How “DUP” and “ee” Predict the Dynamic OD Syndromes in the Long - Termcourse of Schizophrenia?

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Cechnicki ◽  
R. Polczyk ◽  
A. Bielańska
Keyword(s):  
Repeated Measures ◽  
First Episode ◽  
First Year ◽  
List Type ◽  
Type Number ◽  
Long Term Outcomes ◽  
Course Of Illness ◽  
Negative Syndrome

Objective:The study in Krakow investigated the way in which EE and DUP correlated with long term outcomes of the treatment and the course of illness.Subjects and methods:58 out of 80 DSM III schizophrenia diagnosed patients took part in 1, 3, 7 and 12 follow-up. the Follow-Up Chart, BPRS, and CFI were used. as the outcome criteria only dynamic of symptoms were included. the dynamic of the symptoms and the relation between DUP and EE were analyzed by repeated measures of ANOVA.Results:1.General, positive and negative syndromes decreased rapidly after the first hospitalization, and increased slightly between 7 and 12 yrs. (ps < 0.001). the negative syndrome decreased less rapidly during the first year.2.The dynamic of general and positive syndrome were modified by the DUP and by EE. in long DUP (general syndrome: p = 0.028; positive syndrome: p = 0.001) the dynamic was worse. High EE subjects had more severe syndromes at the admission. after the first hospitalization their results became as good as in the case of low EE (general syndrome: p = 0.004; positive syndrome: p = 0.044).3.The dynamic of negative syndrome was neither modified by DUP (p = 0.896) or by EE (p = 0.309).Conclusion:The dynamic of general and positive syndromes were modified by DUP during 12 years follow-up and by EE only in acute state in the first episode. the dynamic of negative syndrome was not modified by DUP and EE.

How “DUP” and “EE” Predict the Dynamic OD Syndromes in the Long - Termcourse of Schizophrenia?

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Cechnicki ◽  
R. Polczyk ◽  
A. Bielańska
Keyword(s):  
Repeated Measures ◽  
First Episode ◽  
First Year ◽  
List Type ◽  
Type Number ◽  
Long Term Outcomes ◽  
Course Of Illness ◽  
Negative Syndrome

Objective:The study in Krakow investigated the way in which EE and DUP correlated with long term outcomes of the treatment and the course of illness.Subjects and methods:58 out of 80 DSM III schizophrenia diagnosed patients took part in 1, 3, 7 and 12 follow-up. The Follow-Up Chart, BPRS, and CFI were used. As the outcome criteria only dynamic of symptoms were included. The dynamic of the symptoms and the relation between DUP and EE were analyzed by repeated measures of ANOVA.Results:1.General, positive and negative syndromes decreased rapidly after the first hospitalization, and increased slightly between 7 and 12 yrs. (ps < 0.001). The negative syndrome decreased less rapidly during the first year.2.The dynamic of general and positive syndrome were modified by the DUP and by EE. In long DUP (general syndrome: p = 0.028; positive syndrome: p = 0.001) the dynamic was worse. High EE subjects had more severe syndromes at the admission. After the first hospitalization their results became as good as in the case of low EE (general syndrome: p = 0.004; positive syndrome: p = 0.044).3.The dynamic of negative syndrome was neither modified by DUP (p = 0.896) or by EE (p = 0.309).Conclusion:The dynamic of general and positive syndromes were modified by DUP during 12 years follow-up and by EE only in acute state in the first episode. The dynamic of negative syndrome was not modified by DUP and EE.

scholarly journals The critical period

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. Birchwood
Keyword(s):  
Critical Period ◽  
Psychotic Symptoms ◽  
First Episode ◽  
List Type ◽  
Episode Psychosis ◽  
Follow Up Studies ◽  
Long Term Follow Up ◽  
Ecological Risk Factors

Aim:Evidence from long-term follow-up studies of schizophrenia and from the ‘new epidemiology’ of psychoses has forced us to rewrite the textbooks and challenge accepted wisdom. In this paper I aim to review the concept of my ‘Critical Period’ in the long-term trajectory of schizophrenia.Method:I will review long-term follow-up studies of first episode psychosis.Results:Studies suggest that:a.the course of the psychoses is very variable;b.much of this variability is laid down during the ‘prodromal’ and first 3 - 5 years following the first episode;c.the ‘disability’ plateaus quickly, much of it occuring before the positive symptoms develop (the ‘symptom-disability gap’) butd.the psychosocial and ecological risk factors that have now been uncovered, suggest a more protean, malleable process in the development of psychosis, as witnessed, for example by the considerable number of ‘at risk’ individuals with low-level, but disabling psychotic symptoms, who escape psychosis (the misnomer of the ‘false positive’).Conclusion:This picture presents a fresh take on my concept of the ‘critical period’ with implications for public health and prevention.

scholarly journals Long-term outcomes after endoscopic treatment for Barrett’s neoplasia with radiofrequency ablation ± endoscopic resection: results from the national Dutch database in a 10-year period

Gut ◽  
2021 ◽  
pp. gutjnl-2020-322615
Author(s):  
Sanne van Munster ◽  
Esther Nieuwenhuis ◽  
Bas L A M Weusten ◽  
Lorenza Alvarez Herrero ◽  
Auke Bogte ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Endoscopic Resection ◽  
Recurrence Risk ◽  
Low Risk ◽  
First Year ◽  
Long Term Outcomes ◽  
Oesophageal Stenosis ◽  
Uniform Treatment

ObjectiveRadiofrequency ablation (RFA)±endoscopic resection (ER) is the preferred treatment for early neoplasia in Barrett’s oesophagus (BE). We aimed to report short-term and long-term outcomes for all 1384 patients treated in the Netherlands (NL) from 2008 to 2018, with uniform treatment and follow-up (FU) in a centralised setting.DesignEndoscopic therapy for early BE neoplasia in NL is centralised in nine expert centres with specifically trained endoscopists and pathologists that adhere to a joint protocol. Prospectively collected data are registered in a uniform database. Patients with low/high-grade dysplasia or low-risk cancer, were treated by ER of visible lesions followed by trimonthly RFA sessions of any residual BE until complete eradication of BE (CE-BE). Patients with ER alone were not included.ResultsAfter ER (62% of cases; 43% low-risk cancers) and median 1 circumferential and 2 focal RFA (p25-p75 0–1; 1–2) per patient, CE-BE was achieved in 94% (1270/1348). Adverse events occurred in 21% (268/1386), most commonly oesophageal stenosis (15%), all were managed endoscopically. A total of 1154 patients with CE-BE were analysed for long-term outcomes. During median 43 months (22–69) and 4 endoscopies (1–5), 38 patients developed dysplastic recurrence (3%, annual recurrence risk 1%), all were detected as endoscopically visible abnormalities. Random biopsies from a normal appearing cardia showed intestinal metaplasia (IM) in 14% and neoplasia in 0%. A finding of IM in the cardia was reproduced during further FU in only 33%, none progressed to neoplasia. Frequent FU visits in the first year of FU were not associated with recurrence risk.ConclusionIn a setting of centralised care, RFA±ER is effective for eradication of Barrett’s related neoplasia and has remarkably low rates of dysplastic recurrence. Our data support more lenient FU intervals, with emphasis on careful endoscopic inspection. Random biopsies from neosquamous epithelium and cardia are of questionable value.Netherlands trial register numberNL7039.

scholarly journals Short and long-term outcomes of medical management of patients with a first episode of arrhythmic storm

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C.M Gonzalez De La Portilla-Concha ◽  
J Acosta Martinez ◽  
J.L Dominguez Cano ◽  
M.R Caballero Valderrama ◽  
A Abril Molina ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Confidence Interval ◽  
Medical Management ◽  
High Rate ◽  
First Episode ◽  
Long Term Outcomes ◽  
All Cause Mortality ◽  
Short And Long Term

Abstract Introduction There is few data about long-term outcomes of conservative management (without catheter ablation) of patients with a first episode of arrhythmic storm (AS) in the current context. This study analyzes the short and long-term outcomes of implantable cardioverter defibrillator (ICD) patients with a first episode of AS receiving non-interventional management. Methods Consecutive patients admitted with a first episode of AS between January 2008 and June 2019 receiving medical management without catheter ablation were included. AS was defined as 3 or more appropriate ICD therapies occurring during a 24 h span. Medical management included: correction of triggers, sedation/mechanical ventilation, antiarrhythmic drugs, ICD reprogramming and neuraxial modulation. Baseline clinical characteristics and follow-up data were recorded. All patients were followed every 6 months at the ICD office. The primary end-point was all-cause mortality. Results 60 patients (81% male, 62.8±16.2 years, 43% ischaemic, LVEF 35.4±14%) with a first episode of AS treated conservatively were included. Thirty-day survival was 96.5% and 1-year survival was 82%. During a median (interquartilic range) follow-up of 31 (6–69) months, 31 (51.7%) patients died (51.6% due to cardiovascular aetiology) and 35 (58.3%) patients were readmitted (48.5% due to recurrent arrhythmic events and 45.7% due to heart failure). Age [HR 1.05 (95% confidence interval: 1.01–1.08)] and end-diastolic diameter [HR 1.05 (95% confidence interval: 1–2)] were the strongest independent predictors of all-cause mortality. Conclusion Despite the severity of this entity, medical management (without catheter ablation) of a first episode of AS is reasonable given its good 30-day and 1-year survival. However, a high rate of AS recurrence and readmissions are observed during long-term follow-up. Efforts are needed in order to identify those patients with a first episode of AS that could benefit from an early catheter ablation strategy. Funding Acknowledgement Type of funding source: None

The Course of Schizophrenia Over 13 Years

1996 ◽  
Vol 169 (5) ◽  
pp. 580-586 ◽  
Author(s):  
Peter Mason ◽  
Glynn Harrison ◽  
Cristine Glazebrook ◽  
Ian Medley ◽  
Tim Croudace
Keyword(s):  
Social Adjustment ◽  
First Episode ◽  
First Year ◽  
Survival Curves ◽  
Course Of Illness ◽  
First Relapse ◽  
Late Recovery ◽  
Representative Cohort ◽  
First Episode Of Schizophrenia

BackgroundThis paper describes the 13 year course of illness in an epidemiologically defined and representative cohort of patients selected when they were experiencing their first episode of schizophrenia.MethodIn a 13-year follow-up study of 67 patients with ICD–9 schizophrenia, identified in Nottingham in 1978–80, the course of illness (symptoms, disability and hospitalisation) was assessed using standardised instruments, applied at onset 1, 2, and 13 years. Time to first relapse and first readmission were calculated and plotted as survival curves and patients were assigned to the course types described by Ciompi.ResultsThe survival curves show that first relapses and first readmissions occur during the first five years. The amount of time spent in psychotic episodes and in hospital is greatest in the first year of follow-up, but stable thereafter. Social adjustment improves from entry to the study to the first follow-up year, but there is a small deterioration in social adjustment between 2 and 13 years.ConclusionsThe findings reported suggest that after the initial episode the course of schizophrenia is relatively stable. The data support neither concepts of progressive deterioration nor progressive amelioration. There was no evidence of a ‘late recovery’.

P505Short and long-term outcomes of medical management of patients with a first episode of arrhythmic storm

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
J Acosta Martinez ◽  
M Caballero Valderrama ◽  
J L Dominguez Cano ◽  
A Campos Pareja ◽  
M Frutos Lopez ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Confidence Interval ◽  
Medical Management ◽  
High Rate ◽  
First Episode ◽  
Long Term Outcomes ◽  
All Cause Mortality ◽  
Few Data

Abstract INTRODUCTION There is few data about long-term outcomes of conservative management (without catheter ablation) of patients with a first episode of arrhythmic storm (AS) in the current context. This study analyzes the short and long-term outcomes of implantable cardioverter defibrillator (ICD) patients with a first episode of AS receiving non-interventional management.  METHODS Consecutive patients admitted with a first episode of AS between January 2008 and June 2019 receiving medical management without catheter ablation were included. AS was defined as ≥ 3 appropriate ICD therapies occurring during a 24h span. Medical management included: correction of triggers, sedation/mechanical ventilation, antiarrhythmic drugs, ICD reprogramming and neuraxial modulation. Baseline clinical characteristics and follow-up data were recorded. All patients were followed every 6 months at the ICD office. The primary end-point was all-cause mortality. RESULTS 60 patients (81% male, 62.8 ± 16.2 years, 43% ischaemic, LVEF 35.4 ± 14%) with a first episode of AS treated conservatively were included. Thirty-day survival was 96.5% and 1-year survival was 82%. During a median (interquartilic range) follow-up of 31 (6-69) months 31 (51.7%) patients died (51.6% due to cardiovascular aetiology) and 35 (58.3%) patients were readmitted  (48.5% due to recurrent arrhythmic events and 45.7% due to heart failure). Age [HR 1.05 (95% confidence interval: 1.01-1.08)] and end-diastolic diameter [HR 1.05 (95% confidence interval: 1-2)] were the strongest independent predictors of all-cause mortality. CONCLUSION Despite the severity of this entity, medical management (without catheter ablation) of a first episode of AS is reasonable given its good 30-day and 1-year survival. However, a high rate of AS recurrence and readmissions are observed during long-term follow-up. Efforts are needed in order to identify those patients with a first episode of AS that could benefit from an early catheter ablation strategy.

scholarly journals Prospective Long-Term Cohort Study of Subjects With First-Episode Psychosis Examining Eight Major Outcome Domains and Their Predictors: Study Protocol

2021 ◽  
Vol 12 ◽  
Author(s):  
Victor Peralta ◽  
Lucía Moreno-Izco ◽  
Elena García de Jalón ◽  
Ana M. Sánchez-Torres ◽  
Lucía Janda ◽  
...  
Keyword(s):  
Psychosocial Functioning ◽  
Psychotic Disorders ◽  
First Episode ◽  
Naturalistic Study ◽  
Personal Recovery ◽  
Long Term Outcomes ◽  
Term Outcome ◽  
Long Term Outcome

Background: Our current ability to predict the long-term course and outcome of subjects with a first-episode of psychosis (FEP) is limited. To improve our understanding of the long-term outcomes of psychotic disorders and their determinants, we designed a follow-up study using a well-characterized sample of FEP and a multidimensional approach to the outcomes. The main goals were to characterize the long-term outcomes of psychotic disorders from a multidimensional perspective, to address the commonalities and differential characteristics of the outcomes, and to examine the common and specific predictors of each outcome domain. This article describes the rationale, methods, and design of a longitudinal and naturalistic study of subjects with epidemiologically defined first-admission psychosis.Methods: Eligible subjects were recruited from consecutive admissions between January 1990 and December 2009. Between January 2018 and June 2021, we sought to trace, re-contact, and re-interview the subjects to assess the clinical course, trajectories of symptoms and functioning, and the different outcomes of psychotic disorders. Since this is a naturalistic study, the research team will not interfere with the subjects' care and treatment. Predictors include antecedent variables, first-episode characteristics, and illness-related variables over the illness course. We assess eight outcome domains at follow-up: psychopathology, psychosocial functioning, self-rated personal recovery, self-rated quality of life, cognitive performance, neuromotor dysfunction, medical and psychiatric comorbidities, and mortality rate. The range of the follow-up period will be 10–31 years with an estimated mean of 20 years. We estimate that more than 50% of the baseline sample will be assessed at follow-up.Discussion: The study design was driven by the increasing need to refine the ability to predict the different clinical outcomes in FEP, and it aims to close current gaps in knowledge, with a broad approach to both the definition of outcomes and their determinants. To the best of our knowledge, this study is one of the few attempting to characterize the very long-term outcome of FEP and the only study addressing eight major outcome domains. We hope that this study helps to better characterize the long-term outcomes and their determinants, enabling better risk stratification and individually tailored, person-based interventions.

Periprocedural risk and long-term outcome of intracranial angioplasty based on a single-centre experience

VASA ◽  
2013 ◽  
Vol 42 (4) ◽  
pp. 264-274
Author(s):  
Dagmar Krajíčková ◽  
Antonín Krajina ◽  
Miroslav Lojík ◽  
Martina Mulačová ◽  
Martin Vališ
Keyword(s):  
Death Rate ◽  
Long Term Outcomes ◽  
Single Centre ◽  
Intracranial Atherosclerotic Stenosis ◽  
Atherosclerotic Stenosis ◽  
Angioplasty And Stenting ◽  
Aggressive Medical Management ◽  
Stroke Death

Background: Intracranial atherosclerotic stenosis is a major cause of stroke and yet there are currently no proven effective treatments for it. The SAMMPRIS trial, comparing aggressive medical management alone with aggressive medical management combined with intracranial angioplasty and stenting, was prematurely halted when an unexpectedly high rate of periprocedural events was found in the endovascular arm. The goal of our study is to report the immediate and long-term outcomes of patients with ≥ 70 % symptomatic intracranial atherosclerotic stenosis treated with balloon angioplasty and stent placement in a single centre. Patients and methods: This is a retrospective review of 37 consecutive patients with 42 procedures of ballon angioplasty and stenting for intracranial atherosclerotic stenosis (≥ 70 % stenosis) treated between 1999 and 2012. Technical success (residual stenosis ≤ 50 %), periprocedural success (no vascular complications within 72 hours), and long-term outcomes are reported. Results: Technical and periprocedural success was achieved in 90.5 % of patients. The within 72 hours periprocedural stroke/death rate was 7.1 % (4.8 % intracranial haemorrhage), and the 30-day stroke/death rate was 9.5 %. Thirty patients (81 %) had clinical follow-up at ≥ 6 months. During follow-up, 5 patients developed 6 ischemic events; 5 of them (17 %) were ipsilateral. The restenosis rate was 27 %, and the retreatment rate was 12 %. Conclusions: Our outcomes of the balloon angioplasty/stent placement for intracranial atherosclerotic stenosis are better than those in the SAMMPRIS study and compare favourably with those in large registries and observational studies.

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