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Objective:To explore the effect of attentional bias training on the attentional bias, psychological craving and relapse rate of alcohol dependent patients during rehabilitation.Methods:A randomized controlled trial was used to select 90 alcohol-dependent patients and randomly divide them into an intervention group and a control group. The alcohol cue pictures and neutral pictures were imported into E-Prime software at a ratio of 1∶1.The patients in the two groups were trained for eight times with attentional bias and without attentional bias by point delection paradigm. After each training, the software automatically records the response time and correct rate of the cue pictures and neutral pictures, and before intervention(T0), after 4 interventions(T4), and after 8 interventions(T8), the alcohol craving score was assessed by visual analogue scale and the relapse situation was followed up 1 month after the intervention. SPSS 24.0 software was used for statistical analysis.Repeat measure ANOVA, χ2 test and t-test were used to compare the response time, accuracy and psychological craving of the two groups. Results:Repeated measurement analysis of variance showed that there were interaction between group and time in cue-map response time, line chart accuracy and psychological craving score of the two groups ( F=5.218, 6.939, 147.14, all P<0.01). Simple effect analysis showed that there was no significant difference in cue pictures response time, cue pictures accuracy and psychological craving score between the intervention group and the control group at T0(all P>0.05), but there was significant difference at T4 and T8 (all P<0.05), and there was significant difference in neutral pictures reaction only at T8 ( P<0.05). The comparison between two groups showed that the intervention group showed a downward trend in cue pictures response, T4 and T8 were lower than T0, with statistical difference (both P<0.001), while there was no difference in the control group. In the intervention group, the correct rate of cue pictures increased, T4 and T8 were higher than T0, and there were statistical differences (both P<0.001), while there was no difference in the control group( P>0.05). The psychological craving scores of both the intervention group and the control group showed a downward trend, T4 and T8 were lower than T0, there were statistical differences (both P<0.001), but the difference between T4 and T8 in the control group remained unchanged. One month after the end of the intervention, the difference in the rate of relapse between the intervention group and the control group was marginal (11.10%, 26.70%, P=0.059). The total number of days of abstinence in the intervention group was longer than that in the control group ((28.33±4.99)d, (26.47±6.66)d, P=0.010). Conclusion:Attentional bias training can improve the mental craving and attentional bias of alcohol-dependent patients during the rehabilitation period, and the relapse rate decreased one month after the intervention.
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Objective:To explore the effect of alcohol abstinence intervention based on timing theory on patients with alcoholic liver disease.Methods:A total of 106 patients with alcoholic liver disease hospitalized in the Department of liver disease of Taian Medical District, 960th Hospital of Chinese PLA from July 2018 to June 2019 were selected by convenience sampling method and divided into observation group and control group by random digits table method, 53 cases in each group. The control group received routine nursing, and through the improvement of patients' cognition and support system, implemented short abstinence intervention during hospitalization; the observation group received abstinence intervention based on timing theory on the basis of the control group intervention. At 1 month and 6 months after discharge, the differences of rehydration rate, alcohol dependence and physical and mental status between the two groups were compared.Results:Finally, 49 cases in the control group completed the study, and 51 cases in the observation group completed the study. The rehydration rates of the observation group were 21.57%(11/51) and 15.69%(8/51) respectively at 1 month and 6 months after discharge, while those of the control group were 40.82%(20/49) and 36.73%(18/49) respectively at 1 month and 6 months after discharge. The difference was statistically significant ( χ2 values were 4.328, 5.754, P<0.05). The alcohol dependence scores were 0(2,3), 0(1,2) in the observation group and 2(0,3), 3(1,4) in the control group at 1 month and 6 months after discharge, and the difference was statistically significant ( Z values were -6.719, -7.345, P<0.01). There was no significant difference in the score of Symptom Checklist-90(SCL-90) before intervention and 1 month after discharge between the two groups ( P>0.05). Six months after discharge, the score of SCL-90 was 8.26 ± 1.37 in the observation group and 10.11 ± 1.68 in the control group, and the difference was statistically significant( t value was 6.046, P<0.01). Conclusions:The application of timing theory in alcohol abstinence of patients with alcoholic liver disease can significantly reduce the relapse rate and the degree of alcohol dependence of patients with alcoholic liver disease, improve the physical and mental state of patients.
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Abstract Objective Acute lymphoblastic leukemia is the most common childhood cancer, yet surprisingly, very few studies have reported the treatment outcomes and the relapse rate of patients from low/middle-income countries. Method This study was a 5-year retrospective cohort study. It was conducted at Oncology Center of Mansoura University in Egypt and aimed to estimate the treatment outcomes and the relapse rates of newly diagnosed acute lymphoblastic leukemia in children. Results Two hundred children suffering from acute lymphoblastic leukemia were studied; forty-six patients (23%) died during induction and most of those deaths were related to infection. Forty-one patients (27%) relapsed out of the 152 patients who achieved complete remission. The most common site of relapse was the bone marrow, followed by the isolated central nervous system, 53.7% and 31.7%, respectively. Seventy-eight percent of relapses occurred very early/early rather than later. The majority of relapse patients' deaths were related to infection and disease progression. The 5-year overall survival rate for patients was 63.1% (82.1% for non-relapsed compared to 36.6% for relapsed patients). Conclusion There was a high incidence of induction deaths related to infection and high percentages of very early/early relapses, with high mortalities and low 5-year overall survival rates. These findings suggest the urgent need for modification of chemotherapy regimens to be suitable for the local conditions, including implementation of supportive care and infection control policies. There is also a requirement for antimicrobial prophylaxis during induction period combined with the necessary increase in government healthcare spending to improve the survival of acute lymphoblastic leukemia in Egyptian children.
Resumo Objetivo Estimar os desfechos do tratamento e as taxas de recidiva de crianças recém-diagnosticadas com leucemia linfoblástica aguda. É o câncer infantil mais comum, mas surpreendentemente poucos estudos relataram os desfechos do tratamento e a taxa de recidiva em pacientes de países de renda baixa/média. Método Estudo de coorte retrospectivo de cinco anos. Foi feito no Centro de Oncologia da Universidade de Mansoura, no Egito. Resultados Foram estudadas 200 crianças com leucemia linfoblástica aguda, das quais 46 (23%) morreram durante a indução e a maioria dessas mortes estava relacionada à infecção. Dos 152 pacientes que alcançaram a remissão completa, 41 (27%) apresentaram recidiva. O local mais comum de recidiva foi a medula óssea, seguido pelo sistema nervoso central isolado, com 53,7% e 31,7% dos casos, respectivamente. Das recidivas, 78% ocorreram muito precocemente ou precocemente, em vez de tardiamente. A maioria das mortes de pacientes com recidiva estava relacionada à infecção e progressão da doença. A taxa de sobrevida global em cinco anos para os pacientes foi de 63,1% (82,1% para não recidivados em comparação com 36,6% para os recidivados). Conclusão Houve uma alta incidência de mortes na indução relacionadas à infecção e altos percentuais de recidivas muito precoces ou precoces, com altas taxas de mortalidade e baixas taxas de sobrevida global em cinco anos. Nossos achados sugerem a necessidade urgente de modificação dos esquemas quimioterápicos para adequação às nossas condições locais, implantação de políticas de cuidados de suporte e controle de infecções. Há também a necessidade de profilaxia antimicrobiana durante o período de indução, junto com um aumento necessário nos gastos governamentais com a saúde, para melhorar a capacidade de sobrevivência das crianças egípcias com leucemia linfoblástica aguda.
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Humans , Child , Developing Countries , Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/therapy , Recurrence , Remission Induction , Survival Rate , Retrospective Studies , Treatment Outcome , EgyptABSTRACT
@#BACKGROUND: Several trials on relapse rates on duration of multibacillary regimens have varying results. OBJECTIVE: To compare the relapse rate among smear-positive Leprosy patients receiving 12 blister packs of multibacillary drug therapy and 24 blister packs of multibacillary drug therapy. METHOD: A review of records of smear positive Leprosy patients seen from 2002 to 2006 was done. Demographic, clinical and therapeutic data were collected. Bacteriologic index was determined from Leprosy Laboratory records. RESULT: A total of 391 patients were found to have complete records for review and analysis. Relapse rate was 11.9%(28) for patients who received 12 blister packs and 1.91%(3) for patients who received 24 blister packs and the difference was found to be statistically significant (p<0.01). Distribution of relapse was statistically significant according to age (p<0.01), bacteriologic index (p<0.01) and clinical spectrum (p<0.01). CONCLUSION: Relapse rates shown among smear positive leprosy patients receiving 12 blister packs vs. those receiving 24 blister packs was statistically higher which differs from previously published studies. Significant predictors were clinical spectrum, bacteriologic index of >3.5, and >4 and number of blister packs.
Subject(s)
Leprostatic Agents , Drug Therapy, Combination , Leprosy , Recurrence , Chronic DiseaseABSTRACT
@#AIM: To explore the possible application of quadrant classification in retinopathy of premature infants at threshold and type 1 pre-threshold stage.<p>METHODS: Thirty-two preterm infants with retinopathy at the threshold and type 1 threshold preterm stage in the Affiliated Eye Hospital of Nanchang University from April 2017 to January 2018 were recruited for retrospective case analysis. The main location and stage of the retinopathy in these premature infants were divided into three categories by the quadrant method: only one quadrant(above the nose, subnasal, supratemporal, and subtemporal)recorded as “1 quadrant”; distributed in two quadrants(supertemporal+infratemporal, supra-nasal+sub-nasal, supra-nasal+super-temporal, sub-nasal+sub-temporal, supra-nasal+sub-temporal, sub-nasal+super-temporal)were recorded as “2 quadrants”; distributed more than two quadrants recorded as “>2 quadrants”. The clinic characteristics of all cases and the responses to intravitreal injection of ranibizumab were observed according to the quadrant method. <p>RESULTS: Totally 32 cases with 62 eyes of premature infants recruited in the study. Only 2 eyes were in 1 quadrant before surgery, and the efficiency of a single injection was 100%. A total of 25 eyes were distributed in 2 quadrants, and with a single injection, the effective rate was 100%. 35 eyes with a distribution “2 quadrants” had a single injection rate of only 74% and a recurrence rate of 26%. <p>CONCLUSION: The main lesions in most cases are distributed in “2 quadrants”(supertemporal+subtemporal). The more of quadrants accumulated for the major lesions and the more severe of the condition; the higher recurrence rate after intravitreous anti-VEGF therapy.
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Objective: To observe short-term and long-term efficacies of Danlu Tongdu tablets on lumbar disc herniation (LDH) with kidney deficiency and stasis syndrome, and its effect on nucleus pulposus reabsorption and immunoinflammatory factors. Method: One hundred and sixty patients were randomly divided into control group (80 cases) and observation group by random number table. Patients in control group (80 cases) got acupoint massage and acupuncture, 1 time/day. In addition to the therapy of control group, patients in observation group were also given Danlu Tongdu tablets, 4 tablets/time, 3 times/days. A course of treatment was 12 weeks, and a 9-month follow-up was recorded. Lumbago and leg pain were recorded by visual simulation (VAS) before treatment and at the first, second, third month after treatment. Before and after treatment, Japanese orthopaedic association (JOA), symptoms and signs were scored. During the 9-month follow-up, relapse rate and relapse time were recorded, and VAS and JOA were scored. Absorption of nucleus pulposus was assessed, and levels of interleukin-1 (IL-1), IL-17, tumor necrosis factor-α (TNF-α), matrix metalloproteinases-3 (MMP-3) were detected. Result: By rank sum test, the clinical efficacy in observation group was better than that in control group (Z=2.125, PZ=1.924, PPPPPχ2=5.138, Pα and MMP-3 were lower than that in control group (Pχ2=4.668, PPPPConclusion: In addition to acupuncture and massage therapy, Danlu Tongdu tablets can also be used to relieve pain and ameliorate function, improve clinical efficacy, reduce relapse rate, promote nucleus pulposus reabsorption, and relieve inflammation of nerve root.
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Objective To observe the clinical efficacy of acupuncture-moxibustion in treating endometriosis (EM). Method Fifty EM patients were randomized into two groups, 25 cases in each group. The treatment group was intervened by acupuncture-moxibustion, while the control group was intervened by oral administration of Mifepristone tablets. Abdominal pain, pelvic lump, and relevant indicators were observed before and after the treatment, and the therapeutic efficacies were compared.Result After 6-month treatment, symptoms including abdominal pain obviously subsided in the treatment group and the total effective rate was 92.0%, versus 52.0% in the control group, and the between-group difference was statistically significant (P<0.01). The pelvic lump size was significantly changed after the treatment in both groups (P<0.05), suggesting that the lump size became smaller in both groups after the treatment;there was a significant difference in comparing the pelvic lump size between the two groups after the treatment (P<0.05), indicating that the lump size was reduced more significantly in the acupuncture-moxibustion group. The level of serum CA125 changed significantly after the treatment in both groups (P<0.05), suggesting that serum CA125 dropped in both groups after the treatment; there was a significant difference in comparing the level of serum CA125 between the two groups after the treatment (P<0.05), indicating that serum CA125 dropped more significantly in the acupuncture-moxibustion group. A year later, there was a significant difference in comparing the relapse rate between the two groups (P<0.05), revealing that the relapse rate was significantly lower in the acupuncture-moxibustion group than in the medication group.Conclusion Acupuncture-moxibustion can produce a marked therapeutic efficacy in treating EM.
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Objective To observe the clinical efficacy of moxibustion plus anus-lifting exercise in preventing hemorrhoids relapse.Method Seventy eligible patients with mixed hemorrhoids whose symptoms had been released by conservative treatment were randomized into a treatment group and a control group, 35 cases in each group. The treatment group was intervened by moxibustion plus anus-lifting exercise, while the control group only practiced anus-lifting exercise. The intervention was conducted successively for 4 weeks. Symptoms including hematochezia, bearing-down pain, prolapse, and size of hemorrhoid were scored in the 1st, 2nd, 3rd, and 4th treatment weeks as well as the 4th week after the intervention, meanwhile, the relapse rates of the above symptoms were observed.Result In the 3rd treatment week, there were significant differences in comparing the scores of prolapse, bearing-down pain, and hemorrhoid size between the two groups (allP<0.05); in the 4th treatment week and the 4th week after the intervention, there were significant differences in comparing the scores of hematochezia, prolapse, bearing-down pain and hemorrhoid size between the two groups (allP<0.05); in the 4th week after the intervention, there were significant differences in comparing the relapse rates of hematochezia, bearing-down pain, prolapse and hemorrhoid size between the two groups (P<0.05).Conclusion Moxibustion plus anus-lifting exercise can produce a significant efficacy in preventing the hemorrhoids relapse.
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Objective To investigate the clinical efficacy of dog days' acupoint application in treating allergic rhinitis and assess its safety.Methods Two hundred and forty-nine patients were randomly allocated to a dog days' acupoint application group of 166 cases and a placebo group of 83 cases. The two groups were received treatment at the first day of the first, second and last periods of the hot season The dog days' acupoint application group received acupoint application of Chinese herbal medicine and the placebo group, acupoint application of non-medicinal placebo. In the two groups, the symptoms and signs were scored and the VAS score was recorded before and after treatment and during the follow-up period, and adverse reactions and relapses were observed and the clinical therapeutic effect of acupoint application and its safety were assessed after treatment and during the follow-up period.Results The total efficacy rate was 69.8% in the dog days' acupoint application group and 44.4% in the placebo group. The therapeutic effect was significantly better in the dog days' acupoint application group than in the placebo group (P0.05). The relapse rate was 46,6% at the 6-month follow-up and 62.1% at the 12-month follow-up in the dog days' acupoint application group and 85.2% and 95.1% in the placebo group; there were statistically significant differences between the two groups (P<0.01).Conclusions Dog days' acupoint application has better short-term and long-term therapeutic effect on allergic rhinitis with a low relapse rate and high safety.
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Objective Analyze the demographics, clinical characteristics, efficacy and safety of natalizumab treatment in Brazilian patients with multiple sclerosis (MS) followed up for at least 12 months, in two tertiary MS care centers in São Paulo.Method We evaluated the effect of natalizumab treatment on annualized relapse rate and disability progression in 75 patients with MS treated with natalizumab for at least 12 months. A subgroup analysis was performed to evaluate efficacy of natalizumab treatment in patients with Expanded Disability Status Scale (EDSS) ≤ 3.0 vs patients with EDSS > 3.Results Patients treated for at least one year with natalizumab showed a 91% reduction in aRR, as well and an improvement in neurological disability. The impact of natalizumab treatment was greater in patients with EDSS < 3.0. Overall, natalizumab was safe but one patient developed progressive multifocal leukoencephalopathy.Conclusion Natalizumab as a third line therapy is safe and efficacious, especially in patients with mild neurological disability.
Objetivo Analisar as características clínicas e demográficas, assim como a eficácia e segurança do tratamento com natalizumabe (usado em terceira linha), por no mínimo 12 meses, em pacientes brasileiros acompanhados em dois centros de tratamento de esclerose múltipla, na cidade de São Paulo.Método Avaliamos o efeito do tratamento com natalizumabe na taxa anualizada de surto (aRR) e progressão de incapacidade (medida por Expanded Disability Status Scale (EDSS)) em 75 pacientes tratados por, no mínimo 12 meses. Realizamos uma análise de subgrupo em pacientes com EDSS ≤ 3,0 e com EDSS > 3, para avaliar o impacto no tratamento, considerando-se o grau de incapacidade neurológica.Resultados O tratamento com natalizumabe, por pelo menos um ano, reduziu a aRR em 91%, assim como melhorou a incapacidade neurológica. Em pacientes com EDSS ≤ 3,0 observamos um impacto maior do tratamento na incapacidade neurológica, reduzindo sua progressão em 51%, durante o período do estudo. O tratamento com natalizumabe é seguro, porém um paciente desenvolveu leucoencefalopatia multifocal progressiva.Conclusão O tratamento com natalizumabe, em terceira linha terapêutica é seguro e eficaz especialmente, em pacientes com incapacidade neurológica leve (EDSS ≤ 3.0).
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Adult , Female , Humans , Male , Immunologic Factors/therapeutic use , Multiple Sclerosis/drug therapy , Natalizumab/therapeutic use , Brazil , Recurrence , Retrospective Studies , Treatment OutcomeABSTRACT
Objective The aim of the study is to study the effect of manual massage on relapse rate and quality of life of grand mal epilepsy patients.Methods Using prospective research method,clinical data of patients with epileptic seizures and without attack up to 3 years and undergoing withdrawal of drugs for one year were collected.The grand mal epilepsy patients were randomly divided into the experimental group and the control group (76 cases in each group).The experimental group was given manual massage.The control group was not given manual massage.Both groups were given follow-up for 1 year.The relapse rate and quality of life were compared between two groups.Results The relapse rate of the ex perimental group was 17％,and that of the control group was 33％,the difference was significant.The score of life quality in the experimental group was significantly better than that of the control group.Conclusions Manual massage can reduce relapse rate and improve quality of life for patients with epileptic seizures after withdrawal of drugs,which is worthy of wide application.
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ObjectiveTo investigate environmental factors of the relapse of alcohol dependence.MethodsOne hundred and seventeen in-patients with alcohol dependence were assessed with a home-designed questionnaire,Family Environment Scale Chinese Version (FES-CV),Clinic Institute Alcohol Withdrawal Syndrome Scale Chinese Version(CIWA-Ar) and the Scale of Personality Change Post-Traumatic Brain Injury(SPCPTBI).One hundred and five patients reassessed with alcohol dependence syndrome diagnostic criteria 1 year after hospitalization.t -test,chi-square and logistic regression were used for analysis.Results 57 of 105 were relapse and 48 of them were not relapse.The results showed that relapse group had a higher divorce or separated or remarried rate (21/36) than the no-relapse one (7/41 ) ( chi-square =6.60,P =0.010) ; a less number of years of education (5.2 ± 1.8 vs 7.2 ± 1.7,t =5.64,P =0.000) ; a bigger daily drinking ( (512 ± 186) ml vs (396 ± 109) ml,t =3.93,P =0.000) ; a higher drinking frequency in relapse group ( (2.6 ± 0.9 ) vs ( 1.8 ± 0.6) times,t =5.38,P=0.000) ;a higher rates in personality change(47/57 vs 15/48 ),brain damages (27/57 vs 13/48 ) and mood disorders (35/57 vs 17/48 ),They also showed that relapse group had more problems on intimate degree (5.66 ±1.40 vs 6.20 ± 1.20),emotional expression (4.59 ± 1.54 vs 5.41 ± 1.26,independence (3.61 ± 1.29 vs 4.64± 1.49),organization (4.26 ± 1.56 vs 5.22 ± 1.18 ),and self-controlling (4.21 ± 1.43 vs 5.12 ± 1.12 ),the differences were significant (P＜0.05) ;a higher contradiction score(4.35 ± 1.73 vs 3.64 ± 1.22,t =2.42,P =0.017).Logistic regression analysis showed that the number of daily drinking,intelligent damaged,emotional problems,arid dependence were the risk factors for the alcoholic relapse ( OR =7.44,3.99,3.92,2.96) ;Self-controlling was the protective factors for the alcoholic relapse ( OR =0.19).ConclusionProblem marital status,less education,and heavy drinking,and the number of drinking times,personality change,intellectual impairment and mood change,and poor family environment were the risk factors for the relapse of alcohol dependence.
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PURPOSE: To investigate the efficacy of early infliximab use and to follow the progress of pediatric cases of Crohn's disease for 3 years. METHODS: We reviewed the medical records of 28 pediatric patients who had been treated with infliximab for Crohn's disease. Eighteen patients (the 'top-down' group) received infliximab and azathioprine for induction and maintenance therapy for the first year, and then were treated with azathioprine for 2 additional years. Ten patients who were refractory to conventional therapy were categorized in the 'step-up' group. All patients were followed for at least 36 months. Treatment efficacy was assessed by the relapse rate using the pediatric Crohn's disease activity index (PCDAI) score in each group at 12, 24, and 36 months. Blood samples were available from 10 patients, and were used to assess antibody to infliximab (ATI). RESULTS: The relapse rate in 'top-down' group was lower than that in 'step-up' group at 1, 2, and 3 years. But, just the relapse rate at the 2 years was significantly different. At 3 years, the relapse rate according to different characteristic variables (sex, age at diagnosis, involvement, PCDAI at diagnosis) was not significantly different. Only one patient treated with infliximab had an adverse event, consisting of dyspnea and tachycardia. ATI was not detected in the blood samples from 10 patients. CONCLUSION: Early induction with infliximab at diagnosis ('top-down' therapy) is effective for reducing the relapse rate compared to conventional therapies in pediatric Crohn's disease possibly for up to 3 years.
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Humans , Antibodies, Monoclonal , Azathioprine , Crohn Disease , Dyspnea , Follow-Up Studies , Medical Records , Recurrence , Tachycardia , Treatment Outcome , InfliximabABSTRACT
Background Multiple drug therapy for leprosy has been in use in Malaysia since 1985. The SBAMDT is a modified WHO-MDT with an initial intensive phase and a longer duration of treatment. Objective The aim of the study is to compare the efficacy and safety of SBA-MDT against WHOMDT in the Treatment of Leprosy in Malaysia. Methodology A retrospective study was conducted between 1985 and 2009 in thirteen Malaysian dermatology centres. Data collected were analysed for comparison of relapse rates, compliance rates and adverse drug effects between the 2 regimes. Results A total of 1113 patients were included, of which 966 patients completed the SBA-MDT and 147 patients completed the WHO-MDT. Both the MDT regimes had a treatment failure rate of less than 2%. The relapse rate was 1.7% with SBA-MDT and 1.4% with WHO-MDT (p = 0.79). For multibacillary leprosy, the relapse rates were 0.9% with the former and 0 with the latter (p = 0.32). For paucibacillary leprosy, it was 3.1% and 5.0% respectively (p = 0.52). Patients on SBA-MDT had higher type 1 (16.1% vs. 8.8%, p = 0.03) and type 2 lepra reactions (19.2% vs. 6.1%, p < 0.001). Similarly, those on SBA-MDT also had higher rate of severe adverse drug reactions (11.1% vs. 5.6%, p = 0.01). Conclusion Both the SBA-MDT and the WHO-MDT regimes were effective in inducing clinical remission. Incidence of lepra reactions and severe adverse drug reactions were higher in patients with SBA-MDT.
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Introduction: Brucellosis, a serious zoonosis, is a widespread disease in many countries, especially the developing ones, with an annual report of 500,000 new cases to the World Health Organization (WHO). Although successful results have been achieved by the combination therapies recommended by the WHO, their relapse rates have been high, and therefore, the most effective agents with least side-effects are still undetermined. Materials and Methods: An observational study has been prospectively carried out from 2007 to 2010 in the Infectious Clinics of Hashemi-nejad and Imam Reza Hospitals, Mashhad, Iran. In this study, among the patients of brucellosis, whose diseases were recently diagnosed, 50 patients, receiving one of the two common authentic regimens of doxycycline plus rifampin for eight weeks or ciprofloxacin plus rifampin for six weeks, were selected. The diagnosis was based on the presence of signs and symptoms compatible with brucellosis, including a positive Wright and 2ME tests, with titers equal to or more than 1/160 and 1/40 respectively. Results: The cure rate was the same for the groups (P=0.55). However, the relapse rate was much more for the latter (P= 0.02). Conclusion: Doxycycline plus rifampin was considered better than ciprofloxacin plus rifampin for the treatment of acute brucellosis.
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Objective: To determine the significantly associated factors with the relapse rate in chronic hepatitis C patients treated with conventional interferon and their predictive strength through the regression model. Material & Methods: In a retrospective analysis of 244 patients, result of PCR, gender, fatty liver, diabetes, abnormal ALT at start and end of treatment were the qualitative variables. Age, weight, ALT at start and end of treatment, hemoglobin, platelets and WBC at start of treatment were quantitative variables. Bivariate, multivariate analysis and odds ratio were computed to verify statistically significant association with relapse rate by running binary logistic regression model. Results: Out of total 244 patients there were 54.1% male and 45.9% female. Eighty two (33.6%) patients had weight > 70 Kg, 30 (12.3%) had fatty liver, 18 were (7.4%) diabetic, 12 (4.9%) had normal ALT at start of therapy and 140 (57.4%) had abnormal ALT at the end. Eighty four (34.4%) patients relapsed while 160 (65.6%) maintained SVR after 6 month to 2 years of completion. In bivariate analysis, age, weight, fatty liver, high fever, decrease and increase in Hb were found significant. The binary logistic regression revealed the significant association of weight (OR=84.813; p=0.000), high fever (OR=4.478; p= 0.038) and Hb increase at 1st month (OR=0.037; p=0.013) with relapse rate. Nagelkerke R Square and Cox & Snell R Square statistics explained 71.1% and 51.1% variation in the model respectively and 93.1% area under the curve gave it very good prediction strength.
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Objective The purpose of this study is to determine the outcome of patients with acne vulgaris treated with oral isotretinoin from January 2003 till January 2008. Methodology This is a 5-year retrospective study of patients with acne vulgaris who were started on oral isotretinoin from January 2003 to January 2008. Only patients who have completed at least 4 months of treatment were included. Case notes were retrieved and analyzed with regards to demographic data, total cumulative dose of oral isotretinoin, duration of treatment, average daily dose of isotretinoin, response, relapse and subsequent treatment. Patients who defaulted follow-up were contacted via phone to ascertain if they had any relapse. Laboratory data that were analyzed included serial liver enzymes, total cholesterol, triglyceride and LDL levels. Results A total of 110 case notes were reviewed but only 83 patients fulfilled the inclusion and exclusion criteria. Average daily dose of isotretinoin was 0.24 mg /kg/day and mean duration of treatment was 9.56 months. Mean total accumulated dose of isotretinoin was 61.96 ± 34.15 mg/kg (range from 11.18 mg/kg to 151.79mg/kg). There were only 6 (7.2%) patients who achieved total accumulated dose of more than 120mg/kg/day. All of our patients responded to treatment with 24 (28.9%) of them were in complete clearance. However, a high percentage (71.2%) of patients developed mucocutaneous side-effects out of which 27.7% required dose reduction. Relapse rate among those who completed treatment and follow up or contactable for at least 6 months post treatment was 24.2% (8 out of 33 patients). There were only 3 (3.6%) patients who developed raised transaminases during treatment but all were less than twice the upper normal limit. Mean total cholesterol, triglyceride and LDL level were significantly raised at 4 months of treatment when compared to the baseline (p<0.05). Conclusion Low dose Isotretinoin (<0.5mg/kg) is an effective treatment for moderate to severe acne vulgaris in our population. All of our patients showed good response to isotretinoin even though some of them relapsed subsequently. Intolerability as a result of mucocutaneous side-effects seems to be a challenging issue when starting isotretinoin in our population.
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BACKGROUND/AIMS: Ulcerative colitis (UC) is a chronic inflammatory bowel disease with heterogeneous clinical features. Data on the disease course and prognosis of UC patients who have been regularly treated are lacking. We aimed to investigate relapse rates of UC in remission and factors related to relapse. METHODS: We retrospectively analyzed clinical courses of 84 patients (43 males, median age 43 years, ranged 20-73 years) diagnosed as UC at Ajou University Hospital between January 1997 and December 2005 based on clinical, endoscopic and pathologic findings, and who were regularly followed for at least one year after the remission. RESULTS: Study subjects consisted of 32 proctitis (38%), 21 left-sided colitis (25%), and 31 subtotal or total colitis (37%). Of 84 patients, relapse was observed in 52 patients (62%) during the follow-up period (ranged 1-9 years). The relapse rate was 24%, 41%, 51%, 65%, 71%, and 79% at 1 year, 2 years, 3 years, 4 years, 5 years and 6 years, respectively. Among sex, age, hemoglobin, ESR, and the extent of disease on admission, decrease of hemoglobin level was the only independent factor related to relapse (odds ratio=2.67, 95% CI (1.32-5.42), p<0.01). CONCLUSIONS: In Korea, relapse of UC in remission is not rare. Decrease of hemoglobin level is an independent risk factor related to its relapse, while the extent of disease is not.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Antimetabolites/therapeutic use , Azathioprine/therapeutic use , Chronic Disease , Colitis, Ulcerative/diagnosis , Data Interpretation, Statistical , Follow-Up Studies , Hemoglobins/analysis , Mesalamine/therapeutic use , Odds Ratio , Recurrence , Retrospective Studies , Risk Factors , Time FactorsABSTRACT
Objective To find out the beneficial effects of oral cyclophosphamide in patients with frequently relapsing nephrotic syndrome. Design Prospective study Setting: University paediatric unit, Galle Method Patients presenting with frequently relapsing, steroid sensitive nephrotic syndrome were included. Patients were given an 8 week course of oral cyclophosphamide (2.5mg/kg/day). Number of relapses before and after cyclophosphamide therapy, duration of remission and state of the disease were recorded. Results There were 17 patients included in the study (male 10, female 07). Mean age of onset of the disease was 35.2 months (SD± 4.3). Mean relapse rate before cyclophosphamide therapy was 4.5 per year (SD±1.2). Mean relapse rate after cyclophosphamide therapy was 1.1 per year (SD± 0.9). This decrease in relapse rate was statistically highly significant
ABSTRACT
OBJECTIVES: In order to provide useful data for the further clinical studies with Korean alcohol-dependent patients, enrollment and non-relapse rates were investigated while alcohol-dependent patients were followed up for 24 weeks. METHODS: The subjects of this study were alcohol-dependent male patients who, for the first time, visited a hospital among 3 groups of hospitals, University Hospital, General Hospital or Mental Hospital, or those who needed to be followed up after discharge from those hospitals. After assigning 12 subjects to each hospital, we investigated enrollment and non-relapse rates while cognitive-behavioral therapy and pharmacotherapy were provided. RESULTS: 1) Forty-eight patients were enrolled and the rate of enrollment was 36.4%. The enrollment rate in the University Hospital group was 52.1%, in the General Hospital group 50.0%, and in the Mental Hospital group 10.4%. 2) In 48 patients, non-relapse rate was 27.1% at 12 week and 18.8% at 24 weeks after starting follow-up. It was 24.4% and 20.0% at 12 and 24 weeks, repectively, in the University Hospital group while the General Hospital group showed 33.3% and 16.7%, respectively, and the Mental Hospital Group showed 20.0% at both 12 and 24 weeks. CONCLUSION: These results provide important data for further clinical studies of Korean alcohol-dependent patients.