Are There Predictive Factors for Long-Term Outcome after Withdrawal in Drug-Induced Chronic Daily Headache?

Cephalalgia ◽  
2001 ◽  
Vol 21 (6) ◽  
pp. 691-696 ◽  
Author(s):  
GG Tribl ◽  
P Schnider ◽  
C Wöber ◽  
S Aull ◽  
A Auterith ◽  
...  
Keyword(s):  
Chronic Daily Headache ◽  
Favourable Outcome ◽  
Drug Induced ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Clear Cut ◽  
Standardized Interview ◽  
Daily Headache ◽  
Drug Overuse

Objectives To investigate prognostic factors for long-term outcome of patients after inpatient withdrawal because of drug-induced chronic daily headache. Procedures Fifty-five patients (36 females) were re-examined by means of a standardized interview after inpatient withdrawal. The mean observation period was 9.28 ± 2.85 years (mean ± sd; median 8.58; range 5.00–13.50). Results Five years after withdrawal, one-third of the patients (34.6%) had an overall favourable outcome, one-third (32.7%) had no recurrent drug overuse and reported a clear-cut improvement of headache, and one-third (32.7%) developed recurrent drug overuse. Most relapses occurred within 2 years, and a small percentage within 5 years. No predictors for long-term outcome after inpatient withdrawal were found. Conclusions All patients with drug-induced chronic daily headache should be considered as good candidates for inpatient withdrawal, and no patient should be excluded from that therapy.

A 13-Year Long-Term Outcome Study of Elderly With Chronic Daily Headache

Cephalalgia ◽  
2008 ◽  
Vol 28 (10) ◽  
pp. 1017-1022 ◽  
Author(s):  
J-L Fuh ◽  
S-J Wang ◽  
S-R Lu ◽  
P-H Tsai ◽  
T-H Lai ◽  
...  
Keyword(s):  
Chronic Daily Headache ◽  
Medication Overuse Headache ◽  
Tension Type Headache ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Headache Type ◽  
Daily Headache ◽  
Type Headache

We established a cohort of 60 subjects with chronic daily headache (CDH) out of 1533 community-based elderly in 1993 and finished two short-term follow-ups in 1995 and 1997. All of the 26 survivors without dementia (4 M/22 F, mean age 82.7 ± 3.4 years) finished the follow-up in 2006. The mean headache frequency was 8.4 ± 11.8 days per month in the past year, and seven (27±) had persistent CDH. Based on the International Classification of Headache Disorders, 2nd edn, the CDH subtypes diagnoses were chronic migraine in three subjects, chronic tension-type headache in three, and one with medication-overuse headache. All these seven subjects had CDH during the 1995 and 1997 follow-ups. The diagnosis of CDH with migrainous features increased from 25 to 71± in those with CDH from 1993 to 2006. Migraine was the most common headache type in those with CDH resolution. Aggressive treatment should be applied especially for those with persistent CDH at short-term follow-ups.

Prediction of outcome in neurotic disorder: a 5-year prospective study

1998 ◽  
Vol 28 (5) ◽  
pp. 1149-1157 ◽  
Author(s):  
H. SEIVEWRIGHT ◽  
P. TYRER ◽  
T. JOHNSON
Keyword(s):  
Initial Response ◽  
Favourable Outcome ◽  
Dysthymic Disorder ◽  
Response To Treatment ◽  
Behaviour Therapy ◽  
Neurotic Disorder ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Predicting Outcome

Background. There have been no previous studies of the outcome of different neurotic disorders in which a prospective group with original randomization to treatment have been followed up over a long period. Such studies are important in identifying the factors associated with good and poor outcome.Methods. A 5-year follow-up assessment was made of a cohort of 210 psychiatric out-patients seen in general practice psychiatric clinics with a DSM-III diagnosis of generalized anxiety disorder (71), panic disorder (74) or dysthymic disorder (65) and randomized to drug treatment, cognitive and behaviour therapy, and self-help. A total of 182 of the patients (87%) were assessed after 5 years by examination of hospital and GP records using a standardized procedure and outcome determined with a four-point outcome scale.Results. One hundred and seven (60%) of the patients had a favourable outcome but the remainder continued to be handicapped either intermittently or continuously throughout the 5-year period. Analysis of the value of initial data in predicting outcome using polychotomous step-wise logistic regression revealed that five variables were significant predictors of poor prognosis: older age; recurrent episodes; the presence of personality disorder at entry; general neurotic syndrome at entry; and symptom severity after 10 weeks. The initial DSM diagnosis and original treatment given, together with ten other variables, were of no predictive value.Conclusions. The long-term outcome of neurotic disorder is better predicted by age, personality and recency of onset than by other clinical variables with the exception of initial response to treatment.

Long-Term Outcome of Patients with Headache and Drug Abuse after Inpatient Withdrawal

Cephalalgia ◽  
1996 ◽  
Vol 16 (7) ◽  
pp. 481-485 ◽  
Author(s):  
P Schnider ◽  
S Aull ◽  
C Baumgartner ◽  
A Marterer ◽  
C Wöber ◽  
...  
Keyword(s):  
Drug Abuse ◽  
Drug Withdrawal ◽  
International Headache Society ◽  
Close Correlation ◽  
Tension Type Headache ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Daily Headache ◽  
Type Headache

Thirty-eight patients with “chronic daily” headache and ergotamine and/or analgesics abuse according to the criteria proposed by the international Headache Society were re-investigated 5 years after inpatient drug withdrawal. At the end of the observation period, 19 patients (50.0%) had their headaches on only 8 days per month or less, 18 patients (47.4%) were free of symptoms or had only mild headaches. A close correlation was found between the frequency of headache and the duration of drug abuse, as well as between the intensity of headache and the number of tablets taken per month. Frequency and intensity of headache had changed within the first 2 years after withdrawal, but remained stable afterwards. Fifteen patients (39.5%) reported on recurrent drug abuse. Patients with migraine showed a tendency towards a better prognosis compared to patients with tension-type headache or with combined migraine and tension-type headache. The results of this study highlight the long-term efficacy of inpatient drug withdrawal in patients with headache and ergotamine and/or analgesics abuse.

scholarly journals Long-term outcome after tricuspid valvectomy in a neonate with Candida endocarditis: a case report

2019 ◽  
Vol 29 (4) ◽  
pp. 528-530
Author(s):  
Ellen S. I. Vanhie ◽  
Ad J. J. C. Bogers ◽  
Willem A. Helbing
Keyword(s):  
Case Report ◽  
Surgical Intervention ◽  
Pulmonary Regurgitation ◽  
Favourable Outcome ◽  
Early Infancy ◽  
Term Outcome ◽  
Long Term Outcome

AbstractTricuspid valvectomy is a rare surgical intervention, and knowledge regarding long-term outcome in children is lacking. We report a favourable outcome 11 years after tricuspid valvectomy in early infancy without subsequent surgery or other cardiac interventions. Specific criteria for timing of re-intervention are lacking. Application of adult tricuspid and pulmonary regurgitation recommendations is helpful but has limitations.

scholarly journals Long-term outcome of profound hyponatremia: a prospective 12 months follow-up study

2016 ◽  
Vol 175 (6) ◽  
pp. 499-507 ◽  
Author(s):  
Bettina Winzeler ◽  
Nica Jeanloz ◽  
Nicole Nigro ◽  
Isabelle Suter-Widmer ◽  
Philipp Schuetz ◽  
...  
Keyword(s):  
Sodium Level ◽  
Medical Condition ◽  
Tertiary Care ◽  
Drug Induced ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Mortality And Morbidity ◽  
Follow Up Study

Background Hyponatremia is the most common electrolyte abnormality in hospitalized patients and given its impact on mortality and morbidity, a relevant medical condition. Nevertheless, little is known about factors influencing long-term outcome. Methods This is a prospective observational 12-month follow-up study of patients with profound hyponatremia (≤125 mmol/L) admitted to the emergency department of two tertiary care centers between 2011 and 2013. We analyzed the predictive value of clinical and laboratory parameters regarding the following outcomes: 1-year mortality, rehospitalization and recurrent profound hyponatremia. Results Median (IQR) initial serum sodium (s-sodium) level of 281 included patients was 120 mmol/L (116–123). During the follow-up period, 58 (20.6%) patients died. The majority (56.2%) were rehospitalized at least once. Recurrent hyponatremia was observed in 42.7%, being profound in 16%. Underlying comorbidities, assessed by the Charlson Comorbidity Index, predicted 1-year mortality (odds ratio (OR) 1.43, 95% confidence interval (CI) 1.25–1.64, P < 0.001). Furthermore, ‘s-sodium level at admission’ (OR 1.14, 95% CI 1.01–1.29, P = 0.036) and ‘correction of hyponatremia’ defined as s-sodium ≥135 mmol/L at discharge were associated with mortality (OR 0.47, 95% CI 0.23–0.94, P = 0.034). Mortality rate fell with decreasing baseline s-sodium levels and was lower in the hyponatremia category ≤120 mmol/L vs >120 mmol/L (14.8% and 27.8%, P < 0.01). Patients with s-sodium level ≤120 mmol/L were more likely to have drug-induced hyponatremia, whereas hypervolemic hyponatremia was more common in patients with s-sodium >120 mmol/L. Conclusion Hyponatremia is associated with a substantial 1-year mortality, recurrence and rehospitalization rate. The positive correlation of s-sodium and mortality emphasizes the importance of the underlying disease, which determines the outcome besides hyponatremia itself.

scholarly journals Drug-Induced Changes in Risk/Biomarkers and Their Relationship with Renal and Cardiovascular Long-Term Outcome in Patients with Diabetes

2011 ◽  
Vol 57 (2) ◽  
pp. 186-195 ◽  
Author(s):  
Yan Miao ◽  
Paul A Smink ◽  
Dick de Zeeuw ◽  
Hiddo J Lambers Heerspink
Keyword(s):  
Risk Management ◽  
Short Term ◽  
Drug Induced ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Patients With Diabetes ◽  
Changes In Risk ◽  
Risk Biomarkers ◽  
Induced Changes

BACKGROUND Optimal renal and cardiovascular risk management in diabetic patients includes optimal maintenance of blood pressure and control of glucose and lipids. Although the optimal control of these risk factors or “risk/biomarkers” has proven to be effective, it often is difficult to achieve. Consequently, the risk for renal and cardiovascular complications remains devastatingly high. Many risk/biomarkers have been discovered that accurately predict long-term renal and cardiovascular outcome. However, the aim of measuring risk/biomarkers may not be only to determine an individual's risk, but also to use the risk/biomarker level to guide therapy and thereby improve long-term clinical outcome. CONTENT This review describes the effects of various drugs on novel risk/biomarkers and the relationship between (drug induced) short-term changes in risk/biomarkers and long-term renal and cardiovascular outcome in patients with diabetes. SUMMARY In post hoc analyses of large trials, the short-term reductions in albuminuria, transforming growth factor-β, and N-terminal pro-B–type natriuretic peptide (NT-proBNP) induced by inhibitors of the renin-angiotensin-aldosterone system were associated with a decreased likelihood of long-term adverse renal and cardiovascular outcomes. However, the few studies that systematically investigated the utility of prospectively targeting novel risk/biomarkers such as hemoglobin or NT-proBNP failed to demonstrate long-term cardiovascular protection. The latter examples suggest that although a risk/biomarker may have superior prognostic ability, therapeutically changing such a risk/biomarker does not necessarily improve long-term outcome. Thus, to establish the clinical utility of other novel risk/biomarkers, clinical trials must be performed to prospectively examine the effects of therapeutically-induced changes in single or multiple risk/biomarkers on long-term risk management of patients with diabetes.

The Significance of Stupor in the Long-Term Outcome of Chronic Schizophrenia

1989 ◽  
Vol 155 (3) ◽  
pp. 352-355 ◽  
Author(s):  
J. C. Rigby ◽  
S. M. Wood ◽  
R. H. S. Mindham
Keyword(s):  
Psychiatric Hospital ◽  
Mental State ◽  
Chronic Schizophrenia ◽  
Favourable Outcome ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Chronic Schizophrenic ◽  
Schizophrenic Patients ◽  
Similar Sample

The admission records of 271 long-stay chronic schizophrenic patients, resident in a large psychiatric hospital, were examined in order to identify those who had presented in stupor at the onset of their illness. Twelve patients were found (ten men and two women). When compared, in terms of current mental state and behaviour, with a similar sample of schizophrenics in whom stupor had been absent, significant differences between the two groups were detected, with those presenting in stupor demonstrating a less favourable outcome.

scholarly journals Study of the Long-Term Results of Decompressive Craniectomy after Severe Traumatic Brain Injury Based on a Series of 60 Consecutive Cases

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Gaétane Gouello ◽  
Olivier Hamel ◽  
Karim Asehnoune ◽  
Eric Bord ◽  
Roger Robert ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Hypertension ◽  
Decompressive Craniectomy ◽  
Severe Traumatic Brain Injury ◽  
Favourable Outcome ◽  
Long Term Results ◽  
Term Outcome ◽  
Long Term Outcome

Background. Decompressive craniectomy can be proposed in the management of severe traumatic brain injury. Current studies report mixed results, preventing any clear conclusions on the place of decompressive craniectomy in traumatology.Methods. The objective of this retrospective study was to evaluate the results of all decompressive craniectomies performed between 2005 and 2011 for refractory intracranial hypertension after severe traumatic brain injury. Sixty patients were included. Clinical parameters (Glasgow scale, pupillary examination) and radiological findings (Marshall CT scale) were analysed. Complications, clinical outcome, and early and long-term Glasgow Outcome Scale (GOS) were evaluated after surgery. Finally, the predictive value of preoperative parameters to guide the clinician’s decision to perform craniectomy was studied.Results. Craniectomy was unilateral in 58 cases and the mean bone flap area was 100 cm2. Surgical complications were observed in 6.7% of cases. Mean followup was 30 months and a favourable outcome was obtained in 50% of cases. The initial Glasgow Scale was the only statistically significant predictive factor for long-term outcome.Conclusion. Despite the discordant results in the literature, this study demonstrates that decompressive craniectomy is useful for the management of refractory intracranial hypertension after severe traumatic brain injury.

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