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Month Follow-up (month + follow-up)
Terms modified by Month Follow-up Selected AbstractsBipolar Radiofrequency-Induced Thermotherapy of Turbinate Hypertrophy: Pilot Study and 20 Months' Follow-upTHE LARYNGOSCOPE, Issue 1 2003Jan Seeger MD Abstract Objectives/Hypothesis The present report is a pilot clinical study about a new bipolar ablation technique for the treatment of turbinate hypertrophy, which offers an alternative to conventional methods. Study Design Prospective, clinical. Methods From August 1999 to March 2000, a new bipolar radiofrequency system with acoustic feedback control was submucosally applied for the treatment of 38 patients with nasal airway obstruction of vasomotor (n = 31) or allergic (n = 7) genesis. The therapy was made ambulatory with surface anesthesia. Data were collected by questionnaire and rhinomanometry preoperatively and 2 and 20 months postoperatively. Results Nearly all patients reported an improvement of their nasal breathing, with 68% of them reporting a full and 29% a partial recovery. No significant differences were reported with regard to the response of the allergic versus the vasomotor rhinitis. On average, a definite benefit was observed after 2 weeks. Side effects, such as bleeding, synechia, or atrophic changes of the mucosa, which would have to be treated, were not observed. Conclusion The new bipolar radiofrequency thermotherapy presents an efficient option for the treatment of turbinate hypertrophy, which meets the requirements for an outpatient treatment. [source] Extended Mechanical Circulatory Support With a Continuous-Flow Rotary Left Ventricular Assist DeviceCONGESTIVE HEART FAILURE, Issue 2 2010Scott Harris DO Background LVAD therapy is an established treatment modality for patients with advanced heart failure. Pulsatile LVADs have limitations in design precluding their use for extended support. Continuous-flow rotary LVADs represent an innovative design with potential for small size and greater reliability by simplification of the pumping mechanism. Methods In a prospective multicenter study, 281 patients urgently listed (United Network for Organ Sharing status 1A or 1B) for heart transplant underwent implant of a continuous-flow LVAD. Survival and transplant rates were assessed at 18 months. Patients were assessed for adverse events throughout the study and for quality of life, functional status, and organ function for 6 months. Results Of 281 patients, 222 (79%) underwent transplant or LVAD removal for cardiac recovery or had ongoing LVAD support at 18-month follow-up. Actuarial survival on support was 72% (95% confidence interval, 65%,79%) at 18 months. At 6 months, there were significant improvements in functional status and 6-minute walk test results (from 0% to 83% of patients in New York Heart Association functional class I or II and from 13% to 89% of patients completing a 6-minute walk test) and in quality of life (mean values improved 41% with Minnesota Living With Heart Failure and 75% with Kansas City Cardiomyopathy questionnaires). Major adverse events included bleeding, stroke, right heart failure, and percutaneous lead infection. Pump thrombosis occurred in 4 patients. Conclusions A continuous-flow LVAD provides effective hemodynamic support for at least 18 months in patients awaiting transplant, with improved functional status and quality of life. [source] Recurrent trauma histories of two ,unlucky teeth': 42-month follow-upDENTAL TRAUMATOLOGY, Issue 5 2008Zuhal K The fracture type, severity of dislocation, mobility of fragments and diastasis have negative influence on the healing process. The aim of this study was to describe the treatment and the 42-month follow-up period of three trauma histories in a 12-year-old patient in 1 year and to emphasize the negative effects of recurrent traumas on the healing pattern and prognosis of root fractures. [source] Crown-root fracture of a lower first primary molar: report of an unusual caseDENTAL TRAUMATOLOGY, Issue 3 2008Gabriela da Rosa Götze Abstract,,, Dental traumas are highly prevalent lesions in primary teeth, but crown-root fractures are seldom observed in posterior teeth of this dentition. The aim of the present report was to describe the diagnosis, treatment, and a 24-month follow-up of an unusual case of complicated crown-root fracture in a lower first primary molar of a 3-year-old boy. [source] Surgical extrusion of a crown-root fractured immature permanent incisor: 36 month follow-upDENTAL TRAUMATOLOGY, Issue 6 2007Zuhal K Abstract,,, Crown-root fracture is defined as a fracture involving enamel, dentin and pulp and can be classified as either complicated or uncomplicated. The tooth with crown-root fracture presents a lot of problems during coronal restorations and extraction was formerly used in many cases. But loss of a permanent incisor in a young patient may create severe emotional problems and alternative treatment approaches must be considered. This report presents the successful results of a surgical extrusion of a complicated crown-root fractured, immature permanent incisor in a 9-year-old boy. Examination 36 months after the trauma indicated that the treatment had provided functional and esthetic results. [source] Preventing depression: a randomized trial of interpersonal psychotherapy-adolescent skills training,DEPRESSION AND ANXIETY, Issue 5 2010Jami F. Young Ph.D. Abstract Background: The study evaluated the efficacy of an indicated prevention program for adolescent depression. Methods: Fifty-seven adolescents with elevated depression symptoms were randomized to receive Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) or school counseling (SC). Hierarchical linear modeling examined differences in rates of change in depression symptoms and overall functioning and analysis of covariance examined mean differences between groups. Rates of depression diagnoses in the 18-month follow-up period were compared. Results: Adolescents in IPT-AST reported significantly greater rates of change in depression symptoms and overall functioning than SC adolescents from baseline to post-intervention. At post-intervention, IPT-AST adolescents reported significantly fewer depression symptoms and better overall functioning. During the follow-up phase, rates of change slowed for the IPT-AST adolescents, whereas the SC adolescents continued to show improvements. By 12-month follow-up, there were no significant mean differences in depression symptoms or overall functioning between the two groups. IPT-AST adolescents reported significantly fewer depression diagnoses in the first 6 months following the intervention but by 12-month follow-up the difference in rates of diagnoses was no longer significant. Conclusions: IPT-AST leads to an immediate reduction in depression symptoms and improvement in overall functioning. However, the benefits of IPT-AST are not consistent beyond the 6-month follow-up, suggesting that the preventive effects of the program in its current format are limited. Future studies are needed to examine whether booster sessions lengthen the long-term effects of IPT-AST. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source] Pain interference impacts response to treatment for anxiety disordersDEPRESSION AND ANXIETY, Issue 3 2009Carrie Farmer Teh PhD Abstract Background: Anxiety disorders and pain are commonly comorbid, though little is known about the effect of pain on the course and treatment of anxiety. Methods: This is a secondary analysis of a randomized controlled trial for anxiety treatment in primary care. Participants with panic disorder (PD) and/or generalized anxiety disorder (GAD) (N=191; 81% female, mean age 44) were randomized to either their primary-care physician's usual care or a 12-month course of telephone-based collaborative care. Anxiety severity, pain interference, health-related quality of life, health services use, and employment status were assessed at baseline, and at 2-, 4-, 8-, and 12-month follow-up. We defined response to anxiety treatment as a 40% or greater improvement from baseline on anxiety severity scales at 12-month follow-up. Results: The 39% who reported high pain interference at baseline had more severe anxiety (mean SIGH-A score: 21.8 versus 18.0, P<.001), greater limitations in activities of daily living, and more work days missed in the previous month (5.8 versus 4.0 days, P=.01) than those with low pain interference. At 12-month follow-up, high pain interference was associated with a lower likelihood of responding to anxiety treatment (OR=.28; 95% CI=.12,.63) and higher health services use (26.1% with ,1 hospitalization versus 12.0%, P<.001). Conclusions: Pain that interferes with daily activities is prevalent among primary care patients with PD/GAD and associated with more severe anxiety, worse daily functioning, higher health services use, and a lower likelihood of responding to treatment for PD/GAD. Depression and Anxiety, 2009. © 2009 Wiley-Liss, Inc. [source] Autologous Cultured Fibroblast Injection for Facial Contour Deformities: A Prospective, Placebo-Controlled, Phase III Clinical TrialDERMATOLOGIC SURGERY, Issue 3 2007ROBERT A. WEISS MD BACKGROUND Previous data indicate that injections of autologous fibroblasts increase collagen formation, accompanied by a concomitant increase in thickness and density of dermal collagen. OBJECTIVE The purpose of this study was to determine efficacy and side effects of autologous living fibroblast injections versus placebo in a randomized Phase III trial for the treatment of various facial contour defects. METHODS This was a double-blind, randomized comparison of injectable living autologous fibroblast cells and placebo for the treatment of facial contour defects (N=215). Live fibroblasts (20 million/mL) or placebo (the transport medium without living cells) were given as three doses administered at 1- to 2-week intervals. Efficacy evaluations were performed 1, 2, 4, 6, 9, and 12 months after the first injection. RESULTS Living fibroblasts produced statistically significantly greater improvements in dermal deformities and acne scars than did placebo. The difference between live fibroblast injections and placebo achieved statistical significance at 6 months (p<.0001). At 9- and 12-month follow-up, live fibroblast,treated patients continued to demonstrate benefit from treatment with response rates of 75.0 and 81.6%, respectively. No serious treatment-related adverse events were reported. CONCLUSIONS Our results indicate that autologous fibroblast injections can safely and effectively produce improvements in rhytids, acne scars, and other dermal defects continuing for at least 12 months after injection. [source] Laser Lipolysis Using a Novel 1,064 nm Nd:YAG LaserDERMATOLOGIC SURGERY, Issue 2 2006KAREN H. KIM MD BACKGROUND We studied the safety and efficacy of a 1,064 nm Nd:YAG laser with a 300 ,m fiber for the reduction of small unwanted fat areas. METHODS Thirty subjects with focal areas of fat less than 100 cm3 were enrolled. Ten subjects were treated with laser lipolysis and had magnetic resonance imaging (MRI) at baseline and 3 months post-treatment. Ten subjects had laser lipolysis followed by biweekly treatments with the Tri-active system. The last group of 10 subjects served as control. Patients were seen at baseline, 1 week, 1 month, and 3 month follow-up visits. RESULTS Twenty-nine patients completed the study. Self-assessment evaluations reported an improvement of 37% at the 3-month follow-up visit. MRI demonstrated an average 17% reduction in fat volume. Smaller baseline volume areas, such as the submentum, showed better results, suggesting a dose-response relationship. The most common side effects were mild bruising and swelling resolving within 2 weeks. CONCLUSION Laser lipolysis using the 1,064 nm Nd:YAG laser with 300 ,m fiber appears to be a very promising procedure that delivers good, reproducible results safely and effectively. The advantages include excellent patient tolerance, quick recovery time, as well as the benefit of dermal tightening. [source] A 12-month follow-up study of treating overweight schizophrenic patients with aripiprazoleACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2008S. G. Schorr Objective:, To investigate the feasibility of switching overweight schizophrenic patients to aripiprazole and to assess the impact of 12 months of aripiprazole treatment on weight in routine practice. Method:, This was a non-controlled cohort study in overweight schizophrenic patients. Data were collected before treatment with aripiprazole was started and at 12-month follow-up. Results:, A total of 53 patients were included; of these 55% continued using aripiprazole for 12 months. Aripiprazole treatment for 12 months (P = 0.027) and stopping clozapine or olanzapine treatment (P = 0.038) predicted weight loss (,3 kg). Patients receiving aripiprazole monotherapy (n = 16, mean ,3.0 kg) had similar weight loss than patients receiving aripiprazole in addition to another antipsychotic drug (n = 13, mean ,4.4 kg). Conclusion:, In routine practice once aripiprazole treatment was started, more than half of the patients remained on aripiprazole and most of them lost weight. Adding aripiprazole to clozapine gave similar weight loss as monotherapy with aripiprazole. [source] Perinatal infection is an important risk factor for cerebral palsy in very-low-birthweight infantsDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 6 2000Mary Wheater MAPhD FRCPCH Consultant Paediatrician Sixty-nine very-low-birthweight infants out of a population of 923 had cerebral palsy (CP) at an 18-month follow-up. Thirty-nine of these had cranial ultrasound abnormalities in the neonatal period and 30 had normal cranial ultrasounds. The distribution of subtypes of CP differed markedly between the two groups, with hemiplegia predominating in those with abnormal cranial ultrasounds and diplegia in those with normal cranial ultrasounds. Regardless of ultrasound appearance, the relative risk of CP increased approximately fourfold with a neonatal history of sepsis. [source] Substance misuse over the first 18 months of specialized intervention for first episode psychosisEARLY INTERVENTION IN PSYCHIATRY, Issue 3 2009Jason A. R. Carr Abstract Aim: Examine substance misuse over the first 18 months of first-episode psychosis treatment. Method: Clinicians rated alcohol and drug (mostly cannabis) misuse for 243 individuals followed prospectively. Assessments were completed at baseline and after 3, 6 and 18 months. Interventions relating to substance misuse included ongoing assessment of use, education and counselling to avoid. Results: Alcohol and drug misuse declined significantly between baseline and 3 months, especially among patients with a substance abuse or dependence diagnosis at baseline. Overall, these reductions were maintained over the 18-month follow-up period. The exception was worsening alcohol misuse over time among patients with alcohol abuse or dependence on entry. Conclusions: With good usual care, education and support, alcohol and drug misuse declined significantly during the first months of psychosis treatment. The improvements in drug misuse were generally maintained over the 18-month follow-up, and worsening alcohol misuse over time may be the greater issue. [source] Rumination as a predictor of drinking behaviour in alcohol abusers: a prospective studyADDICTION, Issue 6 2010Gabriele Caselli ABSTRACT Aims To investigate the role of depression and rumination in predicting drinking status (absence or presence of alcohol use) and level of alcohol use at 3, 6 and 12 months following a brief course of cognitive,behavioural therapy for alcohol abuse. Methods A total of 80 out-patients with a diagnosis of alcohol abuse completed measures of depression (Beck Depression Inventory), rumination (Ruminative Responses Scale) and alcohol use (Quantity,Frequency Scale). Results These indicated that rumination predicted drinking status and level of alcohol use at 3-, 6- and 12-month follow-up. The contribution of rumination was independent of depression and initial level of alcohol use. Conclusions The results confirm that rumination is an important prospective predictor of drinking status and level of alcohol use in alcohol abusers and highlight the potential relevance of targeting rumination in the treatment of alcohol abuse. [source] Internet-based prevention for alcohol and cannabis use: final results of the Climate Schools courseADDICTION, Issue 4 2010Nicola C. Newton ABSTRACT Aims To establish the long-term efficacy of a universal internet-based alcohol and cannabis prevention programme in schools. Methods A cluster-randomized controlled trial was conducted to assess the effectiveness of the Climate Schools: Alcohol and Cannabis Course. The evidence-based course, aimed at reducing alcohol and cannabis use, is facilitated by the internet and consists of 12 novel and curriculum consistent lessons delivered over 6 months. Participants A total of 764 year 8 students (13 years) from 10 Australian secondary schools were allocated randomly to the internet-based prevention programme (n = 397, five schools), or to their usual health classes (n = 367, five schools). Measures Participants were assessed at baseline, immediately post, and 6 and 12 months following completion of the intervention, on measures of alcohol and cannabis knowledge, attitudes, use and related harms. Results This paper reports the final results of the intervention trial, 12 months following the completion of the Climate Schools: Alcohol and Cannabis Course. The effectiveness of the course 6 months following the intervention has been reported previously. At the 12-month follow-up, compared to the control group, students in the intervention group showed significant improvements in alcohol and cannabis knowledge, a reduction in average weekly alcohol consumption and a reduction in frequency of drinking to excess. No differences between groups were found on alcohol expectancies, cannabis attitudes or alcohol- and cannabis-related harms. The course was found to be acceptable by teachers and students as a means of delivering drug education in schools. Conclusions Internet-based prevention programs for school-age children can improve student's knowledge about alcohol and cannabis, and may also reduce alcohol use twelve months after completion. [source] Ethnic differences in drinking outcomes following a brief alcohol intervention in the trauma care settingADDICTION, Issue 1 2010Craig A. Field ABSTRACT Background Evidence suggests that brief interventions in the trauma care setting reduce drinking, subsequent injury and driving under the influence (DUI) arrest. However, evidence on the effectiveness of these interventions in ethnic minority groups is lacking. The current study evaluates the efficacy of brief intervention among whites, blacks and Hispanics in the United States. Methods We conducted a two-group parallel randomized trial comparing brief motivational intervention (BMI) and treatment as usual with assessment (TAU+) to evaluate treatment differences in drinking patterns by ethnicity. Patients were recruited from a level 1 urban trauma center over a 2-year period. The study included 1493 trauma patients, including 668 whites, 288 blacks and 537 Hispanics. Hierarchical linear modeling was used to evaluate ethnic differences in drinking outcomes including volume per week, maximum amount consumed in 1 day, percentage days abstinent and percentage days heavy drinking at 6- and 12-month follow-up. Analyses controlled for age, gender, employment status, marital status, prior alcohol treatment, type of injury and injury severity. Special emphasis was given to potential ethnic differences by testing the interaction between ethnicity and BMI. Results At 6- and 12-month follow-up, BMI significantly reduced maximum amount consumed in 1 day (P < 0.001; P < 0.001, respectively) and percentage days heavy drinking (P < 0.05; P < 0.05, respectively) among Hispanics. Hispanics in the BMI group also reduced average volume per week at 12-month follow-up (,2 = 6.8, df = 1, P < 0.01). In addition, Hispanics in TAU+ reduced maximum amount consumed at 6- and 12-month follow-up (P < 0.001; P < 0.001) and volume per week at 12-month follow-up (P < 0.001). Whites and blacks in both BMI and TAU+ reduced volume per week and percentage days heavy drinking at 12-month follow-up (P < 0.001; P < 0.01, respectively) and decreased maximum amount at 6- (P < 0.001) and 12-month follow-up (P < 0.001). All three ethnic groups In both BMI and TAU+ reduced volume per week at 6-month follow-up (P < 0.001) and percentage days abstinent at 6- (P < 0.001) and 12-month follow-up (P < 0.001). Conclusions All three ethnic groups evidenced reductions in drinking at 6- and 12-month follow-up independent of treatment assignment. Among Hispanics, BMI reduced alcohol intake significantly as measured by average volume per week, percentage days heavy drinking and maximum amount consumed in 1 day. [source] Bayes' Theorem to estimate population prevalence from Alcohol Use Disorders Identification Test (AUDIT) scoresADDICTION, Issue 7 2009David R. Foxcroft ABSTRACT Aim The aim in this methodological paper is to demonstrate, using Bayes' Theorem, an approach to estimating the difference in prevalence of a disorder in two groups whose test scores are obtained, illustrated with data from a college student trial where 12-month outcomes are reported for the Alcohol Use Disorders Identification Test (AUDIT). Method Using known population prevalence as a background probability and diagnostic accuracy information for the AUDIT scale, we calculated the post-test probability of alcohol abuse or dependence for study participants. The difference in post-test probability between the study intervention and control groups indicates the effectiveness of the intervention to reduce alcohol use disorder rates. Findings In the illustrative analysis, at 12-month follow-up there was a mean AUDIT score difference of 2.2 points between the intervention and control groups: an effect size of unclear policy relevance. Using Bayes' Theorem, the post-test probability mean difference between the two groups was 9% (95% confidence interval 3,14%). Interpreted as a prevalence reduction, this is evaluated more easily by policy makers and clinicians. Conclusion Important information on the probable differences in real world prevalence and impact of prevention and treatment programmes can be produced by applying Bayes' Theorem to studies where diagnostic outcome measures are used. However, the usefulness of this approach relies upon good information on the accuracy of such diagnostic measures for target conditions. [source] Computer-based psychological treatment for comorbid depression and problematic alcohol and/or cannabis use: a randomized controlled trial of clinical efficacyADDICTION, Issue 3 2009Frances J. Kay-Lambkin ABSTRACT Aims To evaluate computer- versus therapist-delivered psychological treatment for people with comorbid depression and alcohol/cannabis use problems. Design Randomized controlled trial. Setting Community-based participants in the Hunter Region of New South Wales, Australia. Participants Ninety-seven people with comorbid major depression and alcohol/cannabis misuse. Intervention All participants received a brief intervention (BI) for depressive symptoms and substance misuse, followed by random assignment to: no further treatment (BI alone); or nine sessions of motivational interviewing and cognitive behaviour therapy (intensive MI/CBT). Participants allocated to the intensive MI/CBT condition were selected at random to receive their treatment ,live' (i.e. delivered by a psychologist) or via a computer-based program (with brief weekly input from a psychologist). Measurements Depression, alcohol/cannabis use and hazardous substance use index scores measured at baseline, and 3, 6 and 12 months post-baseline assessment. Findings (i) Depression responded better to intensive MI/CBT compared to BI alone, with ,live' treatment demonstrating a strong short-term beneficial effect which was matched by computer-based treatment at 12-month follow-up; (ii) problematic alcohol use responded well to BI alone and even better to the intensive MI/CBT intervention; (iii) intensive MI/CBT was significantly better than BI alone in reducing cannabis use and hazardous substance use, with computer-based therapy showing the largest treatment effect. Conclusions Computer-based treatment, targeting both depression and substance use simultaneously, results in at least equivalent 12-month outcomes relative to a ,live' intervention. For clinicians treating people with comorbid depression and alcohol problems, BIs addressing both issues appear to be an appropriate and efficacious treatment option. Primary care of those with comorbid depression and cannabis use problems could involve computer-based integrated interventions for depression and cannabis use, with brief regular contact with the clinician to check on progress. [source] In 12-step groups, helping helps the helperADDICTION, Issue 8 2004Sarah E. Zemore ABSTRACT Aims The helper therapy principle suggests that, within mutual-help groups, those who help others help themselves. The current study examines whether clients in treatment for alcohol and drug problems benefit from helping others, and how helping relates to 12-step involvement. Design Longitudinal treatment outcome. Participants An ethnically diverse community sample of 279 alcohol- and/or drug-dependent individuals (162 males, 117 females) was recruited through advertisement and treatment referral from Northern California Bay Area communities. Participants were treated at one of four day-treatment programs. Measurements A helping checklist measured the amount of time participants spent, during treatment, helping others by sharing experiences, explaining how to get help and giving advice on housing and employment. Measures of 12-step involvement and substance use outcomes were administered at baseline and a 6 month follow-up. Findings Helping and 12-step involvement emerged as important and related predictors of treatment outcomes. In the general sample, total abstinence at follow-up was strongly and positively predicted by 12-step involvement at follow-up, but not by helping during treatment; still, helping positively predicted subsequent 12-step involvement. Among individuals still drinking at follow-up, helping during treatment predicted a lower probability of binge drinking, whereas effects for 12-step involvement proved inconsistent. Conclusions Findings support the helper therapy principle and clarify the process of 12-step affiliation. [source] Motivational enhancement and coping skills training for cocaine abusers: effects on substance use outcomesADDICTION, Issue 7 2004Damaris J. Rohsenow Abstract Aims This clinical trial investigated effects of motivational enhancement treatment (MET) and group coping-skills training (CST) tailored for cocaine dependence. Effects of MET were hypothesized to be greater with CST and for less motivated patients. Design and interventions A 2 × 2 design investigated two individual sessions of MET compared to meditation,relaxation (MRT), followed by four group sessions of CST versus drug education (ED), as daily adjuncts to intensive treatment. Setting The substance abuse program provided full-day treatment with a learning-theory and 12-Step orientation. Participants Cocaine-dependent patients were recruited. Measurements Assessment included treatment retention; change in cocaine-related urge, self-efficacy, pros and cons, and motivation; substance use and problems during 12-month follow-up. Findings Of 165 patients, follow-up status is known for 90% (n = 149). Patients in MET with low initial motivation to change reported less cocaine and alcohol relapse and use days and fewer alcohol problems than MET patients with higher initial motivation. MET produced more employment improvement than MRT, with no other significant benefit for MET. Patients with higher motivation had more cocaine use and alcohol problems after MET than MRT. Group CST reduced cocaine and alcohol use during follow-up for women only and reduced alcohol relapse for men and women. Conclusions MET is more beneficial for patients with lower initial motivation than for patients with high initial motivation. CST reduced cocaine and alcohol use for women only and reduced alcohol relapses, in contrast to results with lengthier individual CST. [source] A randomized controlled trial of a smoking cessation intervention based in community pharmaciesADDICTION, Issue 2 2001T. A. Maguire Aims. To evaluate whether a structured community pharmacy-based smoking cessation programme (the PAS model) would give rise to a higher smoking cessation rate compared with ad hoc advice from pharmacists. Design. A randomized controlled trial comparing a structured intervention with usual care. Setting. One hundred pharmacists working in community pharmacies in N. Ireland and 24 in London took part in the study and were each asked to enroll 12 smokers; 44% of pharmacists who were trained managed to recruit one or more smokers during the recruitment period of approximately 1 year. Participants. A total of 484 smokers were enrolled by the pharmacists and individually randomized into the PAS intervention group ( N = 265) or the control group ( N = 219). Intervention. The PAS intervention involved a structured counselling programme, an information leaflet and a follow-up weekly for the first 4 weeks then monthly as needed. Measurements. The primary outcome measure of this study was self-reported smoking cessation for 12 months with cotinine validation at the 12-month follow-up. Findings. Of smokers in the PAS group, 14.3% (38) were abstinent up to 12 months compared with 2.7% (6) in the control group ( p < 0.001 for the difference). Conclusion. The community pharmacy-based PAS smoking cessation service can be an effective method of helping people stop smoking when delivered by pharmacists willing to adopt this approach. [source] Osteomyocutaneous peroneal artery perforator flap for reconstruction of composite maxillary defects,HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 4 2006Sukru Yazar MD Abstract Background. Composite maxillary defects often involve the maxilla, nasal mucosa, palate, and maxillary sinus. We presented the surgical techniques and outcome of the osteomyocutaneous peroneal artery perforator (PAP) flap for reconstruction of composite maxillary defects. Methods. Six patients underwent an osteomyocutaneous PAP flap reconstruction of composite maxillary defects. The average age was 52 years. The defects were Cordeiro type II in three patients and type IV midfacial defects in another three patients. Results. No total or partial flap failures occurred. At a mean 12-month follow-up, five patients had a normal speech and were able to eat a regular diet. One patient tolerated a soft diet and had intelligible speech. One patient had ectropion develop. Excellent cosmesis was found in five patients. Conclusions. The osteomyocutaneous PAP flap represents a further refinement of the fibula flap and increases its versatility, with multiple skin paddles, bone segments, and soleus muscle independently isolated. It is a comparable reconstruction option for composite maxillary defects. © 2005 Wiley Periodicals, Inc. Head Neck28: 297,304, 2006 [source] Low cholesterol along with inflammation predicts morbidity and mortality in hemodialysis patientsHEMODIALYSIS INTERNATIONAL, Issue 2 2009George TSIRPANLIS Abstract Low and not high cholesterol seems to predict high mortality in hemodialysis (HD) patients. The confirmation of this reverse epidemiology as well as its possible interconnection with the increased inflammatory activity observed in this population is being explored in the present study. A group of 136 HD patients was prospectively studied for 2 years, and cardiovascular disease (CVD) as well as all-cause mortality and morbidity were recorded. Baseline lipid profile, inflammatory status, and patients' characteristics were studied as potential survival and hospitalization predictors. During the 24-month follow-up, 21 deaths (52.4% due to CVD) and 38 hospitalizations (55.3% due to CVD) were recorded. In multivariate Cox regression analysis, decreased interleukin-10 (IL-10) and decreased total serum cholesterol (TChol) were the only independent predictors of CVD mortality while C-reactive protein and decreased TChol predicted all-cause mortality. Interleukin-10 at baseline was 11.29 ± 21.49 vs. 5.51 ± 4.57 pg/mL (P<0.018) and TChol 167.37 ± 47.84 vs.122.04 ± 26.48 mg/dL (P<0.000) in survivors vs. nonsurvivors from CVD, while C-reactive protein at baseline was 9.37 ± 11.54 vs. 23.15 ± 18.76 mg/L (P<0.000) and TChol 169.26 ± 46.42 vs. 133.26 ± 46.33 mg/dL (P<0.003) in survivors vs. nonsurvivors from any cause of death. Using the same method of statistical analysis, IL-6 and decreased soluble gp130 (sgp130),an antagonist of IL-6 action,were found to be the only independent prognostic factors for hospitalization due to CVD while decreased soluble gp130 remained the sole predictor of hospitalization due to any cause. In conclusion, reverse epidemiology regarding cholesterol is confirmed in the present study. Furthermore, inflammatory activity also predicts, independently of or in conjunction with low-cholesterol, CVD and all-cause morbidity and mortality in HD patients. [source] Apical surgery of a maxillary molar creating a maxillary sinus window using ultrasonics: a clinical caseINTERNATIONAL ENDODONTIC JOURNAL, Issue 11 2010B. García García B, Peñarrocha M, Peñarrocha MA, von Arx T. Apical surgery of a maxillary molar creating a maxillary sinus window using ultrasonics: a clinical case. International Endodontic Journal, 43, 1054,1061, 2010. Abstract Aim, To describe a method of carrying out apical surgery of a maxillary molar using ultrasonics to create a lateral sinus window into the maxillary sinus and an endoscope to enhance visibility during surgery. Summary, A 37-year-old female patient presented with tenderness to percussion of the maxillary second right molar. Root canal treatment had been undertaken, and the tooth restored with a metal-ceramic crown. Radiological examination revealed an apical radiolucency in close proximity to the maxillary sinus. Apical surgery of the molar was performed through the maxillary sinus, using ultrasonics for the osteotomy, creating a window in the lateral wall of the maxillary sinus. During surgery, the lining of the sinus was exposed and elevated without perforation. The root-end was resected using a round tungsten carbide drill, and the root-end cavity was prepared with ultrasonic retrotips. Root-end filling was accomplished with MTA®. An endoscope was used to examine the cut root face, the prepared cavity and the root-end filling. No intraoperative or postoperative complications were observed. At the 12-month follow-up, the tooth had no clinical signs or symptoms, and the radiograph demonstrated progressing resolution of the radiolucency. Key learning points ,,When conventional root canal retreatment cannot be performed or has failed, apical surgery may be considered, even in maxillary molars with roots in close proximity to the maxillary sinus. ,,Ultrasonic sinus window preparation allows more control and can minimize perforation of the sinus membrane when compared with conventional rotary drilling techniques. ,,The endoscope enhances visibility during endodontic surgery, thus improving the quality of the case. [source] Randomized clinical trial of root-end resection followed by root-end filling with mineral trioxide aggregate or smoothing of the orthograde gutta-percha root filling , 1-year follow-upINTERNATIONAL ENDODONTIC JOURNAL, Issue 2 2009R. Christiansen Abstract Aim, To compare healing after root-end resection with a root-end filling of mineral trioxide aggregate (MTA) or smoothing of the orthograde gutta-percha (GP) root filling. Methodology, Forty-four patients (consisting of 52 teeth with periapical infection), average age of 54.6 years (range 30,77) participated in a randomized clinical trial (RCT) comparing the MTA and GP treatment methods. Radiographs produced 1-week and 12 months post-operatively were compared after blinding for treatment method, and healing was assessed as complete, incomplete, uncertain, or unsatisfactory. Results, Six teeth were not available for the 12-month follow-up: three teeth (GP) had been re-operated because of pain and two teeth (one GP, one MTA) had been extracted because of root fracture (these five teeth were classified as failures). One patient (GP) was not available for recall. In the GP group, seven teeth (28%) showed complete healing, six teeth (24%) incomplete healing, six teeth (24%) uncertain healing and two teeth (8%) unsatisfactory healing after 1 year. In the MTA group, 22 teeth (85%) showed complete healing, three teeth (12%) incomplete healing, and none were scored as uncertain or unsatisfactory healing after 1 year. The difference in healing between the GP and the MTA groups was significant (P < 0.001). Conclusions, The results from this RCT emphasize the importance of placing a root-end filling after root-end resection. Teeth treated with MTA had significantly better healing (96%) than teeth treated by smoothing of the orthograde GP root filling only (52%). [source] Low-molecular-weight heparin as bridging therapy during interruption of oral anticoagulation in patients undergoing colonoscopy or gastroscopyINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 2 2007M. Constans Summary Nowadays, most patients under oral anticoagulant therapy (OAT) require invasive procedures such as colonoscopy (CC) or gastroscopy (GC). The goals of the management of OAT are to minimise the risk of thromboembolism and bleeding. We have performed the first prospective, observational study to evaluate these parameters using fixed-dose high-risk thromboprophylactic therapy with sodic bemiparin (Hibor®) as bridging therapy. From January 2004 to January 2005, patients under OAT were included. Periprocedure prophylaxis consisted of: Acenocumarol patients: Day ,3: withdrawal acenocumarol. Days ,2,,1,0: Hibor ®3500 UI/d sc and days +1,+2,+3: Hibor® 3500 U/I + acenocumarol. And day +5: acenocumarol only. Warfarin patients: Days ,5,,4: withdrawal warfarin, ,3,,2,,1, 0; Hibor® 3500 UI/day sc, days +1,+2,+3,+4: Hibor® 3500 UI/day sc and warfarin and day +5; warfarin only. Thromboembolic complications and bleeding were recorded in a 3 month follow-up. We included 100 consecutive patients in the intention-to-treat group. The remaining 98 patients were 50 women and 48 men. Mean age of women was 71.1 (range: 46,87) years and 70.7 (range: 39,86) years in men. Eighty-three took acenocumarol, and 15 warfarin. Thirty-two gastroscopies and 61 colonoscopies were performed and in five patients both were performed. No thromboembolic and bleeding complications related to bemiparin were observed in the 103 endoscopies. Two patients developed pruritus at the punction site. Fixed-dose high-risk thromboprophilactic therapy with bemiparin (Hibor®) is safe and effective as a bridging therapy in patients under OAT who require GC or CC. [source] Restraint, hunger, and disinhibition following treatment for binge-eating disorderINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 6 2009Kristina A. Downe MS Abstract Objective: To examine changes in total, flexible and rigid restraint, hunger, and disinhibition in obese individuals with Binge-Eating Disorder (BED), and assess whether these variables are associated with binge abstinence at post-treatment and during two-year follow-up. Method: A total of 116 obese individuals with BED were randomized to a 20-week treatment trial plus two-year follow-up. Using the Eating Inventory (EI), we assessed these factors at pretreatment, post-treatment, and follow-up time-points and examined their relationship to binge abstinence at post-treatment, 12- and 24-month follow-up. Results: Low disinhibition and high-total restraint are associated with post-treatment binge abstinence. There are no significant relationships between post-treatment EI variables and binge abstinence at 12- and 24-month follow-up. Discussion: Reducing disinhibition as well as increasing EI dietary restraint during BED treatment may be important for short-term success. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord 2009 [source] A randomized comparison of cognitive behavioral therapy and behavioral weight loss treatment for overweight individuals with binge eating disorderINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 2 2007Simone Munsch PhD Abstract Objectives: The aim of this study was to determine the efficacy of cognitive-behavioral therapy (CBT) and behavioral weight loss treatment (BWLT) for overweight patients with binge eating disorder (BED). Method: Eighty obese patients meeting criteria of BED according to DSM-IV-TR were randomly assigned to either CBT or BWLT consisting of 16 weekly treatments and 6 monthly follow-up sessions. Binge eating, general psychopathology, and body mass index (BMI) were assessed before, during, and after treatment, and at 12-month follow-up. Results: At posttreatment results favored CBT as the more effective treatment. Analysis of the course of treatments pointed to a faster improvement of binge eating in CBT based on the number of self-reported weekly binges, but faster reduction of BMI in BWLT. At 12-month follow-up, no substantial differences between the two treatment conditions existed. Conclusion: CBT was somewhat more efficacious than BWLT in treating binge eating but this superior effect was barely maintained in the long term. Further research into cost effectiveness is needed to assess which treatment should be considered the treatment of choice. © 2006 by Wiley Periodicals, Inc. Int J Eat Disord 2006 [source] The persistence of neuropsychiatric symptoms in dementia: the Cache County StudyINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2004Martin Steinberg Abstract Objective To estimate the 18-month persistence of neuropsychiatric symptoms in dementia in a population-based sample, and to compare the severity of neuropsychiatric symptoms at baseline to the severity at 18-month follow-up. Methods A population-based sample of 329 residents of Cache County, Utah, diagnosed with dementia was rated on the Neuropsychiatric Inventory (NPI). Of the 204 participants with neuropsychiatric symptoms at baseline (defined as total NPI score >0), NPI data were obtained approximately 18 months later on 117 who were alive and available for follow-up. Results Eighty-one percent of those with neuropsychiatric symptoms at baseline (defined as total NPI score>0) continued to have at least one symptom at follow-up. Sixty-seven percent of participants with a clinically significant total NPI score (defined as ,;4) at baseline continued to have a clinically significant total NPI score at follow-up. Among the ten neuropsychiatric domains assessed at baseline, delusions persisted in 65.5% of individuals, followed by depression (58.3%), and aberrant motor behavior (55.6%), while hallucinations and disinhibition persisted in only 25.0% and 11.1% respectively. In participants who were symptomatic at both baseline and follow-up, the mean severity scores at the two observation points were comparable in all ten neuropsychiatric domains. Conclusions Neuropsychiatric symptoms in dementia overall were highly persistent. Among those in whom symptoms did persist, symptom severity a year and a half later appeared to be comparable. Copyright © 2004 John Wiley & Sons, Ltd. [source] Haemolytic uraemic syndrome: prognostic factorsINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 1 2000D. A. Green Haemolytic uraemic syndrome (HUS) associated with Escherichia coli O157:H7 is the commonest cause of acute renal failure (ARF) in childhood. Production of verotoxin by the organism is pivotal in the pathogenesis of the disease. Verotoxin binds to a receptor on blood and endothelial cells, expressed as the P1 blood group antigen on red blood cells. A protective effect of the P1 phenotype has been proposed in this disease. This study investigates prognostic factors and the relationship between outcome and P1 phenotype in 27 cases of diarrhoea-associated HUS. A poor outcome as defined by the presence of chronic renal failure (CRF), hypertension or proteinuria on 6 month follow-up was associated with the age of the patient at presentation and with the following clinical markers: maximum WBC and duration of raised WBC, duration of anuria and duration of need for dialysis. None of these outcome measures or prognostic factors, and no extra-renal manifestations of the disease were associated with P1 phenotype. [source] Gingival fibromatosis and significant tooth eruption delay in an 11-year-old male: a 30-month follow-upINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 4 2005K. KAVVADIA Summary. This case report describes the dental management of an unusual case of idiopathic gingival fibromatosis with multiple impacted primary teeth, and the absence of eruption of permanent teeth, in an 11-year-old boy and at the 30-month follow-up. The patient presented with severely enlarged gingival tissues affecting both arches and multiple retained and nonerupted primary teeth. He had already been subjected to localized gingivectomies at the ages of 7 and 9 years. He had no known syndrome and there was no family history of any similar disorder. The patient was treated under general anaesthesia to remove the excessive gingival tissues using apically positioned flaps. During the surgical procedure, over-retained and unerupted impacted primary teeth were extracted in order to facilitate the eruption of the permanent successors. Two years postoperatively, there was no recurrence of the gingival enlargement. Overdentures were then constructed because none of the permanent teeth had yet erupted. Furthermore, preeruptive coronal resorption was detected radiographically affecting the crown of the unerupted 36. Thirty months postoperatively, no recurrence of gingival enlargement was seen, but the permanent teeth had still not erupted. [source] | |||||||||||||||||||||||||||||||||||||