scholarly journals The metabolic syndrome: setting the scene. The pros

2007 ◽  
Vol 4 (2_suppl) ◽  
pp. S1-S3 ◽  
Author(s):  
Sir George Alberti
Keyword(s):  
Metabolic Syndrome ◽  
Outcome Studies ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Metabolic Syndrome ◽  
Differences Of Opinion ◽  
Definition Of

Conclusion: The definition of metabolic syndrome needs further refinement and it requires long-term outcome studies to evaluate the various criteria definitively. In general, however, differences of opinion surrounding the syndrome are minor.

scholarly journals The Influence of the Metabolic Syndrome on the Short- and Long-Term Outcome After Carotid Endarterectomy

Angiology ◽  
2016 ◽  
Vol 68 (4) ◽  
pp. 306-314 ◽  
Author(s):  
Linda Visser ◽  
Bas M. Wallis de Vries ◽  
Douwe J. Mulder ◽  
Maarten Uyttenboogaart ◽  
Sterre van der Veen ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Carotid Endarterectomy ◽  
Density Lipoprotein ◽  
High Serum ◽  
Serum Triglycerides ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Metabolic Syndrome ◽  
Short And Long Term

The metabolic syndrome (MetS) is a cluster of risk factors for cardiovascular disease. The aim of this study is to determine the influence of MetS on short- and long-term outcome and survival after carotid endarterectomy (CEA). Between January 2005 and December 2014, data from all patients undergoing CEA were prospectively recorded. The metabolic syndrome was defined based on the presence of ≥3 of the following criteria: hypertension, high serum triglycerides, low levels of high-density lipoprotein cholesterol, high fasting serum glucose, and obesity. Primary end points were the occurrence of transient ischemic attack (TIA)/cerebrovascular accident (CVA), myocardial infarction, and mortality. A total of 564 interventions (in 525 patients) were performed, of which 244 (43.3%) were in patients who met the diagnosis of MetS. There were no differences in short- and long-term complications and overall survival between patients with and without MetS. Patients with diabetes mellitus (DM) had significantly more ipsilateral TIA/CVA after 30 days ( P = .001). The presence of MetS has no negative effect on the outcome after CEA. However, patients with DM have a significantly higher risk of ipsilateral TIA/CVA.

ANOREXIA NERVOSA

PEDIATRICS ◽  
1982 ◽  
Vol 70 (4) ◽  
pp. 525-525
Author(s):  
Robert J. Haggerty
Keyword(s):  
Anorexia Nervosa ◽  
Early Onset ◽  
Age Of Onset ◽  
Outcome Studies ◽  
Psychosomatic Disorder ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Follow Up Studies

Anorexia nervosa is a serious psychosomatic disorder which most typically begins between 16 and 18 years of age. Clinicians have often held that early onset (eg, ages 11 to 15) is associated with a better outcome. This paper reviews the long-term outcome studies on anorexia nervosa and concludes that this contention is not supported by available data. The methodologies of seven outcome studies that focus on an early onset population are critiqued, and it is concluded that two methodologies are strong. Because of the increasing prevalence of anorexia nervosa, this once rare disorder can now be more easily investigated, and consequently better follow-up studies, which examine potential prognostic factors including age of onset, should be forthcoming.

Adjustment Disorder and Its Clinical Management

2017 ◽  
Author(s):  
Mauro Giovanni Carta ◽  
Antonio Preti
Keyword(s):  
Adjustment Disorder ◽  
Operational Definition ◽  
Clinical Settings ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Key Words Adaptation ◽  
The One ◽  
Definition Of ◽  
Anxiety Depression

Adjustment disorder is a condition of subjective emotional distress triggered as a consequence of a meaningful change in life. The diagnosis of adjustment disorder is hindered by the difficult operational definition of stress and of its related concept of “vulnerability,” by the problem of disentangling symptoms of adjustment disorder from those attributable to comorbid anxiety and mood disorders, and by the poor boundaries of the disorder with other stress-related conditions on the one hand and with common adaptation to life events on the other. Despite the high frequency of its diagnosis in clinical settings, there has been relatively little research on the adjustment disorder and, consequently, very few hints about its treatments. Several psychotherapies have been developed to deal with patients diagnosed with adjustment disorder, with inconclusive evidence on their effectiveness. Antidepressants may abate the symptoms and help patients reacquire occupational and social functioning. The medium-term outcome of adjustment disorder is good, with 70 to 80% of those diagnosed with it showing no evidence of psychopathology when reassessed 5 years from the episode. However, when comorbid with a personality disorder or a substance use disorder, the short-term risk of suicide may be increased. The long-term outcome of adjustment disorder seems to be worse in children and adolescents than in adults. In particular, adolescents diagnosed with adjustment disorder were more likely than adults to have received a diagnosis of a severe mental disorder at the 5-year follow-up, including schizophrenia, schizoaffective disorder, and bipolar disorder. This review contains 1 figure, 6 tables, and 52 references. Key words: adaptation, adjustment disorder, anxiety, depression, stress, trauma, treatment, vulnerability

Primum Nocere (First to Harm) Countertransference and Poisonous Pedagogy: A Hypothesis to Explain Why Psychiatrists Promote Dangerous, Harmful, and Ineffectual Neuroleptic Drugs

2013 ◽  
Vol 15 (2) ◽  
pp. 87-99
Author(s):  
Joseph Tarantolo
Keyword(s):  
Endocrine System ◽  
Biological Psychiatry ◽  
First Line ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Psychological Phenomena ◽  
Working Definition ◽  
Definition Of ◽  
Psychiatric Power

This article will briefly review the case that multigenerations of neuroleptic (NL) drugs are dangerous: causing brain damage, shortening life span, disrupting the endocrine system, interfering with cognitive function, and are half as likely to have a positive long-term outcome as are nonmedical approaches. Given this dismal record, the writer will address the question of why then are they the first line of treatment for seriously disturbed patients? This article will explore how a corrupt and corrupting system of pharmaceutical science and psychiatric power feeds the insecurities of psychotherapists who treat these patients. The author posits the theory that countertransferential phenomena, as elaborated by (Searles, 1979; Winnicott, 1949; and Miller, 1980) (hate, fear, guilt, powerlessness, inability to comfort, capitulation to manipulation, and rationalizations that delusions are biological rather than psychological phenomena), prevent the therapist from properly doing his job. This article will offer a working definition of acute psychosis as unexplored eccentric thinking that will support nonpharmacological psychotherapeutic intervention and distinguish between enlightened and unenlightened biological psychiatry.

scholarly journals Proposal of a New Definition of “Very Early” Intrahepatic Cholangiocarcinoma—A Retrospective Single-Center Analysis

2021 ◽  
Vol 10 (18) ◽  
pp. 4073
Author(s):  
Oliver Beetz ◽  
Angelica Timrott ◽  
Clara A. Weigle ◽  
Andreas Schroeter ◽  
Sebastian Cammann ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Intrahepatic Cholangiocarcinoma ◽  
Tumor Size ◽  
Tumor Biology ◽  
Extrahepatic Disease ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Definition Of

Intrahepatic cholangiocarcinoma (ICC) is a rare disease with poor outcome, despite advances in surgical and non-surgical treatment. Recently, studies have reported a favorable long-term outcome of “very early” ICC (based on tumor size and absence of extrahepatic disease) after hepatic resection and liver transplantation, respectively. However, the prognostic value of tumor size and a reliable definition of early disease remain a matter of debate. Patients undergoing resection of histologically confirmed ICC between February 1996 and January 2021 at our institution were reviewed for postoperative morbidity, mortality, and long-term outcome after being retrospectively assigned to two groups: “very early” (single tumor ≤ 3 cm) and “advanced” ICC (size > 3 cm, multifocality or extrahepatic disease). A total of 297 patients were included, with a median follow-up of 22.8 (0.1–301.7) months. Twenty-one (7.1%) patients underwent resection of “very early” ICC. Despite the small tumor size, major hepatectomies (defined as resection of ≥3 segments) were performed in 14 (66.7%) cases. Histopathological analyses revealed lymph node metastases in 5 (23.8%) patients. Patients displayed excellent postoperative outcome compared to patients with “advanced” disease: intrahospital mortality was not observed, and patients displayed superior long-term survival, with a 5-year survival rate of 58.2% (versus 24.3%) and a median postoperative survival of 62.1 months (versus 25.3 months; p = 0.013). In conclusion, although the concept of a “very early” ICC based solely on tumor size is vague as it does not necessarily reflect an aggressive tumor biology, our proposed definition could serve as a basis for further studies evaluating the efficiency of either surgical resection or liver transplantation for this malignant disease.

Adjustment Disorder and Its Clinical Management

2017 ◽  
Author(s):  
Mauro Giovanni Carta ◽  
Antonio Preti
Keyword(s):  
Adjustment Disorder ◽  
Operational Definition ◽  
Clinical Settings ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Key Words Adaptation ◽  
The One ◽  
Definition Of ◽  
Anxiety Depression

Adjustment disorder is a condition of subjective emotional distress triggered as a consequence of a meaningful change in life. The diagnosis of adjustment disorder is hindered by the difficult operational definition of stress and of its related concept of “vulnerability,” by the problem of disentangling symptoms of adjustment disorder from those attributable to comorbid anxiety and mood disorders, and by the poor boundaries of the disorder with other stress-related conditions on the one hand and with common adaptation to life events on the other. Despite the high frequency of its diagnosis in clinical settings, there has been relatively little research on the adjustment disorder and, consequently, very few hints about its treatments. Several psychotherapies have been developed to deal with patients diagnosed with adjustment disorder, with inconclusive evidence on their effectiveness. Antidepressants may abate the symptoms and help patients reacquire occupational and social functioning. The medium-term outcome of adjustment disorder is good, with 70 to 80% of those diagnosed with it showing no evidence of psychopathology when reassessed 5 years from the episode. However, when comorbid with a personality disorder or a substance use disorder, the short-term risk of suicide may be increased. The long-term outcome of adjustment disorder seems to be worse in children and adolescents than in adults. In particular, adolescents diagnosed with adjustment disorder were more likely than adults to have received a diagnosis of a severe mental disorder at the 5-year follow-up, including schizophrenia, schizoaffective disorder, and bipolar disorder. This review contains 1 figure, 6 tables, and 52 references. Key words: adaptation, adjustment disorder, anxiety, depression, stress, trauma, treatment, vulnerability

Significance of Suboptimal Response to Imatinib, as Defined by the European LeukemiaNet, in Long-Term Outcome for Patients (Pts) with Chronic Phase (CP) Chronic Myeloid Leukemia (CML).

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1932-1932 ◽  
Author(s):  
Yesid Alvarado ◽  
Hagop Kantarjian ◽  
Stefan Faderl ◽  
Jan Burger ◽  
Gautam Borthakur ◽  
...  
Keyword(s):  
Chronic Phase ◽  
Cytogenetic Response ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Complete Hematologic Response ◽  
Starting Dose ◽  
Prognostic Implications ◽  
Definition Of

Abstract The European LeukemiaNet recently published recommendations for evaluating response to imatinib among pts with CML. Criteria for failure and suboptimal responses were proposed. The significance of failure is accepted and constitutes grounds for change in treatment. The prognostic implications of having a suboptimal response are less clear making treatment decisions less clear in this setting. We analyzed the outcome of 281 pts treated with imatinib as frontline therapy for CML in CP: 73 at initial dose of 400mg daily and 208 at 800mg daily. Their median age was 48 yrs (range, 15 to 84 yrs) and their median follow-up 48 months (mo) (2–79 mo). After 3 mo of therapy none of the 273 evaluable pts met definition of suboptimal response according to the European LeukemiaNet, while 3 of 273 (1%) met definition for failure. At 6 mo 10/259 (4%) evaluable had suboptimal response and 9 (3%) failure. At 12 mo 19/246 (8%) had suboptimal and 14 (6%) failure, and at 18 mo 91/224 (41%) had suboptimal and 21 (9%) had failure. The probability of having a suboptimal response at 6 and 12 mo was significantly higher for pts treated with a starting dose of 400mg than those treated at 800mg: at 6 mo [12% suboptimal at 400mg vs 1% at 800mg (p=0.002)] and at 12 mo [17% and 4%, respectively (p<0.001)]. The outcome at 24 months* by the response at specific times was as follows: Time Response % CCyR % MMR % Transf % Event CCyR=Complete cytogenetic remission, MMR=Major molecular remission, Transf=Transformation to accelerated or blast phase, Event=loss of complete hematologic response, loss of major cytogenetic response, transformation, or death 6 mo Optimal 91 60 2 6 Suboptimal 0 0 30 50 Failure 0 0 22 67 P .001 .001 .001 .001 12 mo Optimal 94 63 2 4 Suboptimal 56 25 0 16 Failure 0 0 21 57 P .001 .001 .001 .001 18 mo Optimal 98 85 0 1 Suboptimal 93 39 2 5 Failure 15 0 19 43 P .001 .001 .001 .001

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