Borderline patients before and after one year of transference-focused psychotherapy (TFP): A detailed analysis of change of attachment representations.

2021 ◽  
Vol 38 (1) ◽  
pp. 12-21 ◽  
Author(s):  
Anna Tmej ◽  
Melitta Fischer-Kern ◽  
Stephan Doering ◽  
Susanne Hörz-Sagstetter ◽  
Michael Rentrop ◽  
...  
Keyword(s):  
Detailed Analysis ◽  
Attachment Representations ◽  
Before And After ◽  
Borderline Patients ◽  
Analysis Of Change ◽  
One Year ◽  
Transference Focused Psychotherapy

scholarly journals Real-World Experience of the One-Year Efficacy of Rifaximin Add-On to Lactulose Is Superior to Lactulose Alone in Patients with Cirrhosis Complicated with Recurrent Hepatic Encephalopathy in Taiwan

2021 ◽  
Vol 11 (6) ◽  
pp. 478
Author(s):  
Ching Chang ◽  
Chien-Hao Huang ◽  
Hsiao-Jung Tseng ◽  
Fang-Chen Yang ◽  
Rong-Nan Chien
Keyword(s):  
Hepatic Encephalopathy ◽  
Real World ◽  
Ammonia Level ◽  
Decompensated Cirrhosis ◽  
Control Group ◽  
Multivariable Logistic Regression Model ◽  
Before And After ◽  
One Year ◽  
The One ◽  
Serum Ammonia

Background: Hepatic encephalopathy (HE), a neuropsychiatric complication of decompensated cirrhosis, is associated with high mortality and high risk of recurrence. Rifaximin add-on to lactulose for 3 to 6 months is recommended for the prevention of recurrent episodes of HE after the second episode. However, whether the combination for more than 6 months is superior to lactulose alone in the maintenance of HE remission is less evident. Therefore, the aim of this study is to evaluate the one-year efficacy of rifaximin add-on to lactulose for the maintenance of HE remission in Taiwan. Methods: We conducted a real-world single-center retrospective cohort study to compare the long-term efficacy of rifaximin add-on to lactulose (group R + L) versus lactulose alone (group L, control group). Furthermore, the treatment efficacy before and after rifaximin add-on to lactulose was also analyzed. The primary endpoint of our study was time to first HE recurrence (Conn score ≥ 2). All patients were followed up every three months until death, and censored at one year if still alive. Results and Conclusions: 12 patients were enrolled in group R + L. Another 31 patients were stratified into group L. Sex, comorbidity, ammonia level, and ascites grade were matched while age, HE grade, and model for end-stage liver disease (MELD) score were adjusted in the multivariable logistic regression model. Compared with group L, significant improvement in the maintenance of HE remission and decreased episodes and days of HE-related hospitalizations were demonstrated in group R + L. The serum ammonia levels were significantly lower at the 3rd and 6th month in group 1. Concerning changes before and after rifaximin add-on in group R + L, mini-mental status examination (MMSE), episodes of hospitalization, and variceal bleeding also improved at 6 and 12 months. Days of hospitalization, serum ammonia levels also improved at 6th month. Except for concern over price, no patients discontinued rifaximin due to adverse events or complications. The above results provide evidence for the one-year use of rifaximin add-on to lactulose in reducing HE recurrence and HE-related hospitalization for patients with decompensated cirrhosis.

Changes In Prothrombin And Activated Partial Thromboplastin Time During Replacement Therapy With Human Recombinant Growth Hormone In Growth Hormone Deficient Adults

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S102-S103
Author(s):  
Y S Kamel
Keyword(s):  
Growth Hormone ◽  
Replacement Therapy ◽  
Healthy Subjects ◽  
Recombinant Growth Hormone ◽  
Gh Replacement ◽  
Coagulation Tests ◽  
Before And After ◽  
Human Recombinant Growth Hormone ◽  
Male Patients ◽  
One Year

Abstract Introduction/Objective The aim of this study was to investigate the effects of GH administration on basic coagulation parameters: PT, aPTT and fibrinogen concentrations in adult GHD patients before and during one year of GH replacement. Methods Twenty-one adult patients with severe GHD (mean age +/- SE: 38.6 +/- 2.8 years) were included in this hospital based, prospective, interventional study. All patients were treated with rhGH for 12 months (GH dose: 0.4 mg/day for male and 0.6 mg/day for female patients). IGF-1 concentrations were determined using RIA-INEP kits. Basic coagulation tests, i.e. aPTT and fibrinogen concentrations, were measured before and after 3, 6 and 12 months of treatment with rhGH. Control values were obtained from fourteen “healthy” subjects matched by age, sex and body mass index (BMI). Results At baseline, we observed no significant differences in PT, aPTT and fibrinogen values between GHD and healthy subjects. IGF-1 concentrations increased significantly within 3 months of GH therapy (8.2 +/- 1.5 vs. 24.2 +/- 2.9 nmol/l, p <0.05) and remained stable thereafter. A significant increase in PT values, which was more pronounced in female subjects, was noted after 6 and 12 months of treatment with GH. aPTT values increased significantly after 12 months of treatment only in male patients (28.8 +/- 4.6 vs. 39.7 +/- 2.1 s.; p <0.05). No significant changes in fibrinogen concentrations were found during the study. Conclusion Twelve months of GH replacement therapy led to a significant increase in PT and aPTT values in adult GHD patients, while fibrinogen concentrations did not change. Changes in PT were more pronounced in female GHD patients, while an increase in aPTT values was observed only in male patients with GHD. The clinical significance of these changes needs further evaluation.

scholarly journals 19 Colectomy Rate for Moderate to Severe Ulcerative Colitis with Biologics

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
J W H Koh ◽  
C H Ng ◽  
M H Lee ◽  
Y H Chin ◽  
Z H Ong ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Current Literature ◽  
Biologic Therapy ◽  
Meta Analysis ◽  
Severe Ulcerative Colitis ◽  
Before And After ◽  
Arcsine Transformation ◽  
One Year

Abstract Introduction Biologics are recommended by both the ACG and ECCO community for the treatment of ulcerative colitis. Yet, current literature has yet to estimate the rate of colectomies after biologic therapy, and thus a pooled meta-analysis was conducted the rate of colectomies in 1month, 6 months, 1 year, 2years and five years after biologics. Method Medline and Embase were searched for articles examining biologics use in moderate to severe UC or acute severe UC (ASUC) from inception to 21st May 2020. Analysis of proportions were undertaken after a freeman-tukey double arcsine transformation. Results The pooled overall colectomy rates of ASUC and moderate to severe UC were 9% (CI: 4% - 14%) at one month, 18% (CI: 13% - 25%) at six months, 21% (CI:16% - 27%) at one year, 29% (CI:24% - 34%) at two years and 38% (CI:30% - 45%) at five years. Additionally, colectomy rates were consistently lower comparing between articles before and after 2010. At one-year, overall colectomy rate following infliximab use was at 25%, golimumab at 15%, vedolizumab at 14%, and adalimumab at 3%. Conclusions Colectomy rates in the era of biologics ranged from 8% to 38% and lower post-2010 showing significant improvement in management and supporting the utility of biologics in Ulcerative colitis management.

Exercise Training and the Speed of Self-Selected Walking Pace in Men at Retirement

1986 ◽  
Vol 5 (1) ◽  
pp. 19-26 ◽  
Author(s):  
D. A. Cunningham ◽  
P. A. Rechnitzer ◽  
A. P. Donner
Keyword(s):  
Exercise Training ◽  
Training Program ◽  
Walking Speed ◽  
Exercise Group ◽  
Cardiovascular Fitness ◽  
Blue Collar ◽  
Intervention Trial ◽  
Before And After ◽  
Exercise Endurance ◽  
One Year

ABSTRACTAn intervention trial with regular physical activity was carried out to test the hypothesis that walking speed is related to the level of cardiovascular fitness (maximal oxygen uptake). Earlier research has demonstrated that when VO2 max is held constant in a multiple regression analysis the association between walking speed and age (29–65 y) is eliminated. To describe the association between self-selected speeds of walking, and level of cardiovascular fitness, 63 men age 60 to 65 were studied before and after a 1 year program of exercise training. VO2 max was determined on a motor driven treadmill. A test of self-selected walking pace was administered over a 240 m indoor course. The men were asked to walk at 3 paces considered by the subjects to be rather slow, normal, and fast, respectively. They were randomly assigned with stratification for white and blue collar occupation to a program of exercise training (n = 33) or control (n = 27). The training program consisted of walking or jogging for 30 min three times per week for one year. After the training program the exercise group increased their VO2 max (9.5%) and their normal walking speed (1.29 to 1.43 m.s−1) significantly compared to the controls. A program of exercise endurance training will result in an increase in the speed of self-selected pace.

Aortic endograft and bridging stent-graft remodeling after branched endovascular aortic repair

Vascular ◽  
2020 ◽  
pp. 170853812098369
Author(s):  
Stefano Fazzini ◽  
Giovanni Torsello ◽  
Martin Austermann ◽  
Efthymios Beropoulis ◽  
Roberta Munaò ◽  
...  
Keyword(s):  
Stent Graft ◽  
Endovascular Repair ◽  
Main Body ◽  
Thoracoabdominal Aneurysm ◽  
Before And After ◽  
Long Term Follow Up ◽  
Instability Rate ◽  
One Year ◽  
The Impact

Objectives The results of branched endovascular repair of thoracoabdominal aneurysms are mainly dependent on durability of the graft used. The purpose of this study was to evaluate postoperative aortic main body and bridging stent-graft remodeling, and their impact on bridging stent-graft instability at one year. Methods Computed tomoangiographies of 43 patients (43 aortic main body mated with 171 bridging stent-grafts) were analyzed before and after branched endovascular repair as well as after a follow-up of 12 months. Primary endpoint was aortic main body remodeling (migration >5 mm, shortening >5 mm, scoliosis >5° or lordosis >5°). Shortening was defined as a reduced length in the long axis, scoliosis as left-right curvature, and lordosis as antero-posterior curvature. Aortic main body remodeling, aneurysm sac changes, and bridging stent-graft tortuosity were evaluated to study their correlations and the impact on the bridging stent-graft instability. Results At 12 months, aortic main body remodeling was observed in 72% of the cases, migration in 39.5% (mean 5.21 mm), shortening in 41.9% (mean 5.79 mm), scoliosis in 58.1%, (mean 10.10°), lordosis in 44.2% (mean 5.78°). Migration, shortening, and scoliosis were more frequent in patients with larger aneurysms ( p = .005), while scoliosis was significantly more frequent in type II thoracoabdominal aneurysm ( p = .019). Aortic main body remodeling was significantly associated to bridging stent-graft remodeling (r: 0.3–0.48). The bridging stent-graft instability rate was 9.3%. Despite a trend toward significance ( p = .07), none of the evaluated aortic main body and bridging stent-graft changes were associated with bridging stent-graft instability at 12 months. Conclusions Aortic main body remodeling is frequent especially in large and extended thoracoabdominal aneurysm aneurysms. Aortic main body and bridging stent-graft remodeling was significantly correlated. While these geometric changes had no significant impact on bridging stent-graft instability at one year, a close long-term follow-up after branched endovascular repair could predict bridging stent-graft failures.

Divergent patterns of anti-fracture medication use following fracture on therapy: A population-based cohort study

2021 ◽  
Author(s):  
Gregory A Kline ◽  
Suzanne N Morin ◽  
Lisa M Lix ◽  
William D Leslie
Keyword(s):  
Cohort Study ◽  
Medication Adherence ◽  
Vertebral Fracture ◽  
Drug Efficacy ◽  
Population Based ◽  
Duration Of Treatment ◽  
Traumatic Fracture ◽  
Before And After ◽  
One Year

Abstract Context Fracture-on-therapy should motivate better anti-fracture medication adherence. Objective Describe osteoporosis medication adherence in women before and following a fracture. Design Retrospective cohort study. Setting Manitoba BMD Registry (1996-2013). Patients Women who started anti-fracture drug therapy after a DXA-BMD with follow-up for 5 years during which a non-traumatic fracture occurred at least one year after starting treatment. Main Outcome Linked prescription records determined medication adherence (estimated by medication possession ratios, MPR) in one-year intervals. The variable of interest was MPR in the year before and after the year in which the fracture occurred with subgroup analyses according to duration of treatment pre-fracture. We chose an MPR of ≥0.50 to indicate minimum adherence needed for drug efficacy. Results There were 585 women with fracture-on-therapy, 193(33%) had hip or vertebral fracture. Bisphosphonates accounted for 82.2% of therapies. Median MPR the year prior to fracture was 0.89(IQR 0.49-1.0) and 0.69(IQR 0.07-0.96) the year following the year of fracture(p< 0.0001). The percentage of women with MPR ≥ 0.5 pre-fracture was 73.8%, dropping to 57.3% post-fracture(p<0.0001); restricted to hip/vertebral fracture results were similar (58.2% to 33.3%, p <0.002). Among those with pre-fracture MPR <0.5, only 21.7% achieved a post-fracture MPR ≥ 0.5. Conclusions Although fracture-on-therapy may motivate sustained/improved adherence, MPR remains low or even declines after fracture in many. This could reflect natural decline in MPR with time but is paradoxical to expectations. Fracture-on-therapy represents an important opportunity for clinicians to re-emphasize treatment adherence.

The effect of the COVID-19 pandemic on metabolic control in children with type 1 diabetes: a single-center experience

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Emre Sarıkaya ◽  
Dilek Çiçek ◽  
Ebru Gök ◽  
Leyla Kara ◽  
Uğur Berber ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Metabolic Control ◽  
Glycosylated Hemoglobin ◽  
Emergency Admissions ◽  
Single Center Experience ◽  
Number Of Patients ◽  
Significant Difference ◽  
Before And After ◽  
One Year

Abstract Objectives Coronavirus disease 2019 has caused a major epidemic worldwide, and lockdowns became necessary in all countries to prevent its spread. This study aimed to evaluate the effects of staying-at-home practices on the metabolic control of children and adolescents with type 1 diabetes during the pandemic period. Materials and Methods Eighty-nine patients younger than 18 years old who were diagnosed with type 1 diabetes at least one year before the declaration of the pandemic were included in the study. The last visit data of the patients before and after the declaration of the pandemic, and the frequency of presentation of diabetes-related emergencies from one year after diagnosis of type 1 diabetes to the declaration of the pandemic, and from the declaration of the pandemic to the last visit after the pandemic declaration were compared. Results The total number of patients was 89, and 48 (53.9%) were boys. The mean (± standard deviation [SD]) age at diagnosis was 8.4 ± 3.7 years (boys 7.9 ± 3.6 years; girls 8.9 ± 3.9 years). There was no statistically significant difference when the SD values of the anthropometric measurements, and the glycosylated hemoglobin (HbA1c) and lipid profile tests were compared. However, the frequency of admission to the emergency service related to diabetes was significantly different. Conclusions Although the pandemic did not significantly affect the metabolic and glycemic controls of the children with type 1 diabetes included in this study, an increase in the frequency of diabetes-related emergency admissions was noted.

scholarly journals Clinical and Contrast-Enhanced Ultrasound Echography Outcomes in Psoriatic Arthritis Patients after One Year of Continuous Therapy with Anti-TNF Drugs

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Claudio Bonifati ◽  
Fulvia Elia ◽  
Dario Graceffa ◽  
Fabrizio Ceralli ◽  
Elisa Maiani ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Significant Proportion ◽  
Joint Inflammation ◽  
Joint Involvement ◽  
Contrast Enhanced Ultrasound ◽  
Continuous Therapy ◽  
Clinical Variables ◽  
Contrast Enhanced ◽  
Before And After ◽  
One Year

Background. We wanted to verify retrospectively the proportion of patients with psoriatic arthritis who were in remission after 1 year of continuous therapy with either etanercept or adalimumab. Remission was defined as the absence of both clinical and contrast-enhanced ultrasound (CEUS) findings suggestive of joint inflammation. Patients and Methods. The data of twenty-five patients with psoriatic arthritis were available for the clinical and CEUS evaluations before and after 1 year of continuous therapy with etanercept or adalimumab. The count of swollen (ACR66), tender (ACR68), and active inflamed joints (AJC) was used to measure the severity of joint involvement. PASI was used to score the severity of psoriasis. HAQ, DLQI, VAS pain, and VAS itching were administered to each patient before starting therapy and every 3 months, up to 1 year. Results. Eight (32%) out of twenty-five patients were in remission after 1 year of therapy with etanercept or adalimumab. A significant reduction of all clinical variables analysed was seen during the course of therapy. Conclusion. Although a significant proportion of patients achieved remission of arthritis after 1 year of effective anti-TNF therapy, the majority of them continued to have either clinical or CEUS findings suggestive of persistence of joint inflammation.

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