scholarly journals A naturalistic, long-term follow-up of purging disorder

2020 ◽  
pp. 1-8
Author(s):  
K. Jean Forney ◽  
Ross D. Crosby ◽  
Tiffany A. Brown ◽  
Kelly M. Klein ◽  
Pamela K. Keel

Abstract Background The DSM-5 introduced purging disorder (PD) as an other specified feeding or eating disorder characterized by recurrent purging in the absence of binge eating. The current study sought to describe the long-term outcome of PD and to examine predictors of outcome. Methods Women (N = 84) who met research criteria for PD completed a comprehensive battery of baseline interview and questionnaire assessments. At an average of 10.24 (3.81) years follow-up, available records indicated all women were living, and over 95% were successfully located (n = 80) while over two-thirds (n = 58) completed follow-up assessments. Eating disorder status, full recovery status, and level of eating pathology were examined as outcomes. Severity and comorbidity indicators were tested as predictors of outcome. Results Although women experienced a clinically significant reduction in global eating pathology, 58% continued to meet criteria for a DSM-5 eating disorder at follow-up. Only 30% met established criteria for a full recovery. Women reported significant decreases in purging frequency, weight and shape concerns, and cognitive restraint, but did not report significant decreases in depressive and anxiety symptoms. Quality of life was impaired in the physical, psychological, and social domains. More severe weight and shape concerns at baseline predicted meeting criteria for an eating disorder at follow-up. Other baseline severity indicators and comorbidity did not predict the outcome. Conclusions Results highlight the severity and chronicity of PD as a clinically significant eating disorder. Future work should examine maintenance factors to better adapt treatments for PD.

2007 ◽  
Vol 38 (10) ◽  
pp. 1435-1442 ◽  
Author(s):  
P. K. Keel ◽  
B. E. Wolfe ◽  
J. A. Gravener ◽  
D. C. Jimerson

BackgroundRecent studies suggest that purging disorder (PD) may be a common eating disorder that is associated with clinically significant levels of distress and high levels of psychiatric co-morbidity. However, no study has established evidence of disorder-related impairment or whether distress is specifically related to PD rather than to co-morbid disorders.MethodThree groups of normal-weight women [non-eating disorder controls (n=38), with PD (n=24), and with bulimia nervosa (BN)-purging subtype (n=57)] completed structured clinical interviews and self-report assessments.ResultsBoth PD and BN were associated with significant co-morbidity and elevations on indicators of distress and impairment compared to controls. Compared to BN, PD was associated with lower rates of current and lifetime mood disorders but higher rates of current anxiety disorders. Elevated distress and impairment were maintained in PD and BN after controlling for Axis I and Axis II disorders.ConclusionsPD is associated with elevated distress and impairment and should be considered for inclusion as a provisional disorder in nosological schemes such as the Diagnostic and Statistical Manual to facilitate much-needed research on this clinically significant syndrome.


2022 ◽  
Vol 59 (1) ◽  
Author(s):  
Cathrine Nitter ◽  
◽  
Kari Anne Vrabel ◽  
Per-Einar Binder ◽  
Irene Kingswick ◽  
...  

This study evaluates a mindful eating-based program for people with self-reported binge eating problems. The study was initiated by a non-governmental eating disorder interest organization. Participants met once a week over eight weeks. The Eating Disorder Questionnaire (EDE-Q) and three subscales of the Self-Compassion Scale (SCS) were used to measure eating pathology, self-compassion and mindfulness before, after, and six-months after the program. Results: Significant improvements in EDE-Q and SCS scores were found, and results remained stable at the six-month follow-up. The number of binge eating days decreased significantly during the study, both from before to after program participation, and from post-program participation to six-month follow-up. Conclusion: Future studies investigating the current program are clearly needed. These preliminary results are nonetheless encouraging and illustrate that mindful eating-based interventions as an interesting treatment avenue for individuals with binge eating pathology, a group which currently has few treatment options available to them.


Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2331
Author(s):  
Enza Speranza ◽  
Lidia Santarpia ◽  
Maurizio Marra ◽  
Emilia De Filippo ◽  
Olivia Di Vincenzo ◽  
...  

Background: This study aimed to evaluate several socio-demographic and long-term clinical outcomes in a cohort of women living with a restrictive eating disorder. Methods: Patients were asked to fill in a general data collection form aiming to investigate their current conditions and to attend the outpatient unit for a 10-year follow-up clinical and laboratory evaluation. Results: Forty-four patients completed the follow-up general data collection form and 20 agreed to attend the outpatient unit for the 10 year-follow-up evaluation. In total, 52% of patients were single, 55% had achieved a university degree, and 55% had steady employment. After 10 years, there was a clear improvement in biochemical markers, but cholesterol levels were still slightly high. The prevalence of osteopenia in the whole sample was 70% when measured on the lumbar column and 20% on the total body, while osteoporosis was found in 10% of patients and only on the lumbar column. Conclusion: According to the collected data, women with a history of restrictive eating disorders appear to re-adapt well to social life by obtaining the level of their unaffected peers in terms of education and employment.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
F Sanguineti ◽  
P Garot ◽  
T Hovasse ◽  
T Unterseeh ◽  
X Troussier ◽  
...  

Abstract Background The natural history of acute myocarditis (AM) remains partially unknown and predictors of outcome are still debated. The study objectives were to determine the potential value of cardiovascular magnetic resonance (CMR) parameters for the long-term Major Adverse Cardiac Events (MACE) prediction in patients presenting with suspected AM. In our centre we published in 2015 a first analysis of the CMR myocarditis registry which included patients presenting with suspected AM in routine practice, clinically followed-up for 18 months (median follow up). This first analysis, in disagreement with the published data, did not find CMR predictors of MACE except for the LVEF. Purpose As in myocarditis MACE could have a gradual evolution, to confirm our initial results, the aim of this study is to reinvestigate in the same population, the potential value of CMR parameters with a longer follow-UP (median 8.34 years, interquartile range: 7.7 to 9.16 years). Methods In a single-centre longitudinal prospective study, 203 routine consecutive patients with clinical suspicion of AM and initial CMR-based diagnosis of AM (typical Late Gadolinium Enhancement, LGE) were clinically followed up. Various CMR parameters were evaluated as potential predictors of outcome. The primary endpoint was defined as the occurrence of at least one of the combined MACE: cardiac death or aborted sudden cardiac death, cardiac transplantation, sustained documented ventricular tachycardia, heart failure, recurrence of acute myocarditis, and the need for hospitalization for cardiac causes. Results The vast majority of patients (70,44%; N=143) presented with chest pain, mild to moderate troponin elevation and ST-segment or T wave abnormalities. Various CMR parameters were evaluated on initial CMR performed 3±2 days after acute clinical presentation (LV functional parameters, presence/extent of edema on T2, presence/extent of Early Gadolinium Enhancement (EGA) and extent of late gadolinium enhancement lesions). Out of the 203 patients, 35 (17.2%) experienced at least one major cardiovascular event during follow-up. Among all CMR parameters, initial alteration of LVEF was confirmed a MACE independent predictor by multivariate analysis (HR: 1.03 per 10% decrease, 95% CI: 1.01 to 1.06, p=0.04). Furthermore, at longer FU analysis, absence of EGA predicted adverse clinical outcome (HR: 2.7, 95% CI: 1.12 to 6.27, p=0.02) suggesting a potential protecting role of inflammatory response. Conclusions In routine clinical practice, in patients without severe hemodynamic compromise and a CMR-based diagnosis of AM, various CMR parameters such as the presence, extent and myocardial localisation of late gadolinium-enhanced LV myocardial lesions, were not predictive of events at long term follow up. CMR predictor of adverse clinical outcome were an initial alteration of LVEF and the absence of EGA.


2012 ◽  
Vol 7 (9) ◽  
pp. 1069-1076 ◽  
Author(s):  
André Luz ◽  
Christine Hughes ◽  
Rui Magalhães ◽  
Teodoro Bisceglia ◽  
Fleur Descoutures ◽  
...  

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 307-307
Author(s):  
Kathryn Tzung-Kai Chen ◽  
John Parker Hoffman

307 Background: Because the focus of pancreatoduodenectomy for pancreatic adenocarcinoma is placed on disease-free and overall survival, morbidity in long-term survivors is not well described. We sought to evaluate outcomes of long-term survivors of pancreatic cancer after pancreatoduodenectomy. Methods: We identified 30 patients from our prospectively collected database of patients with pancreatic adenocarcinoma who had undergone pancreatoduodenectomy, and who were without evidence of disease with at least 40 months of follow-up. Demographics, treatment and pathologic characteristics were collected for review. Data with regards to long-term sequelae were also collected, particularly those complications requiring additional procedures and the development of metachronous cancers. Results: The median length of follow up was 83 months, with 60% of patients still alive. Half the patients were male, and the median age at diagnosis was 70 years. With regard to treatment, 80% of patients received chemoradiation, with half of these patients receiving it in the neoadjuvant setting. All patients received an R0 resection, although two patients required at least partial resection of the superior mesenteric or portal veins. Thirty-three percent of patients had N1 disease. Forty-four percent of patients did not have any significant subsequent sequelae. In the remainder, four patients (13%) developed ascites requiring repeated paracentesis or Denver shunt, with median time to development (MTD) of 63 months. Six patients (20%) developed a biliary stricture requiring stent placement (MTD 56 months), one patient developed portal venous thrombosis requiring a venous stent (MTD 52 months), and 3 patients (10%) experienced clinically significant gastric anastomotic ulcers (MTD 47 months). With regards to metachronous cancers, 2 patients developed subsequent lymphomas (MTD 92 months). Conclusions: Long-term survivors of patients who undergo pancreatoduodenectomy for pancreatic adenocarcinoma can develop significant late sequelae, which often can manifest more than three to five years after surgery. Continued follow-up and counseling is warranted.


Author(s):  
Анашкин ◽  
Aleksey Anashkin ◽  
Жиборкин ◽  
Gleb Zhiborkin ◽  
Бобыкин ◽  
...  

Purpose of the study: to study the efficacy and safety of Ranibizumab in patients with pathologic myopia and choroidal neovascularization (CNV).22patients (22eyes) with myopic CNV were included in the study. Mean age was 54.0±14.4years, axial length – 28.25±1.9mm, follow-up – from 12 to 59months (mean follow-up – 26.9±13.8months). Ranibizumab was administered intravitreally according to the label in patients with active CNV confirmed by fluorescein angiography. The treatment was shown to have favorable early and long-term outcomes. For example, visual acuity increased (from 0.25 to 0.54; p<0.01), central retinal thickness decreased (from 335.8 to 273.25μm; p<0,05), subretinal neovascular membrane area decreased (from 1272 to 969μm; p<0.05). Clinically significant treatment complications were not observed.Conclusions: The study confirmed high efficacy and safety of anti-angiogenic therapy.


Author(s):  
S. A. Firsov ◽  
A. G. Levshin ◽  
R. P. Matveev

Analysis of safety and efficacy of the currently marked peroral anticoagulants was performed in long term follow up of patients after large joints arthroplasty. Total number of 5025 patients after total knee arthroplasty and 5216 patients after total hip arthroplasty were examined. All patients were divided into groups depending on the prescribed anticoagulant. The course of anticoagulant therapy made up 35 days and 6 weeks after surgery, respectively. US examination of the veins of lower extremities was performed to all patients prior to and on day 5 after operation. In patients on Dabigatran the rate of clinically significant deep vein thrombosis was lower than in group of patients on Rivaroxaban and Apixaban, but the rate of postoperative hematomas in lust two groops was higher.


2019 ◽  
Author(s):  
Barbel Knauper ◽  
huma shireen ◽  
Kimberly Carriere ◽  
Mallory Frayn ◽  
Elena Ivanova ◽  
...  

Abstract Background: The NIH-developed Diabetes Prevention Program (DPP) is successful in achieving clinically significant weight loss in individuals with overweight/obesity when delivered one-on-one. However, due to high cost of implementation, the long-term effectiveness remains limited. In response, a group-based version of the program, called the National DPP, was developed. The average weight loss following participation in this program was only about 3.5% with low long-term weight loss maintenance. Purpose: We aimed to optimize weight loss outcomes of the National DPP by integrating the habit formation tool of if-then plans into the program. Results at 3 and 12 months of participation showed no between-group differences between standard and enhanced DPP but higher weight loss in both groups compared to the National DPP. This paper reports the long-term weight loss maintenance data following participation in the program. Methods: Of the 172 participants enrolled at the beginning of the study, data from 110 participants was available and analyzed at 24 months, i.e. 12 months following the end of the 12-month intervention. Results: No between-group difference in weight loss maintenance was seen. Pooled results showed a significant weight regain from 12 to 24 months, i.e. an average of 7.85lbs of the 20.36lbs lost. However, participants from both groups were still 12.51lbs or 6.13% lighter at 24 months than at baseline. Conclusion: If-then plans did not result in a higher percentage of weight loss at 24-month follow-up. However, at 24 months, both groups maintained a significant portion of the weight lost at the end of intervention.


2003 ◽  
Vol 13 (Suppl 2) ◽  
pp. 144-148 ◽  
Author(s):  
M. J. Piccart ◽  
K. Bertelsen ◽  
G. Stuart ◽  
J. Cassidy ◽  
C. Mangioni ◽  
...  

Two independent and consecutive randomized clinical trials, conducted by the American Gynecological Oncology Group and by an European–Canadian Intergroup, have shown superiority, in clinical response rate, progression-free survival, and overall survival, of a cisplatin–paclitaxel regimen over cisplatin–cyclophosphamide given as first-line chemotherapy for women with advanced epithelial ovarian cancer. The results of these studies, published with a median follow-up of about 3 years, have been updated with a 6.5-year follow-up: In each case, an 11% absolute gain in survival favoring the paclitaxel arm is shown; this advantage remains both statistically and clinically significant and supports a role for paclitaxel in frontline chemotherapy for advanced ovarian cancer.


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