Treatment Outcome
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2021 ◽  
pp. 014556132110546
Changhee Lee ◽  
Nayeon Choi ◽  
Yurimi Lee ◽  
Joo Hyun Park ◽  
Young-Ik Son

Rosai–Dorfman disease (RDD) is a rare non-malignant disorder, characterized by painless multiple cervical lymphadenopathy, fever, and elevated inflammatory markers. Its diagnosis is difficult due to its rare incidence and various clinical presentations, especially in extranodal involvement. In this report, we demonstrate a patient with RDD who presented with a nasal septum and laryngeal tumor that caused dyspnea. We achieved a successful treatment outcome with combined surgical resection of the laryngeal mass and corticosteroid medication. The symptoms and tumors were resolved within 3 weeks after treatment. We reported our experiences with review of literatures.

2021 ◽  
Vol 21 (1) ◽  
Jasper Nidoi ◽  
Winters Muttamba ◽  
Simon Walusimbi ◽  
Joseph F. Imoko ◽  
Peter Lochoro ◽  

Abstract Background Tuberculosis (TB) is a major public health problem and at 48%, Karamoja in North-Eastern Uganda has the lowest treatment success rate nationally. Addressing the social determinants of TB is crucial to ending TB. This study sought to understand the extent and ways in which socio-economic factors affect TB treatment outcomes in Karamoja. Methods We conducted a convergent parallel mixed methods study in 10 TB Diagnostic and Treatment Units. The study enrolled former TB patients diagnosed with drug-susceptible TB between April 2018 and March 2019. Unit TB and laboratory registers were reviewed to identify pre-treatment losses to follow-up. Four focus group discussions with former TB patients and 18 key informant interviews with healthcare workers were conducted. Principle component analysis was used to generate wealth quintiles that were compared to treatment outcomes using the proportion test. The association between sociodemographic characteristics and TB treatment outcomes was evaluated using the chi-square test and multiple logistic regression. Results A total of 313 participants were randomly selected from 1184 former TB patients recorded in the unit TB registers. Of these, 264 were contacted in the community and consented to join the study: 57% were male and 156 (59.1%) participants had unsuccessful treatment outcomes. The wealthiest quintile had a 58% reduction in the risk of having an unsuccessful treatment outcome (adj OR = 0.42, 95% CI 0.18–0.99, p = 0.047). People who were employed in the informal sector (adj OR = 4.71, 95% CI 1.18–18.89, p = 0.029) and children under the age of 15 years who were not in school or employed (adj OR = 2.71, 95% CI 1.11–6.62, p = 0.029) had significantly higher odds of unsuccessful treatment outcome. Analysis of the pre-treatment loss to follow-up showed that 17.2% of patients with pulmonary bacteriologically confirmed TB did not initiate treatment with a higher proportion among females (21.7%) than males (13.5%). Inadequate food, belonging to migratory communities, stigma, lack of social protection, drug stock-outs and transport challenges affected TB treatment outcomes. Conclusions This study confirmed that low socio-economic status is associated with poor TB treatment outcomes emphasizing the need for multi- and cross-sectoral approaches and socio-economic enablers to optimise TB care.

2021 ◽  
pp. 145507252110507
Jacob Hystad ◽  
Turid Wangensteen

Aim: The aim of this study was to explore the narratives of former substance use disorder (SUD) inpatients about substance use after their discharge from long-term SUD treatment in 2017. Method: We conducted semi-structured in-depth interviews with 11 former inpatients of SUD treatment. The data were analysed using a qualitative, thematic analysis model. Findings: During the analysis, two main themes emerged pertaining to participant reflections on substance use – their experience of non-problematic substance use (that is, substance use without declining into pre-treatment levels of misuse behaviours) and problematic substance use (that is, substance use associated with destructive patterns). All participants except one had engaged in substance use after their discharge three to four years ago. The commonly used substance was alcohol, which also appeared to be the most common substance for which there was consensus among the informants regarding non-problematic use. Conclusions: Most of the participants continued to use substances in some way, and some reported that such use did not affect them negatively. Healthcare providers and therapists in SUD treatment should avoid defining a relapse or failed treatment outcome in concrete terms. What is perceived as an actual relapse or a failed treatment outcome is highly subjective. Furthermore, complete sobriety might not necessarily be the best or the only way to measure the SUD treatment stay. An improvement in the quality of life and well-being, even when core symptoms are still present, may be considered a successful treatment outcome.

2021 ◽  
Katrin Haller ◽  
Pauline Becker ◽  
Helen Niemeyer ◽  
Johanna Boettcher

Objective: To our knowledge, no systematic review or meta-analysis has been conducted on all predictors or moderators of treatment outcome across diagnoses in guided internet-based interventions (IBIs) for adults. We aimed to aggregate the results of relevant studies and identify research gaps. Methods: After duplicate removal, 1615 articles, identified by searching the databases PsycInfo, Ovid Medline, and Pubmed and through snowballing, were screened following detailed in- and exclusion criteria in April and May 2021. Risk of bias (QUIPS) and intra- and interrater reliability for screening and risk of bias were assessed. Variables were grouped and categorized, then synthesized using vote counting based on direction of effect. Results: N=50 articles were included in the review. Seventy-seven predictors or moderators were generated, of which adherence, baseline symptoms, education, age, and gender were most frequently assessed. Adherence, treatment credibility, working alliance, and baseline scores emerged as conclusive predictors/moderators. Results for other variables were mainly inconsistent or inconclusive. Conclusion: Our review highlights that it is currently difficult to predict, across diagnoses, who will benefit from guided IBIs. Further rigorous research is needed to identify predictors and moderators based on a sufficient number of studies. PROSPERO registration: CRD42021242305.

2021 ◽  
Vol 3 (1) ◽  
Yueqian Sun ◽  
Guoping Ren ◽  
Jiechuan Ren ◽  
Qun Wang

AbstractHigh-frequency oscillations (HFOs) in the electroencephalography (EEG) have been extensively investigated as a potential biomarker of epileptogenic zones. The understanding of the role of HFOs in epilepsy has been advanced considerably over the past decade, and the use of scalp EEG facilitates recordings of HFOs. HFOs were initially applied in large scale in epilepsy surgery and are now being utilized in other applications. In this review, we summarize applications of HFOs in 3 subtopics: (1) HFOs as biomarkers to evaluate epilepsy treatment outcome; (2) HFOs as biomarkers to measure seizure propensity; (3) HFOs as biomarkers to reflect the pathological severity of epilepsy. Nevertheless, knowledge regarding the above clinical applications of HFOs remains limited at present. Further validation through prospective studies is required for its reliable application in the clinical management of individual epileptic patients.

2021 ◽  
Vol 12 ◽  
Kari Guderud ◽  
Line H. Sunde ◽  
Siri T. Flåm ◽  
Marthe T. Mæhlen ◽  
Maria D. Mjaavatten ◽  

BackgroundMethotrexate (MTX) is the first line treatment of rheumatoid arthritis (RA), and methylation changes in bulk T cells have been reported after treatment with MTX. We have investigated cell-type specific DNA methylation changes across the genome in naïve and memory CD4+ T cells before and after MTX treatment of RA patients. DNA methylation profiles of newly diagnosed RA patients (N=9) were assessed by reduced representation bisulfite sequencing.ResultsWe found that MTX treatment significantly influenced DNA methylation levels at multiple CpG sites in both cell populations. Interestingly, we identified differentially methylated sites annotated to two genes; TRIM15 and SORC2, previously reported to predict treatment outcome in RA patients when measured in bulk T cells. Furthermore, several of the genes, including STAT3, annotated to the significant CpG sites are relevant for RA susceptibility or the action of MTX.ConclusionWe detected CpG sites that were associated with MTX treatment in CD4+ naïve and memory T cells isolated from RA patients. Several of these sites overlap genetic regions previously associated with RA risk and MTX treatment outcome.

Mycoses ◽  
2021 ◽  
Durga Shankar Meena ◽  
Deepak Kumar ◽  
Madhulata Agarwal ◽  
Gopal Krishana Bohra ◽  
Rahul Choudhary ◽  

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