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Years Post-treatment (year + post-treatment)
Selected AbstractsPersonality Disorder Features as Predictors of Symptoms Five Years Post-TreatmentTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 3 2008Irene Jansson MSc Personality disorders are associated with dysfunction in a variety of areas. Recent longitudinal research has shown that personality disorders are also predictive of problems later in life, as well as of poor response to treatment of depression and anxiety. This study assessed whether personality disorder features were associated with psychiatric symptoms in a cohort of women treated for substance abuse in Sweden. Patients were diagnosed with personality disorders using the Structured Clinical Interview for DSM-IV (SCID-II) personality questionnaire and SCID-II interview, and were then administered a self-report questionnaire designed to measure symptoms of psychiatric illness, the Symptoms Checklist-90 (SCL-90), during and five years after treatment. Concurrently, features of all personality disorders, except histrionic, were associated with SCL-90 score. At five-year follow-up, most personality disorders remained associated with SCL-90 score, with the exception of paranoid and schizoid personality disorder. After controlling for baseline score on the SCL-90, conduct disorder, borderline personality disorder, and narcissistic personality disorder remained significantly associated with symptoms at follow-up. After controlling for abstinence and baseline score, only borderline personality disorder features remained associated with SCL-90 score at follow-up. Patients with personality disorders should be monitored after treatment for psychiatric symptoms. [source] Amitriptyline treatment of chronic pain in patients with temporomandibular disordersJOURNAL OF ORAL REHABILITATION, Issue 10 2000O. Plesh Randomized clinical trials of amitriptyline will require data from pilot studies to be used for sample size estimates, but such data are lacking. This study investigated the 6-week and 1-year effectiveness of low dose amitriptyline (10,30 mg) for the treatment of patients with chronic temporomandibular disorder (TMD) pain. Based on clinical examination, patients were divided into two groups: myofascial and mixed (myofascial and temporomandibular joint disorders). Baseline pain was assessed by a Visual Analogue Scale (VAS) for pain intensity and by the McGill Pain Questionnaire (MPQ). Depression was assessed by the Beck Depression Inventory (BDI) short form. Patient assessment of global treatment effectiveness was obtained after 6 weeks and 1 year of treatment by using a five-point ordinal scale: (1) worse, (2) unchanged, (3) minimally improved, (4) moderately improved, (5) markedly improved. The results showed a significant reduction for all pain scores after 6 weeks and 1 year post-treatment. The depression scores changed in depressed but not in non-depressed patients. Global treatment effectiveness showed significant improvement 6 weeks and 1 year post-treatment. However, pain and global treatment effectiveness were less improved at 1 year than at 6 weeks. [source] Long-term effect of repetitive transcranial magnetic stimulation on motor function recovery after acute ischemic strokeACTA NEUROLOGICA SCANDINAVICA, Issue 1 2010E. M. Khedr Objective,,, Although there is evidence for short term benefits of rTMS in stroke, longer term effects have not been reported. The aim of the study was to evaluate the effect of two different frequencies of rTMS on motor recovery and on cortical excitability up to 1 year post-treatment. Methods,,, Forty-eight patients with acute ischemic stroke were randomly classified into three groups. The first two groups received real rTMS over motor cortex (3 and 10 Hz respectively) of the affected hemisphere and the third group received sham stimulation of the same site, daily for five consecutive days. Disability was assessed before, after fifth sessions, and then after 1, 2, 3 and 12 months. Cortical excitability was assessed for both hemispheres before and after the second and fifth sessions. Results,,, A significant ,rTMS × time' interaction was obtained indicating that real and sham rTMS had different effects on rating scales. This was because real rTMS produced greater improvement than sham that was evident even at one year follow-up. These improvements were associated with changes in cortical excitability over the period of treatment. Conclusion,,, These results confirm that real rTMS over motor cortex can enhance and maintain recovery and may be a useful add on therapy in treatment of acute stroke patients. [source] RESEARCH REPORT Alcoholism treatment and medical care costs from Project MATCHADDICTION, Issue 7 2000Harold D. Holder Aims. This paper examines the costs of medical care prior to and following initiation of alcoholism treatment as part of a study of patient matching to treatment modality. Design Longitudinal study with pre- and post-treatment initiation. Measurements. The total medical care costs for inpatient and outpatient treatment for patients participating over a span of 3 years post-treatment. Setting. Three treatment sites at two of the nine Project MATCH locations (Milwaukee, WI and Providence, RI). Participants. Two hundred and seventy-nine patients. Intervention. Patients were randomly assigned to one of three treatment modalities: a 12-session cognitive behavioral therapy (CBT), a four-session motivational enhancement therapy (MET) or a 12-session Twelve-Step facilitation (TSF) treatment over 12 weeks. Findings. Total medical care costs declined from pre- to post-treatment overall and for each modality. Matching effects independent of clinical prognosis showed that MET has potential for medical-care cost-savings. However, patients with poor prognostic characteristics (alcohol dependence, psychiatric severity and/or social network support for drinking) have better cost-savings potential with CBT and/or TSF., Conclusions. Matching variables have significant importance in increasing the potential for medical-care cost-reductions following alcoholism treatment. [source] Testing liana cutting and controlled burning as silvicultural treatments for a logged forest in the eastern AmazonJOURNAL OF APPLIED ECOLOGY, Issue 6 2001Jeffrey J. Gerwing Summary 1In the eastern Brazilian Amazon, logged forests frequently include patches where liana density is particularly high. In these so-called liana tangles, competition from lianas is predicted to reduce tree growth significantly, thus effectively impeding future timber production. To begin to develop a silvicultural strategy for these patches, the impact of liana cutting and controlled burning on liana density, tree growth and tree regeneration in liana-dominated patches was investigated in a logged forest in the eastern Brazilian Amazon. 2The two treatments (liana cutting and controlled burning) and a control were installed in 40 × 40-m plots in a randomized complete block design of six blocks. Treatments were conducted during October 1997, and tree diameter growth and mortality, canopy cover, regeneration and liana density were monitored over 2 years. 3Mean mortality following burning was significantly higher for lianas (79%) than for trees (48%), as was the mean coppicing rate of top-killed stems (42% for lianas vs. 20% for trees). Coppicing combined with some recruitment from seed resulted in liana densities in the burned plots returning to 70% of the values in the control plots only 2 years post-treatment. 4Canopy light transmittance, estimated from hemispherical canopy photographs taken at 1 m above the ground, increased significantly from c. 4% in controls to 8% in cut and 12% in burned treatments, and these differences persisted over the 2-year study period. 5In the absence of silvicultural intervention, mean tree diameter increments were low (1·3 mm year,1), suggesting that the successional transition to higher stature forest was occurring very slowly. Each of the treatments resulted in a more than doubling of mean annual tree growth (3 and 2·8 mm year,1 for liana-cut and burned treatments, respectively). The treatments also significantly reduced the occurrence of trees that showed no growth over the study period, from 56% in controls to 30% in cut and 32% in burned treatments. 6The results of this study suggest that although burning resulted in increased tree growth, rapid recolonization of surviving trees by lianas and the high vulnerability of burned stands to unwanted repeat burns are likely to cancel out any of the possible benefits of controlled burning as a silvicultural treatment for liana-dominated patches. Liana cutting, on the other hand, showed promise and its adoption as part of a larger strategy for the recuperation of the timber production potential of logged tropical forests seems warranted. [source] The relative importance of specific risk factors for insomnia in women treated for early-stage breast cancerPSYCHO-ONCOLOGY, Issue 1 2008Wayne A. Bardwell Abstract Background: Many individual risk factors for insomnia have been identified for women with a history of breast cancer. We assessed the relative importance of a wide range of risk factors for insomnia in this population. Methods: Two thousand six hundred and forty-five women ,4 years post-treatment for Stage I (,1 cm),IIIA breast cancer provided data on cancer-related variables, personal characteristics, health behaviors, physical health/symptoms, psychosocial variables, and the Women's Health Initiative-Insomnia Rating Scale (WHI-IRS; scores ,9 indicate clinically significant insomnia). Results: Thirty-nine per cent had elevated WHI-IRS scores. In binary logistic regression, the variance in high/low insomnia group status accounted for by each risk factor category was: cancer-specific variables, 0.4% (n.s.); personal characteristics, 0.9% (n.s.); health behaviors, 0.6% (n.s.); physical health/symptoms, 13.4% (p<0.001); and, psychosocial factors, 11.4% (p<0.001). Insomnia was associated with worse depressive (OR = 1.32) and vasomotor symptoms (particularly night sweats) (OR = 1.57). Conclusion: Various cancer-specific, demographic, health behavior, physical health, and psychosocial factors have been previously reported as risk factors for insomnia in breast cancer. In our study (which was powered for simultaneous examination of a variety of variables), cancer-specific, health behavior, and other patient variables were not significant risk factors when in the presence of physical health and psychosocial variables. Only worse depressive and vasomotor symptoms were meaningful predictors. Copyright © 2007 John Wiley & Sons, Ltd. [source] Epithelial cell proliferative activity and oral cancer progressionCELL PROLIFERATION, Issue 2002P. J. Thomson Abstract. Accurate, predictive assessment of the behaviour and progression of oral cancers and precancers remains elusive in clinical practice. Archival tissue specimens from 10 previously treated patients with oral lesions of known clinical outcome (3 years post-treatment) were re-examined histopathologically, and proliferative cell labelling indices (LIs) determined for Ki67, cyclin A and histone mRNA cell cycle markers. While histone mRNA labelling ultimately proved unreliable, both Ki67 and cyclin A LIs demonstrated a clear trend for enhanced labelling to occur in increasingly dysplastic and neoplastic tissue, with particular emphasis on suprabasal labelling in abnormal tissue. Perhaps of greatest significance was the observation of increased LIs and suprabasal labelling in lesions with poor clinical outcome, such as patients developing recurrent disease or cervical lymph node metastasis. Measurement of cell proliferative activity in individual oral epithelial dysplastic lesions or invasive squamous cell carcinomas may thus provide unique, predictive information on clinical outcome. [source] Conservation surgery in the management of T1 and T2 oropharyngeal squamous cell carcinoma: the Birmingham UK experienceCLINICAL OTOLARYNGOLOGY, Issue 6 2002J.C. Watkinson The aim of this paper was to evaluate our experience using conservation surgery in the management of T1 and T2 oropharyngeal squamous cell carcinoma. Eighteen patients underwent conservation surgery between 1993 and 2000 and were analysed retrospectively. The mean age was 54 years and the male to female ratio was 8:1. There were 14 tonsil and 4 tongue base tumours and 83% of cases presented with neck nodes, thereby classifying them as having advanced disease (stages 2,4). All patients received postoperative radiotherapy. All patients were followed up to December 2001. The median follow-up time was 3.8 years (minimum was 1.5 years). The 2-year and 5-year survival rates were 100% and 92% respectively. Approximately 66% of patients returned the EORTC and GHQ/12 quality-of-life questionnaires. Of these, seventy-five percent had a high healthy level of general functioning in accordance with the EORTC general health section. These results show that conservation surgery techniques are effective in the treatment of T1 and T2 oropharyngeal squamous carcinoma associated with significant metastatic neck disease. The techniques are well tolerated, produce minimal functional deficit and do not have a negative impact on the patients quality of life in either the immediate postoperative period or up to 4 years post-treatment. [source] Dental fear in adults: a meta-analysis of behavioral interventionsCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 4 2004Gerd Kvale Abstract , Objectives:, The aim of this meta-analytic and systematic quantitative approach is to examine the effects of behavioral interventions for dental anxiety and dental phobia. Methods:, Eighty studies were identified where dental fear treatment with behavioral methods was evaluated. Thirty-eight of 80 met entry criteria and were included in a meta-analysis. Results:, The calculated effect sizes (ESs) for self-reported anxiety after intervention indicate positive changes in 36 of the 38 studies and no changes in two. The overall ES = 1.8 (95% CI: 1.6, 1.8). The percent of subjects with post-treatment dental visits in the first 6 months post-treatment varied between 50 and 100%. The overall ES for attendance at dental visits, weighted by sample size, is 1.4 (95% CI: 1.3, 1.6). The homogeneity analysis indicates that the studies cannot be adequately described in one ES. The reported percentage of subjects with a dental visit between 6 months and 4 years post-treatment varied from 48 to 100%. The overall weighted ES for visiting the dentist, adjusted for drop-outs in the studies, is 1.2 (95% CI: 0.99, 1.4). Conclusions:, Despite extensive heterogeneity, changes in self-reported anxiety represent medium to large ESs. Patients signing up for a behavioral intervention for dental fear can be expected to report a significant reduction in their fear, and this effect generally seems to be lasting. Mean long-term attendance (>4 years after treatment) is 77%. [source] | |||||||||||||