Length Of Time In Treatment Research Articles

Maxillary Distraction Osteogenesis

Background: Distraction Osteogenesis is popular for long bones. And nowadays it has found its role in facial bone deficiency treatments. Purpose: We used our special designed Distractor for advancement of Maxillary deficiencies in cleft lip and palate patients. The purpose of this paper is to compare the treatment of hypoplastic, posteriorly retruded maxillary of cleft palate patients using distraction osteogenesis vs. Le fort I orthognathic surgery for length of advancement, stabil- ity and relapse, growth after distraction and soft tissue expansion and soft tissue profile changes. Meterial & Methods: In group A only Le fort I and surgical maxillary advancement sometimes with bone graft were done. In group B we used our special Distractor for Distraction Osteogenesis and advancement of the Maxillary bone. Demographic data, length of retrusion of maxilla, time length of treatment, length of advancement and relapse, SNA and SNB angles were measured and in- cluded in the study. The results were compared in each group before and after advancement and between both groups. The rate of distraction was 0.5 mm twice per day to achieve normal occlu- sion with 2 mm overcorrection more than calculated measures. The devices removed after 10 weeks as latency period. Results: The SNA increased at the end of distraction (p 10 mm) we recommend Distraction Osteogenesis, and it preferred to start it soon in younger ages.

Pt-Based Catalytic Microcombustor for Micropower Generation

This paper presents the fabrication and characterization of platinum-based catalytic microcombustor. The platinum catalyst was deposited onto type-304 stainless steel using the wet impregnation method. The stainless steel undergoes controlled conversion coating treatment in sulfuric acid solution to increase the porosity of its surface before the deposition of the platinum catalyst. The scanning electron microscopy result showed that the porosity on the stainless steel surface will depend on the length of treatment time in the sulfuric acid solution. The surface porosity increased as the treatment time increases. The stainless steel surface morphology changed from smooth to ‘cracked-mud’ morphology after treatment in sulfuric acid solution. The treatment time also provide significant effect to the amount of platinum deposited on the stainless steel surface. The energy dispersive x-ray analysis showed that the amount of deposited platinum for 10 seconds of treatment time was 0.68 wt%, whereas those for 20 and 30 seconds were 0.87 wt% and 1.10 wt%, respectively. Liquefied petroleum gas-air combustion result showed that the flame completely submerged inside the microcombustor with a catalyst, whereas portions of flame can be observed at the exhaust for the microcombustor without a catalyst. The minimum air-to-fuel ratios before the combustion blow-out for 10, 20, and 30 seconds of treatment time was 0.5, 0.4, and 0.3 respectively.

Physiotherapists demonstrate weight stigma: a cross-sectional survey of Australian physiotherapists.

Do physiotherapists demonstrate explicit and implicit weight stigma? Cross-sectional survey with partial blinding of participants. PARTICIPANTS responded to the Anti-Fat Attitudes questionnaire and physiotherapy case studies with body mass index (BMI) manipulated (normal or overweight/obese). The Anti-Fat Attitudes questionnaire included 13 items scored on a Likert-type scale from 0 to 8. Any score greater than zero indicated explicit weight stigma. Implicit weight stigma was determined by comparing responses to case studies with people of different BMI categories (where responses were quantitative) and by thematic and count analysis for free-text responses. Australian physiotherapists (n=265) recruited via industry networks. The mean item score for the Anti-Fat Attitudes questionnaire was 3.2 (SD 1.1), which indicated explicit weight stigma. The Dislike (2.1, SD 1.2) subscale had a lower mean item score than the Fear (3.9, SD 1.8) and Willpower (4.9, SD 1.5) subscales. There was minimal indication from the case studies that people who are overweight receive different treatment from physiotherapists in clinical parameters such as length of treatment time (p=0.73) or amount of hands-on treatment (p=0.88). However, there were indications of implicit weight stigma in the way participants discussed weight in free-text responses about patient management. Physiotherapists demonstrate weight stigma. This finding is likely to affect the way they communicate with patients about their weight, which may negatively impact their patients. It is recommended that physiotherapists reflect on their own attitudes towards people who are overweight and whether weight stigma influences treatment focus.

Psychiatric Comorbidity, Red Flag Behaviors, and Associated Outcomes among Office-Based Buprenorphine Patients Following Hurricane Sandy

In October 2012, Bellevue Hospital Center (Bellevue) in New York City was temporarily closed as a result of Hurricane Sandy, the largest hurricane in US history. Bellevue's primary care office-based buprenorphine program was temporarily closed and later relocated to an affiliate public hospital. Previous research indicates that the relationships between disaster exposure, substance use patterns, psychiatric symptoms, and mental health services utilization is complex, with often conflicting findings regarding post-event outcomes (on the individual and community level) and antecedent risk factors. In general, increased use of tobacco, alcohol, and illicit drugs is associated with both greater disaster exposure and the development or exacerbation of other psychiatric symptoms and need for treatment. To date, there is limited published information regarding post-disaster outcomes among patients enrolled in office-based buprenorphine treatment, as the treatment modality has only been relatively approved recently. Patients enrolled in the buprenorphine program at the time of the storm were surveyed for self-reported buprenorphine adherence and illicit substance and alcohol use, as well as disaster-related personal consequences and psychiatric sequelae post-storm. Baseline demographic characteristics and insurance status were available from the medical record. Analysis was descriptive (counts and proportions) and qualitative, coding open-ended responses for emergent themes. There were 132 patients enrolled in the program at the time of the storm; of those, 91 were contacted and 89 completed the survey. Almost half of respondents reported disruption of their buprenorphine supply. Unexpectedly, patients with psychiatric comorbidity were no more likely to report increased use/relapse as a result. Rather, major risk factors associated with increased use or relapse post-storm were: (1) shorter length of time in treatment, (2) exposure to storm losses such as buprenorphine supply disruption, (3) a pre-storm history of red flag behaviors (in particular, repeat opioid-positive urines), and (4) new-onset post-storm psychiatric symptoms. Our findings highlight the relative resilience of buprenorphine as an office-based treatment modality for patients encountering a disaster with associated unanticipated service disruption. In responding to future disasters, triaging patient contact and priority based on a history of red-flag behaviors, rather than a history of psychiatric comorbidity, will likely optimize resource allocation, especially among recently enrolled patients. Additionally, patients endorsing new-onset psychiatric manifestations following disasters may be an especially high-risk group for poor outcomes, warranting further study.

The nursing effect of ICU patients with artificial airway

Objective To explore the clinical effect of nursing for patients with artificial airway in ICU.Methods A total of 368 patients being established artificial airway were divided into study group and control group,each group had 184 cases.The control group was received conventional nursing,the study group was given bundle nursing.The artificial airway time,duration of ICU,mortality,pulmonary infection and the incidence of accidental decannulation were compared.Results ICU treatment time and artificial airway time of study group were shorter than those of control group (P ＜ 0.05) ; the pulmonary infection and accidental decannulation rate study group were lower than those of control group (P ＜ 0.05).Conclusions Bundle nursing is a good way of nursing,can effectively reduce the occurrence of complications in patients with risk,shorten the length of treatment time,and the use of ICU in patients with artificial airway. Key words: ICU ; Artificial airway ; Bundle nursing

Client disengagement from substance misuse treatment – Referral Agent perspectives

Length of time in treatment for substance misuse problems reliably predicts post-treatment outcomes. The reasons why people prematurely drop out of treatment remain poorly understood. This article explored client disengagement from the perspective of the referral agent. Implications for service provision are discussed.

Prevalence of anxiety symptoms among the clients maintained in methadone maintenance treatment programme at Tribhuvan University Teaching Hospital

Background: The symptoms of anxiety are widely prevalent among the former opioid addicts in methadone maintenance treatment (MMT). It is clinically important to be aware of the severity of the co-morbidity as it plays a crucial role in the methadone dosage, length of time in treatment and the relapse rate and the co-existence of co-morbidity has been described as the factor which worsens the prognosis. Aim: to study the prevalence of the symptoms of anxiety among MMT clients Methods: a descriptive, survey and a cross- sectional study, 60 MMT clients were selected who had been attending the MMTP for more than 2 months and were given with semistructured proforma specifically designed for this study only. Then after, they were evaluated for the anxiety symptoms with Beck Anxiety Inventory (BAI). Finally, the information obtained from the demographic profile and the rating scale were analyzed with the help of computer program SPSS. Results: The study showed around 41.7 % of the patients had symptoms of anxiety with varying severity. Correlates of presence of anxiety symptom among MMT client in the present study showed higher prevalence among age group 20-29(88%), 66% were separated and 64% were unmarried, 50% were Buddhist, majority of the case were chhetri (70%), 75% had primary level education, 67% were unemployed, and 65% from middle class socioeconomic status. Limitation: The study was a cross sectional, which showed only the symptoms of anxiety not the disorder and the drug use, withdrawals itself, could distort evaluation and lead to misdiagnosis of anxiety. Conclusion: The major risk factor for was male gender, separated, primary education level, students and middle socio-economic status.DOI: http://dx.doi.org/10.3126/jonmc.v1i1.7283 Journal of Nobel Medical College Vol.1(1) 2011 15-19

Impact of short-time treatment of prophylactic antibiotics for surgical site infection in cervical spinal surgery

This study is designed to determine the impact of the short-time usage of prophylactic antibiotics to prevent postoperative wound infection in spinal surgery. The medical records of 965 patients who underwent cervical spinal operation between 2009 and 2011 were collected for the assessment. These patients were divided into two groups based on antibiotic selection and duration of prophylactic antibiotic treatment:234 patients treated with prophylactic antibiotics for a short period of time were set as Group A, whereas Group B included 731 patients treated with prophylactic antibiotics for experience-based length of time. All the patients' records, including personal information, preoperational medical records, surgical records, postoperative medical information and the development of surgical site infections, were collected for analysis. In Group A, 153 patients were treated by second generation cephalosporins and 81 patients were treated by clindamycin. The duration of treatment was 1.17 ± 0.38 days. In Group B, 41 patients were treated by penicillin, 375 and 2 patients were treated by second and third generation cephalosporins, respectively, 128 patients were treated by clindamycin, 42 patients were treated by cephamycin, 128 patients were treated by quinolone, other antibiotic was used by 1 patient and other 14 patients were treated by combinations of antibiotics. The duration of the treatment in Group B was 5.72 ± 1.63 days. The significant differences between the length of treatment time in Group A and B were observed (P < 0.001). There were no statistical differences of pre-/post-operational leukocytes number compared between Group A and B. In addition, although the neutrophils in Group A and B are 70.70% ± 9.71% and 67.09% ± 9.78% respectively, indicating a subtle difference (t = 2.921, P = 0.004), however, these numbers were in normal range; therefore, no clinical significance was found from the comparison of neutrophils in groups. A total of 7 cases (0.73%) of surgical site infection were recorded, including 4 cases (1.71%) in Group A and 3 cases (0.41%) in Group B, all of which were posterior laminoplasty. With Fisher analysis (P = 0.063), these infection rates were not statistically significant. An appropriate usage of prophylactic antibiotics in a short period of time in cervical spinal surgery did not increase the rate of surgical site infection.

Return to work after acquired brain injury: A patient perspective

Primary objective: To study significant factors supporting vocational rehabilitation after acquired brain injury from a patient perspective.Methods: Two focus group interviews were accomplished with former patients. One focus group interview with professional rehabilitation personnel was performed to review the correspondence between patients’ and professionals’ opinion.Subjects: Fourteen informants with acquired brain injury (ABI) were interviewed. All were working at the time of the focus group interviews. Three occupational therapists and two psychologists participated in the professional group.Results: Two themes were identified as significant for returning to work: Personal and Society factors. Identified meaningful units could be categorized into sub-categories, which were grouped into six main- and 14 sub-categories. The main categories were: Self-continuity, Coping, Social factors, Rehabilitation intervention, Professionalism and Health insurance. Length of treatment time was described as crucial for the rehabilitation process and for utilizing individual resources.Conclusions: The effects of various synergies and processes form the basis for a successful return to work, which are dependent on, influence and reinforce each other. Society factors support personal factors to be used for returning to work after acquired brain injury. The impact of individual resources and rehabilitation highlights that vocational rehabilitation is inseparable from the individual's capacity, society and the context in which the individual lives.

Survey of a community-based infusion program for Australian patients with rheumatoid arthritis requiring treatment with tocilizumab: patient characteristics and drivers of patient satisfaction and patient-perceived benefits and concerns

BackgroundTocilizumab is an effective therapy for patients with moderate to severe rheumatoid arthritis that is administered by infusion over one hour every 4 weeks. The community-based infusion (ACTiv) program was introduced to Australia in August 2010 to provide accessible and convenient treatment for patients with rheumatoid arthritis who require tocilizumab. The primary objectives of this study were to determine the characteristics of patients in the ACTiv program, patient satisfaction, and patient-perceived benefits and concerns with the ACTiv program, and drivers of patient satisfaction and patient-perceived benefits and concerns.MethodsA voluntary self-administered survey was given to all 608 patients in the ACTiv program between January 27, 2011 and March 31, 2011.ResultsA total of 351 surveys were returned completed, giving a response rate of 58% (351/608). Most patients in the ACTiv program were women aged 40–64 years, with a mean disease duration of 13.7 years and moderate disability, who had been in the ACTiv program for ≥5 months. Most patients (88%, 302/342) were either very satisfied or satisfied with the ACTiv program and believed that they were very unlikely or somewhat unlikely to switch from the ACTiv program (64%, 214/335). The most important benefit was the reassurance of receiving treatment from a trained nurse in a professional medical environment (33%, 102/309). The most important concern was the fear of side effects (48%, 134/280). The main drivers of patient satisfaction and patient-perceived benefits and concerns of patients were health profile, previous medication experience, and length of treatment time in the program.ConclusionThe ACTiv program is used by patients of various ages, family life situations, and locations. Patient satisfaction with the program is high, which enables patients to benefit from long-term use of tocilizumab.

Pu-erh tea can inhibit atherosclerosis by promoting macrophage apoptosis in plaque through NF-κB pathway in ApoE null mice

PurposePu-erh tea has recently become very popular in China and most southeast Asian countries. Fermented Pu-erh tea may help regulate blood lipids, prevent and treat atherosclerosis (AS). Below, we discuss...

How to incorporate recent improvements in invisalign into clinical practice

Invisalign is an established technique in the treatment of malocclusion. Over the past few years, modifications have been incorporated into the system to produce more consistent and improved treatment results. Also, AcceleDent has been introduced, which has had a positive influence on the length of treatment time. Clinical Relevance: Keeping up with advances in the Invisalign technique allows for the best treatment results for our patients.

Women with alcohol problems: The possible significance of personality clustering for treatment planning

Establishing subgroups in clinical practice is important for treatment planning. The aim of the study was to cluster the study group subjects according to personality traits and psychological health variables and to establish possible differences in treatment outcome in terms of: (i) drinking outcomes (gram and number of drinking days); (ii) perceived physiological health; and (iii) use of treatment resources (length of time in treatment and number of visits) among 134 treatment-seeking women with alcohol problems in a clinical context, between the two clusters obtained. Data were collected from 134 consecutive women at a Swedish clinic specialised in treating women with alcohol problems. A hierarchical cluster analysis was performed on the basis of self-rated personality scale scores and psychological health variables. Two clusters were identified: one in which the women displayed personality and psychological health scores indicating problems (Cluster 1); and another where the women showed personality and psychological health scores within the norm range (Cluster 2). Alcohol consumption rates at the start of treatment were the same in both clusters. The consumption rates were also the same at the end of treatment for the cluster, showing a significant decrease in alcohol consumption in each. The Cluster 1 women, however, had a significantly higher number of visits at the clinic, and rated the consequences of their alcohol drinking as being significantly worse than Cluster 2 women. The importance of individual differences according to personality traits for treatment planning is discussed in terms of the need for variation in treatment time and methods.

Gay, Lesbian, Bisexual, and Transgendered People and Chemical Dependency: Exploring Successful Treatment

This exploratory and quantitative study presents a model of treatment success of the nation's oldest and largest chemical dependency treatment provider for the gay, lesbian, bisexual, and transgender (GLBT) population. The main purpose is to examine the potential ability of the predictor variables’ degree of affiliation with Alcoholics Anonymous (AA), the severity of chemical use, the strength of a higher power relationship, attitudes about sexual orientation, and length of time in treatment to predict length of time clean and sober. The proposed model demonstrated the ability to explain 29% of the variance in time clean and sober. Results lend tentative support for culturally competent treatment and include specific intervention recommendations for professionals, including social workers, chemical dependency counselors, and therapists.

Midpalatal implants for orthodontic anchorage

Randomised controlled trial. Patients with various malocclusions in which any forward movement of the molars would prevent achievement of an ideal Class I canine relationship were randomly allocated to either the headgear or the implant group. Randomisation was carried out by using a block design and computer-generated random numbers. The allocations were concealed in consecutively numbered, sealed envelopes. The outcomes were; surgical and orthodontic success rates of the implants, the number of visits, the length of treatment time and the success of treatment as judged by the peer assessment rating (PAR) score reductions and the patients' attitudes to implant placement. The surgical success rate of the implants was 75% and the orthodontic success rate was more than 90%. Both implants and headgear proved to be effective methods of reinforcing anchorage. The total number of visits was greater in the implant group, but the overall treatment times were almost identical. There were no statistically significant differences between the 2 groups in PAR scores either at the start or the end of treatment, and the percentages of PAR score reductions were almost identical. The patients had no problems accepting midpalatal implants as a method of reinforcing anchorage. The use of palatal implants to reinforce anchorage was as effective as extraoral anchorage with headgear.

CHARACTERISTICS OF NANOCRYSTALLINE COMPOUND LAYER OF ELECTROPLATED HARD CHROMIUM COATINGS AFTER PULSED PLASMA ELECTROLYTIC NITROCARBURIZING

Electrolytic Plasma nitrocarburizing was carried out on the hard chromium coating deposited in SM45C mild carbon steel substrate by electroplating in two different times and voltages. The electroplated samples were connected cathodically to a high-current pulsed power supply and biased with a negative voltage of 400 V. The treatment times were 5 and 60 minutes. A 5-μm thick layer was formed on the surface of Cr coating with microhardness of about 950- 1200 HV0.1. The microstructure of the treated layers depends strongly on the treatment time length. The corrosion properties of the treated layers depend on microstructure and can be improved, especially if a thin and dense complex layer is produced at the surface.

Palatal implants are a good alternative to headgear: A randomized trial

The objective of this study was to compare the effectiveness of midpalatal implants with that of headgear as methods of supplementing anchorage during orthodontic treatment. This was a randomized, clinical trial at the Chesterfield and North Derbyshire Royal Hospital NHS Trust and the Charles Clifford Dental Hospital, Sheffield, United Kingdom. Fifty-one orthodontic patients between the ages of 12 and 39 with absolute anchorage requirements were randomly allocated to receive either a midpalatal implant or headgear to reinforce orthodontic anchorage. The outcome measures of the trial were the surgical and orthodontic success rates of the implants, the number of visits, and the length of treatment time, and the success of treatment as judged by the peer assessment rating (PAR) score reductions and the patients' attitudes to implant placement. The surgical success rate of the implants was 75%, and the orthodontic success rate was more than 90%. Both implants and headgear proved to be effective methods of reinforcing anchorage. The total number of visits was greater in the implant group, but the overall treatment times were almost identical. There were no statistically significant differences between the 2 groups in PAR scores either at the start or the end of treatment, and the percentages of PAR score reductions were almost identical. The patients had no problems accepting midpalatal implants as a method of reinforcing anchorage. Midpalatal implants are an acceptable technique for reinforcing anchorage in orthodontic patients and a good alternative for patients who do not wish to wear headgear.

Does integrated trauma‐informed substance abuse treatment increase treatment retention?

AbstractThis article presents findings from a quasi‐experimental, nonrandomized group design study that explored whether trauma‐enhanced substance abuse treatment results in longer residential treatment stays and improved outcomes compared with treatment‐as‐usual. We used a subsample (N = 461) of participants in the Women, Co‐Occurring Disorders and Violence Study, which was sponsored by the Substance Abuse and Mental Health Services Administration. The intervention group was 31% less likely to discontinue treatment within 4 months. Baseline mental health and trauma symptoms and alcohol and drug severity scores predicted neither overall length of time in treatment nor differences in retention between intervention and comparison groups. Substance abuse and mental health symptoms improved with increased duration of treatment, particularly for women with more severe baseline symptoms. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 845–862, 2007.

Establishment of DNA oxidative damage model in colorectal crypt cells by hydrogen peroxide

To induce DNA oxidative damage in colorectal crypt cells by hydrogen peroxide in vitro. Hydrogen peroxide was diluted into 100, 50, 10, 5 and 1 micromol/L with RPMI 1640. Colorectal crypt cells were treated with peroxide for 10 min, 30 min, 1 h, 1.5 h, 12 h and 24 h respectively. The survival of colorectal crypt cell was measured by MTT method, and the DNA oxidative damage special product, 8-OhdG was detected with immunohistochemical staining. Liner regression was used to measure the time trend of survival rate with SPSS 10.0 software. Survival rate of colorectal crypt cell was 60% and 80% after 10 min of hydrogen peroxide treatment. The longer treatment of hydrogen peroxide, the lower survival rate; the survival rate was reduced to 30% in 24 h. After 10 or 30 min treatment of 100 or 50 micromol/L hydrogen peroxide, the survival rates of colorectal crypt cells were reduced by 20% compared with those of 10, 5 and 1 micromol/L hydrogen peroxide. However, while cells were treated with different concentrations of hydrogen peroxide for 1.0 h or above, there were no differences in cell survival rates. The time trend test results demonstrated that the survival rates of colorectal crypt cells treated with 10, 5 and 1 micromol/L hydrogen peroxide were significantly decreased with the time length of treatment. Colorectal crypt cells treated with different concentrations of hydrogen peroxide for 15 minutes were positively stained brown in cytoplasm and nuclear by immunohistochemistry with 8-OhdG monoclonal antibody. Hydrogen peroxide could induce DNA oxidative damage in colorectal crypt cells. And treated with 1 - 10 micromol/L hydrogen peroxide for 10 - 30 min, DNA oxidative damage is apt to be induced in colorectal crypt cell.

Comparative Effects of Methylphenidate and Mixed Salts Amphetamine on Height and Weight in Children With Attention-Deficit/Hyperactivity Disorder

To determine whether methylphenidate (MPH) and mixed salts amphetamine (MSA) have different effects on growth in children with attention-deficit/hyperactivity disorder. Patients treated for at least 1 year with MPH or MSA were identified. A linear regression was performed to determine the effect of stimulant type, patient gender, cumulative stimulant dose, and length of time in treatment on change in Z scores for height. A subset of patients was identified who had 3 years of consistent stimulant treatment on either MSA or MPH. Repeated-measures analyses of variance were performed to examine the effects of time and medication type on Z scores for weight, height, and body mass index. The linear regression showed no effect of stimulant type, drug holidays, or length of time of treatment on change in height Z score. Cumulative dose of stimulant had a small (-0.26) relationship to change in height Z scores. For patients treated for 3 years, there were no effects of stimulant or time on height Z scores. MSA produced more decrease in weight and body mass index Z scores than MPH; all of the subjects were heavier than average at baseline. MSA and MPH did not differ in their effects on height. MSA had more of an effect on weight than MPH, although the effect was modest in magnitude and may be of limited clinical significance.