Evolution of Transfusion Requirement in Algerian Thalassemic Major (TM) and Intermediate (TI) Patients Treated with Hydroxyurea (HU).

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 1588-1588
Author(s):  
Mohamed Bradai ◽  
Serge Pissard ◽  
Mohand Tayeb Abad ◽  
Agnes Dechartres ◽  
Jean-Antoine Ribeil ◽  
...  
Keyword(s):  
Partial Response ◽  
Malignant Transformation ◽  
Transfusion Requirement ◽  
Clinical Status ◽  
Myeloproliferative Disorder ◽  
Factors Associated ◽  
Transfusion Requirements ◽  
Erythrocyte Concentrates ◽  
One Year

Abstract Context: Benefits of HU treatment in thalassemic patients are controversial. Most studies agree that HU decreases transfusion requirements in patients with TI, whereas results in patients with TM are inconsistent. Objectives: To assess the proportion of good responders to HU and the factors associated with good response. Methods: We initiated HU treatment in 54 thalassemic patients (9 TI and 45 TM). Median ages at first transfusion were 57 months (32–252) in TI and 13 months (4–60) in TM patients. Median ages at inclusion were 12.4 years (4.4–54.9) in TI and 9.9 years (2.0–21.0) in TM patients. Median numbers of erythrocyte concentrates (EC) transfused the year before HU were 3 (1–9) in TI and 12 (8–16) in TM patients (10–65). Good response was defined as more than 70% decrease of transfusional needs one year after beginning HU, partial response as a decrease between 40 and 70%, and non response as a decrease of less than 40%. Patients were transfused when their hemoglobin (Hb) level was < 6g/dL; not transfused when Hb was > 7 g/dL; decision to transfuse was based on clinical status for Hb level between 6 and 7 g/dL. Mean HU dose was 17 ± 2 mg/kg/d (13–21). Mean follow-up was 29.3 ± 14 months. Results: Eight (90%) TI and 20 (44.5%) TM patients had a good response to HU. No TI and 9 (20%) TM patients had a partial response to HU. One (10%) TI and 16 (35,5%) TM patients had no response to HU. Clinical and hematological tolerance were good except for one 55 yr old TI patient who developed in the 3rd year of treatment an acute myeloblastic leukemia. Retrospectively, a malignant transformation of a pre-existent myeloproliferative disorder can not be excluded and the responsibility of HU is questionable. A better response to HU was associated with a later beginning of transfusion (p=0.02), a higher pre-HU Hb (p= 0.0004), codon 6(-A) mutation (p= 0.002), and with TI diagnosis (p=0.03). On the contrary, Gγ-158 C/C genotype (Xmn1−/−) (p= 0.0001) was associated with a worse response. After adjustment, decrease of transfusional needs was associated with the number of CE transfused the year before HU treatment (p= 0.001), Xmn1 polymorphism (p= 0.003) and the age at the beginning of HU (p=0.03) but not with the type of thalassemia. In conclusion, HU may represent an alternative to transfusions for both TI and TM patients in countries with limited blood supplies when beginning early.

scholarly journals 357 Factors associated with changes in health-related quality of life in children with cystic fibrosis during one-year follow-up

2017 ◽  
Vol 16 ◽  
pp. S154
Author(s):  
M. Van Horck ◽  
B. Winkens ◽  
G. Wesseling ◽  
K. de Winter-de Groot ◽  
I. De Vreede ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cystic Fibrosis ◽  
Health Related Quality ◽  
Factors Associated ◽  
Related Quality ◽  
Health Related ◽  
One Year

Help-Seeking in Depressed Out-patients Following Maintenance Therapy

1976 ◽  
Vol 129 (3) ◽  
pp. 252-260 ◽  
Author(s):  
Myrna M. Weissman ◽  
Stanislav V. Kasl
Keyword(s):  
Maintenance Therapy ◽  
Help Seeking ◽  
Maintenance Treatment ◽  
Suicide Attempts ◽  
Clinical Status ◽  
Subsequent Treatment ◽  
Access To Treatment ◽  
One Year

SummaryThis paper reports on the clinical status, help-seeking and subsequent treatment experiences of 150 women one year after they had completed out-patient maintenance treatment by amitriptyline and/or psychotherapy for a depressive episode.While the majority of patients were asymptomatic at follow-up, a substantial minority had a return of acute symptoms and 2 per cent made minor suicide attempts during the year. Admission to hospital was rare. However, only 30 per cent of the patients did not seek any treatment during the year and the majority received some psychotropic medication.The findings support the long-term need for prompt access to treatment by patients who have recovered from an acute depression.

scholarly journals Risk factors associated with the development of death events during the first year of follow-up after pulmonary thromboembolism

2019 ◽  
pp. 80-85
Author(s):  
S. A. Berns ◽  
E. A. Schmidt ◽  
A. G. Neeshpapa ◽  
A. A. Potapenko ◽  
K. V. Smirnov ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Anticoagulant Therapy ◽  
Severe Heart Failure ◽  
First Year ◽  
Factors Associated ◽  
Risk Of Death ◽  
One Year ◽  
The One

Purpose: to identify the factors associated with the development of death events during the year follow-up after hospitalization for pulmonary embolism (PE). Materials and methods: 93 patients with PE discharged to the outpatient stage of observation were studied. 45 (61,6%) patients were female with an average age of 66 years. The examination of patients at the stage of inclusion in the study consisted of standard methods of examination for this pathology. The diagnosis was confirmed by multislice computed tomography. Follow-up was 12 months. Statistical analysis was performed using the MedCalc Version 16.2.1. Results: during the one-year follow-up period 62 (66,7%) patients with PE were alive but 11 patients (11,8%) died, and no information was obtained about 20 patients. The causes of death were as follows: the development of recurrent PE – 4 (36,4%) patients, cancer – 3 patients (27,3%), stroke – 2 (18,1%), one patient (9,1%) died due to severe heart failure and one – myocardial infarction. A comparative analysis in the groups of alive patients (n = 62) and patients with a fatal events (n = 11) showed that the dead patients were older (78 (68; 81) vs. 65 (49; 75) years; p = 0,003), had a higher PESI score (119,0 (99,7; 137,2) vs. 88,0 (68,0; 108,0); p = 0,016) and were less compliant to prolonged anticoagulant therapy during the one year of observation (45,5% of patients (n = 5) vs. 82,3% ( = 51); p = 0,015). The ROC curve determined that a high risk of death during the one year after PE is associated with age over 70 years (p = 0,0001) and more than 95 points by PESI in the hospital period (p = 0,0001). Conclusion: The death events were developed in 11,8% of cases in patients with pulmonary embolism during the first year of follow-up. The death outcomes were significantly associated with elderly age, intermediate and high risk by PESI in the hospital period and low compliance to anticoagulant therapy extended during the year after pulmonary embolism.

scholarly journals Incidence and Predictors of Infections and All-Cause Death in Patients with Cardiac Implantable Electronic Devices: The Italian Nationwide RI-AIAC Registry

2022 ◽  
Vol 12 (1) ◽  
pp. 91
Author(s):  
Giuseppe Boriani ◽  
Marco Proietti ◽  
Matteo Bertini ◽  
Igor Diemberger ◽  
Pietro Palmisano ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Clinical Status ◽  
Electronic Devices ◽  
Clinical Event ◽  
Clinical Factors ◽  
Factors Associated ◽  
Cardiac Implantable Electronic Devices ◽  
Clinical Events ◽  
Event Score

Background: The incidence of infections associated with cardiac implantable electronic devices (CIEDs) and patient outcomes are not fully known. Aim: To provide a contemporary assessment of the risk of CIEDs infection and associated clinical outcomes. Methods: In Italy, 18 centres enrolled all consecutive patients undergoing a CIED procedure and entered a 12-months follow-up. CIED infections, as well as a composite clinical event of infection or all-cause death were recorded. Results: A total of 2675 patients (64.3% male, age 78 (70–84)) were enrolled. During follow up 28 (1.1%) CIED infections and 132 (5%) deaths, with 152 (5.7%) composite clinical events were observed. At a multivariate analysis, the type of procedure (revision/upgrading/reimplantation) (OR: 4.08, 95% CI: 1.38–12.08) and diabetes (OR: 2.22, 95% CI: 1.02–4.84) were found as main clinical factors associated to CIED infection. Both the PADIT score and the RI-AIAC Infection score were significantly associated with CIED infections, with the RI-AIAC infection score showing the strongest association (OR: 2.38, 95% CI: 1.60–3.55 for each point), with a c-index = 0.64 (0.52–0.75), p = 0.015. Regarding the occurrence of composite clinical events, the Kolek score, the Shariff score and the RI-AIAC Event score all predicted the outcome, with an AUC for the RI-AIAC Event score equal to 0.67 (0.63−0.71) p < 0.001. Conclusions: In this Italian nationwide cohort of patients, while the incidence of CIED infections was substantially low, the rate of the composite clinical outcome of infection or all-cause death was quite high and associated with several clinical factors depicting a more impaired clinical status.

Factors Associated with Dropout and Noncompliance in Patients with Schizophrenia: Results of a One-Year Follow-Up

2007 ◽  
Vol 1 (2) ◽  
pp. 161-167 ◽  
Author(s):  
Alp Üçok ◽  
Kazim Yazici ◽  
Levent Mete ◽  
Savaş Kültür ◽  
A. Göğüs ◽  
...  
Keyword(s):  
Factors Associated ◽  
One Year

Post-Hysterectomy Adaptation: A Review and Report of two Follow-Up Studies

1983 ◽  
Vol 17 (3) ◽  
pp. 227-235 ◽  
Author(s):  
B. Singh ◽  
B. Raphael ◽  
R. Gyaneshwar ◽  
P. Johnston
Keyword(s):  
Prognostic Factors ◽  
Factors Associated ◽  
Follow Up Studies ◽  
One Year ◽  
Psychiatric Outcome

Hysterectomy, its indications and its consequences for later health, have been prominent topics in recent psychiatric, gynaecological and lay literature. This study describes the results of two recent surveys, one of 216 women less than 45 years old who had a hysterectomy for non-malignant conditions at a major Sydney hospital. These women were interviewed on the seventh to tenth postoperative day. One hundred and ninety-four were then followed up by questionnaire 13 months later. In a later study carried out at a hospital on the outskirts of Sydney, 100 out of 146 women responded to a follow-up questionnaire approximately one year after their operations. These studies and their relevance to recent similar studies are discussed in terms of post-hysterectomy adaptation and prognostic factors associated with poor psychiatric outcome.

scholarly journals Impact of Endovascular Treatment on Clinical Status and Health-Related Quality of Life

2008 ◽  
Vol 97 (1) ◽  
pp. 50-55 ◽  
Author(s):  
J. Virkkunen ◽  
M. Venermo ◽  
J. Saarinen ◽  
L. Keski-Nisula ◽  
P. Apuli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Status ◽  
Critical Limb Ischaemia ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
One Year ◽  
The One

Background and Aims: Investigating the impact of percutaneous transluminal angioplasty (PTA) on clinical status and health related quality of life in patients with claudication and critical limb ischaemia (CLI). Material and Methods: 61 patients and 64 limbs underwent a primary PTA (30 claudication and 34 CLI cases). Clinical status was graded according to Ahn and Rutherford and ankle/brachial index (ABI). Quality of life was assessed using the Nottingham Health Profile (NHP) preoperatively, one month and one year after the procedure. Triplex scan evaluation of the treated arterial segment was carried out postoperatively and one year after the procedure. Results: Claudication: 24/27 patients underwent one-year follow up, after which 20/24 had no claudication. In triplex evaluation 17 (63.0%) treated segments were open with 0–50% restenosis, 9 (33.3%) with 51–99% restenosis and one (3.7%) was occluded. CLI: 13/34 (38.2%) patients underwent one-year follow-up after which eight patients (61.5%) were asymptomatic and five (38.1%) had claudication. In triplex evaluation there was 0–50% restenosis in 6 (46.2%) segments treated with PTA and 51–99% restenosis in 7 (53.8%) segments. 21 (61.8%) patients did not conclude the one year follow up: 7 had died, 5 had undergone bypass surgery and 6 an amputation and 3 did not attend the follow-up up for unknown reasons. Quality of life: For CLI patients, improvement was observed in the domain of pain, which continued throughout the follow-up period. Among the claudicants, the domain of physical mobility was improved at one month's follow-up, but this effect disappeared during the following year and could not be seen at one the one- year follow-up. Conclusions: Technical success and one-year results in claudication are good, and the rate of complications is low. However, although PTA resulted in an immediate improvement in the quality of life, this effect was not seen in the long term. In critical limb ischemia there was a group of patients in whom PTA led to a significant benefit in terms of limb salvage and quality of life.

scholarly journals Factors Associated with Short-Term Seizure Recurrence in Extratemporal Epilepsy Surgery

2021 ◽  
Vol 9 (3) ◽  
pp. 01-07
Author(s):  
Aisel Santos
Keyword(s):  
Epilepsy Surgery ◽  
Incomplete Resection ◽  
Epileptogenic Zone ◽  
Drug Resistant ◽  
Seizure Recurrence ◽  
Short Term ◽  
Factors Associated ◽  
Epileptiform Discharges ◽  
One Year

Introduction: Drug-resistant extratemporal epilepsy is the second cause of referral to epilepsy surgery. Objectives: To identify factors associated with short-term seizure recurrence following extratemporal epilepsy surgery. Materials and Methods: We performed a retrospective study of 19 consecutive patients who underwent surgery for drug-resistant extratemporal epilepsy at the National Institute of Neurology and Neurosurgery of Havana, Cuba, from September 2014 to October 2019. All patients had at least one year of postoperative follow-up. Fisher's exact test was used to search for an association between dichotomous variables. A value of p≤0.05 was considered significant. Results: After one year of follow-up, seizure freedom reached 31.6% (Engel I) and 36.8% showed significant improvement in the number of seizures (Engel II). The frontal location (p=0.046) and incomplete resection of the epileptogenic zone (p=0.017), bilateral interictal discharges on the preoperative electroencephalogram (EEG) (p=0.017), the presence of epileptiform discharges on the postsurgical EEG (p=0.001), and the occurrence of seizures after the sixth month of surgery (p=0.001), were associated with seizures recurrence. Conclusions: After one year, 31.6% of patients operated on for extratemporal epilepsy were seizure-free. The incomplete resection of the epileptogenic zone and the presence of epileptogenic discharges in the postsurgical EEG, and the presence of seizures after the sixth month of surgery were the most significant factors of seizure recurrence.

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