Predictive Factors for Treatment Success in the Early Period of Buprenorphine/Naloxone Maintenance Treatment for Opiate Addiction

Author(s):  
Cavid Guliyev ◽  
◽  
L. İlhan Yargıç ◽  
2021 ◽  
pp. 1-6
Author(s):  
Ediz Vuruskan ◽  
Hakan Ercil ◽  
Umut Unal ◽  
Ergun Alma ◽  
Hakan Anil ◽  
...  

<b><i>Introduction:</i></b> The aim of our study is to evaluate the predictive factors affecting the success of treatment with nephrectomy in patients with poorly functioning kidney and nephrogenic hypertension. <b><i>Methods:</i></b> Data for patients who underwent nephrectomy with a diagnosis of nephrogenic hypertension in 3 centers between May 2010 and January 2020 were analyzed. In the postoperative period, if the blood pressure (BP) was below 140/90 mm Hg without medical treatment, it was accepted as complete response; if the arterial BP was below 140/90 mm Hg with medical treatment or less medication, it was accepted as partial response; and if BP did not decrease to normal values, it was accepted as unresponsive. Demographic characteristics, duration of hypertension, preoperative and postoperative BP values, and presence of metabolic syndrome were statistically evaluated. <b><i>Results:</i></b> Our study consisted of 91 patients with a mean preoperative hypertension duration of 23.3 ± 12.1 months. Among patients, 42 (46.2%) had complete response, 18 (19.8%) had partial response, and 31 (34.0%) had no response. Preoperative systolic and diastolic BP values were not effective on treatment success (<i>p</i> = 0.071, <i>p</i> = 0.973, respectively), but the increase in age and hypertension duration (<i>p</i> = 0.030 and <i>p</i> &#x3c; 0.001, respectively) and the presence of metabolic syndrome (<i>p</i> = 0.002) significantly decreased the complete response rates. <b><i>Conclusions:</i></b> Preoperative hypertension duration, advanced age, and presence of metabolic syndrome are predictive factors affecting the response to treatment in patients who undergo nephrectomy due to nephrogenic hypertension.


2019 ◽  
Vol 34 (4) ◽  
pp. 1612-1620 ◽  
Author(s):  
Tatsuya Sato ◽  
Hirofumi Kogure ◽  
Yousuke Nakai ◽  
Kazunaga Ishigaki ◽  
Ryunosuke Hakuta ◽  
...  

2009 ◽  
Vol 26 (4) ◽  
pp. 399-414 ◽  
Author(s):  
Mats Ekendahl

In Sweden, maintenance treatment (MT) with methadone has been a controversial exception to drug-free treatment. However, efficacy, prescription control and the provision of simultaneous psychosocial treatment (PST) have provided MT with political legitimacy. This view, notably stressing that PST is an important complement to medication, was presented in central Swedish policy documents that paved the way for less strict MT regulations in 2005. Aim The present study aims to analyse how the various stakeholders involved in this policy process described and evaluated the efficacy and legitimacy of PST within the framework of the MT discussion. Data & Method The data consists of a document authored by a state agency (a preliminary review of MT research) and various stakeholders' written commentaries on it. different representations of PST (so-called constructions) were coded thematically and analysed using discourse analytical concepts. Results The results show that stakeholders' constructions of PST draw on different discourses related to the governance of Swedish opiate addiction treatment. Four constructions were identified, PST as: “mere complement” (narrow empirical discourse); “underrated intervention” (practitioner discourse); “preferred intervention” (ideological discourse) and “complex intervention” (antireductionist discourse). The study illustrates how the narrow empirical discourse's construction of PST as a mere complement was challenged by the three other discourses, but shows that the former remained the dominant influence on subsequent MT regulations. It also highlights that references to beliefs and alleged facts are intertwined in stakeholders' rhetorical efforts to assign meaning to PST. This suggests that science and ideology are interrelated in policy discussions on opiate addiction treatment, and that firm conclusions about the value of help interventions rely as much on scientific evidence as on strategic argumentation.


2009 ◽  
Vol 104 (11) ◽  
pp. 2760-2767 ◽  
Author(s):  
Andrea Cassinotti ◽  
Giovanni C Actis ◽  
Piergiorgio Duca ◽  
Alessandro Massari ◽  
Elisabetta Colombo ◽  
...  

2003 ◽  
Vol 37 (4) ◽  
pp. 458-463 ◽  
Author(s):  
Tal Weizman ◽  
Marc Gelkopf ◽  
Yuval Melamed ◽  
Miriam Adelson ◽  
Avraham Bleich

Objective: Therapeutic approaches for benzodiazepine (BZD) dependence in patients in methadone maintenance treatment (MMT) have met with limited success. Clonazepam detoxification (CDTX) and clonazepam maintenance treatment (CMT) were compared in an open, clinical naturalistic study on such patients. Methods: Benzodiazepine dependent patients substituted their BZD of abuse for clonazepam and were then either detoxified (CDTX) or a maintenance dose was reached and maintained (CMT). Patients were considered as failing the trial if they either abused BZDs (CDTX group) or abused BZDs over the maintenance dose (CMT group). Treatment outcome was evaluated based upon self and staff reports over 1 year after beginning treatment. Axis I and II psychiatric diagnosis was assessed and methadone dosage and history of abuse was recorded. Results: In the CDTX group, 9/33 (27.3%), were BZD-free after 2 months. In the CMT group, 26/33 (78.8%) refrained from abusing additional BZDs over the maintenance dose after 2 months. The same success rate remained over the entire year. Survival analysis showed CMT to be more successful than the CDTX. Axis I psychiatric comorbidity was found to be positively related to treatment success in the CMT group while axis II antisocial personality disorder was found to be negatively related to treatment success in that group. It had no impact in the CDTX group. Conclusions: Maintenance strategy with clonazepam is a useful BZD treatment modality for BZD-dependent MMT patients with a long-term history of abuse and previous attempts at detoxification. Psychiatric comorbidity may have an important role in choosing the adequate treatment modality and influencing treatment outcome.


2003 ◽  
Vol 48 (S1) ◽  
Author(s):  
John-Paul Vader ◽  
Robert H�mmig ◽  
Jacques Besson ◽  
Christopher Eastus ◽  
Christina Eggenberger ◽  
...  

2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Caglar Helvacioglu ◽  
Keziban Doğan

Objectives: To investigate the predictive factors of success or failure in treating ectopic tubal pregnancies with two-dose methotrexate (MTX). Methods: The records of patients treated for tubal EP with two-dose MTX were retrospectively reviewed. Patients were divided into two groups; the Group-I (failure) consisted of patients who did not respond to MTX therapy and the Group-II (success) included patients who were successfully treated with MTX. Parameters, including the week of gestation, presence or absence of fetal cardiac activity, gestational sac size, serum β-hCG levels, and adverse effects were compared. Results: Fifty patients were included in this study, 8 (16%) were in Group-I and 42 (84%) were in Group-II. Patients in Group-I required surgery after a mean duration of 6.7±3 days after administering the initial dose of MTX. There was no difference between the groups in terms of the week of gestation, presence or absence of fetal cardiac activity, gestational sac size, serum β-hCG levels, and adverse effects. The average time to β-hCG negativization was 31 days in Group-II. Conclusions: The two-dose MTX protocol has a reasonable success rate, which seems to be dependent on serum β-hCG levels. doi: https://doi.org/10.12669/pjms.37.5.4299 How to cite this:Helvacioglu C, Dogan K. Predictive factors of treatment success in two-dose methotrexate regimen in ectopic tubal pregnancy: A retrospective study. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4299 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2012 ◽  
Vol 26 (7) ◽  
pp. 429-435 ◽  
Author(s):  
Yasmine Yousef ◽  
Kathie Béland ◽  
Emmanuel Mas ◽  
Pascal Lapierre ◽  
Dorothée Bouron Dal Soglio ◽  
...  

BACKGROUND: Hepatitis B virus (HBV) infections are responsible for the development of chronic hepatitis in 400 million people worldwide. Currently, no consensus exists as to when treatment should be initiated for pediatric patients.OBJECTIVES: To evaluate the risks and predictive factors of success of lamivudine treatment in children with chronic, active HBV infection.METHODS: Forty-three children (22 male, median age 9.6 years) chronically infected with HBV and treated between 1998 and 2008 at CHU Ste-Justine (Montreal, Quebec) were included in the present chart review study. Inclusion criteria were detectable hepatitis B surface antigen and hepatitis B e antigen (HBeAg), minimum serum alanine aminotransferase (ALT) level of two times the upper limit of normal and detectable serum HBV DNA for at least three months. Patients received lamivudine for a minimum of six months (median 14 months). Genotyping was performed.RESULTS: Lamivudine treatment was effective in 35% of cases (15 of 43) and overall virological response (during or after treatment) was achieved in 51% of patients. Three patients harboured suspected lamivudine-resistant mutations and five progressed to HBeAg-chronic HBV. Predictive factors for success of treatment were: younger age at beginning of treatment (P=0.05), elevated ALT levels throughout treatment duration (P=0.003) and loss of HBeAg during treatment (P=0.016). Asian origin did not affect treatment success or spontaneous viral control during follow-up. HBV genotype did not influence treatment success.CONCLUSIONS: Lamivudine treatment in a carefully selected cohort of HBV patients demonstrated a good rate of success and low incidence of mutation. Younger age at the beginning of treatment and high ALT levels during treatment predicted a positive outcome.


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