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Selected AbstractsContemporary management of pulmonary embolism: the answers to ten questionsJOURNAL OF INTERNAL MEDICINE, Issue 3 2010H. Bounameaux Abstract., Bounameaux H (Division of Angiology and Hemostasis, Department of Internal Medicine, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland). Contemporary management of pulmonary embolism: the answers to ten questions (Review). J Intern Med 2010; 268: 218,231. Pulmonary embolism (PE) cannot be diagnosed solely on a clinical basis, because of the lack of sensitivity and specificity of clinical signs and symptoms. Pulmonary angiography is invasive and resource demanding. Because the prevalence of PE is relatively low (20% or less) amongst individuals who are clinically suspected of having the disease, submitting all of them to imaging (multi-detector CT angiography or ventilation/perfusion lung scintigraphy) would not be cost-effective. Therefore, diagnostic algorithms have been developed that include clinical probability assessment and D-dimer measurement to select the patients who require noninvasive imaging. Once the diagnosis is suspected or confirmed, therapy must be started to avoid potentially fatal recurrence. Treatment starts for an initial 3-month period with a 5-day course of parenteral unfractionated or low-molecular-weight heparin or fondaparinux overlapping with and followed by oral vitamin K antagonists monitored to maintain an international normalized ratio of 2,3. This initial period of 3 months may then be followed by a long-term secondary prevention period in patients who experience an idiopathic thromboembolic event and are at low risk of bleeding. New oral anticoagulants that do require patient monitoring and might exhibit a more favourable benefit,risk balance are currently under extensive clinical testing and might change the situation in the near future. A critical appraisal of the contemporary management of suspected PE is given in this overview with the discussion of 10 practical questions. [source] Girls with anorexia nervosa as young adults: Personality, self-esteem, and life satisfactionINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 4 2006Inger Halvorsen MD Abstract Objective: The current study evaluated personality, self-esteem, and life satisfaction in former patients with different outcomes of childhood and adolescent-onset anorexia nervosa (AN). Methods: Forty-four female patients with AN were assessed 8.5 ± SD 3.4 years after treatment start with a clinical interview and questionnaires including the Temperament and Character Inventory (TCI) and the Rosenberg Self-Esteem Scale. Self-esteem and general life satisfaction in former patients were compared with women in a large population study. Results: Former AN patients with no eating disorder and normal eating attitudes at follow-up (n = 21 [48%]) had similar TCI profiles and self-esteem as samples from normal populations, whereas participants with poorer outcome had significantly lower TCI Self Directedness, self-esteem, and life satisfaction scores. Life satisfaction was reduced in all outcome groups and was strongly associated with self-esteem. Conclusion: Personality, self-esteem, and life satisfaction varied significantly between outcome groups. The results indicate that young patients with AN with a good outcome may have normal personality and self-esteem features in young adulthood. © 2006 by Wiley Periodicals, Inc., Int J Eat Disord, 2006 [source] Adjuvant treatment of atopic eczema: assessment of an emollient containing N-palmitoylethanolamine (ATOPA study)JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 1 2008B Eberlein Abstract Background For long-term management of atopic eczema, the use of skin care creams is recommended, but effectiveness of this treatment is not well established. Objective The objective of this study was to yield data on the skin care properties of a cream with a unique lamellar matrix containing N -palmitoylethanolamine (PEA) and to assess quality-of-life variables in patients with mild to moderate atopic eczema. Setting In this multinational, multicentre, observational, non-controlled, prospective cohort study, patients between 2 and 70 years of age were enrolled. All patients were supplied with the study product sufficient for treatment over the entire study period. Outcome was followed in periods between 3 and 7 days and 4 and 6 weeks after study start. Data were gathered from doctor reports and patient self-assessments via patient questionnaires. Results Data from 2456 patients entered the database. The mean examination intervals were 6 days for the 3- to 7-day period and 38 days for the 4- to 6-week period. At study end, intensities of erythema, pruritus, excoriation, scaling, lichenification and dryness were significantly reduced with a combined score reduction of 58.6% in the entire population (57.7% in adults > 12 years and 60.5% in children , 12 years) according to doctors' reports. Patients reported a reduction of pruritus on visual analogue scales from 4.9 ± 2.6 to 2.7 ± 2.4 6 days after treatment start and a further reduction to 2.0 ± 2.3 at study end (P < 0.001 each). Likewise, sleep quality improved significantly during the study period. Earlier-used topical corticosteroids were omitted by 56% of all patients (53.4% in adults and 62.5% in children) at study end, and the average weekly application rate decreased by 62% from 7.9 ± 6.0 to 3.0 ± 5.1 (P < 0.001). The tolerance was assessed as very good or good in 92% of cases by both patients and doctors. Conclusion This study showed substantial relief of objective and subjective symptoms of atopic eczema after regular skin care with the study cream. The patient-related effectiveness (decline of pruritus and loss of sleep) indicated a gain in quality of life in these patients. The reduced use of topical corticosteroids is important in view of safety and pharmacoeconomic implications in the treatment of atopic eczema. [source] Cancer risk in patients with rheumatoid arthritis treated with anti,tumor necrosis factor , therapies: Does the risk change with the time since start of treatment?ARTHRITIS & RHEUMATISM, Issue 11 2009Johan Askling Objective To determine the short-term and medium-term risks of cancer in patients receiving anti,tumor necrosis factor , (anti-TNF,) therapies that have proven effective in the treatment of chronic inflammatory conditions. Methods By linking together data from the Swedish Biologics Register, Swedish registers of RA, and the Swedish Cancer Register, we identified and analyzed for cancer occurrence a national cohort of 6,366 patients with RA who first started anti-TNF therapy between January 1999 and July 2006. As comparators, we used a national biologics-naive RA cohort (n = 61,160), a cohort of RA patients newly starting methotrexate (n = 5,989), a cohort of RA patients newly starting disease-modifying antirheumatic drug combination therapy (n = 1,838), and the general population of Sweden. Relative risks (RRs) were estimated using Cox regression analyses, examining overall RR as well as RR by time since the first start of anti-TNF therapy, by the duration of active anti-TNF therapy, and by the anti-TNF agent received. Results During 25,693 person-years of followup in 6,366 patients newly starting anti-TNF, 240 first cancers occurred, yielding an RR of 1.00 (95% confidence interval 0.86,1.15) versus the biologics-naive RA cohort, and similar RRs versus the other 2 RA comparators. RRs did not increase with increasing time since the start of anti-TNF therapy, nor with the cumulative duration of active anti-TNF therapy. During the first year following the first treatment start, but not thereafter, dissimilar cancer risks for adalimumab, etanercept, and infliximab were observed. Conclusion During the first 6 years after the start of anti-TNF therapy in routine care, no overall elevation of cancer risk and no increase with followup time were observed. [source] Encoding and reconstruction in parallel MRINMR IN BIOMEDICINE, Issue 3 2006Klaas P. Pruessmann Abstract The advent of parallel MRI over recent years has prompted a variety of concepts and techniques for performing parallel imaging. A main distinguishing feature among these is the specific way of posing and solving the problem of image reconstruction from undersampled multiple-coil data. The clearest distinction in this respect is that between k -space and image-domain methods. The present paper reviews the basic reconstruction approaches, aiming to emphasize common principles along with actual differences. To this end the treatment starts with an elaboration of the encoding mechanisms and sampling strategies that define the reconstruction task. Based on these considerations a formal framework is developed that permits the various methods to be viewed as different solutions of one common problem. Besides the distinction between k -space and image-domain approaches, special attention is given to the implications of general vs lattice sampling patterns. The paper closes with remarks concerning noise propagation and control in parallel imaging and an outlook upon key issues to be addressed in the future. Copyright © 2006 John Wiley & Sons, Ltd. [source] | ||||||||||