scholarly journals Natural course of schizophrenia: 2-year follow-up study in a rural Chinese community

2001 ◽  
Vol 178 (2) ◽  
pp. 154-158 ◽  
Author(s):  
Maosheng Ran ◽  
Mengze Xiang ◽  
Mingsheng Huang ◽  
Youhe Shan
Keyword(s):  
Clinical Outcome ◽  
Drug Treatment ◽  
Rural Community ◽  
Natural Course ◽  
Psychosocial Treatment ◽  
Duration Of Illness ◽  
Natural Outcome ◽  
Antipsychotic Drug Treatment ◽  
Drug Treatment Group

BackgroundA number of studies have questioned whether the natural course of schizophrenia is more favourable in ‘developing’ than ‘developed’ societies and whether culture is a factor in producing a favourable course.AimsThis prospective study tests the hypothesis that the natural outcome of schizophrenia would be favourable in a Chinese rural area.MethodWe investigated all patients with schizophrenia, including patients who had not received any treatment, among 149 231 rural community population in Xinjin County, Sichuan in 1994. Those patients who had never received treatment were followed up for two years.ResultsThree-quarters of patients with schizophrenia who had not been treated remained symptomatic. As the duration of illness increased, the illness became more serious. The clinical outcome of the drug-treatment group was significantly better than for patients who had not received any treatment.ConclusionsThe natural clinical outcome of schizophrenia in the Chinese rural community was poor, and occupational functioning of patients with schizophrenia was comparatively better. Schizophrenia itself has a specific natural course – antipsychotic drug treatment and psychosocial treatment will produce an improvement in prognosis.

scholarly journals A Prospective Comparative Study on Cardiac Alterations After Surgery and Drug Treatment of Primary Aldosteronism

2021 ◽  
Vol 12 ◽  
Author(s):  
Yi-Lin Chen ◽  
Ting-Yan Xu ◽  
Jian-Zhong Xu ◽  
Li-Min Zhu ◽  
Yan Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Treatment Group ◽  
Drug Treatment ◽  
Primary Aldosteronism ◽  
Structure And Function ◽  
Cardiac Structure ◽  
Cardiac Structure And Function ◽  
And Function ◽  
Drug Treatment Group

BackgroundCurrent guideline recommends both surgery and drug treatment for primary aldosteronism. Treatment effects on the cardiac structure and function remain under investigation.ObjectiveWe performed a prospective study in patients with primary aldosteronism to compare effects of surgery and drug treatment on the cardiac structure and function as assessed by the left ventricular (LV) pressure-strain loop, a novel echocardiographic technique that incorporates myocardial deformation and LV pressure.MethodsOur study included 39 and 28 patients treated with surgery and a mineralocorticoid antagonist, respectively. We performed conventional and speckle tracking echocardiography at baseline and 3 and 6 months of follow-up.ResultsDuring follow-up, both surgery and drug treatment normalized serum potassium concentration and significantly reduced blood pressure. Both treatments significantly and similarly decreased LV mass index and left atrial volume index. However, only in the surgery group did global wasted work significantly decrease (200.8 ± 86.7 at baseline vs. 142.1 ± 58.1 mmHg% at 6 months) and global work efficiency (91.5 ± 3.1 vs. 93.6 ± 2.3%) and global longitudinal strain (−18.3 ± 2.7 vs. −19.2 ± 1.9%) significantly (p < 0.01) increase at 6 months of follow-up. The corresponding differences from the changes in the drug treatment group were 39.5 mmHg% (95% CI, 17.1, 62.0 mmHg%), −1.64% (95% CI, −2.56, −0.71%), and −0.85% (95% CI, −1.51, −0.20%), respectively. In addition, the changes in global wasted work at 6 months of follow-up was significantly correlated with that in 24-h urinary aldosterone excretion in the drug treatment group (r = 0.54) and two groups combined (r = 0.55), but not the surgery group.ConclusionIn spite of similar serum potassium normalization and blood pressure control, surgical removal of an adrenal gland, but not mineralocorticoid receptor antagonism, showed early improvement in cardiac function.

Adherence to antipsychotic drug treatment in early-episode schizophrenia: A six-month naturalistic follow-up study

2011 ◽  
Vol 130 (1-3) ◽  
pp. 176-181 ◽  
Author(s):  
Vered Baloush-Kleinman ◽  
Stephen Z. Levine ◽  
David Roe ◽  
Dan Shnitt ◽  
Abraham Weizman ◽  
...  
Keyword(s):  
Drug Treatment ◽  
Antipsychotic Drug ◽  
Follow Up Study ◽  
Antipsychotic Drug Treatment

Treatment of Uremic Tumoral Calcinosis in Maintenance Hemodialysis Patients

2020 ◽  
Vol 49 (6) ◽  
pp. 658-664 ◽  
Author(s):  
Guibao Ke ◽  
Sijia Li ◽  
Yanhai Cui ◽  
Xueqin  Chen ◽  
Huimin  Che ◽  
...  
Keyword(s):  
Treatment Group ◽  
Drug Treatment ◽  
Clinical Symptoms ◽  
Sodium Thiosulfate ◽  
Tumoral Calcinosis ◽  
Maintenance Hemodialysis ◽  
Limited Data ◽  
Metastatic Tissue ◽  
Drug Treatment Group

<b><i>Background/Aims:</i></b> Uremic tumoral calcinosis (UTC) is a rare disease with metastatic tissue calcification in maintenance hemodialysis (HD) patients. However, limited data are available on the treatment of UTC in HD patients. This article mainly discusses the diagnostic findings and efficacy of treatment on HD patients with UTC. <b><i>Methods:</i></b> A retrospective analysis was conducted based on the data of 13 cases of UTC, including their clinical features, biochemical indicators, imaging findings, diagnosis, therapeutic methods, and follow-up results. Parathyroidectomy (PTX) or drug treatment was determined based on intact parathyroid hormone (iPTH) levels and clinical symptoms. <b><i>Results:</i></b> All 13 patients were diagnosed as UTC definitely by imaging examination. The predominant areas involved were the buttocks (4 cases, 30.77%), shoulders (4 cases, 30.77%), and elbows (3 cases, 23.08%). Based on the levels of iPTH, cases were categorized into 2 different groups: PTX treatment group was associated with high levels of iPTH, while drug treatment group (lanthanum carbonate or sevelamer with sodium thiosulfate) was associated with lower iPTH levels. After PTX treatment, there was a significant decrease in serum iPTH, calcium (Ca), phosphate (P), and alkaline phosphatase levels (<i>p</i> &#x3c; 0.05). In drug treatment group, the serum <i>p</i> levels were decreased significantly, along with a finding that hemoglobin levels were increased (<i>p</i> &#x3c; 0.05). All the UTC had lessened or even disappeared after 4–6 months treatment. <b><i>Conclusions:</i></b> Although most UTC patients have an increased iPTH, a small number had lower iPTH levels. Based on iPTH levels and clinical symptoms, the patients were treated with PTX or drug therapy. With proper treatment, UTC disappeared without the need for surgery to remove calcinosis tissue.

scholarly journals M41. TRAJECTORIES AND PREDICTORS OF OUTCOME IN SCHIZOPHRENIA: THE BENEFICIAL ROLE OF AMISULPRIDE

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S149-S150
Author(s):  
Petros Drosos ◽  
Erik Johnsen ◽  
Christoffer A Bartz-Johannessen ◽  
Rune A Kroken
Keyword(s):  
Drug Treatment ◽  
Antipsychotic Drug ◽  
Antipsychotic Drugs ◽  
Strong Response ◽  
Schizophrenia Spectrum ◽  
Significant Difference ◽  
One Year ◽  
Response Group ◽  
Antipsychotic Drug Treatment

Abstract Background Schizophrenia is a serious illness and treatment with antipsychotic drugs remains one of the most effective types of treatment. The course of schizophrenia, however, is highly heterogeneous and currently it is not possible to predict which patient will respond adequately to which antipsychotic drug. The aim of our study was to define trajectories regarding response to antipsychotic drug treatment in patients with schizophrenia spectrum disorders. A second aim was to evaluate demographic factors and antipsychotic drugs as predictors for the different trajectories. Methods Best Intro is a randomized, rater-blind, head-to-head comparison of amisulpride, aripiprazole and olanzapine. Adult patients with a diagnosis in the schizophrenia spectrum (ICD-10 diagnoses F20-29) were included. Participants had symptoms of ongoing psychosis as determined by a score of four or more on at least one of the following PANSS (Positive and Negative Syndrome Scale) items: P1 (delusions), P3 (hallucinations), P5 (grandiosity), P6 (suspiciousness/persecution) or G9 (unusual thought content). Patients were followed over a period of 52 weeks and the assessment points were at baseline, after one week, three weeks, six weeks, three months, six months, nine months, and 12 months. Totally 359 patients were assessed for eligibility, and 144 of them were enrolled and randomized to one of the study drugs. We used the R statistical program to define trajectories of antipsychotic response. Results We identified three different trajectories regarding the reduction of PANSS total score, with Bayesian information criterion (BIC) = 6157 (BIC for two groups=6164 and for four groups=6171). A large group of patients (N=106, 74%) showed a trajectory of good improvement in PANSS total score over the first 26 weeks of follow-up and maintained it after one year with a total of 35% reduction in PANSS total score (Good response group). A second group of patients (N=19, 13%) followed a trajectory of quick response (already at one week) and a large reduction of PANSS total score (Strong response group). After one year, the reduction of PANSS total score was 58%. There was a difference in the starting point for PANSS total score in these two groups with a higher value at baseline in the Strong response group, but the ending point was quite similar. A third group of patients (N= 19, 13%) followed a trajectory of poor improvement and a 9% reduction in PANSS total score over the studied period (Slight response group). The demographic variables age, sex, civil status and living alone, or drug naivety did not predict participants grouping in the various trajectories. Furthermore, we examined the predictive value of different antipsychotic drug treatment for the different trajectories with the “Intention to treat” method. There was a statistically significant difference in favor of amisulpride treatment for belonging to the Strong response group, while olanzapine strongly predicted the belonging to the Slight response group. There was no significant difference among the antipsychotic drugs regarding the Good response group. Discussion Most patients (74%) with a schizophrenia spectrum diagnosis showed a good response during the one year follow-up and another 13% showed a remarkable strong improvement. That means that a total of 87% of patients had a satisfactory course of illness during the first year. Use of amisulpride predicts a better course compared to aripiprazole and olanzapine. This finding can be useful for clinicians when selecting antipsychotic drugs for their patients.

P2776Radiofrequent pulmonary artery denervation - alternative treatment of residual chronic thromboembolic pulmonary hypertension. Results of a randomized pilot study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
N Novikova ◽  
A M Chernyavskiy ◽  
A B Romanov ◽  
D S Grankin ◽  
A G Edemskiy ◽  
...  
Keyword(s):  
Heart Failure ◽  
Treatment Group ◽  
Pulmonary Artery ◽  
Drug Treatment ◽  
Safety And Efficacy ◽  
Long Term Follow Up ◽  
The Mean ◽  
Drug Treatment Group

Abstract Background/Introduction Pulmonary endarterectomy (PEA) is the gold standard of CTEPH treatment. However, residual CTEPH develops in 10–40% of patients after PEA, which leads to progression of right ventricular insufficiency. Currently, the only way to treat residual CTEPH is PAH-specific drug therapy. However, this treatment is not indicated for all patients because of the arterial hypotension and dyspeptic disorders. Purpose To assess the safety and efficacy of radiofrequent pulmonary artery denervation (PADN) in patients with residual CTEPH after PEA. Methods In 2015, a randomized pilot study was conducted to evaluate PADN in patients with residual CTEPH (NCT 02745106). 278 patients with CTEPH after PEA were screened. In 62 of them, according to the echocardiography, residual CTEPH (systolic pulmonary artery pressure (PAP) ≥45 mm Hg) was detected. In 50 patients, residual CTEPH was confirmed during right heart catheterization (RHC): mean PAP ≥25 mmHg and pulmonary vascular resistance (PVR) >400 dyn s cm–5. Patients were randomized into two groups: 25 in PADN group and 25 in drug therapy group with riociguat. Mean age was 39 years [26; 51]. The mean duration after PEA was 4.5 years [1; 8.5]. The primary end point was PVR in the short-term and long-term follow-up. Secondary end points were: mean PAP, cardiac output, 6-minute walk test (6MWD) and NYHA functional class. All patients were followed up for 12 months after discharge. The PADN procedure was performed using electrophysiological catheter Navistar RMT Thermocool, Biosense Webster, Diamond Bar, CA, USA and non-fluroscopic 3D navigation system. Results There was no mortality. In two patients (one in each group) hematoma developed in femoral vein puncture site without any consequences. The mean surgery time was 105 [93; 120] minutes. After 12 months, PVR was significantly lower in the PADN group compared with the drug treatment group (343±149 dyn s cm–5 vs 444±145 dyn s cm–5, respectively; mean difference −101, 95% confidence interval from −193 to −10; p=0.032). The mean PAP was also significantly lower in the PADN group (25.8±7.3 mm Hg vs. 33.8±6.4 mm Hg, p<0.001). We noticed a significant improvement of 6MWD test in PADN group compared with the drug treatment group (470±84 m versus 399±116 m, respectively, p=0.031). In PADN group 1 (4%) patient was hospitalized due to progression of heart failure compared with 7 patients (29%) in the drug treatment group (p=0.049). One patient (4%) in the PADN group and two patients (8%) in the drug treatment group died due to progression of heart failure over the long-term follow-up. Conclusions The PADN technique showed its safety and efficacy in the treatment of patients with residual CTEPH and can be used in clinical practice. The obtained first results showed that the proposed PADN, together with optimal medical therapy, can take a place in the treatment of residual CTEPH after PEA.

II. the Incidence of Compliance Problems, Side-effects, Neurotic Symptoms and Depression

1985 ◽  
Vol 146 (5) ◽  
pp. 469-474 ◽  
Keyword(s):  
Side Effects ◽  
Drug Treatment ◽  
Tardive Dyskinesia ◽  
Antipsychotic Drug ◽  
Psychotic Symptoms ◽  
Acute Psychosis ◽  
Patient Admissions ◽  
Depot Neuroleptics ◽  
Antipsychotic Drug Treatment

SummarySeven years after the completion of the original trial, over 73% of patients were maintained on depot neuroleptics, and 70% had received such medication for over seven years. About 40% had presented with a problem of compliance at some time, and there was a significant correlation between poor compliance and in-patient admissions and schizophrenic relapses. The prevalence of parkinsonian side-effects, akathisia, and tardive dyskinesia was low. Non-psychotic symptoms were common, even in the absence of acute psychosis. Depression was found in a subgroup of patients; it was frequently reported as an indication for admission during follow-up period, and seemed to be part of the schizophrenic illness rather than a result of antipsychotic drug treatment.

Effect of Manipulation under Anesthesia of the First Knee in Staged Bilateral Total Knee Arthroplasty on Clinical Outcome and Satisfaction

2020 ◽  
Author(s):  
Jung-Won Lim ◽  
Yong-Beom Park ◽  
Dong-Hoon Lee ◽  
Han-Jun Lee
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Functional Score ◽  
Manipulation Under Anesthesia ◽  
Total Knee

AbstractThis study aimed to evaluate whether manipulation under anesthesia (MUA) affect clinical outcome including range of motion (ROM) and patient satisfaction after total knee arthroplasty (TKA). It is hypothesized that MUA improves clinical outcomes and patient satisfaction after primary TKA. This retrospective study analyzed 97 patients who underwent staged bilateral primary TKA. MUA of knee flexion more than 120 degrees was performed a week after index surgery just before operation of the opposite site. The first knees with MUA were classified as the MUA group and the second knees without MUA as the control group. ROM, Knee Society Knee Score, Knee Society Functional Score, Western Ontario and McMaster Universities (WOMAC) score, and patient satisfaction were assessed. Postoperative flexion was significantly greater in the MUA group during 6 months follow-up (6 weeks: 111.6 vs. 99.8 degrees, p < 0.001; 3 months: 115.9 vs. 110.2 degrees, p = 0.001; 6 months: 120.2 vs. 117.0 degrees, p = 0.019). Clinical outcomes also showed similar results with knee flexion during 2 years follow-up. Patient satisfaction was significantly high in the MUA group during 12 months (3 months: 80.2 vs. 71.5, p < 0.001; 6 months: 85.8 vs. 79.8, p < 0.001; 12 months: 86.1 vs. 83.9, p < 0.001; 24 months: 86.6 vs. 85.5, p = 0.013). MUA yielded improvement of clinical outcomes including ROM, and patient satisfaction, especially in the early period after TKA. MUA in the first knee could be taken into account to obtain early recovery and to improve patient satisfaction in staged bilateral TKA.

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