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Sample records for 123i-imp spect follow-up

  1. Sequential sup 123 I-IMP-SPECT in acute infantile hemiplegia

    SciTech Connect

    Shirasaka, Y.; Ito, M.; Okuno, T.; Fujii, T.; Mikawa, H. )

    1989-09-01

    Sequential {sup 123}I-N-isopropyl-p-iodoamphetamine (IMP) single-photon emission computed tomography (SPECT) was performed in 2 patients with acute infantile hemiplegia. In both patients, low uptake of IMP was detected in the targeted abnormal hemisphere. The {sup 123}I-IMP-SPECT findings indicative of a pathologic condition persisted even when the clinical findings and electroencephalographic abnormalities improved. Because of its sensitivity, noninvasiveness, and accurate reflection of the cerebral blood flow distribution, {sup 123}I-IMP-SPECT is useful in the examination of acute infantile hemiplegia and in the evaluation of prognosis.

  2. 123I-IMP-SPECT in a patient with cerebral proliferative angiopathy: a case report.

    PubMed

    Kimiwada, Tomomi; Hayashi, Toshiaki; Shirane, Reizo; Tominaga, Teiji

    2013-11-01

    Cerebral proliferative angiopathy (CPA) is a new clinical entity demonstrating a diffuse network of densely enhanced vascular abnormalities with intermingled normal brain parenchyma and is distinguishable from classical arteriovenous malformations by specific clinical and imaging markers. However, the pathophysiological nature of this disease is unclear, and there is no consensus on the treatment. We describe cerebral perfusion abnormalities in a patient with CPA by using N-isopropyl-p-[123I] iodoamphetamine single-photon emission computed tomography (123I-IMP-SPECT) and perfusion-weighted magnetic resonance imaging. The patient, a 13-year-old boy, had reversible focal neurological deficits unrelated to cerebral hemorrhage. 123I-IMP-SPECT at resting state showed preserved uptake within the vascular lesion, yet lower uptake in the area adjacent to the lesion. In addition, acetazolamide-stressed 123I-IMP-SPECT exhibited severely impaired cerebrovascular reactivity over the affected hemisphere, suggesting that his focal neurological deficits were related to the cerebral ischemia. The perfusion abnormalities on 123I-IMP-SPECT in a CPA patient have never been previously reported. The concept of vascular malformation-related hypoperfusion is discussed. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  3. [Compartment analysis of 123I-IMP brain SPECT].

    PubMed

    Higano, S; Shishido, F; Aizawa, Y; Miura, S; Murakami, M; Inugami, A; Kanno, I; Fujita, H; Uemura, K

    1990-01-01

    To clarify the kinetics of N-isopropyl [123I]p-iodoamphetamine (IMP) in the brain, 2-compartment analysis was applied for brain SPECT with 57-minute dynamic scan in 9 subjects. The model consisted of blood component and brain tissue component. Two transfer rate constants were defined; k1 showed the rate from the blood to the brain tissue, and k2 was that of back diffusion. The late scan was performed 210 minutes after the tracer injection. Suitable k values best fitting to the dynamic data were determined for all regions of interest. Predicted regional cerebral activity at 210 minutes using 57-minute dynamic data was well agreed with measured activity. These showed the kinetics of IMP in the brain was well described by the 2-compartment model. The partition coefficient (k1/k2 ratio) was as large as about 35, and almost constant in the various brain structures including hypoperfused areas. These findings indicated that the initial IMP images reflected the reasonable CBF distribution, which gave relatively reliable CBF values even if using microsphere model.

  4. Brain imaging with sup 123 I-IMP-SPECT in migraine between attacks

    SciTech Connect

    Schlake, H.P.; Boettger, I.G.G.; Grotemeyer, K.H.; Husstedt, I.W.

    1989-06-01

    {sup 123}I-IMP-SPECT brain imaging was performed in patients with classic migraine (n = 5) and migraine accompagnee (n = 18) during the headache-free interval. A regional reduction of tracer uptake into brain was observed in all patients with migraine accompagnee, while in patients with classic migraine only one case showed an area of decreased activity. The most marked alteration was found in a patient with persisting neurological symptoms (complicated migraine). In most cases the areas of decreased tracer uptake corresponded to headache localization as well as to topography of neurologic symptoms during migraine attacks. It may be concluded that migraine attacks occur in connection with exacerbations of preexisting changes of cerebral autoregulation due to endogenous or exogenous factors.

  5. "Luxury perfusion" with 99mTc-HMPAO and 123I-IMP SPECT imaging during the subacute phase of stroke.

    PubMed

    Moretti, J L; Defer, G; Cinotti, L; Cesaro, P; Degos, J D; Vigneron, N; Ducassou, D; Holman, B L

    1990-01-01

    To compare the merits of 123I-isopropyl-iodoamphetamine (123I-IMP) and 99mTc-HMPAO in showing abnormal brain uptake distribution during cerebral ischemia, we studied ten patients during the subacute phase of their stroke, a period where metabolism and blood flow are frequently uncoupled. SPECT imaging was performed using both radiopharmaceuticals in the 10 patients from 48 h to 4 weeks after onset of symptoms. Two patients out of the 10 had similar defects with 123I-IMP and 99mTc-HMPAO SPECT, the location of the defects corresponding to the area of infarction observed on CT. Six patients had normal 99mTc-HMPAO SPECT and abnormal 123I-IMP SPECT with defects in the area of infarction shown by CT. The remaining 2 patients had hyperactive abnormalities on 99mTc-HMPAO in areas corresponding to defects on the 123I-IMP images. Two of the patients with SPECT mismatches were studied again more than 1 month after onset. On reexamination, 99mTc-HMPAO SPECT which was previously normal or hyperactive became hypoactive with a focal area of decreased activity corresponding to the defect on 123I-IMP. Crossed cerebellar diaschisis was found in 7 patients with 99mTc-HMPAO and was absent for both 123I-IMP and 99mTc-HMPAO in 3. We suggest that SPECT with 99mTc-HMPAO could show transient hyperemia not demonstrated by 123I-IMP whereas in some cases cerebral infarction would be more difficult to demonstrate with 99mTc-HMPAO than with 123I-IMP. SPECT with both tracers is recommended to follow the evolution of strokes in terms of regional cerebral blood flow and tissue metabolism.

  6. [A technique for a rapid imaging of regional CBF and partition coefficient using dynamic SPECT and N-isopropyl-p-[123I]iodoamphetamine (123I-IMP)].

    PubMed

    Itoh, H; Iida, H; Murakami, M; Bloomfield, P M; Miura, S; Okudera, T; Inugami, A; Ogawa, T; Hatazawa, J; Fujita, H

    1993-01-01

    IMP is a flow tracer due to a large first pass extraction fraction and high affinity in the brain, but significant clearance from the brain causes change of distribution when the scan start time is delayed. The purpose of the present study is to develop a new method to rapidly calculate a quantitative CBF image by taking into account for the clearance effects. A dynamic SPECT scan was performed on 5 subjects (4 patients with cerebral infarction and 1 normal volunteer) following slow intravenous infusion of 123I-IMP. The arterial input function was obtained by frequent blood sampling and by measuring an octanol extraction ratio for each sample. Firstly, non-linear least square fitting (NLS) was performed to investigate the tracer kinetics of 123I-IMP. The 3 compartment model analysis yielded negligibly small k3 (retaining rate constant) (0.0056 +/- 0.0128 (ml/ml/min)), and consistent k1 (transport rate constant) with those determined by 2 compartment model (2CM) analysis (r = 0.96, p < 0.001). In addition, k1 was consistent with CBF measured by 15O water PET technique. These observations suggested validity of using 2CM for describing the IMP tracer kinetics. Secondly, a weighted integration (WI) technique has been implemented to calculate rapidly images of CBF and partition coefficient (Vd). The WI technique yielded values of CBF (k1) and Vd (k1/k2). They were confirmed to be consistent with those determined by NLS technique (CBF; r = 0.99, p < 0.001, Vd; r = 0.99, p < 0.001), and calculated k1 agreed well with PET CBF (r = 0.91, p < 0.001). We observed changed Vd in infarcted patients. This supports an importance for calculating of Vd image. Vd image will provide additional clinical information because 123I-IMP binding mechanism may be related to cell viability.

  7. [Quantitation of cerebral blood flow and partition coefficient using 123I-IMP dynamic SPECT with single arterial blood sampling].

    PubMed

    Mizumura, S; Kumita, S; Kumazaki, T

    1996-03-01

    A method base on the two-compartment model was developed to measure quantitative cerebral blood flow (CBF) and partition coefficient (lambda) of IMP from dynamic SPECT and single arterial blood sampling. In this method, the linear differential equation of two-compartment model, Yokoi proposed, was employed and quantitative CBF and lambda values were measured with the standard input function calibrated by single arterial sampling. The input function was derived from the standard input function scaled by a factor determined by the single arterial blood sample. This new technique was applied to 5 normal volunteers (Ages ranged from 25 to 29 yr., average 26 yr.). The optimal time to calibrate the standard input function in the individual study and optimal the period of the upper limit time to which input function is integrated from IMP administration for analysis of the equation were determined to minimize the difference between integration of the calibrated standard input function and of the individual input function. Minimization of the difference yields an optimal calibration time (4 to 10 min after IMP administration) and the period of the upper limit time (8 to 60 min after acquisition start). Comparison of CBF and lambda values obtained by the graphical method using the calibrated standard data and individual input function were performed. It should be noted that CBF values were in good agreement between the two methods, respectively (r = 0.92, P<0.01; r = 0.72, p = 0.01). This method is easy to estimate CBF and lambda by only single arterial blood sampling and IMP dynamic SPECT, and useful for routine studies.

  8. Early differential diagnosis between Alzheimer's disease and dementia with Lewy bodies: Comparison between (18)F-FDG PET and (123)I-IMP SPECT.

    PubMed

    Chiba, Yuhei; Iseki, Eizo; Fujishiro, Hiroshige; Ota, Kazumi; Kasanuki, Koji; Suzuki, Masaru; Hirayasu, Yoshio; Arai, Heii; Sato, Kiyoshi

    2016-03-30

    Both (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and (123)I-iodoamphetamine (IMP) single-photon emission computed tomography (SPECT) have been used for the differential diagnosis of Alzheimer's disease (AD) and dementia with Lewy bodies (DLB). Less information is available, however, regarding the differential diagnosis of mild cognitive impairment (MCI) due to AD and MCI due to DLB. We examined nine AD patients (AD group), nine DLB patients (DLB group), eight MCI due to AD patients (MCI-AD group), and nine MCI due to DLB patients (MCI-DLB group) with FDG PET and IMP SPECT using a well-characterized normal database and a stereotactic extraction estimation method. In the AD and DLB groups, receiver operating characteristic (ROC) analysis in the occipital regions showed significant accuracy of both FDG PET and IMP SPECT for the differential diagnosis. In the MCI-AD and MCI-DLB groups, ROC analysis showed significant accuracy of only FDG PET for the differential diagnosis. Both FDG PET and IMP SPECT would be useful for the differential diagnosis between AD and DLB. For the differential diagnosis of MCI-AD versus MCI-DLB, FDG PET would be more useful than IMP SPECT. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. [Normal database (NDB) of 123I-IMP brain perfusion SPECT examination is affected by statistical image analysis in the presence or absence of scatter correction and attenuation correction].

    PubMed

    Shimada, Hirotaka; Otake, Hidenori; Higuchi, Tetsuya; Arisaka, Yukiko; Oriuchi, Noboru; Endo, Keigo

    2012-11-01

    The purpose of our study is the establishment of normal database (NDB) from persons (aged 50-80 years) for 3D-SSP analysis of 123I-IMP brain perfusion SPECT image, and we analyzed whether the presence or absence of image correction methods, scatter correction (SC) and attenuation correction (AC), affects the created NDB and 3D-SSP analysis. We created NDB from 63 healthy volunteers (32 males and 31 females, aged 50-80 years), and calculated the coefficient of variation for each pixel from the mean value and standard deviation. Next, we compared the visual assessments of the standard deviation images by each image correction method, and the coefficient of variation of SEE analysis in each part of the brain. Furthermore, we examined frontotemporal dementia and healthy volunteers by 3D-SSP analysis, and evaluated the differences of Z-score in the presence or absence of image correction methods. In NDB, the coefficient of variation was the minimum when SC and AC were not applied and the maximum in periventricular and cerebellum when SC and AC were applied. In Z-score image of 3D-SSP analysis, Z-score of the low value was the maximum when SC and AC were not applied. It was shown that the results from NDB coefficient of variation and 3D-SSP analysis were affected by the differences of image correction methods. It is important to understand the feature of imaging reconstruction conditions in your own facilities, and evaluate 3D-SSP analysis.

  10. Assessment of Hemodynamic Compromise Using Computed Tomography Perfusion in Combination with (123)I-IMP Single-Photon Emission Computed Tomography without Acetazolamide Challenge Test.

    PubMed

    Hashimoto, Atsumu; Mikami, Takeshi; Komatsu, Katsuya; Noshiro, Shouhei; Hirano, Tohru; Wanibuchi, Masahiko; Mikuni, Nobuhiro

    2017-03-01

    The acetazolamide challenge test in conjunction with (123)I-IMP single-photon emission computed tomography (SPECT) is a known method of assessing cerebrovascular reserve capacity. In this study, we investigated whether CT perfusion in combination with resting state (123)I-IMP SPECT could be used instead of the acetazolamide challenge test to evaluate hemodynamic compromise in patients with atherosclerotic occlusive disease. Twenty consecutive patients with unilateral internal carotid artery or middle cerebral artery steno-occlusive disease were enrolled. (123)I-IMP SPECT was performed with and without the acetazolamide challenge test, and with CT perfusion. Cerebral blood flow (CBF), cerebral blood volume, and mean transit time (MTT) obtained by CT perfusion were compared with CBF and cerebrovascular reactivity (CVR) obtained by (123)I-IMP SPECT. The asymmetry ratio of MTT as measured by CT perfusion showed a strong correlation with the CVR to acetazolamide as measured by (123)I-IMP SPECT (ρ = -.780, P <.001). Based on the CBF obtained through (123)I-IMP SPECT and the MTT obtained through CT perfusion, hemodynamic compromise was detected with high sensitivity (1.000) and specificity (.929), and a cutoff value of 30% was found to be suitable for the asymmetry ratio of MTT. MTT prolongation was significantly improved after revascularization surgery in hemodynamic compromise (P = .028). MTT as measured by CT perfusion in combination with CBF as measured by resting state (123)I-IMP SPECT may be useful for evaluating hemodynamic compromise as an alternative to the acetazolamide challenge test. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  11. Regional cerebral blood flow study with 123I-IMP in patients with degenerative dementia

    SciTech Connect

    Ohnishi, T.; Hoshi, H.; Nagamachi, S.; Jinnouchi, S.; Futami, S.; Watanabe, K.; Mitsuyama, Y. )

    1991-05-01

    Regional cerebral blood flow was evaluated by single-photon emission CT (SPECT) with 123I-N-isopropyl-p-iodoamphetamine (123I-IMP) in 11 patients with dementia of the Alzheimer type, three patients with progressive dementia and motor neuron disease, and eight healthy control subjects. Regional blood flow measurements in the bilateral frontal, parietal association, and temporal cortices were lower in the Alzheimer dementia patients than in controls. Flow deficits in the parietal association cortex were demonstrated in all patients with Alzheimer-type dementia; these deficits were correlated with the severity of disease. Lateral hemispheric asymmetry was seen in nine of 11 patients with Alzheimer-type dementia. In all three patients with progressive dementia and motor neuron disease, flow deficits were demonstrated in the bilateral frontal and temporal cortices, but no flow deficits were seen in the parietal association cortex. Brain SPECT with 123I-IMP may be useful in the differential diagnosis and evaluation of the severity of degenerative dementia.

  12. Fully automatic input function determination program for simple noninvasive (123)I-IMP microsphere cerebral blood flow quantification method.

    PubMed

    Yamashita, Kosuke; Uchiyama, Yoshikazu; Ofuji, Asato; Mimura, Hiroaki; Okumiya, Shintaro; Takaki, Akihiro; Sone, Teruki; Ito, Shigeki

    2016-09-01

    We recently developed a simple noninvasive (123)I-IMP microsphere (SIMS) method using chest dynamic planar images and brain single photon emission computed tomography. The SIMS method is an automatic analysis method, except for the process of setting the region of interest (ROI) of the input function. If a fully automatic ROI setting algorithm can be developed to determine the input function for the SIMS method, repeatability and reproducibility of the analysis of regional cerebral blood flow (rCBF) of the SIMS method can be guaranteed. The purpose of this study is to develop a fully automatic input function determination program for the SIMS method and to confirm the clinical usefulness of this program. The automatic input function determination program consists of two ROI setting programs for the PA and lung regions, and it is developed using the image phase analysis of a chest RI angiogram. To confirm the clinical usefulness of this program, the rCBF in 34 patients measured using the automatic method were compared with the values obtained through the manual setting method. Input functions by the automatic and manual methods were approximately equal. A good correlation was observed between the rCBF values obtained by the automatic method and those obtained by the manual setting method (r=0.96, p<0.01). Further, the total time taken for the automatic SIMS analysis is 1-2min as compared to 20-30min for the current analysis, and therefore, this technique contributes to the improvement of the throughput of nuclear medical examinations. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  13. In vivo radioactive metabolite analysis for individualized medicine: a basic study of a new method of CYP activity assay using (123)I-IMP.

    PubMed

    Nishi, Kodai; Mizutani, Asuka; Shikano, Naoto; Fujita, Ken-Ichi; Kobayashi, Masato; Ono, Masahiro; Nishii, Ryuichi; Sasaki, Yasutuna; Kinuya, Seigo; Kawai, Keiichi

    2015-02-01

    (123)I-N-isopropyl-p-iodoamphetamine ((123)I-IMP) is metabolized and converted to (123)I-p-iodoamphetamine ((123)I-PIA) by CYP2C19 in humans. Since variations in (123)I-PIA levels reflect variations in CYP2C19 activity, CYP2C19 activity can be estimated by quantitative analysis of (123)I-PIA levels. Thus, (123)I-IMP administration can provide diagnostic information not only regarding cerebral blood flow (rCBF) but also regarding metabolic function. The aim of the present study was to detect variations in CYP activity in mice using metabolite analysis. Metabolism of (125)I-IMP in pooled homogenates of mouse liver (MLH) was analyzed by high-performance liquid chromatography (HPLC) in the presence or absence of NADPH. The amount of (125)I-PIA generated was calculated as the normalized peak area of the chromatogram. Inhibition of (125)I-IMP metabolism was evaluated using the inhibitor SKF-525A. A biodistribution study of (125)I-IMP was performed to determine the organ distribution of (125)I-IMP/(125)I-IMP metabolites and the effect of SKF-525A. Variations in CYP activity in vivo were detected by administration of (123)I-IMP and/or SKF-525A to mice. The liver and the kidney were then excised, homogenized and analyzed using HPLC. (125)I-IMP was metabolized by MLH in the presence of NADPH, and the production of (125)I-PIA was inhibited by SKF-525A. SKF-525A did not greatly affect the biodistribution of (125)I-IMP/(125)I-IMP metabolites in vivo. Both (123)I-IMP and (123)I-PIA were detected in organs of control mice. However, (123)I-PIA was not detected in the livers or kidneys of mice treated with SKF-525A. CYP activity in vivo was inhibited by SKF-525A treatment. Variations in CYP activity could be detected in the blood, liver and kidney as changes in the peak area of (123)I-PIA. (123)I-IMP metabolite analysis has the potential to provide beneficial information for prediction of the effect of medicines, in addition to its contribution to more accurate rCBF diagnosis that

  14. Diagnosis of dementia with Lewy bodies: can (123)I-IMP and (123)I-MIBG scintigraphy yield new core features?

    PubMed

    Sakamoto, Fumi; Shiraishi, Shinya; Tsuda, Noriko; Hashimoto, Mamoru; Tomiguchi, Seiji; Ikeda, Manabu; Yamashita, Yasuyuki

    2017-02-01

    Since the clinical symptoms of different types of dementia frequently overlap, especially in the earlier stages at onset, it is difficult to distinguish dementia with Lewy bodies (DLB) from other neurodegenerative dementias based on their clinical manifestations alone. Nuclear medicine imaging has been reported as a high-value index for the objective evaluation and diagnosis of DLB. The aim of this study was to evaluate whether nuclear medicine imaging findings may yield core features to be added to the diagnosis of DLB. We enrolled 332 patients with suspected DLB. All were evaluated by both (123)I-metaiodobenzylguanidine ((123)I-MIBG) myocardial scintigraphy and (123)I-labelled N-isopropyl-p-iodoamphetamine ((123)I-IMP). brain perfusion single-photon emission CT. The final clinical diagnosis indicated probable DLB in 92 patients (40 males, 52 females; mean age ± standard deviation, 77.4 ± 6.4 years; range, 56-89 years); 240 patients (98 males, 142 females; mean age, 75.5 ± 9.0 years; range, 70-87 years) were recorded as being without DLB. The accepted core features used for clinical evaluations were fluctuating cognition, visual hallucinations and Parkinsonism. The nuclear medicine evaluation indices were the severity score of cerebral blood flow on (123)I-IMP scintigraphs of the posterior cingulate and praecuneus and a reduction in the blood flow in the occipital lobe. For (123)I-MIBG evaluation, we recorded the early and delayed heart-to-mediastinum (H/M) ratios and the washout rate. Univariate and multivariate analyses of fluctuating cognition, visual hallucinations, Parkinsonism and early H/M ratio in patients with probable and without DLB revealed significant differences. Parameters based on (123)I-IMP studies did not show any significant differences by multivariate analysis. The area under the curve for the early H/M ratio was 0.918; for fluctuating cognition, visual hallucinations and Parkinsonism, it was 0.693, 0.760 and 0.611, respectively

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

    PubMed Central

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

    2014-01-01

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

  16. Pre- and Postsynaptic Dopamine SPECT in Idiopathic Parkinsonian Diseases: A Follow-Up Study

    PubMed Central

    Forsgren, Lars; Holmberg, Henrik; Larsson, Anne; Riklund, Katrine

    2013-01-01

    We prospectively evaluated the diagnostic contribution of 123I-FP-Cit (DAT) and 123I-IBZM (IBZM) SPECT in 29 patients with Parkinson's disease (PD) (74.4 ± 4.2 years) and 28 patients with atypical parkinsonian diseases (APD) (74.3 ± 9.2 years). Twelve had multiple system atrophy (MSA) and 16 progressive supranuclear palsy (PSP). Sixteen age-matched healthy controls (HC) were included. DAT and IBZM SPECTs were made at baseline and after 1 year in all PD patients and in 20 (DAT) and 18 (IBZM) of the APD patients, and after 3 years in 22 (DAT) and 17 (IBZM) of the PD patients and in 10 (DAT) and 10 (IBZM) of the APD patients. The relative DAT uptake decrease was faster in PD and PSP than in HC and MSA. In PSP the DAT uptake was lower than in MSA after 1 year but not after 3 years. Baseline IBZM uptake was not significantly different between patients and HC or between PD and APD. One year after initiated dopaminergic treatment the mean IBZM uptake in the MSA patients remained high compared to PSP and after 3 years compared to PD, PSP, and HC. Thus, the pattern of uptake of these ligands over time may be of value in discriminating between these diagnoses. PMID:24163811

  17. [Follow-up of patients with good exercise capacity in stress test with myocardial single-photon emission computed tomography (SPECT)].

    PubMed

    González, Javiera; Prat, Hernán; Swett, Eduardo; Berrocal, Isabel; Fernández, René; Zhindon, Juan Pablo; Castro, Ariel; Massardo, Teresa

    2015-11-01

    The evaluation of coronary artery disease (CAD) can be performed with stress test and myocardial SPECT tomography. To assess the predictive value of myocardial SPECT using stress test for cardiovascular events in patients with good exercise capacity. We included 102 males aged 56 ± 10 years and 19 females aged 52 ± 10 years, all able to achieve 10 METs and ≥ 85% of the theoretical maximum heart rate and at least 8 min in their stress test with gated 99mTc-sestamibi SPECT. Eighty two percent of patients were followed clinically for 33 ± 17 months. Sixty seven percent of patients were studied for CAD screening and the rest for known disease assessment. Treadmill stress test was negative in 75.4%; 37% of patients with moderate to severe Duke Score presented ischemia. Normal myocardial perfusion SPECT was observed in 70.2%. Reversible defects appeared in 24.8% of cases, which were of moderate or severe degree (> 10% left ventricular extension) in 56.6%. Only seven cases had coronary events after the SPECT. Two major (myocardial infarction and emergency coronary revascularization) and 5 minor events (elective revascularization) ere observed in the follow-up. In a multivariate analysis, SPECT ischemia was the only statistically significant parameter that increased the probability of having a major or minor event. Nearly a quarter of our patients with good exercise capacity demonstrated reversible defects in their myocardial perfusion SPECT. In the intermediate-term follow-up, a low rate of cardiac events was observed, being the isotopic ischemia the only significant predictive parameter.

  18. CT perfusion with angiography as a substitute for both conventional digital subtraction angiography and acetazolamide-challenged SPECT in the follow-up of postbypass patients.

    PubMed

    Park, Jung Cheol; Kim, Jeong Eun; Kang, Hyun-Seung; Sohn, Chul-Ho; Lee, Dong Soo; Oh, Chang Wan; Han, Moon Hee

    2010-01-01

    We evaluated the clinical usefulness of CT perfusion (CTP) with angiography (CTA) as an alternative to digital subtraction angiography (DSA) and acetazolamide (ACZ)-challenged single-photon emission computed tomography (SPECT) in the follow-up evaluation of hemodynamic changes and bypass patency after bypass surgery in chronic cerebral ischemic diseases. Thirty-five patients who underwent superficial temporal artery/middle cerebral artery bypass surgery for chronic cerebral ischemic diseases were retrospectively enrolled. We assessed the relationship between CTP parameters [cerebral blood volume, cerebral blood flow (CBF), mean transit time (MTT), affected-to-unaffected hemisphere (ATU) ratio of perfusion parameters and MTT differences between hemispheres] and SPECT parameters (regional CBF and cerebrovascular reserve) and compared the preoperative CTP parameters with the postoperative ones. For the bypass patency, we compared CTA with DSA. MTT showed the best correlation with CVR of SPECT (r = -0.343; p < 0.001). ATU ratio (r = -0.547; p < 0.001) and ATU differences (r = -0.592; p < 0.001) of MTT correlated well with the ATU ratio of rCBF on ACZ-challenged SPECT. Significant improvement of perfusion parameters could be demonstrated in the affected vascular territory with postoperative CTP. The CTA findings were consistent with those of DSA in 96% of the cases. The examination-related complication rate was 0, 2.8 and 8.6% for CT studies, DSA and SPECT, respectively. CTP performed simultaneously with CTA seems to be a safe and efficient substitute for DSA and ACZ-challenged SPECT in the follow-up evaluation after bypass surgery in patients with chronic cerebral ischemic diseases. Copyright © 2010 S. Karger AG, Basel.

  19. Tl-201 myocardial SPECT in patients with Duchenne's muscular dystrophy: A long-term follow-up

    SciTech Connect

    Nagamachi, S.; Jinnouchi, S.; Ono, S.; Hoshi, H.; Inoue, K.; Watanabe, K. )

    1989-11-01

    Tl-201 SPECT was used to evaluate myocardial involvement in 13 patients with Duchenne's muscular dystrophy. Serial studies of 9 patients were done at two-year intervals. The hypoperfused areas of the left ventricle became more prominent with age and severity.

  20. Regional Cerebral Blood Flow in [123]I-IMP Single-photon Emission Computed Tomography and the Wechsler Memory Scale-revised in Nondemented Elderly Subjects with Subjective Cognitive Impairment.

    PubMed

    Niwa, Fumitoshi; Kondo, Masaki; Sakurada, Kumi; Nakagawa, Masanori; Imanishi, Jiro; Mizuno, Toshiki

    Objective Regional cerebral blood flow (rCBF) imaging with single-photon emission computed tomography (SPECT) is useful in the early diagnosis of dementia. We aimed to investigate the association between the rCBF and various domains related to the memory function in elderly subjects with subjective cognitive impairment (SCI). Methods Thirty-two subjects with SCI were included in the present study. Patients with dementia and mild cognitive impairment (MCI) were excluded based on the presence of logical memory impairment. N-isopropyl-p-[(123)I]-iodoamphetamine SPECT was performed and Wechsler Memory Scale-Revised (WMS-R) was administered to all subjects (mean age, 68.4 years; average Mini-Mental State Examination score, 27.6). The SPECT results were analyzed using the easy Z-score imaging system and the voxel-based stereotactic extraction estimation method. Correlation analyses were performed to investigate the correlation between the mean positive Z-scores in the decrease of the rCBF and the WMS-R indices. Results The SPECT study indicated marked hypoperfusion in some areas, including the bilateral temporal areas, the caudate, and the thalamus, in these subjects in comparison to the normal database. The decrease in the rCBF that was observed in several regions, including the left precuneus and left inferior frontal gyrus (LIFG), showed a significant negative correlation with several indices of the memory function, particularly visual memory. Conclusion The regional hypoperfusion observed in the study using the voxel-based stereotactic extraction estimation method suggest that the regional cerebral dysfunction is associated with the memory function of patients with SCI, even though the subjects in the present study were cognitively intact. The correlation analysis with the WMS-R suggested the contribution of the LIFG to the memory function and indicated the significance of visual memory dysfunction in the neuropsychological assessment to determine the stage of SCI.

  1. Regional Cerebral Blood Flow in [123]I-IMP Single-photon Emission Computed Tomography and the Wechsler Memory Scale-revised in Nondemented Elderly Subjects with Subjective Cognitive Impairment

    PubMed Central

    Niwa, Fumitoshi; Kondo, Masaki; Sakurada, Kumi; Nakagawa, Masanori; Imanishi, Jiro; Mizuno, Toshiki

    2016-01-01

    Objective Regional cerebral blood flow (rCBF) imaging with single-photon emission computed tomography (SPECT) is useful in the early diagnosis of dementia. We aimed to investigate the association between the rCBF and various domains related to the memory function in elderly subjects with subjective cognitive impairment (SCI). Methods Thirty-two subjects with SCI were included in the present study. Patients with dementia and mild cognitive impairment (MCI) were excluded based on the presence of logical memory impairment. N-isopropyl-p-[123I]-iodoamphetamine SPECT was performed and Wechsler Memory Scale-Revised (WMS-R) was administered to all subjects (mean age, 68.4 years; average Mini-Mental State Examination score, 27.6). The SPECT results were analyzed using the easy Z-score imaging system and the voxel-based stereotactic extraction estimation method. Correlation analyses were performed to investigate the correlation between the mean positive Z-scores in the decrease of the rCBF and the WMS-R indices. Results The SPECT study indicated marked hypoperfusion in some areas, including the bilateral temporal areas, the caudate, and the thalamus, in these subjects in comparison to the normal database. The decrease in the rCBF that was observed in several regions, including the left precuneus and left inferior frontal gyrus (LIFG), showed a significant negative correlation with several indices of the memory function, particularly visual memory. Conclusion The regional hypoperfusion observed in the study using the voxel-based stereotactic extraction estimation method suggest that the regional cerebral dysfunction is associated with the memory function of patients with SCI, even though the subjects in the present study were cognitively intact. The correlation analysis with the WMS-R suggested the contribution of the LIFG to the memory function and indicated the significance of visual memory dysfunction in the neuropsychological assessment to determine the stage of SCI

  2. Prognostic value of myocardial perfusion single photon emission computed tomography for major adverse cardiac cerebrovascular and renal events in patients with chronic kidney disease: results from first year of follow-up of the Gunma-CKD SPECT multicenter study.

    PubMed

    Kasama, Shu; Toyama, Takuji; Sato, Makito; Sano, Hirokazu; Ueda, Tetsuya; Sasaki, Toyoshi; Nakahara, Takehiro; Higuchi, Tetsuya; Tsushima, Yoshito; Kurabayashi, Masahiko

    2016-02-01

    Patients with chronic kidney disease (CKD) have an increased risk of adverse cardio-cerebrovascular events. We examined whether stress myocardial perfusion single photon emission computed tomography (SPECT) provides reliable prognostic markers for these patients. In this multicenter, prospective cohort trial from the Gunma-CKD SPECT study protocol, patients with CKD [estimated glomerular filtration rate (eGFR) < 60 min/ml per 1.73 m(2)] undergoing stress (99m)Tc-tetrofosmin SPECT for suspected or possible ischemic heart disease were initially followed for 1 year, with the following study endpoints: primary, the occurrence of cardiac deaths (CDs), and secondary, major adverse cardiac, cerebrovascular, and renal events (MACCREs). The summed stress score (SSS), summed rest score, and summed difference score (SDS) were estimated with the standard 17-segment, 5-point scoring model. Left ventricular end-diastolic volume, end-systolic volume (ESV), and ejection fraction were measured using electrocardiogram-gated SPECT. During the first year of follow-up, 69 of 299 patients experienced MACCREs (CD, n = 7; non-fatal myocardial infarction, n = 3; hospitalization for heart failure, n = 13; cerebrovascular accident, n = 1; need for revascularization, n = 38; and renal failure, i.e., hemodialysis initiation, n = 7). ESV and SSS were associated with CDs (p < 0.05), and eGFR and SDS were associated with MACCREs (p < 0.05), in multivariate logistic analysis. Patients with high ESV and high SSS had a significantly higher CD rate during the first year than the other CKD patient subgroups (p < 0.05). Patients with low eGFR and high SDS had a significantly higher MACCRE rate than the other subgroups (p < 0.05). Myocardial perfusion SPECT can provide reliable prognostic markers for patients with CKD.

  3. [New analysis algorithm for regional cerebral blood flow and partition coefficient with dynamic SPECT and N-isopropyl-p-[123I]iodoamphetamine: graphical plot method].

    PubMed

    Yokoi, T; Iida, H; Kanno, I

    1991-07-01

    We developed a new analysis algorithm based on multiple-time graphical plot to estimate the regional cerebral blood flow and partition coefficient using dynamic SPECT and N-isopropyl-p-[123I]iodoamphetamine (123I-IMP). By assuming the 2-compartment model of the kinetic for 123I-IMP, we derived a linear relationship between the ratio of the tissue activity concentration at the times to the time-integral arterial concentration at the respective times (formula; see text) and the ratio of the time-integral tissue concentration to the time-integral arterial concentration (formula; see text), and demonstrated that the Y-intercept and X-intercept of the plot line represent the regional cerebral blood flow (K1) and partition coefficient (lambda), respectively. The slope of the line represents a clearance constant k2. The present method was applied to data on four normal subjects measured by dynamic SPECT. Values of the K1 and lambda for the gray matter were obtained 40.8 +/- 6.5 ml/100 g/min and 28.8 +/- 5.3 ml/g, respectively, and the corresponding values for the white matter were 29.1 +/- 4.7 ml/100 g/min and 28.1 +/- 7.1 ml/g. The new method enabled a rapid estimation of both K1 and lambda.

  4. Functional imaging of brain maturation in humans using iodine-123 iodoamphetamine and SPECT

    SciTech Connect

    Rubinstein, M.; Denays, R.; Ham, H.R.; Piepsz, A.; VanPachterbeke, T.; Haumont, D.; Nol, P. )

    1989-12-01

    The application of regional cerebral blood flow (rCBF) study by means of lipophilic radiotracers and single photon emission computed (SPECT) devices in very young infants is hampered by the considerable changes of rCBF pattern as a result of the cerebral maturation process. In an attempt to determine the normal evolution of ({sup 123}I)IMP SPECT pattern as a function of age, we retrospectively selected the studies of 30 babies with normal clinical examination, EEG and CT or ultrasound scans at time of SPECT. There was a marked predominance of the thalamic perfusion over cortical areas until the end of the second month. The distribution of regional cortical activity followed a strict sequence. The perfusion of both parietal and occipital areas was well-visualized around the 40th week of gestational age and thereafter rapidly rose, always, however, with a slight predominance of the parietal activity. At the opposite, frontal activity which remained scarcely recognizable up to the second month tremendously rose to present the adult-like pattern at the beginning of the second year. The rCBF changes described above are well in agreement with the behavioral evolution occurring during prime infancy.

  5. 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

  6. Postoperative Electroencephalogram for Follow up of Pediatric Moyamoya Disease

    PubMed Central

    Kim, Deok-Soo; Ra, Young-Shin; Choi, Choong-Gon

    2006-01-01

    It is well known that the electroencephalographic finding in patients with moyamoya disease demonstrates the characteristic "re-build up" phenomenon a few minutes after hyperventilation. To evaluate the usefulness of an electroencephalogram (EEG) in the postoperative management of children with moyamoya disease, we studied the presence or absence of improvement in the clinical, single photon emission computed tomography (SPECT) and EEG findings, before and after surgery. Twenty-two patients, who underwent indirect revascularization surgery for moyamoya disease, were included in our study. Clinical improvement was assessed as the disappearance or decrease of a transient ischemic attack or headache. The findings on the EEG and SPECT were considered improved when the re-build up phenomenon was absent and when there was improvement in the cerebrovascular reserve as a result of the acetazolamide challenge test. The statistical correlation analysis for both clinical and EEG improvement were consistent (kappa value=0.409, p<0.05). However, the result from the clinical and SPECT improvement as well as that from EEG and SPECT improvement were not statistically significant. Our results suggest that EEG can be used as a noninvasive and simple follow-up test for moyamoya disease after indirect revascularization surgery if the hyperventilation procedure is effectively performed during EEG recording. PMID:16778396

  7. Follow-Up Treatment and Rehabilitation

    MedlinePlus

    ... imaging techniques (such as functional MRI [fMRI], single-photon emission tomography [SPECT], and positron emission tomography [PET] ... treatment occur quickly, this is not usually possible. two-thirds of brain tumor survivors will experience some ...

  8. Prospect Follow Up Pays Dividends in Enrollment.

    ERIC Educational Resources Information Center

    Wassom, Julie

    1993-01-01

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

  9. 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…

  10. Impact of Follow-Up Ischemia on Myocardial Perfusion Single-Photon Emission Computed Tomography in Patients with Coronary Artery Disease

    PubMed Central

    Kang, Se Hun; Choi, Hyo In; Lee, Eun Young; Ahn, Jung-Min; Han, Seungbong; Lee, Pil Hyung; Roh, Jae-Hyung; Yun, Sung-Han; Park, Duk-Woo; Kang, Soo-Jin; Lee, Seung-Whan; Lee, Cheol Whan; Moon, Dae Hyuk; Park, Seong-Wook; Park, Seung-Jung

    2017-01-01

    Purpose Few studies have reported on predicting prognosis using myocardial perfusion single-photon emission computed tomography (SPECT) during coronary artery disease (CAD) treatment. Therefore, we aimed to assess the clinical implications of myocardial perfusion SPECT during follow-up for CAD treatment. Materials and Methods We enrolled 1153 patients who had abnormal results at index SPECT and underwent follow-up SPECT at intervals ≥6 months. Major adverse cardiac events (MACE) were compared in overall and 346 patient pairs after propensity-score (PS) matching. Results Abnormal SPECT was associated with a significantly higher risk of MACE in comparison with normal SPECT over the median of 6.3 years (32.3% vs. 19.8%; unadjusted p<0.001). After PS matching, abnormal SPECT posed a higher risk of MACE [32.1% vs. 19.1%; adjusted hazard ratio (HR)=1.73; 95% confidence interval (CI)=1.27–2.34; p<0.001] than normal SPECT. After PS matching, the risk of MACE was still higher in patients with abnormal follow-up SPECT in the revascularization group (30.2% vs. 17.9%; adjusted HR=1.73; 95% CI=1.15–2.59; p=0.008). Low ejection fraction [odds ratio (OR)=5.33; 95% CI=3.39–8.37; p<0.001] and medical treatment (OR=2.68; 95% CI=1.93–3.72; p<0.001) were independent clinical predictors of having an abnormal result on follow-up SPECT. Conclusion Abnormal follow-up SPECT appears to be associated with a high risk of MACE during CAD treatment. Follow-up SPECT may play a potential role in identifying patients at high cardiovascular risk. PMID:28792136

  11. Impact of Follow-Up Ischemia on Myocardial Perfusion Single-Photon Emission Computed Tomography in Patients with Coronary Artery Disease.

    PubMed

    Kang, Se Hun; Choi, Hyo In; Kim, Young Hak; Lee, Eun Young; Ahn, Jung Min; Han, Seungbong; Lee, Pil Hyung; Roh, Jae Hyung; Yun, Sung Han; Park, Duk Woo; Kang, Soo Jin; Lee, Seung Whan; Lee, Cheol Whan; Moon, Dae Hyuk; Park, Seong Wook; Park, Seung Jung

    2017-09-01

    Few studies have reported on predicting prognosis using myocardial perfusion single-photon emission computed tomography (SPECT) during coronary artery disease (CAD) treatment. Therefore, we aimed to assess the clinical implications of myocardial perfusion SPECT during follow-up for CAD treatment. We enrolled 1153 patients who had abnormal results at index SPECT and underwent follow-up SPECT at intervals ≥6 months. Major adverse cardiac events (MACE) were compared in overall and 346 patient pairs after propensity-score (PS) matching. Abnormal SPECT was associated with a significantly higher risk of MACE in comparison with normal SPECT over the median of 6.3 years (32.3% vs. 19.8%; unadjusted p<0.001). After PS matching, abnormal SPECT posed a higher risk of MACE [32.1% vs. 19.1%; adjusted hazard ratio (HR)=1.73; 95% confidence interval (CI)=1.27-2.34; p<0.001] than normal SPECT. After PS matching, the risk of MACE was still higher in patients with abnormal follow-up SPECT in the revascularization group (30.2% vs. 17.9%; adjusted HR=1.73; 95% CI=1.15-2.59; p=0.008). Low ejection fraction [odds ratio (OR)=5.33; 95% CI=3.39-8.37; p<0.001] and medical treatment (OR=2.68; 95% CI=1.93-3.72; p<0.001) were independent clinical predictors of having an abnormal result on follow-up SPECT. Abnormal follow-up SPECT appears to be associated with a high risk of MACE during CAD treatment. Follow-up SPECT may play a potential role in identifying patients at high cardiovascular risk.

  12. 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…

  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. 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.

  15. 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…

  16. 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.

  17. Combination of blood flow asymmetry in the cerebral and cerebellar hemispheres on brain perfusion SPECT predicts 5-year outcome in patients with symptomatic unilateral major cerebral artery occlusion.

    PubMed

    Nomura, Jun-ichi; Ogasawara, Kuniaki; Saito, Hideo; Terasaki, Kazunori; Matsumoto, Yoshiyasu; Takahashi, Yoshihiro; Ogasawara, Yasushi; Saura, Hiroaki; Yoshida, Koji; Sato, Yuiko; Kubo, Yoshitaka; Ogawa, Akira

    2014-03-01

    Misery perfusion increases the risk of stroke recurrence in patients with symptomatic major cerebral artery occlusion. The ratio of brain perfusion contralateral-to-affected asymmetry in the cerebellar hemisphere to brain perfusion affected-to-contralateral asymmetry in the cerebral hemisphere (CblPR/CbrPR) indicates affected-to-contralateral asymmetry of oxygen extraction fraction (OEF) in the cerebral hemisphere. The purpose of the present study was to determine whether the CblPR/CbrPR on brain perfusion single-photon emission computed tomography (SPECT) predicts 5-year outcomes in patients with symptomatic unilateral occlusion of the middle cerebral artery (MCA) or internal carotid artery (ICA). Brain perfusion was assessed using N-isopropyl-p-[123I]-iodoamphetamine (123I-IMP) SPECT in 70 patients. A region of interest (ROI) was manually placed in the bilateral MCA territories and in the bilateral cerebellar hemispheres, and the CblPR/CbrPR was calculated. All patients were prospectively followed for 5 years. The primary end points were stroke recurrence or death. A total of 17 patients exhibited the primary end points, 11 of whom experienced subsequent ipsilateral strokes. Multivariate analysis revealed that only high CblPR/CbrPR was significantly associated with the development of the primary end point or subsequent ipsilateral strokes (95% confidential limits [CIs], 1.130-3.145; P  =  0.0114 or 95% CIs, 2.558-5.140; P  =  0.0045, respectively). The CblPR/CbrPR provided 65% (11/17) or 91% (10/11) sensitivity and 88% (47/53) or 88% (52/59) specificity in predicting the primary end point or subsequent ipsilateral strokes, respectively. The CblPR/CbrPR on brain perfusion SPECT predicts 5-year outcomes in patients with symptomatic unilateral occlusion of the MCA or ICA.

  18. Robotic Follow-Up for Human Exploration

    NASA Technical Reports Server (NTRS)

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

    2010-01-01

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

  19. Collimator selection for SPECT brain imaging: the advantage of high resolution

    SciTech Connect

    Mueller, S.P.; Polak, J.F.; Kijewski, M.F.; Holman, B.L.

    1986-11-01

    We compared a prototype long-bore (LB) high-resolution collimator with a low-energy, general-purpose collimator (LEGP) using 99mTc and /sup 123/I. The LB collimator provided a 56% improvement in tomographic resolution (autocorrelation width) over the LEGP for 99mTc; for /sup 123/I, the gain was 79%, providing substantially improved contrast for small structures. The sensitivity of the LB collimator, however, is only 32% of that of the LEGP. The imaging tasks to be performed on (/sup 123/I)IMP brain scans involve localization and discrimination of small, high-contrast brain structures and detection of abnormalities in shape, size, or uptake, rather than simple detection of lesions. Observer performance in such higher-order imaging tasks is known to depend on high spatial resolution, even at the cost of sensitivity. Patient studies confirmed that, for resolution-limited tasks, the increase in resolution outweighs the increased noise due to a loss in sensitivity. When the tomographic resolution of the LB collimator was degraded by smoothing to that of the LEGP, the noise in the LB images was lower than that of the LEGP by a factor of 2.9 for the same imaging time, demonstrating the advantage of high-resolution detectors and a smooth reconstruction filter over low-resolution detectors without smoothing. Therefore, collimators designed for high resolution, even at substantial cost in sensitivity, are expected to yield significant improvements for brain SPECT. Geometric calculations show that commercially available low-energy, high-resolution cast collimators promise to meet these requirements.

  20. 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 ...

  1. 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.

  2. 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)…

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

    ERIC Educational Resources Information Center

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

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

  4. [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.

  5. 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.

  6. 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.

  7. 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…

  8. 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…

  9. Facilitating Follow-Up in ELT INSET

    ERIC Educational Resources Information Center

    Waters, Alan

    2006-01-01

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

  10. 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

  11. 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.

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

    PubMed

    Gasteyger, C; Giusti, V

    2006-03-29

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

  13. The 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.

  14. 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.

  15. [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.

  16. Atomoxetine administration combined with intensive speech therapy for post-stroke aphasia: evaluation by a novel SPECT method.

    PubMed

    Yamada, Naoki; Kakuda, Wataru; Yamamoto, Kazuma; Momosaki, Ryo; Abo, Masahiro

    2016-09-01

    We clarified the safety, feasibility, and efficacy of atomoxetine administration combined with intensive speech therapy (ST) for patients with post-stroke aphasia. In addition, we investigated the effect of atomoxetine treatment on neural activity of surrounding lesioned brain areas. Four adult patients with motor-dominant aphasia and a history of left hemispheric stroke were studied. We have registered on the clinical trials database (ID: JMA-IIA00215). Daily atomoxetine administration of 40 mg was initiated two weeks before admission and raised to 80 mg 1 week before admission. During the subsequent 13-day hospitalization, administration of atomoxetine was raised to 120 mg and daily intensive ST (120 min/day, one-on-one training) was provided. Language function was assessed using the Japanese version of The Western Aphasia Battery (WAB) and the Token test two weeks prior to admission, on the day of admission, and at discharge. At two weeks prior to admission and at discharge, each patient's cortical blood flow was measured using (123)I-IMP-single photon emission computed tomography (SPECT). This protocol was successfully completed by all patients without any adverse effects. Four patients showed improved language function with the median of the Token Test increasing from 141 to 149, and the repetition score of WAB increasing from 88 to 99. In addition, cortical blood flow surrounding lesioned brain areas was found to increase following intervention in all patients. Atomoxetine administration and intensive ST were safe and feasible for post-stroke aphasia, suggesting their potential usefulness in the treatment of this patient population.

  17. Impact of DaTscan SPECT imaging on clinical management, diagnosis, confidence of diagnosis, quality of life, health resource use and safety in patients with clinically uncertain parkinsonian syndromes: a prospective 1-year follow-up of an open-label controlled study.

    PubMed

    Kupsch, Andreas R; Bajaj, Nin; Weiland, Frederick; Tartaglione, Antonio; Klutmann, Susanne; Buitendyk, Melanie; Sherwin, Paul; Tate, Ann; Grachev, Igor D

    2012-06-01

    This study assessed the impact of DaTscan on clinical management, diagnosis, confidence of diagnosis (CoD), quality of life (QoL), health resource use (HRU) and safety during a 1-year follow-up in patients with clinically uncertain parkinsonian syndromes (CUPS). A total of 19 university hospital centres in Europe and the USA participated in this open-label, single-dose, prospective, clinical trial in patients with CUPS who were randomised to a DaTscan imaging group or to a no-imaging (control) group. The proportion of patients with changes in clinical management, diagnosis, CoD, QoL and HRU from baseline through 1 year post-DaTscan was compared between groups. There were 273 patients randomised (135 DaTscan, 138 control). Significantly more patients in the DaTscan imaging group had at least one change in their actual clinical management after 12 weeks (p=0.002) and after 1 year (p<0.001) compared with patients in the control group. In addition, significantly more DaTscan patients had changes in diagnosis and an increased CoD at 4 weeks, 12 weeks and 1 year (all p<0.001) compared with control patients. No significant differences in total score for QoL or HRU were observed between groups during the 1-year follow-up period. DaTscan was safe and well tolerated. One patient in the imaging group had an adverse event (headache) with suspected relationship to DaTscan post-administration. DaTscan had a significant impact on clinical management, diagnosis and CoD in patients with CUPS. DaTscan is safe and well tolerated, and is a useful adjunct to differentiate a diagnosis of CUPS. Trial registration number http://ClinicalTrials.gov Identifier: NCT00382967.

  18. 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

  19. A case of bronchial carcinoid: diagnosis and follow-up with 111In-DTPA-octreotide.

    PubMed

    Orsolon, P; Bagni, B; Basadonna, P; Geatti, O; Talmassons, G; Guerra, U P

    1995-12-01

    Scintigraphy with radiolabelled analogue of somatostatin is highly sensitive in detecting carcinoid tumors especially if performed with Single Photon Computed Tomography (SPECT). In this report we describe our experience with 111In-DTPA-Octreotide in a female patient affected by a small asymptomatic intrabronchial carcinoid demonstrated by CT scan and bronchial endoscopy performed after recurrent left pneumonias. Planar views and SPECT images, using 111In-DTPA-Octreotide, were collected before and four hours after the first endoscopic laser resection. All groups of SPECT images were positive in the left parahilar region but at a different degree. Scans performed after resection showed a low degree of uptake which was considered to be probably secondary to local swelling; CT scan was negative. Follow up endoscopic biopsy repeated at six months, showed a relapse always in the same site; CT scan of the thorax was again negative. 111In-DTPA-Octreotide images obtained at twelve months were positive always in the left parahilar region, CT scan was negative but another biopsy was not possible. Therefore it was suspected a relapse of the carcinoid which was probably growing only through the bronchial wall without spreading towards the bronchial lumen and/or the lung parenchima. In this occasion, it was also thought that images collected four hours after resection could be positive not only for swelling but for a relapse as well. In every scintigraphic session, SPECT images presented higher quality than planar. This case suggests that 111In-DTPA-Octreotide SPECT is a non-invasive diagnostic technique which could be applied as a follow-up tool especially to patients with no-secreting carcinoid neoplasm and/or with negative or doubtful endoscopic and radiological investigations.

  20. 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

  1. 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%.

  2. 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.

  3. 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.

  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. 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

  6. 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.

  7. 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.

  8. [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.

  9. Tomographic ventilation/perfusion lung scintigraphy in the monitoring of the effect of treatment in pulmonary embolism: serial follow-up over a 6-month period.

    PubMed

    Begic, Amela; Jögi, Jonas; Hadziredzepovic, Amra; Kucukalic-Selimović, Elma; Begovic-Hadzimuratovic, Sadzida; Bajc, Marika

    2011-06-01

    Pulmonary embolism (PE) is a severe condition with nonspecific symptoms. Diagnosis relies on medical imaging but follow-up is currently based on clinical symptoms and general risk factors. The duration of anticoagulant treatment after an acute episode of PE is still subject to debate and the best method of identifying the risk of recurrence in individual patients is undefined. Tomographic lung scintigraphy [ventilation/perfusion single photon emission computed tomography (V/P SPECT)] has improved the diagnostic accuracy with regard to PE but has not been evaluated for PE follow-up. The aim of this prospective study was to quantitatively follow the natural history of treated PE using V/P SPECT, which could prove helpful in defining an anticoagulant treatment regime for individual patients. Of 83 consecutive patients with clinically suspected PE examined with V/P SPECT, 23 patients with confirmed PE were followed by serial V/P SPECT examinations over a 6-month period. All patients were also followed clinically. The mean relative decrease in PE extent compared with the time of diagnosis was 54±26% at 2 weeks, 79±30% at 3 months, and 82±30% at 6 months. Significant resolution of mismatched perfusion defects occurred between V/P SPECT controls within the first 3 months of anticoagulation (P<0.001) but not thereafter. V/P SPECT identified four patients with chronic PE, even though all patients were free from symptoms at 3-month follow-up. Follow-up of PE with V/P SPECT is feasible to evaluate treatment effectiveness in individual patients and to identify patients that develop chronic PE. This study also confirms that resolution of perfusion defects after PE occurs within the first 3 months of treatment. It is therefore recommended that V/P SPECT follow-up should be considered at 3 months after diagnosis.

  10. 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.

  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. Adaptive SPECT

    PubMed Central

    Barrett, Harrison H.; Furenlid, Lars R.; Freed, Melanie; Hesterman, Jacob Y.; Kupinski, Matthew A.; Clarkson, Eric; Whitaker, Meredith K.

    2008-01-01

    Adaptive imaging systems alter their data-acquisition configuration or protocol in response to the image information received. An adaptive pinhole single-photon emission computed tomography (SPECT) system might acquire an initial scout image to obtain preliminary information about the radiotracer distribution and then adjust the configuration or sizes of the pinholes, the magnifications, or the projection angles in order to improve performance. This paper briefly describes two small-animal SPECT systems that allow this flexibility and then presents a framework for evaluating adaptive systems in general, and adaptive SPECT systems in particular. The evaluation is in terms of the performance of linear observers on detection or estimation tasks. Expressions are derived for the ideal linear (Hotelling) observer and the ideal linear (Wiener) estimator with adaptive imaging. Detailed expressions for the performance figures of merit are given, and possible adaptation rules are discussed. PMID:18541485

  13. Incremental value of (99m)Tc-HYNIC-TOC SPECT/CT over whole-body planar scintigraphy and SPECT in patients with neuroendocrine tumours.

    PubMed

    Trogrlic, Mate; Težak, Stanko

    2017-06-12

    The aim of this study was to evaluate the additional value of (99m)Tc-HYNIC-TOC SPECT/CT over planar whole-body (WB) scintigraphy and SPECT alone in the detection and accurate localisation of neuroendocrine tumour (NET) lesions. This study included 65 patients with a definitive histological diagnosis of NET prior to scintigraphy. Planar WB scintigraphy, SPECT, and SPECT/CT images were acquired at 4 h post-administration of 670 MBq (99m)Tc-HYNIC-TOC. Additional SPECT images at 10 min after tracer administration were also acquired. Clinical and imaging follow-up findings were considered as the reference standards (minimum follow-up period, 15 months). Patient and lesion-based analyses of the efficacies of the imaging modalities were performed. While 38 patients exhibited metastasis of NETs, 27 presented no evidence of metastasis. Upon patient-based analysis, the sensitivity and specificity of SPECT/CT were found to be 88.9 and 79.3 %, respectively. The diagnostic accuracies of WB scintigraphy, 4h-SPECT, and SPECT/CT were 72.3, 73.8, and 84.6 %, respectively. The area under curve (AUC) value for SPECT/CT (0.84) was the highest, followed by those for 4h-SPECT (0.75) and WB scintigraphy (0.74). The accuracy and AUC values of SPECT/CT were significantly better compared to those of WB scintigraphy (p < 0.001), 10 min-SPECT (p < 0.001), and 4 h-SPECT (p = 0.001). The findings of SPECT/CT led to the change in treatment plan of 11 patients (16.9 %). The sensitivity and diagnostic accuracy of SPECT/CT in the evaluation of NET lesions outperforms planar WB imaging or SPECT alone.

  14. 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…

  15. 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…

  16. 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...

  17. 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...

  18. 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...

  19. Comparing office and telephone follow-up after medical abortion.

    PubMed

    Chen, Melissa J; Rounds, Kacie M; Creinin, Mitchell D; Cansino, Catherine; Hou, Melody Y

    2016-08-01

    Compare proportion lost to follow-up, successful abortion, and staff effort in women who choose office or telephone-based follow-up evaluation for medical abortion at a teaching institution. We performed a chart review of all medical abortions provided in the first three years of service provision. Women receiving mifepristone and misoprostol could choose office follow-up with an ultrasound evaluation one to two weeks after mifepristone or telephone follow-up with a scheduled telephone interview at one week post abortion and a second telephone call at four weeks to review the results of a home urine pregnancy test. Of the 176 medical abortion patients, 105 (59.7%) chose office follow-up and 71 (40.3%) chose telephone follow-up. Office evaluation patients had higher rates of completing all required follow-up compared to telephone follow-up patients (94.3% vs 84.5%, respectively, p=.04), but proportion lost to follow-up was similar in both groups (4.8% vs 5.6%, respectively, p=1.0). Medical abortion efficacy was 94.0% and 92.5% in women who chose office and telephone follow-up, respectively. We detected two (1.2%) ongoing pregnancies, both in the office group. Staff rescheduled 15.0% of appointments in the office group. For the telephone follow-up cohort, staff made more than one phone call to 43.9% and 69.4% of women at one week and four weeks, respectively. Proportion lost to follow-up is low in women who have the option of office or telephone follow-up after medical abortion. Women who choose telephone-based evaluation compared to office follow-up may require more staff effort for rescheduling of contact, but overall outcomes are similar. Although women who choose telephone evaluation may require more rescheduling of contact as compared to office follow-up, having alternative follow-up options may decrease the proportion of women who are lost to follow-up. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Cerebral SPECT imaging: Impact on clinical management

    SciTech Connect

    Bloom, M.; Jacobs, S.; Pozniakof, T.

    1994-05-01

    Although cerebral SPECT has been reported to be of value in a variety of neurologic disorders, there is limited data available on the value of SPECT relative to clinical management decisions. The purpose of this study was to determine the effect of cerebral SPECT imaging on patient management. A total of 94 consecutive patients referred for clinical evaluation with brain SPECT were included in this study. Patients were assigned to one of nine groups depending on the clinical indication for the study. These groups included transient ischemia (16), stroke (20), dementia (18), seizures (5), hemorrhage (13), head trauma (6), arteriovenous malformations (6), encephalopathy (6) and a miscellaneous (4) group. All patients were injected with 99mTc HMPAO in doses ranging from 15 mCi to 22 mCi (555 MBq to 814 MBq) and scanned on a triple headed SPECT gamma camera. Two weeks after completion of the study, a standardized interview was conducted between the nuclear and referring physicians to determine if the SPECT findings contributed to an alteration in patient management. Overall, patient management was significantly altered in 47% of the cases referred. The greatest impact on patient management occurred in the group evaluated for transient ischemia, where a total of 13/16 (81%) of patients had their clinical management altered as a result of the cerebral SPECT findings. Clinical management was altered in 61% of patients referred for evaluation of dementia, 67% of patients evaluated for arteriovenous malformations, and 50% of patients with head trauma. In the remainder of the patients, alteration in clinical management ranged from 17% to 50% of patients. This study demonstrates the clinical utility of cerebral SPECT imaging since in a significant number of cases clinical management was altered as a result of the examination. Long term follow up will be necessary to determine patient outcome.

  1. 49 CFR 219.211 - Analysis and follow-up.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  2. 49 CFR 219.211 - Analysis and follow-up.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

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

    ERIC Educational Resources Information Center

    Stank, Peggy L.

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

  4. 33 CFR 179.15 - Follow-up report.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

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

    ERIC Educational Resources Information Center

    Smedley, Rande H.; Olson, George H.

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

  6. 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.

  7. Postnatal gestational diabetes mellitus follow-up: Australian women's experiences.

    PubMed

    Kilgour, Catherine; Bogossian, Fiona Elizabeth; Callaway, Leonie; Gallois, Cindy

    2015-12-01

    Postnatal follow-up screening is recommended for all women diagnosed with gestational diabetes mellitus (GDM). However follow-up rates are poor and highly variable in Australia and internationally. The reasons that mothers are not completing recommended postnatal screening after GDM diagnosis are not well understood or studied. The quality of communication may be an important influence on the completion of postnatal GDM follow-up. To explore and assess women's communication experiences of postnatal GDM follow-up. Theoretical, purposeful sampling was used to identify women diagnosed with GDM. Convergent interviews explored participants' communication experiences with GDM and postnatal follow-up. Transcripts were provided to and updated by participants. Data was analysed with Leximancer(®) (V4, 2011) automated content analysis software. This research was conducted at a major tertiary referral hospital in Queensland, Australia, between December 2012 and July 2013. Women participating in maternity shared care and diagnosed with GDM were interviewed (n=13). Five themes, all concerned with obtaining information, were identified: diagnosis of GDM; seeking GDM information; accessing specialist services; need for postnatal GDM follow-up; and completing GDM follow-up. Results were interpreted using Communication Accommodation Theory (CAT) to explore whether and how the information needs of women were accommodated. Women's interpretations of communication events influenced their knowledge, perceptions and motivation to complete recommended postnatal follow-up. Accommodation of the communication and information needs of women with GDM may be an effective strategy for clinicians to encourage completion of recommended postnatal GDM follow-up. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

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

    PubMed Central

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

    2014-01-01

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

  9. 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.

  10. 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

  11. Short-Term Follow-Up of Narcotic Addicts

    ERIC Educational Resources Information Center

    Swartz, June; Jabara, Raymond

    1974-01-01

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

  12. Short-Term Follow-Up of Narcotic Addicts

    ERIC Educational Resources Information Center

    Swartz, June; Jabara, Raymond

    1974-01-01

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

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

    PubMed

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

    2007-03-01

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

  14. Outpatient follow-up for critical limb ischemia.

    PubMed

    Watch, Libby

    2014-09-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2015-09-01

    Complications following paediatric burns are well documented and care needs to be taken to ensure the appropriate follow up of these patients. Historically this has meant follow up into adulthood however this is often not necessary. The centralisation of burns services in the UK means that patients and their parents may have to travel significant distances to receive this follow up care. To optimise our burns service we have introduced a burns outreach service to enable the patients to be treated closer to home. The aim of this study is to investigate the impact of the introduction of the burns outreach service and within this environment define the optimum length of time needed to follow up these patients. A retrospective analysis was carried out of 100 consecutive paediatric burns patients who underwent surgical management of their burn. During the follow up period there were 43 complications in 32 patients (32%). These included adverse scarring (either hypertrophic or keloid), delayed healing (taking >1 month to heal) and contractures (utilising either splinting or surgical correction). Fifty-nine percent of these complications occurred within 6 months of injury and all occurred within 18 months. Size of burn was directly correlated to the risk of developing a complication. The outreach service reduced the distance the patient needs to travel for follow up by more than 50%. There was also a significant financial benefit for the service as the follow up clinics were on average 50% cheaper with burns outreach than burns physician. Burns outreach is a feasible service that not only benefits the patients but also is cheaper for the burns service. The optimum length of follow up for paediatric burns in 18 months, after which if there have not been any complications they can be discharged. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  17. 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.

  18. 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.

  19. Comparing cancer detection rates of patients undergoing short term follow-up vs routine follow-up after benign breast biopsies, is follow-up needed?

    PubMed

    Plecha, Donna M; Garlick, Courtney; Dubchuck, Christina; Thompson, Cheryl; Constantinou, Niki

    To compare cancer rates after benign breast biopsies between patients with short term imaging follow-up (STFU) and those with routine follow-up (RFU). Retrospective review of benign stereotactic, US or DCE-MRI breast biopsies. Of 580 lesions, 192 (33%) had STFU, and 388 (67%) had RFU. For US and mammographic detected lesions, there is no difference in cancer rates between the STFU (1 cancer, n=148) and the RFU group (0 cancer, n=365) (p=0.29). There were 2 cancers in the STFU group versus 0 in the RFU DCE-MRI group (p=0.54). Our results support RFU after benign ultrasound and stereotactic breast biopsies. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    PubMed

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

    2013-09-01

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

  1. Longitudinal follow-up of SWEDD subjects in the PRECEPT Study.

    PubMed

    Marek, Kenneth; Seibyl, John; Eberly, Shirley; Oakes, David; Shoulson, Ira; Lang, Anthony E; Hyson, Chris; Jennings, Danna

    2014-05-20

    To compare the clinical and imaging characteristics of those PRECEPT (Parkinson Research Examination of CEP-1347 Trial) subjects with a scan without evidence of dopaminergic deficit (SWEDD) to those with dopamine transporter (DAT) deficit scans at study baseline and during a 22-month follow-up. Baseline (n = 799) and 22-month follow-up (n = 701) [(123)I] β-CIT SPECT scans were acquired. The percent change in [(123)I] β-CIT striatal binding ratio, the percentage of subjects requiring dopaminergic therapy, the change in Unified Parkinson's Disease Rating Scale (UPDRS) score, and the PRECEPT Study investigators' diagnosis at study termination were compared between SWEDD and DAT deficit subjects. SWEDD subjects (n = 91) compared with DAT deficit subjects (n = 708) showed reduced UPDRS score at baseline (18.7 [SD 8.5] vs 25.5 [SD 10.5], p < 0.05) and minimal change in both [(123)I] β-CIT striatal binding ratio (-0.2% [SD 12.2] vs -8.5% [SD 11.9], p < 0.0001) and UPDRS score (0.5 [SD 6.9] vs 10.5 [SD 8.9], p < 0.0001) at follow-up assessments. At PRECEPT termination, the diagnosis by study investigators was changed from Parkinson disease (PD) to other disorders not associated with DAT deficit in 44% (95% confidence interval 34.2, 54.7) of SWEDD subjects compared with 3.6% (95% confidence interval 2.3, 5.1) of DAT deficit subjects. These results indicate that subjects identified as having a SWEDD, with DAT imaging within the normal range, have minimal evidence of clinical or imaging PD progression. These data strongly suggest that SWEDD subjects are unlikely to have idiopathic PD. © 2014 American Academy of Neurology.

  2. Longitudinal follow-up of SWEDD subjects in the PRECEPT Study

    PubMed Central

    Seibyl, John; Eberly, Shirley; Oakes, David; Shoulson, Ira; Lang, Anthony E.; Hyson, Chris; Jennings, Danna

    2014-01-01

    Objective: To compare the clinical and imaging characteristics of those PRECEPT (Parkinson Research Examination of CEP-1347 Trial) subjects with a scan without evidence of dopaminergic deficit (SWEDD) to those with dopamine transporter (DAT) deficit scans at study baseline and during a 22-month follow-up. Methods: Baseline (n = 799) and 22-month follow-up (n = 701) [123I] β-CIT SPECT scans were acquired. The percent change in [123I] β-CIT striatal binding ratio, the percentage of subjects requiring dopaminergic therapy, the change in Unified Parkinson's Disease Rating Scale (UPDRS) score, and the PRECEPT Study investigators’ diagnosis at study termination were compared between SWEDD and DAT deficit subjects. Results: SWEDD subjects (n = 91) compared with DAT deficit subjects (n = 708) showed reduced UPDRS score at baseline (18.7 [SD 8.5] vs 25.5 [SD 10.5], p < 0.05) and minimal change in both [123I] β-CIT striatal binding ratio (−0.2% [SD 12.2] vs −8.5% [SD 11.9], p < 0.0001) and UPDRS score (0.5 [SD 6.9] vs 10.5 [SD 8.9], p < 0.0001) at follow-up assessments. At PRECEPT termination, the diagnosis by study investigators was changed from Parkinson disease (PD) to other disorders not associated with DAT deficit in 44% (95% confidence interval 34.2, 54.7) of SWEDD subjects compared with 3.6% (95% confidence interval 2.3, 5.1) of DAT deficit subjects. Conclusion: These results indicate that subjects identified as having a SWEDD, with DAT imaging within the normal range, have minimal evidence of clinical or imaging PD progression. These data strongly suggest that SWEDD subjects are unlikely to have idiopathic PD. PMID:24759846

  3. 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.

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

    PubMed

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

    2015-01-01

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

  5. 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.

  6. [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.

  7. Potential value of serial cerebral SPECT scanning in the evaluation of psychiatric illness

    SciTech Connect

    Notardonato, H.; Gonzalez-Avilez, A.; Van Heertum, R.L.; O'Connell, R.A.; Yudd, A.P.

    1989-05-01

    Cerebral SPECT imaging has the potential to make an important contribution to clinical psychiatry. Cerebral SPECT scanning, stimulated by the work with PET, is readily available and much less expensive than PET. This paper reports a case demonstrating the potential value of cerebral SPECT scanning with I-123 IMP, specifically in the serial evaluation of a schizophrenic patient with auditory hallucinations. The initial scan revealed focal areas of increased uptake in the caudate nuclei of the basal ganglia, and in the right temporal lobe. After pharmacological treatment with clinical improvement, the follow-up SPECT scan demonstrated significant improvement in the distribution of the radiopharmaceutical.

  8. Long term follow up of untreated primary hyperparathyroidism.

    PubMed Central

    Paterson, C R; Burns, J; Mowat, E

    1984-01-01

    Fourteen patients with primary hyperparathyroidism and whose initial serum calcium concentrations were 2.75 mmol/l (11.0 mg/100 ml) or more were followed up for five to 23 years without operative treatment. One had osteitis fibrosa when seen and died with a fibrosarcoma 22 years later. The remaining 13 patients, who were followed up for a mean of 10 years, came to little obvious harm from not being operated on. Their serum calcium concentrations did not rise and there was no evidence of progressive renal impairment. In four patients who presented originally with renal calculi there were three further episodes of renal colic in 54 patient years of follow up. Conservative management of primary hyperparathyroidism is not an unreasonable option, and patients who do not have symptoms need not necessarily be pressed to accept surgery. PMID:6437508

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

    Khatcheressian, James; Swainey, Craig

    2008-01-01

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

  11. Outpatient Follow-up and Secondary Prevention for Melanoma Patients

    PubMed Central

    Gamble, Ryan G.; Jensen, Daniel; Suarez, Andrea L.; Hanson, Anne H.; McLaughlin, Lauren; Duke, Jodi; Dellavalle, Robert P.

    2010-01-01

    Health care providers and their patients jointly participate in melanoma prevention, surveillance, diagnosis, and treatment. This paper reviews screening and follow-up strategies for patients who have been diagnosed with melanoma, based on current available evidence, and focuses on methods to assess disease recurrence and second primary occurrence. Secondary prevention, including the roles of behavioral modification and chemoprevention are also reviewed. The role of follow-up dermatologist consultation, with focused physical examinations complemented by dermatoscopy, reflectance confocal microscopy, and/or full-body mapping is discussed. Furthermore, we address the inclusion of routine imaging and laboratory assessment as components of follow-up and monitoring of advanced stage melanoma. The role of physicians in addressing the psychosocial stresses associated with a diagnosis of melanoma is reviewed. PMID:24281112

  12. Posttreatment Follow-Up of Brucellosis by PCR Assay

    PubMed Central

    Morata, Pilar; Queipo-Ortuño, María Isabel; Reguera, José María; García-Ordoñez, Miguel Angel; Pichardo, Cristina; Colmenero, Juan de Dios

    1999-01-01

    In order to evaluate the usefulness of a peripheral blood PCR assay in the posttreatment follow-up of brucellosis, a cohort of 30 patients was studied by means of blood cultures, rose Bengal, seroagglutination, Coombs' antibrucella tests, and PCR assay at the time of diagnosis, at the end of treatment, and 2, 4, and 6 months later. Of the 29 patients whose PCR assays were initially positive, 28 (96.5%) were negative at the conclusion of the treatment. PCR was positive for the two patients who had relapses and negative for another four who had suspected but unconfirmed relapses. PCR was negative for 98.3% of the follow-up samples from those patients who had a favorable evolution. In conclusion, PCR appears to be a very useful technique, not only for the initial diagnosis of the disease, but also for posttreatment follow-up and the early detection of relapses. PMID:10565954

  13. 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.

  14. 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.

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

    PubMed

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

    2013-06-01

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

  16. MFP-REA Follow-Up 2002-2005

    DTIC Science & Technology

    2007-03-01

    70 328 09 61 MFP- REA follow-up 2002-2005 info-DenV@tno.nl Date March 2007 Author(s) Prof Dr D.G. Simons C.A.M. van Moll. MSc Classification report...TNO 20070817259 DISTRIBUTION STATEMENTA Approved for Public Release Distribution Unlimited 3/26 MFP- REA follow-up 2002-2005 Het geluid van brekende...Kan hiermee de bodemsoort bepaald worden? onderdeel van Rapid Environmental onderzocht. De combinatie van Assessment, REA . bodemaverliesmodel en

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

    PubMed Central

    Agapitos, P J; Hart, I R

    1987-01-01

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

  18. MAGIC electromagnetic follow-up of gravitational wave alerts

    NASA Astrophysics Data System (ADS)

    de Lotto, Barbara; Ansoldi, Stefano; Antonelli, Angelo; Berti, Alessio; Carosi, Alessandro; Longo, Francesco; Stamerra, Antonio

    The year 2015 witnessed the first direct observations of a transient gravitational-wave (GW) signal from binary black hole mergers by the Advanced Laser Interferometer Gravitational-wave Observatory (aLIGO) Collaboration with the Virgo Collaboration. The MAGIC two 17m diameter Cherenkov telescopes system joined since 2014 the vast collaboration of electromagnetic facilities for follow-up of gravitational wave alerts. During the 2015 LIGO-Virgo science run we set up the procedure for GW alerts follow-up and took data following the last GW alert. MAGIC results on the data analysis and prospects for the forthcoming run are presented.

  19. 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

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

    PubMed

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

    1990-05-01

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

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

    ERIC Educational Resources Information Center

    Holt, Marianne; Lucas, John A.

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

  2. Loss to Follow-Up: Issues and Recommendations

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  3. Trident Technical College 1998 Graduate Follow-Up.

    ERIC Educational Resources Information Center

    Trident Technical Coll., Charleston, SC.

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

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

    ERIC Educational Resources Information Center

    Trident Technical Coll., Charleston, SC.

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

  5. 1988-89 Graduate Follow-Up Report.

    ERIC Educational Resources Information Center

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

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

  6. 1987-88 Graduate Follow-Up Report.

    ERIC Educational Resources Information Center

    Davison, Glen A.

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

  7. Follow-Up Report: 2005 Placements of 2004 NDUS Graduates

    ERIC Educational Resources Information Center

    Anderson, Debra; Dunn, Eddie; Hillman, Mike; Morth, Tom; Schepp, Julie; Padilla, Gina

    2007-01-01

    Some of the questions most frequently asked of the North Dakota University System relate to the status of graduates and program completers of state educational institutions. Follow-up Information on North Dakota Education and Training (FINDET) is a consortium of several state agencies formed to provide answers to those questions. This report,…

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

    ERIC Educational Resources Information Center

    Peterson, Charlene M.; And Others

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

  9. Natural history of childhood asthma. 20-year follow-up.

    PubMed Central

    Blair, H

    1977-01-01

    Of 417 asthmatic children seen in hospital from 1941 to 1947, only 208 (50%) were still attending the hospital and were available for long-term follow-up, whereas a 91% follow-up was achieved from a personal follow-up of 267 asthmatic children seen in an East London group practice from 1948 to 1952 and followed for more than 20 years to December 1972. 125 patients (52%) were almost or completely symptom free; 51 (21%) had never had any symptom-free period for longer than 6 months; a further 63 (27%) had a remission of symptoms for 3 years before relapsing. 7 patients died, 3 due to their asthma. The final prognosis was influenced by the severity of the asthma at onset, by breast feeding, by the presence of associated atopic disease, and by a positive family history of atopic disease in first-degree relatives. It was uninfluenced by the age of onset of the asthma, by the sex of the patients, or by skin testing results. Short-term follow-up of such patients will fail to include those patients whose asthma remits and subsequently relapses. PMID:921306

  10. A Follow-Up Study of the Deaf.

    ERIC Educational Resources Information Center

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

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

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

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

    ERIC Educational Resources Information Center

    Perry, Pat; Cater, Margot

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

  13. A Follow-up Study of Secretarial Students.

    ERIC Educational Resources Information Center

    Gell, Robert L.; Bleil, David F.

    To determine how effectively the Secretarial Studies Department's program was meeting the needs of its students, a follow-up study was conducted of former Montgomery Community College Secretarial Studies students. The survey sought to determine, in particular, if the students had secured employment that was related to their course work at the…

  14. Loss to Follow-Up: Issues and Recommendations

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  15. Follow-up Studies at Regional State Universities.

    ERIC Educational Resources Information Center

    Kohut, Sylvester, Jr.

    At regional state universities, teacher education is usually a university-wide endeavor. The majority of American public school teachers are prepared at regional state universities. This paper describes a successful, low-cost follow-up study model at a regional state university, Kutztown University (Pennsylvania) Since 1952, the university has…

  16. Extended Follow-Up | Division of Cancer Prevention

    Cancer.gov

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

  17. Factors Associated with Adherence to Follow-up Colposcopy

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  18. 10 CFR 1022.17 - Follow-up.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  19. 10 CFR 1022.17 - Follow-up.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  20. 10 CFR 1022.17 - Follow-up.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  1. 10 CFR 1022.17 - Follow-up.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  2. 10 CFR 1022.17 - Follow-up.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

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

  4. Three Year Follow-Up of 1974 Graduates.

    ERIC Educational Resources Information Center

    Baratta, Mary Kathryne

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

  5. Factors Associated with Adherence to Follow-up Colposcopy

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  6. Elevation Follow up Letter - signed January 19, 2001

    EPA Pesticide Factsheets

    Elevation Follow up Letter in response to the U.S. EPA's request to review a Clean Water Act (CWA) Section 404 decision to issue a permit to Diablo Grande Limited Partnership for the Diablo Grande Resort Development, Phase 1 in Stanislaus County, CA.

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

    ERIC Educational Resources Information Center

    Windham, Patricia

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

  8. Gamma Ray Burst Follow-Ups with Bootes-4

    NASA Astrophysics Data System (ADS)

    Guziy, Sergey; Castro-Tirado, Guziy, Alberto J.; Jelinek, Martin; Gorosabel, Javier; Kubanek, Petr; Cunniffe, Ronan; Lara-Gil, Oscar; Tello, Juan C.; Jeong, Soomin; Oates, Samantha R.; Xu, Youdong; Perez-Ramirez, Dolores; Cui, Chenzou; Fan, Yufeng; Wan, Chuanjun; Bai, Jinming; Kheyfets, I.

    The Burst Observer and Optical Transient Exploring System (BOOTES), is a global robotic observatory network, which started in 1998 with Spanish leadership devoted to study optical emissions from gamma ray bursts (GRBs) that occur in the Universe. We present shot history and current status of BOOTES-4 telescope. Some details of 38 GRBs followed-up with BOOTES-4 are discussed.

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

    PubMed

    Guerrero, Cesar A

    2012-07-01

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

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

    PubMed Central

    Guerrero, Cesar A.

    2012-01-01

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

  11. Follow-up photometry of iPTF16geu

    NASA Astrophysics Data System (ADS)

    Lee, C.-H.

    2016-10-01

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

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

    ERIC Educational Resources Information Center

    Stuart, Elizabeth A.; Lalongo, Nicholas S.

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Stuart, Elizabeth A.; Lalongo, Nicholas S.

    2010-01-01

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

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

    PubMed Central

    Hansen, Luke; Shaheen, Aisha; Crandall, Marie

    2014-01-01

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

  15. Dropped head syndrome preceding the onset of dementia with Lewy bodies.

    PubMed

    Tanaka, Kanta; Wada, Ikko; Okunomiya, Taro; Shima, Atsushi; Kambe, Daisuke; Shinde, Akiyo; Kageyama, Takashi; Suenaga, Toshihiko

    2014-01-01

    A 67-year-old woman developed dropped head. Her neck was severely flexed, with prominent cervical paraspinal muscles, although no parkinsonism was observed. Brain MRI showed no significant findings. We considered dystonia as the cause of the dropped head and administered trihexyphenidyl, an anticholinergic. After 10 years of follow-up, remarkable psychotic symptoms, including hallucinations regarding insects, appeared. Following the discontinuation of trihexyphenidyl, the psychotic symptoms decreased but still remained. (123)I-N-isopropyl-p-iodoamphetamine single-photon emission computed tomography ((123)I-IMP SPECT) revealed hypoperfusion in the bilateral occipital lobes. We diagnosed the patient with dementia with Lewy bodies (DLB). This case suggests that dropped head syndrome may precede the onset of DLB.

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

    NASA Astrophysics Data System (ADS)

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

    2015-08-01

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

  17. Walk-Off Follow-Up, Spring 1982 Students. TEX-SIS Follow-Up, Volume 5, #1.

    ERIC Educational Resources Information Center

    Yavapai County Community Coll. District, Prescott, AZ.

    A follow-up study was undertaken at Yavapai College to determine why students stopped attending class and if possible to help them return to class. Instructors identified student "walk-outs" and notified Special Services staff who attempted to contact the students. In spring 1982, 129 walk-outs were contacted to determine why they had stopped…

  18. Recent advances in SPECT

    SciTech Connect

    Tsui, Benjamin M. W.

    1998-08-28

    Single photon emission computed tomography (SPECT) is a medical imaging modality that combines conventional nuclear medicine imaging technique and methods of computed tomography (CT). From images that represent the biodistribution of the injected radiopharmaceutical in the patient, SPECT provides functional information that is unique. The first SPECT system was developed in the sixties. However, early progress of SPECT was hampered by the lack of adequate image reconstruction methods. The development of x-ray CT and image reconstruction methods in the seventies spurred a renewed interest in SPECT. In 1981, the first commercial SPECT system based on a single rotating camera was available for clinical use. Today, most modern SPECT systems consist of multiple cameras that rotate around the patients. They have better spatial resolution and higher detection efficiency as compared to the earlier single camera systems. Recently, a new generation of dual camera systems allowing for coincidence imaging of positron emitting radiopharmaceuticals has emerged in the commercial market. Additionally, new quantitative image reconstruction methods are under development. They compensate for image degrading factors including attenuation, collimator-detector blurring and scatter. Also, they result in SPECT images with improved image quality and more accurately represent the three-dimensional radioactivity distribution in the patient. Such advances in radiopharmaceuticals, instrumentation, image reconstruction, compensation methods, and clinical applications have fueled a steady growth of SPECT as an important diagnostic tool in patient management.

  19. 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.

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

    NASA Technical Reports Server (NTRS)

    Kocevski, Daniel

    2017-01-01

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

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

    PubMed

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

    2014-07-01

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

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

    PubMed

    Morgan, David L

    2015-06-01

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

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

    PubMed Central

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

    2000-01-01

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

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

    PubMed

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

    2015-10-01

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

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

    PubMed

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

    2013-10-01

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

  6. Medium term follow up of the Biodynamic neck sparing prosthesis.

    PubMed

    Molfetta, Luigi; Capozzi, Michele; Caldo, Davide

    2011-01-01

    Hip resurfacing (HR) and neck sparing prostheses (NSP) have been advocated for the treatment of arthritis in younger patients. Some complications following HR have been documented in the recent literature, but NSP are not yet supported by clinical follow-up studies of sufficient duration. We present an assessment of the neck sparing "Biodynamic" prosthesis. 153 patients were evaluated in a longitudinal cohort prospective study, with survival analysis, clinical score and radiographic assessment of stability and osteointegration at 41.8 months average follow up. Survival and clinical outcome were similar to most traditional prostheses in the literature. On radiographic analysis we recorded good neck preservation and osteointegration. Only two stem failures were recorded. Poor clinical outcome was related to misalignment of prostheses implanted during the 'learning curve'. The NSP system described may be a good alternative to HR for younger patients. The system is characterized by good survival and clinical and radiographic outcome combined with bone stock preservation.

  7. Long-term follow-up of congenital diaphragmatic hernia.

    PubMed

    Hollinger, Laura E; Harting, Matthew T; Lally, Kevin P

    2017-06-01

    Increased survival of patients with congenital diaphragmatic hernia has created a unique cohort of children, adolescent, and adult survivors with complex medical and surgical needs. Disease-specific morbidities offer the opportunity for multiple disciplines to unite together to provide long-term comprehensive follow-up, as well as an opportunity for research regarding late outcomes. These children can exhibit impaired pulmonary function, altered neurodevelopmental outcomes, nutritional insufficiency, musculoskeletal changes, and specialized surgical needs that benefit from regular monitoring and intervention, particularly in patients with increased disease severity. Below we aim to characterize the specific challenges that these survivors face as well as present an algorithm for a multidisciplinary long-term follow-up program. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Trismus-pseudocamptodactyly syndrome: a 20 year follow-up.

    PubMed

    Marianetti, T M; Dall'Asta, L; Torroni, A; Gasparini, G; Pelo, S

    2014-07-01

    Trismus-Pseudocamptodactyly Syndrome (TPS) is a rare autosomal syndrome characterised by the inability to open the mouth fully, pseudocamptodactyly, short stature and foot deformities. The maxillofacial feature entails hyperplasia of the coronoid processes which mechanically interfere with the zygomatic processes during mouth opening. A 22-year- old girl affected by a severe form of TPS was followed from the age of three years. Bone reossification was observed after two coronoidotomies of both hyperplasic coronoid processes. After the decision to perform a coronoidectomy, the four-year follow-up showed a favourable outcome. Meanwhile the patient developed an anterior open bite which was treated with a fourth orthognathic surgery. The follow-up underscores how the correction of malformation leads to the generation of EMG activity of the masticatory muscles after many years of passiveness.

  9. Improving Lunar Exploration with Robotic Follow-up

    NASA Technical Reports Server (NTRS)

    Fong, T.; Bualat, M.; Deans, M.; Heggy E.; Helper, M.; Hodges, K.; Lee, P.

    2011-01-01

    We are investigating how augmenting human field work with subsequent robot activity can improve lunar exploration. Robotic "follow-up" might involve: completing geology observations; making tedious or long-duration measurements of a target site or feature; curating samples in-situ; and performing unskilled, labor-intensive work. To study this technique, we have begun conducting a series of lunar analog field tests at Haughton Crater (Canada). Motivation: In most field geology studies on Earth, explorers often find themselves left with a set of observations they would have liked to make, or samples they would have liked to take, if only they had been able to stay longer in the field. For planetary field geology, we can imagine mobile robots - perhaps teleoperated vehicles previously used for manned exploration or dedicated planetary rovers - being deployed to perform such follow-up activities [1].

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

    PubMed

    Andersson, G

    2000-01-01

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

  11. Brain single photon emission computed tomography in neonates

    SciTech Connect

    Denays, R.; Van Pachterbeke, T.; Tondeur, M.; Spehl, M.; Toppet, V.; Ham, H.; Piepsz, A.; Rubinstein, M.; Nol, P.H.; Haumont, D. )

    1989-08-01

    This study was designed to rate the clinical value of ({sup 123}I)iodoamphetamine (IMP) or ({sup 99m}Tc) hexamethyl propylene amine oxyme (HM-PAO) brain single photon emission computed tomography (SPECT) in neonates, especially in those likely to develop cerebral palsy. The results showed that SPECT abnormalities were congruent in most cases with structural lesions demonstrated by ultrasonography. However, mild bilateral ventricular dilatation and bilateral subependymal porencephalic cysts diagnosed by ultrasound were not associated with an abnormal SPECT finding. In contrast, some cortical periventricular and sylvian lesions and all the parasagittal lesions well visualized in SPECT studies were not diagnosed by ultrasound scans. In neonates with subependymal and/or intraventricular hemorrhage the existence of a parenchymal abnormality was only diagnosed by SPECT. These results indicate that ({sup 123}I)IMP or ({sup 99m}Tc)HM-PAO brain SPECT shows a potential clinical value as the neurodevelopmental outcome is clearly related to the site, the extent, and the number of cerebral lesions. Long-term clinical follow-up is, however, mandatory in order to define which SPECT abnormality is associated with neurologic deficit.

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

    SciTech Connect

    United Industries Corporation.

    1986-06-01

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

  13. Paediatrician office follow-up of common minor fractures

    PubMed Central

    Koelink, Eric; Boutis, Kathy

    2014-01-01

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

  14. Developmental Screening and Follow-up by Nurses.

    PubMed

    Lynch, Brian A; Weaver, Amy L; Starr, Stephanie R; Ytterberg, Karen L; Rostad, Paulette V; Hall, David J; Tucker, Sharon J

    2015-01-01

    The Ages and Stages Questionnaire (ASQ) and Modified Checklist for Autism in Toddlers (M-CHAT) are commonly used screening tools for developmental delay and autism, respectively. This study aimed to evaluate the effectiveness of implementing 18-month developmental and autism screening by mail, with a standardized follow-up process for abnormal screen results. Within a prospective cohort study design, parents of 892 children received by mail the 18-month ASQ and M-CHAT questionnaires between December 2008 and September 2009. A registered nurse scored the questionnaires and, if needed, administered follow-up screening or set up a referral to Early Intervention or subspecialty pediatrics. Medical record reviews determined clinical outcomes of children who required intervention after initial screening through September 2010. Additionally, demographic factors were evaluated for association with responding to the questionnaires. The ASQ and M-CHAT questionnaires were returned by 529 (59.3%) of the parents. Parents of White children (390/575 [67.8%]) and those with private insurance (457/660 [69.2%]) were significantly more likely to return screening questionnaires than parents of non-White (64/171 [37.4%]; P < .001) and government-insured children (58/169 [34.3%]; P < .001), respectively. Of the 529 children with returned surveys, 109 (20.6%) did not pass at least 1 of the initial screens and 12 (2.3%) were referred after not passing the follow-up screening process. Developmental and autism screening by mail is not a sufficient method to comprehensively screen a general pediatric population. A nurse-completed, standardized follow-up process after an initial failed developmental screen may increase the yield of appropriate Early Intervention or subspecialty referrals.

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

    ERIC Educational Resources Information Center

    Kondwros, Jerry M.

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

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

    ERIC Educational Resources Information Center

    Kondwros, Jerry M.

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

  17. Postencephalitic pure anomic aphasia: 2-year follow-up.

    PubMed

    Okuda, B; Kawabata, K; Tachibana, H; Sugita, M; Tanaka, H

    2001-06-15

    We report a patient with pure anomic aphasia following encephalitis. Brain magnetic resonance imaging (MRI) revealed bilateral temporal lesions, and subsequent focal atrophy in the left anterior inferior temporal lobe. Over the course of a 2-year follow-up, the patient's naming difficulty persisted without other dysfunction of language or memory. These observations indicate a contribution of the left anterior inferior temporal region to object naming.

  18. Optical follow-up of SN 2017eaw

    NASA Astrophysics Data System (ADS)

    D'Avanzo, P.; Wolter, A.; della Penna, F.; Garofolo, S.; Monteverdi, F.; Moreschi, B. E.; Prato, A.; Salimbeni, M.; Zizioli, M.; Covino, S.; Bersanelli, M.; Tomasi, M.

    2017-05-01

    We carried out optical follow-up of the Type II supernova 2017eaw in the nearby galaxy NGC 6946 (ATel #10372, #10374, #10376, #10377) with the 1.3m Ruths telescope of the INAF-Brera Astronomical Observatory sited in Merate (Lecco, Italy) equipped with an SBIG STL-1001E CCD. The observations, carried out under clear sky and seeing of 3", were taken as part of the Astronomy II classes of the Physics Department of the University of Milan.

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

    ERIC Educational Resources Information Center

    North Conejos School District, Capulin, CO.

    The study guide and follow-up activities were designed primarily to give students a feeling of Ute life in the San Luis Valley in Colorado. The unit begins with six Southern Ute stories about the wolf and coyote, the race between the skunk and the coyote, the frog and the eagle, why the frog croaks, the bear (Que Ye Qat), and the two Indian…

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

    PubMed Central

    2012-01-01

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

  1. Follow-up after treatment for breast cancer

    PubMed Central

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

    2016-01-01

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

  2. 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

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

    PubMed

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

    1994-02-01

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

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

    PubMed

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

    2016-02-01

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

  5. 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.

  6. [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.

  7. 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.

  8. Investigating follow-up outcome change using hierarchical linear modeling.

    PubMed

    Ogrodniczuk, J S; Piper, W E; Joyce, A S

    2001-03-01

    Individual change in outcome during a one-year follow-up period for 98 patients who received either interpretive or supportive psychotherapy was examined using hierarchical linear modeling (HLM). This followed a previous study that had investigated average (treatment condition) change during follow-up using traditional methods of data analysis (repeated measures ANOVA, chi-square tests). We also investigated whether two patient personality characteristics-quality of object relations (QOR) and psychological mindedness (PM)-predicted individual change. HLM procedures yielded findings that were not detected using traditional methods of data analysis. New findings indicated that the rate of individual change in outcome during follow-up varied significantly among the patients. QOR was directly related to favorable individual change for supportive therapy patients, but not for patients who received interpretive therapy. The findings have implications for determining which patients will show long-term benefit following short-term supportive therapy and how to enhance it. The study also found significant associations between QOR and final outcome level.

  9. Percutaneous mitral balloon valvotomy: six-year follow-up.

    PubMed

    Dighero, H; Zepeda, F; Sepúlveda, P; Soto, J R; Aranda, W

    2001-12-01

    Percutaneous mitral valvotomy (PMV) is an alternative to the surgical treatment of mitral stenosis. Results obtained with PMV appear to depend on the echocardiographical characteristics of the valvular apparatus. The purpose of this study was to report the immediate and late-term results with PMV. The incidence of late events (restenosis, mitral valve replacement and death), and their correlation with echocardiographic score (Wilkin's score) are also discussed. Between December 1987 and August 1999, a total of 160 PMVs were performed at our institution. Ninety-six patients with a minimum of 6 months follow-up and echocardiographic evaluation of the mitral valve (Wilkin's score) before and after the procedure were selected for this study. Follow-up was available for 99% of the patients, with a mean follow-up of 33 +/- 22 months (range, 6 months to 11 years). Hazard ratio (HR) and Cox's regression were used for statistical analyses. PMV was successfully performed in 97% of the cases; in 84%, the result was considered optimal. The incidence of complications related to the procedure was 10%; no mortality was observed due to PMV. Severe mitral regurgitation was observed in 7% of the patients, but only 3% of the total group developed ventricular dysfunction or worsened their New York Heart Association functional class. Eight-four percent of the patients were free of late events at the end of the follow-up period. A restenosis rate of 34% was observed during follow-up; this rate did not correlate with age, functional class or atrial fibrillation. Restenosis was associated with pulmonary hypertension (HR 2.85; 95% confidence interval, 0.68-11.80). Also, Wilkin's score was not useful to predict the development of restenosis or clinical events in the mid- to long-term. In our series, PMV had a high immediate success rate and a low incidence of complications due to the procedure. Incidence of late events was also low and was unrelated to the Wilkin's score; however

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

    SciTech Connect

    Wessels, Jan-Albert

    2015-01-15

    Independent Environmental Impact Assessment (EIA) follow-up verifiers such as monitoring agencies, checkers, supervisors and control officers are active on various construction sites across the world. There are, however, differing views on the value that these verifiers add and very limited learning in EIA has been drawn from independent verifiers. This paper aims to appraise how and to what extent independent EIA follow-up verifiers add value in major construction projects in the developing country context of South Africa. A framework for appraising the role of independent verifiers was established and four South African case studies were examined through a mixture of site visits, project document analysis, and interviews. Appraisal results were documented in the performance areas of: planning, doing, checking, acting, public participating and integration with other programs. The results indicate that independent verifiers add most value to major construction projects when involved with screening EIA requirements of new projects, allocation of financial and human resources, checking legal compliance, influencing implementation, reporting conformance results, community and stakeholder engagement, integration with self-responsibility programs such as environmental management systems (EMS), and controlling records. It was apparent that verifiers could be more creatively utilized in pre-construction preparation, providing feedback of knowledge into assessment of new projects, giving input to the planning and design phase of projects, and performance evaluation. The study confirms the benefits of proponent and regulator follow-up, specifically in having independent verifiers that disclose information, facilitate discussion among stakeholders, are adaptable and proactive, aid in the integration of EIA with other programs, and instill trust in EIA enforcement by conformance evaluation. Overall, the study provides insight on how to harness the learning opportunities

  11. [Cost-effectiveness of stress-only myocardial perfusion single photon emission computed tomography (SPECT) imaging].

    PubMed

    Vallejo, Enrique; Acevedo, César; Varela, Samuel; Alburez, José Carlos; Bialostozky, David

    2012-01-01

    Single photon emission computed tomography (SPECT) myocardial perfusion imaging is widely used for diagnosing coronary artery disease (CAD). However, SPECT costs, imaging time, and radiation exposure, limit SPECT indications. Determine whether a stress-only SPECT imaging would be enough to obtain a diagnosis of CAD improving nuclear laboratory efficiency. 122 patients with unknown CAD were evaluated with stress-only SPECT imaging. In order to evaluate diagnostic accuracy and the prognostic value of the stress-only protocol, patients with abnormal SPECT underwent invasive angiography and patients with normal SPECT were followed-up during 3 years. Diagnosis time, SPECT cost, and radiopharmaceutical dosage were significantly lower as compared with the conventional SPECT imaging protocol (30, 40 and 55%, respectively). Diagnostic accuracy and cardiac prognosis information were comparable to those obtained with the conventional imaging protocol (positive predictive value for CAD of 85% and negative predictive value for cardiac events of 97%). In patients with intermediate risk for CAD, stress-only SPECT imaging will significantly improve nuclear laboratory efficiency, and with similar accuracy than that the one obtained with the conventional protocol.

  12. ¹⁸F-Fluorocholine PET/CT as a complementary tool in the follow-up of low-grade glioma: diagnostic accuracy and clinical utility.

    PubMed

    Gómez-Río, Manuel; Testart Dardel, Nathalie; Santiago Chinchilla, Alicia; Rodríguez-Fernández, Antonio; Olivares Granados, Gonzalo; Luque Caro, Raquel; Zurita Herrera, Mercedes; Chamorro Santos, Clara E; Lardelli-Claret, Pablo; Llamas-Elvira, José M

    2015-05-01

    The follow-up of treated low-grade glioma (LGG) requires the evaluation of subtle clinical changes and MRI results. When the result is inconclusive, additional procedures are required to assist decision-making, such as the use of advanced MRI (aMRI) sequences and nuclear medicine scans (SPECT and PET). The aim of this study was to determine whether incorporating (18)F-fluorocholine PET/CT in the follow-up protocol for treated LGG improves diagnostic accuracy and clinical utility. This was a prospective case-series study in patients with treated LGG during standard follow-up with indeterminate clinical and/or radiological findings of tumour activity. All patients underwent clinical evaluation, aMRI, (201)Tl-SPECT and (18)F-fluorocholine PET/CT. Images were interpreted by visual evaluation complemented with semiquantitative analysis. Between January 2012 and December 2013, 18 patients were included in this study. The final diagnosis was established by histology (five surgical specimens, one biopsy specimen) or by consensus of the Neuro-Oncology Group (11 patients) after a follow-up of >6 months (mean 14.9 ± 2.72 months). The global diagnostic accuracies were 90.9% for aMRI (38.8% inconclusive), 69.2 % for (201)Tl-SPECT (11.1% inconclusive), and 100% for (18)F-fluorocholine PET/CT. (201)Tl-SPECT led correctly to a change in the initial approach in 38.9% of patients but might have led to error in 27.8%. The use of (18)F-fluorocholine PET/CT alone rather than (201)Tl-SPECT led correctly to a change in the approach suggested by routine follow-up in 72.2% of patients and endorsed the approach in the remaining 27.8%. Our results support the need to complement structural MRI with aMRI and nuclear medicine procedures in selected patients. (18)F-Fluorocholine PET/CT can be useful in the individualized management of patients with treated LGG with uncertain clinical and/or radiological evidence of tumour activity.

  13. SPECT radiopharmaceuticals for dementia.

    PubMed

    Guidotti, Claudio; Farioli, Daniela; Gaeta, Maria Chiara; Giovannini, Elisabetta; Lazzeri, Patrizia; Meniconi, Martina; Ciarmiello, Andrea

    2013-12-01

    Over the last decade the interest towards functional neuroimaging has gradually increased, especially in the field of neurodegenerative diseases. At present, diagnosis of dementia is mostly clinical. Numerous modalities of neuroimaging are today available, each of them allowing a different aspect of neurodegeneration to be investigated. Although during the last period many have predicted a forthcoming disappearance of SPECT imaging in favour of the PET imaging, many new radiotracers SPECT, dual-SPECT tracers techniques and receptor targeting designed radiopharmaceuticals are currently at study. Besides, last decade has also assisted to the development of new SPECT imaging systems, most of them integrated with other imaging modalities (MRI, CT, ultrasound techniques), granting improved imaging capabilities. All these improved conditions, especially appealing for the neuroimaging, together with the new radiopharmaceuticals in development may renovate the interest for SPECT clinical applications.

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

    NASA Astrophysics Data System (ADS)

    Kohler, Susanna

    2016-02-01

    Bitten by the gravitational-wave bug? While we await Thursdays press conference, heres some food for thought: if LIGO were able to detect gravitational waves from compact-object mergers, how could we follow up on the detections? A new study investigates whether the upcoming James Webb Space Telescope (JWST) will be able to observe electromagnetic signatures of some compact-object mergers.Hunting for MergersStudying compact-object mergers (mergers of black holes and neutron stars) can help us understand a wealth of subjects, like high-energy physics, how matter behaves at nuclear densities, how stars evolve, and how heavy elements in the universe were created.The Laser Interferometer Gravitational-Wave Observatory (LIGO) is searching for the signature ripples in spacetime identifying these mergers, but gravitational waves are squirrelly: LIGO will only be able to localize wave sources to tens of square degrees. If we want to find out more about any mergers LIGO discovers in gravitational waves, well need a follow-up search for electromagnetic counterparts with other observatories.The Kilonova KeyOne possible electromagnetic counterpart is kilonovae, explosions that can be produced during a merger of a binary neutron star or a neutron starblack hole system. If the neutron star is disrupted during the merger, some of the hot mass is flung outward and shines brightly by radioactive decay.Kilonovae are especially promising as electromagnetic counterparts to gravitational waves for three reasons:They emit isotropically, so the number of observable mergers isnt limited by relativistic beaming.They shine for a week, giving follow-up observatories time to search for them.The source location can beeasily recovered.The only problem? We dont currently have any sensitive survey instruments in the near-infrared band (where kilonova emission peaks) that can provide coverage over tens of square degrees. Luckily, we will soon have just the thing: JWST, launching in 2018!JWSTs

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

    PubMed

    Ponsot, P

    2006-01-01

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

  16. 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.

  17. Pediatric malignant salivary gland tumors: 60 year follow up.

    PubMed

    Cockerill, Cara C; Gross, Brian C; Contag, Stephanie; Rein, Sarah; Moore, Eric J; Olsen, Kerry D; Orvidas, Laura J

    2016-09-01

    To evaluate the presentation, treatments and outcomes in pediatric patients with salivary gland malignancies. Retrospective chart review (1950-2012), Prospective phone interview. Patients ≤18 years old with a salivary gland malignancy treated at our institution were identified. Patients were also contacted by phone for a follow up survey. Fifty-six patients were identified. Tumor origin was 88% parotid (n = 49), 5% (n = 3) submandibular and 7% (n = 4) minor salivary glands. Time from onset of symptoms to diagnosis was over one year (mean = 14.4 years). Fifteen out of 52 patients with major gland malignancy had a locoregional recurrence and local recurrences were almost all after initial enucleation. Two of these patients died of disease (overall disease specific survival = 96%). Three out of 4 patients with minor gland malignancy had a local recurrence and two patients with high grade pathology developed metastases and died of their disease (overall survival = 50%). On long term follow up survey in 13 patients (25%), 100% reported normal facial movement and 54% described symptoms of Frey's syndrome, which is higher than other reported series in children. Recurrence was noted up to 45 years after initial treatment. The majority of malignant pediatric salivary gland tumors are low grade and have excellent survival, especially if found at an early stage. Minor salivary gland malignancies, particularly high grade, have a worse prognosis. Long term mild Frey's syndrome can be expected in approximately half of patients. We advocate a need for long term follow up and increased awareness among providers to diagnose these patients earlier. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

    PubMed Central

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

    2017-01-01

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

  19. Alberta Euthanasia Survey: 3-year follow-up.

    PubMed Central

    Verhoef, M J; Kinsella, T D

    1996-01-01

    OBJECTIVE: To determine whether the opinions of Alberta physicians about active euthanasia had changed and to assess the determinants of potential changes in opinion. DESIGN: Follow-up survey (mailed questionnaire) of physicians included in the 1991 Alberta Euthanasia Survey. SETTING: Alberta. PARTICIPANTS: Of the 1391 physicians who participated in the 1991 survey 1291 (93%) had indicated that they were willing to take part in a follow-up survey. A follow-up questionnaire was mailed in 1994 to 1146 physicians who could be traced through the 1994 Medical Directory of the provincial college of physicians and surgeons; 25 questionnaires were returned because they could not be delivered. OUTCOME MEASURES: Physicians' opinions about (a) the morality of active euthanasia, (b) changes in the law to permit active euthanasia and (c) the practice of legalized euthanasia. RESULTS: Of the 1121 physicians sent a follow-up questionnaire 866 (77%) returned it completed. The responses of these same 866 physicians in 1991 provided a basis for comparison. Of the 866, 360 (42%) stated in the 1994 survey that it is sometimes right to practise active euthanasia; a similar proportion (384 [44%]) gave this response in 1991. However, other opinions changed significantly. In 1991, 250 of the respondents (29%) indicated that they would practise active euthanasia if it were legalized, as compared with 128 (15%) in 1994 (p < 0.01). In 1991, 429 (50%) of the respondents thought that the law should be changed to permit active euthanasia, as compared with 316 (37%) in 1994 (p < 0.01). Religious activity was the most important characteristic associated with changes in opinion. Despite the decrease in support for the practice and legalization of active euthanasia between 1991 and 1994, in both surveys at least 70% of those who responded to this question indicated that active euthanasia, if it were legalized, should be performed only by physicians and should be taught at medical sites. CONCLUSION

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

    PubMed

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

    2013-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Tichý, Miloš; Tichá, Jana; Kočer, Michal

    2016-01-01

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

  2. MAXI J1305-704: Swift follow-up observations

    NASA Astrophysics Data System (ADS)

    Kennea, J. A.; Altamirano, D.; Evans, P. A.; Krimm, H. A.; Romano, P.; Mangano, V.; Curran, P.; Yamaoka, K.; Negoro, H.

    2012-04-01

    We present analysis of Swift follow-up observations of MAXI J1305-704 (Sato et al., ATEL #4024), which has been proposed to be a newly discovered Galactic black-hole binary (BHB; Greiner et al., ATEL #4030). Starting 16:07UT on April 11th, 2012, Swift observed MAXI J1305-704 for 1ks as a Target of Opportunity, with the Swift/XRT in Windowed Timing (WT) mode, to avoid pile-up. This follows initial observations made by Swift in a 4-pointing Photon Counting (PC) mode tiling observation on April 10th, initial results of which have been reported by Greiner et al.

  3. [Clinical and sperm follow-up after subinguinal varicocelectomy].

    PubMed

    Vicari, E; Arancio, A; Costanzo, C; Ingrassia, G; Cannizzaro, M A

    2000-06-01

    In order to evaluate the sperm output and the adverse-side-effects after subinguinal varicoceloctomy, a follow-up study of 16 months was performed on 196 selected patients (aged from 22 to 43 years) affected by left varicocele (VR). In the pre-treatment, both Doppler ultrasonography and didymo-epididymal ultrasonography allowed to distinguish two homogeneous patient groups: group A (no. = 136), including patients affected by VR alone and, group B (n. = 60), including patients with VR combined to coincidental didymo-epididymal morphological abnormalities, DEMA). These DEMA lesions (testis size < 12 ml, epididymides abnormalities: increased head- > or = 12 mm- and/or tail- > or = 6 mm-diameter, multiple microcysts, large idrocele) were omolaterally to VR in 30/60 (50%), eterolaterally in 19/60 (31.7%) or bilaterally in 11/60 (18.3%). During sperm follow-up, group A patients showed both a significant temporal change (p < 0.01 ANOVA) of all sperm parameters studied (sperm density, total sperm count, motility and morphology) from month 8 onward and sperm values significantly higher than found in group B patients. On the contrary, the sperm parameters of group B patients did not change significantly during the follow-up observations. As far as the varicocelectomy-mediated clinical symptoms, some patients complained early and transiently (on 1-2-4 weeks following varicocelectomy) the following symptoms: didymal pain (1.5%), didymo-epididymal pain (4.1%) and parasthesiaes on the anterior-medial side of the left thigh (4.1%) or scrotal (3.1%); only four patients (2%) complained permanent paresthesiaes on the anterior-medial side of the left thigh. Furthermore, the clinical follow-up also revealed a low rate of complications: persistent VR (3.6%), hydrocele (1.5%), intrascrotal venous ecstasies (6.1%), epididymitis (0.5%). Some morpho-structural abnormalities at US scans were transient (1-2 weeks): scrotal oedema (6.1%), orchitis (2%), orchi-epididymitis (1%). Subinguinal

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

    SciTech Connect

    Ashley, Paul R.

    2008-03-01

    In April and May 2007 the Regional HEP Team (RHT) conducted a follow-up HEP analysis on the Egger (612 acres) and Herzog (210 acres) parcels located at the north end of the Shillapoo Wildlife Area. The Egger and Herzog parcels have been managed with Bonneville Power Administration funds since acquired in 1998 and 2001 respectively. Slightly more than 936 habitat units (936.47) or 1.14 HUs per acre was generated as an outcome of the 2007 follow-up HEP surveys. Results included 1.65 black-capped chickadee HUs, 280.57 great blue heron HUs, 581.45 Canada goose HUs, 40 mallard HUs, and 32.80 mink HUs. Introduction A follow-up Habitat Evaluation Procedures (HEP) (USFWS 1980) analysis was conducted by the Columbia Basin Fish and Wildlife Authority's (CBFWA) Regional HEP Team (RHT) during April and May 2007 to document changes in habitat quality and to determine the number of habitat units (HUs) to credit Bonneville Power Administration (BPA) for providing operation and maintenance (O&M) funds since WDFW acquired the parcels. The 2007 follow-up HEP evaluation was limited to Shillapoo Wildlife Area (SWA) parcels purchased with Bonneville Power Administration funds. D. Budd (pers. comm.) reported WDFW purchased the 612 acre Egger Farms parcel on November 2, 1998 for $1,737,0001 and the 210 acre Herzog acquisition on June 21, 2001 for $500,000 with Memorandum of Agreement funds (BPA and WDFW 1996) as partial fulfillment of BPA's wildlife mitigation obligation for construction of Bonneville and John Day Dams (Rasmussen and Wright 1989). Anticipating the eventual acquisition of the Egger and Herzog properties, WDFW conducted HEP surveys on these lands in 1994 to determine the potential number of habitat units to be credited to BPA. As a result, HEP surveys and habitat unit calculations were completed as much as seven years prior to acquiring the sites. The term 'Shillapoo Wildlife Area' will be used to describe only the Herzog and Egger parcels in this document. Details and

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

    PubMed Central

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

    2015-01-01

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

  6. Follow-up of 13 children after ureterosigmoidostomy.

    PubMed Central

    Bakker, N J; van Damme, K J; de Voogt, H J

    1976-01-01

    Follow-up of 13 children who had had a ureterosigmoid anastomosis 3 1/2 to 10 years previously and whose initial urogram had been satisfactory, showed that growth was normal and that there was no serious metabolic disorder. In particular whole-body potassium did not differ significantly from normal values (as given by Langham, 1961). Asymptomatic urinary infection is the chief hazard in these cases but is difficult to diagnose and may lead to progressive dilatation of the ureters. PMID:962364

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

    PubMed

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

    1976-06-12

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

  8. [Rounded atelectasis: a follow up of 10 years by CT].

    PubMed

    Bruyère, P J; Bartsch, P; Ghaye, B

    2005-10-01

    We report the case of a 69-year-old man who presented with a rounded atelectasis (RA). During a 10-year follow-up by Computed Tomography (CT), the lobe showed a progressive shrinkage, and a moderate increase in size of the lesion led to a percutaneous biopsy which confirmed the diagnosis. RA is an unusual form of lung consolidation. The major cause of RA is asbestosis. RA is usually asymptomatic and may simulate a pulmonary neoplasm on chest Xray. The diagnosis is made by CT, demonstrating the pathognomonic "comet tail sign". No treatment is required.

  9. Added value of SPECT/CT in patients suspected of having bone infection: preliminary results.

    PubMed

    Horger, Marius; Eschmann, Susanne Martina; Pfannenberg, Christina; Storek, Dieter; Vonthein, Reinhard; Claussen, Claus D; Bares, Roland

    2007-04-01

    We evaluated the contribution of SPECT/CT as an adjunct to combined three-phase bone scintigraphy (planar and SPECT) for diagnosing and localizing bone infection. Subsequently, the diagnostic performance of SPECT/CT was compared to visual fusion of SPECT with data of additional CT, X-ray, or MRI studies (SPECT + CT/X-ray/MRI). Thirty-one patients suspected of bone infection, presenting pathological findings on triple-phase bone scintigraphy, underwent additional SPECT/CT. The SPECT/CT-technology combines the acquisition of SPECT and CT data with the same imaging device enabling perfect overlay of anatomical and functional images. (99m)Tc-DPD was used as radiopharmaceutical in all patients. For data analysis findings of bone scintigraphy (planar scans as well as SPECT) were categorized as positive, negative, or equivocal for the presence of osteomyelitis. In a second step, they were compared with SPECT/CT and SPECT + CT/X-ray/MRI with respect to localization and classification of lesions. Validation was achieved by surgery, biopsy, or by clinical follow up over at least 9 months including microbiological and radiological findings. Three-phase bone scan (incl. SPECT) correctly classified 7 lesions as positive and 11 lesions as negative for osteomyelitis. Six scans were interpreted false positive, two false negative, and five as equivocal. Rating the latter as positive for osteomyelitis, sensitivity of bone scan was (78%), specificity (50%). SPECT/CT was true positive in 7 patients, and true negative in 19. There were two false positive and two false negative findings, one scan was equivocal (sensitivity 78%, specificity 86%). Definition of anatomical localization of inflammatory foci was much easier by SPECT/CT due to better depiction of underlying anatomical details. SPECT + CT/X-ray/MRI yielded the highest sensitivity (100% compared to 78% of SPECT/CT), if equivocal findings (5/31 compared to 1/31 for SPECT/CT) are rated as true positive for osteomyelitis. Among

  10. [Follow-up ultrasound of head and neck cancer].

    PubMed

    Künzel, J; Bozzato, A; Strieth, S

    2017-09-13

    In Germany high-resolution sonography using the color duplex mode in addition to computed tomography (CT) is a well-established and proven method in the context of restaging after primary therapy of head and neck squamous cell cancer (HNSCC). There are no international evidence-based restaging guidelines. Decisions concerning neck dissection (ND) after primary radiochemotherapy (RCT) are often individually derived in the respective tumor conferences and are therefore subject to variance. Compared to the UK or USA, in Germany there is a high level of expertise in the use of ultrasound in combination with CT for the routine restaging of HNSCC after RCT. Using high-resolution sonography (B-mode and color duplex) morphological changes in neck lymph nodes can be clearly detected. Another important aspect in the field of sonographic follow-up is the accurate and standardized documentation of findings and control of dynamic changes during follow-up. In summary, clinical presentation and sonography enable therapeutic decisions and treatment from one source.

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

    PubMed

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

    2012-06-01

    The Life Span Study (LSS) is a follow-up study of atomic bomb (A-bomb) survivors to investigate the radiation effects on human health and has collected data for over 60 years. The LSS cohort consists of 93,741 A-bomb survivors and another 26,580 age and sex-matched subjects who were not in either city at the time of the bombing. Radiation doses have been computed based on individual location and shielding status at the time of the bombings. Age at death and cause of death are gathered through the Japanese national family registry system and cancer incidence data have been collected through the Hiroshima and Nagasaki cancer registries. Noncancer disease incidence and health information are collected through biannual medical examinations among a subset of the LSS. Radiation significantly increases the risks of death (22% at 1 Gy), cancer incidence (47% at 1 Gy), death due to leukemia (310% at 1 Gy), as well as the incidence of several noncancer diseases (e.g. thyroid nodules, chronic liver disease and cirrhosis, uterine myoma, and hypertension). Significant effects on maturity (e.g. growth reduction and early menopause) were also observed. Long-term follow-up studies of the A-bomb survivors have provided reliable information on health risks for the survivors and form the basis for radiation protection standards for workers and the public. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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

    NASA Astrophysics Data System (ADS)

    Lister, T.

    2014-07-01

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

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

    PubMed Central

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

    1994-01-01

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

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

    PubMed Central

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

    1984-01-01

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

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

    SciTech Connect

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

    2001-05-15

    Purpose: To assess the efficacy of self-expanding metallic stents in treating inoperable gastric and duodenal stenoses during follow-up and to evaluate the complications encountered.Methods: A total of 31 patients suffering from gastroduodenal obstruction (29 malignant, 2 benign) were treated with a self-expanding metallic stent (Wallstent). In 24 cases insertion was by the peroral route, in seven cases via gastrostomy.Results: All the strictures were successfully negotiated under fluoroscopic guidance without having to resort to endoscopy. A total of 27 patients (87%) were able to resume a regular diet, a soft diet, or a liquid diet orally. Complications included one case of stent malpositioning, one case of leakage of ascitic fluid through the gastrostomy orifice, one case of perforation and fistula to the biliary tree, and two cases of hematemesis. In two patients (6%) additional stents were implanted to improve patency. In all patients follow-up was maintained until death. Recurrence of symptoms immediately before death occurred in seven cases (23%). Mean survival time of patients was 13.3 weeks (SE {+-} 4.6).Conclusions: The deployment of gastroduodenal stents resulted in good palliation of inoperable gastric and duodenal stenoses. Certain technical aspects, e.g., adaptation of stents to bowel morphology, is critical to proper stent function and avoidance of complications.

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

    PubMed Central

    Elit, L.

    2000-01-01

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

  17. Arthroscopic partial meniscectomy: a long-term follow-up.

    PubMed

    Faunø, P; Nielsen, A B

    1992-01-01

    A follow-up study was conducted to clarify the clinical and radiological long-term consequences of arthroscopic meniscus resection. One hundred thirty-six patients who had unilateral arthroscopic resection of an isolated meniscal tear attended for an interview and a physical and radiological examination. Follow-up averaged 8.5 years, with a range of 7.9-11.6 years. The reoperation rate was as high as 22.8%, but was the lowest in the bucket handle tear group (13%). Pain after exercise was less frequent among patients treated for a bucket handle tear compared to other lesions. Fifty-three percent of the patients had at least one of the Fairbanks change in the operated knee and only 22% in the control knees. The radiographic result was not influenced by the type of meniscus lesion nor were high age or intraoperatively described cartilage damage factors of significance. Malalignment less than 4 degrees of valgus and greater than 10 degrees of valgus was found to be a significant risk factor for the development of degenerative changes following meniscus resection.

  18. Results and implications of the INCAP follow-up study.

    PubMed

    Martorell, R

    1995-04-01

    This article is a critical synthesis of 12 papers included in this supplement. The set deals with the short- and long-term effects of improving nutrition in Guatemalan villages characterized by deficient diets, high rates of infection and pronounced growth retardation in the first 3 y of life. The data reviewed come from two studies carried out over two decades: the Institute of Nutrition of Central America and Panama (INCAP) longitudinal study (1966-1977) and its follow-up (1988-1989). The longitudinal study included a nutrition intervention that improved the energy and nutrient intakes of women and preschool children. Its effects included improved birthweights, reduced infant mortality rates and improved growth rates in children < 3 y of age. Growth rates from 3 to 7 y of age, similar to those of well-nourished children, were not affected by the intervention. The follow-up study was conducted when the subjects were 11-27 y old. Among the long-term effects found were greater stature and fat-free mass, particularly in females, improved work capacity in males and enhanced intellectual performance in both genders. The nutrition intervention did not, on the other hand, accelerate maturation during adolescence, as measured by skeletal age or age at menarche. It is concluded that improved nutrition in early childhood has important long-term effects in the adolescent and adult.

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

    PubMed

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

    2002-01-01

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

  20. Serial extraction: 20 years of follow-up

    PubMed Central

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

    2012-01-01

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

  1. Nonautistic motor stereotypies: clinical features and longitudinal follow-up.

    PubMed

    Harris, Kendra M; Mahone, E Mark; Singer, Harvey S

    2008-04-01

    To characterize further the clinical features and long-term outcomes among children with motor stereotypies who do not manifest mental retardation or pervasive developmental disorders, a review of clinical records and semistructured telephone interviews were undertaken. The identified clinical cohort consisted of 100 typically developing children with motor stereotypies. The mean length of follow-up was 6.8 +/- 4.6 years. At most recent follow-up, movements had continued in 94% of the sample (62% for >5 years). Only six children reported complete cessation of movements, with four (3 of 4 with head nodding) doing so >1 year after their initial diagnosis. Thus the course of motor stereotypies, especially in children with arm/hand movements, appears chronic. Nearly half the children in this cohort exhibit other comorbidities, including attention-deficit-hyperactivity disorder (30%), tics (18%), and obsessive-compulsive behaviors/obsessive-compulsive disorder (10%). Twenty-five percent of children with motor stereotypies reported positive family histories of motor stereotypies, suggesting an underlying genetic abnormality. Finally, evidence is emerging that the clinical course of children who exhibit head nodding may differ from those whose motor stereotypy predominantly involves the hands and arms.

  2. 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.

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

    PubMed

    Chow, S P; Yau, A

    1980-01-01

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

  4. 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

  5. Long-term follow-up of DDD pacing mode.

    PubMed

    Ulman, Mateusz; Dębski, Maciej; Ząbek, Andrzej; Haberka, Kazimierz; Lelakowski, Jacek; Małecka, Barbara

    2014-01-01

    The aim of this study was to determine the long-term survival of DDD pacing and identify the main reasons for its loss. The study group consisted of 496 patients in whom a DDD pacing system was implanted between October 1984 and March 2002 and who were followed up until July 2010. The follow-up period was 152.1 ± 35.5 months. The patients' mean age at the time of implantation was 59.5 ± 12.5 years, and 53.5% were male; 58% had sick sinus syndrome (SSS), 26% had atrioventricular block (AVB), 15% had both of these indications simultaneously, and 1% had other indications. The incidence of lead malfunction, progression to chronic atrial fibrillation (AF), and the rate of infective complications was analysed. During the follow-up, 369 patients remained in DDD mode stimulation. DDD mode survival rate at one, five, ten and 15 years was, respectively, 96%, 86%, 77% and 72%. The most common reason for reprogramming out of DDD mode was the development of permanent AF in 65 (13.1%) patients. The occurrence of chronic AF was associated with a prior history of paroxysmal AF (p = 0.0001), SSS (p = 0.0215), and older age at time of implantation (p = 0.0068) compared to patients who remained in sinus rhythm. Lead malfunction caused loss of DDD mode pacing in 56 (11.3%) patients. Atrial leads were damaged in 37 patients, ventricular in 12 patients, and both leads in seven patients. The subclavian vein puncture was correlated with the mechanical damage of the atrial lead (p = 0.02935) compared to cephalic vein access. At the moment of complication, the patients with a dysfunctional lead were significantly younger than those who progressed to chronic AF(p = 0.0019). Infective complications which caused temporary loss of DDD pacing were observed in six patients: five had pocket infection and one had lead-dependent infective endocarditis. 1. Effective DDD pacing from the originally implanted system was noted in a high percentage (72%) of patients in long-term observation (15 years

  6. 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

  7. Proximal row carpectomy: minimum 20-year follow-up.

    PubMed

    Wall, Lindley B; Didonna, Michael L; Kiefhaber, Thomas R; Stern, Peter J

    2013-08-01

    Proximal row carpectomy (PRC) is a motion-sparing procedure for degenerative disorders of the proximal carpal row. Reported results at a minimum 10-year follow-up consistently show maintenance of strength, motion, and satisfaction with an average conversion rate to radiocarpal arthrodesis of 12%. We hypothesized that PRC would continue to provide a high level of satisfaction and function at a minimum of 20 years. Seventeen wrists in 16 patients, including 7 laborers, underwent PRC for symptomatic degenerative disorders of the proximal carpal row at an average age of 36 years. Patients returned for radiographic and clinical evaluation, and the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire and Patient-Related Wrist Evaluation were used for subjective assessment. Follow-up was a minimum of 20 years (average, 24 y). Eleven wrists (65%) underwent no further surgery at a minimum 20-year follow-up. The average time to failure of PRC, defined as the time from PRC to radiocarpal arthrodesis, was 11 years (range, 8 mo to 20 y). Ten of 11 patients who did not undergo radiocarpal arthrodesis continued to be satisfied, with minimal decrease in motion and grip strength compared with the uninvolved side. Average score for QuickDASH was 16 and for Patient-Related Wrist Evaluation was 26. The flexion-extension arc was 68°, and grip strength was 72% of the contralateral side. All patients returned to their original employment. There was no correlation between degenerative radiographic changes and satisfaction level. The predicted probability of failure revealed a higher risk in patients who underwent PRC at a younger age, which leveled off at age 40 years. PRC provides satisfaction at a minimum of 20 years with a survival rate of 65%. Whereas we recommend a minimum age for PRC between 35 and 40 years, young patients should not be excluded as PRC candidates; these patients should undergo appropriate preoperative counseling of their increased failure risk

  8. Neuroreceptor imaging with SPECT.

    PubMed

    Innis, R B

    1992-11-01

    Single photon emission computed tomography (SPECT) imaging can provide useful measurements of brain receptors and endogenous neurotransmitters and may have significant experimental and clinical applications. This presentation reviews the use of SPECT for neuroreceptor imaging. Studies of receptors for benzodiazepines, dopamine D2 agents, and dopamine reuptake sites will be used to exemplify the capabilities of SPECT. Tracers labeled with the radioisotope 125I have high affinity, high brain uptake, and high ratios of specific to nonspecific binding. Imaging studies of human and nonhuman primate brain will be presented, and the potential clinical applicability of these agents will be discussed.

  9. Pulmonary radiofrequency ablation (Part 2): Procedure and follow-up.

    PubMed

    Plasencia Martínez, J M

    2015-01-01

    Pulmonary radiofrequency ablation requires more than just interventional radiology skills. Patients must be selected carefully, and the acts that need to be done before, during, and after the procedure must be coordinated. To guarantee patient safety, radiologists need to know the variants of the technique, the precautions that must be taken, the complications that can occur, and the risks involved. Early differentiation between tumor tissue and normal changes secondary to treatment on imaging tests will make it possible to repeat the treatment without delays, and this will increase survival. This article describes how to coordinate and carry out pulmonary radiofrequency ablation, the complications of the technique, and the current evidence in follow-up. Copyright © 2014 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

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

    PubMed Central

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

    1992-01-01

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

  11. A New GRB follow-up Software at TUG

    NASA Astrophysics Data System (ADS)

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

    2016-12-01

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

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

    PubMed

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

    1982-06-01

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

  13. Follow-up of children with early expressive phonology disorders.

    PubMed

    Lewis, B A; Freebairn, L A; Taylor, H G

    2000-01-01

    Fifty-two children identified at age 4 to 6 years as demonstrating a moderate to severe expressive phonology disorder were followed to the third and fourth grades. Children were classified into two groups based on the presence of an early phonology disorder in isolation (P) or the presence of a phonology disorder with other language problems (PL). At follow-up, articulation measures failed to differentiate the groups; however, the PL group performed more poorly than the P group on measures of phoneme awareness, language, reading decoding, reading comprehension, and spelling. The P group demonstrated poor spelling skills relative to their reading and language abilities, suggesting residual spelling weaknesses in these children. The PL group reported more nuclear family members with speech-language disorders and with reading disorders than the P group. Findings support previous research linking early language disorders with later reading difficulties.

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

    PubMed

    Van Aerschot, Isabelle; Iserin, Laurence

    2011-01-01

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

  15. Long thoracic nerve palsy: a follow-up study.

    PubMed

    Goodman, C E; Kenrick, M M; Blum, M V

    1975-08-01

    Twelve patients who had previously been treated for palsy of the long thoracic nerve of Bell and resultant serratus anterior paralysis were examined in a follow-up study designed to determine their extent of recovery and/or residual disability. The patients' histories were reviewed, following which they were recalled for updating of the history and reexamination. It was found that those patients whose lesions were due to acute trauma had only partial or no recovery of serratus function, while those with infectious, toxic, allergic or idiopathic etiologies had partial or complete recovery. The occurrence of a prolonged interval between onset of symptoms and institution of therapy was found to adversely affect prognosis. Among those patients with no recovery of serratus anterior function, some were able to maintain relatively good active motion in the affected shoulder by substituting with the trapezius.

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

    PubMed

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

    2014-01-01

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

  17. A follow-up campaign for fast radio bursts

    NASA Astrophysics Data System (ADS)

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

    2014-04-01

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

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

    PubMed

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

    2010-01-01

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

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

    PubMed

    Ruiz, J

    2008-06-04

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

  20. Follow up of premature babies treated with artificial surfactant (ALEC).

    PubMed Central

    Morley, C J; Morley, R

    1990-01-01

    Of 235 survivors who had taken part in a randomised trial of artificial surfactant and who were born in Cambridge, follow up information was available for 231 (98%) infants. In 12 cases information came from local doctors; all others were assessed at 9 and 18 months (n = 212) or 9 months only (n = 7). There was no difference between those who had been treated with surfactant and control babies in the incidence of neurological impairment, mental impairment, respiratory infections, allergies, or hospital admissions up to 18 months after full term. In those born before 30 weeks' gestation (where surfactant most improves survival) the number of surviving randomised children who were normal was 35 of 61 in the treated group (57%) compared with 25 of 61 in the control group (41%). Improved neonatal survival after prophylactic surfactant treatment is not associated with an increased incidence of neurodevelopmental impairment. PMID:2201266

  1. Bleeding oesophageal varices with long term follow up.

    PubMed Central

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

    1984-01-01

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

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

    PubMed

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

    2010-01-01

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

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

    PubMed

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

    2014-10-01

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

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

    SciTech Connect

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

    2012-09-01

    We have used the Caltech Submillimeter Observatory (CSO) to follow-up a sample of Wide-field Infrared Survey Explorer (WISE) selected, hyperluminous galaxies, the so-called W1W2-dropout galaxies. This is a rare ({approx}1000 all-sky) population of galaxies at high redshift (peaks at z = 2-3), which are faint or undetected by WISE at 3.4 and 4.6 {mu}m, yet are clearly detected at 12 and 22 {mu}m. The optical spectra of most of these galaxies show significant active galactic nucleus activity. We observed 14 high-redshift (z > 1.7) W1W2-dropout galaxies with SHARC-II at 350-850 {mu}m, with nine detections, and observed 18 with Bolocam at 1.1 mm, with five detections. Warm Spitzer follow-up of 25 targets at 3.6 and 4.5 {mu}m, as well as optical spectra of 12 targets, are also presented in the paper. Combining WISE data with observations from warm Spitzer and CSO, we constructed their mid-IR to millimeter spectral energy distributions (SEDs). These SEDs have a consistent shape, showing significantly higher mid-IR to submillimeter ratios than other galaxy templates, suggesting a hotter dust temperature. We estimate their dust temperatures to be 60-120 K using a single-temperature model. Their infrared luminosities are well over 10{sup 13} L{sub Sun }. These SEDs are not well fitted with existing galaxy templates, suggesting they are a new population with very high luminosity and hot dust. They are likely among the most luminous galaxies in the universe. We argue that they are extreme cases of luminous, hot dust-obscured galaxies (DOGs), possibly representing a short evolutionary phase during galaxy merging and evolution. A better understanding of their long-wavelength properties needs ALMA as well as Herschel data.

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

    PubMed

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

    2005-02-01

    To study prevalence of hallucinations in patients with Parkinson's disease (PD) during a 1-year period, and identify factors predictive of the onset of hallucinations in patients who were hallucination-free at baseline, 141 unselected outpatients with PD were evaluated prospectively for a set of demographic, clinical, and therapeutic variables and the presence of hallucinations during the previous 3 months. Patient groups were compared with nonparametric tests, and logistic regression was applied to significant data. Follow-up data were available for 127 patients. The hallucination prevalence rates (%) at the first and second evaluation were, respectively, 41.7 and 49.6 for hallucinations of all types (NS), 29.1 and 40.2 for minor hallucinations (i.e., presence or passage hallucinations, and illusions) (P = 0.02), 22.8 and 21.2 for formed visual hallucinations (NS), and 8.7 and 8.7 for auditory hallucinations (NS). Hallucinations rarely started or ceased during the study. The most labile forms were minor hallucinations, which developed in 20% of patients and ceased in 9%. During follow-up, 15% of patients started to hallucinate. Three factors, all present at the first evaluation, independently predicted the onset of hallucinations in patients previously free of hallucinations at baseline (odds ratio; 95% confidence interval): severe sleep disturbances (14.3; 2.5-80.9), ocular disorders (9.1; 1.6-52.0), and a high axial motor score (5.7; 1.2-27.4). Hallucinations have a chronic course in most parkinsonian patients. Factors predicting the onset of hallucinations point to a role of extranigral brainstem involvement and a nonspecific, facilitating role of ocular disorders. Copyright 2004 Movement Disorder Society.

  6. Trajectories of Nutritional Risk: The Manitoba Follow-Up Study.

    PubMed

    Lengyel, C O; Jiang, D; Tate, R B

    2017-01-01

    To identify patterns of nutritional risk among older men over a four-year period and to project their survival rates over the next two and a half years. A prospective longitudinal study. Canada. Three hundred and thirty-six male survivors of the Manitoba Follow-up Study (MFUS) cohort with an average age of 90 years in 2011. Four years of nutritional risk SCREEN II scores (five waves) from the male survivors of the MFUS cohort. The semi-parametric group-based trajectory approach and survival analysis were used to investigate the trajectories of nutritional risk. Of the participants, 30% lived alone. Five distinct developmental trajectory groups for nutritional risk score were identified. Significant statistical differences were found among the five trajectory groups for SF-36 mental health (p=.02), SF-36 physical health (p=<.001), perception of aging successfully (p=.04) and living alone (p=<.001). Among the five groups, the most pairwise differences were found in appetite, intake of meat and alternatives, and vegetables and fruit, weight change, skipping meals and eating with others. Men in the poorest nutritional risk trajectory group were two times more likely to die within a 2 1/2 year period compared to men in the best nutritional risk trajectory group (hazard rate = 2.33, p=.07). Distinct nutritional risk trajectories were found for older men over a four year period. Poor nutritional risk trajectories are associated with higher risk of mortality for very old men over a short period of time. Timely nutritional assessments by health professionals are needed to identify older men at nutritional risk. Subsequent nutrition education and follow-up may be important in preventing further decline.

  7. Cold urticaria: a 20-year follow-up study.

    PubMed

    Jain, S V; Mullins, R J

    2016-12-01

    Chronic cold urticaria results in significant morbidity, yet information on its natural history is limited. We examined the natural history of chronic cold urticaria and its impact on quality of life. We analysed the characteristics of patients diagnosed with cold urticaria at a community-based specialist allergy practice in the Australian Capital Territory (ACT) between 1995 and 2015. Follow-up data were obtained using a mailed questionnaire. Possible predictive factors of disease severity and symptom duration were evaluated. A total of 99 patients were assessed with a median age of 42 (range 5-81 years); 63% were female and the median age of onset of symptoms was 22 years. Of 41 questionnaire responders (14 ± 10.9 years follow-up; median 12 years), 5- and 10-year resolution rates were 17.9% ± 6.2% and 24.5% ± 7.2%, respectively. Whereas 22% reported resolution and 23% described improvement, the remaining 55% reported stable or worsening disease. Most individuals relied on lifestyle modification to ameliorate symptoms rather than medication. Risk factors for persistent disease were intercurrent atopic disease (P = 0.025) and those with longer duration of symptoms at the time of initial assessment (P < 0.001). Secondary causes of cold urticaria were identified in only two patients, both with B-cell malignancy. In a subset of patients, cold urticaria has low rates of spontaneous resolution and results in lifestyle changes and impaired quality of life. © 2016 European Academy of Dermatology and Venereology.

  8. Long-term follow-up of elite controllers

    PubMed Central

    Stafford, Kristen A.; Rikhtegaran Tehrani, Zahra; Saadat, Saman; Ebadi, Maryam; Redfield, Robert R.; Sajadi, Mohammad M.

    2017-01-01

    Abstract To estimate the effect of hepatitis C virus (HCV) coinfection on the development of complications and progression of human immunodeficiency virus (HIV) disease among HIV-infected elite controllers. Single-center retrospective cohort. Kaplan–Meier methods, prevalence ratios, and Cox proportional-hazards models were used. In all, 55 HIV-infected elite controllers were included in this study. Among them, 45% were HIV/HCV coinfected and 55% were HIV mono-infected. Median follow-up time for the cohort was 11 years. Twenty-five patients experienced a complication and 16 lost elite controller status during the study period. HCV coinfected patients were 4.78 times (95% confidence interval 1.50–15.28) more likely to develop complications compared with HIV mono-infected patients. There was no association between HCV coinfection status and loss of elite control (hazard ratio 0.75, 95% confidence interval 0.27–2.06). Hepatitis C virus coinfection was significantly associated with the risk of complications even after controlling for sex, injecting drug use, and older age. HCV coinfected patients had higher levels of cellular activation while also having similar levels of lipopolysaccharide and soluble CD14. HCV coinfection was not associated with loss of elite controller status. Taken together, this suggests that HCV coinfection does not directly affect HIV replication dynamics or natural history, but that it may act synergistically with HIV to produce a greater number of associated complications. Continued follow-up will be needed to determine whether HCV cure through the use of direct-acting antivirals among HIV/HCV coinfected elite controllers will make the risk for complications among these patients similar to their HIV mono-infected counterparts. PMID:28658155

  9. [Follow-up of patients with inflammatory bowel disease].

    PubMed

    García-López, Santiago

    2013-10-01

    Multiple data were presented on inflammatory bowel disease (IBD) in Digestive Disease Week (DDW). Of particular interest to gastroenterologists were those on novel treatments and information on safety. Other data, such as those relating to disease "follow-up", were possibly of lesser interest. However, the information reported this year was, in my opinion, highly important, because it could lead to significant changes in clinical practice. Thus, results presented strongly suggest that patients with asymptomatic IBD, specifically Crohn's disease (CD), often develop complications during their clinical course. Moreover, this is especially true in patients with CD and biological signs of inflammation, despite being asymptomatic. In addition, it seems clear that the absence of symptoms does not imply an absence of inflammation. These observations indicate a dual practical message: patients should be followed-up and objectively evaluated. Multiple data were presented on how to objectively evaluate disease activity in IBD. The prognostic value and objectivity of endoscopy has been reaffirmed, specifically with new data on the only validated index, the UCEIS, in ulcerative colitis. Together with endoscopy, the role of less invasive techniques such as imaging tests (magnetic resonance enterography, computed tomography enterography and even echography, with and without contrast agent) and fecal markers has been reaffirmed in several conditions and these techniques have a certain predictive value. Finally, many studies were reported that confirm the therapeutic activity of levels of anti-TNF and its antibodies in certain conditions and with some limitations. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  10. ACR Appropriateness Criteria: follow-up of Hodgkin's lymphoma.

    PubMed

    Ng, Andrea; Constine, Louis S; Advani, Ranjan; Das, Prajnan; Flowers, Christopher; Friedberg, Jonathan; Hodgson, David C; Schwartz, Cindy L; Wilder, Richard B; Wilson, Lynn D; Yunes, Michael J

    2010-01-01

    In the follow-up of Hodgkin's lymphoma patients, the focus in the first 5 years is to detect recurrence, while after 5 years, the focus is on limiting and detecting late effects of treatment. In the first 5 years post-treatment, routine history and physical and computed tomography (CT) imaging (more frequent in the first 2 years) are generally appropriate. However, there are limited data to support the role of positron emission tomography scanning as routine follow-up. Beyond 5 years post-treatment, annual history and physical is appropriate, although there is no longer a role for routine imaging for recurrences. Women irradiated to the chest area at a young age (<35) would benefit from annual mammogram screening given the increased breast cancer risk. Magnetic resonance imaging can be considered, although there is a lack of data supporting its role in this population. Low-dose chest CT for lung cancer screening in patients with history of mediastinal irradiation and/or alkylating chemotherapy exposures and a smoking history can be considered, although data on its utility is lacking. Cardiac screening with echocardiogram and exercise tolerance tests in patients with history of mediastinal irradiation and/or adriamycin exposure may be appropriate, although the optimal screening interval would depend on mediastinal dose, adriamycin dose, presence of other cardiac risk factors and findings at the baseline screening. Patients at risk for cardiac disease due to treatment exposure would also benefit from lipid screening every 1-3 years. Copyright 2010 American College of Radiology. Published by Mosby, Inc. All rights reserved.

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

    NASA Astrophysics Data System (ADS)

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

    2014-11-01

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

  12. 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.

  13. Detailed Follow-up Study of Pediatric Orofacial Granulomatosis Patients.

    PubMed

    Haaramo, Anu; Alapulli, Heikki; Aine, Liisa; Saarnisto, Ulla; Tuokkola, Jetta; Ruuska, Tarja; Sipponen, Taina; Pitkäranta, Anne; Kolho, Kaija-Leena

    2017-10-01

    Orofacial granulomatosis (OFG) is a chronic inflammatory condition affecting the orofacial area. Its connection to Crohn disease (CD) is debated. Our aim was to describe a cohort of pediatric patients with OFG in detail, study the long-term behavior of OFG, and evaluate factors predicting CD in patients with OFG. We invited patients diagnosed with OFG at 2 university hospitals, Finland for a follow-up appointment. Patients (n = 29) were examined by a dentist and an otorhinolaryngologist using a structural schema. Orofacial findings were also recorded using digital photographing. Patients filled in questionnaires about general health and special diets. Patients' nutrition was evaluated from food records. The findings were compared between patients with OFG only and OFG with CD. Patients with CD had more findings in the orofacial area (total score for orofacial findings median 11) compared to patients with OFG only (total score median 7.5). There was no statistically significant difference in the type of lesions between these groups, except the upper lip was more often affected in patients with CD (n = 11) than in patients with OFG only (n = 0). Most of the patients had normal otorhinolaryngological findings. All patients with elevated anti-Saccharomyces cerevisiae antibody A levels had CD (n = 6) and they presented with more orofacial findings (total score) than patients with normal levels of anti-S cerevisiae antibody A (P = 0.0311). Long-term follow-up of pediatric-onset patients with OFG shows good prognosis. Patients with OFG do not seem to have otorhinolaryngological comorbidity. Anti-S cerevisiae antibody A may serve as a factor to indicate the possible presence of underlying CD in patients with OFG, but further studies are requested.

  14. [Intracranial stenosis. Study and follow-up of 38 patients].

    PubMed

    Palomeras Soler, E; Fossas Felip, P; Cano Orgaz, A; Sanz Cartagena, P

    2004-06-01

    To describe vascular risk factors of patients harboring intracranial arterial stenosis (IAS) as well their final outcome. We reviewed clinical reports of all patients admitted to our Institution from April 1, 1999 to November 30, 2001 with the diagnosis of IAS. Diagnosis was made by means of magnetic resonance angiography (MRA) or four-vessels digital subtraction angiography. Thirty-eight patients harboring 56 IAS were identified. Mean follow-up was 18 months. Two control groups were selected: one was a group of 44 patients with stroke and embolic cardiopathy (EC) and the other was a group of 67 patients with stroke and extracranial stenosis without IAS. Mean age was 69.7 years, with male preponderance (76.3 %). Seventeen cases (44.7 %) had associated extracranial carotid stenosis greater than 50 %. Multiple IAS were found in 12 patients. Diabetes mellitus was significantly more frequent in the IAS group than in both control groups. On the other hand, cigarette smoking was more common in the IAS group with respect to the EC group. IAS was symptomatic in 25 cases, whereas in 13 patients IAS was found in the work-up for cerebral ischemia in another territory. From the group of symptomatic patients, 22 (88 %) had a Rankin scale 2 or lower on discharge and, in the long term follow-up, their incidence rate of recurrent ischemic stroke was 15 per 100 patients/year. Diabetes mellitus was the most specific risk factor for IAS. IAS was multiple in 32% of patients and in extracranial stenosis from moderate to severe degree was found in 44.7% of the cases. Stroke secondary to IAS caused a low dependency level at discharge. Incidence rate of recurrent ischemic stroke was 15 % patients/ year.

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

    NASA Technical Reports Server (NTRS)

    Wu, Jingwen; Tsai, Chao-Wei; Sayers, Jack; Benford, Dominic; Bridge, Carrie; Blain, Andrew; Eisenhardt, Peter R.; Stern, Daniel; Petty, Sara; Assef, Roberto; hide

    2012-01-01

    We have used the Caltech Submillimeter Observatory (CSO) to follow-up a sample of Wide-field Infrared Survey Explorer (WISE) selected, hyperluminous galaxies, the so-called W1W2-dropout galaxies. This is a rare (approx.1000 all-sky) population of galaxies at high redshift (peaks at z = 2-3), which are faint or undetected by WISE at 3.4 and 4.6 microns, yet are clearly detected at 12 and 22 microns. The optical spectra of most of these galaxies show significant active galactic nucleus activity. We observed 14 high-redshift (z > 1.7) W1W2-dropout galaxies with SHARC-II at 350-850 microns, with nine detections, and observed 18 with Bolocam at 1.1 mm, with five detections. Warm Spitzer follow-up of 25 targets at 3.6 and 4.5 microns, as well as optical spectra of 12 targets, are also presented in the paper. Combining WISE data with observations from warm Spitzer and CSO, we constructed their mid-IR to millimeter spectral energy distributions (SEDs). These SEDs have a consistent shape, showing significantly higher mid-IR to submillimeter ratios than other galaxy templates, suggesting a hotter dust temperature.We estimate their dust temperatures to be 60 C120 K using a single-temperature model. Their infrared luminosities are well over 10(exp 13) Stellar Luminosity. These SEDs are not well fitted with existing galaxy templates, suggesting they are a new population with very high luminosity and hot dust. They are likely among the most luminous galaxies in the universe.We argue that they are extreme cases of luminous, hot dust-obscured galaxies (DOGs), possibly representing a short evolutionary phase during galaxy merging and evolution. A better understanding of their long-wavelength properties needs ALMA as well as Herschel data.

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

    NASA Technical Reports Server (NTRS)

    Wu, Jingwen; Tsai, Chao-Wei; Sayers, Jack; Benford, Dominic; Bridge, Carrie; Blain, Andrew; Eisenhardt, Peter R. M.; Stern, Daniel; Petty, Sara; Assef, Roberto; hide

    2013-01-01

    We have used the Caltech Submillimeter Observatory (CSO) to follow-up a sample of Wide-field Infrared Survey Explorer (WISE) selected, hyperluminous galaxies, the so-called W1W2-dropout galaxies. This is a rare (approximately 1000 all-sky) population of galaxies at high redshift (peaks at zeta = 2-3), which are faint or undetected by WISE at 3.4 and 4.6 micrometers, yet are clearly detected at 12 and 22 micrometers. The optical spectra of most of these galaxies show significant active galactic nucleus activity. We observed 14 high-redshift (zeta greater than 1.7) W1W2-dropout galaxies with SHARC-II at 350-850 micrometers, with nine detections, and observed 18 with Bolocam at 1.1 mm, with five detections. Warm Spitzer follow-up of 25 targets at 3.6 and 4.5 micrometers, as well as optical spectra of 12 targets, are also presented in the paper. Combining WISE data with observations from warm Spitzer and CSO, we constructed their mid-IR to millimeter spectral energy distributions (SEDs). These SEDs have a consistent shape, showing significantly higher mid-IR to submillimeter ratios than other galaxy templates, suggesting a hotter dust temperature.We estimate their dust temperatures to be 60-120 K using a single-temperature model. Their infrared luminosities are well over 10(exp 13) solar luminosity. These SEDs are not well fitted with existing galaxy templates, suggesting they are a new population with very high luminosity and hot dust. They are likely among the most luminous galaxies in the universe.We argue that they are extreme cases of luminous, hot dust-obscured galaxies (DOGs), possibly representing a short evolutionary phase during galaxy merging and evolution. A better understanding of their long-wavelength properties needs ALMA as well as Herschel data.

  17. [Reversible cerebral vasoconstriction syndrome with cortical subarachnoid hemorrhage presenting as thunderclap headache-a long followed up case].

    PubMed

    Ogura, Aya; Suzuki, Junichiro; Imai, Kazunori; Nishida, Suguru; Kato, Takashi; Yasuda, Takeshi; Ito, Yasuhiro

    2013-01-01

    A 59-year-old woman presented with thunderclap headache. Cranial CT showed cortical subarachnoid hemorrhage (cSAH) at the right parietal lobe and cerebral angiography on day 5 revealed multiple cerebral arterial constriction, diagnosed as reversible cerebral vasoconstriction syndrome (RCVS). We could not detect vasoconstriction in MRA at the first examination on day 4, and vasoconstrictive finding appeared around Willis circle 8 days later. There was a temporal difference in a cephalalgic symptom and vasoconstrictive appearance. Clinical symptoms completely recovered and head CT, MRI/MRA findings were reversible after two months, reflecting a rather good RCVS outcome. However, we also followed up this case precisely using single photon emission computed tomography (SPECT) with easy Z-score imaging system (e-ZIS), and hypoperfusion at the locus of cSAH persisted for more than one year. This finding strongly suggests that tissue damage in the cSAH locus induced by RCVS may be subclinicaly irreversible, even though clinical symptoms and abnormalities in cranial MRI and MRA completely recover.SPECT may be a high sensitive technique to detect the irreversible lesion in RCVS.

  18. Ventilation/Perfusion SPECT for diagnostics of pulmonary embolism in clinical practice.

    PubMed

    Bajc, M; Olsson, B; Palmer, J; Jonson, B

    2008-10-01

    The aim of this retrospective study is to illustrate clinical utility and impact of pulmonary embolism (PE) diagnostics of up to date Ventilation/Perfusion SPECT (V/P (SPECT)) applying holistic interpretation criteria. During a 2-year period 2328 consecutive patients referred to V/P(SPECT) for clinically suspected PE were examined. Final diagnosis was established by physicians clinically responsible for patient care. To establish the performance of V/P(SPECT) negative for PE, patients were followed up by medical records for 6 months. Ventilation/Perfusion SPECT was feasible in 99% of the patients. Data for follow-up were available in 1785 patients (77%). PE was reported in 607 patients (34%). Normal pattern was described in 420 patients (25%). Pathology other than PE such as a pneumonia, left heart failure, obstructive lung disease, tumour was described in 724 patients (41%). Report was nondiagnostic in 19 patients (1%). Six cases were classified as falsely negative because PE was diagnosed at follow-up and was fatal in one case. Six cases were classified as falsely positive because the clinician decided not to treat. In 608 patients with final PE diagnosis, 601 patients had positive V/P(SPECT) (99%). In 1177 patients without final PE diagnosis 1153 patients had negative V/P(SPECT) (98%). Holistic interpretation of V/P(SPECT,) yields high negative and positive predictive values and only 1% of nondiagnostic findings and was feasible in 99% of patients. It is a responsibility and a challenge of nuclear medicine to provide optimal care of patients with suspected PE by making V/P(SPECT) available.

  19. "Alice in wonderland" syndrome: presenting and follow-up characteristics.

    PubMed

    Liu, Alessandra M; Liu, Jonathan G; Liu, Geraldine W; Liu, Grant T

    2014-09-01

    We investigated the distribution of symptoms and etiologies of patients with "Alice in Wonderland" syndrome (visual perception of change in one's body size) and "Alice in Wonderland"-like syndrome (extrapersonal illusions) at presentation and to determine their prognosis. Retrospective chart review and telephone interview. Charts of children diagnosed with "Alice in Wonderland" syndrome by a pediatric neuro-ophthalmologist between July 1993 and July 2013 were reviewed. Patients seen before 2012, or their parents, were contacted for follow-up information. A total of 48 patients (average age 8.1 years) diagnosed with "Alice in Wonderland" syndrome or "Alice in Wonderland"-like syndrome were identified. Common visual symptoms were micropsia (69%), teleopsia (50%), macropsia (25%), metamorphopsia (15%), and pelopsia (10%). Magnetic resonance imaging and electroencephalography were unrevealing in 21 of 21 and 23 of 23 cases, respectively. The etiology was infection in 33% of patients and migraine and head trauma in 6% each. No associated conditions were found in 52%. Of the 15 patients with follow-up, 20% had a few more events of "Alice in Wonderland" syndrome or "Alice in Wonderland"-like syndrome, which eventually stopped after the initial diagnosis; 40% had no more events, and 40% were still having "Alice in Wonderland" syndrome or "Alice in Wonderland"-like syndrome symptoms at the time of the interview, while four patients (27%) developed migraines and one patient (7%) seizures since the diagnosis. "Alice in Wonderland" syndrome and "Alice in Wonderland"-like syndrome typically affect young children, and the most common visual complaints are micropsia and teleopsia. The most common associated condition is infection, but half of these individuals have no obvious trigger. Magnetic resonance imaging and electroencephalography are not helpful. The symptoms of "Alice in Wonderland" syndrome and "Alice in Wonderland"-like syndrome usually resolve, but in more than one

  20. [Variables that influence the indication of a second myocardial perfusion gated-SPECT after a normal stress-rest gated SPECT].

    PubMed

    Romero-Farina, G; Candell-Riera, J; Aguadé-Bruix, S; Cuberas-Borrós, G; Pizzi, M N; Santos, A; de León, G; García-Dorado, D

    2014-01-01

    The objective of this study was to investigate predictor variables at the moment of normal stress-rest myocardial perfusion gated SPECT for indication of a second gated SPECT. A prospective, single center cohort study was conducted. We evaluated 2326 consecutive patients (age 63.6 ± 13 years, 57.3% females) without perfusion defects and with normal left ventricular ejection fraction on a myocardial perfusion gated SPECT. Clinical and stress test variables were studied to predict indication of a second gated SPECT and presence of reversible perfusion defects in the second gated SPECT. During a mean follow-up of 3.6 ± 2 years a second gated SPECT was performed in 286 patients (12.3%). Independent predictor variables of a second gated SPECT were presence of three or more cardiovascular risk factors (χ(2): 5.510; HR: 1.4; p=0.019), previous acute myocardial infarction (χ(2): 3.867; HR: 1.4; p=0.049), previous coronary revascularization (χ(2): 41.081; HR: 2.5; p<0.001), and a positive stress test (χ(2): 8.713; HR: 1.5; p=0.003). Observation of perfusion defects in the 280 patients in whom a second stress-rest gated SPECT was performed was more likely in male patients (χ(2): 4.322; HR: 1.9; p=0.038) who had a first pure pharmacological gated-SPECT (χ(2): 7.182; HR: 2.6; p=0.007). In patients with a first normal myocardial perfusion gated SPECT, various clinical factors and variables derived from the stress test affect the indication of a second gated SPECT and the presence of ischemia in the latter. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  1. Abdominal SPECT imaging

    SciTech Connect

    Van Heertum, R.L.; Brunetti, J.C.; Yudd, A.P.

    1987-07-01

    Over the past several years, abdominal single photon emission computed tomography (SPECT) imaging has evolved from a research tool to an important clinical imaging modality that is helpful in the diagnostic assessment of a wide variety of disorders involving the abdominal viscera. Although liver-spleen imaging is the most popular of the abdominal SPECT procedures, blood pool imaging is becoming much more widely utilized for the evaluation of cavernous hemangiomas of the liver as well as other vascular abnormalities in the abdomen. Adjunctive indium leukocyte and gallium SPECT studies are also proving to be of value in the assessment of a variety of infectious and neoplastic diseases. As more experience is acquired in this area, SPECT should become the primary imaging modality for both gallium and indium white blood cells in many institutions. Renal SPECT, on the other hand, has only recently been used as a clinical imaging modality for the assessment of such parameters as renal depth and volume. The exact role of renal SPECT as a clinical tool is, therefore, yet to be determined. 79 references.

  2. Seven years follow-up after ankle inversion trauma.

    PubMed

    Konradsen, L; Bech, L; Ehrenbjerg, M; Nickelsen, T

    2002-06-01

    During one year all ankle inversion injuries seen at the acute ward of our institution were divided into grades of severity and classified according to the maximal area of tenderness at the time of clinical examination. Seven years later 648 of the subjects (91%) evaluated their ankle with the help of a questionnaire. Location of maximal tenderness at the time of injury was: lateral fibular ligaments 61%, lateral midfoot ligaments 24%, base of the fifth metatarsal/peroneal tendons 5% and combined lesions 8%. 39% were considered minor, 46% were moderate, and 15% severe. All cases followed a functional treatment protocol. Seven years post- injury 32% reported chronic complaints of pain, swelling or recurrent sprains. 72% of the subjects with residual disability reported that they were functionally impaired by their ankle - in most cases a question of not performing sports at a desired level. 4% experienced pain at rest and were severely disabled. 19% were bothered by repeated inversion injuries - 43% of these subjects felt that they could compensate by using an external ankle support. There was no correlation between the severity of the sprain as judged at the time of injury and the frequency of residual disability or between the area of maximal tenderness at the time of injury and the area of maximal pain at the time of follow-up.

  3. Integrated GW-EM Follow-up Analysis

    NASA Astrophysics Data System (ADS)

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

    2015-04-01

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

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

    PubMed

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

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

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

    PubMed

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

    2014-04-01

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

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

    NASA Astrophysics Data System (ADS)

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

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

  7. Videoconferencing for a veteran's pain management follow-up clinic.

    PubMed

    Elliott, Janette; Chapman, Judith; Clark, David J

    2007-03-01

    The under treatment of pain has been well documented. Contributing to this is the limited availability of pain management specialists in many geographic areas. The use of technology to provide care to underserved areas is gaining momentum. We chose to study whether stable patients and staff in chronic pain clinic were satified with the use of a videoconferencing format in care delivery. Our goals were to determine whether patients and staff could successfully operate the extant videoconferencing equipment, was the equipment dependably functional, was the use of a videoconferencing format an acceptable method of healthcare delivery for both patients and staff, whether patients and staff were satisfied with the process, and whether this was a cost-effective mode of care delivery. Thirty-six patients were enrolled over 29 months. Questionnaires were administered to staff and patients. Routine pain clinic patient assessment tools were administered. Results showed the use of videoconferencing for this group of patients is useable and satisfactory for both patients and staff, that the patients save time and money, and that for a system where videoconferencing equipment is already in use, it is also cost effective. Staff were able to identify new patient problems. Some patients would prefer to be seen in person but find that the savings in time and money override this preference. Hearing impaired patients have difficulty using this medium. Dependable equipment and phone connections are needed. A videoconferencing clinic format is a clinically acceptable and cost effective method for follow-up of stable patients with chronic pain.

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

    PubMed

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

    2003-01-01

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

  9. Twenty to 40 year follow up of infantile hiatal hernia.

    PubMed Central

    Johnston, B T; Carré, I J; Thomas, P S; Collins, B J

    1995-01-01

    The aim of this study was to assess clinical and radiological findings of gastro-oesophageal reflux in adults who were diagnosed as having a hiatal hernia in infancy or early childhood. One hundred and eighteen patients with a minimum age of 20 who were diagnosed as having a hiatal hernia in childhood were interviewed; barium meal examination was performed in 96 of these cases. Ninety four patients had not required surgery for their hernia. The hiatal hernia persisted in 53% of these patients and 46% experienced heartburn at least monthly but in only three was this severe. Heartburn was significantly more common in patients in whom reflux was seen on barium meal. The consumption of antacids was significantly lower (20% v 46%) in patients who responded well to treatment as children. Eighteen of 24 patients who underwent surgery as children experienced heart-burn monthly but in only one patient was this severe. Two patients underwent endoscopy at their request because of symptoms during this follow up. Both had Barrett's oesophagus. In conclusion, despite the persistence of the hiatal hernia in half of the non-surgically treated patients, few complained of significant symptoms. Effective treatment in childhood was associated with a significant reduction in antacid consumption for heartburn as adults. The finding of Barrett's oesophagus in two patients high-lights a possible role for endoscopic screening in this patient group. Images p810-a PMID:7615264

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

    PubMed Central

    Şentürk, Mehmet Baki; Güraslan, Hakan; Çakmak, Yusuf; Ekin, Murat

    2015-01-01

    Objective The aim of this study was to evaluate the results of bilateral sacrospinous fixation (SSF), which was performed with surgical mesh interposition and bilateral vaginal repair. Material and Methods Twenty-two patients underwent SSF between 2010 and 2012, and the results were evaluated retrospectively. The results at preoperative and postoperative 6th, 12th, and 18th months of the pelvic organ prolapse quantification system (POP-Q) and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 (PISQ-12) were compared using Friedman and Wilcoxon Signed Ranks tests. Values of p<0.05 and <0.01 were considered statistically significant. Results According to the POP-Q, significant healing was observed on all vaginal vault points (p=0.001), and no prolapse was observed until the 18-month follow-up stage. There were also prominent patients who felt satisfactory with respect to their sexual life according to PISQ-12 (p=0.001). Conclusion This technique appears to provide an adequate clinical resolution, and it may be the primary surgical option for women with pelvic organ prolapse. PMID:26097393

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

    PubMed

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

    2016-01-01

    Skeletal survey is frequently used to identify occult fractures in young children with concern for physical abuse. Because skeletal survey is relatively insensitive for some abusive fractures, a follow-up skeletal survey (FUSS) may be undertaken at least 10-14 days after the initial skeletal survey to improve sensitivity for healing fractures. This was a prospectively planned secondary analysis of a prospective, observational study of 2,890 children who underwent subspecialty evaluation for suspected child physical abuse at 1 of 19 centers. Our objective was to determine variability between sites in rates of FUSS recommendation, completion and fracture identification among the 2,049 participants who had an initial SS. Among children with an initial skeletal survey, the rate of FUSS recommendation for sites ranged from 20% to 97%; the rate of FUSS completion ranged from 10% to 100%. Among sites completing at least 10 FUSS, rates of new fracture identification ranged from 8% to 28%. Among completed FUSS, new fractures were more likely to be identified in younger children, children with higher initial level of concern for abuse, and those with a fracture or cutaneous injury identified in the initial evaluation. The current variability in FUSS utilization is not explained by variability in occult fracture prevalence. Specific guidelines for FUSS utilization are needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    PubMed

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

    2010-01-01

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

  13. Six year follow up of forty five pregnant opiate addicts.

    PubMed

    Keenan, E; Dorman, A; O'Connor, J

    1993-07-01

    Forty five pregnant addicts had attended the National Drug Treatment Centre between 1984-1986. At that time they received intensive counselling, low dose Methadone maintenance and both ante natal and post natal care. Our aim was to follow these women six years later focusing on their drug use and outcome of their children. The women were followed up by chart review, individual interviews and liaison with the social and probation services. Results indicate that a high proportion of the women abused chaotically (50%). There is a worrying high incidence of HIV positive patients (53.4%) and a mortality figure of 15.5% (7). However only 13 women (28.6%) have had further children and 22 women (49%) are currently using some form of contraception. Only 23 women (51.1%) have had further contact with probation services. Five children (11.3%) are under formal care order and 4 children have become HIV positive in their own right. In conclusion, while these women have benefitted in certain areas e.g. family planning, contact with probation services, in other areas they have remained chaotic e.g. continued drug abuse or HIV risk taking behaviour. Thus the authors believe that future programmes should concentrate more directly on detoxification and rehabilitation after pregnancy. We also believe that because of the chaotic nature of these women some review of an "at risk" register for the children should be carried out.

  14. [Surgery for phimosis with Plastibell. A follow-up study].

    PubMed

    Jensen, M K

    1998-06-22

    Fifty-three boys were interviewed 11 years (9-14 years) after an operation for phimosis using the Plastibell technique. The interview concentrated on the cosmetic result, sexual function and late complications. Seventeen patients (31%) experienced cosmetic complications, and 11 patients (21%) claimed to have experienced psycho-social problems due to the appearance of the penis after the operation. Nonetheless an overall of 44 patients (83%) were fully satisfied/satisfied with the cosmetic result. Four patients (8%) claimed to have pain or discomfort on erection or intercourse. One patient (2%) was re-operated three years after the primary operation because of a recurrence of the symptoms. Overall 48 patients (91%) were fully satisfied or satisfied with the result after the operation. In conclusion we find the Plastibell procedure to be a safe and reliable method in treating phimosis. There are some minor technical pitfalls that have to be addressed in learning the technique, but performed in trained hands, the technique offers a very high satisfaction rate at long term follow-up.

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

    PubMed

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

    2008-09-01

    To review the most recent data on preoperative diagnostic methods in kidney cancer and in follow-up and monitoring after ablation therapy. Although the role of the percutaneous biopsy in the diagnostics of renal masses has been limited, new data suggest a high accuracy of the percutaneous core biopsy in the diagnostics of malignancy and a fair to perfect interobserver and intraobserver variability. Accuracy in determining the subtype is also high but lower for Fuhrman grade determination. Data on fine needle aspiration remain controversial. Refinements in cross-sectional imaging might have a value in differentiation of low-fat content angiomyolipoma from renal cell carcinoma. Contrast cross-sectional imaging remains the reference standard in the assessment of ablation results. Contrast-enhanced ultrasound shows promising results in this field but further confirmation is needed. Although few changes are evident in the diagnostic imaging of kidney tumors, percutaneous core biopsy has gained attention and in the light of the current results might play an extended role in the preoperative workup of renal masses. New techniques should be investigated for monitoring after ablation therapies in order to reduce toxicity and costs.

  16. Follow up study of workers manufacturing chrysotile asbestos cement products.

    PubMed Central

    Gardner, M J; Winter, P D; Pannett, B; Powell, C A

    1986-01-01

    A cohort study has been carried out of 2167 subjects employed between 1941 and 1983 at an asbestos cement factory in England. The production process incorporated the use of chrysotile asbestos fibre only, except for a small amount of amosite during four months in 1976. Measured airborne fibre concentrations available since 1970 from personal samplers showed mean levels below 1 fibre/ml, although higher levels had probably occurred previously in certain areas of the factory. No excess of lung cancer was observed in the mortality follow up by comparison with either national or local death rates, and analyses of subgroups of the workforce by job, exposure level, duration of employment, duration since entry, or calendar years of employment gave no real suggestion of an asbestos related excess for this cause of death. There was one death from pleural mesothelioma and one with asbestosis mentioned as an associated cause on the death certificate, but neither is thought to be linked to asbestos exposure at this factory. Other suggested asbestos related cancers, such as laryngeal and gastrointestinal, did not show raised risks. Although the durations of exposure were short in this study, the findings are consistent with two other studies of workers exposed to low concentrations of chrysotile fibre in the manufacture of asbestos cement products which reported no excess mortality. PMID:3024695

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

    SciTech Connect

    Forni, A.

    1996-12-01

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

  18. [Work-related asthma--diagnostics and follow-up].

    PubMed

    Aasen, Tor Olav Brøvig; Kongerud, Johny

    2014-10-28

    Approximately 10-15% of all cases of asthma occurring in adults can be ascribed to exposure at work. Work-related asthma (WRA) includes cases that represent an exacerbation of pre-existing asthma as well as occupational asthma where exposure at work is the cause of the disease. Somewhat more than 350 different sources of exposure are known to be causes of allergic WRA. The purpose of this article is to present an updated review of diagnostics and follow-up of WRA. In addition to our own searches in PubMed and comprehensive clinical experience with this patient group, the article is based on a number of literature reviews undertaken internationally. Early diagnosis requires attention to occupational asthma and rapid initiation of diagnostics, in which primary doctors play a key role. Further examination requires resources that are available only in departments with special competence in this field. Awareness of the condition and an early and correct diagnosis that leads to cessation of exposure have been shown to improve the patients' prognosis. All doctors who have responsibility for asthma patients need to be aware of this condition and provide adequate diagnostics, so that interventions to halt the exposure can be undertaken. Cooperation between GPs, employers, enterprise health services and specialists are required to achieve this.

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

    NASA Technical Reports Server (NTRS)

    Spahr, Timothy; Johnson, Lindley (Technical Monitor)

    2005-01-01

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

  20. Strategies to photometric follow-up transiting exoplanets

    NASA Astrophysics Data System (ADS)

    Mancini, L.

    2014-03-01

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

  1. Broadband Electromagnetic Follow-up of Advanced LIGO Sources

    NASA Astrophysics Data System (ADS)

    Pound Singer, Leo

    2016-04-01

    Advanced LIGO began observing in September 2015 with over 3 times the distance reach (27 times the sensitive volume) of its previous configuration. Some gravitational-wave sources, particularly neutron star binary mergers, are expected to produce broadband electromagnetic transients which may be crucial to understanding the astrophysical context of these events. We have assembled a consortium of over 60 ground- and space-based gamma-ray, x-ray, optical, infrared, and radio facilities collaborating to search for broadband electromagnetic counterparts of gravitational-wave sources. In this talk, we describe the LIGO/Virgo EM follow-up program and the astronomical facilities that participated during this first LIGO observing run. Then, we survey the multi-wavelength observing campaigns embarked upon for specific gravitational-wave events. Finally, we discuss lessons learned and the way forward for joint GW-EM observations in an era of increasingly sensitive GW detectors.Submitted with The LIGO Scientific Collaboration and The Virgo Collaboration.

  2. Diagnosis, Treatment, and Follow-Up of Borderline Ovarian Tumors

    PubMed Central

    Zikan, Michal; Dundr, Pavel; Cibula, David

    2012-01-01

    Borderline ovarian tumors represent a heterogeneous group of noninvasive tumors of uncertain malignant potential with characteristic histology. They occur in younger women, are present at an early stage, and have a favorable prognosis, but symptomatic recurrence and death may be found as long as 20 years after therapy in some patients. The molecular changes in borderline ovarian tumors indicate linkage of this disease to type I ovarian tumors (low-grade ovarian carcinomas). The pathological stage of disease and subclassification of extraovarian disease into invasive and noninvasive implants, together with the presence of postoperative macroscopic residual disease, appear to be the major predictor of recurrence and survival. However, it should be emphasized that the most important negative prognostic factor for recurrence is just the use of conservative surgery, but without any impact on patient survival because most recurrent diseases are of the borderline type—easily curable and with an excellent prognosis. Borderline tumors are difficult masses to correctly preoperatively diagnose using imaging methods because their macroscopic features may overlap with invasive and benign ovarian tumors. Over the past several decades, surgical therapy has shifted from a radical approach to more conservative treatment; however, oncologic safety must always be balanced. Follow-up is essential using routine ultrasound imaging, with special attention paid to the remaining ovary in conservatively treated patients. Current literature on this topic leads to a number of controversies that will be discussed thoroughly in this article, with the aim to provide recommendations for the clinical management of these patients. PMID:23024155

  3. Myxedema madness complicating postoperative follow-up of thyroid cancer.

    PubMed

    Morosán Allo, Yanina J; Rosmarin, Melanie; Urrutia, Agustina; Faingold, Maria Cristina; Musso, Carla; Brenta, Gabriela

    2015-08-01

    Although hypothyroidism is associated with an increased prevalence of psychiatric manifestations, myxedema madness is rarely observed. We report the case of a 62-year-old woman with no prior history of psychiatric disorders, who presented to the emergency department with psychomotor agitation 6 weeks after total thyroidectomy for papillary thyroid cancer. Serum thyroid stimulating hormone (TSH) on admission was 62.9 mIU/L and free T4 was < 0.35 ng/dL, indicating severe hypothyroidism. After ruling out other possible causes, the diagnosis of myxedema madness was considered; hence, antipsychotic drug treatment and intravenous levothyroxine were prescribed. Behavioral symptoms returned to normal within 4 days of presentation, while levels of thyroid hormones attained normal values 1 week after admission. Recombinant TSH (Thyrogen®) was used successfully to prevent new episodes of mania due to thyroid hormone withdrawal in further controls for her thyroid cancer. This case illustrates that myxedema madness can occur in the setting of acute hypothyroidism, completely reverting with levothyroxine and antipsychotic treatment. Recombinant TSH may be a useful tool to prevent myxedema madness or any severe manifestation of levothyroxine withdrawal for the follow-up of thyroid cancer.

  4. Orthopedics management of acromicric dysplasia: follow up of nine patients.

    PubMed

    Klein, Céline; Le Goff, Carine; Topouchian, Vicken; Odent, Sylvie; Violas, Philippe; Glorion, Christophe; Cormier-Daire, Valérie

    2014-02-01

    Acromicric dysplasia (AD) is an autosomal dominant disorder characterized by short stature, short extremities, stiff joint and skeleton features including brachymetacarpia, cone-shaped epiphyses, internal notch of the femoral head, and delayed bone age. Recently, we identified fibrillin 1 (FBN1) as the disease gene of AD. The aim of our study was to further describe the long-term follow up of AD patients with an emphasis on orthopedic management. Nine patients with FBN1 mutations were included in the study ranging in age from 5.5 to 64 years. For all, detailed clinical and radiological data were available. Birth parameters were always normal and patients progressively developed short stature <-3 SD. Carpal tunnel syndrome was observed in four patients. We found discrepancy between the carpal bone age and the radius and ulna epiphysis bone ages, a variable severity of hip dysplasia with acetabular dysplasia, epiphyseal and metaphyseal femoral dysplasia resembling Legg-Perthes-Calvé disease and variable pelvic anteversion and hyperlordosis. Orthopedic surgery was required in two patients for hip dysplasia, in one for limb lengthening and in three for carpal tunnel syndrome. Our observations expand the AD phenotype and emphasize the importance of regular orthopedic survey. © 2013 Wiley Periodicals, Inc.

  5. Melorheostosis: case report with 20-year follow-up.

    PubMed

    Pavone, Vito; Evola, Roberto Francesco; Di Giorgio, Angelo; Ruggieri, Martino; Ardito, Salvatore

    2008-05-01

    The authors report on a typical case of melorheostosis observed in an 18-year-old man, localized in the II digit of the right hand causing tumefaction and irregular pain. At 20-year follow-up, the patient showed a radiographical slight worsening of the lesion. Radiographic examination showed a mild increase in cortical and endosteal hyperostosis with bone shape alteration in the II digit of the right hand, slight cortical and endosteal hyperostosis at the level of right shoulder girdle involving the humerus. The other part of the skeleton was not affected. Clinical examination revealed swelling and tumefaction of the forefinger of the right hand and reduced articular motion both in proximal and distal interphalangeal joint and metacarpal phalangeal joint. The reminder of the clinical examination was normal. Melorheostosis is an uncommon mesenchymal disorder characterized by a chondral hyperostosis of the long bones associated to a sclerosis of the spongious bone. The etiology of this affection is unknown: the most accredited hypothesis is a developmental anomaly with a sequential sclerotomes distribution. Both genders may be affected, with the long tubular bones of the lower limbs more involved. This anomaly is often asymptomatic but maybe accompanied by pain with a smooth symptom progression and periodic exacerbations. Therapy is mainly symptomatic and comprises anti-inflammatory drugs or surgical approach for removal of soft tissue that may preclude daily activities. This case report demonstrates that melorheostosis is a relatively benign disorder with mildly progressive course.

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

    PubMed

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

    2015-10-01

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

  7. SDSS-III MARVELS Planet Candidate RV Follow-up

    NASA Astrophysics Data System (ADS)

    Ge, Jian; Thomas, Neil; Ma, Bo; Li, Rui; SIthajan, Sirinrat

    2014-02-01

    Planetary systems, discovered by the radial velocity (RV) surveys, reveal strong correlations between the planet frequency and stellar properties, such as metallicity and mass, and a greater diversity in planets than found in the solar system. However, due to the sample sizes of extant surveys (~100 to a few hundreds of stars) and their heterogeneity, many key questions remained to be addressed: Do metal poor stars obey the same trends for planet occurrence as metal rich stars? What is the distribution of giant planets around intermediate- mass stars and binaries? Is the ``planet desert'' within 0.6 AU in the planet orbital distribution of intermediate-mass stars real? The MARVELS survey has produced the largest homogeneous RV measurements of 3300 V=7.6-12 FGK stars. The latest data pipeline effort at UF has been able to remove long term systematic errors suffered in the earlier data pipeline. 18 high confident giant planet candidates have been identified among newly processed data. We propose to follow up these giant planet candidates with the KPNO EXPERT instrument to confirm the detection and also characterize their orbits. The confirmed planets will be used to measure occurrence rates, distributions and multiplicity of giants planets around F,G,K stars with a broad range of mass (~0.6-2.5 M_⊙) and metallicity ([Fe/H]~-1.5-0.5). The well defined MARVELS survey cadence allows robust determinations of completeness limits for rigorously testing giant planet formation theories and constraining models.

  8. Follow-up of MARVELS Brown Dwarf Candidates using EXPERT

    NASA Astrophysics Data System (ADS)

    Ma, Bo; Ge, Jian; Li, Rui; Sithajan, Sirinrat; Thomas, Neil; Wang, Ji; De Lee, Nathan

    2013-02-01

    The SDSS-III MARVELS survey is a comprehensive radial velocity survey of 3,300 nearby F-K stars, between 7.6 < V < 12.0 in 2008-2012. All of the survey data for 2580 FGK stars from the first two and half years have been processed with the latest data pipeline. A total of 26 new brown dwarfs (BD) candidates have been identified in the processed RV data. We expect to have 8 more BD candidates from the ~800 stars currently under processing, which will make a total of 34 BD candidates. This proposal requests KPNO 2.1m telescope time with the EXPERT instrument, to follow up all of these BD candidates to confirm the detections and characterize the orbits. The results will be used to (1) reveal the overall distribution of the new BDs in the parameter space; (2) measure the occurrence rate of BD around FGK type stars; (3) measure dryness of the brown dwarf desert around stars with different mass and metallicity; (4) constrain theoretical models regarding the formation of brown dwarfs; (5) confirm the discovery of `desert in the brown dwarf desert'; (6) identify additional companions associated with the detected systems.

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

    NASA Astrophysics Data System (ADS)

    Mathieu, Aurore

    2015-10-01

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

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

    PubMed Central

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

    1987-01-01

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

  11. [Attitude of primary care doctors to follow-up dyslipidemias].

    PubMed

    Alonso Cerezo, C; Simón Martín, J; Fernández Jiménez, G; Rivera Franco, J

    2004-04-15

    To know the opinion of primary care physicians about the criteria that they use in the request of the laboratories tests of hyperlipidemia and to confirm the above-mentioned opinion with the parameters edited in some guides of clinical practice published on hyperlipidemia. Transverse and descriptive study. Accomplishment of 2 questionnaires, one by internal post and another one through personal or telephonic interview. Comparison of most important guides of clinical practice. Primary care of an area of Madrid. In the survey directed to all the 199 primary care physicians, 116 valid answers were obtained. In the survey directed to all 20 coordinators of the centers of primary care, 16 valid answers were obtained. The frequency, the percentage and the confidence interval. 109 (94%) of the primary care physicians request laboratories tests in the goal to exclude secondary reasons of hyperlipidemia. The LDL-cholesterol is considered to be a suitable test for the follow-up of the hyperlipidemia by 108 (93.0%) primary care physicians. According to the opinion of the coordinators, the year of edition and/or review of the existing guide in the center changes between 1992-2000. As strategy of improvement of the clinical practice it is necessary to realize and support an updated guide of clinical practice, where the suitable tests are defined to look for the etiología of hyperlipidemia, the determinations that must be requested for the initial control of the treatment and with which periodicity they are requested.

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

    PubMed

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

    2012-12-01

    Pelvic inflammatory disease (PID) can be responsible for infertility and chronic pelvic pain. Treatment of acute PID is very important as it can reduce the risk of sequelae. However, follow-up, partner treatment and counselling are also useful to reduce the reinfection rate. Few weeks after PID, clinical evaluation as well as transvaginal and transabdominal sonography must be performed. The interest of systematic bacteriological tests is not proved. Hysterosalpingography and second-look laparoscopy should be considered only for women with infertility and severe infection. Use of condom is advisable in this population in order to prevent sexually transmitted diseases (STD) including HIV and to decrease rate of recurrence, associated to contraceptive pill, which is also a good option. In selected cases, intrauterine devices can be used in patients with history of PID if the infection is resolved and no significant risk factors for STD exist. Infertility and chronic pelvic pain are the most common sequelae in the population of young women with severe and recurrent infection. The risk of ectopic pregnancy is higher for these women and must be kept in mind. Counselling and risk-reduction interventions decreased significatively the rate of recurrence and sequelae in PID. Copyright © 2012. Published by Elsevier Masson SAS.

  13. Clinical follow up of uniparental disomy 16: First data

    SciTech Connect

    Dworniczak, B.; Koppers, B.; Bogdanova, N.

    1994-09-01

    Following the introduction of the concept of uniparental disomy (UPD) in 1980 by Engel this segregational anomaly is reported in an ever increasing number of patients. So far, several groups of individuals with an increased risk for UPD have been identified including abnormal carriers of familial balanced translocations or centric fusions, carriers of mosaic trisomies, and fetuses after prenatal diagnosis of confined placental mosaicism. A major pathogenetic mechanism appears to be post-meiotic chromosome loss in trisomic conceptuses. UPD was repeatedly observed in the fetus after diagnosis of mosaic or non-mosaic trisomies in the placenta which are usually considered {open_quotes}lethal{close_quotes} (i.e. trisomies 15 and 16). In an ongoing study to determine the incidence and clinical consequences of UPD we investigated the parental origin of chromosomes in the disomic cell line after prenatal diagnosis of mosaicism for various trisomies (e.g. 2, 7, 14, 15, and 16). At present, two maternal disomies 16 and one maternal disomy 15 were identified. Severe intrauterine growth retardation was a common symptome which, however, was also present in some but not all mosaics with a biparental origin of the chromosomes in question. While prognosis is clear in some instances (i.e. UPD 15) counseling can be extremely difficult in others, when imprinting effects and homozygosity for unknown recessive traits present in a parent have to be considered. To assess the clinical significance, detailed follow-up studies of proven cases of uniparental disomies are essential. First data of two cases with UPD 16 are presented.

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

    NASA Technical Reports Server (NTRS)

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

    1993-01-01

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

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

    PubMed Central

    Filon, F Larese; Radman, G

    2006-01-01

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

  16. Follow-up practices for high-grade extremity Osteosarcoma.

    PubMed

    Rothermundt, Christian; Seddon, Beatrice M; Dileo, Palma; Strauss, Sandra J; Coleman, Joanne; Briggs, Timothy W; Haile, Sarah R; Whelan, Jeremy S

    2016-05-06

    The optimal conduct of follow-up (FU) of patients with osteosarcoma is uncertain. In the absence of any formal validation of optimal timing and method of surveillance, guidance is provided by oncology societies' recommendations. FU is designed to detect either local recurrence or metastatic disease at a time when early treatment is still possible and might be effective. We performed a retrospective analysis of 101 patients with high-grade extremity osteosarcoma in a single centre. Chest x-ray (CXR) was used as routine surveillance method; however patients with initial lung metastases or previous suspicious findings had computed tomography (CT) scans. With a median FU time of 30.7 months 34 patients relapsed. Relapse-free survival after 5 years was 61% (CI 52%; 73%), late relapses occurred in only two patients between 2 and 5 years of FU. Twenty-five of the 34 relapses were detected at routine FU appointments. All 8 local recurrences were noted clinically. Twenty-two patients had metastases confined to the lungs, either detected on CXR or CT. Thirty-two percent of patients with lung metastases only were salvaged successfully. Routine FU in high-grade osteosarcoma results in clinical detection of local relapse, and detection of lung metastases by CXR at a time when metastatectomy is possible. The optimal time interval for FU appointments is not known, however we recommend more frequent surveillance visits during the two years after treatment. We hypothesize that routine CT scans are not required and propose CXR for detection of lung metastases.

  17. 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).

  18. Six year follow-up of cryopreserved human embryos.

    PubMed

    Lornage, J; Chorier, H; Boulieu, D; Mathieu, C; Czyba, J C

    1995-10-01

    In 1987, we became aware of the importance of remaining in contact with couples whose embryos had been cryopreserved for > 1 year. As a result, a questionnaire was designed to follow the fate of these embryos. Of 407 couples with cryopreserved embryos, 262 couples opted to use them within 1 year with the intention of fulfilling a parental plan. The remaining 145 couples were questioned by six successive questionnaires sent out between 1987 and 1992. By the end of the study, 336 of the 407 couples (82.5%) had chosen to utilize their embryos in a parental plan. In most cases, the maximum delay of response (5 years according to the Council of State) was respected. The remaining 71 couples (17.5%) either abandoned the parental plan or had not given any information by the end of the study. Initially, anonymous donation to another couple was chosen in preference to destroying the surplus embryos (32 versus 18 couples, P < 0.05). Latterly, however, these differences have balanced out (24 versus 28, not significant). Only those couples who initially opted to donate embryos to another couple changed their attitude in later years. In the long run, 62 couples decided not to pursue their parental plan; of these, 24 couples chose to make a gift to another couple, 28 couples opted for destruction, and 10 chose to make a gift to research. Nine couples (out of 71) declined to make a decision, but they had all achieved a pregnancy during an in-vitro fertilization (IVF) attempt. Three of these were lost to follow-up, i.e. 0.7% of all couples benefiting from the freezing technique.

  19. Clozapine and anemia: a 2-year follow-up study.

    PubMed

    Lee, Jimmy; Bies, Robert; Bhaloo, Amaal; Powell, Valerie; Remington, Gary

    2015-12-01

    Clozapine's association with agranulocytosis led to the implementation of stringent and mandatory hematologic monitoring guidelines in most countries. Although other hematologic aberrations such as eosinophilia and neutropenia have been previously described, clozapine's impact on the erythroid lineage has not been studied. There is a suspicion that a higher rate of anemia is observed in patients receiving clozapine; therefore, we hypothesized that there would be a higher rate of anemia in patients receiving clozapine therapy. All individuals initiated on clozapine at our center from 2009 to 2010 were recruited. Information on age, gender, medical comorbidities, and smoking status was extracted from the medical records. Data from complete blood counts over a 2-year follow-up period were extracted, with anemia defined as a hemoglobin value below 120 g/L for women and 130 g/L for men. Time to anemia event was calculated and Cox regression was employed to identify predictors of anemia. We found a high incidence of anemia in the first 2 years following clozapine initiation; of the 94 individuals (68 men, 26 women) recruited, 23 (24.5%) developed anemia. Higher baseline hemoglobin level (hazard ratio [HR] = 0.86, P = .002) and smoking status (HR = 0.21, P = .021) were identified as significant protective factors against anemia in men but not in women (HR = 0.92, P = .184, and HR = 0.52, P = .467 for baseline hemoglobin and smoking, respectively). Although smoking appears to lower the risk of anemia, we believe this is due to smoking's up-regulation of hemoglobin levels. Further studies are warranted in light of the present findings; for example, we cannot exclude the possibility that anemia was an epiphenomenon, characterizing instead a population with severe mental illness. © Copyright 2015 Physicians Postgraduate Press, Inc.

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

    PubMed Central

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

    1997-01-01

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

  1. [Diagnosis and follow up of 23 children with organic acidurias].

    PubMed

    Cornejo, Verónica; Colombo, Marta; Durán, Gloria; Mabe, Paulina; Jiménez, Mónica; De la Parra, Alicia; Valiente, Alf; Raimann, Erna

    2002-03-01

    Propionic aciduria (PA) and Methymalonic aciduria (MMA) result from an inherited abnormality of the enzymes propionyl CoA carboxylase and methylmalonyl CoA mutase respectively. This produces marked increases in the amino acids methionine, threonine, valine and isoleucine (MTVI). Their clinical presentation can be neonatal or late onset forms. To report 23 children with organic acidurias. Twenty three cases of organic acidurias diagnosed since 1980 (17 PA and 6 MMA) and followed at the Institute of Nutrition and Food Technology, are reported. The average age of diagnosis was 3.9 days for the neonatal form and 8.3 months for the late onset form. The most frequent symptoms were hypotonia, lethargy and vomiting. Neonatal PA had mean ammonemias of 1089 +/- 678.3 micrograms/dl. The figure for MMA was 933 +/- 801.9 micrograms/dl. Seven children were dialyzed and 30% died. 16 children are followed and 81.2% have normal weight for age. Seven children required gastrostomy because of anorexia and failure to thrive. The nutritional treatment is based on natural and artificial proteins without MTVI, with periodical controls, amino acid and ammonia quantification. Some patients were submitted to enzyme assays and molecular studies. An early diagnosis and a very strict follow up allows a normal development of children with organic acidurias. There is a relationship between prognosis and the presentation form, the nutritional status and the emergency treatment during acute episodes. The importance of the enzymatic and molecular studies is emphasized because they facilitate treatment, accurate diagnosis and allow an adequate genetic counseling.

  2. Six month-follow up of laparoscopic sleeve gastrectomy

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    1999-01-01

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

  4. Kepler Data Validation and Follow-up Programs

    NASA Technical Reports Server (NTRS)

    William, Borucki J.

    2009-01-01

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

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

    PubMed

    Bradway, K; Detloff, W

    1996-10-01

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

  6. Kepler Data Validation and Follow-up Programs

    NASA Technical Reports Server (NTRS)

    William, Borucki J.

    2009-01-01

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

  7. 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.

  8. The utility of cerebral blood flow imaging in patients with the unique syndrome of progressive dementia with motor neuron disease

    SciTech Connect

    Ohnishi, T.; Hoshi, H.; Jinnouchi, S.; Nagamachi, S.; Watanabe, K.; Mituyama, Y. )

    1990-05-01

    Two patients presenting with progressive dementia coupled with motor neuron disease underwent brain SPECT using N-isopropyl-p iodine-123-iodoamphetamine (({sup 123}I)IMP). The characteristic clinical features of progressive dementia and motor neuron disease were noted. IMP SPECT also revealed reduced uptake in the bilateral frontal and temporal regions, with no reduction of uptake in the parietal, parietal-occipital regions. We conclude that IMP SPECT has potential for the evaluation of progressive dementia with motor neuron disease.

  9. Quantitative myocardial perfusion SPECT.

    PubMed

    Tsui, B M; Frey, E C; LaCroix, K J; Lalush, D S; McCartney, W H; King, M A; Gullberg, G T

    1998-01-01

    In recent years, there has been much interest in the clinical application of attenuation compensation to myocardial perfusion single photon emission computed tomography (SPECT) with the promise that accurate quantitative images can be obtained to improve clinical diagnoses. The different attenuation compensation methods that are available create confusion and some misconceptions. Also, attenuation-compensated images reveal other image-degrading effects including collimator-detector blurring and scatter that are not apparent in uncompensated images. This article presents basic concepts of the major factors that degrade the quality and quantitative accuracy of myocardial perfusion SPECT images, and includes a discussion of the various image reconstruction and compensation methods and misconceptions and pitfalls in implementation. The differences between the various compensation methods and their performance are demonstrated. Particular emphasis is directed to an approach that promises to provide quantitative myocardial perfusion SPECT images by accurately compensating for the 3-dimensional (3-D) attenuation, collimator-detector response, and scatter effects. With advances in the computer hardware and optimized implementation techniques, quantitatively accurate and high-quality myocardial perfusion SPECT images can be obtained in clinically acceptable processing time. Examples from simulation, phantom, and patient studies are used to demonstrate the various aspects of the investigation. We conclude that quantitative myocardial perfusion SPECT, which holds great promise to improve clinical diagnosis, is an achievable goal in the near future.

  10. 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.

  11. Five-year follow-up after clinical islet transplantation.

    PubMed

    Ryan, Edmond A; Paty, Breay W; Senior, Peter A; Bigam, David; Alfadhli, Eman; Kneteman, Norman M; Lakey, Jonathan R T; Shapiro, A M James

    2005-07-01

    Islet transplantation can restore endogenous beta-cell function to subjects with type 1 diabetes. Sixty-five patients received an islet transplant in Edmonton as of 1 November 2004. Their mean age was 42.9 +/- 1.2 years, their mean duration of diabetes was 27.1 +/- 1.3 years, and 57% were women. The main indication was problematic hypoglycemia. Forty-four patients completed the islet transplant as defined by insulin independence, and three further patients received >16,000 islet equivalents (IE)/kg but remained on insulin and are deemed complete. Those who became insulin independent received a total of 799,912 +/- 30,220 IE (11,910 +/- 469 IE/kg). Five subjects became insulin independent after one transplant. Fifty-two patients had two transplants, and 11 subjects had three transplants. In the completed patients, 5-year follow-up reveals that the majority ( approximately 80%) have C-peptide present post-islet transplant, but only a minority ( approximately 10%) maintain insulin independence. The median duration of insulin independence was 15 months (interquartile range 6.2-25.5). The HbA(1c) (A1C) level was well controlled in those off insulin (6.4% [6.1-6.7]) and in those back on insulin but C-peptide positive (6.7% [5.9-7.5]) and higher in those who lost all graft function (9.0% [6.7-9.3]) (P < 0.05). Those who resumed insulin therapy did not appear more insulin resistant compared with those off insulin and required half their pretransplant daily dose of insulin but had a lower increment of C-peptide to a standard meal challenge (0.44 +/- 0.06 vs. 0.76 +/- 0.06 nmol/l, P < 0.001). The Hypoglycemic score and lability index both improved significantly posttransplant. In the 128 procedures performed, bleeding occurred in 15 and branch portal vein thrombosis in 5 subjects. Complications of immunosuppressive therapy included mouth ulcers, diarrhea, anemia, and ovarian cysts. Of the 47 completed patients, 4 required retinal laser photocoagulation or vitrectomy and 5

  12. Can hybrid SPECT-CT overcome the limitations associated with poor imaging properties of 131I-MIBG?: Comparison with planar scintigraphy and SPECT in pheochromocytoma.

    PubMed

    Sharma, Punit; Dhull, Varun Singh; Jeph, Sunil; Reddy, Rama Mohan; Singh, Harmandeep; Naswa, Niraj; Bal, Chandrasekhar; Kumar, Rakesh

    2013-09-01

    This study aimed to evaluate the incremental value of (131)I-MIBG hybrid SPECT-CT over planar scintigraphy (PS) and SPECT alone in patients with clinical or biochemical suspicion of pheochromocytoma. A total of 126 adrenals of 63 patients (mean [SD] age, 28.6 [15.7] years; male patients, n = 34; female patients, n = 29) with clinical or biochemical suspicion of pheochromocytoma were retrospectively evaluated. All patients had undergone (131)I-MIBG SPECT-CT of adrenal region. The PS, SPECT, and SPECT-CT images were independently evaluated by 2 nuclear medicine physicians with 6 years (R1) and 2 years (R2) experience and in separate sessions 1 week apart. A scoring scale of 1 to 5 was used, in which 1 is definitely abnormal, 2 is probably abnormal, 3 is indeterminate, 4 is probably normal, and 5 is definitely normal. Sensitivity, specificity, predictive values were calculated taking a score 2 or less as abnormal. With receiver operating characteristic (ROC) curve analysis, areas under the curve (AUC) were calculated for each modality and compared. Histopathology and/or clinical/imaging follow-up were taken as reference standard. Of the 126 adrenals evaluated, 29 were indeterminate on PS for R1 and 48 for R2, 39 were indeterminate on SPECT for both, and on SPECT-CT, 1 was indeterminate for R1 and 2 for R2. SPECT-CT correctly characterized 28 of 29 indeterminate adrenals on PS and 37 of 39 indeterminate adrenals on SPECT for R1. Similarly, for R2, SPECT-CT correctly characterized 45 of 48 indeterminate adrenals on PS and 33 of 39 indeterminate adrenals on SPECT. On ROC comparison, PS was inferior to SPECT (P = 0.040 for R1; P < 0.001 for R2) and SPECT-CT (P = 0.001 for R1; P < 0.001 for R2) for both the observers. Moreover, SPECT was inferior to SPECT-CT for both the observers (P = 0.017 for R1 and P = 0.001 for R2). Accuracy of SPECT-CT (R1, 97.6%; R2, 97.6%) was higher than PS (R1, 91.2%; R2, 84.1%) and SPECT (R1, 94.4%; R2, 86.5%). Interobserver agreement was

  13. Educational Goals and Student Flow: Model for Institutional Student Flow and Follow-up. TEX-SIS FOLLOW-UP SC7.

    ERIC Educational Resources Information Center

    Hood, Duane

    This report details the development and implementation of a follow-up system, by Western Texas Community College (WTCC) as a subcontractor for Project FOLLOW-UP, relating student flow patterns to educational goals. Phase I of this project involved establishment of a data base which included elements designed to reveal an adequate picture of…

  14. Patterns of motor signs in spinocerebellar ataxia type 3 at the start of follow-up in a reference unit.

    PubMed

    Pulido-Valdeolivas, Irene; Gómez-Andrés, David; Sanz-Gallego, Irene; Rausell, Estrella; Arpa, Javier

    2016-01-01

    Spinocerebellar ataxia type 3 (SCA3) is a neurodegenerative disorder that affects the cerebellar system and other subcortical regions of the brain. As for other cerebellar diseases, the severity of this type of ataxia can be assessed with the Scale for Assessment and Rating of Ataxia (SARA) which gives a total score that reflects functional impairment out of 8 cerebellar function tests. SCA3 patients score profile is heterogeneous on at the start of follow up. This study investigates possible patterns in those profiles and analyses the impact of other usually concurrent signs of impairment of extracerebellar motor systems in that profile variability by means of multivariate statistical approaches. Seventeen patients with SCA3 underwent systematic anamnesis, neurological and SARA assessment, visual evaluation of (123)I-Ioflupane (DaTSCAN) single-photon emission computed tomography (SPECT) imaging and electrophysiological studies (nerve conduction and electromyography). Patterns in the profiles of SARA item scores were investigated by hierarchical clustering after multivariate correspondence analysis. A network analysis was used to represent relationships between SARA item scores, clinical, genetic and neurological examination parameters as well as abnormalities of DaTSCAN SPECT imaging and electrophysiological studies. The most frequently altered SARA items in all patients are gait and stance, and three profiles of SCA3 patients can be distinguished depending mainly on their degree of impairment in those two items. Other SARA items like the score on heel-shin slide contribute less to the classification. Network analysis shows that SARA item scores configure a single domain that is independent of the size of the mutated expanded allele and age of onset, which are, in turn closely and inversely correlated. The severity of cerebellar dysfunction is correlated with longer disease duration, altered visual evaluation of DaTSCAN SPECT imaging and decreased patellar

  15. Thallium-201 diethyldithiocarbamate: an alternative to iodine-123 N-isopropyl-p-iodoamphetamine

    SciTech Connect

    de Bruine, J.F.; van Royen, E.A.; Vyth, A.; de Jong, J.M.B.V.; van der Schoot, J.B.

    1985-08-01

    The study of cerebral blood flow by single photon emission computed tomography (SPECT) requires lipophilic radiopharmaceuticals. The high cost and limited availability of N-isopropyl-p-(I-123)-iodoamphetamine ((/sup 123/I)IMP) led the authors to search for alternatives. Following the recent development of thallium-201 diethyldithiocarbamate ((/sup 201/Tl)DDC), the authors have compared the brain uptake of (/sup 123/I)IMP and (/sup 201/Tl)DDC in rabbits. The (/sup 201/Tl)DDC uptake was more instantaneous than that of (/sup 123/I)IMP. The ratios of gray to white matter distribution were about equal. In brain macroautoradiography (/sup 201/Tl)DDC yielded images of good quality with excellent demarcation of gray and white matter, persisting for at least 45 min after injection. They conclude that (/sup 123/I)IMP and (/sup 201/Tl)DDC are equally suitable for blood flow study of the rabbit brain. The first human tomographic results obtained in two healthy volunteers demonstrate that clinical application of SPECT (/sup 201/Tl)DDC may be feasible.

  16. [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

  17. Teacher Education Follow-up Surveys: Variables Related to Response Rate.

    ERIC Educational Resources Information Center

    Boser, Judith A.

    This study of teacher education graduate follow-up surveys examined the relationship between response rate and number of graduates, questionnaire length, and follow-up contacts. Also, the study investigated survey practices differentiating between surveys which had high and low return rates in such areas as number of follow-up contacts,…

  18. Findings at follow-up endoscopies in subjects with suspected colorectal abnormalities: effects of baseline findings and time to follow-up.

    PubMed

    Cafferty, Fay H; Wong, Jau-Min; Yen, Amy Ming-Fang; Duffy, Stephen W; Atkin, Wendy S; Chen, Tony Hsiu-Hsi

    2007-01-01

    Guidelines for colonoscopic surveillance after the removal of colorectal polyps already exist in the United Kingdom and United States. However, there is a continuing need to build up an evidence base on the likely effect of different follow-up policies for specific current findings. This article reports on the colonoscopic surveillance of a cohort of patients in Taiwan. The risk of various outcomes at the second examination is assessed according to findings at the first examination and the interval between examinations. Data from baseline and follow-up examinations for 2,287 individuals attending the National Taiwan University Hospital were collected retrospectively. Multivariate logistic regression was used to identify risk factors for the following 4 outcomes: any positive findings; multiple (> or =3) polyps; large (> or =10 mm) polyp(s); or villous adenoma(s) or cancer. The effect of the interval between examinations was assessed in all models. Older age was an independent risk factor for all outcomes. The number of baseline polyps was a significant risk factor for both positive results and multiple polyps, more severe baseline histology was a risk factor for large polyps and villous adenomas/cancer, and larger baseline polyps were a risk factor for large polyps at follow-up. Interval time was only an independent risk factor for villous adenomas/cancer, which tended to be found at shorter follow-up times. The total number of abnormalities found at follow-up was significantly related to the number of follow-up examinations but not to the total follow-up time. Results suggest that, with the possible exception of subjects with villous adenomas at baseline, most reexaminations can safely be delayed for > or =5 years. In the majority of cases staff at the hospital were correctly identifying those subjects at particularly high risk and assigning shorter follow-up intervals accordingly. Models indicate that many of the findings seen at follow-up were due to missed

  19. Methods for successful follow-up of elusive urban populations: an ethnographic approach with homeless men.

    PubMed Central

    Conover, S.; Berkman, A.; Gheith, A.; Jahiel, R.; Stanley, D.; Geller, P. A.; Valencia, E.; Susser, E.

    1997-01-01

    Public health is paying increasing attention to elusive urban populations such as the homeless, street drug users, and illegal immigrants. Yet, valid data on the health of these populations remain scarce; longitudinal research, in particular, has been hampered by poor follow-up rates. This paper reports on the follow-up methods used in two randomized clinical trials among one such population, namely, homeless men with mental illness. Each of the two trials achieved virtually complete follow-up over 18 months. The authors describe the ethnographic approach to follow-up used in these trials and elaborate its application to four components of the follow-up: training interviewers, tracking participants, administering the research office, and conducting assessments. The ethnographic follow-up method is adaptable to other studies and other settings, and may provide a replicable model for achieving high follow-up rates in urban epidemiologic studies. PMID:9211004

  20. 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.

  1. 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.

  2. Molecular SPECT Imaging: An Overview

    PubMed Central

    Khalil, Magdy M.; Tremoleda, Jordi L.; Bayomy, Tamer B.; Gsell, Willy

    2011-01-01

    Molecular imaging has witnessed a tremendous change over the last decade. Growing interest and emphasis are placed on this specialized technology represented by developing new scanners, pharmaceutical drugs, diagnostic agents, new therapeutic regimens, and ultimately, significant improvement of patient health care. Single photon emission computed tomography (SPECT) and positron emission tomography (PET) have their signature on paving the way to molecular diagnostics and personalized medicine. The former will be the topic of the current paper where the authors address the current position of the molecular SPECT imaging among other imaging techniques, describing strengths and weaknesses, differences between SPECT and PET, and focusing on different SPECT designs and detection systems. Radiopharmaceutical compounds of clinical as well-preclinical interest have also been reviewed. Moreover, the last section covers several application, of μSPECT imaging in many areas of disease detection and diagnosis. PMID:21603240

  3. Two-year follow-up of bibliotherapy and individual cognitive therapy for depressed older adults.

    PubMed

    Floyd, Mark; Rohen, Noelle; Shackelford, Jodie A M; Hubbard, Karen L; Parnell, Marsha B; Scogin, Forrest; Coates, Adriana

    2006-05-01

    This study examined the stability of treatment gains after receiving either cognitive bibliotherapy or individual cognitive psychotherapy for depression in older adults. A 2-year follow-up of 23 participants from Floyd, Scogin, McKendree-Smith, Floyd, and Rokke (2004) was conducted by comparing pre-and posttreatment scores with follow-up scores on the Hamilton Rating Scale for Depression (HRSD) and the Geriatric Depression Scale (GDS). Results indicated that treatment gains from baseline to the 2-year follow-up period were maintained on the HRSD and GDS, and there was not a significant decline from posttreatment to follow-up. There were no significant differences between the treatments on the GDS or HRSD at the 2-year follow-up; however, bibliotherapy participants had significantly more recurrences of depression during the follow-up period.

  4. Treatment summaries, follow-up care instructions, and patient navigation: could they be combined to improve cancer survivor's receipt of follow-up care?

    PubMed

    Jabson, Jennifer M

    2015-12-01

    Cancer survivors require follow-up care to ensure early detection of recurrence, management of late/long term effects, preventive screening for early detection of second primary malignancies, as well as other forms of preventive care. But not all survivors receive necessary follow-up care. Combining survivorship care plans and patient navigation may be a successful strategy to improve survivor's receipt of necessary follow-up care. Using data from the 2010 LIVESTRONG online survey of cancer survivors (N = 3854), this study tested associations between receipt of follow-up care instructions (FCI) and treatment summaries (TS) paired with patient navigation (PN), and survivor's receipt of cancer surveillance, preventive cancer screening, and attendance at regular medical appointments. Survivors who received FCI, TS, and patient navigation were the most likely to report attendance at all medical appointments (aOR 4.17, 95% CI 2.30, 7.57, p ≤ .001) and receipt of preventive cancer screening (aOR 3.56, 95% CI 2.28, 5.55, p ≤ .001). Likelihood of receiving follow-up care was greatest when survivors received FCI, TS, and PN. This pairing appeared to be most beneficial for survivor's attendance at medical appointments and receipt of preventive cancer screening. By improving attendance at medical appointments and prevention cancer screening, pairing SCP and PN could benefit survivors through reduced recurrence, earlier recurrence detection, and prevention of second primaries.

  5. Supplement: Localization and broadband follow-up of the gravitational-wave transient GW150914

    DOE PAGES

    Abbott, B. P.

    2016-07-20

    This Supplement provides supporting material for arXiv:1602.08492 . We briefly summarize past electromagnetic (EM) follow-up efforts as well as the organization and policy of the current EM follow-up program. Here, we compare the four probability sky maps produced for the gravitational-wave transient GW150914, and provide additional details of the EM follow-up observations that were performed in the different bands.

  6. Evaluation of Orthopedic Trauma Surgery Follow-up and Impact of a Routine Callback Program.

    PubMed

    Casp, Aaron J; Wells, Jodi; Holzgrefe, Russell; Weiss, David; Kahler, David; Yarboro, Seth R

    2017-01-05

    A high rate of patients lost to follow-up is a common problem in orthopedic trauma surgery. This adversely affects the ability to produce accurate clinical outcomes research. The purpose of this project was to (1) evaluate the rate of loss to follow-up at an academic level I trauma center; (2) identify the patient-reported reasons for loss to follow-up; and (3) evaluate the efficacy of a routine patient callback program. All patients who underwent surgery in the orthopedic trauma division of the University of Virginia Medical Center from April 1, 2014, to September 30, 2014, and did not complete their postoperative clinic follow-up were analyzed. The characteristics of these patients were evaluated, and the primary reason for not completing the recommended follow-up was identified. All patients were then offered additional orthopedic follow-up at the time of contact. Of the 480 patients who met the inclusion criteria, 41 (8.5%) failed to complete the recommended postoperative follow-up course. The most common reason for being lost to follow-up was feeling well and not having the need to be seen (46.3%). Only 6 (14.6%) of the 41 patients requested follow-up care at the time of contact. The lost to follow-up rate in this study, 8.5%, was considerably lower than that previously reported, but patient characteristics were consistent with those of prior studies on this subject. The low lost to follow-up rate may reflect a difference in geographic location or patient population. The patient callback program had a low yield of patients requesting additional follow-up after being contacted. [Orthopedics. 201x; xx(x):xx-xx.].

  7. Supplement: Localization and broadband follow-up of the gravitational-wave transient GW150914

    DOE PAGES

    Abbott, B. P.

    2016-07-20

    This Supplement provides supporting material for arXiv:1602.08492 . We briefly summarize past electromagnetic (EM) follow-up efforts as well as the organization and policy of the current EM follow-up program. Here, we compare the four probability sky maps produced for the gravitational-wave transient GW150914, and provide additional details of the EM follow-up observations that were performed in the different bands.

  8. 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

  9. MRI and thallium-201 SPECT in the prediction of survival in glioma.

    PubMed

    Vos, Maaike J; Berkhof, Johannes; Hoekstra, Otto S; Bosma, Ingeborg; Sizoo, Eefje M; Heimans, Jan J; Reijneveld, Jaap C; Sanchez, Esther; Lagerwaard, Frank J; Buter, Jan; Noske, David P; Postma, Tjeerd J

    2012-06-01

    This paper aims to study the value of MRI and Thallium 201 ((201)Tl) single-photon emission computed tomography (SPECT) in the prediction of overall survival (OS) in glioma patients treated with temozolomide (TMZ) and to evaluate timing of radiological follow-up. We included patients treated with TMZ chemoradiotherapy for newly diagnosed glioblastoma multiforme (GBM) and with TMZ for recurrent glioma. MRIs and (201)Tl SPECTs were obtained at regular intervals. The value of both imaging modalities in predicting OS was examined using Cox regression analyses. Altogether, 138 MRIs and 113 (201)Tl SPECTs in 46 patients were performed. Both imaging modalities were strongly related to OS (P ≤ 0.02). In newly diagnosed GBM patients, the last follow-up MRI (i.e., after six adjuvant TMZ courses) and SPECT (i.e., after three adjuvant TMZ courses) were the strongest predictors of OS (P = 0.01). In recurrent glioma patients, baseline measurements appeared to be the most predictive of OS (P < 0.01). The addition of one imaging modality to the other did not contribute to the prediction of OS. Both MRI and (201)Tl SPECT are valuable in the prediction of OS. It is adequate to restrict to one of both modalities in the radiological follow-up during treatment. In the primary GBM setting, MRI after six adjuvant TMZ courses contributes significantly to the prediction of survival. In the recurrent glioma setting, baseline MRI appears to be a powerful predictor of survival, whereas follow-up MRIs during TMZ seem to be of little additional value.

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

    PubMed

    Klinken, Sven; Humphries, Charlotte; Ferguson, John

    2017-10-01

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

  11. The process and outcomes of a nurse-led colorectal cancer follow-up clinic.

    PubMed

    McFarlane, K; Dixon, L; Wakeman, C J; Robertson, G M; Eglinton, T W; Frizelle, F A

    2012-05-01

    Evidence suggests that follow-up after colorectal cancer improves survival. Colorectal cancer is so common that patient follow-up can overwhelm a service, affecting the ability to see new referrals and reassess patients seen previously who have new symptoms. In order to cope with this demand a nurse-led follow-up service was started in 2004. We aimed to review the results of a nurse-led colorectal cancer follow-up clinic. Between 1 December 2004 and 31 January 2011, patients who underwent resection for colorectal cancer were followed up by a nurse specialist according to a protocol determined by the colorectal surgeons in the unit. All patient details were recorded prospectively in a purpose designed database. Nine hundred and fifty patients were followed up over 7 years. Some 368 patients were discharged from the follow-up programme, 474 patients remain actively involved in the programme and 108 patients died. Of the patients discharged from the follow-up scheme 269 (73%) were discharged to their general practitioner free of disease after 5 years. Of the 108 who patients died, 98 were as a result of colorectal cancer. Twenty patients (2.1%) were identified with local (peri-anastomotic) disease recurrence and 93 patients (9.8%) were found to have developed distant metastatic disease. Of these, 65 patients (6.8%) were referred for palliative care and 28 (2.9%) had surgery for focal metastatic disease of whom 18 were still alive at the time of this analysis. This paper shows that a nurse-led clinic for colorectal cancer follow-up can achieve satisfactory results with detection rates of recurrent or metastatic disease comparable to consultant follow-up. A nurse-led clinic provides the benefits of follow-up without overwhelming the consultant colorectal surgical clinic practice. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

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

    PubMed

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

    2003-12-01

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

  13. [Impact of follow-up loss over visual deficiency in open-globe ocular trauma].

    PubMed

    Lima-Gómez, Virgilio; García-Rubio, Yatzul Zuhaila; Blanco-Hernández, Dulce Milagros Razo

    2013-01-01

    Open-globe ocular trauma causes visual deficiency; calculating the magnitude of the latter often misses the estimation in patients without follow-up. to identify the modification of the postoperative proportion of visual deficiency in open-globe ocular trauma, which would introduce considering the proportion estimated in patients without follow-up. Non-interventional, retrospective, longitudinal, analytical study. Visual outcome in eyes with open-globe trauma, with and without follow-up, was calculated using the Ocular Trauma Score. The observed postoperative proportion of visual deficiency was identified in eyes with follow-up; in eyes without follow-up, the postoperative proportion of visual deficiency was estimated using an analysis of scenarios: best (Ocular Trauma Score), mean (that of eyes with follow-up) and worst (last observation/no visual improvement). The estimated proportion of visual deficiency was added to that observed in eyes with follow-up, and the resulting proportion was compared with that expected in the sample, using the Ocular Trauma Score (χ(2)). 104 eyes, 70 without follow-up and 34 without it. In eyes with follow-up the expected proportion of visual deficiency was 58.6%, and the observed one was 71.4% (p = 0.1); the estimated proportion of visual deficiency in eyes without follow-up was 76.5%. The resulting postoperative proportion of visual deficiency in the sample would be 73.1%, which would overcome that expected by the Ocular Trauma Score (59.6%, p = 0.04). In open-globe ocular trauma, the efficacy of surgery to reduce the proportion of visual deficiency would decrease with regard to the standard expected by the Ocular Trauma Score, if the deficiency estimated in eyes without follow-up were considered.

  14. Follow-up care of adolescent survivors of childhood cancer: The role of health beliefs.

    PubMed

    Lupatsch, Judith E; Wengenroth, Laura; Rueegg, Corina S; Teuffel, Oliver; Gumy-Pause, Fabienne; Kuehni, Claudia E; Michel, Gisela

    2016-02-01

    Little is known about follow-up care attendance of adolescent survivors of childhood cancer, and which factors foster or hinder attendance. Attending follow-up care is especially important for adolescent survivors to allow for a successful transition into adult care. We aimed to (i) describe the proportion of adolescent survivors attending follow-up care; (ii) describe adolescents' health beliefs; and (iii) identify the association of health beliefs, demographic, and medical factors with follow-up care attendance. Of 696 contacted adolescent survivors diagnosed with cancer at ≤ 16 years of age, ≥ 5 years after diagnosis, and aged 16-21 years at study, 465 (66.8%) completed the Swiss Childhood Cancer Survivor Study questionnaire. We assessed follow-up care attendance and health beliefs, and extracted demographic and medical information from the Swiss Childhood Cancer Registry. Cross-sectional data were analyzed using descriptive statistics and logistic regression models. Overall, 56% of survivors reported attending follow-up care. Most survivors (80%) rated their susceptibility for late effects as low and believed that follow-up care may detect and prevent late effects (92%). Few (13%) believed that follow-up care is not necessary. Two health beliefs were associated with follow-up care attendance (perceived benefits: odds ratio [OR]: 1.56; 95% confidence interval [CI]: 1.07-2.27; perceived barriers: OR: 0.70; 95%CI: 0.50-1.00). We show that health beliefs are associated with actual follow-up care attendance of adolescent survivors of childhood cancer. A successful model of health promotion in adolescent survivors should, therefore, highlight the benefits and address the barriers to keep adolescent survivors in follow-up care. © 2015 Wiley Periodicals, Inc.

  15. 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

  16. 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.

  17. Testicular Microlithiasis: Patient Compliance in a Two-Year Follow-Up Program

    PubMed Central

    Pedersen, M. R.; Osther, P. J. S.; Soerensen, F. B.; Rafaelsen, S. R.

    2016-01-01

    Introduction: We present a retrospective 2-year follow-up cohort of 103 men with testicular microlithiasis (TML) and discuss patient compliance and the value of surveillance. Methods: A retrospective analysis of patients examined with scrotal ultrasonography (US) in the period from 2008 through 2010 was performed. A total of 103 men with TML were diagnosed and offered US follow-up every 6 months for 2 years. They were retrospectively analyzed regarding demographics and follow-up details, including the development of any kind of malignancy until March 2015, using the Danish Electronic Pathology Registry. Results: The prevalence of TML was 10.3%. Of the 103 men with TML, 23 (22.3%) had TML in the left testicle, 38 (36.9%) in the right (p=0.002), and 42 (40.8%) had bilateral TML. Patient compliance was low with 11.7% participating in all US follow-up examinations. 5 men presented risk factors (testicular atrophy (N=1) and previous testicular cancer (N=4)), but no cases of testicular malignancy were found in the follow-up period. Conclusion: The low patient compliance conflicts with the ESUR Scrotal Imaging Subcommittee guidelines that recommend scrotal US follow-up annually for TML until the age of 55 years. The fact that no cancers were found during follow-up using the pathology registry calls the value of follow-up into question. PMID:27921092

  18. Infantile Amnesia across the Years: A 2-Year Follow-Up of Children's Earliest Memories

    ERIC Educational Resources Information Center

    Peterson, Carole; Warren, Kelly L.; Short, Megan M.

    2011-01-01

    Although infantile amnesia has been investigated for many years in adults, only recently has it been investigated in children. This study was a 2-year follow-up and extension of an earlier study. Children (4-13 years old) were asked initially and 2 years later for their earliest 3 memories. At follow-up, their age at the time of these memories…

  19. A Research on Students' Needs for Follow-Up Curriculum of College English

    ERIC Educational Resources Information Center

    Jin, Jie; Liu, Hengying; Zhang, Yan

    2015-01-01

    Increased universities and colleges offer the undergraduates with more follow-up courses with the further reform in college English education in China. An investigation on self-evaluation, difficulty, and willingness of undergraduates in learning English further was made in order to design more appropriate and adaptable follow-up courses. This…

  20. Socializing Intellectual Talk: A Case Study of Instructor Follow-Up Statements in Classroom Discourse

    ERIC Educational Resources Information Center

    Parsons, Caroline S.

    2017-01-01

    By analyzing the audio recording and transcription of classroom discourse, this case study focused on the ways in which the instructor used follow-up statements to socialize students into intellectual talk. Four relevant categories of follow-up statements emerged: (a) revoicing, (b) contextualization, (c) parallel elaboration, and (d) assistive…

  1. How Do Mode and Timing of Follow-up Surveys Affect Evaluation Success?

    ERIC Educational Resources Information Center

    Koundinya, Vikram; Klink, Jenna; Deming, Philip; Meyers, Andrew; Erb, Kevin

    2016-01-01

    This article presents the analysis of evaluation methods used in a well-designed and comprehensive evaluation effort of a significant Extension program. The evaluation data collection methods were analyzed by questionnaire mode and timing of follow-up surveys. Response rates from the short- and long-term follow-ups and different questionnaire…

  2. Laboratory guidelines for the diagnosis and follow-up of patients with monoclonal gammopathies.

    PubMed

    Bravo García-Morato, M; Padilla-Merlano, B; Nozal, P; Espiño, M; Juárez, C; Villar, L M; López-Trascasa, M

    2016-04-01

    We present guidelines from the Immunochemistry group of the Spanish Society for Immunology that are designed to provide a practical tool for the diagnosis and follow-up of monoclonal gammopathies. We review the clinical and analytical features of various monoclonal gammopathies, international consensus guidelines and techniques used to detect and follow-up monoclonal components.

  3. High School and Beyond Second Follow-Up (1982). Technical Report.

    ERIC Educational Resources Information Center

    Jones, Calvin; And Others

    Details of the High School and Beyond's Second (1982) Follow-Up survey are presented. Probability samples of approximately 15,000 1980 sophomores and 12,200 1980 seniors were retained for the second follow-up. The former students were asked to complete a questionnaire detailing their post-high school activities. Technical aspects of the survey are…

  4. 48 CFR 2027.305-3 - Follow-up by Government.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Follow-up by Government... GENERAL CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Patent Rights Under Government Contracts 2027.305-3 Follow-up by Government. (a) The contracting officer shall, as a part of the closeout of...

  5. Phylloides tumours of the breast: best practice for follow-up.

    PubMed

    Mylvaganam, Senthurun; Toro, Clare; Frank, Lucinda; Vestey, Sarah; Thrush, Steven

    2015-03-01

    Phylloides tumours are rare fibroepithelial breast tumours accounting for 1% of breast cancers. No UK guidance exists on the assessment, treatment and follow-up of these patients. To assess the diagnostic accuracy of the clinical core biopsy compared to the gold standard excision biopsy and determine the current follow-up practice and recurrence rate of phylloides tumours across two UK hospital trusts. Multicentre retrospective analysis of all cases of phylloides tumours over 6 years at Worcestershire Acute NHS Trust (WANHST) and Gloucestershire Hospitals NHS Trust (GHNHST). 94 Patients included. Mean age 48 years. Mean clinical and radiological size of lesions 31.7 and 35.4 mm, respectively, preoperative core biopsy sensitivity was 87% for WANHST and 74% for GHNHST with a positive predictive value of 90 and 100%, respectively. 29 Different follow-up regimes were observed from the practice of the 10 surgeons observed following diagnosis and resection of tumours. The follow-up length ranged from discharge following one post-operative clinic attendance to 5-year clinical and/or radiological follow-up. 4 Benign and 2 malignant recurrent phylloides tumours were seen. All benign recurrences were local and found independently of follow-up. The earliest benign phylloides recurrence was at 6 years and the latest at 10 years. There is no standard follow-up of benign or malignant phylloides tumours. This study suggests that in the benign group, the risk of recurrence is small. We advocate no routine follow-up of benign phylloides tumours.

  6. Compilation of Case Studies: Exemplary Placement and Follow-Up Studies.

    ERIC Educational Resources Information Center

    Dale, Jack

    Examples of placement and follow-up conceptual models developed for a program of vocational education (kindergarten through university) are presented. Section 1 contains a historical overview of placement and follow-up activities in Florida and describes a comprehensive model. Section 2, describing a model for utilizing community resources for the…

  7. From Student Follow-Up Responses to a Statewide Supply/Demand Analysis of Educational Programs.

    ERIC Educational Resources Information Center

    Hall, Toni

    The Texas Student Follow-up Information System (Tex-SIS) for comprehensive postsecondary follow-up and the supply/demand analysis work of the Texas 1202 Commission, Office of Postsecondary Education Planning, together may provide a valuable prototype for other states and perhaps even for a national system of data collection and analysis. Tex-SIS…

  8. High School and Beyond Third Follow-Up (1986): Sample Design Report. Contractor Report.

    ERIC Educational Resources Information Center

    Spencer, Bruce D.; And Others

    The third follow-up survey associated with the High School and Beyond (HSB) Study was conducted during the spring of 1986. This report provides information that fully documents major technical aspects of the third follow-up sample selection and implementation, describes the weighting procedures, examines the possible impact of non-response on…

  9. Documentation for the 2008-09 Teacher Follow-up Survey. NCES 2011-304

    ERIC Educational Resources Information Center

    Graham, Shawna; Parmer, Randall; Chambers, Lisa; Tourkin, Steven; Lyter, Deanna M.

    2011-01-01

    The Teacher Follow-up Survey (TFS) is sponsored by the National Center for Education Statistics (NCES) on behalf of the U.S. Department of Education and is conducted by the U.S. Census Bureau. TFS is a follow-up survey of selected elementary and secondary school teachers who participated in the Schools and Staffing Survey (SASS). SASS is the…

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

    ERIC Educational Resources Information Center

    Zimmerman, Stephanie; Makoroff, Kathi; Care, Marguerite; Thomas, Amy; Shapiro, Robert

    2005-01-01

    Objective: To evaluate the utility of a follow-up skeletal survey in suspected child physical abuse evaluations. Methods: In this prospective study, follow-up skeletal surveys were recommended for 74 children who, after an initial skeletal survey and evaluation by the Child Abuse Team, were suspected victims of physical abuse. The number and…

  11. Effect on Mail Survey Return Rates of Including Questionnaires With Follow-Up Letters.

    ERIC Educational Resources Information Center

    Futrell, Charles M.; Lamb, Charles W., Jr.

    1981-01-01

    Two thousand questionnaires were mailed to respondents allocated among seven treatments. Controls received an initial mailing (questionnaire and cover letter) only. The remaining six treatments varied by number of follow-up mailings and whether another questionnaire copy was included. Results suggest more than one follow-up letter with a…

  12. Infantile Amnesia across the Years: A 2-Year Follow-Up of Children's Earliest Memories

    ERIC Educational Resources Information Center

    Peterson, Carole; Warren, Kelly L.; Short, Megan M.

    2011-01-01

    Although infantile amnesia has been investigated for many years in adults, only recently has it been investigated in children. This study was a 2-year follow-up and extension of an earlier study. Children (4-13 years old) were asked initially and 2 years later for their earliest 3 memories. At follow-up, their age at the time of these memories…

  13. Two-Year Follow-Up of Bibliotherapy and Individual Cognitive Therapy for Depressed Older Adults

    ERIC Educational Resources Information Center

    Floyd, Mark; Rohen, Noelle; Shackelford, Jodie A. M.; Hubbard, Karen L.; Parnell, Marsha B.; Scogin, Forrest; Coates, Adriana

    2006-01-01

    This study examined the stability of treatment gains after receiving either cognitive bibliotherapy or individual cognitive psychotherapy for depression in older adults. A 2-year follow-up of 23 participants from Floyd, Scogin, McKendree-Smith, Floyd, and Rokke (2004) was conducted by comparing pre- and posttreatment scores with follow-up scores…

  14. Two-Year Follow-Up of Bibliotherapy and Individual Cognitive Therapy for Depressed Older Adults

    ERIC Educational Resources Information Center

    Floyd, Mark; Rohen, Noelle; Shackelford, Jodie A. M.; Hubbard, Karen L.; Parnell, Marsha B.; Scogin, Forrest; Coates, Adriana

    2006-01-01

    This study examined the stability of treatment gains after receiving either cognitive bibliotherapy or individual cognitive psychotherapy for depression in older adults. A 2-year follow-up of 23 participants from Floyd, Scogin, McKendree-Smith, Floyd, and Rokke (2004) was conducted by comparing pre- and posttreatment scores with follow-up scores…

  15. 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.

  16. [Secondary ambulatory prophylaxis of venous thromboembolism: outcome of patients who were lost to follow-up].

    PubMed

    Wawrzyńska, L; Hajduk, B; Kober, J; Filipecki, S

    1998-01-01

    We have attempted to determine the outcome of 87 out-patients who were lost from follow-up. Several factors have been assessed: causes of lost from follow-up duration of oral anticoagulation, recurrent venous thromboembolic events, cause of death (if applicable).

  17. Compilation of Case Studies: Exemplary Placement and Follow-Up Studies.

    ERIC Educational Resources Information Center

    Dale, Jack

    Examples of placement and follow-up conceptual models developed for a program of vocational education (kindergarten through university) are presented. Section 1 contains a historical overview of placement and follow-up activities in Florida and describes a comprehensive model. Section 2, describing a model for utilizing community resources for the…

  18. 25 CFR 26.36 - What follow-up service is available after I complete training?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... JOB PLACEMENT AND TRAINING PROGRAM Training Services § 26.36 What follow-up service is available after I complete training? Job Placement assistance may follow training. ... 25 Indians 1 2013-04-01 2013-04-01 false What follow-up service is available after I complete...

  19. 25 CFR 26.28 - What follow-up services are available after I become employed?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false What follow-up services are available after I become... JOB PLACEMENT AND TRAINING PROGRAM Job Placement Services § 26.28 What follow-up services are available after I become employed? As determined by the service provider, the following type of services may...

  20. 25 CFR 26.36 - What follow-up service is available after I complete training?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... JOB PLACEMENT AND TRAINING PROGRAM Training Services § 26.36 What follow-up service is available after I complete training? Job Placement assistance may follow training. ... 25 Indians 1 2014-04-01 2014-04-01 false What follow-up service is available after I complete...

  1. 25 CFR 26.28 - What follow-up services are available after I become employed?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false What follow-up services are available after I become... JOB PLACEMENT AND TRAINING PROGRAM Job Placement Services § 26.28 What follow-up services are available after I become employed? As determined by the service provider, the following type of services may...

  2. 30 CFR 62.173 - Follow-up evaluation when an audiogram is invalid.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Follow-up evaluation when an audiogram is invalid. 62.173 Section 62.173 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR UNIFORM MINE HEALTH REGULATIONS OCCUPATIONAL NOISE EXPOSURE § 62.173 Follow-up evaluation when an...

  3. Follow Up Study of Non College Bound Somerset County High School Graduates June 1990, New Jersey.

    ERIC Educational Resources Information Center

    Doty, Charles R.

    A follow-up study sought to determine what happened to the 1990 noncollege-bound graduates of all the high schools in Somerset County, New Jersey. Data were gathered through a mailed survey and telephone follow-up (approximately 45 percent response) of the 408 graduates of the 12 of 13 high schools providing names. Some of the findings from…

  4. 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.

  5. Men with Intellectual Disabilities Who Have Attended Sex Offender Treatment Groups: A Follow-up

    ERIC Educational Resources Information Center

    Heaton, Kathryn M.; Murphy, Glynis H.

    2013-01-01

    Background: There have been a number of studies of treatment for men with intellectual disabilities and sexually abusive behaviour but few follow-up studies. Our aim was to follow up men with intellectual disabilities who had attended group cognitive behavioural treatment (CBT) for sexually abusive behaviour. Method Thirty-four men (from seven…

  6. Career Program Completers. 1989-90 Long-Term Follow-Up Study.

    ERIC Educational Resources Information Center

    Johnson County Community Coll., Overland Park, KS. Office of Institutional Research.

    In summer 1994, a long-term follow-up study was conducted of 1989-90 graduates of career programs at Johnson County Community College (JCCC) in Kansas. A survey was mailed to 536 graduates, certificate holders, and students who left JCCC with marketable skills to assess their satisfaction with JCCC and their jobs. With telephone follow-up, a…

  7. Suggested Guidelines: Employer Follow-up of Vocational Program Graduates and Early Leavers.

    ERIC Educational Resources Information Center

    Clatsop County Intermediate Education District, Astoria, OR.

    This handbook for administrators, teachers, parents, and students describes a system of strategies that will assist in implementing follow-up studies of former vocational program participants (completers and/or early leavers). Section 1 discusses use of the handbook. Section 2 concerns the rationale for doing follow-up and includes legislation,…

  8. High School and Beyond First Follow-Up (1982). Sample Design Report.

    ERIC Educational Resources Information Center

    Tourangeau, Roger; And Others

    This report documents the major technical aspects of the sample selection and implementation of the 1982 High School and Beyond First Follow Up, the first in a series of planned resurveys of the students and schools in the 1980 High School and Beyond Base Year Survey. The First Follow-Up included subsamples of nearly 30,000 sophomore cohort and…

  9. 48 CFR 2427.305-2 - Follow-up by contractor.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Follow-up by contractor....305-2 Follow-up by contractor. (b) Contractor reports. Contractors shall complete and submit to the... Contracting Officer shall send the form to those contractors whose contract work may have required...

  10. Barriers to Follow-Up for Abnormal Papanicolaou Smears among Female Sex Workers in Lima, Peru.

    PubMed

    Aharon, Devora; Calderon, Martha; Solari, Vicky; Alarcon, Patricia; Zunt, Joseph

    2017-01-01

    Cervical cancer is the most prevalent cancer among Peruvian women. Female sex workers (FSW) in Peru are at elevated risk for HPV infection, and receive annual Papanicolaou screening. The objective of this study was to identify barriers to follow-up for abnormal Pap smears among FSW in Peru. 97 FSW attending the Alberto Barton Health Center in Lima were surveyed regarding their STI screening history. 17 women with a history of an abnormal Pap smear were interviewed about their experiences regarding follow-up care. Of the 27 HPV-positive women, only 8 (30%) received follow-up treatment. Of the 19 women who did not receive follow-up, 7 (37%) had not been informed of their abnormal result. Qualitative interviews revealed that the major barrier to follow-up was lack of knowledge about HPV and potential health consequences of an abnormal Pap smear. HPV infection is highly prevalent in Peruvian FSW, yet only 30% of FSW with abnormal Pap smears receive follow-up care. The predominant barriers to follow-up were lack of standardization in recording and communicating results and insufficient FSW knowledge regarding health consequences of HPV infection. Standardization of record-keeping and distribution of educational pamphlets have been implemented to improve follow-up for HPV.

  11. Barriers to Follow-Up for Abnormal Papanicolaou Smears among Female Sex Workers in Lima, Peru

    PubMed Central

    Aharon, Devora; Calderon, Martha; Solari, Vicky; Alarcon, Patricia; Zunt, Joseph

    2017-01-01

    Background Cervical cancer is the most prevalent cancer among Peruvian women. Female sex workers (FSW) in Peru are at elevated risk for HPV infection, and receive annual Papanicolaou screening. The objective of this study was to identify barriers to follow-up for abnormal Pap smears among FSW in Peru. Methods 97 FSW attending the Alberto Barton Health Center in Lima were surveyed regarding their STI screening history. 17 women with a history of an abnormal Pap smear were interviewed about their experiences regarding follow-up care. Results Of the 27 HPV-positive women, only 8 (30%) received follow-up treatment. Of the 19 women who did not receive follow-up, 7 (37%) had not been informed of their abnormal result. Qualitative interviews revealed that the major barrier to follow-up was lack of knowledge about HPV and potential health consequences of an abnormal Pap smear. Conclusion HPV infection is highly prevalent in Peruvian FSW, yet only 30% of FSW with abnormal Pap smears receive follow-up care. The predominant barriers to follow-up were lack of standardization in recording and communicating results and insufficient FSW knowledge regarding health consequences of HPV infection. Standardization of record-keeping and distribution of educational pamphlets have been implemented to improve follow-up for HPV. PMID:28060937

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

    ERIC Educational Resources Information Center

    Zimmerman, Stephanie; Makoroff, Kathi; Care, Marguerite; Thomas, Amy; Shapiro, Robert

    2005-01-01

    Objective: To evaluate the utility of a follow-up skeletal survey in suspected child physical abuse evaluations. Methods: In this prospective study, follow-up skeletal surveys were recommended for 74 children who, after an initial skeletal survey and evaluation by the Child Abuse Team, were suspected victims of physical abuse. The number and…

  13. Men with Intellectual Disabilities Who Have Attended Sex Offender Treatment Groups: A Follow-up

    ERIC Educational Resources Information Center

    Heaton, Kathryn M.; Murphy, Glynis H.

    2013-01-01

    Background: There have been a number of studies of treatment for men with intellectual disabilities and sexually abusive behaviour but few follow-up studies. Our aim was to follow up men with intellectual disabilities who had attended group cognitive behavioural treatment (CBT) for sexually abusive behaviour. Method Thirty-four men (from seven…

  14. How Do Mode and Timing of Follow-up Surveys Affect Evaluation Success?

    ERIC Educational Resources Information Center

    Koundinya, Vikram; Klink, Jenna; Deming, Philip; Meyers, Andrew; Erb, Kevin

    2016-01-01

    This article presents the analysis of evaluation methods used in a well-designed and comprehensive evaluation effort of a significant Extension program. The evaluation data collection methods were analyzed by questionnaire mode and timing of follow-up surveys. Response rates from the short- and long-term follow-ups and different questionnaire…

  15. GuLF Study: The Gulf Long-Term Follow-Up Study

    MedlinePlus

    ... Investigator for the GuLF STUDY The Gulf Long-term Follow-up Study ( GuLF STUDY ) is the largest ... in Spain and South Korea – included any long-term follow-up. Early data from these studies suggested ...

  16. Follow-Up 92. Minnesota High School Follow-Up. Class of 1991--One Year Later. Trend Data: 1978-1991.

    ERIC Educational Resources Information Center

    Sedey, John M.

    A study examined the educational and employment activities of members of Minnesota's high school class of 1991. Data regarding 12,270 students (11,674 graduates, 218 dropouts, and 378 students school leavers not classified as dropouts) were collected from 107 high schools participating in the Minnesota Secondary School Follow-up System and from…

  17. Follow-Up 91. Minnesota High School Follow-Up. Class of 1990--One Year Later. Trend Data: 1978-1990.

    ERIC Educational Resources Information Center

    Sedey, John M.

    A study examined the educational and employment activities of members of Minnesota's high school class of 1990. Data regarding 12,458 students (11,814 graduates, 356 dropouts, and 288 students school leavers not classified as dropouts) were collected from 90 high schools participating in the Minnesota Secondary School Follow-up System and from 926…

  18. Follow-Up 90. Minnesota High School Follow-Up. Class of 1989: One Year Later. Trend Data: 1978-1989.

    ERIC Educational Resources Information Center

    Sedey, John M.

    A study examined the educational and employment activities of members of Minnesota's high school class of 1989. Data regarding 14,636 students (14,024 graduates, 324 dropouts, and 288 students school leavers not classified as dropouts) were collected from 97 high schools participating in the Minnesota Secondary School Follow-up System and from 853…

  19. Follow-Up 89. Minnesota High School Follow-Up. Class of 1988: One Year Later. Trend Data: 1978-1988.

    ERIC Educational Resources Information Center

    Sedey, John M.

    A study examined the educational and employment activities of members of Minnesota's high school class of 1988. Data regarding 15,232 students (14,151 graduates, 503 dropouts, and 578 students school leavers not classified as dropouts) were collected from 87 high schools participating in the Minnesota Secondary School Follow-up System and from 966…

  20. Post-surgical tympanostomy tube follow up with audiology: experience at the Freeman Hospital.

    PubMed

    Davies-Husband, C R; Harker, C; Davison, T; Yates, P D

    2012-02-01

    Tympanostomy tube (grommet) insertion is a common procedure, with little guidance in the current literature regarding post-operative surveillance. Our institution implemented a protocol to follow up post-surgical grommet patients via audiology at six weeks. A retrospective audit of all patients less than 16 years old who had undergone grommet insertion during a three-month period. A total of 149 patients had grommets inserted. Exclusion criteria left a cohort of 123 individuals; 82 (67 per cent) were followed up by audiology. Of these, 13 (11 per cent) did not attend follow up, and were discharged; 53 (43 per cent) were discharged from audiology with normal thresholds; and 16 (13 per cent) were referred back to a consultant. Therefore, the overall reduction in patients followed up by an otolaryngologist was 54 per cent. We recommend a six-week follow up with audiology following grommet insertion, allowing for referral back to ENT services in the event of related complications.

  1. Follow-up outcomes after benign concordant MRI-guided breast biopsy.

    PubMed

    Hayward, Jessica H; Ray, Kimberly M; Wisner, Dorota J; Joe, Bonnie N

    2016-01-01

    To evaluate outcomes of benign concordant magnetic resonance imaging (MRI)-guided breast biopsy. We retrospectively reviewed 611 consecutive MRI-guided breast core biopsies at our institution from 2005 to 2012. Benign concordant cases with MRI follow-up constituted the study group. Lesion appearance on follow-up MRI was assessed and the false-negative rate was calculated. Eighty-four lesions in 68 women underwent benign concordant MRI-guided biopsy with subsequent MRI follow-up. Mean time to first follow-up MRI was 10.5 months. Two false negatives were identified on follow-up at 8 and 26 months. We report a false-negative rate of MRI-guided breast biopsy of 2.4%. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. EA follow-up in the Ghanaian mining sector: Challenges and opportunities

    SciTech Connect

    Appiah-Opoku, Seth; Bryan, Hobson C.

    2013-07-15

    Environmental assessment (EA) follow-up provides a means for monitoring and evaluating the implementation of environmental impact studies. It is integral to the success or failure of a project or program. In spite of its importance, very little attention is given to the need for follow-up programs in most jurisdictions in Africa. Using a case study in the Ghanaian mining sector, this paper explores the challenges and opportunities within the country's EA process for an effective follow-up program. The paper is based on informal interviews, content analysis of relevant publications, official EA documents, and internet searches. The authors suggest a standard EA follow-up program to be formalized as an integral part of Ghana's environmental assessment policy. They also propose a follow-up process that harnesses existing opportunities within the country's EA system. This approach can be replicated in other African countries.

  3. Cost Analysis of Following Up Incomplete Low-Risk Fetal Anatomy Ultrasounds.

    PubMed

    O'Brien, Karen; Shainker, Scott A; Modest, Anna M; Spiel, Melissa H; Resetkova, Nina; Shah, Neel; Hacker, Michele R

    2017-03-01

    To examine the clinical utility and cost of follow-up ultrasounds performed as a result of suboptimal views at the time of initial second-trimester ultrasound in a cohort of low-risk pregnant women. We conducted a retrospective cohort study of women at low risk for fetal structural anomalies who had second-trimester ultrasounds at 16 to less than 24 weeks of gestation from 2011 to 2013. We determined the probability of women having follow-up ultrasounds as a result of suboptimal views at the time of the initial second-trimester ultrasound, and calculated the probability of detecting an anomaly on follow-up ultrasound. These probabilities were used to estimate the national cost of our current ultrasound practice, and the cost to identify one fetal anomaly on follow-up ultrasound. During the study period, 1,752 women met inclusion criteria. Four fetuses (0.23% [95% CI 0.06-0.58]) were found to have anomalies at the initial ultrasound. Because of suboptimal views, 205 women (11.7%) returned for a follow-up ultrasound, and one (0.49% [95% CI 0.01-2.7]) anomaly was detected. Two women (0.11%) still had suboptimal views and returned for an additional follow-up ultrasound, with no anomalies detected. When the incidence of incomplete ultrasounds was applied to a similar low-risk national cohort, the annual cost of these follow-up scans was estimated at $85,457,160. In our cohort, the cost to detect an anomaly on follow-up ultrasound was approximately $55,000. The clinical yield of performing follow-up ultrasounds because of suboptimal views on low-risk second-trimester ultrasounds is low. Since so few fetal abnormalities were identified on follow-up scans, this added cost and patient burden may not be warranted. © 2016 Wiley Periodicals, Inc.

  4. Follow-up on the treatment of panic disorder with or without agoraphobia: a quantitative review.

    PubMed

    Bakker, A; van Balkom, A J; Spinhoven, P; Blaauw, B M; van Dyck, R

    1998-07-01

    We conducted a meta-analysis to update the knowledge of long-term efficacy of different treatments in panic disorder with or without agoraphobia. Included were 68 studies pertaining to 106 treatment conditions and 1346 patients. Effect sizes Cohen's d were calculated within the treatment conditions at posttest and at follow-up for panic and agoraphobia. A comparison was made between six treatments: high-potency benzodiazepines, antidepressants, psychological panic management, exposure in vivo, antidepressants combined with exposure, and psychological panic management combined with exposure in vivo. The mean (+/- SD) duration of the follow-up period was 62 +/- 89 weeks. In the majority of the studies (84%), follow-up had a naturalistic character. The lack of information about treatments received between posttest and follow-up limits the interpretation of the results. For all conditions, the treatment gains at posttest were maintained during the follow-up period. The mean (+/- SD) d for panic was 1.11 +/- 0.70 at posttest and 1.28 +/- 0.61 at follow-up; for agoraphobia, the mean d at posttest was 1.36 +/- 1.10 and at follow-up it was 1.41 +/- 0.82. Significant differences were found in efficacy on agoraphobic measures at follow-up between the combination of antidepressants and exposure in vivo versus psychological panic management, exposure in vivo, and the combination of psychological panic management and exposure. Overall, the data suggest that different treatment options for panic disorder with or without agoraphobia are effective at both posttest and follow-up. Research on long-term treatment, discontinuation of therapies, and interventions between posttest and follow-up need more attention, for pharmacotherapy as well as psychotherapy.

  5. Gynaecological cancer follow-up: national survey of current practice in the UK

    PubMed Central

    Leeson, Simon; Stuart, Nick; Sylvestre, Yvonne; Hall, Liz; Whitaker, Rhiannon

    2013-01-01

    Objective To establish a baseline of national practice for follow-up after treatment for gynaecological cancer. Design Questionnaire survey. Setting Gynaecological cancer centres and units. Geographical location UK. Participants Members of the British Gynaecological Cancer Society and the National Forum of Gynaecological Oncology Nurses. Interventions A questionnaire survey. Outcome measures To determine schedules of follow-up, who provides it and what routine testing is used for patients who have had previous gynaecological cancer. Results A total of 117 responses were obtained; 115 (98%) reported hospital scheduled regular follow-up appointments. Two involved general practitioners. Follow-up was augmented or replaced by telephone follow-up in 29 responses (25%) and patient-initiated appointments in 38 responses (32%). A total of 80 (68%) cancer specialists also offered combined follow-up clinics with other specialties. Clinical examinations for hospital-based follow-up were mainly performed by doctors (67% for scheduled regular appointments and 63% for patient-initiated appointments) while telephone follow-up was provided in the majority by nurses (76%). Most respondents (76/117 (65%)) provided routine tests, of which 66/76 (87%) reported carrying out surveillance tests for ovarian cancer, 35/76 (46%) for cervical cancer, 8/76 (11%) for vulval cancer and 7/76 (9%) for endometrial cancer. Patients were usually discharged after 5 years (82/117 (70%)), whereas three (3%) were discharged after 4 years, nine (8%) after three years and one (1%) after 2 years. Conclusions Practice varied but most used a standard hospital-based protocol of appointments for 5 years and routine tests were performed usually for women with ovarian cancer. A minority utilised nurse-led or telephone follow-up. General practitioners were rarely involved in routine care. A randomised study comparing various models of follow-up could be considered. PMID:23883880

  6. Gynaecological cancer follow-up: national survey of current practice in the UK.

    PubMed

    Leeson, Simon; Stuart, Nick; Sylvestre, Yvonne; Hall, Liz; Whitaker, Rhiannon

    2013-01-01

    To establish a baseline of national practice for follow-up after treatment for gynaecological cancer. Questionnaire survey. Gynaecological cancer centres and units. Members of the British Gynaecological Cancer Society and the National Forum of Gynaecological Oncology Nurses. A questionnaire survey. To determine schedules of follow-up, who provides it and what routine testing is used for patients who have had previous gynaecological cancer. A total of 117 responses were obtained; 115 (98%) reported hospital scheduled regular follow-up appointments. Two involved general practitioners. Follow-up was augmented or replaced by telephone follow-up in 29 responses (25%) and patient-initiated appointments in 38 responses (32%). A total of 80 (68%) cancer specialists also offered combined follow-up clinics with other specialties. Clinical examinations for hospital-based follow-up were mainly performed by doctors (67% for scheduled regular appointments and 63% for patient-initiated appointments) while telephone follow-up was provided in the majority by nurses (76%). Most respondents (76/117 (65%)) provided routine tests, of which 66/76 (87%) reported carrying out surveillance tests for ovarian cancer, 35/76 (46%) for cervical cancer, 8/76 (11%) for vulval cancer and 7/76 (9%) for endometrial cancer. Patients were usually discharged after 5 years (82/117 (70%)), whereas three (3%) were discharged after 4 years, nine (8%) after three years and one (1%) after 2 years. Practice varied but most used a standard hospital-based protocol of appointments for 5 years and routine tests were performed usually for women with ovarian cancer. A minority utilised nurse-led or telephone follow-up. General practitioners were rarely involved in routine care. A randomised study comparing various models of follow-up could be considered.

  7. Factors associated with intentions to adhere to colorectal cancer screening follow-up exams

    PubMed Central

    Zheng, Ying-Fang; Saito, Tami; Takahashi, Miyako; Ishibashi, Teruo; Kai, Ichiro

    2006-01-01

    Background To increase adherence rate to recommendations for follow-up after abnormal colorectal cancer (CRC) screening results, factors that inhibit and facilitate follow-up must be identified. The purpose of this study was to identify the factors associated with intention to adhere to CRC screening follow-up exams. Methods During a 4-week period in October 2003, this survey was conducted with 426 subjects participating in a community-based CRC screening program in Nagano, Japan. Study measures included intention to adhere to recommendation for clinical follow-up in the event of an abnormal fecal occult blood test (FOBT) result, perceived susceptibility and severity of CRC, perceived benefits and barriers related to undergoing follow-up examination, social support, knowledge of CRC risk factors, health status, previous CRC screening, personality and social demographic characteristics. Univariate and multivariate logistic regression analyses on intention to adhere to recommendations for follow-up were performed. Results Among the 288 individuals analyzed, approximately 74.7% indicated that they would definitely adhere to recommendations for follow-up. After controlling for age, gender, marital status, education, economic status, trait anxiety, bowel symptoms, family history of CRC, and previous screening FOBT, analyses revealed that lower levels of perceived barriers, higher levers of perceived benefits and knowledge of CRC risk factors were significantly associated with high intention respectively. Conclusion The results of this study suggest that future interventions should focus on reducing modifiable barriers by clarifying misperceptions about follow-up, promoting the acceptance of complete diagnostic evaluations, addressing psychological distress, and making follow-up testing more convenient and accessible. Moreover, educating the public regarding the risk factors of CRC and increasing understanding of the benefits of follow-up is also important. PMID:17083746

  8. 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.

  9. 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.

  10. Interventions to Improve Follow-Up of Abnormal Findings in Cancer Screening

    PubMed Central

    Bastani, Roshan; Yabroff, K. Robin; Myers, Ronald E.; Glenn, Beth

    2006-01-01

    The potential reduction in morbidity and mortality through cancer screening cannot be realized without receipt of appropriate follow-up care for abnormalities identified via screening. In this paper, the authors critically examine the existing literature on correlates of receipt of appropriate follow-up care for screen-detected abnormalities, as well as the literature on interventions designed to increase rates of receipt of follow-up care. Lessons learned describe what is known and not known about factors that are related to or predict receipt of follow-up care. Similarly, effective interventions to increase follow-up are described and gaps identified. A conceptual model is developed that categorizes the health care system in the United States as comprising four levels: policy, practice, provider, and patient. Some patient-level factors that influence follow-up receipt are identified, but the lack of data severely limit the understanding of provider, practice, and policy-level correlates. The majority of intervention studies to increase follow-up receipt have focused on patient-level factors and have targeted follow-up of abnormal Papanicolaou smears. Insufficient information is available regarding the effectiveness of provider, practice, or policy-level interventions. Standard definitions of what constitutes appropriate follow-up are lacking, which severely limit comparability of findings across studies. The validity of various methods of obtaining outcome data has not been clearly established. More research is needed on interventions targeting provider, system, and policy-level factors, particularly interventions focusing on follow-up of colorectal and breast abnormalities. Standardization of definitions and measures is needed to facilitate comparisons across studies. PMID:15316914

  11. 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

  12. Follow-up care instructions, treatment summaries, and cancer survivors' receipt of follow-up health care and late/long term effects.

    PubMed

    Jabson, Jennifer M

    2015-07-01

    Cancer survivors need follow-up care. Survivorship care plans (SCP), including follow-up care instructions (FCI) and treatment summaries (TS), were designed to improve cancer survivors' receipt of follow-up care after cancer treatment. However, there is a paucity of evidence regarding the relationship between survivors' receipt of FCI and TS and their receipt of follow-up care and late/long term effects. This study used data from the 2010 LIVESTRONG online survey of people affected by cancer, including 3541 cancer survivors who had completed treatment. Receipt of FCI was associated with greater likelihood of attendance at all regular medical appointments (aOR 2.28, 95% CI 1.60-3.23), receipt of cancer surveillance (aOR 1.64, 95% CI 1.28-2.09), being up to date on preventive cancer screening (aOR 2.63, 95% CI 2.00-3.47), and with fewer late/long term effects (IRR 0.77, 95% CI 0.69-0.85). Receipt of TS was associated with greater likelihood of attendance at all regular medical appointments (aOR 1.79, 95% CI 1.31-2.44) and being up to date on preventive cancer screening (aOR 1.43, 95% CI 1.14-1.78), but not cancer surveillance or late/long term effects. This study is among the first to document the associations between SCP and survivors' attendance at regular medical appointments, cancer surveillance, preventive cancer screenings, and late/long term effects. The findings suggest that SCP may facilitate follow-up care needed by cancer survivors after cancer treatment is completed.

  13. Using technology to deliver cancer follow-up: a systematic review

    PubMed Central

    2014-01-01

    Background People with cancer receive regular structured follow up after initial treatment, usually by a specialist in a cancer centre. Increasing numbers of cancer survivors prompts interest in alternative structured follow-up models. There is worldwide evidence of increasing interest in delivering cancer follow-up using technology. This review sough evidence supporting the use of technology in cancer follow-up from good quality randomised controlled trials. Method A search strategy was developed to identify randomised controlled trials and reviews of randomised trials of interventions delivering some aspect of structured cancer follow-up using new technologies. Databases searched were: All EBM Reviews; Embase; Medline (No Revisions); Medline (Non-Indexed Citations), and CAB Abstracts. Included articles were published in English between 2000 and 2014. Key words were generated by the research question. Papers were read independently and appraised using a standardised checklist by two researchers, with differences being resolved by consensus [J Epidemiol Community Health, 52:377–384, 1998]. Information was collected on the purpose, process, results and limitations of each study. All outcomes were considered, but particular attention paid to areas under consideration in the review question. Results The search strategy generated 22879 titles. Following removal of duplicates and abstract review 17 full papers pertaining to 13 randomised controlled studies were reviewed. Studies varied in technologies used and the elements of follow-up delivered, length of follow-up, tumour type and numbers participating. Most studies employed only standard telephone follow-up. Most studies involved women with breast cancer and included telephone follow-up. Together the results suggest that interventions comprising technology had not compromised patient satisfaction or safety, as measured by symptoms, health related quality of life or psychological distress. There was insufficient

  14. Using technology to deliver cancer follow-up: a systematic review.

    PubMed

    Dickinson, Rebekah; Hall, Susan; Sinclair, Jenny E; Bond, Christine; Murchie, Peter

    2014-05-03

    People with cancer receive regular structured follow up after initial treatment, usually by a specialist in a cancer centre. Increasing numbers of cancer survivors prompts interest in alternative structured follow-up models. There is worldwide evidence of increasing interest in delivering cancer follow-up using technology. This review sough evidence supporting the use of technology in cancer follow-up from good quality randomised controlled trials. A search strategy was developed to identify randomised controlled trials and reviews of randomised trials of interventions delivering some aspect of structured cancer follow-up using new technologies. Databases searched were: All EBM Reviews; Embase; Medline (No Revisions); Medline (Non-Indexed Citations), and CAB Abstracts. Included articles were published in English between 2000 and 2014. Key words were generated by the research question. Papers were read independently and appraised using a standardised checklist by two researchers, with differences being resolved by consensus [J Epidemiol Community Health, 52:377-384, 1998]. Information was collected on the purpose, process, results and limitations of each study. All outcomes were considered, but particular attention paid to areas under consideration in the review question. The search strategy generated 22879 titles. Following removal of duplicates and abstract review 17 full papers pertaining to 13 randomised controlled studies were reviewed. Studies varied in technologies used and the elements of follow-up delivered, length of follow-up, tumour type and numbers participating. Most studies employed only standard telephone follow-up. Most studies involved women with breast cancer and included telephone follow-up. Together the results suggest that interventions comprising technology had not compromised patient satisfaction or safety, as measured by symptoms, health related quality of life or psychological distress. There was insufficient evidence to comment on the cost

  15. Large Regional Differences in Serological Follow-Up of Q Fever Patients in The Netherlands

    PubMed Central

    Morroy, Gabriëlla; Wielders, Cornelia C. H.; Kruisbergen, Mandy J. B.; van der Hoek, Wim; Marcelis, Jan H.; Wegdam-Blans, Marjolijn C. A.; Wijkmans, Clementine J.; Schneeberger, Peter M.

    2013-01-01

    Background During the Dutch Q fever epidemic more than 4,000 Q fever cases were notified. This provided logistical challenges for the organisation of serological follow-up, which is considered mandatory for early detection of chronic infection. The aim of this study was to investigate the proportion of acute Q fever patients that received serological follow-up, and to identify regional differences in follow-up rates and contributing factors, such as knowledge of medical practitioners. Methods Serological datasets of Q fever patients diagnosed between 2007 and 2009 (N = 3,198) were obtained from three Laboratories of Medical Microbiology (LMM) in the province of Noord-Brabant. One LMM offered an active follow-up service by approaching patients; the other two only tested on physician's request. The medical microbiologist in charge of each LMM was interviewed. In December 2011, 240 general practices and 112 medical specialists received questionnaires on their knowledge and practices regarding the serological follow-up of Q fever patients. Results Ninety-five percent (2,226/2,346) of the Q fever patients diagnosed at the LMM with a follow-up service received at least one serological follow-up within 15 months of diagnosis. For those diagnosed at a LMM without this service, this was 25% (218/852) (OR 54, 95% CI 43–67). Although 80% (162/203) of all medical practitioners with Q fever patients reported informing patients of the importance of serological follow-up, 33% (67/203) never requested it. Conclusions Regional differences in follow-up are substantial and range from 25% to 95%. In areas with a low follow-up rate the proportion of missed chronic Q fever is potentially higher than in areas with a high follow-up rate. Medical practitioners lack knowledge regarding the need, timing and implementation of serological follow-up, which contributes to patients receiving incorrect or no follow-up. Therefore, this information should be incorporated in national guidelines

  16. [Predictors of participation in medical rehabilitation follow-up in working patients with chronic back pain].

    PubMed

    Sibold, M; Mittag, O; Kulick, B; Müller, E; Opitz, U; Jäckel, W H

    2011-12-01

    Outpatient follow-up programmes aim to increase the sustainability of rehabilitation. However, the factors influencing participation in follow-up programmes are still unclear. The aim of this study was to examine participation in the MERENA follow-up programme of the Rhineland-Palatinate German Pension Fund. The study was conducted in 12 outpatient rehabilitation centres with 192 working patients who were being treated for chronic back pain at the time the survey was conducted. Both patients and physicians completed a written survey at the outset of rehabilitation, on completion, and again (if applicable) at the end of the follow-up programme. The data collected mainly concerned the patients' health and factors related to their occupational situation (e. g. functional capacity, working capacity) and reasons for refusing to participate in the MERENA follow-up programme. Predictors for participation in the follow-up programme were determined using binary logistic regression analysis. On completion of rehabilitation, nearly all patients were given the recommendation to participate in the follow-up programme. Half of these patients took advantage of the programme. The most frequently given reason for refusal to participate was that participation in the programme was not compatible with their duties at work. Low functional capacity and continued work disability increased the probability that a patient would take part in a follow-up programme after rehabilitation. In contrast, a longer commute to the centre was an obstacle to participation. Women were more likely to participate in the programme than men. The results indicate that participation in a follow-up programme is often not compatible with employment. We could not satisfactorily explain why women were more likely to participate in the programme. This result could have been related to women's more flexible time schedules. An improvement of the current situation could be achieved by having follow-up programmes

  17. The optimized evaluation of diabetic foot infection by dual isotope SPECT/CT imaging protocol.

    PubMed

    Heiba, Sherif I; Kolker, Dov; Mocherla, Bharat; Kapoor, Karan; Jiang, Manli; Son, Hongju; Rangaswamy, Balasubramanya; Kostakoglu, Lale; Savitch, Ina; DaCosta, Maria; Machac, Josef

    2010-01-01

    Sequential Tc-99m hydroxymethylene-diphosphonate (HDP) 3-phase bone (BS) and In-111 leukocyte scanning (WBCS) have been frequently used to evaluate the diabetic foot, as nonosteomyelitis BS uptake is repeatedly observed and osteomyelitis (OM) in WBCS is often uncertain without BS correlation. Additionally, both modalities are limited in lesion localization because of low resolution and lack of anatomic details. We investigated a method that combined BS/WBCS, and if needed, WBCS/bone marrow scanning (BMS) using SPECT/CT to accurately diagnose/localize infection in a practical protocol. Blood flow/pool images were obtained followed by WBC reinjection and next day dual isotope (DI) BS/WBCS planar and SPECT/CT. BMS/WBCS SPECT/CT (step 2 DI) was obtained on the following day when images were suspicious for mid/hindfoot OM. Diagnosis accuracy and confidence were judged for the various imaging combinations. Diagnosis was classified as OM, soft tissue infection (STI), both OM/STI, and other/no bony pathology by microbiology/pathology or follow-up. Distinction between various diagnostic categories and overall OM diagnostic accuracy in 213 patients were higher for DI than WBCS or BS alone, and for DI SPECT/CT than DI planar or SPECT only. Diagnostic confidence/lesion site was significantly higher for DI SPECT/CT than other comparative imaging methods. In a group of 97 patients with confirmed microbiologic/pathologic diagnosis, similar results were attained. Step 2 DI SPECT/CT performed in 67 patients further improved diagnostic accuracy/confidence. DI SPECT/CT is a highly accurate modality that considerably improves detection and discrimination of STI and OM while providing precise anatomic localization in the diabetic foot. This combined imaging technique promises to beneficially impact diabetic patient care. Copyright © 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Predictors of Follow-Up Completion Among Runaway Substance-Abusing Adolescents and their Primary Caretakers

    PubMed Central

    Patton, Rikki; Bantchevska, Denitza; Guo, Xiamei; Kim, Yunhwan

    2010-01-01

    Follow-up rates reported among longitudinal studies that focus on runaway adolescents and their families are relatively low. Identifying factors associated with follow-up completion might be useful for improving follow-up rates and therefore study validity. The present study explored how individual- and family-level constructs, as well as research project activities, influence the follow-up completion rate among runaway adolescents (N = 140) and their primary caregiver. Results showed that follow-up completion rates decreased as the number of research assistants (RA) assigned to each case increased and as participants’ address changes increased. Additionally, among adolescents, more frequent alcohol use was associated with lower follow-up rates. The current findings suggest that researchers should (1) design their research so that one RA is assigned to each specific case, and (2) adjust their retention strategies to account for the differences in follow-up rates based upon the participants’ drug of choice and residential stability. PMID:20043208

  19. Rural-Urban Differences in the Effect of Follow-Up Care on Postdischarge Outcomes.

    PubMed

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

    2017-08-01

    To assess rural-urban differences in quality of postdischarge care among Medicare beneficiaries, controlling for selection bias of postdischarge services. The Medicare Current Beneficiary Survey (MCBS), Cost and Use Files from 2000 to 2010, the Area Resource File, Provider of Services File, and the Dartmouth Atlas of Health Care. Retrospective analysis of 30- and 60-day hospital readmission, emergency department (ED) use, and mortality using two-stage residual inclusion; receipt of 14-day follow-up care was the main independent variable. We defined index admission from the MCBS as any admission without a previous admission within 60 days. Noninstrumental variables estimation was the preferred estimation strategy. Fourteen-day follow-up care reduced the risk of readmission, ED use, and mortality. There were no rural- urban differences in the effect of 14-day follow-up care on readmission and mortality. Rural beneficiaries experienced a greater effect of 14-day follow-up care on reducing 30-day ED use compared to urban beneficiaries. Follow-up care reduces 30- and 60-day readmission, ED use, and mortality. Rural and urban Medicare beneficiaries experience similar beneficial effects of follow-up care on the outcomes. Policies that improve follow-up care in rural settings may be beneficial. © Health Research and Educational Trust.

  20. Adherence to Follow-Up Recommendations by Triathlon Competitors Receiving Event Medical Care

    PubMed Central

    Lloyd, Jarem B.; Copeli, Nikoli

    2017-01-01

    Introduction. We sought to investigate triathlete adherence to recommendations for follow-up for participants who received event medical care. Methods. Participants of the 2011 Ironman Syracuse 70.3 (Syracuse, NY) who sought evaluation and care at the designated finish line medical tent were contacted by telephone approximately 3 months after the initial encounter to measure adherence with the recommendation to seek follow-up care after event. Results. Out of 750 race participants, 35 (4.6%) athletes received event medical care. Of these 35, twenty-eight (28/35; 80%) consented to participate in the study and 17 (61%) were available on telephone follow-up. Of these 17 athletes, 11 (11/17; 65%) of participants reported that they had not followed up with a medical professional since the race. Only 5 (5/17; 29%) confirmed that they had seen a medical provider in some fashion since the race; of these, only 2 (2/17; 12%) sought formal medical follow-up resulting from the recommendation whereas the remaining athletes merely saw their medical providers coincidentally or as part of routine care. Conclusion. Only 2 (2/17; 12%) of athletes who received event medical care obtained postrace follow-up within a one-month time period following the race. Event medical care providers must be aware of potential nonadherence to follow-up recommendations. PMID:28203462

  1. Language Barriers, Location of Care and Delays in Follow-up of Abnormal Mammograms

    PubMed Central

    Karliner, LS; Ma, L; Hofmann, M; Kerlikowske, K

    2013-01-01

    Background Breast cancer is frequently diagnosed after an abnormal mammography result. Language barriers can complicate communication of those results. Objectives We evaluated the association of non-English language with delay in follow-up. Methods: Retrospective cohort study of women at three mammography facilities participating in the San Francisco Mammography Registry (SFMR) with an abnormal mammogram result from 1997-2008. We measured median time from report of abnormal result to first follow-up test. Results Of 13,014 women with 16,109 abnormal mammograms, 4,027 (31%) had a non-English patient language. Clinical facilities differed in proportion of non-English-speakers and in time to first follow-up test: facility A (38%; 25 days), facility B (18%; 14 days), facility C (51%; 41 days). Most (67%) mammography examinations had BIRADS 0 (incomplete) assessment, requiring radiographic follow-up. At 30 days of follow-up 67% of all English speakers with incomplete assessments had a follow-up exam compared with 50% of all non-English speakers (p<.0001). The facility with the least delay and the lowest proportion of non-English speakers, had the biggest difference by language; compared to English speakers and adjusting for education, non-English speakers had twice the odds of >30 day delay in follow-up (OR 2.3; 95 CI 1.4-3.9). Conclusions There are considerable differences among facilities in delays in diagnostic follow-up of abnormal mammography results. More attention must be paid to understanding mammography facility factors, such as wait time to schedule diagnostic mammography and radiology workload, in order to improve rates of timely follow-up, particularly for those facilities disproportionately serving vulnerable non-English speaking patients. PMID:21993060

  2. Obesity, Gynecological Factors, and Abnormal Mammography Follow-Up in Minority and Medically Underserved Women

    PubMed Central

    Wujcik, Debra; Lin, Jin-Mann S.; Grau, Ana; Wilson, Veronica; Champion, Victoria; Zheng, Wei; Egan, Kathleen M.

    2009-01-01

    Abstract Background The relationship between obesity and screening mammography adherence has been examined previously, yet few studies have investigated obesity as a potential mediator of timely follow-up of abnormal (Breast Imaging Reporting and Data System [BIRADS-0]) mammography results in minority and medically underserved patients. Methods We conducted a retrospective cohort study of 35 women who did not return for follow-up >6 months from index abnormal mammography and 41 who returned for follow-up ≤6 months in Nashville, Tennessee. Patients with a BIRADS-0 mammography event in 2003–2004 were identified by chart review. Breast cancer risk factors were collected by telephone interview. Multivariate logistic regression was performed on selected factors with return for diagnostic follow-up. Results Obesity and gynecological history were significant predictors of abnormal mammography resolution. A significantly higher frequency of obese women delayed return for mammography resolution compared with nonobese women (64.7% vs. 35.3%). A greater number of hysterectomized women returned for diagnostic follow-up compared with their counterparts without a hysterectomy (77.8% vs. 22.2%). Obese patients were more likely to delay follow-up >6 months (adjusted OR 4.09, p = 0.02). Conversely, hysterectomized women were significantly more likely to return for timely mammography follow-up ≤6 months (adjusted OR 7.95, p = 0.007). Conclusions Study results suggest that weight status and gynecological history influence patients' decisions to participate in mammography follow-up studies. Strategies are necessary to reduce weight-related barriers to mammography follow-up in the healthcare system including provider training related to mammography screening of obese women. PMID:19558307

  3. Medium to long-term follow-up after ACL revision.

    PubMed

    Lind, Martin; Lund, Bent; Faunø, Peter; Said, Sinan; Miller, Lene Lindberg; Christiansen, Svend Erik

    2012-01-01

    The aim of the present study is to present epidemiology and clinical outcome after revision anterior cruciate ligament (ACL) reconstruction with an intermediate follow-up time of up to 9 years. A retrospective study of patients treated with ACL revision from 2001 to 2007 at a university referral clinic was conducted. Study follow-up was performed in 2010; this follow-up included objective IKDC scores, KOOS, Tegner and SANE subjective scores, KT-1000 knee laxity measurements and registration of reoperations and complications. One hundred and twenty-eight patients were available for follow-up. Median follow-up time was 6 (2-9) years. Mean age was 32 years, 50% were men. Eleven percent required staged procedures, 30% were reconstructed with allograft tendons and 23% had collateral ligament reconstruction in combination with the ACL revision. SANE knee global score (0-100) was 74 at follow-up, KOOS sub-scores were preoperatively 66, 69, 77, 42 and 39 for pain, symptoms, activity of daily living, sports and quality of life, respectively. At follow-up, scores were 70, 76, 81, 50 and 50, respectively. Sport and quality of life scores increased significantly. KT-1000 was 6.2 mm preoperatively and 2.5 at follow-up (P < 0.05). Six percent were re-revised and 2 patients had total knee replacements. Despite objective findings of acceptable sagittal knee stability at follow-up, subjective outcome scores indicate significant knee impairment with low scores in sport and quality of life. A re-revision rate of 6% after 6 years is acceptable. It is imperative that patients eligible for ACL revision receive proper counseling in terms of outcome expectancies. Retrospective case series, Level IV.

  4. 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.

  5. 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

  6. 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.

  7. A Facebook Follow-Up Strategy for Rural Drug-Using Women.

    PubMed

    Dickson, Megan F; Staton-Tindall, Michele; Smith, Kirsten E; Leukefeld, Carl; Webster, J Matthew; Oser, Carrie B

    2017-06-01

    Facebook (FB) use has grown exponentially over the past decade, including in rural areas. Despite its popularity, FB has been underutilized as a research follow-up approach to maintain contact with research participants and may have advantages in less densely populated areas and among more hard-to-reach, at-risk groups. The overall goal of this study was to examine FB as a supplemental follow-up approach to other follow-up strategies with rural drug-using women. Face-to-face interviews were conducted with randomly selected women who completed baseline interviews in 3 rural jails in 1 state. Analyses focus on participants who were released from jail and were eligible for 3-month follow-up (n = 284). Bivariate analyses were used to examine differences between FB users and nonusers, and multivariate logistic regression models examined predictors of 3-month follow-up participation and being located for follow-up using FB. About two-thirds (64.4%) of participants were regular FB users. Bivariate analyses indicated that FB users were younger, more educated, and more likely to have used alcohol in the 30 days before incarceration but less likely to have a chronic health problem. Regression analyses indicated that rural FB users had more than 5 times the odds of being located for the 3-month follow-up interview, even after controlling for other variables. There were no significant predictors of being followed up using FB. Findings suggest that FB is widely used and well accepted among rural drug-using women. Among hard-to-reach populations, including those in rural, geographically isolated regions, FB serves as a method to improve participant follow-up. © 2016 National Rural Health Association.

  8. 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

  9. Pi of the Sky involvement in LSC-Virgo electromagnetic follow-up project

    NASA Astrophysics Data System (ADS)

    ZadroŻny, Adam; Sokołowski, Marcin; Mankiewicz, Lech; Żarnecki, Aleksander Filip

    2016-09-01

    Pi of the Sky took part in LSC-Virgo's Electromagnetic (EM) Follow-up project during first science run of Advanced LIGO detectors between September 2015 and January 2016. More than 60 astronomical teams have signed Memorandum-of-Understanding with LSC-Virgo for EM Follow-up project. LSC-Virgo's EM Follow-up is aimed for searching electromagnetic counterparts to gravitational wave transient candidates. Observing an event both in EM and gravitational wave band might be a important step forward to multi-messenger astronomy. The aim of this paper is to show algorithms used by Pi of the Sky for analysing data taken during the science runs.

  10. Radiopharmaceuticals for SPECT cancer detection

    NASA Astrophysics Data System (ADS)

    Chernov, V. I.; Medvedeva, A. A.; Zelchan, R. V.; Sinilkin, I. G.; Stasyuk, E. S.; Larionova, L. A.; Slonimskaya, E. M.; Choynzonov, E. L.

    2016-08-01

    The purpose of the study was to assess the efficacy of single photon emission computed tomography (SPECT) with 199Tl and 99mTc-MIBI in the detection of breast, laryngeal and hypopharyngeal cancers. A total of 220 patients were included into the study: 120 patients with breast lesions (100 patients with breast cancer and 20 patients with benign breast tumors) and 100 patients with laryngeal/hypopharyngeal diseases (80 patients with laryngeal/hypopharyngeal cancer and 20 patients with benign laryngeal/hypopharyngeal lesions). No abnormal 199Tl uptake was seen in all patients with benign breast and laryngeal lesions, indicating a 100% specificity of 199Tl SPECT. In the breast cancer patients, the increased 199Tl uptake in the breast was visualized in 94.8% patients, 99mTc-MIBI—in 93.4% patients. The increased 199Tl uptake in axillary lymph nodes was detected in 60% patients, and 99mTc-MIBI—in 93.1% patients. In patients with laryngeal/hypopharyngeal cancer, the sensitivity of SPECT with 199Tl and 99mTc-MIBI was 95%. The 199Tl SPECT sensitivity in identification of regional lymph node metastases in the patients with laryngeal/hypopharyngeal cancer was 75% and the 99mTc-MIBI SPECT sensitivity was 17%. The data obtained showed that SPECT with 199Tl and 99mTc-MIBI can be used as one of the additional imaging methods in detection of tumors.

  11. Radiopharmaceuticals for SPECT Cancer Detection

    NASA Astrophysics Data System (ADS)

    Chernov, V. I.; Medvedeva, A. A.; Zelchan, R. V.; Sinilkin, I. G.; Stasyuk, E. S.; Larionova, L. A.; Slonimskaya, E. M.; Choynzonov, E. L.

    2016-06-01

    The purpose of the study was to assess the efficacy of single photon emission computed tomography (SPECT) with 199Tl and 99mTc-MIBI in the detection of breast, laryngeal and hypopharyngeal cancers. Materials and Methods: a total of 220 patients were included into the study. Of them, there were 120 patients with breast lesions (100 patients with breast cancer and 20 patients with benign breast tumors) and '00 patients with laryngeal/hypopharyngeal diseases (80 patients with laryngeal/hypopharyngeal cancer and 20 patients with benign laryngeal/hypopharyngeal lesions). Results: no abnormal 199Tl uptake was seen in all patients with benign breast and laryngeal lesions, indicating a 100% specificity of 199Tl SPECT. In breast cancer patients, increased 199Tl uptake in the breast was visualized in 94.8% patients, 99mTc-MIBI in 93.4% patients. Increased 199Tl uptake in axillary lymph nodes was detected in 60% patients and 99mTc-MIBI in 93.1% patients. In patients with laryngeal/hypopharyngeal cancer, sensitivity of SPECT with 199Tl and 99mTc-MIBI were 95%. The 199Tl SPECT sensitivity in identification of regional lymph node metastases in patients with laryngeal/hypopharyngeal cancer was 75% and the 99mTc-MIBI SPECT sensitivity was 17%. Conclusion: the data obtained show that SPECT with 199Tl and 99mTc-MIBI can be used as one of the additional imaging methods in detection of tumors.

  12. Drug Development in Alzheimer’s Disease: The Contribution of PET and SPECT

    PubMed Central

    Declercq, Lieven D.; Vandenberghe, Rik; Van Laere, Koen; Verbruggen, Alfons; Bormans, Guy

    2016-01-01

    Clinical trials aiming to develop disease-altering drugs for Alzheimer’s disease (AD), a neurodegenerative disorder with devastating consequences, are failing at an alarming rate. Poorly defined inclusion-and outcome criteria, due to a limited amount of objective biomarkers, is one of the major concerns. Non-invasive molecular imaging techniques, positron emission tomography and single photon emission (computed) tomography (PET and SPE(C)T), allow visualization and quantification of a wide variety of (patho)physiological processes and allow early (differential) diagnosis in many disorders. PET and SPECT have the ability to provide biomarkers that permit spatial assessment of pathophysiological molecular changes and therefore objectively evaluate and follow up therapeutic response, especially in the brain. A number of specific PET/SPECT biomarkers used in support of emerging clinical therapies in AD are discussed in this review. PMID:27065872

  13. Metal-on-Metal Total Hip Arthroplasty at Five to Twelve Years Follow-Up: A Concise Follow-Up of a Previous Report.

    PubMed

    Greiner, Justin J; Callaghan, John J; Bedard, Nicholas A; Liu, Steve S; Goetz, Devon D; Mahoney, Craig R

    2016-08-01

    Concern has arisen regarding potential complications with modular metal-on-metal (MoM) acetabular components in total hip arthroplasty. The purpose of this study was to analyze longitudinally the longer term results of a previously reported cohort of patients utilizing a cementless modular acetabular component with a MoM bearing. One hundred sixty-nine consecutive but selected total hip arthroplasties were performed in 148 patients at 2 institutions using a modular acetabular MoM component. One hundred thirty-nine patients (158 hips) were living at minimum 5 years, 1 patient (1 hip) was lost to follow-up and 8 patients (10 hips) were deceased. Patients were evaluated clinically in terms of revision as well as radiographically. Additional testing (metal ion levels, advanced imaging) was performed when concerns for adverse local tissue reaction (ALTR) arose. There were 6 (3.8%) additional hips revised since the prior report for a total of 7 hips (4.4%) revised at 5-12 year follow-up. All newly revised hips (3.8%) demonstrated ALTR. There were 7 (4.7%) additional cases of radiographically detected acetabular osteolysis and 7 (4.7%) cases of femoral osteolysis. Longitudinal evaluation of a modular MoM bearing surface acetabular component demonstrated increased rates of ALTR and osteolysis at longer duration follow-up. Although greater than 95% of hips in this study performed well at 5-12 years, when comparing the results to metal-on-polyethylene bearings using the same acetabular component, the results were inferior. Longitudinal surveillance is warranted with this design and this bearing surface couple as cases of ALTR and osteolysis increased with longer follow-up. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Acute pulmonary embolism detection with ventilation/perfusion SPECT combined with full dose CT: What is the best option?

    PubMed

    Milà, M; Bechini, J; Vázquez, A; Vallejos, V; Tenesa, M; Espinal, A; Fraile, M; Monreal, M

    To compare diagnostic accuracy of Ventilation/Perfusion (V/P) single-photon emission computed tomography (SPECT) combined with simultaneous full-dose CT with a hybrid SPECT/CT scanner versus planar ventilation/perfusion (V/P) SPECT and CT angiography (CTA) in patients suspected with acute pulmonary embolism (PE). Between 2009 and 2011, consecutive patients suspected of acute PE were referred for V/P SPECT/CT (reviewed board approved study). A contrast agent was administered to patients who had no contraindications. Non-contrast V/P SPECT/CT was performed on the remaining patients. All patients were followed-up for at least 3 months. A total of 314 patients were available during the study period, with the diagnosis of PE confirmed in 70 (22.29%) of them. The overall population sensitivity and specificity was 90.91% and 92.44%, respectively for V/P SPECT, 80% and 99.15%, respectively, for CTA, and 95.52% and 97.08% for V/P SPECT/CT. SPECT/CT performed better than V/P SPECT (AUC differences=0.0419, P=0.0043, 95% CI; 0.0131-0.0706) and CTA (AUC differences=0.0681, P=0.0208, 95% CI; 0.0103-0.1259)). Comparing imaging modalities when contrast agent could be administered, sensitivity and specificity increased and V/P SPECT/CT was significantly better than CTA (AUC differences=0.0681, P=0.0208, 95% CI; 0.0103-0.1259) and V/P SPECT (AUC differences=0.0659, P=0.0052, 95% CI; 0.0197-0.1121). In case of non-contrast enhancement, there was non-significant increase of specificity. Secondary findings on CT impacted patient management in 14.65% of cases. Our study shows that combined V/P SPECT/CT scanning has a higher diagnostic accuracy for detecting acute PE than V/P SPECT and CTA alone. When feasible, V/P SPECT/CT with contrast enhancement is the best option. Copyright © 2016. Publicado por Elsevier España, S.L.U.

  15. Breast Cancer and the Environment on Long Island Follow-up Study

    Cancer.gov

    A follow-up study on women with breast cancer who participated in the parent population-based case-control study of Long Island women to determine whether environmental and other lifestyle factors influence breast cancer survival.

  16. Did successfully treated pulmonary tuberculosis patients undergo all follow-up sputum smear examinations?

    PubMed

    Satyanarayana, S; Nagaraja, S B; Kelamane, S; Jaju, J; Chadha, S S; Chander, K; Vishnu, H; Wilson, N C; Harries, A D

    2011-12-21

    To assess response to anti-tuberculosis treatment as per national guidelines, a retrospective record review was undertaken in four districts of Andhra Pradesh, India, in December 2009 to determine whether pulmonary tuberculosis (PTB) patients reported as successfully treated (cured or treatment completed) underwent all scheduled follow-up sputum smear examinations. In a quarterly cohort of 3000 PTB patients reported as successfully treated, 1847 (61.5%) underwent all follow-up sputum examinations, with a higher proportion of new cases (65%) than retreatment cases (45%). The mid-continuation phase follow-up sputum examinations were commonly missed, and 11% patients had not undergone end-of-treatment follow-up sputum examinations.

  17. Assault history and follow-up contact of women survivors of recent sexual assault.

    PubMed

    Boykins, Anita D; Mynatt, Sarah

    2007-08-01

    The purpose of this comparative descriptive study is to describe and examine differences in assault characteristics and the issues surrounding follow-up contact of women survivors of a recent sexual assault. This study identified assault characteristics: half of the assaults were by strangers; approximately one-third of the assaults occurred in the victim's home; 29% of the victims were abducted; weapons and physical force were used in over half of the cases; 63% were vaginal assaults; and 86% involved penile penetration. Three months after the assault and the initial examination, only 23% (n = 18) of the study participants could be contacted by telephone for follow-up. The study's findings provide not only data regarding the characteristics of sexual assault, but also the difficulties in contacting adult female survivors for follow-up services. Recommendations outline the importance of thorough, individualized examinations and the need for improved, timely, follow-up services for sexual assault victims.

  18. Improving follow-up after fragility fractures: an evidence-based initiative.

    PubMed

    Myrick, Karen M

    2011-01-01

    Patients with fragility fractures are at risk for recurrent fractures and are at risk for inadequate follow up. Prevention of future fractures through appropriate follow-up can decrease annual healthcare expenditures and patient morbidity and mortality. The purpose of this quality improvement project was to delineate an evidence-based practice initiative at a university health center to improve patient follow-up care after fragility fractures. A review of the literature revealed significant evidence calling for notification of the patients' primary care provider, ordering a bone density scan within 3 months, and a referral to osteoporosis. A plan for improving patient outcomes was developed utilizing the iowa Model of Evidence-Based Practice to Promote Quality Care. The evidence-based initiative was implemented, and the outcomes were assessed. The results were that 100% of patients received adequate follow-up after fragility fractures.

  19. 46 CFR 4.06-50 - Specimen analysis and follow-up procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Involving Vessels in Commercial Service § 4.06-50 Specimen analysis and follow-up procedures. (a) Each... required by 49 CFR part 40, subpart G, and submit his or her findings to the marine employer. Blood test...

  20. 46 CFR 4.06-50 - Specimen analysis and follow-up procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Involving Vessels in Commercial Service § 4.06-50 Specimen analysis and follow-up procedures. (a) Each... required by 49 CFR part 40, subpart G, and submit his or her findings to the marine employer. Blood test...

  1. [Feasibility of following up a representative sample of the adult population in Barcelona (Spain)].

    PubMed

    Martínez-Sánchez, Jose M; Fu, Marcela; Sureda, Xisca; Ballbè, Montse; Riccobene, Anna; Fernández, Esteve

    2013-01-01

    The objective of this work was to study the feasibility of following up a representative sample of the adult population of Barcelona 8 years after the baseline study. We selected a random sample (n=100) of the 1161 participants who consented to be re-contacted. We contacted 66 participants: 52 (78.8%) agreed to participate in the follow-up, three (4.5%) had died, four (6.1%) had moved, and seven (10.6%) declined to participate in the follow-up. The participation rate in the feasibility study was 52%. In conclusion, the results of our study show a good feasibility of conducting a follow-up study 8 years after the baseline study. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

  2. Benefits of and barriers to SEA follow-up - Theory and practice

    SciTech Connect

    Gachechiladze-Bozhesku, M.; Fischer, T.B.

    2012-04-15

    If SEA is to facilitate 'strategic' changes, it needs to focus on shaping the ways in which strategic initiatives are implemented, not just formulated. This is why follow-up which refers to postdecisional activities of SEA and strategic initiatives is increasingly seen as crucial. However, to date follow-up has only received limited attention in the SEA literature, as well as in practical guidance. The key reasons for why post decision activities are often overlooked are the lack of understanding of its actual benefits and purportedly multiple problems with its accomplishment. This paper reports on the results of a comprehensive literature review and an international e-survey on the topic, as well as an in-depth analysis of six SEA follow-up cases from England and Canada. Practically encountered and perceived benefits of, and obstacles to SEA follow-up are identified and discussed.

  3. Dormaier and Chester Butte 2007 Follow-up Habitat Evaluation Procedures Report.

    SciTech Connect

    Ashley, Paul R.

    2008-01-01

    Follow-up habitat evaluation procedures (HEP) analyses were conducted on the Dormaier and Chester Butte wildlife mitigation sites in April 2007 to determine the number of additional habitat units to credit Bonneville Power Administration (BPA) for providing funds to enhance, and maintain the project sites as partial mitigation for habitat losses associated with construction of Grand Coulee Dam. The Dormaier follow-up HEP survey generated 482.92 habitat units (HU) or 1.51 HUs per acre for an increase of 34.92 HUs over baseline credits. Likewise, 2,949.06 HUs (1.45 HUs/acre) were generated from the Chester Butte follow-up HEP analysis for an increase of 1,511.29 habitat units above baseline survey results. Combined, BPA will be credited with an additional 1,546.21 follow-up habitat units from the Dormaier and Chester Butte parcels.

  4. Using Structured Telephone Follow-up Assessments to Improve Suicide-related Adverse Event Detection

    PubMed Central

    Arias, Sarah A.; Zhang, Zi; Hillerns, Carla; Sullivan, Ashley F.; Boudreaux, Edwin D.; Miller, Ivan; Camargo, Carlos A.

    2014-01-01

    Adverse event (AE) detection and reporting practices were compared during the first phase of the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE), a suicide intervention study. Data were collected using a combination of chart reviews and structured telephone follow-up assessments post-enrollment. Beyond chart reviews, structured telephone follow-up assessments identified 45% of the total AEs in our study. Notably, detection of suicide attempts significantly varied by approach with 53 (18%) detected by chart review, 173 (59%) by structured telephone follow-up assessments, and 69 (23%) marked as duplicates. Findings provide support for utilizing multiple methods for more robust AE detection in suicide research. PMID:24588679

  5. Asian Women Less Likely to Get Follow-Up After Abnormal Mammogram

    MedlinePlus

    ... https://medlineplus.gov/news/fullstory_166510.html Asian Women Less Likely to Get Follow-up After Abnormal ... 2017 MONDAY, June 12, 2017 (HealthDay News) -- Asian women in the San Francisco area were less likely ...

  6. 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.

  7. Remote monitoring and follow-up of pacemakers and implantable cardioverter defibrillators

    PubMed Central

    Burri, Haran; Senouf, David

    2009-01-01

    In the era of communication technology, new options are now available for following-up patients implanted with pacemakers (PMs) and defibrillators (ICDs). Most major companies offer devices with wireless capabilities that communicate automatically with home transmitters, which then relay data to the physician, thereby allowing remote patient follow-up and monitoring. These systems are being widely used in the USA for remote follow-up, and have been more recently introduced in Europe, where their adoption is increasing. In this article, we describe the currently existing systems, review the available evidence in the literature regarding remote follow-up and monitoring of PMs and ICDs, and finally discuss some unresolved issues. PMID:19470595

  8. Notification: Follow-up on a Framework for Developing Tribal Capacity

    EPA Pesticide Factsheets

    Project #OA-FY12-0333, March 1, 2012. We plan to follow-up on the 2008 report Framework for Developing Tribal Capacity Needed in the Indian General Assistance Program. and the Agency’s corrective actions.

  9. 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.

  10. Early Primary Care Provider Follow-up and Readmission After High-Risk Surgery

    PubMed Central

    Brooke, Benjamin S.; Stone, David H.; Cronenwett, Jack L.; Nolan, Brian; DeMartino, Randall R.; MacKenzie, Todd A.; Goodman, David C.; Goodney, Philip P.

    2014-01-01

    IMPORTANCE Follow-up with a primary care provider (PCP) in addition to the surgical team is routinely recommended to patients discharged after major surgery despite no clear evidence that it improves outcomes. OBJECTIVE To test whether PCP follow-up is associated with lower 30-day readmission rates after open thoracic aortic aneurysm (TAA) repair and ventral hernia repair (VHR), surgical procedures known to have a high and low risk of readmission, respectively. DESIGN, SETTING, AND PARTICIPANTS In a cohort of Medicare beneficiaries discharged to home after open TAA repair (n = 12 679) and VHR (n = 52 807) between 2003 to 2010, we compared 30-day readmission rates between patients seen and not seen by a PCP within 30 days of discharge and across tertiles of regional primary care use. We stratified our analysis by the presence of complications during the surgical (index) admission. MAIN OUTCOMES AND MEASURES Thirty-day readmission rate. RESULTS Overall, 2619 patients (20.6%) undergoing open TAA repair and 4927 patients (9.3%) undergoing VHR were readmitted within 30 days after surgery. Complications occurred in 4649 patients (36.6%) undergoing open TAA repair and 4528 patients (8.6%) undergoing VHR during their surgical admission. Early follow-up with a PCP significantly reduced the risk of readmission among open TAA patients who experienced perioperative complications, from 35.0% (without follow-up) to 20.4% (with follow-up) (P < .001). However, PCP follow-up made no significant difference in patients whose hospital course was uncomplicated (19.4% with follow-up vs 21.9% without follow-up; P = .31). In comparison, early follow-up with a PCP after VHR did not reduce the risk of readmission, regardless of complications. In adjusted regional analyses, undergoing open TAA repair in regions with high compared with low primary care use was associated with an 18% lower likelihood of 30-day readmission (odds ratio, 0.82; 95% CI, 0.71–0.96; P = .02), whereas no significant

  11. Rationale and design of the health economics evaluation registry for remote follow-up: TARIFF.

    PubMed

    Ricci, Renato P; D'Onofrio, Antonio; Padeletti, Luigi; Sagone, Antonio; Vicentini, Alfredo; Vincenti, Antonio; Morichelli, Loredana; Cavallaro, Ciro; Ricciardi, Giuseppe; Lombardi, Leonida; Fusco, Antonio; Rovaris, Giovanni; Silvestri, Paolo; Guidotto, Tiziana; Pollastrelli, Annalisa; Santini, Massimo

    2012-11-01

    The aims of the study are to develop a cost-minimization analysis from the hospital perspective and a cost-effectiveness analysis from the third payer standpoint, based on direct estimates of costs and QOL associated with remote follow-ups, using Merlin@home and Merlin.net, compared with standard ambulatory follow-ups, in the management of ICD and CRT-D recipients. Remote monitoring systems can replace ambulatory follow-ups, sparing human and economic resources, and increasing patient safety. TARIFF is a prospective, controlled, observational study aimed at measuring the direct and indirect costs and quality of life (QOL) of all participants by a 1-year economic evaluation. A detailed set of hospitalized and ambulatory healthcare costs and losses of productivity that could be directly influenced by the different means of follow-ups will be collected. The study consists of two phases, each including 100 patients, to measure the economic resources consumed during the first phase, associated with standard ambulatory follow-ups, vs. the second phase, associated with remote follow-ups. Remote monitoring systems enable caregivers to better ensure patient safety and the healthcare to limit costs. TARIFF will allow defining the economic value of remote ICD follow-ups for Italian hospitals, third payers, and patients. The TARIFF study, based on a cost-minimization analysis, directly comparing remote follow-up with standard ambulatory visits, will validate the cost effectiveness of the Merlin.net technology, and define a proper reimbursement schedule applicable for the Italian healthcare system. NCT01075516.

  12. Oncologists' Perspectives of Their Roles and Responsibilities During Multi-disciplinary Breast Cancer Follow-Up.

    PubMed

    Neuman, Heather B; Steffens, Nicole M; Jacobson, Nora; Tevaarwerk, Amye; Anderson, Bethany; Wilke, Lee G; Greenberg, Caprice C

    2016-03-01

    Improving the quality of follow-up provided to the 3 million U.S. breast cancer survivors is a high priority. Current guidelines do not provide guidance regarding who should participate in follow-up or what providers' specific responsibilities should be. Given the multidisciplinary nature of breast cancer care, this results in significant variation and creates the potential for redundancy and/or gaps. Our objective was to provide insight into why different types of oncologists believe their participation in follow-up is necessary. A purposeful sample of breast medical, radiation, and surgical oncologists was identified (n = 35) and in-depth one-on-one interviews were conducted. Data were analyzed using content analysis. Medical oncologists were driven by a sense of Responsibility for Ongoing Therapy, perceived Strong Patient Relationship, and belief that their systemic approach to follow-up represented a Specific Skillset beneficial to patients. In contrast, surgical and radiation oncologists were selective about which patients they followed, participating when they perceived their Specific Skillset of enhanced local-regional assessments would be valuable. Additionally, they endorsed participating to Ensure Follow-up is Received or not participating to Minimize Redundancy. These individual decisions led to either a Complementary Oncologist Team or Primary Oncologist follow-up approach. Oncologists' feel responsible for the cancer-related components of follow-up. Differences amongst oncology specialists' perceived responsibilities influenced decisions to provide ongoing follow-up. Based on these individual decisions, a Complementary Oncologist Team or Primary Oncologist model of care evolves organically. Guidelines that explicitly direct patients into a care model have the potential to significantly improve care quality and efficiency.

  13. Timing of follow-up after abnormal screening and diagnostic mammograms.

    PubMed

    Wernli, Karen J; Aiello Bowles, Erin J; Haneuse, Sebastien; Elmore, Joanne G; Buist, Diana S M

    2011-02-01

    To evaluate woman-level characteristics associated with timing of follow-up after abnormal mammograms in an integrated healthcare system with an active breast health program. Retrospective cohort study. The study included women aged 40-84 years who had an abnormal mammogram (20,060 screening and 3184 diagnostic) recommended for follow-up. We compared characteristics of women who received any follow-up evaluation within <7, 8 to 14, 15 to 21, and 22 to 180 days. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using multivariate ordinal logistic regression. The proportion of women seeking care within 7 days was 23% for screening and 69% for diagnostic mammograms. Characteristics associated with later follow-up (>8 days vs <7 days) after an abnormal screening mammogram included being older (OR=1.15; 95% CI, 1.04-1.26 [age 70-79 years]; OR=1.31; 95% CI, 1.14-1.51 [age 80+ years]), Asian (OR=1.18; 95% CI, 1.04-1.33), or having a college degree (OR=1.10; 95% CI, 1.01-1.19). Characteristics associated with earlier follow-up included family history of breast cancer (OR=0.93; 95% CI, 0.88-0.98), symptoms at time of mammogram (OR=0.79; 95% CI, 0.70-0.88), or extremely dense breasts (OR=0.82; 95% CI, 0.69-0.96). For diagnostic mammograms, symptoms at time of mammogram (OR=0.47; 95% CI, 0.39-0.56) and being obese (OR=0.79; 95% CI, 0.65-0.98) were associated with earlier follow-up. Several woman-level characteristics were associated with timely follow-up after an abnormal screening exam, but only presence of symptoms and being obese was associated with timely follow-up after an abnormal diagnostic exam.

  14. What Happens Next? Follow-Up from the Children's Toddler School Program

    ERIC Educational Resources Information Center

    Akshoomoff, Natacha; Stahmer, Aubyn C.; Corsello, Christina; Mahrer, Nicole E.

    2010-01-01

    This study was a follow-up of a group of 29 children diagnosed with autism spectrum disorders at age 2 who attended an inclusive toddler program until age 3. Children ranged in age from 4 to 12 years at the time of the parent survey and follow-up testing. The majority of children were placed in a special education (noninclusive) preschool class,…

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

    PubMed

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

    2017-07-01

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

  16. Bilateral Ovarian Torsion during Follow-up for Antenatally Detected Ovarian Cysts.

    PubMed

    Zupancic, Bozidar; Baskovic, Marko; Sovic, Ljudevit; Habek, Dubravko

    2017-01-01

    Ovarian torsion is a surgical emergency demanding timely diagnosis and treatment to prevent loss of the ovaries which if happens may result in functional and emotional consequences. Simple (less than 5cm in size) ovarian cysts require follow-up for potential self-resolution. We describe a case of antenatally detected bilateral ovarian cysts that developed bilateral ovarian torsions on follow-up, postnatally.

  17. Bilateral Ovarian Torsion during Follow-up for Antenatally Detected Ovarian Cysts

    PubMed Central

    Zupancic, Bozidar; Sovic, Ljudevit; Habek, Dubravko

    2017-01-01

    Ovarian torsion is a surgical emergency demanding timely diagnosis and treatment to prevent loss of the ovaries which if happens may result in functional and emotional consequences. Simple (less than 5cm in size) ovarian cysts require follow-up for potential self-resolution. We describe a case of antenatally detected bilateral ovarian cysts that developed bilateral ovarian torsions on follow-up, postnatally. PMID:28540192

  18. 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.

  19. Follow-up care in cancer: adjusting for referral targets and extending choice.

    PubMed

    Wilson, Kate; Lydon, Anne; Amir, Ziv

    2013-03-01

    Over recent years, several initiatives have impacted on the referral of patients to secondary care, most notably targets for urgent referral in suspected cancer and the patient choice agenda. At the same time, improved long-term survival in cancer has increased numbers attending follow-up, doubts about the effectiveness of specialist follow-up have emerged, and alternative models of follow-up have been tested. The aim of the study was to explore patient and carer perspectives on the flexibility and responsiveness of cancer services. This article focuses on findings relating to referral, subsequent outpatient appointments and cessation of outpatient follow-up. Issues were explored in a qualitative study using face-to-face interviews with a purposive sample of 54 people affected by cancer. Data were analysed concurrently with data collection, using qualitative analysis software. The study gave rise to a number of salient themes. Links were identified between three of these: choice and responsiveness during referral; the flexibility and responsiveness of outpatient appointment systems; and negotiating cessation of follow-up. It appeared that policy on urgent referrals might be adversely affecting practice relating to appointment systems and the continuance of follow-up. Hospital-based cancer follow-up is being given decreasing priority because of doubts about effectiveness and a target-driven focus on referral. This is impacting on patients, who may value outpatient follow-up as a 'safety net' but have difficulties in obtaining appointments, and may be discharged without negotiation or adequate support. For these reasons, new forms of flexible/responsive aftercare are urgently needed. © 2011 Blackwell Publishing Ltd.

  20. Estimated cost of a factitious disorder with 6-year follow-up.

    PubMed

    Hoertel, Nicolas; Lavaud, Pierre; Le Strat, Yann; Gorwood, Philip

    2012-12-30

    Long-term follow up is rarely described for patients with Factitious Disorder, mainly because of the lack of access to patient's confidential information. In addition, the financial burden of multiple uses of health care system has not been examined so far. We report a 6-year follow-up for a patient with Factitious Disorder who first reported neurological then psychiatric symptoms, and investigate the cost of his detected hospitalizations.

  1. Failure to follow-up test results for ambulatory patients: a systematic review.

    PubMed

    Callen, Joanne L; Westbrook, Johanna I; Georgiou, Andrew; Li, Julie

    2012-10-01

    Serious lapses in patient care result from failure to follow-up test results. To systematically review evidence quantifying the extent of failure to follow-up test results and the impact for ambulatory patients. Medline, CINAHL, Embase, Inspec and the Cochrane Database were searched for English-language literature from 1995 to 2010. Studies which provided documented quantitative evidence of the number of tests not followed up for patients attending ambulatory settings including: outpatient clinics, academic medical or community health centres, or primary care practices. Four reviewers independently screened 768 articles. Nineteen studies met the inclusion criteria and reported wide variation in the extent of tests not followed-up: 6.8% (79/1163) to 62% (125/202) for laboratory tests; 1.0% (4/395) to 35.7% (45/126) for radiology. The impact on patient outcomes included missed cancer diagnoses. Test management practices varied between settings with many individuals involved in the process. There were few guidelines regarding responsibility for patient notification and follow-up. Quantitative evidence of the effectiveness of electronic test management systems was limited although there was a general trend towards improved test follow-up when electronic systems were used. Most studies used medical record reviews; hence evidence of follow-up action relied upon documentation in the medical record. All studies were conducted in the US so care should be taken in generalising findings to other countries. Failure to follow-up test results is an important safety concern which requires urgent attention. Solutions should be multifaceted and include: policies relating to responsibility, timing and process of notification; integrated information and communication technologies facilitating communication; and consideration of the multidisciplinary nature of the process and the role of the patient. It is essential that evaluations of interventions are undertaken and solutions

  2. What Happens Next? Follow-Up from the Children's Toddler School Program

    ERIC Educational Resources Information Center

    Akshoomoff, Natacha; Stahmer, Aubyn C.; Corsello, Christina; Mahrer, Nicole E.

    2010-01-01

    This study was a follow-up of a group of 29 children diagnosed with autism spectrum disorders at age 2 who attended an inclusive toddler program until age 3. Children ranged in age from 4 to 12 years at the time of the parent survey and follow-up testing. The majority of children were placed in a special education (noninclusive) preschool class,…

  3. To what extent are current guidelines for cutaneous melanoma follow up based on scientific evidence?

    PubMed Central

    Marciano, N J; Merlin, T L; Bessen, T; Street, J M

    2014-01-01

    Background Clinical practice guidelines should aim to assist clinicians in making evidence-based choices in the care of their patients. This review attempts to determine the extent of evidence-based support for clinical practice guideline recommendations concerning cutaneous melanoma follow up and to evaluate the methodological quality of these guidelines. Methods Current guidelines providing graded recommendations regarding patient follow up were identified through a systematic literature review. The authors reviewed the evidence base used to formulate recommendations in each of the guidelines and appraised the quality of the guidelines using the AGREE II (Appraisal of Guidelines for Research and Evaluation) instrument. Results Most guideline recommendations concerning the frequency of routine skin examinations by a clinician and the use of imaging and diagnostic tests in the follow up of melanoma patients were based on low-level evidence or consensus expert opinion. Melanoma follow-up guidelines are of variable methodological quality, with some guidelines not recommended by the appraisers for use in clinical practice. Conclusion Clinicians should be aware of how scant the evidence base is for many recommended courses of action. As a consequence of the paucity of evidence in the field of melanoma follow up, there is considerable variability in the guidance provided. The variable methodological quality of guidelines for melanoma follow up could be improved by attention to the criteria described in AGREE II. PMID:24548269

  4. Comparison of clinical outcomes of endodontic microsurgery: 1 year versus long-term follow-up.

    PubMed

    Song, Minju; Nam, Taekjin; Shin, Su-Jung; Kim, Euiseong

    2014-04-01

    The purpose of this study was to examine and compare the clinical outcome of endodontic microsurgery after 1 year of follow-up and over a period of 4 years. The database of the Department of Conservative Dentistry, Yonsei University, Seoul, South Korea, was searched for patients who had undergone endodontic microsurgery and had been evaluated 1 year after surgery and over a period of 4 years. Two examiners independently evaluated the postoperative radiographs taken 1 year after surgery and over a period of 4 years using Rud's criteria. To analyze and compare the success rate based on the observation period, the McNemar test was performed with a significance level of 0.05. The study included 115 cases. Using Rud's criteria, the overall success rate of cases with 4 or more years of follow-up was 87.8% compared with 91.3% at 1 year of follow-up. There was no significant difference between the follow-up periods (P = .344). There was no significant difference in the clinical outcome after endodontic microsurgery when comparing 1-year follow-up periods with longer follow-up periods. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  5. Use of an extended INR follow-up interval for Veteran patients in an anticoagulation clinic.

    PubMed

    Porter, Andrea L; Margolis, Amanda R; Schoen, Rebecca R; Staresinic, Carla E; Ray, Cheryl A; Fletcher, Christopher D

    2017-04-01

    A prospective, single-arm study of 50 participants evaluated an extended INR follow-up interval to determine the implementation feasibility and safety of an extended interval in Veterans on a stable dose of warfarin. A protocol was designed to allow for a rigorous, yet pragmatic evaluation of a 12-week INR follow-up interval. Feasibility was determined by study enrollment, retention, and participant achievement rates for the extended INR interval. Safety was determined by bleeding and thromboembolism rates. Participants were monitored for 6 months. Despite the long-term stability of participants prior to enrollment, only 56% achieved a 12-week follow-up interval and only 34% of enrolled participants maintained a 12-week interval. Sixteen percent of participants were never eligible for an extension of their INR follow-up interval despite meeting initial enrollment criteria. There were two major bleeding events and one participant who experienced a thromboembolic event. Implementation of an extended interval of INR follow-up appears feasible as participant enrollment goals were met and pharmacists were able to follow the study protocol. However, a lower than expected proportion of participants were able to achieve and maintain an extended INR follow-up interval. Future evaluations are needed to confirm the safety of an extended INR interval.

  6. Radiology-led Follow-up System for IVC Filters: Effects on Retrieval Rates and Times

    SciTech Connect

    Lee, L.; Taylor, J.; Munneke, G.; Morgan, R.; Belli, A.-M.

    2012-04-15

    Purpose: Successful IVC filter retrieval rates fall with time. Serious complications have been reported following attempts to remove filters after 3-18 months. Failed retrieval may be associated with adverse clinical sequelae. This study explored whether retrieval rates are improved if interventional radiologists organize patient follow-up, rather than relying on the referring clinicians. Methods: Proactive follow-up of patients who undergo filter placement was implemented in May 2008. At the time of filter placement, a report was issued to the referring consultant notifying them of the advised timeframe for filter retrieval. Clinicians were contacted to arrange retrieval within 30 days. We compared this with our practice for the preceding year. Results: The numbers of filters inserted during the two time periods was similar, as were the numbers of retrieval attempts and the time scale at which they occurred. The rate of successful retrievals increased but not significantly. The major changes were better documentation of filter types and better clinical follow-up. After the change in practice, only one patient was lost to follow-up compared with six the preceding year. Conclusions: Although there was no significant improvement in retrieval rates, the proactive, radiology-led approach improved follow-up and documentation, ensuring that a clinical decision was made about how long the filter was required and whether retrieval should be attempted and ensuring that patients were not lost to follow-up.

  7. Comfort monitoring? Environmental assessment follow-up under community-industry negotiated environmental agreements

    SciTech Connect

    Noble, Bram; Birk, Jasmine

    2011-01-15

    Negotiated environmental agreements are becoming common practice in the mining industry. In principle, negotiated environmental agreements are said to respond to many of the shortcomings of environmental impact assessment by providing for improved follow-up of project impacts through, among other things, data provision, engaging stakeholders in the monitoring and management of project impacts, and building capacity at the local level to deal with project-induced environmental change. In practice, however, little is known about the efficacy of follow-up under negotiated environmental agreements between proponents and communities and the demonstrated value added to project impact management. This paper examines follow-up practice under negotiated environmental agreements with a view to understanding whether and how community-based monitoring under privatized agreements actually contributes to improved follow-up and impact management. Based on lessons emerging from recent experiences with environmental agreements in Canada's uranium industry, we show that follow-up under negotiated agreements may be described as 'comfort monitoring'. While such monitoring does improve community-industry relations and enhance corporate image, it does little to support effects-based management. If follow-up under negotiated agreements is to be credible over the long term, there is a need to ensure that monitoring results are useful for, and integrated with, regulatory-based monitoring and project impact management practices.

  8. Creating the Action Model for High Risk Infant Follow Up Program in Iran

    PubMed Central

    Heidarzadeh, Mohammad; Jodiery, Behzad; Mirnia, Kayvan; Akrami, Forouzan; Hosseini, Mohammad Bagher; Heidarabadi, Seifollah; HabibeLahi, Abbas

    2013-01-01

    Abstract Background Intervention in early childhood development as one of the social determinants of health, is important for reducing social gap and inequity. In spite of increasingly developing intensive neonatal care wards and decreasing neonatal mortality rate, there is no follow up program in Iran. This study was carreid out to design high risk infants follow up care program with the practical aim of creating an model action for whole country, in 2012. Methods This qualitative study has been done by the Neonatal Department of the Deputy of Public Health in cooperation with Pediatrics Health Research Center of Tabriz University of Medical Sciences, Iran. After study of international documents, consensus agreement about adapted program for Iran has been accomplished by focus group discussion and attended Delphi agreement technique. After compiling primary draft included evidence based guidelines and executive plan, 14 sessions including expert panels were hold to finalize the program. Results After finalizing the program, high risk infants follow up care service package has been designed in 3 chapters: Evidence based clinical guidelines; eighteen main clinical guidelines and thirteen subsidiaries clinical guidelines, executive plan; 6 general, 6 following up and 5 backup processes. Education program including general and especial courses for care givers and follow up team, and family education processes. Conclusion We designed and finalized high risk infants follow up care service package. It seems to open a way to extend it to whole country. PMID:26171344

  9. 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

  10. 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.

  11. Behavior Problems and Psychiatric Diagnoses in Girls with Gender Identity Disorder: A Follow-Up Study.

    PubMed

    Drummond, Kelley D; Bradley, Susan J; Peterson-Badali, Michele; VanderLaan, Doug P; Zucker, Kenneth J

    2017-06-08

    This study evaluated the presence of clinical range behavior problems and psychiatric diagnoses in 25 girls referred for gender identity disorder (GID) in childhood (mean age: 8.88 years) at the time of follow-up in adolescence or adulthood (mean age: 23.2 years). At follow-up, three (12%) of the girls were judged to have persistent GID based on DSM-IV criteria. With regard to behavior problems at follow-up, 39.1% of the girls had a clinical range score on either the Child Behavior Checklist or Adult Behavior Checklist as rated by their mothers, and 33.3% had a clinical range score on either the Youth Self-Report or the Adult Self-Report. On either the Diagnostic Interview for Children and Adolescents or the Diagnostic Interview Schedule, the girls had, on average, 2.67 diagnoses (range: 0-10); 46% met criteria for three or more diagnoses. From the childhood assessment, five variables were significantly associated with a composite Psychopathology Index (PI) at follow-up: a lower IQ, living in a non-two-parent or reconstituted family, a composite behavior problem index, and poor peer relations. At follow-up, degree of concurrent homoeroticism and a composite index of gender dysphoria were both associated with the composite PI. Girls with GID show a psychiatric vulnerability at the time of follow-up in late adolescence or adulthood, although there was considerable variation in their general well-being.

  12. Cohort profile of the Japan Collaborative Cohort Study at final follow-up.

    PubMed

    Tamakoshi, Akiko; Ozasa, Kotaro; Fujino, Yoshihisa; Suzuki, Koji; Sakata, Kiyomi; Mori, Mitsuru; Kikuchi, Shogo; Iso, Hiroyasu; Sakauchi, Fumio; Motohashi, Yutaka; Tsuji, Ichiro; Nakamura, Yosikazu; Mikami, Haruo; Kurosawa, Michiko; Hoshiyama, Yoshiharu; Tanabe, Naohito; Tamakoshi, Koji; Wakai, Kenji; Tokudome, Shinkan; Hashimoto, Shuji; Wada, Yasuhiko; Kawamura, Takashi; Watanabe, Yoshiyuki; Miki, Tsuneharu; Date, Chigusa; Kurozawa, Yoichi; Yoshimura, Takesumi; Shibata, Akira; Okamoto, Naoyuki; Shio, Hideo

    2013-01-01

    The Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study) was established in the late 1980s to evaluate the risk impact of lifestyle factors and levels of serum components on human health. During the 20-year follow-up period, the results of the study have been published in almost 200 original articles in peer-reviewed English-language journals. However, continued follow-up of the study subjects became difficult because of the retirements of principal researchers, city mergers throughout Japan in the year 2000, and reduced funding. Thus, we decided to terminate the JACC Study follow-up at the end of 2009. As a final point of interest, we reviewed the population registry information of survivors. A total of 207 (0.19%) subjects were ineligible, leaving 110 585 eligible participants (46 395 men and 64 190 women). Moreover, errors in coding date of birth and sex were found in 356 (0.32%) and 59 (0.05%) cases, respectively, during routine follow-up and final review. Although such errors were unexpected, their impact is believed to be negligible because of the small numbers relative to the large total study population. Here, we describe the final cohort profile at the end of the JACC Study along with selected characteristics of the participants and their status at the final follow-up. Although follow-up of the JACC Study participants is finished, we will continue to analyze and publish study results.

  13. Preparing for LSST with the LCOGT NEO Follow-up Network

    NASA Astrophysics Data System (ADS)

    Greenstreet, Sarah; Lister, Tim; Gomez, Edward

    2016-10-01

    The Las Cumbres Observatory Global Telescope Network (LCOGT) provides an ideal platform for follow-up and characterization of Solar System objects (e.g. asteroids, Kuiper Belt Objects, comets, Near-Earth Objects (NEOs)) and ultimately for the discovery of new objects. The LCOGT NEO Follow-up Network is using the LCOGT telescope network in addition to a web-based system developed to perform prioritized target selection, scheduling, and data reduction to confirm NEO candidates and characterize radar-targeted known NEOs.In order to determine how to maximize our NEO follow-up efforts, we must first define our goals for the LCOGT NEO Follow-up Network. This means answering the following questions. Should we follow-up all objects brighter than some magnitude limit? Should we only focus on the brightest objects or push to the limits of our capabilities by observing the faintest objects we think we can see and risk not finding the objects in our data? Do we (and how do we) prioritize objects somewhere in the middle of our observable magnitude range? If we want to push to faint objects, how do we minimize the amount of data in which the signal-to-noise ratio is too low to see the object? And how do we find a balance between performing follow-up and characterization observations?To help answer these questions, we have developed a LCOGT NEO Follow-up Network simulator that allows us to test our prioritization algorithms for target selection, confirm signal-to-noise predictions, and determine ideal block lengths and exposure times for observing NEO candidates. We will present our results from the simulator and progress on our NEO follow-up efforts.In the era of LSST, developing/utilizing infrastructure, such as the LCOGT NEO Follow-up Network and our web-based platform for selecting, scheduling, and reducing NEO observations, capable of handling the large number of detections expected to be produced on a daily basis by LSST will be critical to follow-up efforts. We hope our

  14. Does routine follow up after head injury help? A randomised controlled trial.

    PubMed Central

    Wade, D T; Crawford, S; Wenden, F J; King, N S; Moss, N E

    1997-01-01

    OBJECTIVE: To evaluate the Medical Disability Society's 1988 recommendation that "every patient attending hospital after a head injury should be registered and offered an outpatient follow up appointment" by determining whether offering a routine follow up service to patients presenting to hospital with a head injury of any severity affects outcome six months later. DESIGN: A randomised controlled trial design with masked assessment of outcome. SETTING: A mixed rural and urban health district with a population of about 560000. PATIENTS: 1156 consecutive patients resident in Oxfordshire aged between 16 and 65 years presenting over 13 months to accident and emergency departments or admitted to hospital and diagnosed as having a head injury of any severity, including those with other injuries. INTERVENTIONS: Patients were registered and randomised to one of two groups. Both groups continued to receive the standard service offered by the hospitals. The early follow up group were approached at 7-10 days after injury and offered additional information, advice, support, and further intervention as needed. All randomised patients were approached for follow up assessment six months after injury by independent clinicians blind to their group. MAIN OUTCOME MEASURES: Validated questionnaires were used to elicit ratings of post-concussion symptoms (the Rivermead postconcussion symptoms questionnaire), and changes in work, relationships, leisure, social, and domestic activities (the Rivermead head injury follow up questionnaire). RESULTS: The two groups were comparable at randomisation. Data was obtained at six months on 226 of 577 "control" patients and 252 of 579 "trial" patients (59% were lost to follow up). There were no significant differences overall between the trial and control groups at follow up, but subgroup analysis of the patients with moderate or severe head injuries (posttraumatic amnesia > or = one hour, or admitted to hospital), showed that those in the early

  15. 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.

  16. Automated telecommunication to obtain longitudinal follow-up in a multicenter cross-sectional COPD study.

    PubMed

    Stewart, Jeffrey I; Moyle, Sarah; Criner, Gerard J; Wilson, Carla; Tanner, Ron; Bowler, Russell P; Crapo, James D; Zeldin, Robert K; Make, Barry J; Regan, Elizabeth A; For The Copdgene Investigators

    2012-08-01

    It can be challenging to maintain longitudinal follow-up of subjects in clinical studies. COPDGene is a multicenter, observational study designed to identify genetic factors associated with COPD and to characterize COPD-related phenotypes. To obtain follow-up data on patient's vital status and outcomes, the COPDGene Longitudinal Follow-up (LFU) Program was developed to supplement its parent study. We used a telecommunication system that employed automated telephone contact or web-based questions to obtain longitudinal follow-up data in our subjects. A branching questionnaire asked about exacerbations, new therapies, smoking status, development of co-morbid conditions, and general health status. Study coordinators contacted subjects who did not respond to one of the automated methods. We enrolled 10,383 subjects in the COPDGene study. As of August 29, 2011, 7,959 subjects completed 19,955 surveys. On the first survey, 68.8% of subjects who completed their survey did so by electronic means, while 31.3% required coordinator phone follow-up. On each subsequent survey the number of subjects who completed their survey by electronic means increased, while the number of subjects who required coordinator follow-up decreased. Despite many of the patients in the cohort being chronically ill and elderly, there was broad acceptance of the system with over half the cohort using electronic response methods. The COPDGene LFU Study demonstrated that telecommunications was an effective way to obtain longitudinal follow-up of subjects in a large multicenter study. Web-based and automated phone contacts are accepted by research subjects and could serve as a model for LFU in future studies.

  17. What patients think about ICU follow-up services: a qualitative study

    PubMed Central

    Prinjha, Suman; Field, Kate; Rowan, Kathy

    2009-01-01

    Introduction UK policy recommendations advocate the use of intensive care unit (ICU) follow-up services to help detect and treat patients' physical and emotional problems after hospital discharge and as a means of service evaluation. This study explores patients' perceptions and experiences of these services. Methods Thirty-four former ICU patients were recruited throughout the UK, using maximum variation sampling to achieve as broad a range of experiences of the ICU as possible. Participants were interviewed at home by a qualitative researcher unconnected to their hospital care. Interviews were recorded and transcribed for analysis. We report a qualitative thematic analysis of patients' experiences of ICU follow up. Results Former patients said they valued ICU follow-up services, which had made an important contribution to their physical, emotional and psychological recovery in terms of continuity of care, receiving information, gaining expert reassurance and giving feedback to ICU staff. Continuity of care included having tests and being monitored, referrals to other specialists and ICU follow-up appointments soon after hospital discharge. Information about physical, emotional and psychological recovery was particularly important to patients, as was information that helped them make sense of their ICU experience. Those without access to ICU follow-up care often felt abandoned or disappointed because they had no opportunity to be monitored, referred or get more information. Conclusions Former patients value having ICU follow-up services but many found that their healthcare needs were unmet because hospitals were unable to provide the aftercare they required. Most participants were aware of the financial constraints on the health system. Although they valued ICU follow-up care, they did not want it to continue indefinitely, with many of them declining appointment invitations when they themselves felt they no longer needed them. PMID:19338653

  18. 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.

  19. 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.

  20. 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

  1. Follow-up patterns of cancer survivors: a survey of Canadian radiation oncologists.

    PubMed

    Ye, Allison Y; Cheung, Winson Y; Goddard, Karen J; Horvat, Daniel; Olson, Robert A

    2015-09-01

    With continual advancements in cancer care, improved outcomes, and increasing survivors, survivorship has become an important area of research. This project seeks to determine the current status of follow-up care in oncology. An electronic survey was sent to the Canadian Association of Radiation Oncology members. Based on brief clinical scenarios pertaining to various survivor populations, questions were posed to determine routine follow-up practices. One hundred eleven radiation oncologists (RO) responded (44% response rate); 29% were female, 43% were in practice <10 years, and most of Canada was represented. Most worked in centers with >10 oncologists (69%) and saw >200 new consults per year (78%). Only 10% reported not following their patients routinely, mainly in those with breast cancer. Most would follow their central nervous system, gastrointestinal, head and neck, gynecologic, and genitourinary patients. Lack of resources and a belief that follow-up by family physicians (FPs) is equally effective were the top reasons for not following. Treatment toxicity and possibility of further treatment were the most common reasons for routine follow-up. The majority (55%) would follow patients for <5 years, with 36% for 5-10 years, and a minority (9%) for longer than 10 years; 54% would not change the frequency of follow-up, but 39% would decrease and only 7% would increase follow-up. Some felt transferring more care to other health professionals would require additional training and more guidelines. Survivorship care plans are underutilized. Transfer of follow-up care to FPs is desired and feasible. This would allow for more comprehensive medical care and improve access to care for newly diagnosed patients. The development and usage of survivorship care plans would improve this care. Survivors may be increasingly followed by family physicians. Better coordination between oncologists and family physicians, including the use of survivorship care plans, may facilitate

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

    PubMed

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

    2016-08-01

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

  3. Automated Telecommunication to Obtain Longitudinal Follow-up in a Multicenter Cross-sectional COPD Study

    PubMed Central

    Stewart, Jeffrey I.; Moyle, Sarah; Criner, Gerard J.; Wilson, Carla; Tanner, Ron; Bowler, Russell P.; Crapo, James D.; Zeldin, Robert K.; Make, Barry J.; Regan, Elizabeth A.

    2013-01-01

    Background It can be challenging to maintain longitudinal follow-up of subjects in clinical studies. COPDGene is a multicenter, observational study designed to identify genetic factors associated with COPD and to characterize COPD-related phenotypes. To obtain follow-up data on patient's vital status and outcomes, the COPDGene Longitudinal Follow-up (LFU) Program was developed to supplement its parent study. Methods/Results We used a telecommunication system that employed automated telephone contact or web-based questions to obtain longitudinal follow-up data in our subjects. A branching questionnaire asked about exacerbations, new therapies, smoking status, development of co-morbid conditions, and general health status. Study coordinators contacted subjects who did not respond to one of the automated methods. We enrolled 10,383 subjects in the COPDGene study. As of August 29, 2011, 7,959 subjects completed 19,955 surveys. On the first survey, 68.8% of subjects who completed their survey did so by electronic means, while 31.3% required coordinator phone follow-up. On each subsequent survey the number of subjects who completed their survey by electronic means increased, while the number of subjects who required coordinator follow-up decreased. Despite many of the patients in the cohort being chronically ill and elderly, there was broad acceptance of the system with over half the cohort using electronic response methods. Conclusions The COPDGene LFU Study demonstrated that telecommunications was an effective way to obtain longitudinal follow-up of subjects in a large multicenter study. Web-based and automated phone contacts are accepted by research subjects and could serve as a model for LFU in future studies. PMID:22676387

  4. 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.

  5. What patients think about ICU follow-up services: a qualitative study.

    PubMed

    Prinjha, Suman; Field, Kate; Rowan, Kathy

    2009-01-01

    UK policy recommendations advocate the use of intensive care unit (ICU) follow-up services to help detect and treat patients' physical and emotional problems after hospital discharge and as a means of service evaluation. This study explores patients' perceptions and experiences of these services. Thirty-four former ICU patients were recruited throughout the UK, using maximum variation sampling to achieve as broad a range of experiences of the ICU as possible. Participants were interviewed at home by a qualitative researcher unconnected to their hospital care. Interviews were recorded and transcribed for analysis. We report a qualitative thematic analysis of patients' experiences of ICU follow up. Former patients said they valued ICU follow-up services, which had made an important contribution to their physical, emotional and psychological recovery in terms of continuity of care, receiving information, gaining expert reassurance and giving feedback to ICU staff. Continuity of care included having tests and being monitored, referrals to other specialists and ICU follow-up appointments soon after hospital discharge. Information about physical, emotional and psychological recovery was particularly important to patients, as was information that helped them make sense of their ICU experience. Those without access to ICU follow-up care often felt abandoned or disappointed because they had no opportunity to be monitored, referred or get more information. Former patients value having ICU follow-up services but many found that their healthcare needs were unmet because hospitals were unable to provide the aftercare they required. Most participants were aware of the financial constraints on the health system. Although they valued ICU follow-up care, they did not want it to continue indefinitely, with many of them declining appointment invitations when they themselves felt they no longer needed them.

  6. 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.

  7. Under-utilization of controller medications and poor follow-up rates among hospitalized asthma patients.

    PubMed

    Lintzenich, Annie; Teufel, Ronald J; Basco, William T

    2011-07-01

    Recommended preventive care following an asthma admission includes prescribing controller medications and encouraging outpatient follow-up. We sought to determine (1) the proportion of patients who receive controller medications or attend follow-up after asthma admission and (2) what factors predict these outcomes. South Carolina Medicaid data from 2007-2009 were analyzed. Patients who were included were 2 to 18 years old, and had at least one admission for asthma. Variables examined were: age, gender, race, and rural location. Outcome variables were controller medication prescription and follow-up appointment. Any claim for an inhaled corticosteroid (ICS) or ICS/long-acting beta-agonist in the 2 months after admission was considered appropriate. Any outpatient visit for asthma in the 2 months after admission was considered appropriate. Bivariate analyses used chi-square tests. Logistic regression models identified factors that predict controller medications and follow-up. Five hundred five patients were included, of whom 60% were male, 79% minority race/ethnicity, and 58% urban. Rates of receiving controller medications and attending follow-up appointments were low, and an even lower proportion received both. Overall, 52% received a controller medication, 49% attended follow-up, and 32% had both. Multivariable analyses demonstrated that patients not of minority race or ethnicity were more likely to receive controller medications (odds ratio, 1.7; 95% confidence interval, 1.1-2.6). Patients with asthma admitted for acute exacerbations in South Carolina have low rates of controller medication initiation and follow-up attendance. Minority race/ethnicity patients are less likely to receive controller medications. To decrease rates of future exacerbations, inpatient providers must improve the rates of preventive care delivery in the acute care setting with a focus on racial/ethnic minority populations.

  8. Progress in BazookaSPECT.

    PubMed

    Miller, Brian W; Barber, H Bradford; Furenlid, Lars R; Moore, Stephen K; Barrett, Harrison H

    2009-01-01

    Recent progress on a high-resolution, photon-counting gamma-ray and x-ray imager called BazookaSPECT is presented. BazookaSPECT is an example of a new class of scintillation detectors based on integrating detectors such as CCD(charge-coupled device) or CMOS(complementary metal-oxide semiconductor) sensors. BazookaSPECT is unique in that it makes use of a scintillator in close proximity to a microchannel plate-based image intensifier for up-front optical amplification of scintillation light. We discuss progress made in bringing about compact BazookaSPECT modules and in real-time processing of event data using graphics processing units (GPUs). These advances are being implemented in the design of a high-resolution rodent brain imager called FastSPECT III. A key benefit of up-front optical gain is that any CCD/CMOS sensor can now be utilized for photon counting. We discuss the benefits and feasibility of using CMOS sensors as photon-counting detectors for digital radiography, with application in mammography and computed tomography (CT). We present as an appendix a formal method for comparing various photon-counting integrating detectors using objective statistical criteria.

  9. Progress in BazookaSPECT

    PubMed Central

    Miller, Brian W.; Barber, H. Bradford; Furenlid, Lars R.; Moore, Stephen K.; Barrett, Harrison H.

    2010-01-01

    Recent progress on a high-resolution, photon-counting gamma-ray and x-ray imager called BazookaSPECT is presented. BazookaSPECT is an example of a new class of scintillation detectors based on integrating detectors such as CCD(charge-coupled device) or CMOS(complementary metal-oxide semiconductor) sensors. BazookaSPECT is unique in that it makes use of a scintillator in close proximity to a microchannel plate-based image intensifier for up-front optical amplification of scintillation light. We discuss progress made in bringing about compact BazookaSPECT modules and in real-time processing of event data using graphics processing units (GPUs). These advances are being implemented in the design of a high-resolution rodent brain imager called FastSPECT III. A key benefit of up-front optical gain is that any CCD/CMOS sensor can now be utilized for photon counting. We discuss the benefits and feasibility of using CMOS sensors as photon-counting detectors for digital radiography, with application in mammography and computed tomography (CT). We present as an appendix a formal method for comparing various photon-counting integrating detectors using objective statistical criteria. PMID:21297897

  10. Clinical Utility of SPECT Neuroimaging in the Diagnosis and Treatment of Traumatic Brain Injury: A Systematic Review

    PubMed Central

    Raji, Cyrus A.; Tarzwell, Robert; Pavel, Dan; Schneider, Howard; Uszler, Michael; Thornton, John; van Lierop, Muriel; Cohen, Phil; Amen, Daniel G.; Henderson, Theodore

    2014-01-01

    Purpose This systematic review evaluated the clinical utility of single photon emission computed tomography (SPECT) in traumatic brain injury (TBI). Methods After defining a PICO Statement (Population, Intervention, Comparison and Outcome Statement), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria were applied to identify 1600 articles. After screening, 374 articles were eligible for review. Inclusion for review was focus on SPECT in the setting of mild, moderate, or severe TBI with cerebral lobar specificity of SPECT findings. Other inclusion criteria were comparison modalities in the same subjects and articles in English. Foreign language articles, SPECT studies that did not include comparison modalities, and case reports were not included for review. Results We identified 19 longitudinal and 52 cross-sectional studies meeting inclusion criteria. Three longitudinal studies examined diagnostic predictive value. The first showed positive predictive value increases from initial SPECT scan shortly after trauma to one year follow up scans, from 59% to 95%. Subsequent work replicated these results in a larger cohort. Longitudinal and cross sectional studies demonstrated SPECT lesion localization not detected by CT or MRI. The most commonly abnormal regions revealed by SPECT in cross-sectional studies were frontal (94%) and temporal (77%) lobes. SPECT was found to outperform both CT and MRI in both acute and chronic imaging of TBI, particularly mild TBI. It was also found to have a near 100% negative predictive value. Conclusions This review demonstrates Level IIA evidence (at least one non-randomized controlled trial) for the value of SPECT in TBI. Given its advantages over CT and MRI in the detection of mild TBI in numerous studies of adequate quality, and given its excellent negative predictive value, it may be an important second test in settings where CT or MRI are negative after a closed head injury with post

  11. Inter-Physician Variation in Follow-Up Colonoscopies after Screening Colonoscopy

    PubMed Central

    Stock, Christian; Hoffmeister, Michael; Birkner, Berndt; Brenner, Hermann

    2013-01-01

    Background and Aims Surveillance is an integral part of the colorectal cancer (CRC) screening process. We aimed to investigate inter-physician variation in follow-up procedures after screening colonoscopy in an opportunistic CRC screening program. Methods A historical cohort study in the German statutory health insurance system was conducted. 55,301 individuals who underwent screening colonoscopy in 2006 in Bavaria, Germany, and who were not diagnosed with CRC were included. Utilization of follow-up colonoscopies performed by the same physician (328 physicians overall) within 3 years was ascertained. Mixed effects logistic regression modelling was used to assess the effect of physicians and other potential predictors (screening result, age group, and sex) on re-utilization of colonoscopy. Physicians were grouped into quintiles according to individual effects estimated in a preliminary model. Predicted probabilities of follow-up colonoscopy by screening result and physician group were calculated. Results The observed rate of follow-up colonoscopy was 6.2% (95% confidence interval: 5.9-6.4%), 18.6% (17.8-19.4%), and 37.0% (35.5-38.4%) after negative colonoscopy, low-risk adenoma and high-risk adenoma detection, respectively. All considered predictors were statistically significantly associated with follow-up colonoscopy. The predicted probabilities of follow-up colonoscopy ranged from 1.7% (1.4-2.0%) to 11.0% (10.2-11.7%), from 7.3% (6.2-8.5%) to 35.1% (32.6-37.7%), and from 17.9% (15.5-20.6%) to 56.9% (53.5-60.3%) in the 1st quintile (lowest rates of follow-up) and 5th quintile (highest rates of follow-up) of physicians after negative colonoscopy, low-risk adenoma and high-risk adenoma detection, respectively. Conclusions This study suggests substantial inter-physician variation in follow-up habits after screening colonoscopy. Interventions, including organizational changes in CRC screening should be considered to reduce this variation. PMID:23874941

  12. Factors impacting follow-up care after placement of temporary inferior vena cava filters.

    PubMed

    Gyang, Elsie; Zayed, Mohamed; Harris, E John; Lee, Jason T; Dalman, Ronald L; Mell, Matthew W

    2013-08-01

    Rates of inferior vena cava (IVC) filter retrieval have remained suboptimal, in part because of poor follow-up. The goal of our study was to determine demographic and clinical factors predictive of IVC filter follow-up care in a university hospital setting. We reviewed 250 consecutive patients who received an IVC filter placement with the intention of subsequent retrieval between March 2009 and October 2010. Patient demographics, clinical factors, and physician specialty were evaluated. Multivariate logistic regression analysis was performed to identify variables predicting follow-up care. In our cohort, 60.7% of patients received follow-up care; of those, 93% had IVC filter retrieval. Major indications for IVC filter placement were prophylaxis for high risk surgery (53%) and venous thromboembolic event with contraindication and/or failure of anticoagulation (39%). Follow-up care was less likely for patients discharged to acute rehabilitation or skilled nursing facilities (P < .0001), those with central nervous system pathology (eg, cerebral hemorrhage or spinal fracture; P < .0001), and for those who did not receive an IVC filter placement by a vascular surgeon (P < .0001). In a multivariate analysis, discharge home (odds ratio [OR], 4.0; 95% confidence interval [CI], 1.99-8.2; P < .0001), central nervous system pathology (OR, 0.46; 95% CI, 0.22-0.95; P = .04), and IVC filter placement by the vascular surgery service (OR, 4.7; 95% CI, 2.3-9.6; P < .0001) remained independent predictors of follow-up care. Trauma status and distance of residence did not significantly impact likelihood of patient follow-up. Service-dependent practice paradigms play a critical role in patient follow-up and IVC filter retrieval rates. Nevertheless, specific patient populations are more prone to having poorer rates of follow-up. Such trends should be factored into institutional quality control goals and patient-centered care. Copyright © 2013 Society for Vascular Surgery. Published by

  13. Timing of discharge follow-up for acute pulmonary embolism: retrospective cohort study.

    PubMed

    Vinson, David R; Ballard, Dustin W; Huang, Jie; Rauchwerger, Adina S; Reed, Mary E; Mark, Dustin G

    2015-01-01

    Historically, emergency department (ED) patients with pulmonary embolism (PE) have been admitted for several days of inpatient care. Growing evidence suggests that selected ED patients with PE can be safely discharged home after a short length of stay. However, the optimal timing of follow up is unknown. We hypothesized that higher-risk patients with short length of stay (<24 hours from ED registration) would more commonly receive expedited follow up (≤3 days). This retrospective cohort study included adults treated for acute PE in six community EDs. We ascertained the PE Severity Index risk class (for 30-day mortality), facility length of stay, the first follow-up clinician encounter, unscheduled return ED visits ≤3 days, 5-day PE-related readmissions, and 30-day all-cause mortality. Stratifying by risk class, we used multivariable analysis to examine age- and sex-adjusted associations between length of stay and expedited follow up. The mean age of our 175 patients was 63.2 (±16.8) years. Overall, 93.1% (n=163) of our cohort received follow up within one week of discharge. Fifty-six patients (32.0%) were sent home within 24 hours and 100 (57.1%) received expedited follow up, often by telephone (67/100). The short and longer length-of-stay groups were comparable in age and sex, but differed in rates of low-risk status (63% vs 37%; p<0.01) and expedited follow up (70% vs 51%; p=0.03). After adjustment, we found that short length of stay was independently associated with expedited follow up in higher-risk patients (adjusted odds ratio [aOR] 3.5; 95% CI [1.0-11.8]; p=0.04), but not in low-risk patients (aOR 2.2; 95% CI [0.8-5.7]; p=0.11). Adverse outcomes were uncommon (<2%) and were not significantly different between the two length-of-stay groups. Higher-risk patients with acute PE and short length of stay more commonly received expedited follow up in our community setting than other groups of patients. These practice patterns are associated with low rates of

  14. 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.

  15. 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.

  16. Applicable Railroad Commission rules regarding notification, cleanup, and follow up reporting of inland crude spills

    SciTech Connect

    Grossman, G.M.

    1996-08-01

    There are a myriad of regulations, both federal, state, and local dealing with spill notification cleanup, and follow up reporting. This paper describes the applicable Railroad Commission (RRC) Oil and Gas Division Rules and Regulations requiring notification, cleanup, and follow up reporting of inland crude oil spills in the state of Texas. Statewide Rule (SWR) titled {open_quotes}water protection{close_quotes} requires that {open_quotes}no person conducting activities subject to the regulation of RRC may cause or allow pollution of the surface or subsurface water in the state{close_quotes}. SWR 20 titled {open_quotes}notification of fire, breaks, leaks, or blowouts{close_quotes}, requires immediate notice of a fire, leak, spill, or break from production facilities to the appropriate district office and follow up written reporting. SWR 71 titled {open_quotes}Pipeline Tariffs{close_quotes} requires pipeline companies to give immediate notice of spills and fires to the appropriate district office along with follow up reports. SWR 91 titled {open_quotes}Cleanup of soil contaminated by a crude oil spill{close_quotes} requires notification, cleanup, and follow up reporting requirements for crude oil spills.

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

    PubMed

    Meyenburg, Bernd; Kröger, Anne; Neugebauer, Rebecca

    2015-01-01

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

  18. Follow-up disparities after trauma: a real problem for outcomes research.

    PubMed

    Leukhardt, William H; Golob, Joseph F; McCoy, Andy M; Fadlalla, Adam M A; Malangoni, Mark A; Claridge, Jeffrey A

    2010-03-01

    The objectives of this study were to (1) determine risk factors associated with failure to follow-up (FTF) after traumatic injury and (2) in those patients who do follow up, to determine if information within the electronic medical record (EMR) is an adequate data-collection tool for outcomes research. A 6-year retrospective analysis was conducted on all admitted trauma patients using data from the trauma registry, National Death Index, 2000 Census Data, and the EMR. Bivariate and logistic regression analyses identified risk factors for FTF. A subgroup analysis evaluated the utility of using the EMR to determine basic functional outcomes (Glasgow outcome scale, diet, ambulation, and employment status). A total of 14,784 patients were discharged, and 61% had follow-up appointments. Lower income, higher poverty rates, and lower education were significantly (P<.05) associated with FTF. Logistic regression analysis (excluding census data) identified that older age, lower Injury Severity Score, less severe head injury, nonwhite race, blunt injury, death after discharge, zip code within 25 miles, and patients discharged to home independently predicted FTF after traumatic injury. A subgroup analysis of the EMR showed the inability to reliably determine functional outcomes. There are several disparities related to follow-up after trauma. Furthermore, charting deficiencies, even with an EMR, highlight the weaknesses of data available for trauma outcomes research. Trauma process improvement programs could target patients at risk for not following up and use a structured electronic outpatient note. Copyright (c) 2010. Published by Elsevier Inc.

  19. Estimating bias from loss to follow-up in the Danish National Birth Cohort.

    PubMed

    Greene, Naomi; Greenland, Sander; Olsen, Jørn; Nohr, Ellen Aagaard

    2011-11-01

    Loss to follow-up in cohort studies may result in biased association estimates. Of 61,895 women entering the Danish National Birth Cohort and completing the first data-collection phase, 37,178 (60%) opted to be in the 7-year follow-up. Using national registry data to obtain end point information on all members of the cohort, we estimated associations in the baseline and the 7-year follow-up participant populations for 5 exposure-outcome associations: (a) size at birth and childhood asthma, (b) assisted reproductive treatment and childhood hospitalizations, (c) prepregnancy body mass index and childhood infections, (d) alcohol drinking in early pregnancy and childhood developmental disorders, and (e) maternal smoking in pregnancy and childhood attention-deficit hyperactivity disorder (ADHD). We estimated follow-up bias in the odds or rate ratios by calculating relative ratios. For all but one of the above analyses, the bias appeared to be small, between -10% and +8%. For maternal smoking in pregnancy and childhood ADHD, we estimated a positive bias of approximately 33% (95% bootstrap limits of -30% and +152%). The presence and magnitude of bias due to loss to follow-up depended on the nature of the factors or outcomes examined, with the most pronounced contribution in this study coming from maternal smoking. Our methods and results may inform bias analyses in future pregnancy cohort studies.

  20. 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

  1. 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

  2. What is the best way to schedule patient follow-up appointments?

    PubMed

    Saine, Patrick J; Baker, Suzanne M

    2003-06-01

    What is the best way to schedule follow-up appointments? The most popular model requires the patient to negotiate a follow-up appointment time on leaving the office. This process accounts for the majority of follow-up patient scheduling. There are circumstances when this immediate appointment arrangement is not possible, however. The two common processes used to contact patients for follow-up appointments after they have left the office are the postcard reminder method and the prescheduled appointment method. In 2001 the two methods used to contact patients for follow-up appointments after they had left the clinic were used for all 2,116 reappointment patients at an ophthalmology practice at Dartmouth-Hitchcock Medical Center. The number of completed successful appointments, the no-show rate, and patient satisfaction for each method were calculated. A larger number of patient reappointments were completed using the prescheduled appointment procedure than the postcard reminder system (74% vs 54%). The difference between completed and pending appointments (minus no-shows) of the two methods equaled 163 patients per quarter, or 652 patients per year. Additional revenues associated with use of the prescheduled appointment letter method were estimated at $594,600 for 3 years. Using the prescheduled appointment method with a patient notification letter is advised when patients do not schedule their appointments on the way out of the office.

  3. IMMEDIATE AND FOLLOW-UP EFFECTS OF A POSTURE EDUCATION PROGRAM FOR ELEMENTARY SCHOOL STUDENTS

    PubMed Central

    dos Santos, Natália Brites; Sedrez, Juliana Adami; Candotti, Cláudia Tarragô; Vieira, Adriane

    2017-01-01

    ABSTRACT Objective: To assess the short- and medium-term effects of the posture education program (PEP) for students of elementary school regarding theoretical knowledge and posture during activities of daily living (ADLs). Methods: The sample consisted of 38 students (aged 8-12 years) in the third grade of elementary school in Porto Alegre, Rio Grande do Sul (Southern Brazil). The children were evaluated in three moments: prior to attending the PEP (pretest); after attending the PEP (post-test); and five months after the conclusion of the PEP, immediately after a learning review of four lessons (five months follow-up). The posture during ADLs and the theoretical knowledge about spine and body posture were assessed, based on specific instruments (layout for assessing the dynamic posture - LADy; and questionnaire). The Friedman test, post hoc Wilcoxon test, and Bonferroni correction were applied to identify the differences among the evaluative moments, as they are statistically significant at α<0.05. Results: No statistically significant difference was found between the post-test and follow-up concerning the theoretical knowledge. In addition, no statistically significant difference was found between post-test and follow-up in relation to ADLs; however, the performance of students was higher in the post-test and follow-up, when compared with the pretest. Conclusions: Immediately after the PEP’s conclusion, the students improved their posture in ADLs. These positive effects and the theoretical knowledge were retained in the follow-up (after the review lessons).

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  6. 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.

  7. Identification of treated target points for parkinsonism on gamma knife follow-up MR images.

    PubMed

    Cheung, Y C; Yu, C P

    2002-03-01

    Identification of treated target points for Parkinsonism on follow-up MR images is difficult because of different orientations employed between the treatment and the follow-up MR scan. In the present work, the treated target points for Parkinsonism can be easily found, once the anterior-commissure (AC) and posterior-commissure (PC) have been defined in Leksell GammaPlan. The follow-up MR images must first be defined with the Cartesian co-ordinate system using a non-fiducial based technique. The mathematics of 3-dimensional coordinate geometry is then applied to locate the treated target points for Parkinsonism. Spreadsheet computer software helped to calculate the exact coordinates of the treated target points quickly and accurately. The coordinates of treated target points can be found easily based on the coordinates of the AC and PC points on the follow-up MR images. Different orientations employed between the treatment and the follow-up MR scan are no longer a problem. Copyright 2002, Elsevier Science Ltd. All rights reserved.

  8. Long-term follow-up of echolalia and question answering.

    PubMed

    Foxx, R M; Faw, G D

    1990-01-01

    A long-term follow-up of echolalia and correct question answering was conducted for 6 subjects from three previously published studies. The follow-up periods ranged from 26 to 57 months. In a training site follow-up, subjects were exposed to baseline/posttraining conditions in which the original trainer and/or a novel person(s) presented trained and untrained questions. Four subjects displayed echolalia below baseline levels, and another did so in some assessments. Overall, echolalia was lower than in baseline in 80.6% of the follow-ups. Five subjects displayed correct responding above baseline levels. No clear differences were noted in correct responding or echolalia between the trainer and novel-person presentations or between trained and untrained questions. In a follow-up in a natural environment conducted by a novel person, lower than baseline levels of echolalia were displayed by 3 subjects; 2 subjects displayed lower than baseline levels in some assessments. Two subjects consistently displayed correct responding above baseline, and 3 did so occasionally. Issues related to the study of maintenance are discussed.

  9. 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.

  10. Parental Involvement in Cognitive Behavior Therapy for Children with Anxiety Disorders: 3-Year Follow-Up.

    PubMed

    Walczak, Monika; Esbjørn, Barbara H; Breinholst, Sonja; Reinholdt-Dunne, Marie Louise

    2016-07-12

    Parental factors have been linked to childhood anxiety, hence, parental involvement in cognitive behavioral therapy (CBT) for anxious children has been examined. However, findings do not consistently show added effects of parent-enhanced CBT, longitudinal investigations are scarce and long-term effects unclear. In the present study, 40 out of 54 families who, 3 years previously, completed one of two types of CBT treatment: with limited or active parental involvement, were assessed using semi-structured diagnostic interviews. Diagnostic status at 3-years follow-up was compared between groups. Changes in diagnostic status across assessment points: posttreatment, 6-month and 3-year follow-up were analyzed within groups. Diagnostic change from 6-month to 3-year follow-up was compared between groups. Intent-to-treat analyses revealed no significant difference in diagnostic status between groups at 3-year follow-up. Nonetheless, children whose parents actively participated in treatment showed significantly more remission from 6-month to 3-year follow-up than children with limited parental participation.

  11. Microvascular Angina - Long-Term Exercise Stress Test Follow-up.

    PubMed

    Lanza, Gaetano A; Filice, Monica; De Vita, Antonio; Villano, Angelo; Manfredonia, Laura; Lamendola, Priscilla; Crea, Filippo

    2017-09-09

    A sizeable proportion of patients with primary stable microvascular angina (MVA; exercise-induced angina, positive exercise stress test [EST], normal coronary arteries) have recurrent symptoms during follow-up. There have been no previous studies, however, on the long-term results of EST and their correlation with symptom outcome.Methods and Results:Follow-up EST was performed in 71 MVA patients at an average of 16.2 years (range, 5-25 years) from the first EST. Angina status was assessed on weekly frequency of angina episodes and nitroglycerin consumption and by whether symptoms had worsened, improved, or remained unchanged over time. At follow-up EST, 41 patients (group 1) had exercise-induced ischemia, whereas 30 patients (group 2) had negative EST. Compared to group 2, group 1 patients more frequently had exercise-induced dyspnea, and had a greater maximum ST-segment depression and a lower coronary blood flow response to adenosine and cold pressor test, but group 2 patients had a more frequent history of rest angina. No differences between the 2 groups were found at follow-up in angina status or change in symptom status during follow-up. Electrocardiogram results improve significantly in a sizeable proportion of patients with MVA. Changes in EST results, however, were not associated with clinical outcome.

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

    PubMed

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

    2017-03-01

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

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

    PubMed

    Hagen, Knut; Jensen, Rigmor; Bøe, Magne Geir; Stovner, Lars Jacob

    2010-10-01

    No guidelines for performing and presenting the results of studies on patients with medication overuse headache (MOH) exist. The aim of this study was to review long-term outcome measures in follow-up studies published in 2006 or later. We included MOH studies with >6 months duration presenting a minimum of one predefined end point. In total, nine studies were identified. The 1,589 MOH patients (22% men) had an overall mean frequency of 25.3 headache days/month at baseline. Headache days/month at the end of follow-up was reported in six studies (mean 13.8 days/month). The decrease was more pronounced for studies including patients with migraine only (-14.6 days/month) compared to studies with the original diagnoses of migraine and tension-type headache (-9.2 days/month). Six studies reported relapse rate (mean of 26%) and/or responder rate (mean of 28%). Medication days/month and change in headache index at the end of follow-up were reported in only one and two of nine studies, respectively. The present review demonstrated a lack of uniform end points used in recently published follow-up studies. Guidelines for presenting follow-up data on MOH are needed and we propose end points such as headache days/month, medication days/month, relapse rate and responder rate defined as ≥50% reduction of headache frequency and/or headache index from baseline.

  14. Guidelines for the follow-up of patients undergoing bariatric surgery.

    PubMed

    O'Kane, Mary; Parretti, Helen M; Hughes, Carly A; Sharma, Manisha; Woodcock, Sean; Puplampu, Tamara; Blakemore, Alexandra I; Clare, Kenneth; MacMillan, Iris; Joyce, Jacqueline; Sethi, Su; Barth, Julian H

    2016-06-01

    Bariatric surgery can facilitate weight loss and improvement in medical comorbidities. It has a profound impact on nutrition, and patients need access to follow-up and aftercare. NICE CG189 Obesity emphasized the importance of a minimum of 2 years follow-up in the bariatric surgical service and recommended that following discharge from the surgical service, there should be annual monitoring as part of a shared care model of chronic disease management. NHS England Obesity Clinical Reference Group commissioned a multi-professional subgroup, which included patient representatives, to develop bariatric surgery follow-up guidelines. Terms of reference and scope were agreed upon. The group members took responsibility for different sections of the guidelines depending on their areas of expertise and experience. The quality of the evidence was rated and strength graded. Four different shared care models were proposed, taking into account the variation in access to bariatric surgical services and specialist teams across the country. The common features include annual review, ability for a GP to refer back to specialist centre, submission of follow-up data to the national data base to NBSR. Clinical commissioning groups need to ensure that a shared care model is implemented as patient safety and long-term follow-up are important. © 2016 World Obesity.

  15. 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.

  16. SPECT imaging with resolution recovery

    SciTech Connect

    Bronnikov, A. V.

    2011-07-01

    Single-photon emission computed tomography (SPECT) is a method of choice for imaging spatial distributions of radioisotopes. Many applications of this method are found in nuclear industry, medicine, and biomedical research. We study mathematical modeling of a micro-SPECT system by using a point-spread function (PSF) and implement an OSEM-based iterative algorithm for image reconstruction with resolution recovery. Unlike other known implementations of the OSEM algorithm, we apply en efficient computation scheme based on a useful approximation of the PSF, which ensures relatively fast computations. The proposed approach can be applied with the data acquired with any type of collimators, including parallel-beam fan-beam, cone-beam and pinhole collimators. Experimental results obtained with a micro SPECT system demonstrate high efficiency of resolution recovery. (authors)

  17. 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.

  18. Reactive attachment disorder in maltreated twins follow-up: from 18 months to 8 years.

    PubMed

    Heller, Sherryl Scott; Boris, Neil W; Fuselier, Sarah-Hinshaw; Page, Timothy; Koren-Karie, Nina; Miron, Devi

    2006-03-01

    The best means for the diagnosis and treatment of reactive attachment disorder of infancy and early childhood have not been established. Though some longitudinal data on institutionalized children is available, reports of maltreated young children who are followed over time and assessed with measures of attachment are lacking. This paper presents the clinical course of a set of maltreated fraternal twins who were assessed and treated from 19 months to 30 months of age and then seen in follow-up at 3 and 8 years of age. A summary of the early assessment and course is provided and findings from follow-up assessments of the cognitive, behavioral, and interpersonal functioning of each child is analysed. Follow-up measures, chosen to capture social-cognitive processing of these children from an attachment perspective, are highlighted. Finally, findings from the case are discussed from nosological and theoretical perspectives.

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

    PubMed

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

    1993-01-01

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

  20. Ameloblastic fibroma: a rare case report with 7-year follow-up.

    PubMed

    Melo, Leonardo de Araújo; Barros, Adna Conceição; Sardinha, Sandra de Cássia Santana; Cerqueira, Arlei; dos Santos, Jean Nunes

    2015-01-01

    Ameloblastic fibroma (AF) is a rare benign odontogenic tumor that usually occurs in the fi two decades of life. It affects adolescents and young adults and is found in the mandible and with a high frequency in the posterior region of this segment. There are rare case reports with a long-term follow-up. We report the case of a 6-year-old boy with extensive ameloblastic fibroma in the man ble. Treatment consisted of enucleation and bone curettage, with the preservation of permanent teE adjacent to the tumor. Clinical and radiographic follow-up of the patient over a period of 7 years show no signs of recurrence or malignant transformation. Patients with AF should be under follow-up for prolonged periods of time, even in ca! exhibiting a low proliferation index, because of the potential for recurrence and malignant transformation of this tumor.