Eighteen-month Follow-up Research Articles

Serial Clinical and Angiographic Follow-Up After Phosphorylcholine-Coated Stent Implantation

The efficacy of drug-eluting stents (DES) has been proven, but concerns about late complications after DES have been raised. Polymers that do not increase inflammatory or hypersensitivity reactions which may contribute to late complications are needed for new generation DES. To evaluate the safety and efficacy of phosphorylcholine-polymer coating, we investigated serial clinical and angiographic outcomes after phosphorylcholine-coated stent placement. Seventy-five consecutive patients treated with a BiodivYsio phosphorylcholine-coated stent for de novo lesions at our institute between October 2001 and August 2002 were enrolled. Six-month follow-up angiography was performed in 71 lesions (94.7%), and angiographic restenosis was found in 19 lesions (26.8%). Target lesion revascularization (TLR) was performed in 10 lesions (14.1%). Eighteen-month follow-up angiography was performed in 58 (95.1%) of the remaining 61 lesions (excluding TLR lesions), and angiographic restenosis was found in only 3 lesions. The cumulative MACE-free survival rate was 86.3%, 83.6%, and 78.6% at 6-month, 18-month, and 8-year follow-up, respectively. There were no episodes of stent thrombosis. Late loss decreased significantly from 0.74 ± 0.40 mm (6-months) to 0.51 ± 0.46 mm (18-months) (P < 0.0001). Phosphorylcholine-coated stent implantation was associated with acceptable clinical and angiographic results. Phosphorylcholine-coating may be an ideal polymer for new generation DESs.

Successful Pregnancy after Simultaneous Pancreas-Kidney Transplantation

The effect of pregnancy on simultaneous pancreas-kidney transplant recipients has previously been described, but experience is limited. We describe the case of a thirty-five-year-old female who previously underwent simultaneous pancreas-kidney transplant for type 1 diabetes mellitus-complicated nephropathy. An integrated multidisciplinary team including the transplant team, nephrologist, endocrinologist, and obstetrician closely followed progress during pregnancy. Blood glucose levels and HbA1c remained within normal limits, and she did not require insulin treatment at any point. She experienced deterioration in renal indices and underwent an uncomplicated, elective Caesarean section at thirty-week gestation. She delivered a male infant of 1.18 kg, appropriate for gestational age, who had hypothermia and respiratory distress, which required intubation and ventilation and an eleven-week stay in the special care baby unit. At eighteen-month followup the infant shows normal development, and there has been no deterioration in either grafts' function.

UP-1.44: Laser vaporization for the treatment of BPH: prospective study with an eighteen-month follow-up

Selective photo vaporization with the 80-Watts KTP laser for the treatment of BPH is gaining interest in many countries. Short-term outcomes appear promising. However, long-term data are scarce. We report our experience with 18-month follow-up.

Eighteen-Month Follow-Up of HIV-1–Infected Mothers and Their Children Enrolled in the Kesho Bora Study Observational Cohorts

To assess the effectiveness and safety of antiretrovirals (ARVs) used for treatment or prophylaxis in a breastfeeding population of HIV-1-infected women (Burkina-Faso, Kenya, South Africa). HIV-1-infected pregnant women with <200 CD4 cells per cubic millimeter or with World Health Organization stage 4 disease (cohort A) and asymptomatic women with >500 CD4 cells per cubic millimeter (cohort B) were enrolled into 2 prospective cohorts. Women with 200-500 CD4 cells per cubic millimeter were enrolled in a parallel randomized trial. Women in cohort A initiated antiretroviral therapy. Women in cohort B received zidovudine from 34 to 36 weeks gestation until delivery, with single-dose nevirapine in labor (cohort B). All children received single-dose nevirapine. Of 248 women enrolled, 111 (cohort A) and 125 (cohort B) infants alive at 24 hours after birth were analyzed. Sixty-nine percent and 42% of women had undetectable viral load at delivery, respectively. Ten children in each cohort died. The 18-month cumulative incidences of HIV-1 infection were 7.5% (95% confidence interval: 3.8% to 14.5%) (cohort A) and 5.8% (2.8% to 11.8%) (cohort B). Sixty-one percent (cohort A) and 78% (cohort B) were breastfed for a median duration of 20 weeks. Four children in cohort A and only 1 in cohort B became HIV-1 infected after 6 weeks of age. Antiretroviral therapy initiated a median of 7 weeks before delivery in women with advanced HIV-1 disease was associated with a significant residual risk of HIV-1 transmission due to insufficient decrease in viral load by the time of delivery. Among women with >500 CD4 cells per cubic millimeter, the risk of breast-milk transmission was very low despite lack of postnatal prophylaxis.

Inflammatory Pseudotumor of the Spleen Associated With a Clonal Epstein-Barr Virus Genome

We report a case of an inflammatory pseudotumor (IPT) of the spleen occurring in an 81-year-old woman with a history of a monoclonal gammopathy of undetermined significance. Eighteen-month follow-up after splenectomy demonstrated no tumor recurrence or progression of underlying plasma cell disease. Histologic examination of the tumor demonstrated a polymorphic population of inflammatory and epithelioid and spindle cells. Immunophenotyping showed large numbers of T cells, B cells, and polyclonal plasma cells. The epithelioid and spindle cells were positive for vimentin and CD68 but lacked expression of follicular dendritic cell markers and actin. Epstein-Barr virus (EBV) genome was identified in the epithelioid and spindle cell population by in situ hybridization using probes specific for EBV-encoded RNAs (EBER1 and EBER2). Southern blot analysis of digested DNA extracted from the tumor using an EBV-specific probe (XhoI) demonstrated the presence of a single high-intensity band, indicative of EBV monoclonality. While there have been 2 previous reports of hepatic IPTs containing a monoclonal population of EBV-infected tumor cells, this is the first report of such an association occurring in the spleen. The presence of clonal EBV DNA suggests some splenic IPTs may be true neoplasms.

Eighteen-month Follow-up of Infants Fed Evaporated Milk Formula

In parts of Canada including Newfoundland and Labrador and among Aboriginal peoples, infants still consume evaporated milk (EM) formulas for cultural and economic reasons. At 3 and 6 months, full-term infants fed EM (n = 30) received low intakes of iron, thiamine, selenium and had higher weight velocity than breastfed (BF, n = 29) infants. EM infants had greater anemia, lowered transketolase activity (thiamine) and lowered glutathione peroxidase (selenium) activity (p < 0.05). To determine the later effect of early feeding deficit on nutritional status, we examined these same infants at 18 months of age. At that time, there were no differences in dietary intakes of energy, protein, zinc, copper, selenium and iron, nor in plasma levels of zinc, copper, vitamin C, nor in red blood cell activity levels of glutathione reductase (riboflavin), transketolase, glutathione peroxidase, nor in superoxide dismutase. However, EM infants weighed more and were more likely to visit a physician, have anemia, and have iron depletion than were BF infants. We conclude that infants consuming evaporated milk formulas should receive iron supplements throughout infancy.

Eighteen-month follow-up of male subfertility clinic attenders: A comparison between men whose partner subsequently became pregnant and those with continuing subfertility

This paper reports follow-up data on 50 male subfertility clinic attenders and compares outcome in those whose partners subsequently became pregnant and those who remained subfertile. At 18 months 30% of participants reported pregnancies. Data were collected on mood, life satisfaction and self-blame. Over time there were no significant within subject changes on any measures in either the subsequently pregnant or continuing subfertile group. At initial clinic attendance there was no significant difference between those whose partner subsequently became pregnant and those whose partner did not. At 18-month follow-up there was a significantly greater change in life satisfaction scores (in a positive direction) in the pregnant group as compared with continuing subfertile group.

Eighteen-Month Follow-up of Glipizide and Human Insulin Combination in the Treatment of Type II Diabetes Mellitus

Eighteen-Month Follow-up of Glipizide and Human Insulin Combination in the Treatment of Type II Diabetes Mellitus

The Effects of Group Treatment for Men Who Batter: An 18-Month Follow-Up Study

Social workers, psychologists, and other mental health professionals are increasingly offering services to men who batter their women partners. This article describes the results of an experiment comparing three types of brief treatment groups offered in two differing intensities to batterers. Of 283 men who were randomly assigned to one of the six treatment conditions, 153 completed 80% or more of the assigned sessions. Eighteen-month follow-up interviews were conducted with 70 program completers or their partners. The results indicated that short-term, relatively structured group treatment tended to produce the most consistent successful results compared to an earlier study. Men's involvement with the courts and their lack of prior mental health treatment predicted lower levels of violence at the 18-month follow-up.

Self-Help versus Group Approaches to Smoking Cessation in the Workplace: Eighteen-Month Follow-up and Cost Analysis

Abstract This study evaluated the relative efficacy and cost-effectiveness of a stop smoking clinic and self-help kit, and characteristics of those who benefited most from each approach. Employees attended an orientation of quit smoking programs that included a brief description of the American Lung Association's "Freedom From Smoking" clinic and "Freedom From Smoking in 20 Days" self-help kit. Seventy registrants provided both baseline and 18-month follow-up information by questionnaire. The two methods attracted smokers with somewhat different socio-demographic characteristics. The combined quit rate for the two groups was 17 percent at 18 months. Cost per participant was twice as high for the clinic method ($32 vs. $16), but cost per successful quitter was similar in both groups (about $150). In light of these results, employees should continue to be offered a choice of self-help and clinic approaches to smoking cessation in order to reach the largest potential number of participants.

Eighteen-month follow-up of neuropsychiatric effects of pentaborane intoxication

Fourteen individuals briefly exposed to the neurotoxic compound Pentaborane were reevaluated 18 months following initial neurpsychiatric study. Psychiatric interview utilizing standardized diagnostic criteria, neuropsychological and psychological assessment, and CT scan ventricular brain ratios were reevaluated. Assessment revealed interaction of bilogical and psychological factors worsening. Post-traumatic stress disorder, major affective disorder, alcohol abuse, and phobias were the most common diagnoses at follow-up.

Predictors of long term outcome following a bladder re-training programme

A total of fifty-three female patients suffering from urinary urgency and urge incontinence completed a bladder re-training programme which comprised behavioural and biofeedback treatment components. The psychological status of patients prior to treatment and at eighteen-month follow-up was compared. The role of clinical and psychological factors was examined in relation to treatment outcome (immediately following treatment and at eighteen-month follow-up). Compared to pre-treatment, patients at the eighteen-month follow-up were experiencing fewer psychological symptoms and were more internal with respect to their locus of control, irrespective of urological response to the programme. Poor treatment compliance predicted a poor treatment response both in the short-and long-term. Excessive worrying about, and preoccupation with, the urinary symptoms, previous surgery, and chronic urinary symptoms were all good predictors of a poor treatment response in the long term.

Eighteen-month follow-up on the treatment of urinary schistosomiasis with a single dose of metrifonate.

Egg excretion of school children with urinary schistosomiasis treated with a single 10 mg/kg dose of metrifonate was monitored over a period of 18 months. At 18 months 68.8% of infected children showed a greater than 90% reduction in egg excretion and 23.7% had ceased excreting eggs. During the study period 25% of children with no evidence of infection at the start of the trial had become infected, while 45.5% of children apparently cured by the metrifonate treatment had recommenced egg excretion. The evidence suggested that reinfection rather than recovery of adult worms was responsible. Children with scanty or light infections, in general, showed increasing egg excretion rates during the following period, while those with heavy or severe infections showed a sustained reduction. In view of this, single dose metrifonate may be a useful approach to mass treatment in a schistosomiasis control program, resulting in significant reduction in egg excretion in those most likely to be important sources of transmission.

Preliminary Contact With a Mailed Follow-Up Survey

This study examined the effects of preliminary contact by mail and telephone on the rate of response to a follow-up survey offormer mental health patients. The subjects were the par ents or parenting figures of 145 children due for six- or eighteen-month follow-up as part of the evaluation of the services provided at an outpatient child psychiatric facility. The survey instruments were the Child Behavior Checklist and a thirty-one item descriptive adjective rating scale. A significant effect wasfoundfor the use of preliminary contact, but notfor the use of telephone contact rather than mailed precontact. Additionally, it wasfound that it was difficult to contact subjects over the telephone and that telephone precontact was more expensive than mailed precontact. This article also addresses the problem of maintaining patient confidentiality while identifying prospective subjects who had moved since their last visit to the facility for treatment. This balance between study power and former patients' rights to privacy is a difficult question for mental health service evaluations.

Brief group therapy following myocardial infarction: eighteen-month follow-up of a controlled trial.

Sixty post-myocardial infarction (MI) subjects have been followed for up to eighteen months' time following their MI. Thirty-eight of these subjects completed a brief series of four to six group therapy sessions during their early rehabilitation phase; the others received no group therapy. Both groups were placed on otherwise identical schedules of outpatient follow-up. Group therapy patients have, to date, experienced significantly fewer cardiac complications than controls. Only one death has occurred, and that one patient was in the control group. A coronary heart disease teaching evaluation questionnaire was given to a sample of group therapy patients, a sample of controls, and a comparison group of men without MI. Following their group therapy sessions, these men demonstrated significantly greater knowledge of their disease and its optimal rehabilitation than did control or comparison subjects. Control patients' questionnaire results proved to be insignificantly different from those of the comparison group.

Case study in self-modification: Suppression of inflammatory scratching while awake and asleep

Self-directed modification programs are of increasing interest, and can be of use even in rather serious conditions. The subject of the case reported here maximized the self-direction, since she designed, maintained and terminated her own treatment, using only brief non-professional consultation. The young woman suffered from a neurodermatitis of 17 yr duration. Scratching her limbs while awake and asleep inflamed and infected her skin. A 20-day contingency program reduced scratching to zero, and eliminated itching. Eighteen-month follow-up revealed two brief recurrences, quickly suppressed by reinstitution of the self-modification program. She is currently asymptomatic.

Eighteen-Month Follow-up of Gastric Freezing in 173 Patients With Duodenal Ulcer

Gastric freezing for chronic duodenal-ulcer disease has been performed in 173 cases and an 18-month minimum follow-up has been achieved. The overall study indicates that 92.5% of the patients had symptoms or corrective surgery for recurrent disease at the time of the 18-month evaluation. Patients experience relief from previously distressing symptoms immediately following gastric freezing but the secretion of hydrochloric acid quickly returns to prefreeze levels or higher. Some patients are deceptively asymptomatic at three months postfreeze although acid levels are again high. Gastric freezing is a dramatic episode in the life of a patient with chronic duodenal ulcer and it appears to have a rather strong emotional appeal and to support subjective relief even in the absence of objective improvement.

Eighteen-month follow-up of gastric freezing in 173 patients with duodenal ulcer

Eighteen-month follow-up of gastric freezing in 173 patients with duodenal ulcer