Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Retreatment”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources
PubMed1982

Lung cancer: retreatment of local recurrence after definitive irradiation.

Aggressive radiation therapy for the management of inoperable lung cancer has increased tumor control and survival. However, approximately 20% of patients continue to experience local recurrence as the sole manifestation of treatment failure. Seven hundred thirty-four patients were initially treated by radiation therapy for inoperable lung cancer, for recurrence after resection, or as adjunct postoperative therapy. Twenty-nine patients were referred for retreatment of cancer that recurred within the original treatment field. Following retreatment, 14 of 29 patients (48%) had a favorable subjective response, and 20 of 27 patients (74%) a favorable objective response. A favorable response was observed for all cell types and over a wide range of retreatment dosages. Symptomatic radiation pneumonitis developed in one patient, rib sclerosis and fracture developed in another. Th median survival after onset of retreatment was five months with a range of one month to 54 months. The clinically determined mechanisms of death were persistent intrathoracic disease in 14 of 25 patients (56%), intrathoracic disease and distant metastasis in 7 of 25 (28%), distant metastasis in 3 of 25 (12%), and unknown in 1 of 25 (4%).

Adult↗
PubMed1996

A family retreat as a comprehensive intervention for children with arthritis and their families.

OBJECTIVE: Family resources and coping skills are important to adaptation to pediatric chronic illness. Psychological and educational interventions have been found to enhance the coping skills of children with juvenile rheumatic disease (JRD) and their families. We examined the efficacy of a 3-day family retreat as a multidisciplinary, comprehensive treatment. METHODS: Children with JRD and their caregivers completed questionnaires assessing the children's behavioral and emotional functioning, pain, strain on caregivers' work and leisure activities, and caregivers' psychological distress before and 6 months after the family retreat. Principal caregivers were both parents for 16 children, mothers only for 10 children, and an aunt for 1 child. RESULTS: Improvements were found in children's emotional functioning, strain on caregivers' work, and strain on caregivers' leisure activities. Reductions in reported pain were not consistently revealed. CONCLUSIONS: Family retreats are an efficacious, multidisciplinary approach to helping families of children with JRD cope with the disease and its manifestations. Importantly, retreats offer a comprehensive intervention package that might not be available to families on an individual basis.

Adaptation, Psychological↗
PubMed1999

Chronic hepatitis C virus patients with breakthroughs during interferon treatment can successfully be retreated with consensus interferon. The Consensus Interferon Study Group.

Patients with chronic hepatitis C who have not had a sustained hepatitis C virus (HCV)-RNA response or serum alanine transaminase (ALT) response to a 6-month course of interferon (IFN) may respond to higher dose retreatment with consensus interferon (CIFN). Some nonresponders to initial IFN treatment have a transient response defined as undetectable HCV RNA or normalization of ALT during treatment, but subsequently have a "breakthrough" while still on treatment. The aim of this study was to determine if nonresponders who had breakthroughs responded differently to CIFN retreatment than nonresponders without breakthroughs using data from a large, multicenter trial. ALT and HCV RNA were monitored frequently during initial IFN therapy (either 9 mcg CIFN or 3 MU IFN-alpha2b 3 times per week). HCV-RNA breakthroughs were observed in 86 of 467 (18%) of all treated patients, and ALT breakthroughs were observed in 90 of 467 (19%) of all treated patients. There was no association between breakthroughs and the presence of either binding or neutralizing anti-IFN antibodies. When the patients who were nonresponders to initial IFN treatment were retreated with CIFN (15 mcg) for 12 months, 27% of those with viral breakthroughs had a sustained viral response compared with 8% in prior nonresponders without breakthroughs (P =.102). Sustained ALT responses were observed in 39% with breakthroughs compared with 10% in those without breakthroughs (P =.014). The data suggest that prior nonresponders with breakthroughs have a greater chance of responding to retreatment than do nonresponders without breakthroughs. However, most breakthrough patients would be missed unless repeated HCV-RNA testing were conducted during therapy.

Alanine Transaminase↗
PubMed1982

Role of retreatment in minimal-power argon laser therapy for port wine stains.

Retreatment of previously lased areas of port wine stains can offer significant additional improvement over initial results. From 1977 to 1981 123 patients were subjected to 191 treatments employing the argon laser using an individually varied minimal power dose. Thirty-three areas have been treated a second time a year after the first therapy and six doubly treated areas have also been studied. The additional improvement achieved by retreatment together with the minimal additional chance of complication adds to the safety and practicality of minimal dosage technique. The theoretical considerations allowing successful retreatment are presented and the results of this approach are demonstrated. The timing of retreatment and its limitations are also considered.

Argon↗
PubMed1988

Comparison of a daily and three intermittent retreatment regimens for pulmonary tuberculosis administered under programme conditions.

One daily and 3 thrice weekly retreatment regimens given for 12 months under programme conditions were compared. The daily regimen was rifampicin and ethambutol (RE7). The three intermittent regimens also contained rifampicin and ethambutol: one of them, rifampicin and ethambutol throughout (RE3); the next one supplemented with pyrazinamide for the first 3 months (REZ3); the last one supplemented with prothionamide for the first 3 months (REPt3). The pyrazinamide containing regimen was subdivided into ordinary and high dose groups. The subjects for retreatment were those who have had, at least, more than 6 months of initial triple chemotherapy of isoniazid, PAS and streptomycin at the health centres, and failed to convert to bacteriologically negative status. Among 419 patients who were available for sensitivity tests before commencing retreatment, 393 (94.3%) were resistant to isoniazid. Six hundred and seventy-four patients (674) were allocated randomly to the regimens: 64 patients were excluded due to various pretreatment reasons and 109 did not complete 12 months of chemotherapy. There remain 501 patients who completed their retreatment. As assessed at 12 months, a bacteriologically favourable response was achieved in 68% of 135 RE7 patients, 62% of 129 RE3 patients, 74% of 132 REZ3 patients, and in 79% of 108 REPt3 patients. Adverse reactions were uncommon: 4% in RE7, 5% in RE3 and 9% in REZ3, but 32% in REPt3. Relapse rates during 2 years after termination of chemotherapy were 15% in RE7, 14% in RE3 and REZ3, and 26% in REPt3, as calculated by life table analysis.

Adolescent↗
PubMed1994

Retreatment with radiotherapy for painful bone metastases.

PURPOSE: To evaluate the response to reirradiation of painful bone metastases following initial treatment with radiotherapy. METHODS AND MATERIALS: A retrospective analysis of 105 consecutive patients treated with palliative radiotherapy for painful bone metastases. A total of 280 individual treatment sites were identified, of which 57 were retreated once and 8 were retreated twice. RESULTS: The overall response rate to initial treatment was 84% for pain relief, and at first retreatment this was 87%. Seven of eight patients retreated a second time also achieved pain relief. No relation to radiation dose, primary tumor type, or site was seen. CONCLUSIONS: In patients relapsing after radiotherapy to painful bone metastases who have responded initially, reirradiation can be recommended with a similar probability of response.

Adult↗
PubMed2002

Undersurface ablation of the flap for laser in situ keratomileusis retreatment.

OBJECTIVE: To develop a novel technique, undersurface ablation of the flap (UAF), for laser in situ keratomileusis (LASIK) retreatment in eyes with insufficient posterior stroma. DESIGN: Noncomparative, interventional case series. PARTICIPANTS: From 30 eyes examined, 25 eyes with a spherical equivalent residual refraction between -0.75 and -3.25 diopters (D) and astigmatism between 0.0 and -1.5 D were prospectively included in the study. In these eyes, calculated postenhancement flap thickness was >150 micro m using micropachymetric optical coherence tomography (OCT), whereas with further ablation of the bed, posterior stromal thickness would have been <250 micro m. Primary LASIK procedures had been performed with the Hansatome microkeratome. INTERVENTION: The flap was lifted and the eye deviated downward, so that the corneal visual axis mark aligned with the laser beam. Mirror pattern ablations with an optical zone of 5 mm were performed on the flap stroma using either the Summit Apex Plus excimer laser or the Technolas Keracor 217 spot-scanning excimer laser. New axis orientation for toric ablations was calculated with the formula: beta = 180 degrees - alpha. MAIN OUTCOME MEASURES: Refraction, visual acuity, OCT pachymetry, tangential videokeratography, and patient satisfaction. RESULTS: The average follow-up was 6.36 +/- 2.64 months (range, 3-12 months). Mean preenhancement spherical equivalent (-2.05 +/- 0.75 D) was reduced to -0.19 +/- 0.38 D at the last visit (P = 0.001). Mean cylinder decreased from -0.48 +/- 0.53 D before retreatment to -0.23 +/- 0.28 D at the last follow-up (P = 0.003). Best-corrected visual acuity worsened by 1 line in two eyes (8%), and no eye lost 2 or more lines. Satisfactory globe stabilization and stromal smoothness during ablation were more difficult to achieve than with conventional LASIK enhancements. The average central flap thickness before UAF, 187 +/- 13 micro m, decreased to 164 +/- 12 micro m after 1 month (P = 0.001). No keratectasia developed. Finally, 92% of cases were satisfied with surgery compared with 48% before UAF retreatment (P = 0.001). CONCLUSIONS: UAF retreatment for low residual refractive errors after LASIK in eyes with sufficient flap stroma seems to be effective and may prevent future keratectasia.

Adult↗
PubMed1997

Results of excimer laser retreatment of residual myopia after previous photorefractive keratectomy.

BACKGROUND: Nine percent to 30% of all patients who undergo a single excimer laser photorefractive keratectomy (PRK) do not achieve an unaided visual acuity of 20/ 40 or better and may require optical correction to obtain adequate vision. METHODS: The authors performed a retrospective analysis of the records of 164 patients who had undergone retreatment with the excimer laser for residual myopia after a previous PRK. Mean follow-up was 35.5 +/- 15.2 weeks (range, 26-104 weeks). RESULTS: The mean spherical equivalent (MSE) before retreatment was -2.59 +/- 1.36 diopter (D) (range, -0.50 to -7.75 D). The final MSE after reablation was -0.52 +/- 1.36 D (range, 2.50 to -5.50). Of the 164 patients, 107 (65.2%) obtained a final refraction within 1.00 D of emmetropia and 111 (67.3%) achieved an unaided visual acuity of 20/40 or better. Only 10 patients (6.1%) lost more than one Snellen line of best-corrected visual acuity. The final MSE result for the subgroup of patients who had a pre-retreatment myopia of between -0.50 and -1.90 D (-0.31 +/- 1.09 D) was significantly closer to emmetropia than that of the subgroup with a residual myopia of -4.00 to -7.75 D (-1.62 +/- 1.94 D). CONCLUSIONS: Excimer laser retreatment may provide a relatively safe and predictable method of correcting residual myopia after an earlier PRK with a 25% extra correction recommended for residual myopia.

Adult↗
PubMed2001

Retreatment with interferon-alpha at dosages or period increased by 1.3 times is effective for treatment for transient responders and non-responders in chronic hepatitis C patients.

The objectives of retreatment with interferon (IFN) in chronic hepatitis C (CH-C) patients are sustained response and a reduction in the risk of hepatocellular carcinoma (HCC). However, it is still unclear, as to which patients are candidates for retreatment with IFN. Eighteen transient responders (TRs) and 15 non-responders (NRs) to IFN therapy in CH-C received retreatment with IFNalpha. Of the 18 TRs, five showed sustained disappearance of hepatitis C virus, two showed sustained biochemical response, 10 continued as TR and one was a NR. Of the 15 NRs, six showed a TR while nine continued as NRs. Responsive cases, which included the virologically or biochemically sustained and transient responders, received either a dose of IFN 1.3 times greater or were treated for a period of 1.3 times longer in the retreatment than the original treatment. We submit that IFN treatment consisting of either a time period or a dosage 1.3 times those of the original IFN administration may be beneficial in the case of TR and NR in chronic hepatitis C patients.

Journal Article↗
PubMed1996

Treatment of Helicobacter pylori infection with low or high dose omeprazole combined with amoxycillin and the effect of early retreatment.

BACKGROUND: Cure rates of H. pylori infection, using dual therapy with omeprazole and amoxycillin, vary considerably and the efficacy of retreatment with this regimen in the case of initial failure is controversial. Therefore, we conducted a large prospective double-blind randomized trial, studying the efficacy of low vs. high dose omeprazole in dual therapy and of early retreatment with the same regimens. METHODS: One hundred and sixty-eight consecutive H. pylori-positive patients, suffering from either peptic ulcer disease or functional dyspepsia, were enrolled. Group I (n = 84) received omeprazole 20 mg b.d. plus amoxycillin 750 mg t.d.s., for 2 weeks. Group II (n = 84) received omeprazole 40 mg t.d.s. plus amoxicillin 750 mg t.d.s., for 2 weeks. RESULTS: The H. pylori eradication rate was 60.2% in group I and 64.3% in group II (P = 0.59). Cure of H. pylori infection was significantly better in patients with peptic ulcer disease, compared to non-ulcer dyspeptics (P = 0.016). Retreatment, given in 54 patients, was successful in 21.4% patients in group I and in 28% patients in group II (P = 0.58). CONCLUSIONS: High dose of omeprazole has no advantage compared to low dose in terms of eradication efficacy. Early retreatment with the same regimen offers limited improvement in cure rate. Presence of peptic ulcer disease influences cure rates significantly.

Adolescent↗
PubMedDate not supplied

Tapestry: a retreat program of support for persons living with cancer.

PURPOSE: In an effort to mitigate the negative psychological sequelae of a cancer diagnosis and cancer treatment, efforts have been made to explore a variety of psychosocial issues and interventions. This article describes the provision and preliminary evaluation of a novel psychosocial service delivery, a residential "retreat" program called Tapestry, which is run under the aegis of the established cancer care community in Alberta, Canada. OVERVIEW: Retreat programs offer a novel way to provide psychosocial support for those persons who are living with cancer. The retreats are unique in the provision of a respite and the opportunity to address the isolation and other existential issues arising from a cancer diagnosis. The program described in this article has provided such a service six times per year since 1998. The intervention is described, and preliminary evaluation data are presented. CLINICAL IMPLICATIONS: Cancer care has begun to move beyond a solely biomedical paradigm toward a more holistic ethos in service delivery and research orientation. While the face value of and demand for such programming continues to grow, few residential psychosocial programs are offered under the auspices of conventional cancer care centers, and little work has been done to examine the nature and possible efficacy of retreat programs as a valid forum for psychosocial service delivery.

Complementary Therapies↗
PubMed2001

Interferon alpha treatment and retreatment of hepatitis B e antigen-negative chronic hepatitis B.

BACKGROUND AND AIMS: In hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHBe-), interferon (IFN) achieves very low biochemical sustained response rates. No information exists on retreatment. METHODS: Two hundred sixteen CHBe- patients treated for 5 or 12 months with 3 MU IFN-alpha2b thrice weekly and retreated (51 patients, 60 courses) because of no response or relapse were retrospectively analyzed. RESULTS: After 7.0 years of median follow-up, 39 naive patients (18.1%) were still in biochemical and virologic remission after a single IFN course. Longer treatment and a biochemical response within 4 months were significant predictors, inversely related to relapse by multivariate analysis (relative hazard [RH], 0.611; 95% confidence interval [CI], 0.448-0.834 and RH, 0.290; 95% CI, 0.192-0.438, respectively). Retreatment resulted in 18.4% sustained response by intention-to-treat (18 of 98 patients). Patients with sustained response had persistently normal alanine aminotransferase levels, undetectable hepatitis B virus (HBV) DNA by molecular hybridization, and significant improvement of histologic grade, and 32% of them lost hepatitis B surface antigen. In sustained responders, serum HBV DNA was undetectable or very low at the end of treatment and at the end of follow-up (median 3934 and 903 copies/mL, respectively) by quantitative polymerase chain reaction. CONCLUSIONS: IFN induced long-term biochemical and virologic remission in approximately 18% of naive or retreated patients with CHBe-. Sustained responders exhibited significant histologic improvement and a high rate of HBsAg loss.

Adult↗
PubMed1991

Relapse after response to interleukin-2-based immunotherapy: patterns of progression and response to retreatment.

The initial site of disease relapse was identified for 79 patients with metastatic renal cell cancer (RCC), melanoma, colon cancer, or non-Hodgkin's lymphoma (NHL), who had achieved partial or complete responses to one of five IL-2-based immunotherapy regimens. The initial site of relapse was evenly distributed between pre-existing sites of disease (33%), new sites of disease (38%), or both (29%). There was no difference in the distribution of recurrences between patients with partial or complete responses. Fifty-one patients with prior complete or partial responses were retreated with additional IL-2-based therapy following tumor progression. Five of 51 patients retreated following relapse developed new partial responses. There were no complete responses. Three patients with NHL were retreated with IL-2 and LAK cells and all achieved a second response, while only 2 of 48 patients with other histologic diagnoses reresponded. It is concluded that after a partial or complete response to IL-2-based immunotherapy, patients who relapse do so equally at new and pre-existing sites of disease. A response to retreatment following tumor progression may be attained in patients with NHL, while a new response is unlikely for patients with melanoma and RCC.

Humans↗
PubMed1998

Intravenous gamma-globulin treatment and retreatment in Kawasaki disease. US/Canadian Kawasaki Syndrome Study Group.

OBJECTIVE: To determine the prevalence and outcome of intravenous gamma-globulin (IVIG) retreatment in patients with Kawasaki disease (KD). METHOD: Multicenter, retrospective survey of all children with KD evaluated at nine clinical centers across North America during a 15-month period. RESULTS: Data were available for 378 patients. At 48 h after completion of the initial IVIG infusion, 50 patients (13.2%) remained febrile, 29 (58.0%) of whom were retreated with IVIG, including 4 (13.8%) with coronary artery abnormalities before their first IVIG infusion. Among 25 retreated patients with a normal baseline echocardiogram, 5 (20.0%) developed coronary abnormalities and were termed "treatment failures." Among the 323 patients with a normal baseline echocardiogram, only 9 (2.8%) were treatment failures; treatment failure occurred in 4 of 282 (1.4%) patients who became afebrile post-IVIG and in 5 of 41 (12.2%) patients with persistent or recrudescent fever after their first course of IVIG therapy (P=0.002). CONCLUSIONS: The overall prevalence of new coronary abnormalities in KD patients treated with IVIG and aspirin remains low. Persistent or recrudescent fever after the first course of IVIG was associated with an increased risk of treatment failure (P=0.002). IVIG retreatment in patients who remain febrile after the first course of IVIG is now common (58.0%), although the efficacy of this practice requires assessment with a randomized trial.

Chi-Square Distribution↗
PubMed1989

Efficacy of OKT3 retreatment for refractory cardiac allograft rejection.

Although OKT3 monoclonal antibody is a useful therapy for refractory cardiac allograft rejection, the use of OKT3 for prophylaxis may be limited by the potential of sensitization and subsequent loss of efficacy on retreatment. OKT3 was required for refractory rejection in 21 of 165 recipients transplanted between March 1985 and August 1988. Twelve of these patients had previously been exposed to OKT3, and the retreatment efficacy was evaluated. The study population averaged 42.1 +/- 15.3 years of age (mean +/- SEM) and had experienced 2 +/- 1 previous episodes of rejection. The prior episodes of rejection had been treated with pulse methylprednisolone and antithymocyte globulin, and in addition 3 patients (25%) also required a course of antilymphoblast globulin. Retreatment OKT3 for refractory rejection was required 120 +/- 94 days following transplantation. CD3+ lymphocytes were eliminated from the circulation within 24-48 hr in 11 of 12 patients, all of whom showed histologic improvement within the first week. Total resolution on the initial follow-up biopsy was noted in 9 (75%) during the course of therapy. Subsequent rejection episodes occurred in 9 (82%) of the survivors at 71 +/- 64 days. One-year survival was 83% in this vigorously rejecting patient population. Serious infections occurred within 3 months of therapy in 4 (36%). The side effects of OKT3 retreatment were similar to those seen with first exposure and did not require OKT3 discontinuation. Thus OKT3 may be administered with success in most patients who have previously been exposed to it.

Adult↗
PubMed1992

Prediction of successful allograft rejection retreatment with OKT3.

OKT3 is considered to be effective in the prophylaxis and treatment of rejection. However, anti-OKT3 immunization is still a major side-effect. Only the IgG antiidiotypic component of the response is responsible for neutralization of OKT3 therapeutic activity by inhibiting OKT3's binding to T cells (i.e., blocking antibodies). It has recently been reported that successful OKT3 retreatment could be performed in patients showing circulating anti-OKT3 antibodies assessed by ELISA, which does not distinguish between blocking and nonblocking antibodies. The aim of this study was to investigate the role of these two types of anti-OKT3 antibodies for their capacity to interfere with effective OKT3 retreatment. Twelve cadaver renal allograft recipients who received OKT3 inducing therapy, were given a second 10 day-course of OKT3 for treatment of rejection. Circulating CD3+ cells were sequentially monitored. Anti-OKT3 antibodies were detected by using both conventional ELISA and an immunofluorescence inhibition test specifically detecting blocking antibodies. OKT3 and the patient's serum were incubated for 30 min at 4 degrees C, and 2 x 10(5) normal T cells were added (30 min at 4 degrees C). After washing, the cells were incubated with FITC goat antimouse antiserum. Fluorescent cells were counted using a FACS analyzer. In 10 patients, at the end of the 10-day second course, less than 10% circulating CD3+ cells were detected. None of these patients had detectable antibodies in the IF inhibition assay at the beginning of retreatment, irrespective of anti-OKT3 antibody titers detected by ELISA. In contrast, in two patients, OKT3 therapy was ineffective: more than 50% circulating CD3+ cells were detected and OKT3 treatment had to be interrupted soon after it was initiated. In both of them, blocking antibodies were detected by the IF-inhibition assay. These results suggest that specific detection of blocking antiidiotypic antibodies by the IF inhibition assay is a reliable parameter for predicting the feasibility of OKT3 retreatment, avoiding misuse of this expensive therapy.

Adolescent↗
PubMed1993

Residue of gutta-percha and a glass ionomer cement sealer following root canal retreatment.

A previous report indicates that root canals obturated with a new glass ionomer cement endodontic sealer (Ketac-Endo, Espe, Germany) and laterally condensed gutta-percha can be retreated by ultrasonic instrumentation. To address the possibility of Ketac-Endo being used without condensation of gutta-percha, the purpose of this study was to evaluate the efficacy of ultrasonic retreatment in canals obturated with single-cone gutta-percha and Ketac-Endo. Thirty root canals were prepared in a standardized way to ISO size 40 and obturated with gutta-percha and Ketac-Endo. Either a size 40 gutta-percha cone was used with and without lateral condensation, or a size 25 single cone, without condensation. After 14 days, the canals were retreated using chloroform and ultrasonic instrumentation. The roots were split vertically, and the amount of residual debris on the canal walls was assessed by three examiners using a dissecting microscope. Debris was recorded in the apical, middle and coronal canal levels according to a preset evaluation scale. The mean scores for each group were compared by ANOVA and Mann-Whitney U-test, with a 5% level of significance. In the roots obturated with lateral condensation the amounts of residual debris in the coronal and middle canal levels was lower than in the other two groups, whereas in the apical level it was higher. Statistically, only the differences in the apical level were significant (P < 0.03). It was concluded that ultrasonic retreatment may be performed effectively in root canals obturated with single-cone gutta-percha and Ketac-Endo.

Analysis of Variance↗
PubMed1994

Retreatment decision making by a group of general dental practitioners in Germany.

The aim of this study was to evaluate whether retreatment of root fillings was judged necessary or not and which kind of retreatment was preferred among a group of general dental practitioners in Germany. A questionnaire comprising 19 cases of endodontically treated teeth with different case histories and several treatment options was sent to all general practitioners in Göttingen (Germany). The cases included teeth with periapical radiolucencies, pain, apical resorption, under- and overfilling, and unfilled root canals. Results obtained from 43 questionnaires returned indicate that non-intervention or further radiographic monitoring were preferred by the majority of general practitioners in 10 of 19 cases, even in the presence of periapical pathosis. Only five cases were judged to require conservative endodontic retreatment and, in four cases, root resection. The results revealed large inter- and intraindividual discrepancies in the estimation of endodontic retreatment need.

Adult↗