Treatment withdrawal: judges to get advice about visiting patients after decision on covid patient is overturned

BMJ ◽  
2021 ◽  
pp. n2939
Author(s):  
Clare Dyer
Keyword(s):  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Shijun Yang ◽  
Bin Wang ◽  
Xiong Han

AbstractAlthough antiepileptic drugs (AEDs) are the most effective treatment for epilepsy, 30–40% of patients with epilepsy would develop drug-refractory epilepsy. An accurate, preliminary prediction of the efficacy of AEDs has great clinical significance for patient treatment and prognosis. Some studies have developed statistical models and machine-learning algorithms (MLAs) to predict the efficacy of AEDs treatment and the progression of disease after treatment withdrawal, in order to provide assistance for making clinical decisions in the aim of precise, personalized treatment. The field of prediction models with statistical models and MLAs is attracting growing interest and is developing rapidly. What’s more, more and more studies focus on the external validation of the existing model. In this review, we will give a brief overview of recent developments in this discipline.


2020 ◽  
Vol 13 ◽  
Author(s):  
Aisan Ghaemian ◽  
Mahdi Ghomi ◽  
Miles Wrightman ◽  
Colm Ellis-Nee

Abstract The present study aimed to explore patients’ experience with an Improving Access to Psychological Therapies (IAPT) service, and to investigate the reasons for discontinuing their treatment. A qualitative approach was adopted using thematic analysis of semi-structured interviews carried out with 818 patients attending for treatment in Talking Change from November 2015 to January 2019, retrospectively. The five main themes that emerged from the study were: ‘Felt better’, ‘Issues with group settings’, ‘Therapeutic alliance breakdown’, ‘Miscommunication’ and ‘Impracticalities’. The qualitative study uncovered a wide range of reasons for people who had dropped out from their treatment. The findings mainly emphasised general dissatisfaction and inconvenient appointments. However, improvement in symptoms of depression and anxiety was also identified as a key factor among patients who discontinued their treatment. This recovery is known as ‘progress withdrawal’ in which patients withdraw from treatment early due to good therapeutic progress. We present clinical and procedural implications arising from these themes. Key learning aims (1) To explore what can cause discontinuation of therapy. (2) To obtain the experience of people who have received treatment and dropped out from Talking Change Psychological Therapy services. (3) To explore whether people recovered as part of the treatment withdrawal and what may have helped towards that recovery.


Author(s):  
Kristina M. Utzschneider ◽  
Mark T. Tripputi ◽  
Alexandra Kozedub ◽  
Elena Barengolts ◽  
Sonia Caprio ◽  
...  

Author(s):  
Luca Scarallo ◽  
Giulia Bolasco ◽  
Jacopo Barp ◽  
Martina Bianconi ◽  
Monica di Paola ◽  
...  

Abstract Background The aim of the present study was to investigate outcomes of anti-TNF-alpha (ATA) withdrawal in selected pediatric patients with inflammatory bowel disease who achieved clinical remission and mucosal and histological healing (MH and HH). Methods A retrospective analysis was performed on children and adolescents affected by Crohn disease (CD) and ulcerative colitis (UC) who were followed up at 2 tertiary referral centers from 2008 through 2018. The main outcome measure was clinical relapse rates after ATA withdrawal. Results One hundred seventy patients received scheduled ATA treatment; 78 patients with CD and 56 patients with UC underwent endoscopic reassessment. We found that MH was achieved by 32 patients with CD (41%) and 30 patients with UC (53.6%); 26 patients with CD (33.3%) and 22 patients with UC (39.3%) achieved HH. The ATA treatment was suspended in 45 patients, 24 affected by CD and 21 by UC, who all achieved concurrently complete MH (Simplified Endoscopic Score for CD, 0; Mayo score, 0, respectively) and HH. All the patients who suspended ATA shifted to an immunomodulatory agent or mesalazine. In contrast, 17 patients, 8 with CD and 9 with UC, continued ATA because of growth needs, the persistence of slight endoscopic lesions, and/or microscopic inflammation. Thirteen out of 24 patients with CD who suspended ATA experienced disease relapse after a median follow-up time of 29 months, whereas no recurrence was observed among the 9 patients with CD who continued treatment (P = 0.05). Among the patients with UC, there were no significant differences in relapse-free survival among those who discontinued ATA and those who did not suspend treatment (P = 0.718). Conclusions Despite the application of rigid selection criteria, ATA cessation remains inadvisable in CD. In contrast, in UC, the concurrent achievement of MH and HH may represent promising selection criteria to identify patients in whom treatment withdrawal is feasible.


Hepatology ◽  
2007 ◽  
Vol 3 (5) ◽  
pp. 685-689 ◽  
Author(s):  
John E. Hegarty ◽  
Kayhan T. Nouri Aria ◽  
Bernard Portmann ◽  
Adrian L. W. F. Eddleston ◽  
Roger Williams

2006 ◽  
Vol 26 (7) ◽  
pp. 811-816 ◽  
Author(s):  
Arno Kornberg ◽  
Bernadett Kupper ◽  
Andrea Tannapfel ◽  
Katharina Thrum ◽  
Erik Barthel ◽  
...  

Author(s):  
DW Wolmarans ◽  
L Brand ◽  
SF Steyn

Combination oral contraceptives (COCs) are some of the most commonly prescribed drugs for women between the ages of 15–451 and while they are accepted to be safe and highly effective, their use is often associated with a number of minor sideeffects. Considering the limited nature of this review, a detailed overview of the complete clinical profile of COCs falls beyond the current scope. Rather, we will focus on the most frequently reported side-effects of COCs that do not necessitate treatment withdrawal. Adverse effects that require immediate withdrawal of therapy are usually related to deep vein thrombosis (DVT) and other cardiovascular events, malignancies or hepatic pathology2 and would require a more in-depth review.


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