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Follow-up Years (follow-up + year)
Selected AbstractsSustained effect of SQ-standardized grass allergy immunotherapy tablet on rhinoconjunctivitis quality of lifeALLERGY, Issue 6 2010L. Frølund To cite this article: Frølund L, Durham SR, Calderon M, Emminger W, Andersen JS, Rask P, Dahl R. Sustained effect of SQ-standardized grass allergy immunotherapy tablet on rhinoconjunctivitis quality of life. Allergy 2010; 65: 753,757. Abstract Background:, The prevalence of allergic rhinoconjunctivitis has increased significantly over the past decades with grass pollen being a common trigger. The impact of allergy on patient's quality of life is substantial. Aim:, To investigate the sustained effect on quality of life during the grass pollen season 1 year after 3 years of treatment with the SQ-standardized grass allergy immunotherapy tablet (AIT), Grazax® (Phleum pratense 75,000 SQ-T/2800 BAU; ALK, Denmark). Methods:, The trial was a randomized, parallel-group, double-blind, placebo-controlled trial in adult subjects with a history of moderate-severe grass pollen induced rhinoconjunctivitis inadequately controlled by symptomatic medications. Subjects received 3 years of grass AIT (n = 157) or placebo (n = 126), followed by 1 year of follow-up. Quality of life assessments were based on the standardized rhinoconjunctivitis quality of life questionnaire (RQLQ(S)); completed weekly during the entire grass pollen season. Results:, During follow-up, the overall RQLQ(S) score for the entire grass pollen season was significantly improved in the active group (relative difference to placebo: 23%, P = 0.004). The improvement was higher during the peak pollen season (28%, P = 0.001). The treatment effect of grass AIT during the follow-up year and the previous three treatment years was similar. Improvements were found in all seven RQLQ(S) domains. The RQLQ(S) as a function of the weekly average pollen counts showed a clear separation between the treatment groups (P < 0.001). Conclusion:, In subjects inadequately controlled by symptomatic medications, grass AIT provided sustained and clinically relevant improvements in rhinoconjunctivitis quality of life compared to placebo. The effect increased with increasing grass pollen exposure. [source] Public dental service utilization among adults in South AustraliaAUSTRALIAN DENTAL JOURNAL, Issue 2 2009L Luzzi Abstract Background:, Longitudinal patterns of public dental service use may reflect access issues to public dental care services. Therefore, patterns of dental service use among South Australian adult public dental patients over a 3½-year period were examined. Methods:, Public dental patients (n = 898) initially receiving a course of emergency dental care (EDC) or general dental care (GDC) at baseline were followed for up to 3½ years. Patient clinical records were accessed electronically to obtain information on dental visits and treatment received at those visits. Results:, Some 70.7 per cent of EDC and 51.3 per cent of GDC patients returned for dental treatment post-baseline. EDC patients returned within a significantly shorter time period post-baseline, received significantly more courses of care and were visiting more frequently than GDC patients. A greater proportion of EDC patients received oral surgery, restorative, endodontic and prosthodontic services, but fewer received periodontic services. EDC patients received significantly more oral surgery and fewer preventive services per follow-up year, on average, than GDC patients. Large proportions of EDC (52.4 per cent) and GDC (63.8 per cent) patients who returned sought emergency care post-baseline. Conclusions:, Patients appeared to be cycling through emergency dental care because of lack of access to general care services, highlighting access problems to public dental care. [source] Surgical Treatment of Chronic Gluteal Hidradenitis Suppurativa: Reused Skin Graft TechniqueDERMATOLOGIC SURGERY, Issue 2 2003Hung-wen Kuo MD BACKGROUND The treatment of chronic lesions in hidradenitis suppurativa (HS) remains a challenge for dermatologists. In most cases, wide surgical excision of the affected skin reduces the recurrence rate to a minimum. Split-thickness skin grafts have usually been applied to resurface large postoperative defects. OBJECTIVE The aim of this study is to introduce an alternative method of skin grafting, called "reused" or "recycled" skin graft, for the reconstruction of the large skin defect with chronic gluteal HS. METHODS The study consisted of six patients (two females and four males) with gluteal HS. After a wide en bloc excision, the wound was immediately recovered with meshed-skin graft, made from the resected skin itself. Thus, the sacrifice of the skin donor is spared. The drum dermatome (Padgett-Hood) is suitable to take the split-skin graft from the resected skin of the affected buttock. The thickness of grafts was set between 12/1,000 and 20/1,000 inches, and all grafts were meshed with 1.5 times the expansion. The skin grafts were secured in place on the wound and a tie-over dressing was applied. RESULTS Postoperative complications were usually minor ones, such as hematoma, discharge, and small areas of graft skin necrosis (less than 1 cm2), although one patient developed a 3×4 cm2 graft necrosis and wound infection. The follow-up period after surgery ranged from 8 to 36 months. No patient experienced any functional disabilities or recurrence during follow-up years. CONCLUSION When the epidermal involvement remains mild to moderate, this reused skin graft technique is an alternative choice to resurface the surgical defect of gluteal HS. It is superior to the conventional procedure, which requires fresh skin donor site. [source] Three-Year Chemical Dependency and Mental Health Treatment Outcomes Among Adolescents: The Role of Continuing CareALCOHOLISM, Issue 8 2009Stacy Sterling Background:, Few studies have examined the effects of treatment factors, including the types of services [chemical dependency (CD), psychiatric, or both], on long-term outcomes among adolescents following CD treatment, and whether receiving continuing care may contribute to better outcomes. This study examines the effect of the index CD and ongoing CD and psychiatric treatment episodes, 12-step participation, and individual characteristics such as CD and mental health (MH) severity and gender, age, and ethnicity, on 3-year CD and MH outcomes. Methods:, Participants were 296 adolescents aged 13 to 18 seeking treatment at 4 CD programs of a nonprofit, managed care, integrated health system. We surveyed participants at intake, 1 year, and 3 years, and examined survey and administrative data, and CD and psychiatric utilization. Results:, At 3 years, 29.7% of the sample reported total abstinence from both alcohol and drugs (excluding tobacco). Compared with girls, boys had only half the odds of being abstinent (OR = 0.46, p = 0.0204). Gender also predicted Externalizing severity at 3 years (coefficients 18.42 vs. 14.77, p < 0.01). CD treatment readmission in the second and third follow-up years was related to abstinence at 3 years (OR = 0.24, p = 0.0066 and OR = 3.33, p = 0.0207, respectively). Abstinence at 1 year predicted abstinence at 3 years (OR = 4.11, p < 0.0001). Those who were abstinent at 1 year also had better MH outcomes (both lower Internalizing and Externalizing scores) than those who were not (11.75 vs. 15.55, p = 0.0012 and 15.13 vs. 18.06, p = 0.0179, respectively). Conclusions:, A CD treatment episode resulting in good 1-year CD outcomes may contribute significantly to both CD and MH outcomes 3 years later. The findings also point to the value of providing a continuing care model of treatment for adolescents. [source] Single Kidney Transplantation from Young Pediatric Donors in the United StatesAMERICAN JOURNAL OF TRANSPLANTATION, Issue 12 2009L. K. Kayler Kidney transplantation (KTX) from small pediatric donors is performed as single or en bloc. Criteria to determine when to split pediatric donor kidneys and transplant as singles are not well established. Data reported to the Scientific Registry of Transplant Recipient for donors <10 yrs from 1995 to 2007 were reviewed (n = 5079). Donors were categorized by weight group by 5 kg increments and solitary (n = 3503) versus en bloc (n = 1576). The primary outcome was overall graft survival. Results were compared as adjusted hazard ratios (aHR) relative to ideal standard criteria donors (SCDs) (defined as age 18,39 without other risk factors), non-ideal SCDs (all other SCDs) and expanded criteria donors (age 50,59 with other risk factors or age ,60). Single KTX from donors , 35 kg conferred a similar risk of graft survival as ideal SCDs. Of donors 10,34 kg, risks of en bloc KTX were similar to ideal and risks of single KTX to non-ideal SCDs; single and en bloc KTXs had 7.9 and 5.2 graft losses per 100 follow-up years, respectively. Single KTX from donors >35 kg are similar to ideal SCDs. Single KTX from donors 10,35 kg are similar to non-ideal SCDs. From a resource perspective, pediatric donors 10,35 kg used as singles offer more cumulative graft years than when used en bloc. [source] | ||||||||||