One-year Follow-up (one-year + follow-up)

Distribution by Scientific Domains

Selected Abstracts

Percutaneous Lumbar Discectomy: One-Year Follow-Up in an Initial Cohort of Fifty Consecutive Patients with Chronic Radicular Pain

PAIN PRACTICE, Issue 2 2005
Kenneth M. Alņ MD
First page of article [source]

Surgical treatment of peri-implantitis using a bone substitute with or without a resorbable membrane: a prospective cohort study

Ann-Marie Roos-Jansåker
Abstract Objectives: The aim of this prospective cohort study was to compare two regenerative surgical treatment modalities for peri-implantitis. Material and Methods: Thirty-six patients having a minimum of one osseointegrated implant, with a progressive loss of bone amounting to 3 threads (1.8 mm) following the first year of healing, combined with bleeding and/or pus on probing, were involved in this study. The patients were assigned to two different treatment strategies. After surgical exposure of the defect, granulomatous tissue was removed and the infected implant surface was treated using 3% hydrogen peroxide. The bone defects were filled with a bone substitute (Algipore®). In 17 patients (Group 1), a resorbable membrane (Osseoquest®) was placed over the grafted defect before suturing. In 19 patients (Group 2), the graft was used alone. Results: One-year follow-up demonstrated clinical and radiographic improvements. Probing depths were reduced by 2.9 mm in Group 1 and by 3.4 mm in Group 2. Defect fill amounted to 1.5 and 1.4 mm, respectively. There was no significant difference between the groups. Conclusion: It is possible to treat peri-implant defects with a bone substitute, with or without a resorbable membrane. [source]

One-year follow-up of a lentigo maligna: first dermoscopic signs of growth

R. Schiffner
Summary We report a 64-year-old man with a pigmented lesion on his forehead, initially thought to be actinic lentigo. At follow-up 1 year later the lesion had increased in size and showed new areas of pigmentation. Dermoscopic observation and biopsy led to a diagnosis of lentigo maligna and the lesion was excised. The dermoscopic features indicative of early growth of lentigo maligna are identified and discussed. [source]

Natural history of solitary cerebral cysticercosis cases after albendazole therapy: a longitudinal follow-up study from India

D. Goel
Goel D, Mittal M, Bansal KK, Singhal A. Natural history of solitary cerebral cysticercosis cases after albendazole therapy: a longitudinal follow-up study from India. Acta Neurol Scand: 2010: 121: 204,208. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objectives,,, To find out natural course of solitary cerebral cysticercosis (SCC) cases after treating them with 2 weeks albendazole therapy. Material and methods,,, All patients with SCC were treated with 2 weeks of albendazole therapy with follow-up radiological scan at 6 months and 2 years. The evolution of lesion was noted as complete resolution, calcification or persistent active. Antiepileptic drugs (AED) prophylaxis was given for 1 year in patients with complete resolution and for 2 years in calcified lesion, respectively. AED was continued in persistent lesion group till it became calcified or resoluted completely. One-year follow-up was done in all after stopping AED. Results,,, Among 345 cases, 226 (65.5%) had complete resolution with very low seizure relapse rate with 1 year of seizure free period on AED treatment. On the contrary, 105 (30.5%) had calcified lesion with high seizure relapse rate after stopping AED treatment with 2 years of seizure free period. Fourteen patients (4%) could not stop their antiepileptic medication at all because of active lesion. Conclusion,,, Two-third of patients with SCC have favorable outcome with complete resolution and needs short-term AED prophylaxis and the rest one-third requires long AED treatment to prevent seizures. [source]

Radiation following percutaneous balloon aortic valvuloplasty to prevent restenosis (RADAR pilot trial)

Wes R. Pedersen MD
Abstract Objectives: We wished to determine the feasibility and early safety of external beam radiation therapy (EBRT) used following balloon aortic valvuloplasty (BAV) to prevent restenosis. Background: BAV for calcific aortic stenosis (AS) has been largely abandoned because of high restenosis rates, i.e., > 80% at 1 year. Radiation therapy is useful in preventing restenosis following vascular interventions and treating other benign noncardiovascular disorders. Methods: We conducted a 20-patient, pilot study evaluating EBRT to prevent restenosis following BAV in elderly patients with calcific AS. Total doses ranging from 12,18 Gy were delivered in fractions over a 3,5 day post-op period to the aortic valve. Echocardiography was performed pre and 2 days post-op, 1, 6, and 12 months following BAV. Results: One-year follow-up is completed (age 89 ± 4). There were no complications related to EBRT. Eight patients died prior to 1 year; 5 of 10 (50%) in the low-dose (12 Gy) group and 3 of 10 (30%) in the high-dose (15,18 Gy) group. None of these 8 patients had restenosis, i.e., > 50% loss of the initial AVA gain, and only three deaths were cardiac in origin. One patient underwent aortic valve replacement and none repeated BAV. By 1 year, 3 of the initial 10 (30%) in the low-dose group and 1 of 9 (11%) in the high-dose group demonstrated restenosis (21% overall). Conclusions: EBRT following BAV in elderly patients with AS is feasible, free of early complications, and holds promise in reducing the 1 year restenosis rate in a dose-dependent fashion. © 2006 Wiley-Liss, Inc. [source]

One-year follow-up of patients with acromegaly treated with fixed or titrated doses of lanreotide Autogel®

Ph. Caron
Summary objective, Somatostatin analogue treatment is first-line medical therapy for acromegaly. This study compared the efficacy and tolerability of titrated doses of the long-acting somatostatin analogue preparation lanreotide Autogel® with fixed doses and with lanreotide prolonged release (PR) 30 mg microparticles. patients, Patients entering the initial study had received a diagnosis of active acromegaly within the previous 5 years. design, This open, comparative, multicentre study was a 1-year extension of a previous trial during which patients with acromegaly had switched from lanreotide PR 30 mg microparticles injected intramuscularly every 7, 10 or 14 days, for at least 3 months, to one of three fixed doses of lanreotide Autogel® (120, 90, or 60 mg every 28 days, respectively). In this extension study, patients continued to receive 60, 90, or 120 mg of lanreotide Autogel® by deep subcutaneous injection every 28 days for 1 year. Doses could be titrated at entry or after four or eight injections, according to the GH/IGF-I response (dose increased if GH > 2·5 µg/l, or decreased if GH < 1 µg/l with normal IGF-I). measurements, Mean ± SEM GH and IGF-I concentrations were analysed and gallbladder echography performed at weeks 0, 16, 32, and 48. Acromegaly symptoms were recorded monthly and tolerance and side-effects were monitored throughout the study. results, In total, 130 patients entered this extension phase. After 1 year of treatment with titrated doses of lanreotide Autogel®, mean GH (2·4 ± 0·2 µg/l) and IGF-I (287 ± 12 µg/l) concentrations were significantly lower than with lanreotide microparticles (GH, 2·8 ± 0·2 µg/l, P < 0·001; IGF-I, 332 ± 15 µg/l, P < 0·01) or with fixed-dose lanreotide Autogel® (GH, 3·0 ± 0·2 µg/l, P < 0·001; IGF-I, 310 ± 14 µg/l, P = 0·02). GH hypersecretion was reduced to , 2·5 µg/l in 68% of patients with titrated-dose lanreotide Autogel® compared with 49% with microparticles (P < 0·001) and 56% with fixed-dose lanreotide Autogel® (P , 0·005). In the 65 patients who did not require any dose titration, there was no substantial change in serum lanreotide concentration, GH or IGF-I levels over the 12-month study duration. Acromegaly was effectively controlled (GH , 2·5 µg/l and normalized IGF-I) in significantly more patients (43%) compared with microparticles (32%; P < 0·05). There was a trend for improved control of acromegalic symptoms with dose titration, whereas the incidence of gastrointestinal symptoms and local tolerance was similar with lanreotide Autogel® and lanreotide microparticles. Gallbladder echographies showed new lithiasis in 8% of lanreotide Autogel® patients. conclusion, Dose titration of lanreotide Autogel® improved GH and IGF-I control in patients with acromegaly beyond that achieved using fixed doses of lanreotide Autogel® or lanreotide microparticles. Titrated long-term lanreotide Autogel® treatment is well tolerated. [source]

Early Hemodynamic Results of the Shelhigh SuperStentless Aortic Bioprostheses

Paolo Cattaneo M.D.
The aim of the study was to evaluate the early hemodynamic performance of the Shelhigh SuperStentless aortic valve (AV). Methods: Between July 2003 and June 2005, 35 patients (18 females; age 70.8 ± 11.7 years, range: 22-85) underwent AV replacement with the Shelhigh SuperStentless bioprostheses. Most recurrent etiology was senile degeneration in 25 (71%) patients and 24 (69%) were in New York Heart Association (NYHA) functional class III or IV. Concomitant coronary artery bypass grafting was performed in nine patients (25.7%) and mitral valve surgery in two patients (5.7%). Doppler echocardiography was performed before surgery, at six-month and one-year follow-up. Results: There were no hospital deaths and no valve-related perioperative complications. During one-year follow-up, no endocarditis or thromboembolic events were registered, no cases of structural dysfunction or valve thrombosis were noted. Mean and peak transvalvular gradients significantly decrease after AV replacement, with an evident reduction to approximately 50% of the preoperative values at six months. A 20% reduction was also observed for left ventricular mass (LVM) index at six months, with a further regression at one year. Correspondingly, significant increases in effective orifice area (EOA) and indexed EOA were determined after surgery (0.87 ± 0.14 versus 1.84 ± 0.29 cm2 and 0.54 ± 0.19 versus 1.05 ± 0.20 cm2/m2, respectively). Valve prosthesis-patient mismatch was moderate in five patients and severe in one case. Conclusions: Shelhigh SuperStentless AV provided good and encouraging hemodynamic results. Long-term follow-up is necessary to evaluate late hemodynamic performance and durability of this stentless bioprosthesis. [source]

Impact of PTSD comorbidity on one-year outcomes in a depression trial

Bonnie L. Green
Low-income African American, Latino, and White women were screened and recruited for a depression treatment trial in social service and family planning settings. Those meeting full criteria for major depression (MDD; N = 267) were randomized to cognitive,behavior therapy (CBT), antidepressant medication, or community mental health referral. All randomly assigned participants were evaluated by baseline telephone and clinical interview, and followed by telephone for one year. Posttraumatic stress disorder (PTSD) comorbidity was assessed at baseline and one-year follow-up in a clinical interview. At baseline, 33% of the depressed women had current comorbid PTSD. These participants had more exposure to assaultive violence, had higher levels of depression and anxiety, and were more functionally impaired than women with depression alone. Depression in both groups improved over the course of one year, but the PTSD subgroup remained more impaired throughout the one-year follow-up period. Thus, evidence-based treatments (antidepressant medication or structured psychotherapy) decrease depression regardless of PTSD comorbidity, but women with PTSD were more distressed and impaired throughout. Including direct treatment of PTSD associated with interpersonal violence may be more effective in alleviating depression in those with both diagnoses. © 2006 Wiley Periodicals, Inc. J Clin Psychol 62: 815,835, 2006. [source]

Outpatient mental health care, self-help groups, and patients' one-year treatment outcomes

Rudolf Moos
Objective: To examine the association between the duration and amount of outpatient mental health care, participation in self-help groups, and patients' casemix-adjusted one-year outcomes. Methods: A total of 2,376 patients with substance use disorders, 35% of whom also had psychiatric disorders, were assessed at entry to treatment and at a one-year follow-up. Information about the duration and amount of outpatient mental health care was obtained from a centralized health services utilization database. Results: Patients who obtained regular outpatient mental health care over a longer interval and patients who attended more self-help group meetings had better one-year substance use and social functioning outcomes than did patients who were less involved in formal and informal care. The amount of outpatient mental health care did not independently predict one-year outcomes. Conclusions: The duration of outpatient mental health care and the level of self-help involvement are independently associated with less substance use and more positive social functioning. The provision of low intensity treatment for a longer time interval may be a cost-effective way to enhance substance abuse and psychiatric patients' long-term outcomes. © 2001 John Wiley & Sons, Inc. J Clin Psychol 57: 273,287, 2001. [source]

Diclofenac sodium and occlusal splint therapy in TMJ osteoarthritis: a randomized controlled trial

Summary, The aim of the study was to compare treatment with diclofenac sodium (Voltaren 3 × 50 mg) to occlusal splint therapy in a randomized, single-blind controlled trial of patients with a diagnosis of temporomandibular joint (TMJ) osteoarthritis (OA) in accordance with Research Diagnostic Criteria for temporomandibular disorders. Patients with general joint disorders or restrictions against medication with non-steroidal anti-inflammatory drug were not included. Twenty-seven females and two males (aged 36,76 years) included, answered a standardized questionnaire and were clinically examined and they underwent TMJ tomography. The treatment was randomized to either splint (n = 15) or diclofenac (n = 14). The temperatures over the TMJs were determined. The patients were re-examined 1 week, 1 month and 3 months after the start of treatment. A 1-year follow-up was carried out using questionnaires. After 1 week of treatment with diclofenac, significant reductions of pain and discomfort, TMJ tenderness and joint pain on jaw movements were noted. The splint therapy gave a significant reduction of reported symptoms after 1 month of treatment. Both treatments gave few adverse effects and were on an equal level. Estimation of the degree of inflammation by measuring the surface temperature over the TMJ was not reliable. Structural changes of the symptomatic TMJs were radiographically found in 82%, the contralateral, symptom-free TMJ had changes in 36%. There was a discrepancy between the clinical and the radiographical findings. Diclofenac gave a more rapid improvement, but both treatments gave a significant reduction of symptoms of TMJ OA within 3 months which remained at the one-year follow-up. [source]

Unfairness at work as a predictor of absenteeism

Elpine M. de Boer
This study among 514 security guards examines the relationship between perceptions of unfairness at work and absenteeism during a one-year follow-up. On the basis of previous theoretical work and fragmented empirical evidence, it was hypothesized that distributive unfairness causes absence behavior in a direct or indirect way (through health complaints). Procedural unfairness was hypothesized to cause absence behavior through affective commitment or through health complaints. Results of a series of structural equation modelling analyses offer support for the mediating role of health complaints in the relationship between (distributive and procedural) unfairness at work and absenteeism. Moreover, our findings demonstrate that perceived unfairness contributes to explaining T2-absenteeism over and above the impact of T1-absenteeism and traditional work-related stressors (i.e., work load and low job control). The theoretical and practical implications of these findings are discussed. Copyright © 2002 John Wiley & Sons, Ltd. [source]

Relationships Among Risk, Sense of Coherence, and Well-Being in Parents of Children With and Without Intellectual Disabilities

Malin B. Olsson
ABSTRACT The authors studied the nature and function of the relationships of the comparative level of risk, sense of coherence (SOC), and well-being, over time, in mothers and fathers of preschool children with and without intellectual disabilities (IDs). The hypothesis that SOC functions as a moderator between risk and well-being was tested. Parents of children with IDs (mothers: n = 62 (46 at follow-up) and fathers: n = 49 (37 at follow-up)) and control parents (mothers: n = 178 (131 at follow-up) and fathers: n = 141 (97 at follow-up)) answered self-report measures on risk factors (i.e., child behavior problems, negative impact on the family and socioeconomic situation) and sense of coherence. Well-being and quality of life were used as outcomes, and were measured at baseline and at a one-year follow-up. The hypothesis of moderation was tested conducting multiple linear regression analyses. The level of well-being was moderately stable over the two time points, with parents of children with ID having lower level of well-being than control parents both initially and after one year. Well-being was also related to level of SOC and cumulative risk with parents experiencing lower SOC or more risk also reporting lower well-being. The hypothesis of SOC acting as a moderator in the relation between cumulative risk and well-being found some support in the longitudinal analyses, but only for well-being (BDI-2r) among control mothers. [source]

The Management of Pain From Collapse of Osteoporotic Vertebrae With Continuous Intrathecal Morphine Infusion

Maria Rita Saltari MD
ABSTRACT Objectives., Vertebral fractures are the most common consequences of severe osteoporosis. The chronic pain from collapse of osteoporotic vertebrae affects quality of life (QoL) and autonomy of patients. The management of pain with oral or transdermal opiates can cause severe side-effects. Continuous intrathecal administration of morphine through an implantable pump might represent an alternative therapy to conventional oral or transdermal administration of opioids and has some advantages and disadvantages for pain relief and improvement in QoL when compared to conventional opioid delivery. It is our objective to report our experience using intrathecal delivery of analgesics in a population of patients with refractory pain due to vertebral fractures. Materials and Methods., In 24 patients, refractory to conventional delivery of opioids, we used intrathecal analgesic therapy. To test for efficacy and improvement in QoL, we administered the visual analog scale (VAS) for pain and the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Before patients were selected for pump implantation, an intraspinal drug delivery trial was performed to monitor side-effects and responses to intrathecal therapy. Results., Significant pain relief was obtained in all implanted patients. Using the QUALEFFO, we observed significant improvement of all variables such as QDL (quality of daily life), DW (domestic work), ambulation, and PHS (perception of health status), before and after one year after pump implantation. With intrathecal morphine infusion, none of the 24 patients required additional systemic analgesic medication. The mean morphine dose during the spinal trial was 11.28 mg/day, 7.92 mg/day at pump implantation, and 16.32 mg/day at one-year follow-up. Conclusions., Our results show that intrathecal administration of morphine efficiently relieves the symptoms of pain and improves QoL. Continuous intrathecal administration of morphine appears to be an alternative therapy to conventional analgesic drug delivery and has advantages in those patients who have severe side-effects with systemic administration of analgesics. [source]

Exercises and education as secondary prevention for recurrent low back pain

Margret Grotle Soukup
Abstract Background and Purpose Exercise and education is a common physiotherapy approach in the prevention of low back pain. A Mensendieck exercise programme consisting of exercises and ergonomical education has, in a previous study, been shown to be effective in preventing recurrent low back pain during one-year follow-up. The purpose of the present study was to evaluate the long-term effect of the Mensendieck exercise programme on people with recurrent episodes of low back pain who, when entering the study, had finished treatment for their last episode of low back pain. Method A randomized controlled clinical trial in which 41 women and 36 men were allocated to either a Mensendieck or control group. The Mensendieck subjects received 20 group sessions of exercises and ergonomical education over 13 weeks. The control subjects were not offered any prophylactic therapy, but were free to receive treatment or exercises. Outcome measures were the number of recurrences of low back pain, sick leave, low back function and general functional status. Results At three-year follow-up, 11 subjects had been lost to the study. Survival analysis showed a significant reduction (p=0.02) in subjects experiencing recurrent low back pain in the Mensendieck group compared to the control group. Significant improvements in pain and function scores were reported in both groups. There was no significant difference between the groups in pain, function or sick leave. Conclusion A Mensendieck exercise programme seems efficient in reducing recurrent episodes of low back pain at three-year follow-up, but it did not influence sick leave, pain or function scores. Copyright © 2001 Whurr Publishers Ltd. [source]

Cognitive-behavior therapy for Japanese patients with panic disorder: Acute phase and one-year follow-up results

Yumi Nakano md
Aim:, The aim of this paper is to report the outcomes and follow-up data of our cognitive behavioral therapy program for Japanese patients with panic disorder and to examine the baseline predictors of their outcomes. Methods:, Seventy outpatients with panic disorder with or without agoraphobia were treated with manualized group cognitive behavioral therapy. Results:, Fourteen patients (20%) did not complete the program. Among the completers, the average Panic Disorder Severity Scale score fell from 12.8 at baseline to 7.1 post-therapy (44.7% reduction). This effectiveness was sustained for 1 year. While controlling for the baseline severity, the duration of illness and the baseline social dysfunction emerged as significant predictors of the outcome. Conclusions:, Our data suggest that group cognitive behavioral therapy for panic disorder can bring about as much symptom reduction among Japanese patients with panic disorder as among Western patients. [source]

Suicide-related behavior after psychiatric hospital discharge: implications for risk assessment and management,

Jennifer L. Skeem Ph.D.
Suicide-related behavior (SRB), including suicide attempts and instrumental SRB, occurs far more often than completed suicide and exacts a toll on patients, their loved ones, and society. Nevertheless, few prospective studies of SRB have been conducted. In this study, 954 patients were interviewed in a psychiatric hospital and then followed for one year after discharge. During this one-year period, nearly one-quarter of patients (23%) engaged in SRB, with the rate of suicide attempts (18%) three times greater than the rate of instrumental SRB (5%). Risk factors for SRB were demographic (White ethnicity, female gender), clinical (past SRB, depression, impaired functioning), and contextual (unemployment, large social networks). In contrast with other studies, there was no "peak" in the risk of SRB shortly after hospital discharge. Instead, patients' rate of SRB was relatively constant over the one-year follow-up. Implications for risk assessment and management in acute inpatient settings are discussed. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Declining medical decision-making capacity in mild AD: a two-year longitudinal study,

Justin S. Huthwaite Psy.D.
This is a report of a two-year longitudinal study comparing healthy older adult subjects (n,=,15) and mild Alzheimer's disease (AD) patients (n,=,20) using an objective performance measure of medical decision-making capacity (MDC). Capacity to consent to medical treatment was measured using the Capacity to Consent to Treatment Instrument (CCTI). The CCTI is a psychometric measure that tests MDC using a series of four core capacity standards: S1 (evidencing/communicating choice), S3 (appreciating consequences), S4 (providing rational reasons), and S5 (understanding treatment situation), and one experimental standard [S2] (making the reasonable treatment choice). For each standard, mild AD patients were assigned one of three capacity outcomes (capable, marginally capable, or incapable) based on cut-off scores derived from control group performance. At baseline, mild AD patients performed equivalently with controls on simple standards of evidencing a choice (S1) and making the reasonable choice ([S2]), but significantly below controls on complex standards of appreciation, reasoning, and understanding (S3, S4, and S5) (p,<,0.02). Control performance was stable over time on all capacity standards. At one-year follow-up, the mild AD group did not show significant decline from baseline on any capacity standard. However, at two-year follow-up the mild AD group showed significant declines from baseline on the three complex standards (S3, S4, and S5) (p,<,0.02), and a trend on one of the simple standards (S1). Over the two-year period, the proportion of marginally capable and incapable outcomes in the AD group increased substantially for four of the five standards (S1, S3, S4, and S5). Performance on [S2] remained stable over time in the AD group. We conclude that mild AD patients have impaired MDC at baseline, and demonstrate significant additional decline on complex consent abilities of appreciation, reasoning, and understanding over a two-year period. AD patients also show emerging impairment on the simple consent ability of evidencing choice at two-year follow-up. Capacity outcome data reflect similar declines over time for these four consent standards. The findings suggest the value of early assessment and regular monitoring at two-year intervals of MDC in patients with mild AD. Copyright © 2006 John Wiley & Sons, Ltd. [source]