming changes (3,4 vs 28,6%, p<0,001), time to first event was shorter (ventricular arrhythmia - 39 days, p<0,001; intervention - 102 days, p<0,001), time to first necessary programming change was longer (201 days, p<0,001). RM system proved to be save, more accurate (22% visits were performed personally by the physician operating Medtronic CareLink system, 71

  18. Short Text Messages to Encourage Adherence to Medication and Follow-up for People With Psychosis (Mobile.Net): Randomized Controlled Trial in Finland.

    PubMed

    Välimäki, Maritta; Kannisto, Kati Anneli; Vahlberg, Tero; Hätönen, Heli; Adams, Clive E

    2017-07-12

    data can provide clear outcomes for pragmatic randomized trials. SMS messaging tailored with the input of each individual patient did not decrease the rate of psychiatric hospital visits after the 12 months of follow-up. Although there may have been other, more subtle effects, the results of these were not evident in outcomes of agreed importance to clinicians, policymakers, and patients and their families. International Standard Randomized Controlled Trial Number (ISRCTN): 27704027; http://www.isrctn.com/ISRCTN27704027 (Archived by WebCite at http://www.webcitation.org/6rVzZrbuz).

  19. Indirect zirconia-reinforced lithium silicate ceramic CAD/CAM restorations: Preliminary clinical results after 12 months.

    PubMed

    Zimmermann, Moritz; Koller, Christina; Mehl, Albert; Hickel, Reinhard

    2017-01-01

    No clinical data are available for the new computer-aided design/computer-assisted manufacture (CAD/CAM) material zirconia-reinforced lithium silicate (ZLS) ceramic. This study describes preliminary clinical results for indirect ZLS CAD/CAM restorations after 12 months. Indirect restorations were fabricated, using the CEREC method and intraoral scanning (CEREC Omnicam, CEREC MCXL). Sixty-seven restorations were seated adhesively (baseline). Sixty restorations were evaluated after 12 months (follow-up), using modified FDI criteria. Two groups were established, according to ZLS restorations' post-processing procedure prior to adhesive seating: group I (three-step polishing, n = 32) and group II (fire glazing, n = 28). Statistical analysis was performed with Mann-Whitney U test and Wilcoxon test (P < .05). The success rate of indirect ZLS CAD/CAM restorations after 12 months was 96.7%. Two restorations clinically failed as a result of bulk fracture (failure rate 3.3%). No statistically significant differences were found for baseline and follow-up criteria (Wilcoxon test, P > .05). Statistically significant differences were found for criteria surface gloss for group I and group II (Mann-Whitney U test, P < .05). This study demonstrates ZLS CAD/CAM restorations have a high clinical success rate after 12 months. A longer clinical evaluation period is necessary to draw further conclusions.

  20. Evaluation of the Impact of a Policy Change on Diversion Program Recidivism and Justice System Costs: 12-Month Follow-Up

    ERIC Educational Resources Information Center

    Dembo, Richard; Wareham, Jennifer; Schmeidler, James; Chirikos, Thomas N.

    2005-01-01

    Following a national trend of "getting tough" on juvenile crime, the Florida legislature eliminated one of the State's primary community service-oriented juvenile diversion programs, the Juvenile Alternative Services Program (JASP). JASP was subsequently replaced with four other diversion programs, two of which (the Walker Plan and an…

  1. [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.

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. Early transconjunctival needling revision with 5-fluorouracil versus medical treatment in encapsulated blebs: a 12-month prospective study.

    PubMed

    Suzuki, Ricardo; Susanna-Jr, Remo

    2013-10-01

    To compare the efficacy of transconjunctival needling revision with 5-fluorouracil versus medical treatment in glaucomatous eyes with uncontrolled intraocular pressure due to encapsulated bleb after trabeculectomy. Prospective, randomized, interventional study. A total of 40 eyes in 39 patients with elevated intraocular pressure and encapsulated blebs diagnosed at a maximum five months after primary trabeculectomy with mitomycin C were included. The eyes were randomized to either transconjunctival needling revision with 5- fluorouracil or medical treatment (hypotensive eyedrops). A maximum of two transconjunctival needling revisions per patient was allowed in the needling arm. All patients underwent follow-up for 12 months. Successful treatment was defined as an intraocular pressure ≤ 18 mmHg and a 20% reduction from baseline at the final follow-up. Clinicaltrial.gov: NCT01887223. Mean intraocular pressure at the final 12-month follow-up was lower in the transconjunctival needling revision group compared to the medical treatment group. Similar numbers of eyes reached the criteria for treatment success in both the transconjunctival needling revision group and the medical treatment group. Despite similar success rates in eyes randomized to transconjunctival needling revision with 5-fluorouracil compared to eyes receiving medical treatment, there was a significantly lower mean intraocular pressure at 12 months after transconjunctival needling revision.

  7. 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.

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

    PubMed Central

    Sauve, Reg; Lee, Shoo K

    2006-01-01

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

  9. Public service stress and burnout over 12 months.

    PubMed

    Ravalier, J M; McVicar, A; Munn-Giddings, C

    2014-10-01

    Research indicates that workplace stress has the potential to harm employee health with stress and stress-related absence increasing significantly during economic recession and times of organizational change. To explore whether psychosocial hazards and burnout changed over a 12 month period in a public sector organization during a period of severely reduced organizational finances. The Management Standards Indicator Tool (MSIT) and the Maslach Burnout Inventory-General Scale (MBI-GS) were administered to employees of one local government department in July 2011 and July 2012. A total of 128 employees completed the questionnaires in July 2011 (response rate 67%) and 57 in July 2012 (response rate 54%). MSIT factor scores of demands, peer support and role worsened significantly over the period of study. Furthermore, all psychosocial hazards scored worse than the recommended level set by Health and Safety Executive. Two burnout dimensions, 'demands' and 'cynicism', significantly worsened over the 12 month period but professional efficacy increased. The MSIT and MBI-GS appeared to have utility in this comparison. Psychosocial hazards appeared to worsen over the 12 months of the study, as 'demands' and 'cynicism' increased. However, an increase in professional efficacy was also seen, which requires further investigation. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Follow-up Observations of WASP-36

    NASA Astrophysics Data System (ADS)

    Kutra, Taylor; Boley, Aaron; Hughes, Anna; Hickson, Paul

    2017-06-01

    This ongoing work aims to provide follow-up observations of known transiting extrasolar planets using the 35-cm robotic telescope at The University of British Columbia's Southern Observatory (USO), located at the Cerro Tololo Inter-American Observatory (CTIO) in Chile. The observations are part of a long-term effort to search for changes in transit signatures, such as transit timing variations (TTVs) and transit duration variations (TDVs), which could indicate, for example, the presence of additional planets. To help characterize the USO for transit searches, we acquired I-band observations of WASP-36 spanning from 17 January 2017 to 27 February 2017. Three complete transits and one partial transit are included in the data. We present the analysis of these new observations and discuss potential future targets.

  11. 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.

  12. [Allogeneic parathyroid: 2-year follow-up].

    PubMed

    Hermosillo-Sandoval, José Manuel; Leonher-Ruezga, Karla Lisseth; Jiménez-Gómez, José Alfredo; Fuentes-Orozco, Clotilde; González-Ojeda, Alejandro; Ramírez-González, Luis Ricardo

    2015-01-01

    Hypoparathyroidism is one of the most frequent complications of neck surgery. The treatment is currently medical; however this involves several complications secondary to high doses of calcium and vitamin D, thus making parathyroid allotransplantation a good management option. Patients with hypoparathyroidism were selected in the April-December period of 2011 in the general surgical clinic. They were between 16 and 65 years, and ingested high doses of calcium. The donors were patients with primary and secondary hyperparathyroidism, and the transplants were performed in relation to blood group and human leucocyte antigen. Five parathyroid allografts were performed. All the patients had iatrogenic hypoparathyroidism, all women with a mean age of 49.8 years. The graft was implanted under local anaesthesia in the non-dominant forearm. Four of the patients are so far considered functional due to the increase in paratohormone, and demonstrating its function by scintigraphy with sestamibi. One of the patients showed no increase in paratohormone or imaging studies that demonstrate its functionality. After a two year follow up the graft remains functional but with with oral calcium intake at a lower dose than before transplantation. None of the patients had immunosuppression side effects. In this study, allogeneic unrelated living parathyroid transplant with an immunosuppressive regimen of six months has proven to be a safe alternative treatment to improve quality of life by decreasing the excessive calcium intake and improving physical activity with adequate graft survival at 24 months follow up. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  13. Reimbursement for Living Kidney Donor Follow-Up Care: How Often Does Donor Insurance Pay?

    PubMed Central

    Kher, Ajay; Rodrigue, James; Ajaimy, Maria; Wasilewski, Marcy; Ladin, Keren; Mandelbrot, Didier

    2014-01-01

    Background Currently, many transplantation centers do not follow former living kidney donors on a long-term basis. Several potential barriers have been identified to provide this follow-up of former living kidney donors, including concerns that donor insurance will not reimburse transplantation centers or primary care physicians for this care. Here, we report the rates at which different insurance companies reimbursed our transplantation center for follow-up visits of living donors. Methods We collected data on all yearly follow-up visits of living donors billed from January 1, 2007, to December 31, 2010, representing 82 different donors. Concurrent visits of their recipients were available for 47 recipients and were used as a control group. Results We find that most bills for follow-up visits of living kidney donors were paid by insurance companies, at a rate similar to the reimbursement for recipient follow-up care. Conclusions Our findings suggest that, for former donors with insurance, inadequate reimbursement should not be a barrier in providing follow-up care. PMID:23060280

  14. Reimbursement for living kidney donor follow-up care: how often does donor insurance pay?

    PubMed

    Kher, Ajay; Rodrigue, James; Ajaimy, Maria; Wasilewski, Marcy; Ladin, Keren; Mandelbrot, Didier

    2012-11-27

    Currently, many transplantation centers do not follow former living kidney donors on a long-term basis. Several potential barriers have been identified to provide this follow-up of former living kidney donors, including concerns that donor insurance will not reimburse transplantation centers or primary care physicians for this care. Here, we report the rates at which different insurance companies reimbursed our transplantation center for follow-up visits of living donors. We collected data on all yearly follow-up visits of living donors billed from January 1, 2007, to December 31, 2010, representing 82 different donors. Concurrent visits of their recipients were available for 47 recipients and were used as a control group. We find that most bills for follow-up visits of living kidney donors were paid by insurance companies, at a rate similar to the reimbursement for recipient follow-up care. Our findings suggest that, for former donors with insurance, inadequate reimbursement should not be a barrier in providing follow-up care.

  15. 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

  16. 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

  17. Percutaneous vertebroplasty: the follow-up.

    PubMed

    Barbero, S; Casorzo, I; Durando, M; Mattone, G; Tappero, C; Venturi, C; Gandini, G

    2008-02-01

    This article reports on our experience treating vertebral fractures with percutaneous vertebroplasty. A clinical and imaging follow-up designed to identify the early (especially pulmonary embolism of bone cement) and late complications of the technique is proposed. On the basis of the current guidelines, 101 patients were selected: 64 osteoporotic and 37 neoplastic. A total of 173 vertebrae were treated. Procedures were performed with both computed tomography and fluoroscopic guidance. Residual pain was evaluated with a visual analogue scale score immediately after vertebroplasty and 1, 15, 30, 90, 180 and 270 days later. Spine and chest radiographs were obtained 24 h after vertebroplasty; spine radiography was repeated 30 days later. Therapeutic success was obtained in 88% of osteoporotic patients and in 84% of neoplastic patients. Pulmonary cement emboli were identified in four patients, all of whom were asymptomatic. Percutaneous vertebroplasty is a safe and effective technique for the treatment of osteoporotic and neoplastic vertebral fractures. Clinical and imaging followup allows effective patient monitoring and early detection of possible complications.

  18. Two-Year Follow-Up Outcomes of Premature Infants Enrolled in the Phase I Trial of Mesenchymal Stem Cells Transplantation for Bronchopulmonary Dysplasia.

    PubMed

    Ahn, So Yoon; Chang, Yun Sil; Kim, Ji Hye; Sung, Se In; Park, Won Soon

    2017-06-01

    To determine the long-term safety and outcomes of mesenchymal stem cells (MSCs) for bronchopulmonary dysplasia in premature infants enrolled in a previous phase I clinical trial up to 2 years of corrected age (CA). We assessed serious adverse events, somatic growth, and respiratory and neurodevelopmental outcomes at visit 1 (4-6 months of CA), visit 2 (8-12 months of CA), and visit 3 (18-24 months of CA) in a prospective longitudinal follow-up study up to 2 years' CA of infants who received MSCs (MSC group). We compared these data with those from a historical case-matched comparison group. One of 9 infants in the MSC group died of Enterobacter cloacae sepsis at 6 months of CA, the remaining 8 infants survived without any transplantation-related adverse outcomes, including tumorigenicity. No infant in the MSC group was discharged with home supplemental oxygen compared with 22% in the comparison group. The average rehospitalization rate in the MSC group was 1.4/patient because of respiratory infections during 2 years of follow-up. The mean body weight of the MSC group at visit 3 was significantly higher compared with that of the comparison group. No infant in the MSC group was diagnosed with cerebral palsy, blindness, or developmental delay; in the comparison group, 1 infant was diagnosed with cerebral palsy and 1 with developmental delay. Intratracheal transplantation of MSCs in preterm infants appears to be safe, with no adverse respiratory, growth, and neurodevelopmental effects at 2 years' CA. ClinicalTrials.gov: NCT01632475. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  19. South Texas Residency Screening, Brief Intervention, and Referral to Treatment (SBIRT) Training: 12-Month Outcomes.

    PubMed

    Malone, Glenn P; Vale Arismendez, Shruthi; Schneegans Warzinski, Suyen; Amodei, Nancy; Burge, Sandra K; Wathen, Patricia I; Conde, Michelle V; Palmer, Raymond; Williams, Janet F

    2015-01-01

    Screening, brief intervention, and referral to treatment (SBIRT) is an efficacious and cost-effective skill set when implemented in primary care settings regarding hazardous alcohol use. This study assesses the impact of medical resident SBIRT training across 3 specialties and identifies predictors of change in trainee behavior, attitudes, and knowledge over 12 months. This program's substance use SBIRT training was developed and tailored to fit diverse curricular objectives and settings across an array of medical residency programs in South Texas. The 329 residents training in pediatrics, family medicine, and internal medicine during 2009-2012 constituted the trainee group reported in this analysis. Surveys assessing SBIRT-related knowledge, current practice, confidence, role responsibility, attitudes, beliefs, and readiness to change were completed by 234 (71%) trainees at 3 time points: pre-training, then 30 days and 12 months post-initial training. SBIRT-related knowledge, confidence, and practice increased from pre-training to 12-month follow-up. Residents who reported the least amount of pre-training clinical and/or prior academic exposure to substance use reported the greatest SBIRT practice increases. When controlling for demographic and prior exposure variables, the largest contributor to variance in SBIRT practice was attributed to residents' confidence in their SBIRT skills. SBIRT training that employs diverse educational methodologies as part of customizing the training to residency specialties can similarly enhance SBIRT-related knowledge, confidence, and practice. Trainee report of limited prior clinical or academic exposure to substance use and/or low confidence regarding SBIRT skills and their professional role responsibilities related to substance use predicted trainee success and sustained SBIRT strategy application. When customizing SBIRT training, curriculum developers should consider leveraging and capacity building related to those factors

  20. 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

  1. Quantitative muscle ultrasonography in the follow-up of juvenile dermatomyositis.

    PubMed

    Habers, G Esther A; Van Brussel, Marco; Bhansing, Kavish J; Hoppenreijs, Esther P; Janssen, Anjo J W M; Van Royen-Kerkhof, Annet; Pillen, Sigrid

    2015-10-01

    We explored the use of quantitative muscle ultrasonography (QMUS) for follow-up of juvenile dermatomyositis (JDM). Seven JDM patients were evaluated at diagnosis and 1, 3, 6, 12, and 24 months using the Childhood Myositis Assessment Scale (CMAS) and QMUS. Muscle thickness (MT) and quantitative muscle echo intensity (EI) were assessed with QMUS in 4 muscles. Six patients experienced a monocyclic course. At diagnosis EI was slightly increased, and MT was relatively normal. After start of treatment MT first decreased and EI increased, with normalization of EI within 6-12 months (n = 4). One patient had higher EIs at diagnosis and slower normalization, indicating fibrosis, despite early normalization of CMAS. One patient experienced a chronic course, with high EIs and atrophy during follow-up. QMUS can provide additional information for follow-up of JDM regarding disease severity and residual muscle damage, particularly after normalization of CMAS. © 2014 Wiley Periodicals, Inc.

  2. Motor training at 3 months affects object exploration 12 months later.

    PubMed

    Libertus, Klaus; Joh, Amy S; Needham, Amy Work

    2016-11-01

    The development of new motor skills alters how infants interact with objects and people. Consequently, it has been suggested that motor skills may initiate a cascade of events influencing subsequent development. However, only correlational evidence for this assumption has been obtained thus far. The current study addressed this question experimentally by systematically varying reaching experiences in 40 three-month-old infants who were not reaching on their own yet and examining their object engagement in a longitudinal follow-up assessment 12 months later. Results revealed increased object exploration and attention focusing skills in 15-month-old infants who experienced active reaching at 3 months of age compared to untrained infants or infants who only passively experienced reaching. Further, grasping activity after - but not before - reaching training predicted infants' object exploration 12 months later. These findings provide evidence for the long-term effects of reaching experiences and illustrate the cascading effects initiated by early motor skills. © 2015 John Wiley & Sons Ltd.

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. Evaluation of insulin initiation on resource utilization and direct costs of treatment over 12 months in patients with type 2 diabetes in Europe: results from INSTIGATE and TREAT observational studies.

    PubMed

    Brismar, Kerstin; Benroubi, Marianna; Nicolay, Claudia; Schmitt, Henry; Giaconia, Joseph; Reaney, Matthew

    2013-08-01

    To describe the changes in resource utilization in seven European countries (Germany, Greece, Portugal, Romania, Sweden, Spain, and Turkey) and direct costs in four European countries (Germany, Spain, Sweden, and Greece) over the first 12 months of insulin treatment in patients with type 2 diabetes mellitus (T2DM). INSTIGATE and TREAT (2005-2010) were non-interventional, prospective, observational studies in patients with T2DM and initiating insulin for the first time. A 6-month retrospective data capture was conducted at baseline (insulin initiation) followed by prospective data collections at ∼3, 6, and 12 months. Statistical analyses were descriptive; estimated costs are presented as nominal values. This study presents data for 1450 patients. Overall, in the first 6 months after insulin initiation, the use and cost of blood glucose monitoring and insulin increased, while the cost of oral diabetic medication decreased. Contributors to total direct costs differed between countries. Ranges of total mean direct costs over the 6-month period before insulin initiation were €489.10-€658.50 (Greece-Spain); 0-6 months after insulin initiation, €573.40-€1084.70 (Greece-Spain); and 6-12 months after insulin initiation, €495.80-€859.30 (Greece-Germany). Thus, the mean cost of treatment increased in all countries in the first 6 months after insulin initiation and then returned to baseline except in Germany. Overall, 15% of patients were lost to follow-up over 12 months. Costs were not pro-rated to account for variation of visits. Participating centres may not have been fully representative of all levels of care. Contributors to total cost differed between countries, potentially reflecting local clinical practice patterns and insulin regimens. In each country, mean direct total costs of T2DM care increased during the first 6 months after insulin initiation and decreased thereafter.

  8. Multicenter, randomized, double-blind, active-controlled, parallel-group trial of the long-term (6-12 months) safety of acetaminophen in adult patients with osteoarthritis.

    PubMed

    Temple, Anthony R; Benson, Gordon D; Zinsenheim, Joyce R; Schweinle, Jo Ellen

    2006-02-01

    This study evaluated the safety of acetaminophen 4 g/d administered for up to 12 months to adult patients with osteoarthritis pain, using naproxen 750 mg/d as an active comparator. This multicenter, multidose, single-dummy, randomized, double-blind, active-controlled, parallel-group study enrolled patients with mild to moderate osteoarthritis pain of the hip or knee. Patients received acetaminophen 4 g/d or naproxen 750 mg/d for 12 months (group 1) or 6 months (group 2). Patients in both groups had follow-up visits at months 1, 3, and 6 of treatment (or at the time of study withdrawal). Patients in group 1 also had follow-up visits at months 9 and 12 (or at the time of study withdrawal). Tolerability evaluations consisted of determinations of hepatic (aminotransferase activities) and renal (serum creatinine) function, adverse events, and physical examinations. Adverse events reported by the patient or observed by the investigator during clinical evaluation were recorded. In addition, patients were questioned at each visit regarding the occurrence of adverse events using a nonspecific question. Investigators rated the intensity of adverse events and their subjective assessment of the relationship to study medication while blinded to the treatment group. At all visits, patients completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), in visual analog scale format, to assess pain, stiffness, and physical function over the previous 2 weeks. The primary efficacy end point was the mean change from baseline in the WOMAC pain subscale score at 6 months. Data from the 6- and 12-month groups were combined for analysis. Of 581 randomized patients, the safety population included 571 patients who received > or = 1 dose of study medication. The 571 patients had a mean (SD) age of 59.3 (8.6) years, 395 (69.2%) were female, and 480 (84.1%) were white. Of 290 patients randomized to receive acetaminophen, 134 completed 3 months of treatment, 96 completed

  9. 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

  10. Stability of cocaine impurity profiles during 12 months of storage.

    PubMed

    Nielsen, Louise Stride; Villesen, Palle; Lindholst, Christian

    2016-07-01

    During the lifetime of a cocaine batch from production end to consumption, several alterations may occur, leading to possible changes in the original impurity profile. Such profile changes may eventually result in erroneous forensic evaluations. In the present study, the stability of both the alkaloid and the residual solvent impurity profiles of cocaine were evaluated over a period of 12 months under different storage conditions (temperature, purity and weight) using GC-MS and HS-GC-MS, respectively. The sample purity (p<0.001), time of storage (p<0.001) and storage temperature at 37°C (p<0.01) significantly influenced the alkaloid impurity profile. The most significant change was observed in low purity samples stored at 37°C. In contrast, no changes were observed in the residual solvent profile at all storage conditions for the entire 12-month study period. This finding indicates that the residual solvent profile may be more applicable than the corresponding alkaloid profile when cocaine seizures subjected to different storage conditions are compared. Our results clearly demonstrate that cocaine alkaloid profiles change over time and are most susceptible to sample purity and storage temperature. As a consequence, storage conditions and purity should be taken into account when cocaine comparison is conducted in criminal cases. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Course Withdrawal Follow-Up. TEX-SIS Follow-Up, Volume 3, #1.

    ERIC Educational Resources Information Center

    Yavapai County Community Coll. District, Prescott, AZ.

    In spring 1982, a survey was conducted at Yavapai College to determine reasons for student course withdrawal. A TEX-SIS follow-up questionnaire was mailed to all 525 students who had dropped one or two courses, asking them to indicate their reasons for dropping the course(s) and if they felt discussion with a counselor would have been beneficial,…

  12. Twelve-month follow-up of left atrial appendage occlusion with Amplatzer Amulet.

    PubMed

    Kleinecke, Caroline; Park, Jai-Wun; Gödde, Martin; Zintl, Konstantin; Schnupp, Steffen; Brachmann, Johannes

    2017-01-01

    The Amplatzer Amulet (St. Jude Medical, Minneapolis, MN, USA) is a second gen-eration Amplatzer device for left atrial appendage (LAA) occlusion (LAAO) for stroke prophylaxis in patients with atrial fibrillation. This research sought to assess the clinical performance of the Amplatzer Amulet device and in follow up for 12 months. In this single-center registry patients with atrial fibrillation and contraindication to oral anticoagulation underwent LAAO with the Amplatzer Amulet device. Follow-up was performed before discharge, by transesophageal echocardiography (TEE) after 6 weeks and telephone interview after 3, 6 and 12 months. Between October 2014 and August 2015 50 patients (76.1 ± 8.3 years; 30 male) were en-rolled. Procedural success was achieved in 49 (98%) patients. Major periprocedural adverse events were observed in 4 (8%) of patients: 1 device embolization, 2 pericardial effusions requiring pericardiocente-sis and 1 prolonged hospital stay due to retropharyngeal hematoma from the TEE probe. Follow-up TEE was available in 38 of 50 patients showing complete LAA sealing in all. 2 device-related thrombi were also documented. At 12-month follow-up 7 patients had died unrelated to the device. Ischemic stroke occurred in 3 patients. According to neurological examination two were classified as microangiopathic and not cardio-embolic. The other one could not be classified. Bleeding complications (5 minor, 3 major) were documented in 8 patients. Although minimizing procedure-related complications remains challenging, LAAO with the Amplatzer Amulet device showed high procedural success and excellent LAA sealing. (Cardiol J 2017; 24, 2: 131-138).

  13. 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

  14. Follow up on the Actions to Improve the Defense Contract Management Agencys Cost Analysis Function

    DTIC Science & Technology

    2015-10-29

    B E R 2 9 , 2 0 1 5 Follow up on the Actions to Improve the Defense Contract Management Agency’s Cost Analysis Function Report No. DODIG-2016...Department of Defense F r a u d , W a s t e & A b u s e DODIG-2016-005 (D2015-DAPOCF-0032.000) │ i Results in Brief Follow up on the Actions to Improve the...Defense Contract Management Agency’s Cost Analysis Function Visit us at www.dodig.mil Objective We conducted this evaluation to follow up on the

  15. 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.

  16. Lost to follow-up: reasons and outcomes following tibial plateau fractures.

    PubMed

    Hoffmann, Martin F; Sietsema, Debra L; Jones, Clifford B

    2016-12-01

    Different reasons for lost to follow-up are assumed. Besides "objective" reasons, "subjective" reasons and satisfaction contribute to treatment adherence. Retrospective studies usually lack the possibility of acquisition of additional outcome information. Purpose of this study was to determine outcome and factors for patients not returning for follow-up. Between 2002 and 2009, 380 patients underwent internal fixation for tibial plateau fractures. Short Musculoskeletal Function Assessment (SMFA) was collected at 6, 12, and 24 months as long as patients returned for follow-up. Pain and range of motion were measured. Records were studied for reasons of termination of follow-up. Statistical analysis was performed comparing lost to follow-up versus continued office visits regarding demographics, contributing factors, and SMFA. Two hundred fifty-nine patients were followed until treatment was completed (PRN), while 120 patients (32 %) terminated further follow-up. Patients in the 12- and 24-month follow-up groups were older (p = 0.02; p < 0.01, respectively). Pain (VAS ≥ 3) was noticed in 22 % of the patients terminating follow-up before the 6-month survey and 41 % of the patients returning for the 24-month SMFA survey (χ (2) = 0.06). Improvements were found with time in SMFA subscores but arm and hand. No differences in SMFA subscores at 6 or 12 months were found between those leaving treatment untimely and those being released from office visits. Follow-up remains important to obtain as much up-to-date information as possible. The current study does not support the assumption that patients lost to follow-up have a different SMFA outcome than patients returning until PRN. III.

  17. 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.

  18. Hypoglossal Nerve Stimulation Improves Obstructive Sleep Apnea: 12 Month Outcomes

    PubMed Central

    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

    2013-01-01

    Reduced upper airway muscle activity during sleep is a key contributor to obstructive sleep apnoea (OSA) pathogenesis. Hypoglossal nerve stimulation (HGNS) activates upper airway dilator muscles, including the genioglossus, and has the potential to reduce OSA severity. The objective of this study was to examine the safety, feasibility, and efficacy of a novel HGNS system (HGNS®, Apnex Medical, Inc., St. Paul, MN) in treating OSA at 12 months following implantation. Thirty-one subjects (35% female, age 52·4±9·4 years) with moderate to severe OSA and unable to tolerate positive airway pressure underwent surgical implantation and activation of the HGNS system in a prospective single-arm interventional trial. Primary outcomes were changes in OSA severity (apnoea-hypopnoea index, AHI, from in-laboratory polysomnogram) and sleep-related quality of life (Functional Outcomes of Sleep Questionnaire, FOSQ). HGNS was used on 86±16% of nights for 5·4±1·4 hours per night. There was a significant improvement (p < 0·001) from baseline to 12 months in AHI (45.4±17·5 to 25·3±20·6 events/h) and FOSQ score (14·2±2·0 to 17·0±2·4) as well as other polysomnogram and symptom measures. Outcomes were stable compared to 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. HGNS demonstrated favourable safety, feasibility, and efficacy. PMID:24033656

  19. 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.

  20. Comparison of remote and in-clinic follow-up after methotrexate/misoprostol abortion.

    PubMed

    Dunn, Sheila; Panjwani, Dilzayn; Gupta, Melini; Meaney, Christopher; Morgan, Rebecca; Feuerstein, Erika

    2015-09-01

    This study compared adherence to follow-up and clinical outcomes between standard in-clinic and remote follow-up after methotrexate/misoprostol abortion. This nonrandomized trial recruited women requesting medical abortion at two sexual health clinics in Toronto, Canada. Women received methotrexate 50 mg/m(2) followed 3-7 days later by 800 mcg of misoprostol self-administered vaginally. For Day 15, follow-up participants could choose standard in-clinic follow-up with ultrasound and assessment or remote telephone follow-up with serum β-hCG performed at a community laboratory and symptom checklist. Standard and remote follow-up groups were compared for adherence, defined as completing follow-up within 7 days of the scheduled time, and clinical outcomes. Characteristics associated with adherence were assessed using multivariable logistic regression. Of 129 women, 86 (67%) chose remote follow-up. Nonadherence rates for remote (28%) and standard (23%) follow-up groups did not differ in univariate (p=.57) or multivariable analysis (odds ratio: 1.09, 95% confidence interval: 0.39-3.01). Rates of emergency/hospital visits were 3% and 9% for remote and standard groups, respectively (p=.22), and complete loss to follow was 6% and 14% in remote and standard groups (p=.18). Nonadherent women were more likely to be undecided about their contraception (65% vs. 28%; p=.002), and this difference persisted in the multivariable analysis. Given a choice of remote or in-clinic follow-up after methotrexate/misoprostol abortion, most women chose remote follow-up. Rates of adherence to follow-up, adverse outcomes and complete loss to follow-up were similar for women choosing remote and standard follow-up. Since standard and remote follow-up after methotrexate/misoprostol abortion are associated with similar adherence to follow-up and similar safety profiles, women should be offered their choice of follow-up method. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. 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

  2. Long-term follow-up after bariatric surgery in a national cohort.

    PubMed

    Thereaux, J; Lesuffleur, T; Païta, M; Czernichow, S; Basdevant, A; Msika, S; Millat, B; Fagot-Campagna, A

    2017-09-01

    Lifelong medical follow-up is mandatory after bariatric surgery. The aim of this study was to assess the 5-year follow-up after bariatric surgery in a nationwide cohort of patients. All adult obese patients who had undergone primary bariatric surgery in 2009 in France were included. Data were extracted from the French national health insurance database. Medical follow-up (medical visits, micronutrient supplementation and blood tests) during the first 5 years after bariatric surgery was assessed, and compared with national and international guidelines. Some 16 620 patients were included in the study. The percentage of patients with at least one reimbursement for micronutrient supplements decreased between the first and fifth years for iron (from 27.7 to 24.5 per cent; P < 0.001) and calcium (from 14·4 to 7·7 per cent; P < 0·001), but increased for vitamin D (from 33·1 to 34·7 per cent; P < 0·001). The percentage of patients with one or more visits to a surgeon decreased between the first and fifth years, from 87·1 to 29·6 per cent (P < 0·001); similar decreases were observed for visits to a nutritionist/endocrinologist (from 22·8 to 12·4 per cent; P < 0·001) or general practitioner (from 92·6 to 83·4 per cent; P < 0·001). The mean number of visits to a general practitioner was 7·0 and 6·1 in the first and the fifth years respectively. In multivariable analyses, male sex, younger age, absence of type 2 diabetes and poor 1-year follow-up were predictors of poor 5-year follow-up. Despite clear national and international guidelines, long-term follow-up after bariatric surgery is poor, especially for young men with poor early follow-up. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  3. 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

  4. 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

  5. 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

  6. Buprenorphine-naloxone treatment in opioid dependence and risk of liver enzyme elevation: results from a 12-month observational study.

    PubMed

    Soyka, Michael; Backmund, Markus; Schmidt, Peggy; Apelt, Sabine

    2014-01-01

    Some case series mention possible liver toxicity in opioid-dependent patients under buprenorphine treatment. This 12-month prospective observational follow-up study in opioid-dependent patients under buprenorphine-naloxone treatment assessed outcome and safety issues. At baseline, 337 eligible datasets were available; 181 patients completed the 12-month study. Liver enzymes were tested at baseline and after 12, 24, and 52 weeks' treatment. One to two percent of patients showed mostly discrete elevations of liver enzymes, but no patient met the criteria for drug-induced liver injury. No serious liver-related adverse events occurred, but two non-serious cases of liver enzyme increase were recorded. No patient dropped out of treatment for liver-related disorders. This study is in line with some recent studies and provides further evidence that buprenorphine-naloxone is relatively safe with respect to liver injury. © American Academy of Addiction Psychiatry.

  7. The clinical value and the cost-effectiveness of follow-up in endometrial cancer patients.

    PubMed

    Tjalma, W A A; van Dam, P A; Makar, A P; Cruickshank, D J

    2004-01-01

    The aim of the present article was to evaluate the cost-effectiveness of follow-up in endometrial cancer patients. A literature review was performed regarding the studies that addressed routine follow-up of endometrial cancer. For each published study, the costs of the follow-up program were calculated according to Belgium standards. A mean total of 13% relapsed. Symptomatology and clinical examination detected over 83% of the recurrences. The follow-up cost in euro after 5 and 10 years ranged between 127.68 and 2,028.78 and between 207.48 and 2,353.48, respectively. Based on the available data, there is little evidence of routine follow-up improving survival rates. Multiple protocols are used in practice without an evidence base. There is an urgent need for prospective randomized studies to evaluate the value of the current so-called 'standard medical practice of follow-up.' It is to be expected that the cost of follow-up could be reduced considerably, for instance, by tailoring to low- and high-risk groups, or by abandoning routine follow-up. Symptomatic patients, however, should be evaluated immediately. A reduction in the number of visits and examinations would mean an enormous reduction in costs. This economic benefit would be warmly welcomed in the times of increased health costs and decreased budgets.

  8. Clinical outcomes of single-visit oral prophylaxis: a practice-based randomised controlled trial.

    PubMed

    Jones, Clare L; Milsom, Keith M; Ratcliffe, Philip; Wyllie, Annette; Macfarlane, Tatiana V; Tickle, Martin

    2011-12-28

    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. 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. 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. This trial could not identify

  9. 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

  10. 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

  11. Persistent high-risk human papillomavirus infections and other end-point markers of progressive cervical disease among women prospectively followed up in the New Independent States of the Former Soviet Union and the Latin American Screening study cohorts.

    PubMed

    Syrjänen, Kari; Shabalova, Irena; Naud, Paulo; Kozachenko, Vladimir; Derchain, Sophie; Zakharchenko, Sergej; Roteli-Martins, Cecilia; Nerovjna, Raisa; Longatto-Filho, Adhemar; Kljukina, Ludmila; Tatti, Silvio; Branovskaja, Marina; Hammes, Luciano Serpa; Branca, Margherita; Grunjberga, Valerija; Erzen, Mojca; Sarian, Luis Otavio; Juschenko, Anna; Costa, Silvano; Podistov, Jurij; Syrjänen, Stina

    2009-07-01

    New end points are needed in future human papillomavirus (HPV) vaccine efficacy studies that accurately predict disease progression. Potential intermediate end points were analyzed in the combined New Independent States of the Former Soviet Union (NIS) and the Latin American Screening (LAMS) study cohorts. Data files of 2 international screening trials, the NIS (n = 3187) and the LAMS (n = 12,114) study cohorts, were combined, and a subcohort of 1865 (n = 854 and n = 1011 for the NIS and the LAMS, respectively) women prospectively followed up for 19.7 (median, 22.2) months was analyzed for different intermediate end-point markers of disease progression to squamous intraepithelial lesion (SIL), cervical intraepithelial neoplasia grade 1 and higher (CIN1+), and CIN grade 2 and higher (CIN2+) as terminal events. : Altogether, 131 (7.0%), 90 (4.8%), and 39 (2.1%) cases progressed to SIL, CIN1+, and CIN2+, respectively, progression times being equal in the NIS (11.9, 16.8, and 19.6 months) and LAMS (13.6, 14.1, and 15.4 months) cohorts (P = 0.931, P = 0.335, and P = 0.535). The 2 most powerful end-point markers of disease progression to CIN2+ were high-grade squamous intraepithelial lesions based on Papanicolaou test results at 6-month (odds ratio [OR] = 47.1; 95% confidence interval [CI], 17.3-128.7) and 12-month (OR = 21.5; 95% CI, 5.1-90.8) follow-up visits, with longitudinal positive and negative predictive values of 42.1% and 98.0% (6 months) and 33.3% and 97.7% (12 months). Of the virological end points, more than 6 months of persistent high-risk HPV (HR-HPV) was the most powerful predictor of progression to CIN1+ (OR = 18.6; 95% CI, 2.5-136.5), with longitudinal positive and negative predictive values of 10.3% and 99.4%, respectively. No additional benefit was obtained using more than 12 months of persistent HR-HPV end point. High-grade squamous intraepithelial lesion based on a Papanicolaou test results at 6- or 12-month follow-up visits was the most powerful

  12. Treat and Extend versus Pro Re Nata regimens of ranibizumab in neovascular age-related macular degeneration: a comparative 12 Month study.

    PubMed

    Hatz, Katja; Prünte, Christian

    2017-02-01

    To compare outcomes in patients with treatment-naïve neovascular age-related macular degeneration (nAMD) receiving ranibizumab treat and extend (TE) with those receiving ranibizumab pro re nata (PRN) in a clinical setting. During this 12-month retrospective, consecutive, comparative case series, patients received ranibizumab 0.5 mg according to a TE or PRN regimen. Monthly optical coherence tomography (OCT) evaluation was performed during the PRN regimen; retreatment criteria included recurrence of intra-/subretinal fluid, or haemorrhages. During the TE regimen, initial treatment with 4-week intervals was sequentially lengthened by 2 weeks until signs of choroidal neovascularization (CNV) activity recurred. Study end-points included mean change in best corrected visual acuity (BCVA) and central retinal thickness (CRT), mean injection frequency and number of follow-up visits attended. Baseline characteristics were similar between the TE (n = 70) and PRN (n = 70) groups. Mean change in BCVA from baseline to Month 12 was significantly greater in the TE group than the PRN group (+0.18 ± 0.17 versus +0.07 ± 0.20, p < 0.001). Mean change in CRT from baseline to Month 12 was greater in the TE group than the PRN group (-116 ± 132 versus -58 ± 157 μm, p = 0.019). The number of follow-up visits attended was significantly higher in the PRN group than the TE group (11.9 ± 1.1 versus 8.6 ± 1.9, p < 0.001), while patients in the TE group received more injections during the study than those in the PRN group (8.6 ± 1.9 versus 6.0 ± 1.9, p < 0.001). Ranibizumab administered using a TE regimen in treatment-naïve patients with nAMD provided better visual outcomes with fewer clinic visits, compared with a PRN regimen. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  13. BEHAVIOR OF ADIPOKINES AFTER A YEAR FOLLOW-UP IN THE OBESITY OUTPATIENT CLINIC FOR CHILDREN AND ADOLESCENTS.

    PubMed

    Miraglia, Fernanda; de Moraes Silveira, Carla Rosane; Gomes Beghetto, Mariur; dos Santos Oliveira, Fernanda; de Mello, Elza Daniel

    2015-10-01

    demonstrate adipokines progression, along 12 months, in obese children and adolescents who attend the Obesity Outpatient Clinic for Children and Adolescents of the HCPA. children and adolescents in medical treatment for obesity were followed for 12 months, assessing anthropometry, blood pressure, waist circumference, lipid profile, fasting blood sugar and insulin, inter leukine- 6, tumor necrosis factor alpha, and adiponectin in two points in time: at inclusion and after 12 months follow-up in the Obesity Outpatient Clinic for Children and Adolescents. 27 children and adolescents were assessed with median age of 10.3 years. The mean BMI z-scores lowered during this period (p < 0.01), HDL-c increased in the period (p = 0.025). The medians of adipokines did not vary during the period: IL-6 (p = 0.470), TNF-α (p = 0.753) and adiponectin (p = 0.943). There was no correlation of IL-6 and TNF-α with central and global obesity along the 12-months follow-up. Adiponectin increased in 45% of the sample, the increase being more pronounced in females. children and adolescents in medical treatment for obesity, after one-year follow-up, did not improve their adiponectin profile. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  14. 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

  15. Knowledge and beliefs concerning early childhood caries from mothers of children ages zero to 12 months.

    PubMed

    Azevedo, Marina Sousa; Romano, Ana Regina; Dos Santos, Iná da Silva; Cenci, Maximiliano Sergio

    2014-01-01

    This study's purpose was to assess mothers' knowledge and beliefs about early childhood caries (ECC) etiology and prevention. This cross-sectional study targeted mothers (N=277) of zero- to 12-month-olds visiting 12 public health care centers in Pelotas, Rio Grande do Sul, Brazil. Information on causes of and recommendations to prevent ECC, as well as socioeconomic and demographic variables, was collected. Chi-square, univariate, and multiple logistic regression analyses were performed (P<.05). Sugar intake and lack of oral hygiene were the most frequently mentioned causes of caries. Ninety percent of the mothers were aware of the need to begin tooth-brushing during their children's first year. Mothers who had more children and were in lower socioeconomic positions were more likely to not know the correct age for the first dental visit. Our findings showed that mothers do not know all the factors that can influence caries in their children. None reported the role of micro-organisms and lack of fluoride in the caries etiology. These findings highlight the importance of providing preventive orientation to the mothers regarding early childhood caries. Information on age of first dental visit should be emphasized, especially among mothers with more than one child and low-income families.

  16. 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.

  17. 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

  18. Barriers to follow-up care among survivors of adolescent and young adult cancer.

    PubMed

    Smits-Seemann, Rochelle R; Kaul, Sapna; Zamora, Eduardo R; Wu, Yelena P; Kirchhoff, Anne C

    2017-02-01

    Though the need for risk-based follow-up care for survivors of adolescent and young adult (AYA) cancer has been documented, survivors often report forgoing recommended care due to cost. We sought to understand whether additional barriers to follow-up care exist for AYA survivors. We recruited survivors who were diagnosed with cancer between the ages of 15 and 39 using the Utah Cancer Registry (UCR). Overall, 28 survivors participated in 6 focus groups held between March and May 2015 in Salt Lake City and St. George, UT. Focus group discussions focused on the reasons survivors may or may not attend recommended medical visits after completing therapy. Survivors reported myriad barriers to follow-up medical visits, including lack of clear provider recommendation, fear of recurrent cancer diagnosis, wishing to move on with life, competing life responsibilities due to work and children, and not perceiving the need for a visit due to lack of symptoms. Though cost likely plays a major part in follow-up care adherence for survivors of AYA cancer, in our focus groups, participants indicated there were many other psychosocial and logistic barriers to care. Such factors play an important role in the day-to-day lives of survivors and are critical in medical decision-making. Several factors impede follow-up care adherence for survivors of AYA cancer that are amenable to interventions, including clearer provider recommendations, flexible appointment times, and childcare availability in clinics.

  19. Patient attendance in a recall program after prosthodontic rehabilitation: a 5-year follow-up.

    PubMed

    Wolfart, Stefan; Weyer, Nils; Kern, Matthias

    2012-01-01

    This study evaluated the recall attendance and maintenance for a patient population after prosthodontic treatment in undergraduate student courses. Four hundred ninety-three patients who received fixed restorations (FRs; crowns or fixed partial dentures) or removable partial dentures (RPDs; conical crown-retained or precision attachment-retained dental prostheses) were included in a recall program. The number of patients attending regularly scheduled follow-up visits every 6 months was recorded. On the basis of the complexity of the performed treatment, all follow-up interventions were assigned to the categories minimal, moderate, or extensive. After 60 months, a cumulative follow-up attendance rate between 63% (RPD) and 74% (FR) was evident and not gender related. Altogether, 399 patients (193 FR, 206 RPD) regularly attended the follow-up visits. Between 61.9% (RPD) and 93.8% (FR) of these patients did not need any extensive treatment; however, only 19.2% (RPD) to 85.6% (FR) did not need any moderate or extensive treatment between follow-up visits. Patients treated with FRs showed a higher recall attendance than patients treated with RPDs. Further, patients with RPDs needed more extensive and moderate treatments than patients with FRs. This difference should be taken into consideration during prosthetic planning and patient consultation.

  20. Antibody persistence 12 months after a booster dose of meningococcal-C conjugated vaccine in the second year of life.

    PubMed

    Diez-Domingo, Javier; Planelles-Cantarino, M Victoria; Baldo-Torrenti, Jose M; Ubeda-Sansano, Isabel; Jubert-Rosich, Angels; Puig-Barbera, Joan; Gutierrez-Gimeno, M Victoria

    2010-08-01

    We report on the results of the 12-month follow-up of children aged 14 to 18 months who received primary and booster vaccinations with either a meningococcal-C vaccine conjugated to tetanus toxoid or CRM197. Seroprotection (92.8%) and geometric mean titers/serum bactericidal activity (410.5; 95% CI: 273.4-616.3) were higher in children receiving the meningococcal serogroup C tetanus toxoid conjugate, compared with 61.5% and serum bactericidal antibody geometric mean titer of 45.1 (95% CI: 28.5-71.3) when MenC-CRM197 conjugate was used.

  1. 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

  2. Complete clearance is sustained for at least 12 months after treatment of actinic keratoses of the face or balding scalp via daily dosing with imiquimod 3.75% or 2.5% cream.

    PubMed

    Hanke, C William; Swanson, Neil; Bruce, Suzanne; Berman, Brian; Kulp, James; Levy, Sharon

    2011-02-01

    Assess long-term, sustained, complete clearance of actinic keratoses after treatment with imiquimod 3.75% or 2.5% cream using two two-week or three-week cycles of daily dosing. Adults with five to 20 baseline actinic keratoses who achieved complete clearance at the eight-week post-treatment visit in four phase 3 placebo-controlled treatment studies were followed for an additional 12 months. For imiquimod 3.75% and 2.5% cream, respectively, complete clearance was sustained for 12 months in 17/42 (40.5%) and 13/39 (33.3%) subjects from the two-week cycle studies, and in 23/48 (47.9%) and 16/37 (43.2%) subjects from the three-week cycle studies. There were no safety concerns during the follow-up. In subjects with a median of eight to nine baseline actinic keratoses who achieved complete clearance after treatment of the full face or balding scalp with topical imiquimod 3.75% cream, complete clearance of all lesions (baseline, recurrent or new) was sustained in ≥ 40 percent of subjects for at least 14 months after the last dose. Clinicaltrials.gov identifier NCT00668733.

  3. Ultrasonographic follow-up of patients with choroidal melanoma following conservative treatment.

    PubMed

    Ravozzoni, L; Mosci, C; Polizzi, A; Schenome, M; Soldati, M R; Buono, C

    1998-01-01

    The authors assessed the regression of choroidal tumors, following irradiation treatment, by means of B scan sonography (Sonomed B 3000). Thirty-two patients were studied, 12 of whom underwent brachytherapy with 106Ru plaques and 20 of whom were treated with accelerated protons. After a follow-up period of 12 months, the following was observed: reduction of the thickness of the tumor (significantly greater in the tumors which underwent brachytherapy) and morphological and structural changes which consisted in a thinning of the tumor and an increased reflectivity.

  4. A Follow-up Study of Returning Students--A Concentration on Women.

    ERIC Educational Resources Information Center

    Plotsky, Frances; Ohm, Susan

    The office of Services for Returning Students (SRS) at the University of Texas (U.T.) at Austin conducted a follow-up study of men and women students who had visited the office from February 1969 to the end of 1971. The study ascertained the average interval between periods of formal education, the fulfillment of educational goals, and the use of…

  5. Neurocognitive outcome 12 months following cerebellar mutism syndrome in pediatric patients with medulloblastoma

    PubMed Central

    Palmer, Shawna L.; Hassall, Tim; Evankovich, Karen; Mabbott, Donald J.; Bonner, Melanie; Deluca, Cinzia; Cohn, Richard; Fisher, Michael J.; Morris, E. Brannon; Broniscer, Alberto; Gajjar, Amar

    2010-01-01

    The aim is to prospectively assess early neurocognitive outcome of children who developed cerebellar mutism syndrome (CMS) following surgical resection of a posterior fossa embryonal tumor, compared with carefully matched control patients. Children who were enrolled on an ongoing IRB-approved protocol for treatment of embryonal tumors, were diagnosed with postoperative CMS, and had completed prospectively planned neuropsychological evaluation at 12 months postdiagnosis were considered eligible. The cognitive outcomes of these patients were examined in comparison to patients without CMS from the same treatment protocol and matched with regard to primary diagnosis, age at diagnosis, and risk/corresponding treatment (n = 22 pairs). Seventeen were also matched according to gender, and 14 were also matched according to race. High-risk patients received 36–39.6 Gy CSI and 3D conformal boost to the primary site to 55.8–59.4 Gy. Average-risk patients received 23.4 Gy CSI and 3D conformal boost to the primary site to 55.8 Gy. Significant group differences were found on multiple cognitive outcomes. While the matched control patients exhibited performance in the average range, patients who developed CMS postsurgery were found to have significantly lower performance in processing speed, attention, working memory, executive processes, cognitive efficiency, reading, spelling, and math. Patients treated for medulloblastoma who experience postoperative CMS show an increased risk for neurocognitive impairment, evident as early as 12 months following diagnosis. This study highlights the need for careful follow-up with neuropsychological evaluation and for obtaining critical support for patients and their families. PMID:20713408

  6. 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

  7. Integrative review of nurse-led follow-up after discharge from the ICU.

    PubMed

    Jónasdóttir, Rannveig J; Klinke, Marianne E; Jónsdóttir, Helga

    2016-01-01

    To analyse and synthesise the structure, content, types of outcome variables and advantages of nurse-led follow-up of adult patients after discharge from intensive care units. Follow-up service after discharge from the intensive care unit has been suggested as a way of supporting recovery of patients. Nevertheless, varieties exist in the understanding and content of nurse-led follow-up. An integrative review of nurse-led follow-up inspired by the framework of Whittemore and Knafl. An integrative method merged with the recommendations of the PRISMA statement was used to structure the review and findings. Online databases PubMed, CINAHL, ScienceDirect and Scopus were searched from the years 2003-2014. The retrieved articles were independently assessed by two reviewers. Critical appraisal was conducted using check lists from Johanna Briggs Institute. Emerging patterns were validated by all the authors throughout the entire process of analysis. Seventeen papers were included. Three patterns of nurse-led follow-up were identified: (1) Ward visits--in the immediate time after discharge from intensive care unit, (2) Ward visits and appointment(s) to an intensive care unit follow-up clinic and (3) follow-up visit to an intensive care unit and phone call(s) after discharge. Content of short-term nurse-led follow-up (1) ranged from clinical assessment to supporting patients in articulating their subjective health concerns. Long-term nurse-led follow-up (2, 3) included appointments, phone call(s) or information on where advice could be sought. Types of outcome variables were primarily descriptive. There were strong implications for patients' satisfaction with nurse-led follow-up up to six months after discharge. Nurse-led follow-up might promote patients' health and enable use of adequate resources. The findings of this review could be used to design, and test, future interventions and their implementation. © 2015 John Wiley & Sons Ltd.

  8. 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.

  9. 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.

  10. A nurse-led paediatric head injury follow-up service.

    PubMed

    Falk, Ann-Charlotte

    2013-03-01

    The aim of this study was to describe a nurse-led follow-up service, duration of children's late head injury symptoms and parent/child informational needs. Traumatic brain injury (TBI) is an important cause of morbidity and mortality in children. In Sweden; 7200 children and adolescents are hospitalized every year because of head trauma, and 90% of all head traumas are considered a mild head injury. Although the head injury may be mild, 5-15% of children report sequelae (headache, dizziness, fatigue or memory problems), and the need for a follow-up service has been proposed several times. An empirical descriptive study of a nurse-led follow-up service to improve the quality of care among children with mild-to-moderate head injuries. The data were collected in the period 2003-2005 at a Swedish University Hospital. In total, 149 children (mean age: 9.3 years) received the follow-up service. In 92% of cases, one follow-up visit was performed. Eight per cent needed several visits to ensure symptom resolution. Ninety-one per cent of all children described late symptoms [headache (75%) and tiredness (74%)] at the follow-up visits. The mean symptom duration was 5 weeks. However, 18% of the children reported long-lasting symptoms for 8 weeks, and 16 children (10%) reported long-lasting symptoms beyond 3 months postinjury. An early follow-up service with the aim of meeting the family's needs and reducing any negative impact after a childhood head injury could minimize long-lasting complications for both parents and children. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

  11. Telephone follow-up for pediatric ambulatory surgery: parent and provider satisfaction.

    PubMed

    Kassmann, Barbara P; Docherty, Sharron L; Rice, Henry E; Bailey, Donald E; Schweitzer, Michelle

    2012-12-01

    Traditional 4- to 6-week clinic follow-up after pediatric ambulatory surgery does not rapidly identify complications and is often a burden for parents. Telephone follow-up offers support and is preferred in a variety of adult populations, but there is little research in pediatrics to support this practice. This article describes a practice change involving a standardized telephone follow-up protocol by a pediatric nurse practitioner to parents within 1 week of their child's ambulatory surgery. An interview survey method was used to evaluate parent satisfaction with telephone follow-up and desire for a clinic visit. Staff satisfaction and resource utilization are also described. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Timeliness of outpatient follow-up: an evidence-based approach for planning after hospital discharge.

    PubMed

    Jackson, Carlos; Shahsahebi, Mohammad; Wedlake, Tiffany; DuBard, C Annette

    2015-03-01

    Timely outpatient follow-up has been promoted as a key strategy to reduce hospital readmissions, though one-half of patients readmitted within 30 days of hospital discharge do not have follow-up before the readmission. Guidance is needed to identify the optimal timing of hospital follow-up for patients with conditions of varying complexity. Using North Carolina Medicaid claims data for hospital-discharged patients from April 2012 through March 2013, we constructed variables indicating whether patients received follow-up visits within successive intervals and whether these patients were readmitted within 30 days. We constructed 7 clinical risk strata based on 3M Clinical Risk Groups (CRGs) and determined expected readmission rates within each CRG. We applied survival modeling to identify groups that appear to benefit from outpatient follow-up within 3, 7, 14, 21, and 30 days after discharge. The final study sample included 44,473 Medicaid recipients with 65,085 qualifying discharges. The benefit of early follow-up varied according to baseline readmission risk. For example, follow-up within 14 days after discharge was associated with 1.5%-point reduction in readmissions in the lowest risk strata (P <.001) and a 19.1%-point reduction in the highest risk strata (P <.001). Follow-up within 7 days was associated with meaningful reductions in readmission risk for patients with multiple chronic conditions and a greater than 20% baseline risk of readmission, a group that represented 24% of discharged patients. Most patients do not meaningfully benefit from early outpatient follow-up. Transitional care resources would be best allocated toward ensuring that highest risk patients receive follow-up within 7 days. © 2015 Annals of Family Medicine, Inc.

  13. Percutaneous transhepatic lithotripsy using a choledochoscope: long-term follow-up in 14 patients.

    PubMed

    Hayashi, N; Sakai, T; Yamamoto, T; Inagaki, R; Ishii, Y

    1998-11-01

    The purpose of our study was to estimate the long-term prognosis of patients with bile duct stones who undergo electrohydraulic lithotripsy guided by choledochoscopy. Since 1987, at our institution, 14 patients with bile duct stones have been treated using percutaneous electrohydraulic lithotripsy guided by choledochoscopy. The procedure was performed 5-7 days after biliary drainage using a 5-mm choledochoscope placed through an 18- to 20-French sheath. All patients underwent follow-up CT, sonography, or both every 6-12 months after treatment. No complications occurred in the 14 patients who underwent treatment. During a mean follow-up period of 4.8 years (range, 2-9 years), two (14%) of the 14 patients developed recurrent common bile duct stones, and another two (14%) developed recurrent small intrahepatic stones; all patients remained asymptomatic. Percutaneous electrohydraulic lithotripsy can be safely performed using a 5-mm choledochoscope. Recurrent calculi may be seen in 28% of patients.

  14. A gender-dependent analysis of Cushing's disease in childhood: pre- and postoperative follow-up.

    PubMed

    Libuit, Laura G; Karageorgiadis, Alexander S; Sinaii, Ninet; Nguyen May, Nina M; Keil, Margaret F; Lodish, Maya B; Stratakis, Constantine A

    2015-07-01

    To analyse gender differences in the clinical presentation and recovery of paediatric patients with Cushing's disease (CD) after transsphenoidal surgery (TSS). Indeed, gender differences between paediatric patients with CD during presentation, after TSS and postoperative recovery have not been adequately studied. Data were obtained and retrospectively analysed from clinical reports and biochemical tests at the time of presentation, 5-9 days after TSS and at the 6 and 12 months postoperative follow-up visits to determine hypothalamic-pituitary-adrenal axis (HPAA) recovery. Data from 102 paediatric patients (48 females, 54 males, mean age 12.9 ± 3.0) with CD who underwent TSS at the National Institute of Health (NIH) Clinical Center between 1997 and 2011. There was equal distribution of paediatric CD between males and females (53% vs 47%; n = 102, P = 0.484). Males were more likely than females to present with higher mean BMI Z-scores (2.2 ± 0.7 vs 1.9 ± 0.6, P = 0.0079), lower mean height Z-scores (-1.2 ± 1.3 vs -0.7 ± 1.1, P = 0.0467) and higher median plasma ACTH (12.2 vs 8.5 pmol/l; P = 0.0495). Females did not present more frequently with any single sign or symptom. No significant differences were found between males and females for CD cure rates 5-9 days after TSS (87.0% males vs 87.5% females, P = 1.0), long-term cure rates (86.5% vs 93.7%; n = 69; P = 0.4374) and HPAA recovery time (11.2 ± 2.5 vs 11.7 ± 2.5 months; n = 47; P = 0.1992). Paediatric CD is found to have equal distribution between males and females, but male patients present with elevated BMI and potentially shorter height and higher plasma ACTH. There is no significant difference in the cure rate or HPAA recovery time after TSS between males and females. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

  15. Predicting Outcome 12 Months after Mild Traumatic Brain Injury in Patients Admitted to a Neurosurgery Service.

    PubMed

    Hellstrøm, Torgeir; Kaufmann, Tobias; Andelic, Nada; Soberg, Helene L; Sigurdardottir, Solrun; Helseth, Eirik; Andreassen, Ole A; Westlye, Lars T

    2017-01-01

    Accurate outcome prediction models for patients with mild traumatic brain injury (MTBI) are key for prognostic assessment and clinical decision-making. Using multivariate machine learning, we tested the unique and added predictive value of (1) magnetic resonance imaging (MRI)-based brain morphometric and volumetric characterization at 4-week postinjury and (2) demographic, preinjury, injury-related, and postinjury variables on 12-month outcomes, including global functioning level, postconcussion symptoms, and mental health in patients with MTBI. A prospective, cohort study of patients (n = 147) aged 16-65 years with a 12-month follow-up. T1-weighted 3 T MRI data were processed in FreeSurfer, yielding accurate cortical reconstructions for surface-based analyses of cortical thickness, area, and volume, and brain segmentation for subcortical and global brain volumes. The 12-month outcome was defined as a composite score using a principal component analysis including the Glasgow Outcome Scale Extended, Rivermead Postconcussion Questionnaire, and Patient Health Questionnaire-9. Using leave-one-out cross-validation and permutation testing, we tested and compared three prediction models: (1) MRI model, (2) clinical model, and (3) MRI and clinical combined. We found a strong correlation between observed and predicted outcomes for the clinical model (r = 0.55, p < 0.001). The MRI model performed at the chance level (r = 0.03, p = 0.80) and the combined model (r = 0.45, p < 0.002) were slightly weaker than the clinical model. Univariate correlation analyses revealed the strongest association with outcome for postinjury factors of posttraumatic stress (Posttraumatic Symptom Scale-10, r = 0.61), psychological distress (Hospital Anxiety and Depression Scale, r = 0.52), and widespread pain (r = 0.43) assessed at 8 weeks. We found no added predictive value of MRI-based measures of brain cortical morphometry and subcortical volumes

  16. 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…

  17. 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…

  18. 29 CFR 99.315 - Audit findings follow-up.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Audit findings follow-up. 99.315 Section 99.315 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditees § 99.315 Audit findings follow-up. (a) General. The auditee is responsible for follow-up and corrective...

  19. 7 CFR 3052.315 - Audit findings follow-up.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., DEPARTMENT OF AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditees § 3052.315 Audit findings follow-up. (a) General. The auditee is responsible for follow-up and corrective... 7 Agriculture 15 2010-01-01 2010-01-01 false Audit findings follow-up. 3052.315 Section 3052.315...

  20. 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...

  1. Vertical HIV-1 transmission: prophylaxis and paediatric follow-up.

    PubMed

    Carneiro, M; Sanchéz, A; Maneiro, P; Angelosante, W; Pérez, C; Valleé, M

    2001-04-01

    To study the effectiveness of anti-HIV therapy for vertical HIV-1 transmission based on the PACTG protocol 076, modified and adapted to Venezuela. Between March 1997 and March 2000, 74 HIV-1-infected women (15-42 years old) with 77 singleton pregnancies were evaluated. Zidovudine (ZDV) 500 mg/day (average 8 weeks) was begun after Western blot confirmatory tests, independent of CD4+ count or viral load. ZDV was administered as follows: 47 patients (61 per cent) received prenatal, perinatal and postnatal therapy; 13 (17 per cent) received prenatal and postnatal therapy; two (3 per cent) received prenatal and perinatal therapy; one patient received perinatal and postnatal therapy; seven (9 per cent) received only postnatal therapy. Seven HIV-1 infected women received no treatment. Thirty-two newborns were obtained by C-section (45.7 per cent), while 38 were delivered vaginally (54.2 per cent). Due to advanced maternal illness, seven HIV-1-infected women received ZDV+3TC, two women received ZDV+ddI and one woman received ZDV+3TC+ Ritonavir. Breastfeeding was avoided in all cases. Outcomes showed 65 term newborns and five preterm newborns; three abortions; one fetal loss and one preterm death. Two maternal/fetal deaths were secondary to complications related to AIDS at 27 and 29 weeks, respectively. Twenty-one children over 18 months old were considered uninfected. Thirty-five infants below 15 months of age were considered with the status of indeterminate HIV-1 infection (PO). Three infants fewer than 5 months of age with multiple risk factors were considered infected (P2). Two infants were asymptomatic and HIV positive at 12 months of age (P1). Eight children were lost to follow-up. Independent of maternal status and delivery type, confirmed vertical transmission of HIV-1-infected women who received ZDV is 4.25 per cent. Prenatal care with a multidisciplinary team is necessary for good obstetric and newborn outcomes. Copyright 2001 IFPA and Harcourt Publishers Ltd.

  2. Follow-up on Small Abdominal Aortic Aneurysms Using Three Dimensional Ultrasound: Volume Versus Diameter.

    PubMed

    Ghulam, Q M; Bredahl, K K; Lönn, L; Rouet, L; Sillesen, H H; Eiberg, J P

    2017-10-01

    Rupture risk in abdominal aortic aneurysms (AAAs) is assessed using AAA diameter; yet 10% of ruptures occur in a small aneurysm. This underlines the inadequacy of diameter as a standalone parameter. In this prospective follow-up study, ultrasound determined aneurysm diameter was compared with aneurysm volume determined by three dimensional ultrasound (3D-US) in a group of 179 AAAs. This was a prospective cohort study with repeated diameter and volume measurements by 3D-US. In total, 179 patients with small infrarenal AAAs (diameter 30-55 mm) were enrolled consecutively. At enrolment and at 12 month follow-up, maximum diameter, using dual plane technique, and three dimensional volume were measured. Based on a previous accuracy study, significant change in diameter and volume were defined as an increase exceeding the known range of variability (ROV) of each US technique; ±3.7 mm and ±8.8 mL, respectively. Post-hoc Kaplan-Meier analysis was performed to estimate time to conversion to treatment after the conclusion of the follow-up period between two groups. In total, 125 patients (70%) had an unchanged diameter during follow-up. In this group, 50 patients (40%) had an increasing aortic volume. Forty-five (83%) of the 54 patients with an increasing aortic diameter showed a corresponding volume increase. During a median follow-up of 367 days (364-380 days), a mean increase in diameter of 2.7 mm (±2.6 mm) and a mean increase in volume of 11.6 mL (±9.9 mL) were recorded. In post-hoc analysis, it was found that more AAAs with a stable diameter and a growing volume than AAAs with a stable diameter and volume were undergoing aortic repair during follow-up, based on the maximum diameter. In this cohort of small AAAs, 40% of patients with a stable diameter had an increasing volume at 12 month follow-up. From this perspective, 3D-US could have a future supplemental role in AAA surveillance programmes. Copyright © 2017 European Society for Vascular Surgery. Published

  3. 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

  4. 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.

  5. 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

  6. Do electronic cigarettes increase cigarette smoking in UK adolescents? Evidence from a 12-month prospective study.

    PubMed

    Conner, Mark; Grogan, Sarah; Simms-Ellis, Ruth; Flett, Keira; Sykes-Muskett, Bianca; Cowap, Lisa; Lawton, Rebecca; Armitage, Christopher J; Meads, David; Torgerson, Carole; West, Robert; Siddiqi, Kamran

    2017-08-17

    In cross-sectional surveys, increasing numbers of adolescents report using both electronic cigarettes (e-cigarettes) and cigarettes. This study assessed whether adolescent e-cigarette use was associated prospectively with initiation or escalation of cigarette use. Data were from 2836 adolescents (aged 13-14 years at baseline) in 20 schools in England. At baseline, breath carbon monoxide levels, self-reported e-cigarette and cigarette use, sex, age, friends and family smoking, beliefs about cigarette use and percentage receiving free school meals (measure of socioeconomic status) were assessed. At 12-month follow-up, self-reported cigarette use was assessed and validated by breath carbon monoxide levels. At baseline, 34.2% of adolescents reported ever using e-cigarettes (16.0% used only e-cigarettes). Baseline ever use of e-cigarettes was strongly associated with subsequent initiation (n=1726; OR 5.38, 95% CI 4.02 to 7.22; controlling for covariates, OR 4.06, 95% CI 2.94 to 5.60) and escalation (n=318; OR 1.91, 95% CI 1.14 to 3.21; controlling for covariates, this effect became non-significant, OR 1.39, 95% CI 0.97 to 1.82) of cigarette use. This is the first study to report prospective relationships between ever use of e-cigarettes and initiation and escalation of cigarette use among UK adolescents. Ever use of e-cigarettes was robustly associated with initiation but more modestly related to escalation of cigarette use. Further research with longer follow-up in a broader age range of adolescents is required. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. 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

  8. Variation in the Types of Providers Participating in Breast Cancer Follow-Up Care: A SEER-Medicare Analysis.

    PubMed

    Neuman, Heather B; Schumacher, Jessica R; Schneider, David F; Winslow, Emily R; Busch, Rebecca A; Tucholka, Jennifer L; Smith, Maureen A; Greenberg, Caprice C

    2017-03-01

    The current guidelines do not delineate the types of providers that should participate in early breast cancer follow-up care (within 3 years after completion of treatment). This study aimed to describe the types of providers participating in early follow-up care of older breast cancer survivors and to identify factors associated with receipt of follow-up care from different types of providers. Stages 1-3 breast cancer survivors treated from 2000 to 2007 were identified in the Surveillance, Epidemiology and End results Medicare database (n = 44,306). Oncologist (including medical, radiation, and surgical) follow-up and primary care visits were defined using Medicare specialty provider codes and linked American Medical Association (AMA) Masterfile. The types of providers involved in follow-up care were summarized. Stepped regression models identified factors associated with receipt of medical oncology follow-up care and factors associated with receipt of medical oncology care alone versus combination oncology follow-up care. Oncology follow-up care was provided for 80 % of the patients: 80 % with a medical oncologist, 46 % with a surgeon, and 39 % with a radiation oncologist after radiation treatment. The patients with larger tumor size, positive axillary nodes, estrogen receptor (ER)-positive status, and chemotherapy treatment were more likely to have medical oncology follow-up care than older patients with higher Charlson comorbidity scores who were not receiving axillary care. The only factor associated with increased likelihood of follow-up care with a combination of oncology providers was regular primary care visits (>2 visits/year). Substantial variation exists in the types of providers that participate in breast cancer follow-up care. Improved guidance for the types of providers involved and delineation of providers' responsibilities during follow-up care could lead to improved efficiency and quality of care.

  9. RU OK? The acceptability and feasibility of remote technologies for follow-up after early medical abortion.

    PubMed

    Bracken, Hillary; Lohr, Patricia A; Taylor, Jeanette; Morroni, Chelsea; Winikoff, Beverly

    2014-07-01

    We tested the effectiveness and feasibility of remote communication technologies to increase follow-up after early medical abortion. Women (n=999) were randomized to 'remote' follow-up incorporating a low-sensitivity pregnancy test and standardized symptom questionnaire administered online, by text message or telephone by a non-clinical call center operator 2 weeks after treatment, or to 'clinic-based' follow-up with ultrasound at 1 week. Women in the clinic-based group who could not return performed a high-sensitivity pregnancy test at 3 weeks and had a telephone call with clinic staff. The primary outcome was completion of follow-up. Rates of complications, acceptability and preferences were compared. The overall follow-up rate did not differ by group {clinic-based, 73% vs. remote, 69%; risk ratio (RR) 1.0 [95% confidence interval (CI) 0.9-1.2]}. In the clinic-based group, 83% did not return for an ultrasound scan and were followed up by phone. In the remote group, follow-up by phone or text was more successful than online (text: 75.4%; phone: 73.7%; online: 46.5%, p<.001). The proportion of women receiving additional care was 9% in the clinic-based group and was 4% in the remote group [RR 1.8 (95% CI 1.1-3.1)]. Most women found their follow-up method acceptable but would prefer follow-up by phone or text message if needed in future. Follow-up after medical abortion using remote communication is feasible and, for most women, preferable to a clinic visit. Medical abortion protocols typically use follow-up visits to ensure early identification of complications. This study demonstrates that follow-up can be achieved using remote communication technologies. This model may reduce the burden of multiple clinic visits on patients and providers. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. 'Physical Activity 4 Everyone' school-based intervention to prevent decline in adolescent physical activity levels: 12 month (mid-intervention) report on a cluster randomised trial.

    PubMed

    Sutherland, Rachel; Campbell, Elizabeth; Lubans, David R; Morgan, Philip J; Okely, Anthony D; Nathan, Nicole; Wolfenden, Luke; Wiese, Jarrod; Gillham, Karen; Hollis, Jenna; Wiggers, John

    2016-04-01

    Adolescence is a recognised period of physical activity decline, particularly among low-income communities. We report the 12-month (midpoint) effects of a 2-year multicomponent physical activity intervention implemented in disadvantaged secondary schools. A cluster randomised trial was undertaken in 10 secondary schools located in disadvantaged areas in New South Wales, Australia. Students in Grade 7 were recruited, with follow-up in Grade 8. The intervention was guided by socioecological theory and included seven physical activity strategies, and six implementation adoption strategies. The primary outcome was mean minutes of moderate-to-vigorous physical activity (MVPA) per day assessed using Actigraph GT3X accelerometers. Outcome data were analysed using repeated measures linear mixed models. At baseline, 1150 (93%) students participated in the data collection (mean age 12 years, 48% boys) and 1050 (79%) students participated at 12-month follow-up. By the 12-month follow-up, the six implementation adoption strategies had been used to support schools to deliver four of the seven physical activity elements. There was a significant group-by-time interaction for mean minutes of MVPA per day in favour of the intervention group (adjusted difference between groups at follow-up=3.85 min, 95% CI (0.79 to 6.91), p ≤ 0.01), including significantly more vigorous physical activity (2.45 min, p ≤ 0.01), equating to 27 min more MVPA per week. At 12-month follow-up, the intervention had reduced the decline in physical activity among adolescents from disadvantaged schools. The intervention may assist students to meet physical activity guidelines. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Maintained pain reduction in five patients with multiple myeloma 12 months after treatment of the involved cervical vertebrae with vertebroplasty.

    PubMed

    Pflugmacher, R; Schleicher, P; Schröder, R J; Melcher, I; Klostermann, C K

    2006-10-01

    To evaluate in a prospective study the clinical and radiographic outcome of vertebroplasty in patients with osteolytic lesions of the cervical spine caused by multiple myeloma. Pathological vertebral fractures associated with multiple myeloma were treated in five patients. Vertebroplasty was performed in 12 vertebral bodies. Symptomatic levels were identified by correlating the clinical presentation with magnetic resonance imaging (MRI), conventional radiographs, and computed tomography (CT). During the 12-month follow-up, pain symptoms were measured on a self-reported visual analog scale (VAS), neck pain disability index (NPDI, range 0-100%), and cervical spine functional score (CSFS, range 0-100). Medical imaging was performed pre- and postoperatively and after 3, 6, and 12 months. The vertebral height was measured to assess the restoration of the sagittal alignment. The median pain scores (VAS) as well as the NPDI and CSFS decreased significantly after vertebroplasty (P<0.05). Cement leakage occurred in two of 12 vertebral bodies (16.6%), without clinical relevance. The vertebral body height was stabilized during follow-up. Vertebroplasty in the cervical spine is an effective open surgical procedure for the stabilization of pathological vertebral fractures caused by multiple myeloma leading to a statistically significant reduction of pain status. Vertebral body height is stabilized and further deformities are avoided.

  12. Incidence and 12-month outcome of non-transient childhood conversion disorder in the U.K. and Ireland.

    PubMed

    Ani, Cornelius; Reading, Richard; Lynn, Richard; Forlee, Simone; Garralda, Elena

    2013-06-01

    Little is known about conversion disorder in childhood. To document clinical incidence, features, management and 12-month outcome of non-transient conversion disorder in under 16-year-olds in the U.K. and Ireland. Surveillance through the British Paediatric Surveillance Unit and Child and Adolescent Psychiatry Surveillance System. In total, 204 cases (age range 7-15 years) were reported, giving a 12-month incidence of 1.30/100 000 (95% CI 1.11-1.52). The most common symptoms were motor weakness and abnormal movements. Presentation with multiple symptoms was the norm. Antecedent stressors were reported for 80.8%, most commonly bullying in school. Most children required in-patient admission with frequent medical investigations. Follow-up at 12 months was available for 147 children, when all conversion disorder symptoms were reported as improved. Most families (91%) accepted a non-medical explanation of the symptoms either fully or partially. Childhood conversion disorder represents an infrequent but significant clinical burden in the UK and Ireland.

  13. Pivotal ERIVANCE basal cell carcinoma (BCC) study: 12-month update of efficacy and safety of vismodegib in advanced BCC.

    PubMed

    Sekulic, Aleksandar; Migden, Michael R; Lewis, Karl; Hainsworth, John D; Solomon, James A; Yoo, Simon; Arron, Sarah T; Friedlander, Philip A; Marmur, Ellen; Rudin, Charles M; Chang, Anne Lynn S; Dirix, Luc; Hou, Jeannie; Yue, Huibin; Hauschild, Axel

    2015-06-01

    Primary analysis from the pivotal ERIVANCE BCC study resulted in approval of vismodegib, a Hedgehog pathway inhibitor indicated for treatment of adults with metastatic or locally advanced basal cell carcinoma (BCC) that has recurred after surgery or for patients who are not candidates for surgery or radiation. An efficacy and safety analysis was conducted 12 months after primary analysis. This was a multinational, multicenter, nonrandomized, 2-cohort study in patients with measurable and histologically confirmed locally advanced or metastatic BCC taking oral vismodegib (150 mg/d). Primary outcome measure was objective response rate (complete and partial responses) assessed by independent review facility. After 12 months of additional follow-up, median duration of exposure to vismodegib was 12.9 months. Objective response rate increased from 30.3% to 33.3% in patients with metastatic disease, and from 42.9% to 47.6% in patients with the locally advanced form. Median duration of response in patients with locally advanced BCC increased from 7.6 to 9.5 months. No new safety signals emerged with extended treatment duration. Limitations include low prevalence of advanced BCC and challenges of designing a study with heterogenous manifestations. The 12-month update of the study confirms the efficacy and safety of vismodegib in management of advanced BCC. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  14. Alternatives to ultrasound for follow-up after medication abortion: a systematic review.

    PubMed

    Grossman, Daniel; Grindlay, Kate

    2011-06-01

    Requiring a follow-up visit with ultrasound evaluation to confirm completion after medication abortion can be a barrier to providing the service. The PubMed (including MEDLINE), Cochrane Central Register of Controlled Trials and POPLINE databases were systematically searched in October and November 2009 for studies related to alternative follow-up modalities after first-trimester medication abortion to diagnose ongoing pregnancy or retained gestational sac. We calculated the sensitivity, specificity, positive predictive value and negative predictive value compared with ultrasound or clinician's exam. We also calculated the proportion of cases in each study with a positive screening test. Our search identified eight articles. The most promising modalities included serum human chorionic gonadotropin measurements, standardized assessment of women's symptoms combined with low-sensitivity urine pregnancy testing and telephone consultation. These follow-up modalities had sensitivities ≥90%, negative predictive values ≥99% and proportions of "screen-positives" ≤33%. Alternatives to routine in-person follow-up visits after medication abortion are accurate at diagnosing ongoing pregnancy. Additional research is needed to demonstrate the accuracy, acceptability and feasibility of alternative follow-up modalities in practice, particularly of home-based urine testing combined with self-assessment and/or clinician-assisted assessment. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. Rates and Predictors of Renewed Quitting After Relapse During a One-Year Follow-Up Among Primary Care Patients

    PubMed Central

    Bold, Krysten W.; Rasheed, Abdullah S.; McCarthy, Danielle E.; Jackson, Thomas C.; Fiore, Michael C.; Baker, Timothy B.

    2014-01-01

    Background Most people who quit smoking relapse within a year of quitting. Little is known about what prompts renewed quitting after relapse or how often this results in abstinence. Purpose To identify rates, efficacy, and predictors of renewed quit attempts after relapse during a one-year follow-up. Methods Primary care patients in a comparative effectiveness trial of smoking cessation pharmacotherapies reported daily smoking every 6–12 weeks for 12 months to determine relapse, renewed quitting, and 12-month abstinence rates. Results Of 894 known relapsers, 291 (33%) renewed quitting for at least 24 hours and 99 (34%) of these were abstinent at follow-up. The average latency to renewed quitting was 106 days and longer latencies predicted greater success. Renewed quitting was more likely for older, male, less dependent smokers, and later abstinence was predicted by fewer depressive symptoms and longer past abstinence. Conclusions Renewed quitting is common and produces meaningful levels of cessation. PMID:24796541

  16. 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.

  17. Influence of gender on loss to follow-up in a large HIV treatment programme in western Kenya

    PubMed Central

    Ochieng-Ooko, Vincent; Ochieng, Daniel; Sidle, John E; Holdsworth, Margaret; Wools-Kaloustian, Kara; Siika, Abraham M; Yiannoutsos, Constantin T; Owiti, Michael; Kimaiyo, Sylvester

    2010-01-01

    Abstract Objective To determine the incidence of loss to follow-up in a treatment programme for people living with human immunodeficiency virus (HIV) infection in Kenya and to investigate how loss to follow-up is affected by gender. Methods Between November 2001 and November 2007, 50 275 HIV-positive individuals aged ≥ 14 years (69% female; median age: 36.2 years) were enrolled in the study. An individual was lost to follow-up when absent from the HIV treatment clinic for > 3 months if on combination antiretroviral therapy (cART) or for > 6 months if not. The incidence of loss to follow-up was calculated using Kaplan–Meier methods and factors associated with loss to follow-up were identified by logistic and Cox multivariate regression analysis. Findings Overall, 8% of individuals attended no follow-up visits, and 54% of them were lost to follow-up. The overall incidence of loss to follow-up was 25.1 per 100 person–years. Among the 92% who attended at least one follow-up visit, the incidence of loss to follow-up before and after starting cART was 27.2 and 14.0 per 100 person–years, respectively. Baseline factors associated with loss to follow-up included younger age, a long travel time to the clinic, patient disclosure of positive HIV status, high CD4+ lymphocyte count, advanced-stage HIV disease, and rural clinic location. Men were at an increased risk overall and before and after starting cART. Conclusion The risk of being lost to follow-up was high, particularly before starting cART. Men were more likely to become lost to follow-up, even after adjusting for baseline sociodemographic and clinical characteristics. Interventions designed for men and women separately could improve retention. PMID:20865073

  18. Does routine ultrasound change management in the follow-up of patients with vesicoureteral reflux?

    PubMed

    Rudzinski, Jan K; Weber, Bryce; Wildgoose, Petra; Lorenzo, Armando; Bagli, Darius; Farhat, Walid; Harvey, Elizabeth; Salle, Joao Luiz Pippi

    2013-01-01

    Children with vesicoureteral reflux (VUR) usually need a renal ultrasound (RUS). There is little data on the role of follow-up RUS in VUR. We evaluated the impact of follow-up RUS on the change in clinical management in patients with VUR. We prospectively analyzed children with a previous diagnosis of VUR seen in the outpatient clinic with a routine follow-up RUS within 4 months. Variables collected included: demographic data, VUR history, dysfunctional voiding symptoms and concurrent ultrasound findings. Change in management was defined as addition of new medication, nurse counselling, surgery or further investigations. The study included 114 consecutive patients. The mean patient age was 4.5 years old, mean age of VUR diagnosis was 1.7 years, with average follow-up of 2.8 years. A change in management with stable RUS occurred in 14 patients, in which the change included ordering a DMSA in 9, nurse counselling for dysfunctional voiding in 3, and booking surgery in 2 patients. Change on RUS was seen in 4 patients. Multivariable analysis showed that history of urinary tract infection (UTI) since the last follow-up visit was more significant than RUS findings. The RUS findings in most patients followed for VUR remain stable or with minimal changes. The variable showing a significant effect on change in management in our study was history of UTI since the last follow-up visit rather than RUS findings. The value of follow-up RUS for children with VUR may need to be revisited.

  19. Facilitating follow-up after emergency care using an appointment assignment system.

    PubMed

    Vinson, David R; Patel, Pankaj B

    2009-01-01

    Many emergency department (ED) patients require urgent follow-up in primary care. The most effective way to help patients obtain their needed after-visit care is to secure the appointment on their behalf prior to their departure from the ED. This study describes the development, implementation, and outcomes of an appointment assignment system that facilitates patient follow-up at two community hospitals in an integrated healthcare system. This patient-centered system resulted in a high rate of compliance and a very low rate of unscheduled ED recidivism. Improving access in this manner will likely strengthen the continuum of care, improve quality, and increase patient satisfaction.

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

    PubMed Central

    Anda-Juárez, Mariana Catalina De;