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Follow-up Monitoring (follow-up + monitoring)
Selected AbstractsMetabolic side effects of antipsychotic medicationINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 8 2007A. Tschoner Summary The use of second-generation antipsychotics (SGAs) is associated with metabolic side effects including weight gain, diabetes mellitus and an atherogenic lipid profile. These adverse effects are not only the risk factors for cardiovascular disease, insulin resistance and diabetes mellitus leading to increased morbidity and mortality but may also impair the patient's adherence to treatment. SGAs in particular are associated with significant weight gain with clozapine and olanzapine carrying the highest risk, whereas newer agents, such as risperidone and aripiprazole, are considered to be less prone to cause weight gain. Consequently, a consensus development conference convened issuing recommendations on patient monitoring when treated with SGAs. The metabolic effects of antipsychotic drugs should be of concern when planning a patient's treatment strategy. Baseline screening and regular follow-up monitoring whose intervals should depend on the individual predisposition are advised. Possible therapeutical strategies for the management of drug-induced obesity include therapeutic approaches, such as life style change and pharmaceutical intervention. Drugs with a weight reducing effect become more important because of the lack of compliance with behavioural intervention. Topiramate, histamine-antagonists, dopaminergic- and serotoninergic agents have shown positive results in the management of psychotropic medication induced weight gain. However, further trials are required to support a specific therapeutical approach as well as studies to investigate the underlying mechanisms for future drug development. [source] Comparison of three different serological techniques for primary diagnosis and monitoring of nasopharyngeal carcinoma in two age groups from TunisiaJOURNAL OF MEDICAL VIROLOGY, Issue 4 2005H. Karray Abstract Nasopharyngeal carcinoma (NPC) in Tunisia is characterized by its bimodal age distribution involving juvenile patients of 10,24 years and adult patients of 40,60 years. Three serological techniques were compared for primary diagnosis (N,=,117) and post-treatment monitoring (N,=,21) of NPC patients separated in two age groups. Immunofluorescence assay (IFA) was used as the "gold standard" for detection of IgG and IgA antibodies reactive with Epstein-Barr virus (EBV) early (EA) and viral capsid (VCA) antigens. Results were compared with ELISA measuring IgG and IgA antibody reactivity to defined EBNA1, EA, and VCA antigens. Immunoblot was used to reveal the molecular diversity underlying the anti-EBV IgG and IgA antibody responses. The results indicate that young NPC patients have significantly more restricted anti-EBV IgG and IgA antibody responses with aberrant IgG VCA/EA levels in 78% compared to 91.7% in elder patients. IgA VCA/EA was detected in 50% of young patients versus 89.4% for the elder group (P,<,0.001). Immunoblot revealed a reduced overall diversity of EBV antigen recognition for both IgG and IgA in young patients. A good concordance was observed between ELISA and IFA for primary NPC diagnosis with 81,91% overall agreement. Even better agreement (95,100%) was found for antibody changes during follow-up monitoring, showing declining reactivity in patients in remission and increasing reactivity in patients with persistent disease or relapse. ELISA for IgA anti-VCA-p18 and immunoblot proved most sensitive for predicting tumor relapse. VCA-p18 IgA ELISA seems suitable for routine diagnosis and early detection of NPC complication. J. Med. Virol. 75:593,602, 2005. © 2005 Wiley-Liss, Inc. [source] Pilot-scale demonstration of in situ capping of PCB-containing sediments in the lower Grasse RiverREMEDIATION, Issue 1 2003James D. Quadrini A fish-consumption advisory is currently in effect in a seven-mile stretch of the Grasse River in Massena, New York, due to elevated levels of PCBs in fish tissue. One remedial approach that is being evaluated to reduce the PCB levels in fish from the river is in situ capping. An in-river pilot study was conducted in the summer of 2001 to assess the feasibility of capping PCB-containing sediments of the river. The study consisted of the construction of a subaqueous cap in a seven-acre portion of the river using various combinations of capping materials and placement techniques. Optimal results were achieved with a 1:1 sand/topsoil mix released from a clamshell bucket either just above or several feet below the water surface. A longer-term monitoring program of the capped area commenced in 2002. Results of this monitoring indicated: 1) the in-place cap has remained intact since installation; 2) no evidence of PCB migration into and through the cap; 3) groundwater advection through the cap is not an important PCB transport mechanism; and 4) macroinvertebrate colonization of the in-place cap is continuing. Additional follow-up monitoring in the spring of 2003 indicated that a significant portion of the cap and, in some cases, the underlying sediments had been disturbed in the period following the conclusion of the 2002 monitoring work. An analysis of river conditions in the spring of 2003 indicated that a significant ice jam had formed in the river directly over the capping pilot study area, and that the resulting increase in river velocities and turbulence in the area resulted in the movement of both cap materials and the underlying sediments. The pilot cap was not designed to address ice jam,related forces on the cap, as the occurrence of ice jams in this section of the river had not been known prior to the observations conducted in the spring of 2003. These findings will preclude implementation of the longer-term monitoring program that had been envisioned for the pilot study. The data collected immediately after cap construction in 2001 and through the first year of monitoring in 2002 serve as the basis for the conclusions presented in this article. It should be recognized that, based on the observation made in the spring of 2003, some of these conclusions are no longer valid for the pilot study area. The occurrence of ice jams in the lower Grasse River and their importance on sediments and PCBs within the system are currently under investigation. © 2003 Wiley Periodicals, Inc. [source] Realisation of a fully-deterministic microlensing observing strategy for inferring planet populations,ASTRONOMISCHE NACHRICHTEN, Issue 7 2010M. Dominik Abstract Within less than 15 years, the count of known planets orbiting stars other than the Sun has risen from none to more than 400 with detections arising from four successfully applied techniques: Doppler-wobbles, planetary transits, gravitational microlensing, and direct imaging. While the hunt for twin Earths is on, a statistically well-defined sample of the population of planets in all their variety is required for probing models of planet formation and orbital evolution so that the origin of planets that harbour life, like and including ours, can be understood. Given the different characteristics of the detection techniques, a complete picture can only arise from a combination of their respective results. Microlensing observations are well-suited to reveal statistical properties of the population of planets orbiting stars in either the Galactic disk or bulge from microlensing observations, but a mandatory requirement is the adoption of strictly-deterministic criteria for selecting targets and identifying signals. Here, we describe a fully-deterministic strategy realised by means of the ARTEMiS (Automated Robotic Terrestrial Exoplanet Microlensing Search) system at the Danish 1.54-m telescope at ESO La Silla between June and August 2008 as part of the MiNDSTEp (Microlensing Network for the Detection of Small Terrestrial Exoplanets) campaign, making use of immediate feedback on suspected anomalies recognized by the SIGNALMEN anomaly detector. We demonstrate for the first time the feasibility of such an approach, and thereby the readiness for studying planet populations down to Earth mass and even below, with ground-based observations. While the quality of the real-time photometry is a crucial factor on the efficiency of the campaign, an impairment of the target selection by data of bad quality can be successfully avoided. With a smaller slew time, smaller dead time, and higher through-put, modern robotic telescopes could significantly outperform the 1.54-m Danish, whereas lucky-imaging cameras could set new standards for high-precision follow-up monitoring of microlensing events (© 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Effects of invasion of fire-free arid shrublands by a fire-promoting invasive alien grass (Pennisetum setaceum) in South AfricaAUSTRAL ECOLOGY, Issue 8 2009S. J. RAHLAO Abstract Arid shrublands in the Karoo (South Africa) seldom accumulate sufficient combustible fuel to support fire. However, as a result of invasion by an alien perennial grass (Pennisetum setaceum), they could become flammable. This paper reports on an experiment to assess the effects of fire following invasion by P. setaceum. We established 10 plots (5 × 10 m) separated by 2.5 m, and added grass fuel to five plots (5 and 10 tons ha,1 to alternate halves of the plot) leaving the remaining five plots as interspersed controls. Plots with fuel added were burnt, and fire behaviour was measured during the burns. Rates of fire spread were generally low (0.01,0.07 m s,1) and did not differ significantly between burn treatments. Mean fireline intensities were higher in the high compared with the low fuel treatments (894 and 427 kW m,1, respectively). We recorded plant species and their cover before and after burning on each of the plots. After 15 months of follow-up monitoring in the burn plots, only two species, the dwarf shrub (Tripteris sinuata) and the perennial herb (Gazania krebsiana) resprouted. Most individuals of other species were killed and did not reseed during the 15-month study. The mass of added fuel load (high or low) did not influence vegetation recovery rates after fire. Should future invasions by P. setaceum lead to similar fuel loads in these shrublands, inevitable fires could change the vegetation and may favour spread of the flammable grass. Our results have important implications for predicting the effects of invasive alien plants (especially grasses) on fire-free ecosystems elsewhere. The predicted impacts of fire may alter species composition, ultimately affecting core natural resources that support the Karoo economy. [source] Dermoscopic monitoring of melanocytic skin lesions: clinical outcome and patient compliance vary according to follow-up protocolsBRITISH JOURNAL OF DERMATOLOGY, Issue 2 2008G. Argenziano Summary Background, Dermoscopic monitoring of melanocytic lesions increases the likelihood that featureless melanomas are not overlooked and minimizes the excision of benign lesions. Objective, To examine clinical outcome and patient compliance using different follow-up protocols. Methods, A retrospective analysis of 600 lesions from 405 patients (aged 6,79 years) was performed to examine patient compliance and clinical outcome in patients with multiple atypical melanocytic lesions undergoing sequential dermoscopy imaging during short-, medium- or long-term follow-up. Based on the degree of dermoscopic atypical features, patients were scheduled for short-term monitoring with follow-up after 3 months, medium-term monitoring with follow-up after 6 months or long-term monitoring with annual follow-up. Criteria leading to excision of monitored lesions differed according to the follow-up protocol. Results, In a median follow-up period of 23 months, 54 (9%) lesions were excised, revealing 12 early melanomas (occurring in 3% of monitored patients), one basal cell carcinoma and 41 melanocytic naevi. The melanoma/benign ratio of excised lesions was 1 : 3·4. Seven of 12 melanomas showed changes after two to four visits, corresponding to 8,54 months of follow-up. Patient compliance was 84% for short-term monitoring, 63% for medium-term monitoring and 30% for long-term monitoring. Conclusions, In patients with multiple naevi sequential dermoscopy imaging is a useful strategy to avoid missing melanomas while minimizing unnecessary excision of benign lesions. For better compliance, the first re-examination should be scheduled at 3 months after the baseline visit. Regular annual follow-up monitoring is also needed to detect slow-growing melanomas in which subtle changes may become apparent only over time. [source] | |||||||||||||