Home About us Contact
|
Home About us Contact | ||
|
|
||
Follow-up Visit (follow-up + visit)
Kinds of Follow-up Visit Selected AbstractsLaryngeal Abscess after Injection Laryngoplasty with Micronized AlloDerm,THE LARYNGOSCOPE, Issue 9 2004Philip E. Zapanta MD Objective: Patients with unilateral vocal cord paralysis usually present with dysphonia and occasionally with swallowing problems. Operative management includes thyroplasty type I, injection laryngoplasty, arytenoid adduction, and reinnervation. Recent publications have documented the safety of micronized AlloDerm (Cymetra, LifeCell Corporation, Branchburg, NJ) for injection laryngoplasty, but we report the first documented case of a laryngeal abscess after injection laryngoplasty with Cymetra. Study Design: Single case report of a laryngeal abscess after injection laryngoplasty with Cymetra. Methods: The patient's clinical course is presented and discussed, and the pertinent literature is reviewed. Results: Prompt hospital admission with intravenous antibiotics and steroids resolved this airway emergency. Follow-up visits showed a significantly improved postoperative voice with an intact airway. Conclusion: A review of the literature reveals that this case of a laryngeal abscess after injection laryngoplasty with Cymetra is the first of its kind. Studies have shown that the use of AlloDerm in the head and neck region is safe, but otolaryngologists need to be cognizant of potential complications when working with this material. [source] Acute Adaptation to Volume Unloading of the Functional Single Ventricle in Children Undergoing Bidirectional Glenn AnastomosisCONGENITAL HEART DISEASE, Issue 2 2009Catherine Ikemba MD ABSTRACT Objective., Volume unloading of the functional single ventricle after a bidirectional Glenn anastomosis (BDG) prior to 1 year of age leads to improved global ventricular function as measured by the myocardial performance index (MPI), a Doppler-derived measurement of combined systolic and diastolic ventricular function. Systolic function remains unchanged after BDG according to previous studies; however, acute changes in global and diastolic function have not been previously investigated in this cohort. Our objective was to assess the short-term effects of the BDG on global ventricular function in patients with a functional single ventricle. Design., Echocardiograms to obtain MPI, isovolumic contraction time, and isovolumic relaxation time were performed at four time periods: in the operating room, in the operating room prior to BDG, shortly after separation from cardiopulmonary bypass, less than 24 hours postoperatively, and either prior to hospital discharge or at the first clinic follow-up visit. Results., Twenty-six patients were enrolled. There was significant ventricular dysfunction noted shortly after separation from cardiopulmonary bypass, median MPI 0.63 (0.39,0.81), that persisted in the short term postoperatively median MPI 0.50 (0.40,0.63). Isovolumic contraction time did not change, however, isovolumic relaxation time was significantly prolonged following BDG. Conclusion., In the postoperative patient after BDG, systolic function is preserved; however, there is evidence of diastolic and global ventricular dysfunction, at least in the short term. [source] Persistent Orthopnea and the Prognosis of Patients in the Heart Failure ClinicCONGESTIVE HEART FAILURE, Issue 4 2004Luís Beck Da Silva MD Heart failure (HF) is a public health problem with ever-growing costs. Signs such as jugular venous pressure and third heart sound have been associated with disease prognosis. Symptoms of heart failure are frequently subjective, and their real value is often overlooked. The authors aimed to assess the relationship between orthopnea and left ventricular ejection fraction (LVEF) and hospitalization rate in patients referred to the HF clinic. One hundred fifty-three new consecutive patients referred to the HF clinic from September 2001 to July 2002 were reviewed. Information about orthopnea was available at baseline and at a 6-month to 1-year follow-up. One hundred thirty-one patients had a baseline multigated radionuclide ventriculogram scan, and 68 patients had a follow-up multigated radionuclide ventriculogram scan available. The patients were divided into groups by presence of orthopnea and compared with respect to LVEF and hospitalization rate. Patients with or without orthopnea had similar LVEFs at baseline (32%±17% vs. 33%±15%, respectively; p=NS). However, patients who were orthopnea-free at the follow-up visit had a significant LVEF improvement whereas patients with ongoing orthopnea at follow-up had no LVEF improvement (11%±13% vs. ,1%±6%; p<0.001). Patients who presented with persistent orthopnea had a significantly higher rate of hospitalization (64% vs. 15.3%; p=0.0001). Persistent orthopnea in HF patients is associated with a significantly higher rate of hospitalization and with worsening or no improvement in LVEF. Patients with persistent orthopnea may require a more aggressive approach to improve their outcome. This result may help centers with limited access to LVEF measurements to better stratify HF patients' risk. [source] Severe periodontal damage by an ultrasonic endodontic device: a case reportDENTAL TRAUMATOLOGY, Issue 2 2007John D. Walters Abstract,,, Heat produced within a root canal during use of an ultrasonic instrument can be conducted through the dentin into periodontal ligament, bone and soft tissue. If severe in intensity or long in duration, it can induce damage to these tissues. This report describes a case in which an ultrasonic endodontic instrument apparently induced severe damage to alveolar bone, gingiva and nasal mucosa in a 42-year-old female. Overheating of a maxillary central incisor caused necrosis of soft tissue and bone on the facial and mesial aspects and triggered a protracted inflammatory response in the adjacent nasal cavity. To relieve the severe discomfort associated with this damage, the patient chose to have her maxillary incisors extracted and replaced by a removable partial denture. A defect in the soft tissue and bone was present at a follow-up visit 10 months after the extractions. While morbidity of this nature is rare, this case reinforces the need to maintain adequate cooling of ultrasonic instruments. [source] Clinical Trial of Dual Treatment with an Ablative Fractional Laser and a Nonablative Laser for the Treatment of Acne Scars in Asian PatientsDERMATOLOGIC SURGERY, Issue 7 2009SANGEUN KIM MD BACKGROUND Many methods have been proposed for the treatment of acne scars, with variable cosmetic results. Nonablative skin resurfacing is one method that has been proposed. Because of a need for more noticeable clinical improvements, the ablative fractional laser was recently introduced. OBJECTIVE To reduce complications and improve the results of ablative fractional laser resurfacing by combining this treatment of acne scars with nonablative lasers. METHODS A series of 20 patients (skin phototypes IV,V) with atrophic facial acne scars were randomly divided into two groups that received three successive monthly treatments with an ablative fractional laser using high (group A) and low (group B) energy on one facial half and an ablative fractional laser with low energy plus a nonablative resurfacing laser on the other facial half. Patients were evaluated using digital photography at each treatment visit and at 3 months postoperatively. Clinical assessment scores were determined at each treatment session and follow-up visit. RESULTS Although the use of the ablative fractional laser with high energy resulted in an improvement in patients' acne scars, the combination of ablative fractional laser resurfacing and nonablative laser resurfacing yielded the best results, as assessed in photographs as well as by the overall appearance of the acne scars. With the combination method, fewer complications were observed. [source] Treatment of Pigmented Hypertrophic Scars with the 585 nm Pulsed Dye Laser and the 532 nm Frequency-Doubled Nd:YAG Laser in the Q-Switched and Variable Pulse Modes: A Comparative StudyDERMATOLOGIC SURGERY, Issue 8 2002Leyda Elizabeth Bowes MD background. Pigmented hypertrophic scars are a difficult condition to treat. They may result from traumatic injuries or from surgical and cosmetic procedures. The 585 nm flashlamp-pumped pulsed dye laser (FLPDL) has been used to treat this condition, with significant improvement of varying degrees. It remains to be determined whether other laser modalities may have a similar or even greater success in the treatment of pigmented hypertrophic scars. objective. To determine the efficacy of the 532 nm frequency-doubled Nd:YAG laser in the treatment of pigmented hypertrophic scars as compared to the 585 nm FLPDL. methods. Six patients with pigmented hypertrophic scars and skin phototypes II,IV were chosen. A scar was selected for treatment in each patient and divided into four equal 2 cm segments. Three segments were each treated with a different laser modality and one was left untreated to serve as the control. A 585 nm FLPDL was used with an energy of 3.5 J, a pulse duration of 450 ,sec, and a 10 mm spot size. A 532 nm Q-switched frequency-doubled Nd:YAG laser was set to an energy of 2.8 J, a 10-nsec pulse, and a 3 mm spot size. The same 532 nm laser was set to the variable pulse mode to treat a 2 cm scar segment, with an energy of 9.5 J, a 10-msec pulse, and a 4 mm spot size. An average of 3.3 treatments were performed on each scar segment, at intervals of 4,6 weeks and long-term follow-up at 22 weeks. Treatment outcome was graded by a blind observer using the Vancouver General Hospital (VGH) Burn Scar Assessment Scale. A SigmaStat t -test was used to determine the statistical significance of the values obtained. results. Treatment of pigmented hypertrophic scars with the 532 nm Q-switched Nd:YAG laser led to a significant improvement of 38% in the VGH scores when compared to baseline (P = .005). The 585 nm FLPDL also had a favorable effect on the scars, with an average improvement of 36.1% in the VGH scores. There was no significant difference noted between the outcome of treatment with either of these two lasers. Treatment with the 532 nm variable pulse Nd:YAG laser led to a 19% improvement in the VGH scores of scars, which did not differ significantly from the 16.1% improvement observed in control scars on the last follow-up visit. No side effects or complications from treatment were noted or reported during the course of the study. At the conclusion of the study, five of six patients chose the segment treated with the 532 nm Q-switched Nd:YAG laser as the best segment overall. conclusion. The 532 nm Q-switched Nd:YAG laser and the 585 nm FLPDL offer comparable favorable results in the treatment of pigmented hypertrophic scars. The 532 nm Q-switched Nd:YAG laser may be preferred by patients particularly distressed by the dark color of their scars. [source] Is the dementia rate increasing in Beijing?ACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2007Prevalence, incidence of dementia 10 years later in an urban elderly population Objective:, To examine the time trend of dementia morbidity over the past decade in Beijing, China. Method:, In 1997, 1593 community-dwelling elderly aged 60+ years were examined and followed-up over 2-years to identify incident dementia. A similar cohort study of dementia conducted in the same district 10 years prior was used as historical comparison to examine the time trend of dementia incidence. Results:, Forty prevalent dementia cases were identified at the initial examination for a prevalence of 2.51% (95% CI: 1.74,3.28) and 25 incident cases were identified at the follow-up visit for an incidence of 0.90% (0.55,1.25) among residents aged 60+ years. Alzheimer's dementia (AD) was the most common type of dementia in both prevalent and incident cases. Conclusion:, The prevalence and incidence rates of dementia in Beijing were slightly higher than those 10 years ago, which was partly because of population aging. AD became the most common subtype of dementia. [source] Fine-needle aspiration of subcutaneous panniculitis-like T-cell lymphomaDIAGNOSTIC CYTOPATHOLOGY, Issue 5 2004Frances Manosca M.D. Abstract We report the fine-needle aspiration (FNA) cytology findings of Subcutaneous Panniculitis-like T-cell Lymphoma (SCPTCL) in a 66-year-old woman who presented with a four month history of asymptomatic subcutaneous nodules on her right chest wall and back. An excisional biopsy of the right chest nodules was performed, and the diagnosis of SCPTCL was rendered. On a follow-up visit, several skin lesions were noted throughout her body. A fine-needle aspiration (FNA) of the right inguinal region was performed. The FNA yielded cellular smears, composed mainly of sheets of epithelioid histiocytes and scattered multinucleated cells. However, no distinct granulomas were noted. The background of the cytological smears showed scattered atypical lymphoid cells, some of which displayed nuclear membrane irregularities. To the best of our knowledge, the cytological features on FNA material of SCPTCL have not been described. Diagn. Cytopathol. 2004;31:338,339. © 2004 Wiley-Liss, Inc. [source] Treatment of opioid dependence in adolescents and young adults with extended release naltrexone: preliminary case-series and feasibilityADDICTION, Issue 9 2010Marc J. Fishman ABSTRACT Background Opioid dependence is an increasing problem among adolescents and young adults, but in contrast to the standard in the adult population, adoption of pharmacotherapies has been slow. Extended-release naltrexone (XR-NTX) is a promising treatment that has been receiving increasing interest for adult opioid dependence. Clinical chart abstractions were performed on a convenience sample of 16 serial adolescent and young adult cases (mean age 18.5 years) treated for opioid dependence with XR-NTX who attended at least one out-patient clinical follow-up visit. Case descriptions Of these 16 cases, 10 of 16 (63%) were retained in treatment for at least 4 months and nine of 16 (56%) had a ,good' outcome defined as having substantially decreased opioid use, improvement in at least one psychosocial domain and no new problems due to substance use. Conclusions These descriptive results suggest that XR-NTX in the treatment of adolescents and young adults with opioid dependence is well tolerated over a period of 4 months and feasible in a community-based treatment setting, and associated with good outcomes in a preliminary, small non-controlled case-series. This probably reflects an overall trend towards greater adoption of medication treatments for this population. [source] Long-term clinical outcome of living-donor liver transplantation for primary biliary cirrhosisHEPATOLOGY RESEARCH, Issue 2007Etsuko Hashimoto Aim:, We described the recurrence of primary biliary cirrhosis (PBC) after living donor liver transplantation (LDLT) (Liver Transplantation, 7, 2001: 588). However, since the follow-up period in that study was insufficiently long (median 35.5 months), we performed a long-term study to further characterize recurrence of PBC after LDLT. Patients:, From 1991 to 2006, 15 patients with end-stage PBC underwent LDLT at Tokyo Women's Medical University. Of these patients, we studied 8 PBC patients (age 29 to 51 years, all females) who survived LDLT for more than 5 years. The follow-up period for these patients ranged form 68 to 120 months. Immunosuppression was maintained with tacrolimus and prednisone. Laboratory examinations performed in every patient and donor before LDLT included routine biochemical studies, antimitochondrial antibody (AMA) by immunofluorescence (IF), anti-M2 by enzyme-linked immunosorbent assay as well as antinuclear antibody (ANA) by IF, and immunoglobulin. After LDLT, the same laboratory examinations were performed in patients every 6 months. Liver biopsy was performed when patients exhibited clinical or biochemical signs of graft dysfunction. In addition, protocol biopsy was performed every 1 to 2 years after LDLT. Results:, At the time of LDLT, all patients had end-stage cholestatic liver failure. Seven patients were positive for AMAand anti-M2 while 1 patient was negative for these markers but strongly positive for ANA. Donors were blood relatives in 6 cases, and 2 donors who were not blood relatives still exhibited multiple HLA matches with the recipients. At the end of the study in May 2006, all patients were doing well. On laboratory examination, mild abnormal liver function test results were found in 4 patients: 3 were probably due to recurrence of PBC, 1 resulted from nonalcoholic steatohepatitis. Comparison of the AMA titer between before LDLT and the most recent follow-up visit showed an increase in three patients, a decrease in two patients and no change in three patients. In contrast, the ANA titer increased in five patients. Histologically, strong evidence of recurrent PBC was found in 4 patients, and findings compatible with PBC were present in 2 additional patients. Conclusions:, Although the number of our patients is small, our findings confirm that PBC can recur at high frequency after LDLT. However, this complication has not developed to advanced stages and has not caused appreciable symptoms in our patients, all of whom have a good quality of life. [source] Loss to follow-up in an international, multicentre observational studyHIV MEDICINE, Issue 5 2008A Mocroft Objective The aim of this work was to assess loss to follow-up (LTFU) in EuroSIDA, an international multicentre observational cohort study. Methods LTFU was defined as no follow-up visit, CD4 cell count measurement or viral load measurement after 1 January 2006. Poisson regression was used to describe factors related to LTFU. Results The incidence of LTFU in 12 304 patients was 3.72 per 100 person-years of follow-up [95% confidence interval (CI) 3.58,3.86; 2712 LTFU] and varied among countries from 0.67 to 13.35. After adjustment, older patients, those with higher CD4 cell counts, and those who had started combination antiretroviral therapy all had lower incidences of LTFU, while injecting drug users had a higher incidence of LTFU. Compared with patients from Southern Europe and Argentina, patients from Eastern Europe had over a twofold increased incidence of LTFU after adjustment (incidence rate ratio 2.16; 95% CI 1.84,2.53; P<0.0001). A total of 2743 patients had a period of >1 year with no CD4 cell count or viral load measured during the year; 743 (27.1%) subsequently returned to follow-up. Conclusions Some patients thought to be LTFU may have died, and efforts should be made to ascertain vital status wherever possible. A significant proportion of patients who have a year with no follow-up visit, CD4 cell count measurement or viral load measurement subsequently return to follow-up. [source] Endodontic and periodontal treatments of a geminated mandibular first premolarINTERNATIONAL ENDODONTIC JOURNAL, Issue 2 2002S. Aryanpour Abstract Aim, To describe a rare case of gemination involving a mandibular first premolar. Summary The complex morphology of geminated teeth renders their endodontic and periodontal management difficult. Root canal and periodontal treatments were performed on a geminated mandibular first premolar with three canals. Clinical examination showed two separated crowns with united roots. Radiographically, two distinct pulp chambers with two joined and a third independent canal were seen. Conventional root canal treatment resulted in complete healing of the apical lesion. However, the occurrence of a vertical fracture led to the extraction of the mesial segment. At the follow-up visit, the distal segment was clinically healthy and continued to satisfy functional demands. Key learning points ,Failure to diagnose the initial crack along a gemination groove resulted in further propagation and finally complete vertical fracture. ,Owing to the abnormal morphology of the crown and the complexity of the root canal system in geminated teeth, treatment protocols require special attention. ,For asymptomatic cases without aesthetic or orthodontic problems and without associated pathosis, routine review and careful maintenance are required. [source] Treatment satisfaction and efficacy of the rapid release formulation of sumatriptan 100 mg tablets utilising an early intervention paradigm in patients previously unsatisfied with sumatriptanINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 12 2008L. C. Newman Summary Aims:, To evaluate treatment satisfaction, efficacy and functional ability of the rapid release formulation of sumatriptan 100 mg tablets (sumatriptan RT 100 mg) in an early intervention paradigm in patients who were dissatisfied with low-dose sumatriptan and not completely satisfied with their current migraine regimen. Methods:, Experienced migraineurs who reported a mild migraine pain phase, dissatisfaction with the previous sumatriptan treatment and some dissatisfaction with their current treatment regimen had no experience with sumatriptan at the 100 mg dose were enrolled in an open-label, single group study. Subjects were instructed to treat four migraine attacks within 30 min of the onset of mild pain. Treatment satisfaction was measured with the Patient Perception of Migraine Questionnaire Revised version (PPMQ-R) questionnaire. Results:, More than half of the subjects were either very satisfied or satisfied with the efficacy of early intervention sumatriptan RT 100 mg after each attack and at the follow-up study visit. The mean total PPMQ-R score was 75.2 out of 100. Between 63% and 73% of subjects were pain-free within 4 h of dosing. Between 79% and 90% of subjects reported an ability to function normally within 4 h of taking the study medication. Conclusion:, Subjects who were previously unsatisfied with lower doses of sumatriptan and less than very satisfied with their current treatment regimen were more likely to be satisfied or very satisfied with sumatriptan RT 100 mg in an early intervention paradigm. Results were consistent across four migraine attacks and at a follow-up visit. The treatment satisfaction results corresponded with positive results on efficacy measures and a functional status measure. [source] Depressive Symptoms and Cognitive Decline in Community-Dwelling Older AdultsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2010Sebastian Köhler PhD OBJECTIVES: To examine the temporal association between depressive symptoms and cognitive functioning and estimate the effect measure modification of the apolipoprotein E (APOE) ,4 allele on this relationship. DESIGN: Prospective cohort study. SETTING: General community. PARTICIPANTS: Population-based sample of 598 cognitively intact older adults aged 60 and older, with re-assessments after 3 (N=479) and 6 years (N=412). MEASUREMENTS: Depressive symptoms (Symptom Checklist) and neurocognitive functioning (memory, Visual Verbal Learning Test; attention, Stroop Color,Word Test; processing speed, Letter Digit Substitution Test; general cognition, Mini-Mental State Examination). Longitudinal associations were assessed using linear mixed models. The risk for cognitive impairment, no dementia (CIND) was examined using logistic regression. RESULTS: Adjusting for age, sex, education, and baseline cognition, the rate of change in memory z -scores was 0.00, ,0.11, ,0.20, and ,0.37 for those in the lowest (reference group), second, third, and highest depressive symptom quartiles at baseline, respectively (P<.001 for highest vs lowest quartile). The odds ratios for developing CIND with amnestic features were 1.00, 0.87, 0.69, and 2.98 for the four severity groups (P=.05 for highest vs lowest quartile). Associations were strongest for those with persistent depressive symptoms, defined as high depressive symptoms at baseline and at least one follow-up visit. Results were similar for processing speed and global cognitive function but were not as strong for attention. No APOE interaction was observed. CONCLUSION: Depression and APOE act independently to increase the risk for cognitive decline and may provide targets for prevention and early treatment. [source] Single-Point Assessment of Warfarin Use and Risk of Osteoporosis in Elderly MenJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2008Claudine Woo PhD OBJECTIVES: To determine whether warfarin use, assessed at a single point in time, is associated with bone mineral density (BMD), rates of bone loss, and fracture risk in older men. DESIGN: Secondary analysis of data from a prospective cohort study. SETTING: Six U.S. clinical centers. PARTICIPANTS: Five thousand five hundred thirty-three community-dwelling, ambulatory men aged 65 and older with baseline warfarin use data. MEASUREMENTS: Warfarin use was assessed as current use of warfarin at baseline using an electronic medication coding dictionary. BMD was measured at the hip and spine at baseline, and hip BMD was repeated at a follow-up visit 3.4 years later. Self-reported nonspine fractures were centrally adjudicated. RESULTS: At baseline, the average age of the participants was 73.6 ± 5.9, and 321 (5.8%) were taking warfarin. Warfarin users had similar baseline BMD as nonusers (n=5,212) at the hip and spine (total hip 0.966 ± 0.008 vs 0.959 ± 0.002 g/cm2, P=.37; total spine 1.079 ± 0.010 vs 1.074 ± 0.003 g/cm2, P=.64). Of subjects with BMD at both visits, warfarin users (n=150) also had similar annualized bone loss at the total hip as nonusers (n=2,683) (,0.509 ± 0.082 vs ,0.421 ± 0.019%/year, P=.29). During a mean follow-up of 5.1 years, the risk of nonspine fracture was similar in warfarin users and nonusers (adjusted hazard ratio=1.06, 95% confidence interval=0.68,1.65). CONCLUSION: In this cohort of elderly men, current warfarin use was not associated with lower BMD, accelerated bone loss, or higher nonspine fracture risk. [source] Bone mineral content and bone metabolism in young adults with severe periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2001Nina Von Wowern Abstract Objectives: To clarify in young adults with severe periodontitis (1) whether the bone mineral content (BMC) or density (BMD) in the mandible/other skeletal sites and the systemic bone metabolism differed from normal and (2) whether mandibular/forearm BMC did change during the 5 to 10-year follow-up. Material and Methods: 24 young otherwise normal patients with verified severe periodontitis were included, of which 20 attended the follow-up visit. Mandibular/forearm BMC was measured at both visits by dual-photon absorptiometry, supplemented with femoral neck/lumbar spine BMD measurements at follow-up visit by dual-energy X-ray absorptiometry. Serum alkaline phosphatase/ionized calcium, urinary excretion of pyridinoline/deoxy-pyridinoline were analysed at the follow-up visit. A conventional periodontal examination was performed at both visits. Results: Mandibular BMC was significantly below normal mean BMC at both visits. The mandibular Z-scores were ,2.00 in 33.3% (8/24). BMC/BMD in the remaining sites and the values for bone markers did not differ from normal. Mandibular/forearm BMC was stable while a significant aggravation of alveolar bone loss occurred during the trial without change of probing depth. Conclusions: Severe periodontitis in young adults seems to be a local disorder associated with relatively low BMC in the jaws without systemic alterations of BMC/BMD and bone metabolism. Zusammenfassung Zielsetzung: Abklärung ob bei jungen Erwachsenen mit schwerer Parodontitis (1) der Mineralgehalt und die Dichte des Knochens im Unterkiefer bzw. anderen Teilen des Skeletts sowie deer Knochenstoffwechsel sich von normalen Verhältnissen unterscheiden und (2) ob sich der Mineralgehalt des Unterkiefer- bzw. des Unterarmknochens während eines Beobachtungszeitraums von 5 bis 10 Jahren verändern. Material und Methoden: 24 allgemein gesunde Patienten mit schwerer Parodontitis nahmen an der Studie teil von denen 20 an der Nachuntersuchung teilnahme. Der Mineralgehalt des Unterkiefer- bzw. Unterarmknochens wurde bei beiden Untersuchungen mittels Dual-Photonen-Absorptiometrie bestimmt. Zusätzlich wurden bei der Nachuntersuchung die Knochendichte des Obserschenkelhalses und der Lendenwirbel mittels Dual-Energie-Röntgen-Absorptiometrie erfaßt. Die Serumkonzentrationen alkalischer Phosphatase sowie der Kalzium-Ionen und die Ausscheidung von Pyridinolin sowie Desoxypyridinolin im Urin wurden bei der Nachuntersuchung analysiert. Zu jedem Untersuchungstermin fand eine klinische Untersuchung der parodontalen Verhältnisse statt. Ergebnisse: Der Mineralgehalt des Unterkieferknochens lag zu beiden Untersuchungsterminen unter den mittleren Normalwerten. Die Z-Werte des Unterkiefers lagen in 8 von 24 Fällen (33.3%) ,2.00. Der Mineralgehalt und die Dichte des Knochens der übrigen Regionen und die Werte der Knochenmarker unterschieden sich nicht von den Normalwerten. Der Mineralgehalt des Unterkiefer- und Unterarmknochens verhielt sich während des Untersuchungszeitraumes stabil, während es zu einer deutlichen Verschlimmerung des alveolären Knochenabbaus ohne Veränderung der Sondierungstiefen kam. Schlußfolgerungen: Bei schwerer Parodontitis bei jungen Erwachsenen scheint es sich um eine lokale Störung mit relativ geringem Mineralgehalt der Kieferknochen zu handeln ohne systemische Veränderungen von Mineralgehalt und Dichte des Knochens bzw. des Knochenstoffwechsels. Résumé Le but de cette étude était de connaître chez les jeunes adultes souffrant de parodontite sévère (1) si le contenu en minéraux osseux (BMC) ou la densité (BMD) dans des sites mandibulaires ou du squelette et le métabolisme osseux systémique étaient différents par rapport à ceux de personnes normales et (2) si le BMC de la mandibule ou de l'avant-bras changeait durant une période de suivi de 5 à 10 années. 24 patients normaux mais souffrant de parodontite sévère ont été inclus dans cette investigation mais seul 20 ont poursuivi l'étude. Le BMC de la mandibule et de l'avant-bras ont été mesurés aux 2 sites par absorptiométrie par photon double, avec également des mesures BMD au niveau du fémur et de la colonne vertébrale lors de la visite de suivi par absorptiométrie par RX àénergie double. Le calcium ionisé par phosphatase alcaline sérique et l'excrétion urinaire de pyridinoline/deoxypyridinoline ont été analysés lors de l'examen de suivi. Un examen parodontal conventionnel a été effectué aux 2 visites. Le BMC mandibulaire était significativement inférieur au BMC moyen normal lors des deux visites. Les scores Z mandibulaires étaient ,2.00 dans 33.3% (8/24) des cas. BMC/BMD dans les sites restants et les valeurs des marqueurs osseux ne différaient pas des normaux. BMC mandibulaire/avant-bras était stable tandis qu'une aggravation significative de la perte osseuse alvéolaire se produisait durant l'étude sans changement de la profondeur au sondage. La parodontite sévère chez les jeunes adultes semble être un désordre local associéà un BMC relativement bas dans les mâchoires sans altération systémique de BMC/BMD ni du métabolisme osseux. [source] Detection of drug resistance mutations as a predictor of subsequent virological failure in patients with HIV-1 viral rebounds of less than 1,000 RNA copies/mlJOURNAL OF MEDICAL VIROLOGY, Issue 9 2007Chris Verhofstede Abstract In order to evaluate the usefulness of resistance testing after a viral rebound with plasma HIV RNA levels of less than 1,000 copies (c)/ml, genotyping was performed on 39 samples from patients on highly active antiretroviral therapy (HAART) showing a viremia of over 50 c/ml up to a maximum of 1,000 c/ml after at least one undetectable viral load result. Protease and reverse transcriptase (RT) sequences were obtained for all 39 samples. In 10 (25.6%) of the samples, mutations not seen before the initiation of the regimen were observed. The M184V/I mutation was the most prevalent but in several patients a combination of multiple mutations was detected. Follow-up samples were available for 34 patients. In six (85.71%) out of seven patients with new mutations, the viral load on the follow-up visit remained detectable, indicating true failure, compared to 6 (31.6%) true failures out of 19 patients in whom only wild type virus was detected (P,=,0.02) and three (37.5%) out of eight patients in whom only the mutations already present at the initiation of HAART were seen (P,=,0.08). The results indicate that reliable resistance testing can be performed on samples with a viral burden of less than 1,000 c/ml and demonstrate that multiple drug resistance mutations can be selected at low viral load rebounds. Most importantly, detection of resistance mutations in viral rebound samples was predictive of subsequent virological failure. J. Med. Virol. 79:1254,1260, 2007. © Wiley-Liss, Inc. [source] The BreathmobileÔ: A Novel Comprehensive School-Based Mobile Asthma Care Clinic for Urban Underprivileged ChildrenJOURNAL OF SCHOOL HEALTH, Issue 6 2006Otto Liao Many school-based programs have been funded to improve asthma management, especially for these "high-risk" inner-city children with asthma. Here we report the outcomes of the Children's Hospital of Orange County Breathmobile program, which is a school-based asthma program that combines the use of a mobile clinic and a pediatric asthma specialist. Baseline evaluations included a detailed history and physical, skin prick test to common allergens, spirometry measurements, and asthma severity classification based on the current National Asthma Education and Prevention Program guidelines. From April 2002 to September 2005, a total of 1321 children were evaluated for asthma. Analysis of the 1112 (84%) children diagnosed with asthma showed a population mean age of 7.8 years, 81% Latino ethnicity, and 73% with persistent disease. At baseline, only 24% of children with persistent asthma were on daily anti-inflammatory medications, which increased to 78% by the first follow-up visit. In the year prior to entry into the program, 64% had school absenteeism related to asthma (38% >10 days), 45% had emergency room (ER) visits (28% >1), and 19% had hospitalizations (9% >1). There was a significant reduction (p < .001) in the annual rates of ER visits, hospitalizations, and school absenteeism when comparing pre- and postentry into the program. These data suggest that a mobile asthma van clinic at the school site with an asthma specialist could be an effective model in reducing morbidity in the underserved child with asthma. Further studies are necessary to determine whether this model is applicable to other inner-city settings. (J Sch Health. 2006;76(6):313-319) [source] A randomized, single-blind, placebo-controlled, split-face study with pimecrolimus cream 1% for papulopustular rosaceaJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 6 2008AA Karabulut Abstract Background, Rosacea is a common inflammatory skin disorder for which the pathogenesis is unclear. Currently, there is no cure for rosacea, and it seems that standard therapies have focused mainly on minimizing inflammation. Objectives, The aim of this study is to investigate the potential efficacy, tolerability and safety profile of 1% pimecrolimus cream for the treatment of rosacea. Methods, Twenty-five patients with papulopustular rosacea were enrolled to a randomized, single-blinded, placebo-controlled, split-face trial of pimecrolimus cream 1% consisting 4 week treatment and 2 week follow-up period. The patients were instructed to apply first the ,left side cream' labelled placebo cream (Ultrabase cream, Intendis GmbH, Berlin, Germany) to the left hemi-face then the ,right side cream' labelled 1% pimecrolimus cream (Elidel; Novartis Pharma, Nuremberg, Germany) to the right hemi-face, twice daily. They were informed to apply a standard amount of each cream with the fingertip-unit and not allowed to use any other agent concomittantly other than sunblock. Clinical evaluation and subjective severity assessment were obtained along with photographic documentation at baseline, first, second, and fourth weeks of the therapy and at the follow-up visit. Rosacea severity score for each sign of erythema, papules, pustules, oedema, and telengiectesia were graded from 0 to 3. Patients were questioned for the subjective symptoms, overall improvement on appearance and side-effects. Results, Twenty-four patients completed the study with an exceptional compliance and tolerable safety profile. One patient withdrew from the study due to severe flare-up reaction affecting both hemi-faces. The mean baseline total rosacea severity scores were 5.06 + 1.29 for both sides and reduced to 2.5 ± 1.06 vs. 3.25 ± 1.24 on pimecrolimus vs. placebo applied sides without the significance (P = 0.06). There was not any significant difference concerning each rosacea sign scores and total rosacea severity scores except for the significant improvement in erythema score and total rosacea severity score obtained on the pimecrolimus-applied hemi-face at 2nd week of therapy (P =0.01 and P = 0.03, respectively). The reduction rates of the mean subjective severity scores at 4th week were 49.77% vs. 38.89% for pimecrolimus vs. placebo, respectively, without a statistical significance (P = 0.15). Subjective symptoms responded well in 54.16% of patients concerning pimecrolimus application compared with 12.50% for the placebo application. The side-effects were mostly transient local irritations. Conclusion, Our data implicated that pimecrolimus cream is not superior to placebo except for its efficacy on erythema. We believe that pimecrolimus cream can be a treatment option for rosacea patients with high erythema score for whom an initial accelerated improvement is needed. We believe further studies with topical pimecrolimus cream on larger study groups with different subtypes and severity of rosacea will clarify the potential effect of pimecrolimus cream for the treatment of rosacea. [source] Role of gender and race mismatch and graft failure in patients undergoing liver transplantationLIVER TRANSPLANTATION, Issue 6 2002Vinod K. Rustgi MD Previous data have suggested an increased risk of graft failure in male recipients of female livers, and in nonwhite recipients of orthotopic liver transplantation. United Network for Organ Sharing records of liver transplantations from 1992 through 2000 with at least one follow-up visit were reviewed. Analysis of these data was performed with proportional hazards regression, controlling for follow-up time, age, gender, ethnicity, number of comorbidities, functional status at time of transplant, and status 1 designation. Separate analyses comparing transplants among whites and blacks only and matched versus mismatched transplants for male and female recipients were performed. The results revealed that gender-mismatched patients (n = 13,992) had a higher likelihood of graft failure when compared with gender matched transplants (n = 18,522) (12.2% versus 11.3% respectively, P = .013). After controlling for the above potential confounders, gender-mismatched patients were found to have a 6.9% increase in likelihood of graft failure, (P = .042). Female recipients receiving male organs had no significant change in the risk of graft failure (11.5%; P = .368). A worse outcome was found in male recipients receiving female organs (12.9%; P = .0003). Graft failure rate among patients with donors matched by race (white to white or nonwhite to nonwhite; n = 21,818) was 11.6% versus 11.9%, and among unmatched patients (n = 10,697), the difference was not significant (P = .33). Multivariate regression analysis controlling for potential confounders confirmed that this difference was not significant (P = .21). Mismatch between black donors and white recipients was found to increase the risk of liver graft failure (27.4%, P = < .0001), independently of gender, number of comorbidities, and functional status at time of transplant. [source] Efficacy of long-term continuous subcutaneous apomorphine infusion in advanced Parkinson's disease with motor fluctuations: A multicenter studyMOVEMENT DISORDERS, Issue 8 2008Pedro J. García Ruiz MD Abstract Continuous subcutaneous apomorphine infusion (CSAI) is, at present, an alternative option for advanced Parkinson's disease (PD) with motor fluctuations. We studied the evolution of patients with PD and severe motor fluctuations long-term treated with CSAI. We reviewed data from 82 patients with PD (mean age, 67 ± 11.07; disease duration, 14.39 ± 5.7 years) and severe motor fluctuations referred to 35 tertiary hospitals in Spain. These patients were long-term treated (for at least 3 months) with CSAI and tolerated the procedure without serious side effects. We compared the baseline data of these 82 patients (before CSAI) with those obtained from the last follow-up visit of each patient. The mean follow-up of CSAI was 19.93 ± 16.3 months. Mean daily dose of CSAI was 72.00 ± 21.38 mg run over 14.05 ± 1.81 hours. We found a statistically significant reduction in off-hours, according to self-scoring diaries (6.64 ± 3.09 vs. 1.36 ± 1.42 hours/day, P < 0.0001), total and motor UPDRS scores (P < 0.0001), dyskinesia severity (P < 0.0006), and equivalent dose of antiparkinsonian therapy (1,405 ± 536.7 vs. 800.1 ± 472.9 mg of levodopa equivalent units P < 0.0001). CSAI is an effective option for patients with PD and severe fluctuations, poorly controlled by conventional oral drug treatment. © 2008 Movement Disorder Society. [source] Long-term effects of bilateral subthalamic nucleus stimulation on health-related quality of life in advanced Parkinson's diseaseMOVEMENT DISORDERS, Issue 6 2006Andrew Siderowf MD, MSCE Abstract We evaluated the long-term effects of subthalamic nucleus (STN) stimulation on health-related quality of life (HRQL) in patients with advanced Parkinson's disease (PD). STN stimulation improves motor function and decreases medication requirements in patients with advanced PD. The impact of STN stimulation on HRQL is less well established, especially beyond 1 year after surgery. We report HRQL outcomes for 18 patients with advanced PD. Patients were evaluated with the Parkinson's Disease Questionnaire-39 (PDQ-39), the Medical Outcome Study Short Form (SF-36), and the EuroQol visual analogue scale (VAS) before surgery, 6 months postoperatively, and at a long-term follow-up visit (mean, 35.9 months; range, 18,57 months after surgery). Preoperative scores on HRQL measures were compared to results obtained at short- and long-term follow-up evaluations. The VAS and all domains of the PDQ-39 except for cognition, communication, and social support showed marked improvements at 6 months after surgery. At the long-term follow-up, there were sustained improvements in the VAS (63% improvement; P = 0.0009) and in several domains of the PDQ-39 [mobility: 20%, P = 0.01; activities of daily living (ADL): 29%, P = 0.005; emotional well-being: 26%, P = 0.02; stigma: 43%, P = 0.003; and bodily discomfort: 35%, P = 0.007]. At the long-term evaluation, only the vitality domain of the SF-36 was significantly improved from baseline (16%; P = 0.01). In this selected group of patients, many of the short-term gains in HRQL persist beyond 18 months after STN implantation. Benefits in nonmotor aspects of HRQL such as bodily discomfort and stigma appear to be among the most durable. © 2006 Movement Disorder Society [source] Long-Term Outcomes of Continuous Intrathecal Baclofen Infusion for Treatment of Spasticity: A Prospective Multicenter Follow-Up StudyNEUROMODULATION, Issue 3 2008Elmar M. Delhaas MD ABSTRACT Long-term outcomes of 115 patients treated with continuous intrathecal baclofen infusion are reported. A prospective follow-up study was conducted in eight centers. Patients were followed up over a 12-month period. The follow-up scores on the three spasticity scales (Ashworth, spasm, and clonus scales) were significantly lower at every follow-up visit in comparison to the intake score, except for the clonus scale scores at 12 months. Improvements in health-related quality of life (EQ-5D) and functionality (SIP-68, functional independence measure) were small and nonsignificant. A significant reduction in severity of self-reported personal problems rating scale was observed. Sixty-six patients had no adverse events. Types of adverse events reported were wound complications (22%), catheter problems (36%), cerebrospinal fluid leakage (25%), and other complications (17%). Intrathecal baclofen reduces spasticity and severity of patient-reported problems but its effect on quality of life and functionality is less apparent. Improvements are desired in selection criteria, design of spinal catheters, and outcome scales. [source] The Effects Of Tizanidine HCL (Zanaflex®) In Patients With FibromyalgiaPAIN MEDICINE, Issue 2 2000Article first published online: 25 DEC 200 David McLain, MD, Brookwood Medical Center, Birmingham, AL This open-label, single-center, dose-finding study of Zanaflex (tizanidine hydrochloride) in 43 patients diagnosed with fibromyalgia showed some effectiveness in reducing pain and other symptoms of this syndrome. Fibromyalgia is a common syndrome characterized by chronic musculoskeletal pain in all 4 quadrants and pain in 18 identified tender points. Effects on fatigue, pain, sleep, and tender points were assessed before and during treatment. Starting doses of 2 mg/day were increased to 4 mg/day after 5 days and increased further as tolerated. Most patients stayed at 4 mg/day or 8 mg/day, and the highest dosage achieved was 12 mg/day. After the initial visit, 6 patients discontinued Zanaflex because of side effects (headaches in 3, hallucinations in 1, hypotension in 1, asthenia in 1), and 11 did not return for a follow-up visit. Results are presented for the remaining 26 patients (25 females; average age 50 years (range, 36,64 years); 25 Caucasian, 1 African-American; 9 on disability or applying for it; all stable on one or more of the following concomitant medications: narcotic analgesics 15%, antidepressants 65%, NSAIDs 46%). On average, at the first follow-up visit (average time 7.8 weeks), patients showed reduction in tender points and improvement on global assessment (GA) scores, Fibromyalgia Impact Questionnaire (FIQ) results, and visual assessment (VAS) scores for fatigue, pain, and sleep. The results for patients still working or retired were better than those for patients on disability or applying for it. Of the 26 patients in this ongoing study, 14 have had second follow-up visits (average time 13.3 weeks). Of these, 2 discontinued the drug at the second follow-up visit. Six of these patients responded especially well to long-term treatment (average age 51 years; range 46,60 years; 5 females; 1 on disability or applying for it) and showed the following averaged results: global assessment improved by 47%, FIQ by 35%, VAS-fatigue by 48%, VAS-pain by 40%, VAS-sleep by 37%, and tender points by 18%. Zanaflex appears to be effective in improving overall functioning, reducing pain and fatigue, improving sleep, and reducing the number of painful tender points in some patients with fibromyalgia, especially in those who are not on disability or applying for it. [source] Using medical records to supplement a claims-based comparative effectiveness analysis of antidepressants,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 8 2010Thomas W. Croghan Abstract Purpose Because health insurance claims lack clinical information, comparative effectiveness research studies that rely on these data may be challenging to interpret and may result in biased inference. We conducted an exploratory study to determine if medical information contained in patient charts could offer clinical details that would assist in interpreting the results of a claims-based comparative effectiveness study of selective serotonin reuptake inhibitors (SSRIs). Methods Retrospective review of 457 charts of patients initiating SSRI treatment. Descriptive data elements included patient diagnosis, symptoms of depressive and anxiety disorders, provider's assessment, and medication treatment and side effects. Results Most subjects were excluded from the study because their charts were not accessible (58.7%), they did not have a follow-up visit (55.6%), providers could not be contacted (58.0%), or providers refused participation in the study (36.5%). Among those included in the study, most patients were noted to have depression, but most charts lacked information on the majority of depression symptoms at baseline and follow-up. Few concomitant symptoms, side effects, and other important clinical and treatment characteristics were recorded. Conclusions Inability to obtain charts due to plan or provider refusal, lack of available information in charts at key times in the course of illness, and missing data elements posed considerable challenges and prevented firm conclusions beyond those drawn from the parent, claims-based study. Copyright © 2010 John Wiley & Sons, Ltd. [source] Incidence of tuberculosis and HIV and progression of silicosis and lung function impairment among former basotho gold miners,,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 12 2009Harriet H. Park MPH Abstract Background Pulmonary tuberculosis and HIV incidence, mortality, and the progression of silicosis and lung function impairment are described over a 1-year period in migrant ex-gold miners from Lesotho. Methods Seven hundred seventy-nine Basotho miners were followed for 1 year starting 18 months after lay-off from a South African gold mine in 1998. At baseline and follow-up, they underwent a respiratory symptom interview, physical examination, HIV test, chest radiograph, and spirometry. Results Five hundred thirteen of 779 (65.9%) participants attended both baseline and follow-up visits. HIV incidence was 5.4/100 person-years (95% CI: 3.4,8.2). Prevalence of silicosis (ILO score ,1/1) was 26.6% at baseline and 27.0% at follow-up. Active tuberculosis diagnosed at baseline was a strong predictor of radiological progression of silicosis. Lung function as measured by FEV1 declined an average of 91,ml between visits (95% CI: 67,116,ml). Calculated minimum incidence of tuberculosis was 3,085/100,000/years (95% CI: 1,797,4,940) at follow-up. Of those seen at baseline, 18 died before their scheduled follow-up visit (mean age: 51 years). Conclusions High rates of mortality and of HIV infection and pulmonary tuberculosis were found in this cohort after leaving the South African goldmines. Continuing lung function loss was also apparent. A partnership between the South African mining industry and governments in labor-sending areas of Southern Africa is needed to provide continuity of care and access to HIV and tuberculosis treatment and prevention services. Active silicosis surveillance and an improved statutory compensation system are also needed. These findings can serve as a baseline against which the impact of such interventions can be assessed. Am. J. Ind. Med. 52:901,908, 2009. © 2009 Wiley-Liss, Inc. [source] Telephone Appointment Visits for Head and Neck Surgery Follow-up Care,,THE LARYNGOSCOPE, Issue 6 2002Jeffrey Eaton MD Abstract Objectives/Hypothesis To test the hypothesis that patients with a variety of otolaryngologic diagnoses using telephone appointment visits would be equally as satisfied as patients receiving physician office visits, the study compared telephone appointment visits with physician office visits for health maintenance organization patients who needed routine follow-up care in a head and neck surgery clinic. Study Design Randomized, nonblinded cross-sectional study. Methods After their initial visit to either of two head and neck surgery clinics, new otolaryngology patients were randomly assigned into treatment and control groups. Patients in the treatment group (n = 73) received follow-up care in the form of telephone appointment visits, and patients in the control group (n = 80) received physician office visits for follow-up care. Study data were collected using telephone interviews and physician trackingforms. Results Patients receiving telephone appointment visits were significantly less satisfied with their visits than patients receiving physician office visits (,2 = 25.4, P <.005). Patients who had physician office visits were significantly more likely than were patients in the treatment group to agree "somewhat" or "strongly" that 1) the physician addressed their questions and concerns (,2 = 24.0, P <.005); 2) the physician provided personal care and attention (,2 =29.9, P <.005); and 3) the physician provided high-quality care (,2 =34.5, P <.005). Conclusions Patients who received telephone appointment visits were statistically significantly less satisfied with all aspects of their follow-up appointment than were patients who had physician office visits. The study findings indicate that telephone appointment visits may not be an ideal type of follow-up visit for all patients. Despite these findings, one third of patients in the treatment group would consider receiving a telephone appointment visit for future routine follow-up care, and 21.9% had no preference, perhaps a factor indicating willingness to receive a telephone appointment for a follow-up visit. [source] Testing for high risk human papilloma virus in the initial follow-up of women treated for high-grade squamous intraepithelial lesionsAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 2 2010Olivia Catherine SMART Background:, The follow-up schedule of women who have undergone treatment for high grade squamous intraepithelial lesions (HSIL) is a crucial part of the cervical screening programme. The ability to detect residual disease or early recurrence enables the provision of timely secondary intervention. Aims:, The aim of this study was to determine the prevalence of High Risk HPV and cytological abnormalities at first follow-up visit post treatment. The feasibility, safety and cost benefit of omitting routine colposcopy as a first line investigation were evaluated. Methods:, A total of 100 women with histologically confirmed and treated HSIL were recruited prior to first follow-up visit. Colposcopic assessment, cervical cytology using LBC and HR HPV testing was carried out on all women. Results:, In all, 75% of the study group had both a negative HR HPV test and a normal cervical cytology at first follow-up visit. Mean time interval to first follow-up was 9 months. The rate of residual/recurrent high-grade disease within this cohort was 4% followed up to 18 months post treatment. HR HPV had a sensitivity of 100% to detect persistent HSIL. Conclusion:, High-risk human papilloma virus testing in combination with cytology at first follow-up visit in women treated for HSIL has a very high sensitivity and negative predictive value. Colposcopy does not improve specificity in this cohort and could be omitted in patients who have a negative smear and HPV test. [source] Randomised double-blind trial of the effect of vitamin C on dyspareunia and vaginal discharge in women receiving doxycycline and triple sulfa for chlamydial cervicitisAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 5 2009Marjan KHAJEHEI Background:,Chlamydia trachomatis is the most common bacterial cause of cervicitis. Aim:, The aim of this randomised, double-blind trial was to compare the effect of vitamin C on dyspareunia and vaginal discharge in women receiving doxycycline and triple sulfa for chlamydial cervicitis. Methods:, Eighty women with increased anti- C. trachomatis IgM, reporting abnormal vaginal discharge and dyspareunia, demonstrating signs of cervical oedema and erythema and friability of cervix were included. Thirty-nine women received doxycycline capsules 100 mg twice daily plus triple sulfa vaginal cream once daily for ten days, and 41 received doxycycline capsules 100 mg twice,daily and triple sulfa vaginal cream once daily plus vitamin C tablets 250 mg once daily for ten days. Women were evaluated at follow-up visit, eleventh day, following completion of intervention. Analysis:, The effect of treatment was assessed regarding clinical criteria (presence of endocervical mucopus and cervical severity score) and presence of dyspareunia. Statistical analysis was carried out using spss version 11.5. Results:, The mean age of women was 30.6 ± 8.4 years. There was no relationship between demographics and dyspareunia and discharge (P > 0.05). There was statistically significant difference between the effect of ,doxycycline plus triple sulfa' and ,doxycycline, triple sulfa plus vitamin C' on discharge and dyspareunia (P = 0.005, P < 0.001, respectively). Most frequently reported drug-related adverse event in both groups was heartburn. Conclusion:, Adding vitamin C to doxycycline and triple sulfa was more efficient than standard regimen (doxycycline and triple sulfa without vitamin C) in treating chlamydial cervicitis. [source] Single dose oral azithromycin versus seven day doxycycline in the treatment of non-gonococcal mucopurulent endocervicitisAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2000Fatih SUMMARY The aim of this study was to compare single dose oral azithromycin versus seven-day doxycycline in the treatment of non-gonococcal mucopurulent cervicitis (MPC). One hundred and thirty-one women with non-gonococcal MPC were enrolled in a prospective-randomised study to compare the efficacy and safety of a single oral dose of 1 g azithromycin and a seven-day course of 100 mg doxycycline twice daily Clinical examination and culture samples for Chlamydia trachomatis and other microorganisms were performed before and approximately 14 days after starting the treatment. Of the 131 women recruited (67 in the azithromycin group and 64 in the doxycycline group), Ureaplasma urealyticum was isolated from 21 (16%); Chlamydia trachomatis from 15 (11.5%); and Mycoplasma hominis from 3 (2.3%) of the patients at the initial examination. The eradication rate of baseline culture-positive cases at the follow-up visit in the azithromycin group was 71.4%, and 77.3% in the doxycycline group. There was no statistically significant difference in efficacy between the single dose azithromycin and seven-day course of doxycycline in the treatment of culture-positive cases. Azithromycin 1 g appears to be an effective and safe alternative to doxycycline for the treatment of non-gonococcal MPC. [source] | ||||||||||||||||||||||||||||