scholarly journals Relapse activity in the chronic phase of anti-myelin-oligodendrocyte glycoprotein antibody-associated disease

2021 ◽  
Author(s):  
Tetsuya Akaishi ◽  
Tatsuro Misu ◽  
Kazuo Fujihara ◽  
Toshiyuki Takahashi ◽  
Yoshiki Takai ◽  
...  
Keyword(s):  
Relapse Prevention ◽  
Disease Onset ◽  
Chronic Phase ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Dose Oral ◽  
Comparative Cohort Study ◽  
Aquaporin 4 Antibody ◽  
Relapse Rates

Abstract Objective The patterns of relapse and relapse-prevention strategies for anti-myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are not completely investigated. We compared the patterns of relapse in later stages of MOGAD with those of anti-aquaporin-4 antibody (AQP4-Ab)-positive neuromyelitis optica spectrum disorder (NMOSD). Methods In this observational, comparative cohort study, 66 patients with MOGAD and 90 with AQP4-Ab-positive NMOSD were enrolled. We compared the patterns of relapse and annualized relapse rates (ARRs) in the first 10 years from disease onset, stratified by relapse-prevention treatments. Results Approximately 50% of the patients with MOGAD experienced relapses in the first 10 years. Among those not undergoing relapse-prevention treatments, ARRs in the first 5 years were slightly lower in MOGAD patients than in AQP4-Ab-positive NMOSD patients (MOGAD vs. AQP4-Ab NMOSD: 0.19 vs. 0.30; p = 0.0753). After 5 years, the ARR decreased in MOGAD patients (MOGAD vs. AQP4-Ab NMOSD: 0.05 vs. 0.34; p = 0.0001), with a 72% reduction from the first 5 years (p = 0.0090). Eight (61.5%) of the 13 MOGAD patients with more than 10-year follow-up from disease onset showed relapse 10 years after onset. Clustering in the timing and phenotype of attacks was observed in both disease patients. The effectiveness of long-term low-dose oral PSL for relapse prevention in patients with MOGAD has not been determined. Conclusions The relapse risk in patients with MOGAD is generally lower than that in patients with AQP4-Ab-positive NMOSD, especially 5 years after onset. Meanwhile, relapses later than 10 years from onset are not rare in both diseases.

scholarly journals Bone mineral density and explanatory factors in children and adults with juvenile dermatomyositis at long term follow-up; a cross sectional study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Henriette Schermacher Marstein ◽  
Kristin Godang ◽  
Berit Flatø ◽  
Ivar Sjaastad ◽  
Jens Bollerslev ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Inflammatory Markers ◽  
Juvenile Dermatomyositis ◽  
Inflammatory Myopathy ◽  
Disease Onset ◽  
Whole Body ◽  
Mineral Density ◽  
Z Scores

Abstract Background Juvenile dermatomyositis (JDM) is the most common idiopathic inflammatory myopathy in children and adolescents. Both the disease and its treatment with glucocorticoids may negatively impact bone formation. In this study we compare BMD in patients (children/adolescence and adults) with long-standing JDM with matched controls; and in patients, explore how general/disease characteristics and bone turnover markers are associated with BMD. Methods JDM patients (n = 59) were examined median 16.8y (range 6.6–27.0y) after disease onset and compared with 59 age/sex-matched controls. Dual-energy X-ray absorptiometry (DXA) was used to measure BMD of the whole body and lumbar spine (spine) in all participants, and of ultra-distal radius, forearm and total hip in participants ≥20y only. Markers of bone turnover were analysed, and associations with outcomes explored. Results Reduced BMD Z-scores (<−1SD) were found in 19 and 29% of patients and 7 and 9% of controls in whole body and spine, respectively (p-values < 0.05). BMD and BMD Z-scores for whole body and spine were lower in all patients and for < 20y compared with their respective controls. In participants ≥20y, only BMD and BMD Z-score of forearm were lower in the patients versus controls. In patients, BMD Z-scores for whole body and/or spine were found to correlate negatively with prednisolone use at follow-up (yes/no) (age < 20y), inflammatory markers (age ≥ 20y) and levels of interferon gamma-induced protein 10 (IP-10) (both age groups). In all patients, prednisolone use at follow-up (yes/no) and age ≥ 20y were independent correlates of lower BMD Z-scores for whole body and spine, respectively. Conclusion In long-term JDM, children have more impairment of BMD than adults in spine and whole-body. Associations with BMD were found for both prednisolone and inflammatory markers, and a novel association was discovered with the biomarker of JDM activity, IP-10.

scholarly journals THE ASSIMILATION PROCESS OF PROBLEMATIC EXPERIENCES AND LONG-TERM OUTCOMES IN PSYCHOTHERAPY FOR DEPRESSION: COMPARING A RELAPSED AND A NON-RELAPSED CASE

2021 ◽  
Author(s):  
Beatriz Viana ◽  
◽  
Ricardo Machado ◽  
William B. Stiles ◽  
João Salgado ◽  
...  
Keyword(s):  
Relapse Prevention ◽  
Therapeutic Change ◽  
Long Term Outcomes ◽  
Emotion Focused Therapy ◽  
Therapy Termination ◽  
Assimilation Process ◽  
Problematic Experiences ◽  
One Year

"Over the years, research has demonstrated that psychotherapy is an effective treatment in different psychopathological conditions. However, which are the mechanisms or processes involved in therapeutic change that could explain its efficacy are not yet clear. The Assimilation of Problematic Experiences Model describes change in therapy as a process that occurs through the gradual assimilation of problematic experiences in the self – higher levels of assimilation seem to be associated with a better outcome at the end of therapy. However, little is known about the contribution of this process to the maintenance of therapeutic gains after the end of therapy. In the current study we aimed to explore how the level of assimilation achieved throughout therapy is associated with relapse prevention after treatment. We analyzed two good outcome cases of Emotion-Focused Therapy, previously diagnosed with depression: one case that remained asymptomatic and another that relapsed one year and a half after the end of therapy. The Assimilation of Problematic Experiences (APES) was used to assess the assimilation levels achieved and the Beck Depression Inventory-II (BDI-II) was used to assess the intensity of depressive symptoms. Five therapeutic sessions and three follow-up sessions were rated using the APES. The results showed that higher APES levels were associated with lower intensity of symptoms at the end and after therapy termination, being associated with relapse prevention in depression. These results suggest that a complete assimilation of the problematic experiences may help clients to maintain therapeutic gains reducing the probability of relapsing in depression."

Long-term follow-up of fixed low-dose oral immunotherapy for children with wheat-induced anaphylaxis

2021 ◽  
Author(s):  
Ken-ichi Nagakura ◽  
Yoko Miura ◽  
Takaaki Itonaga ◽  
Makoto Nishino ◽  
Kyohei Takahashi ◽  
...  
Keyword(s):  
Low Dose ◽  
Oral Immunotherapy ◽  
Long Term Follow Up ◽  
Dose Oral

Author response for "Long‐term follow‐up of fixed low‐dose oral immunotherapy for children with severe cow’s milk allergy"

2020 ◽  
Author(s):  
Yoko Miura ◽  
Ken‐ichi Nagakura ◽  
Makoto Nishino ◽  
Mari Takei ◽  
Kyohei Takahashi ◽  
...  
Keyword(s):  
Low Dose ◽  
Oral Immunotherapy ◽  
Author Response ◽  
Cow’S Milk ◽  
Milk Allergy ◽  
Cow's Milk ◽  
Long Term Follow Up ◽  
Dose Oral

Sequenced Treatment Alternatives to Relieve Depression

2018 ◽  
Author(s):  
Eric Lin ◽  
Pochu Ho
Keyword(s):  
Long Term Outcomes ◽  
Population Number ◽  
Study Population ◽  
Location Study ◽  
Study Participants ◽  
Study Intervention ◽  
Treatment Alternatives ◽  
Relapse Rates

This chapter provides a summary of the landmark Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial on major depressive disorder. The STAR*D trial was designed to address some basic questions about depression treatment. What are the outcomes and the remission rates for depression? What are the long-term outcomes, especially the relapse rates, for patients receiving sequential depression therapies? Starting with these questions, this chapter describes the basics of the STAR*D trial, including funding, study location, study population, number of study participants, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. In addition, this chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

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