Six-month Follow-up Study Research Articles

Arrest of chronic acid suppressant drug use after successful Helicobacter pylori eradication in patients with peptic ulcer disease: a six-month follow-up study.

It remains controversial whether successful H. pylori eradication leads to relief of dyspepsia and the subsequent arrest or tapering of acid-suppressant drug therapy, or to an aggravation of acid-related dyspepsia requiring more acid-suppressant drug intake. To evaluate prospectively the effect of H. pylori eradication on the requirement of acid-suppressant drug or antacids and the evolution of dyspeptic symptoms in chronic acid-suppressant drug users with peptic ulcer disease. The use of acid-suppressant drugs, rescue antacids and predominant symptoms were recorded prospectively during 24 weeks after H. pylori eradication therapy in 75 peptic ulcer disease patients. In 71 patients with complete follow-up, ulcers were healed at follow-up endoscopy and H. pylori was successfully eradicated. After 6 months, 93% (66 out of 71) of chronic acid-suppressant drug users had stopped acid-suppressant drug intake. The mean daily acid-suppressant drug dosage per patient decreased from 1.72 at entry to 0.03 units acid-suppressant drug (98%; P < 0.0001) during follow-up. The mean number of antacid tablets/day/patient was 0.26 during follow-up for the relief of mild inter-current dyspeptic symptoms. Medication use was not different in peptic ulcer disease patients with or without gastro-oesophageal reflux disease at baseline. The prevalence of gastro-oesophageal reflux disease decreased from 42% before to 35% after H. pylori eradication (N.S.). Successful H. pylori eradication in peptic ulcer disease patients almost completely eliminates the need for acid-suppressant drug regardless of the presence or absence of gastro-oesophageal reflux disease at entry.

Is Alexithymia a Permanent Feature in Depressed Patients?

Background: A six-month follow-up study was conducted to determine whether alexithymia is a permanent feature in 169 depressed outpatients. Methods: Diagnosis of depression was confirmed by means of the Structured Clinical Interview for DSM-III-R (SCID-I). Alexithymia was screened using the 20-item version of the Toronto Alexithymia Scale (TAS-20) and severity of depression was assessed using the 21-item Beck Depression Inventory (BDI). Results: Almost 40% of the patients were considered alexithymic at baseline, but only 23% at follow-up. Alexithymic patients were more often moderately or severely depressed than other patients in both study phases. The BDI scores explained 23% (at baseline) and 42% (at follow-up) of the variation in TAS-20 scores. The decrease in the TAS-20 scores was associated with a concurrent decrease in BDI scores. Conclusions: Alexithymic patients with depressive disorders do not appear to form a stable group. On the contrary, alexithymia seems to change as a function of depression. In the light of these results, alexithymia appears not to be a stable personality trait among depressed patients, and furthermore, it seems possible that alexithymic features respond to psychiatric treatment.

Female Condom Use among Women at High Risk of Sexually Transmitted Disease

Whereas the female condom has been evaluated in many hypothetical acceptability or short-term use studies, there is little information about its suitability for the prevention of sexually transmitted diseases (STDs) or HIV over extended periods of time. As part of a six-month prospective follow-up study of 1,159 STD clinic patients, clients were interviewed during their initial visit, exposed to a behavioral intervention promoting condoms, given a physical examination and provided with instructions on completing a sexual diary. Potential predictors of trying the female condom were evaluated using logistic regression, and three condom-use groups (exclusive users of female condoms, exclusive users of male condoms and users of both types of condoms) were compared using multinomial regression. Among 895 women who reported having engaged in vaginal intercourse during the study period, one-half had sex with only one partner, while one-quarter each had two partners or three or more partners. A total of 731 women reported using the female condom at least once during the follow-up period--85% during the first month of follow-up. Multiple logistic regression analyses indicated that employed women and those with a regular sexual partner at baseline were significantly more likely to try the female condom. By the end of the follow-up period, 8% of participants had used the female condom exclusively, 15% had used the male condom exclusively, 73% had used both types of condom and 3% had used no condoms. Twenty percent of women who tried the female condom used it only once and 13% used it twice, while 20% used 5-9 female condoms and 32% used 10 or more. Consistent condom users (N=309) were predominantly users of both types of condom (75%), and were less often exclusive users of the male condom (18%) or the female condom (7%). According to a multivariate analysis, women who used the female condom exclusively or who mixed condom types were more likely to be black, were more likely to be employed and were more likely to have a regular partner than were users of the male condom. Women at risk of STDs find the female condom acceptable and will try it, and some use it consistently. Mixing use of female condoms and male condoms may facilitate consistent condom use. The female condom may improve an individual's options for risk reduction and help reduce the spread of STDs.

Analysis of False-Negative Cancer Cases Identified with a Mammography Audit.

The purpose of this study was to analyze the causes of false-negative breast imaging in symptomatic and asymptomatic patients, as defined by cancer diagnosed within 1 year of a nonsuspicious mammogram. A computerized audit of 27,305 mammograms performed between November 1992 and December 1993 identified 50 patients who developed malignancy within 1 year of a mammographic report indicating negative, benign, or probably benign results. The audit revealed 26,661 mammograms interpreted as negative, benign, or probably benign. Of these, 50 patients were diagnosed with carcinoma within 1 year. Thirteen of the cancers were not visible retrospectively. Five were seen only in retrospect. Thirty-two were seen prospectively, of which 5 were interpreted as benign and 27 were interpreted as probably benign. Seventeen of the 27 probably benign were recommended for 6-month follow-up. Ten of the 27 probably benign had immediate ultrasound-guided fine needle aspiration cytology yielding unsuspected malignancy. In most (32/50) false-negative cases the lesions were seen prospectively but were interpreted as benign or probably benign. Ultrasound-guided aspiration averted a delayed diagnosis of malignancy in 20% (10/50) of the false-negative imaging interpretations. Six-month follow-up studies were helpful for 12 of 17 cases, where the lesions progressed within 1 year.

Increased Height Gain of Children Fed a High-Protein Diet during Convalescence from Shigellosis: A Six-Month Follow-Up Study

The impact of dietary supplementation on catch-up growth was evaluated in 69 malnourished children ages 24–60 mo after recovery from shigellosis. They were fed either a high-protein (HP) diet with 15% of energy as protein, or a standard-protein (SP) diet with 7.5% energy as protein, for 3 wk in a metabolic study ward. Children were followed up bi-weekly for 6 mo by trained health assistants when anthropometric measurements and information of any illness were collected. Thirty-one children in the HP group and 28 children in the SP group completed 6-mo follow-up. The increase in height (mean ± SD) was 5.3 ± 1.0 cm vs. 4.1 ± 1.1 cm for HP and SP groups, respectively (P < 0.001), whereas increase in body weight was 1.39 ± 0.58 and 1.29 ± 0.72 kg for children fed HP and SP, respectively (P = 0.59). The proportion of children who were severely stunted (< −2 SD height-for-age) decreased from 45 to 29% in the HP group compared to 50 to 46% in the SP group (P < 0.05) at 6-mo follow-up. The number of diarrheal episodes per child tended to be lower in the HP vs. SP than in the SP group (1.9 vs. 2.3, P = 0.41). These results demonstrate that feeding an HP diet to the malnourished children during recovery from shigellosis enhanced linear growth with a modest reduction in diarrheal morbidity during the 6-mo follow-up period.

国民体育大会出場レベルの高校男子水球選手の整形外科的メディカルチェック

A six-month follow-up study of athletic injury and physical fitness was conducted on ten players in a nationally ranked boys' high school water polo team. The first medical check-up was conducted on May 28th, 1995, and the second just 4 days before the national athletic meet on September 2 nd. The final check-up was done on November 18 th. A thorough examination in addition to X-ray evaluation by an orthopedist was done on June 26th after the first medical check-up.In our check-ups, athletic injuries were defined as injuries due to water polo or disorders which prevented individuals from playing. In the thorough examination, athletic injuries included any physical conditions that required further investigations or treatment by the doctor.Six players had taken part in swimming before taking up water polo, and seven had played water polo since junior high school. Of the athletic injuries sustained, 55% occurred at the age of 13-14 yr. Injuries due to carelessness and over-enthusiasm amounted to six. Motion pain in the pes anserius, iliotibial tract, and hip joints without traumatic episodes were thought to originate from the characteristic leg action under the water.Although body weight and height varied among the players, the differences in the values of body fat percentage, body mass index, and lean body mass were slight.Since the players had few complaints, athletic injuries were difficult to find. However, with periodic medical check-ups and a thorough examination, we are able to prevent some problems such as pain in the pes anserius or iliotibialtract.

Disulfiram Treatment of Alcoholism

To assess the efficacy of supervised disulfiram as an adjunct to out-patient treatment of alcoholics, a randomised, partially blind, six-month follow-up study was conducted in which 126 patients received 200 mg disulfiram or 100 mg vitamin C under the supervision of a nominated informant. In the opinion of the (blinded) independent assessor, patients on disulfiram increased average total abstinent days by 100 and patients on vitamin C by 69, thus enhancing by one-third this measure of treatment outcome. Mean weekly alcohol consumption was reduced by 162 units with disulfiram, compared with 105 units with vitamin C, and the disulfiram patients reduced their total six-month alcohol consumption by 2572 units compared with an average reduction of 1448 units in the vitamin C group. Serum gamma-GT showed a mean fall of 21 IU/I in patients on disulfiram but rose by a mean of 13 IU/I with vitamin C. Unwanted effects in the disulfiram group led to a dose reduction in seven patients and to treatment withdrawal in four (and in one vitamin C patient). Two-thirds of the disulfiram group asked to continue the treatment at the end of the study. There were no medically serious adverse reactions.

Medical students using Grateful Med: Analysis of failed searches and a six-month follow-up study

Medical students at the University of Missouri were taught to search MEDLINE using the Grateful Med software. The traffic files of student searches were analyzed for search behavior. This paper reports on two specific aspects of these analyses: (1) failed searches where retrieval was either too large or too small (zero hits); and (2) a six month follow-up study which focused on error rates and retention of skills. The two major reasons for retrieving too many citations were entering a phrase on a single subject line and a search of only one concept. Of the zero hit searches, the most commonly occurring errors were MeSH (medical subject headings) not used, other MeSH errors, misspelling or keyboard errors, and faulty logic. During the six month follow-up study, the error rates of students declined in spite of the fact that they had not used the software in six months. Furthermore, a larger percentage of the searches showed a more sophisticated use of MeSH than previously employed.

Social Hassles and Psychological Health in the Context of Chronic Crowding

Data are presented on the interactive effects of an enduring environmental stressor with acute, daily social stressors on psychological distress. A cross-sectional study of males in urban India and a longitudinal study of male and female American college students examined the interplay of these two types of stressors. In India, social hassles in the home predicted psychological symptoms only among residents of crowded homes, after statistically adjusting for income. In America, the interaction between social hassles and crowding was replicated in analyses adjusting for prior psychological symptoms, prior social acquaintanceship with housemates, and income. A six-month follow-up study with the American sample replicated the interaction. In all three analyses of the social hassle-crowding interaction, there was a main effect of crowding but no main effect of social hassles on psychological symptoms. These findings suggest that some chronic environmental stressors may increase the impact of acute social stressors, and highlight the importance of examining contextual factors in the stress and health process.

Lack of causal relationship between depressive symptoms and eating abnormalities in a nonclinical population: Findings from a six-month follow-up study

Lack of causal relationship between depressive symptoms and eating abnormalities in a nonclinical population: Findings from a six-month follow-up study

Moving into Homelessness After Psychiatric Hospitalization

A six-month follow-up study of 132 former patients of a state hospital examines those subjects who become homeless and compares them with those subjects who do not. A quantitative and qualitative approach is used to document the process of homelessness that occurs after psychiatric hospitalization. A set of policy options is resented that can respond to the special needs of homeless mentally ill persons.

Parental Participation and a Child's Self-Concept

This study examined the effects of parental participation in a parent group on a child's self-concept with a six-month follow-up study. Forty-five elementary school children were randomly assigned ...

Inmate Adjustment to Prison and the Transition to Community Life

Traditional prisons contain two separate and to some extent mutually ex clusive institutional cultures: the formal culture promulgated by the adminis tration and staff and the informal inmate subculture. While prior research on inmate adaptation to prison has focused on the inmate subculture, this paper examines inmate assimilation into the formal prison culture as well and ex plores the relationship between mode of adjustment to prison and the process of transition to community life. This study consisted of two phases. Phase 1 delineated four modes of adjustment to incarceration-rebellious, institu tionalized, manipulative release oriented, and positivistic-through the use of behavioral, attitudinal, and demographic data. Phase 2, a six-month follow-up study of a sample of inmates after their release from prison, found that pa rolees who had used the institutionalized mode of adjustment to prison had the greatest difficulties during the first two months on parole and rebellious in mates made the smoothest transition. In addition, prisonization was not found to impair postrelease outcome. These results suggest that inmate conformity to the formal institutional culture may lead to difficulties after release, while nonconformity may enhance short-term postrelease adaptation.

College students as contingency managers for adolescents in a program to develop reading skills.

Behavior-modification procedures and an individualized tutorial program were used to remediate reading skill deficits in seventh-grade adolescent subjects. Forty-two college students were trained as reading tutors and contingency managers to use reading diagnostic and remedial materials, and to develop contracts and reinforce positive verbal responses toward reading. Significantly greater increases in reading scores of experimental groups, compared to control groups, substantial improvement in target behaviors, and significant changes in verbalizations toward reading were observed after 10 weeks of treatment. Six-month followup studies showed that all groups had consolidated their gains and that grade scores continued to improve. The improvement of the experimental subjects remained significantly ahead of the control subjects.

Booster Vaccination With Further Live Attenuated Measles Vaccine

Revaccination with live attenuated measles vaccine was evaluated in a large group of children to determine (1) if protective antibody to measles infection could be augmented and (2) after what interval will the revaccination yield optimal results. The rate of decline in measles hemagglutination-inhibition (HI) antibody was observed to be directly related to the time interval since the previous vaccination, and individuals with declining titers became increasingly responsive to revaccination with a maximal response approximately four to six years after previous vaccination. Six-month follow-up studies demonstrated sustained elevations in measles HI antibody titers. Measles-neutralizing antibody showed less tendency to sustain a titer increase with revaccination. The observations suggest that revaccination with live, further attenuated measles vaccine is safe and may augment immunity.

Effect of short-term physical training on patients with rheumatoid arthritis. a six-month follow-up study.

Twenty-three patients with rheumatoid arthritis were retested about 6 months after 5 weeks' physical conditioning and 7 patients from a former control group were also retested. Former training group patients, who had continued to train about 4 times or more per week, had maintained the improved physical status obtained during the initial conditioning, while those patients who had trained less than that or discontinued training, had lost some or most of their improvement. The physical status in the former control group was virtually remained unchanged. Joint status in the former training group was no different at re-test than at post-training or pre-training examinations. A questionnaire, given to the training group patients. Four patients from this group returned to work had positively affected the daily physical activity of these patients. Four patients from this group returned to work after the hospital training program.