scholarly journals Towards the development of a reciprocal liaison service

2000 ◽  
Vol 24 (10) ◽  
pp. 379-381 ◽  
Author(s):  
Mark Davies
Keyword(s):  
Response Rate ◽  
Psychiatric Patients ◽  
Surgical Patients ◽  
Clinical Implications ◽  
Total Response ◽  
District Health ◽  
Total Response Rate ◽  
The Mean ◽  
Equity Of Access

Aims and MethodThe aim of this survey was to determine attitudes among consultants in different specialities towards the development of a reciprocal liaison service providing access for psychiatric patients to medical and surgical liaison services equal to the access of medical and surgical patients to psychiatric liaison services. All medical, surgical and psychiatric consultants in a district health service were surveyed, with a total response rate of 48%.ResultsThe mean number of medical and surgical patients requiring a psychiatric liaison service was 6%. The mean number of psychiatric patients requiring medical and surgical liaison services was 11%. Ratings overall for various components of the two types of liaison service were generally similar, with acute assessments and follow-up being given a high priority for both types.Clinical ImplicationsAs liaison services are developed, the notion of equity of access for all patients is paramount. Commissioning of such services should thereby specify the reciprocal nature of development. This survey shows that generally there is a positive attitude to the development of such a service.

scholarly journals Efficacy and Safety of the TCM Qi-Supplementing Therapy in Patients with Myasthenia Gravis: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Xi-qian Yang ◽  
Ling Liu ◽  
Wen-yu Yang ◽  
Huan-huan Dong ◽  
Yi-ran Yang ◽  
...  
Keyword(s):  
Adverse Events ◽  
Myasthenia Gravis ◽  
Relapse Rate ◽  
Response Rate ◽  
Meta Analysis ◽  
Effective Rate ◽  
Efficacy And Safety ◽  
Total Response ◽  
Total Response Rate

Background. The Traditional Chinese Medicine (TCM) Qi-supplementing therapy has been used widely for treating myasthenia gravis (MG) in China. The purpose of this meta-analysis was to evaluate the efficacy and safety of Qi-supplementing therapy as an adjunctive therapy in MG patients. Methods. Seven electronic databases were searched through June 2016. Randomized controlled trials (RCTs) evaluating the add-on effect of Qi-supplementing therapy in MG patients were included. The outcome measures were the total effective rate, relapse rate, and adverse events. Results. Twenty-three RCTs involving 1,691 MG patients were included. The included studies were of low-to-moderate quality. Meta-analysis showed that Qi-supplementing therapy combined with Western medicine (WM) significantly improved the total response rate and reduced the relapse risk during 6–24 months of follow-up. Subgroup analysis showed that Qi-supplementing therapy only affected the total response rate within the first 6 months of treatment. Moreover, the rate of adverse events was lower with the addition of Qi-supplementing therapy to WM than with WM only. Conclusions. Short-term Qi-supplementing therapy combined with WM appears to be superior to WM for improving the total response rate and reducing the relapse rate. However, more high-quality RCTs are warranted owing to methodological flaws of previous trials.

Retirement intentions of older consultant psychiatrists

2004 ◽  
Vol 28 (4) ◽  
pp. 130-132 ◽  
Author(s):  
Alex Mears ◽  
Tim Kendall ◽  
Cornelius Katona ◽  
Carole Pashley ◽  
Sarah Pajak
Keyword(s):  
Early Retirement ◽  
Response Rate ◽  
Important Determinant ◽  
Clinical Implications ◽  
Consultant Psychiatrist ◽  
Health Officer ◽  
Decisions To Leave ◽  
The Mean ◽  
The Uk ◽  
Retirement Intentions

Aims and MethodThis survey gathered data on the retirement intentions of consultant psychiatrists over the age of 50 years, in order to address retention issues. A questionnaire was sent to all 1438 consultants over this age in the UK.ResultsA total of 848 questionnaires were returned, an adjusted response rate of 59%. The mean age at which consultants intended to retire in this sample was 60 years (s.d. 4.16), suggesting a potential loss of 5725 consultant years. Reasons for early retirement are complex: factors encouraging retirement include too much bureaucracy, lack of free time and heavy case-loads; those discouraging retirement include enjoyment of work, having a good team and money. Mental Health Officer status is an important determinant in the decision to retire early.Clinical ImplicationsWith numerous vacancies in consultant psychiatrist posts throughout the UK, premature retirement is a cause for concern, possibly contributing to an overall reduction in consultant numbers of 5%. Addressing factors that influence consultants' decisions to leave the health service early should form an important part of an overall strategy to increase consultant numbers.

scholarly journals Spatz3 Adjustable Balloon: Weight Loss and Response Rates in Brazil

2018 ◽  
Vol 1 (1) ◽  
pp. 38-41
Author(s):  
Leonard Salles De Almeida
Keyword(s):  
Intragastric Balloon ◽  
Response Rate ◽  
Successful Outcome ◽  
Implantation Time ◽  
Duration Of Effect ◽  
The Mean ◽  
Total Body ◽  
Lost To Follow Up ◽  
Adjustable Balloon

Background: The degree of efficacy and duration of effect of Intragastric Balloons (IGBs) can be variable and unpredictable. The Spatz Adjustable Intragastric Balloon (AIGB) was developed to address these issues by extending implantation to 1 year, decreasing balloon volume for intolerance and increasing volume for decreased balloon effect.Aims: To determine the efficacy and response rate of the Spatz3 AIGB.Methods: Results of 379 consecutive patients (pts) implanted with the Spatz3 AIGB were retrospectively reviewed (3 lost to follow up). Mean BMI 35.5; mean weight (wt) 97.5 kg; mean excess wt 29.1 kg; mean balloon volume 600ml. Balloon volume adjustments were offered: Down adjustments for intolerance and up adjustments for decreased balloon effect.Results: The mean implantation time of 376 pts was 10.6 months yielding mean wt loss 14.9 kg; mean 15.1% Total Body Wt Loss (%TBL) and 58% Excess Wt Loss(%EWL). Response rate (> 25%EWL) was achieved in 79% (297/376) of pts. Down adjustments in 95 pts (mean 2.4 months; mean -152.4 ml) allowed 76/95 (80%) to continue IGB therapy for at least 6 months (mean 9.1 months). Up adjustments in 205/376 (54.5%) pts (mean 5.8 months; mean + 179.2 ml) yielded additional mean wt loss of 6.5 kg. There was 1 gastric ulcer (0.27%). One balloon deflated at 7.4 months and 4 others deflated after 1 year (13-23 months).Conclusions: In this retrospective review of 376 Spatz3 AIGB patients, up adjustments yielded a mean 6.5kg extra wt loss for those with wt loss plateau, and down adjustments alleviated early intolerance. These two adjustment functions may be instrumental in yielding a successful outcome (> 25% EWL) in 79% of pts.

Comparative Efficacy of Homoharringtonine Plus Cytarabine and Decitabine in Patients with MDS/AML

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4340-4340
Author(s):  
Yuejian Liu ◽  
Feili Chen ◽  
Xutao Guo ◽  
Pengcheng Shi ◽  
Jie Zha ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Response Rate ◽  
Complete Response Rate ◽  
Secondary Infection ◽  
Complete Response ◽  
Total Response ◽  
Total Response Rate ◽  
Treatment Related Mortality ◽  
Related Mortality

Abstract Abstract 4340 Background: Myelodysplastic syndrome (MDS) is a malignant hematological disease that comprises a heterogeneous group of clonal hematopoietic stem and progenitor cell disorders, with peripheral cytopenias, bone marrow hypercellularity, high-risk of evolving into acute myeloid leukemia (AML). MDS/AML is a special refractory and palindromic AML characterized by poor therapeutic effects and low complete response rate, as well as high treatment-related complications and mortality. Patients with MDS/AML are often elders and represent more intolerance to routine or intensive chemotherapies. Homoharringtonine, an alkaloid found as the major active component in Chinese plants cephatotaxus fortuneif., has been widely used in AML since the 1970s in China. Decitabine, a hypomethylating agent, is active and has been approved for the treatment of myelodysplastic syndrome (MDS) in recent years. Objective: In order to compare the efficacy, toxicity and long-term prognosis of two chemotherapies HA (Homoharringtonine and cytarabine) and Decitabine regiment in MDS/AML. Methods: A total of 26 MDS/AML patients consisting of 14 males and 12 females were included in this study. They were randomly assigned to receive either HA (H 4mg.d−1,d1–3; A 100mg.m−2d−1, d1–7) or decitabine£.. 20mg.m−2d−1, d1–5£© The effect measures used were hazard ratios (HR) for overall survival (OS), progression-free survival (PFS) and freedom from first progression. Relative risks were used to analyse complete response rate, total response rate, treatment-related mortality and adverse events. A Log-rank test was used in survival analysis, and a Chi-square test was performed for other outcomes. Results: The complete remission (CR) rate with HA regimen according to MDS/AML criteria was 33% and 36% with decitabine (P>0.05). HA group had no lower total response rate than Decitabine group (53% versus 64%, P>0.05). The freedom from first progression in chemotherapy with HA regiment and decitabine was 20% and 18% (P>0.05), respectively. PFS was not statistically significantly longer for two comparators with HR was 0.41(95% confidence interval (CI) 0.09722 to 1.740). There was no statistically significant difference in OS between the HA group and decitabine group with HR was 0.799 (95% CI 0.2992 to 2.133); median survival: 300 days vs 291 days (P>0.05,95% confidence interval (CI) 0.6165 to 1.445). The treatment-related mortality was 13% with HA regimen versus 18% with decitabine at 3 weeks (P>0.05) and 40% with HA regiment versus 18% with decitabine at 3 months (P>0.05). The haematological toxicities and liver function lesion WHO grade III or IV were not significantly higher in the HA group than that in the decitabine group (P>0.05). The total secondary infection rates in all sections of chemotherapies were 58% and 19% (P=0.005) in the two groups, respectively. Secondary infection rate was significantly lower in the decitabine group than that in the HA group. Conclusions: This analysis showed that Homoharringtonine and cytarabine regiment in treating MDS/AML has a similar therapeutic effect and long-term benefit with decitabine, both regiments were associated with relatively safe and effective outcomes in patients with MDS/AML. However, HA regiment shows a higher risk of secondary infection than decitabine. Longer follow-up and further studies will evaluate prospectively the results of HA regiment versus decitabine in this setting. Disclosures: No relevant conflicts of interest to declare.

Study on external Chinese herbal medicine LC07 treating capecitabine-induced hand-foot syndrome in metastatic breast cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 1088-1088
Author(s):  
L. Jia ◽  
Y. Lou ◽  
H. Tan
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Response Rate ◽  
Metastatic Breast ◽  
Chinese Herbs ◽  
Common Side Effect ◽  
Total Response ◽  
Total Response Rate ◽  
Before And After ◽  
Hand Foot Syndrome

1088 Background: With the capecitabine being increasingly used in the treatment of metastatic breast cancer (MBC), the common side effect of capecitabine, hand-foot syndrome (HFS) has become a main problem which can distress both physicians and patients. Severe HFS such as severe pain can have a negative impact on quality of life (QOL) of these patients and cause reduced dosage or even stopping chemotherapy. No effective treatment for HFS can be available at present. Over the years we have used LC07, a kind of external agents from Chinese herbs (Herba Geranii, etc.), to treat capecitabine-induced HFS. In this study, the efficacy and safety of LC07 were evaluated in patients with MBC and HSF. Methods: Eligible patients includes patients with MBC, who had HFS (NCI-CTC grade ≥1) after receiving single capecitabine chemotherapy (1,250 mg/m2, PO, twice daily, cycled days 1–14, every 21 days). LC07 granules 10g was dissolved in 1,000mL of warm water (keep 34°C-37°C in a footbath), the patients soaked their feet and hands in this lotion for 20 minutes, twice daily for 7 days. An independent researcher assessed symptoms before and after treatment. Evaluation criteria, CR as symptom disappearing completely, PR as NCI-CTC grade for HFS decreasing by more than 1 level after treatment, the total response rate as CR+PR. The QOL of these patients were also evaluated before and after treatment using a FACT-B questionnaire (Version 4.0-Chinese). Results: 42 patients (pts) have been enrolled in this study. All of them are Asian and female. Media age 51.5 yrs (25–72). Grade 1 for HFS was seen in 8 pts, G2 in 19 pts, and G3 in 15 pts. The total response rate was 83.3% (35/42), CR 38.1% (16/42), PR 45.2% (19/42). The average time from therapy to pain relief was 1.8±0.8 days, the skin lesion of HFS including dermatitis, peeling, ulceration have been improved after treatment. The QOL scores before and after treatment were 77.24±25.69 and 109.17±20.53, respectively (p < 0.01). No side effects such as skin allergies related to LC07 was found in this study. Conclusions: In the treatment of capecitabine-induced HFS, the external Chinese medicine LC07 is fast effective for relieving pain, and it has the features of easy use and no skin allergies. Thus LC07 can improve the QOL of patients with MBC and HFS. No significant financial relationships to disclose.

P3808iBox-CRT: Better response, less complicated, equally fast

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
I Aguiar Ricardo ◽  
A Nunes-Ferreira ◽  
J Rigueira ◽  
J Agostinho ◽  
R Santos ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Response Rate ◽  
Control Group ◽  
Conduction Delay ◽  
Study Group ◽  
Automatic Assessment ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
The Mean

Abstract Introduction The optimization of the left ventricle (LV) pacing site guided by the electrical delay increases CRT response rate (RR), however it's necessary to develop technology that allows its universal use. Purpose The aim is automatically, and operator-independent, access the conduction delay between the right ventricular (RV) stimulus and the LV available veins in order to select the LV pacing site. It is further intended to compare the total procedure and radiation times in relation to an historical control group. Methods Prospective, single-center study that included patients undergoing CRT implant according to the current ESC Guidelines. All patients were submitted to a clinical, electrocardiographic and echocardiographic basal evaluation prior to CRT implantation and at 6 months of follow-up. To evaluate conduction delays between the RV lead and the LV available veins (RV-LV delay), an external interface - intelligent Box for CRT (iBox-CRT) was used. Four measurements in at least two different tributary veins were made. The implant of all the LV leads was guided by the longest measured delay. A positive response to CRT was defined as an improvement of >10% in left ventricle ejection fraction (LVEF) or a reduction of end-systolic volume (ESV)>15%. The results were compared to a control group (CG) of pts submitted to CRT implantation in the conventional way. Results 60 patients were included (68.3% males, 38% ischemic, mean age 67.4±10.2 years) and submitted to CRT implant (37 CRT-P; 23 CRT-D). At basal evaluation, LVEF was 28±7%, end-diastolic volume (EDV) was 200±73ml and ESV 145±64ml. CG (n=51) had similar characteristics. The RR was 85.7%, significantly higher compared to the CG (55.9%, p=0.003). The ESV reduced 38.2±3% in responders vs 5.7±2% in non-responders (NR) (p=0,005), EDV reduced 33.3±16% in responders vs 13.6±10% in NR (p=0.002), the mean LVEF improved 11% in responders vs −1% in NR (p=0.02). At follow-up, the mean ESV in the study group (SG) was 89±44 ml vs 132±75ml in the CG (p=0.002) and the EDV 136±51 vs 190±78 (p=0.007). In addition to a much better response rate, the responders in the study group had significantly higher mean LVEF at follow-up (39±11% vs 37±7%, p=0.032). The mean intra-procedure RV-LV delay was 187±34mseg. In the responder group the baseline delay was usually higher (190±35 msec) vs NR group RV-LV delay (165±23 msec; p=NS). Compared with CG, the automatic assessment of RV-LV delay with iBox-CRT did not increase fluoroscopy time (15±16min vs 18±16; p=NS) and shortened procedure time (65±34 vs 108±83min, p<0.005). Conclusions The iBox-CRT use enabled an automatic and operator independent RV-LV delays measurement, in order to implant the LV lead at the most delayed site. This technique translated into a major increase in CTR response rate, not compromising the procedure duration nor increasing the radiation exposure.

Prolonged continuous intravenous infusion interleukin-2 and lymphokine-activated killer-cell therapy for metastatic renal cell carcinoma.

1992 ◽  
Vol 10 (6) ◽  
pp. 960-968 ◽  
Author(s):  
J A Thompson ◽  
K L Shulman ◽  
M C Benyunes ◽  
C G Lindgren ◽  
C Collins ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Response Rate ◽  
Interleukin 2 ◽  
Maintenance Phase ◽  
Lak Cells ◽  
Total Response ◽  
Total Response Rate

PURPOSE Two consecutive protocols of continuous intravenous (CIV) infusion interleukin-2 (IL-2) and lymphokine-activated killer (LAK) cells were carried out in patients with metastatic renal cell carcinoma (RCC) to determine the response rate and toxicity. PATIENTS AND METHODS In both protocols, patients received induction IL-2 at 6 x 10(6) U/m2/d on days 1 to 5, and underwent leukapheresis on days 7 to 9 at the peak of rebound lymphocytosis. LAK cells were generated by a 5-day incubation with IL-2 at 1,000 U/mL, and were infused on days 12 to 14. For the first 20 patients (protocol A), maintenance IL-2 was administered at 6 x 10(6) U/m2/d on days 12 to 16. On the assumption that less IL-2 might be required to maintain rather than to induce LAK activity, and that a longer duration of maintenance IL-2 might enhance LAK survival and function in vivo, the protocol for the subsequent 22 patients (protocol B) was altered so that the maintenance phase consisted of a lower dose of IL-2 (2 x 10(6) U/m2/d) administered for a longer period of time (days 10 to 20). RESULTS In protocol A, there were two complete responses (CRs) and three partial responses (PRs), for a total response rate of 25%. One PR was surgically converted into a CR. The durations of the CRs are 36+, 18+, and 18+ months. Hypotension and capillary leak were most severe during maintenance, which limited the median duration of maintenance IL-2 to 4 days. In protocol B, no patient experienced severe hypotension, and the median duration of maintenance IL-2 was 9 days. Two patients exhibited a CR and seven a PR, for a total response rate of 41%. Two PRs were surgically converted to CRs. The durations of CR are 14+, 9+, 6+, and 5+ months. In both protocols, the CIV induction regimen resulted in marked rebound lymphocytosis (mean, 11,097/microL) and LAK-cell yield (mean, 18.1 x 10(10)). The cumulative response rate was 14 of 42 patients, or 33% (95% confidence interval, 19% to 47%). CONCLUSION These results demonstrate that both protocols of CIV IL-2 plus LAK cells have substantial antitumor activity, and that a longer maintenance phase of IL-2 at a lower dose is associated with significantly less toxicity without a loss of therapeutic efficacy.

Multivariate dimensions of hemotologic chaos indices for responders versus non-responders of patients with myelodysplastic syndromes (MDS) after treatment with ptx/cipro/decadron: A qualitative study

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 17540-17540
Author(s):  
R. R. Huang ◽  
A. Raza
Keyword(s):  
Chaos Theory ◽  
Response Rate ◽  
Dimensional Space ◽  
Medical Center ◽  
Median Number ◽  
White Blood Count ◽  
3 Dimensional ◽  
The Mean ◽  
Lower Magnitude

17540 Background: In our clinical study of 35 MDS patients who were treated with PTX/Cipro/Decadron, there was an 80% response rate in terms of achieving improved hematopoiesis (responders) during a 4-week period. The primary question of interest was, “What were the hematologic dynamic patterns that transpired between patients who responded versus those who did not?” The purpose of this study was an attempt to answer this question by applying chaos theory to peruse the underlying patterns that may have prognosis utility. Methods: Responders and non-responders were identified and were matched by age, sex, and FAB type. Only those patients who have sufficient and complete hematologic evaluations after treatment with at least 6 months follow-up to derive stable chaotic indices were included. The resulted sample was 3 patients from the non-responded group and 4 patients from the responded group. The three selected hematoloic parametes were white blood count, hemoglobin and platelets. The selected chaos index to indicate its magnitude of across time was the fractal dimension that has three components, namely capacity, information and correlational. Results: The mean ages for the non-responders and responders were 68 and 65, respectively. The median number of weeks evaluated was 38 for the non-responders and 35 weeks for the responders. The three hematologic parameters were analyzed simultaneously in the form of 3-dimensional space. Table indicates the chaos fractal indices for the two groups. Conclusion: Across the three indices, non-responders have an average of 7.4 % larger than responders, suggesting the former exhibited a relatively higher degree of “chaos” than the latter. For prognosis purpose, this result also suggests that patients who exhibit lower magnitude of the chaotic phenomena, will have a higher probability of responding to therapy. This work was done while the authors were at Rush-Presbyterian-St.Luke’s Medical Center. [Table: see text] No significant financial relationships to disclose.

scholarly journals Usefulness of chemoradiotherapy for inoperable gastric cancer

2017 ◽  
Vol 99 (4) ◽  
pp. 332-336 ◽  
Author(s):  
T Taki ◽  
Y Hoya ◽  
A Watanabe ◽  
T Nakayoshi ◽  
T Okamoto ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Response Rate ◽  
Response Rate ◽  
Local Treatment ◽  
Tumour Response ◽  
Distant Metastases ◽  
Recurrent Gastric Cancer ◽  
Late Adverse Effects ◽  
The Mean

Introduction Radiotherapy is not commonly used for the treatment of gastric cancer in Japan, where surgery is the standard local treatment. We report the results of chemoradiotherapy in patients with advanced or recurrent gastric cancer which was deemed difficult to treat surgically. Methods Twenty-one patients with gastric cancer (including sixteen with advanced/recurrent gastric cancer and five with poor general condition) underwent chemo-radiotherapy, for whom the therapeutic efficacy, toxicity and survival period were analysed. Results The tumour response to chemoradiotherapy was categorised as complete, partial, stable or progressive in 5, 9, 3, and 4 patients, respectively, with an overall response rate of 67%. No serious complications such as gastrointestinal perforation or bleeding occurred, and no cardiac, hepatic or renal dysfunction developed during the follow-up period. The mean survival time was 19.8 months (range, 3–51 months). One patient died of another disease, 18 died of primary cancer and the cause of death was unknown in 2 patients. Conclusions Chemoradiotherapy appears to be an effective treatment for localised gastric cancer without distant metastases, but further studies are needed to determine the indications for chemoradiotherapy and late adverse effects, as well as the chemotherapy regimens to be used.

Stuttering Therapy: The Relation Between Attitude Change and Long-Term Outcome

1978 ◽  
Vol 43 (3) ◽  
pp. 392-400 ◽  
Author(s):  
Barry Guitar ◽  
Colin Bass
Keyword(s):  
Behavior Change ◽  
Attitude Change ◽  
Therapy Outcome ◽  
Clinical Implications ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Mean ◽  
One Year

Previous research has indicated that attitude change generally follows behavior change in operant stuttering therapy programs. This study sought to examine the longterm therapy outcome of stutterers whose communication attitudes were not substantially normalized after fluency establishment and generalization. Posttransfer attitude scores of 20 stutterers were used to classify them into one of two groups: those whose communication attitudes had been modified to show less abnormality than the mean level for normal speakers, and those whose attitudes had not. Follow-up interviews with the 20 stutterers one year later indicated that those whose posttransfer attitudes were not substantially normalized stuttered significantly more. Theoretical and clinical implications are discussed.

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