Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Long term course”

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 55 records · Page 3Linked to original sources
PubMed2006

Long-term course of cognitive impairment in schizophrenia.

The aim of this study was to examine the long-term course of cognitive impairment in people with schizophrenia. Forty-three people with schizophrenia were followed up over an average of 33 years along with a control group of 12 matched individuals free from psychosis. Cognitive function was assessed at baseline and follow-up. The participants with schizophrenia were found to show impairment in verbal and non-verbal intelligence at baseline compared with estimated premorbid scores, this was not found in the control group. At follow-up there was a significant decline in non-verbal intelligence over time in participants with schizophrenia compared with controls (P=0.007). This differential change over time was not seen in verbal intelligence (P= 0.318).

Age Factors↗
PubMed2004

Long-term course of L-dopa-responsive dystonia caused by tyrosine hydroxylase deficiency.

The authors report the long-term course of two siblings with L-dopa responsive dystonia (DRD) associated with a compound heterozygous mutation in the tyrosine hydroxylase (TH) gene. Both siblings manifested with lower-limb onset generalized DRD and had a sustained response to low-dose L-dopa therapy for over 35 years. Although the l-dopa therapy was delayed up to 20 years after disease onset, there were no cognitive or neurologic sequelae of the long-term catecholamine deficit.

Adult↗
PubMed1995

Long-term course of substance use disorders among patients with severe mental illness.

OBJECTIVE: This study assessed the long-term course of substance abuse and dependence among severely mentally ill patients. METHODS: A prospective, naturalistic, seven-year follow-up of severely mentally ill outpatients (most with schizophrenia and schizoaffective disorder) successfully located and reassessed 79.1 percent (N = 148) of the patients from the original study group. The follow-up study group was assessed for alcohol and drug use at baseline and seven-year follow-up by their case manager or primary clinician using the Case Manager Rating Scale (CMRS) for the assessment of substance-related problems among severely mentally ill patients. RESULTS: The prevalence of active substance use disorder changed little from baseline to follow-up. Alcohol abuse or dependence was present in 24 percent of the patients at baseline and 21 percent at follow-up, and drug abuse or dependence was present in 20 percent at baseline and 17 percent at follow-up. However, those with initial alcohol abuse had a higher rate of remission (67 percent) than those with initial alcohol dependence (33 percent). Similarly, those with initial drug abuse had a higher rate of remission (54 percent) than those with initial drug dependence (31 percent). CONCLUSIONS: The higher rates of change for those with initial substance abuse compared with substance dependence suggest that distinguishing between abuse and dependence may have important implications for assessment and prognosis of individuals with a dual diagnosis of a substance use disorder and severe mental illness.

Alcoholism↗
PubMed1990

Psychopathological and social status of patients with affective, schizophrenic and schizoaffective disorders after long-term course.

A total of 106 affective, 101 schizoaffective and 148 schizophrenic disorders were investigated after a long-term course of illness (mean follow-up period 25.1 years), employing narrow definitions and using reliable international instruments of evaluation. In addition, the social consequences of the illness were evaluated (upward and downward social and occupational drift, premature retirement and achievement of the expected social development). Considering all aspects of outcome, schizophrenic patients (narrow defined, slightly modified DSM-III criteria) had persistent alterations in several aspects of social life, communication and cognitive functions, in some cases to a very high degree. Although the outcome of affective disorders is not always favourable, it is significantly more favourable than that of schizophrenia. Schizoaffective disorders occupy a position between affective and schizophrenic disorders regarding outcome, but with more similarities to that of affective than to that of schizophrenic disorders.

Adolescent↗
PubMed1989

[THe effect of pregnancy on the long-term course of chronic glomerulonephritis].

During a long-term study in 34 out of 154 women with bioptically ascertained glomerulonephritis 38 pregnancies were observed. The clinical manifestation took place three times during and thirteen times immediately after the end of the pregnancy. Apart from membranoproliferative glomerulonephritides all morphological forms of glomerulonephritis were present. A nephrotic syndrome was existing in 14 women (41.2%). The patients with pregnancy after on an average 11.3 years observation time showed a stabile renal function in 85.3% in contrast to 71.9% of the other female patients (not significant). The pregnancy, including a nephrotic syndrome, does not deteriorate the long-term prognosis of the glomerulonephritis.

Biopsy↗
PubMed1998

The long-term course of mastalgia.

Mastalgia is a common condition in women of reproductive years. We have assessed the long-term course in patients with severe mastalgia by distributing a postal questionnaire to 212 patients previously studied in 1983 who had attended the mastalgia clinic at the University Hospital of Wales, Cardiff. 175 patients (83%) responded, with an original diagnosis of cyclical mastalgia (CM) in 120 and non-cyclical mastalgia (NCM) in 55. The median age of onset of breast pain was 36 years (range 12-63 years). The average duration of pain was long (median 12 years), especially if it started in the second or third decade of life. Pain persisted in 68 (57%) of CM and 35 (64%) of NCM patients. In CM patients resolution was commonly associated with a 'hormonal' event, notably the menopause; in NCM patients it more often seemed to be spontaneous. Severe mastalgia ran a chronic relapsing course often requiring repeated drug treatments.

Adolescent↗
PubMed1980

[Clinical aspects and differential diagnosis of chronic pancreatitis. Emphasis on the long term course in 258 patients].

Three typical clinical patterns can be distinguished based upon the experience with the long-term course in 258 cases of chronic relapsing pancreatitis. In chronic pancreatitis without local complications there is 1. an early phase, characterized by recurrent episodes of pancreatitis; 2. a late phase, characterized by the triad: absence of pain, severe global pancreatic insufficiency (diabetes/steatorrhea), and pancreatic calcifications (if any). 3. Local complications (e.g. pseudocysts) produce a different pattern characterized by persistent pain and the symptoms of the "pancreatitis tumor", which may cause many different complications such as cholostasis, gastrointestinal bleeding, duodenal obstruction etc. Local complications are observed mainly in the early phase of the disease. Late symptoms such as diabetes, steatorrhea and calcifications indicate that the pancreatitis is virtually "burned out". The occurrence of late symptoms in the course of the disease varies individually.

Adult↗
PubMed2006

Impact of medical students' descriptive evaluations on long-term course development.

BACKGROUND: In medical education, feedback from students is helpful in course evaluation. However, the impact of medical students' feedback on long-term course development is seldom reported. In this project we studied the correspondence between medical students' descriptive evaluations and key features of course development over five years. METHODS: Qualitative content analysis was used. The context was consultation skills courses in the middle of the Göteborg undergraduate curriculum during five years. An analysis of 158 students' descriptive evaluations was brought together with an analysis of key features of course development; learning objectives, course records, protocols from teachers' evaluations and field notes. Credibility of data was tested by two colleagues and by presenting themes at seminars and conferences. Authors' experiences of evaluating the course over many years were also used. RESULTS: A corresponding pattern was found in students' descriptive evaluations and key features of course development, indicating the impact of students' open-ended feed-back. Support to facilitators and a curriculum reform also contributed. Students' descriptive feedback was both initiating and validating longitudinal course implementation. During five years, students' descriptive evaluations and teachers' course records were crucial sources in a learner-centred knowledge-building process of course development. CONCLUSION: Students' descriptive evaluations and course records can be seen as important instruments in developing both courses and students' learning. Continuity and endurance in the evaluation process must be emphasized for achieving relevant and useful results.

Adult↗
PubMed1996

Long-term course and consequences of Helicobacter pylori gastritis. Results of a 32-year follow-up study.

BACKGROUND: The long-term course of Helicobacter pylori gastritis is not well known because there are few follow-up studies available, and the follow-up time has been short. METHODS: The progression of H. pylori infection and chronic gastritis was retrospectively examined in 102 patients followed up for 32 years. In all patients a blind suction biopsy from the corpus mucosa was taken in 1952, and an endoscopic re-examination with biopsy specimens from the antrum and corpus was performed in 1983. RESULTS: In the first examination 85 patients (83%) were H. pylori-positive as assessed from Giemsa-stained corpus mucosa specimens as compared with 70 H. pylori-positive patients (69%) at the end of the follow-up (1983). Two of the 17 patients who were initially H. pylori-negative became positive in 1983, implying an infection rate of 0.4% per patient-year. On the other hand, 17 of the 85 patients who were initially H. pylori-positive became negative in 1983, representing a disappearance rate of 0.6%. However, the stomach became completely normal in only eight cases, which represents a healing rate of 0.3% per patient-year. All patients with duodenal ulcer disease were H. pylori-positive at the first examination and remained so during the follow-up. In these patients chronic gastritis affected predominantly the antral mucosa, and corpus atrophy did not develop. Parietal cell antibodies appeared during the follow-up in six cases, and five of them were H. pylori-positive at the first examination. In most of these cases gastritis progressed into severe grades of corpus atrophy accompanied by the disappearance of H. pylori infection and normalization of the antral mucosa. CONCLUSIONS: New H. pylori infection and complete healing of infected mucosa may occur in adult life, but this is rare. Duodenal ulcer disease is associated with persistent H. pylori infection and absence of corpus atrophy. The appearance of parietal cell antibodies leads to progression of corpus atrophy and disappearance of H. pylori.

Adult↗
PubMed1995

Review of the long-term course of 52 patients with pulmonary atresia and ventricular septal defect. Anatomical and surgical considerations.

This study reviews the long-term course of 52 patients with pulmonary atresia and ventricular septal defect seen in a single institution and followed for a mean period of 8.6 years (range 2 days to 20 years). Before the first operation, pulmonary blood supply was provided by ductus arteriosus supplying confluent pulmonary arteries in 26 patients (50%, group I), and was partially or entirely dependent on systemic collateral arteries in the other 26 patients (group II). The angiographic mean ratio of diameters of the right and left pulmonary artery/descending aorta (McGoon ratio) was significantly lower in group II than in group I, 0.76 +/- 0.42 vs 1.04 +/- 0.17 (P = 0.006). Severe arborization defects (with fewer than 10 pulmonary vascular segments connected to central pulmonary arteries) were present only in group II patients (eight patients: 15%), six of whom had congenital absence of the central pulmonary arteries. Corrective surgery was performed in 23 patients (44%, 14 in group I, nine in group II). All but one, who died later, had a McGoon ratio > or = 1 (mean 1.19 +/- 0.18) at time of repair. There was one hospital death (4%) and two late deaths (9%). All but one of the surviving corrected patients were in functional class I or II. Conduit replacement reoperation was performed in three patients (14%), 6, 10 and 13 years, respectively, after repair. At the end of the study, among the 37 patients (71%) who were alive (17 in group I, 20 in group II), 20 (39%) were corrected (12 in group I, eight in group II), four await corrective surgery, and six (11.5%) are estimated inoperable (all in group II) because of very hypoplastic or absent pulmonary arteries. This study confirms the estimated rate in the published literature of long-term survival in patients with pulmonary atresia and ventricular septal defect, and the good results of corrective surgery whenever the size and distribution of pulmonary arteries are satisfactory. The problem of very hypoplastic pulmonary arteries and severe arborization defects remains contentious.

Adolescent↗
PubMed1988

Long-term course of schizoaffective disorders. Part I: Definitions, methods, frequency of episodes and cycles.

The present study (Cologne study) investigated the long-term course (means = 25.6 years, minimum 10, maximum 59 years) of 72 schizoaffective patients. The diagnosis was based on the longitudinal approach. All patients were interviewed personally, using the Present State Examination and a pool of questions based on some instruments of the WHO (DAS, PIRS, etc.). The course was found to be usually polyphasic (more than 3 episodes) and only exceptionally monophasic (1 episode). For the purposes of statistical analysis an episode was considered in terms of time between the beginning and ending of inpatient or inpatient-like treatment. The number of episodes and cycles were found to be independent from premorbid and sociodemographic variables. But a significant relation was found between number of episodes (and cycles) and (a) polarity of the affective symptomatology, (b) presence of psychotic productive symptoms, (c) polymorphous course, (d) age at onset, and (e) duration of activity of the illness. It can be said that schizoaffective disorders are recurrent whereby the frequency of relapses is higher in bipolar than in unipolar types.

Adult↗
PubMed2003

The long-term course of panic disorder--an 11 year follow-up.

BACKGROUND: The purpose of this study was to assess the naturalistic long-term course of panic disorder over a period of 11 years. METHOD: Thirty DSM-III-R panic disorder patients, who had suffered from panic disorder for 6 years on average and who had taken part in an 8-week multicenter drug trial, were included in the intent-to-follow-up group to be reinterviewed 11 years after the end of the trial. At baseline and at follow-up the same instruments were used to assess frequency of panic attacks, level of phobic avoidance, and disabilities. Treatments received during the follow-up period and attempted suicides were assessed with a structured interview. Periods of well-being during the follow-up period were elicited retrospectively with a specifically designed longitudinal chart. RESULTS: Twenty-four patients could actually be reinterviewed after 11.3 years. While at baseline all patients had suffered from panic attacks and had been severely disabled on a number of measures, 66.7% had no panic attack during the year before follow-up. During the month before follow-up 87.5% had no panic attack, and 54% showed no or only mild phobic avoidance. In the areas of work and family life 90% showed no or only mild disabilities, whereas in the area of social life this percentage was lower (67%). Thirty-three percent of the patients were completely remitted according to a composite remission criterion. CONCLUSIONS: Panic disorder is not a uniformly chronic and progressing disorder. Over a period of 11 years there is a good chance of recovery from panic attacks and disabilities, and full remission is also possible.

Activities of Daily Living↗
PubMed1992

Postoperative long-term course of peripheral blood immune parameters and immunomodulating effects of keyhole limpet hemocyanin in patients with nonmetastatic renal cell carcinoma.

Therapeutic approaches to metastatic renal cell carcinoma (RCC) often focus on the application of immune modulators; the success rates, however, are not satisfactory. Up to the time of this study, no diagnostic tool has been available to select those patients who might profit from immunotherapy. Starting from this point, we have been assessing the immune status of patients suffering from RCC, intending to find markers that would characterize the more favorable prognosis. Our interest is focused not only on the metastatic but also on the nonmetastatic disease, i.e., the disease with the better prognosis. In the present study, we have assessed both the postoperative long-term course of several immune parameters of the peripheral blood and the reactivity of the immune system to immunostimulation with keyhole limpet hemocyanin (KLH) in patients with nonmetastatic RCC. In a prospectively randomized study, the verum group (n = 8) got 1 mg KLH per month up to 1 year while the control group (n = 9) got no immunostimulator after tumor nephrectomy. Both patient groups had stable or even increasing cell counts of lymphocyte subpopulations (T, B, natural killer, T4, T8 cells), and the humoral immunoactivation markers neopterin, beta 2-microglobulin and tumor necrosis factor increased considerably after tumor nephrectomy. An effect of KLH is evident 4-8 months postoperatively: here, the neopterin values in the KLH group are more than twice as high as in the control group. Thus, while patients with metastatic disease had turned out to be immunosuppressed (previous study), in patients with nonmetastatic RCC, both the long-term course indicating postoperative immunostimulation and the reactivity to KLH give evidence of immunocompetence.

Adjuvants, Immunologic↗
PubMed2005

Portal vein complications in the long-term course after pediatric living donor liver transplantation.

The frequency and the outcome of patients with portal vein (PV) complications in the long-term course after pediatric living donor liver transplantation (LDLT) have rarely been reported. Between June 1990 and September 2003, 527 pediatric patients underwent primary LDLT with left lobe grafts, among which 479 patients with functioning grafts at 3 months after LDLT were included in this analysis. The ages ranged from 29 days to 17 years, 3 months (median: 1 year, 9 months) and body weight from 3.1 kg to 62.4 kg (median: 9.6 kg). Biliary cirrhosis was the most common cause for LDLT (81%). The PV was anastomosed with or without a vein graft. Thirty-nine patients (8%) showed a PV complication (stenosis: 16; obstruction: 17; thrombus: 2; twist: 3). Their ages ranged from 4 months to 17 years, 3 months (median: 1 year) and their body weight from 3.8 kg to 44.8 kg (median: 8.5 kg) at operation. PV complications were detected between 4 and 116 months (median: 14 months) after the transplant. Splenomegaly and decreased platelet counts were observed in more than 90% of the patients with a PV complication. In 27 patients (71%), interventional venoplasty was successful. Eleven patients had obstruction of the PV (2.3%) including three who showed cirrhosis; one with severe pulmonary hypertension; one death after retransplantation; and one alive after retransplantation. Moderate fibrosis was found in two patients at 3 and 2 years after the procedure, one of whom had the complication of a moderate intrapulmonary shunt. Early detection of PV stenosis with these two markers can lead to successful angioplasty and avoid graft loss.

Adolescent↗
PubMed2000

Predictive value of the HIV paediatric classification system for the long-term course of perinatally infected children.

BACKGROUND: To compare the Centers for Disease Control and Prevention (CDC) paediatric classification system with the long-term course of perinatal human immunodeficiency virus type 1 (HIV-1) infection. METHODS: Prospective study on 366 perinatally infected children followed-up from birth and checked at least every 2 months. Survival, smoothed hazard, adjusted hazard ratio of death, and transition probabilities in clinical and immunological categories were outcome measures. RESULTS: Survival was 49% (95% CI : 40-58%) at 8 years. The risk of death was high before the age of 2, relatively low between ages 2 and 7, and contained thereafter. Children did not advance through the categories sequentially. Survival at 8 years was 61.7% (95% CI : 49.8-73.6%) in those children who had passed through clinical category A; the hazard ratio of death was 2.5 (95% CI : 1.7-3.8) for 175 (47.9%) children who skipped this category. Transition probability in clinical category B was 39.9% (95% CI : 32.3-45.6%) after one year, but 59.1% (95% CI : 51.4-66.8%) after 5 years. Before 2 years of age, the probability of entry into category C (40%; 95% CI : 35-45%) was higher than that of entry into immunological category 3 (28%; 95% CI : 22-34%). Conclusions The classification system stands comparison with the clinical reality, but the CD4-positive cell thresholds in infancy should be adjusted and category B indicator diseases better distributed to improve their predictive value.

CD4 Lymphocyte Count↗
PubMed1991

The long-term course of Lyme arthritis in children.

BACKGROUND AND METHODS: The natural history of Lyme disease is not completely known. We studied the long-term course of Lyme arthritis in 46 children in whom the onset of the disease occurred between 1976 and 1979 and who received no antibiotic therapy for at least the first four years of the illness. RESULTS: Of the 46 children (age range, 2 to 15 years), 33 (72 percent) initially had erythema migrans, 7 (15 percent) had influenza-like symptoms, and 6 (13 percent) had migratory joint pain. These manifestations were followed by brief attacks of arthritis, particularly affecting the knee. The percentage of children with recurrent episodes of arthritis declined each year. By year 4, only 10 children still had a mean of two episodes of arthritis per year; the duration of arthritis was generally longer in older children (P less than 0.05). During the sixth year of illness, two children (4 percent) had keratitis, and more than 10 years after the onset of disease, a subtle encephalopathy developed in two other children. Of the 39 children whom we were able to contact in 1988-1989, 12 (31 percent) still had occasional brief episodes of joint pain and 1 (3 percent) had marked fatigue. All 46 children had positive IgG antibody responses to Borrelia burgdorferi throughout the illness and on long-term follow-up. As compared with those who became asymptomatic, the children with recurrent symptoms more often had IgM responses to the spirochete and had significantly higher IgG titers (P less than 0.05). CONCLUSIONS: The course of initially untreated Lyme disease in children may include acute infection followed by attacks of arthritis and then by keratitis, subtle joint pain, or chronic encephalopathy.

Acute Disease↗
PubMed1997

Effects of long-term course of alpha-interferon in patients with chronic hepatitis C associated to mixed cryoglobulinaemia.

OBJECTIVE: To evaluate the efficacy of a long-term course of alpha-interferon (alpha-IFN) in the treatment of HCV-related mixed cryoglobulinaemia and to determine the impact of cryoglobulinaemia on therapeutic response to IFN in chronic hepatitis C (CHC) patients. DESIGN: Prospective controlled study. SETTING: University Medical Centre. PARTICIPANTS: Ninety consecutive CHC patients, 50 with cryoglobulinaemia (25 symptomatic and 25 asymptomatic; median cryocrit, 8%; chronic persistent hepatitis (CPH) 7, chronic active hepatitis (CAH) 27, cirrhosis 16) and 40 without cryoglobulinaemia (CPH 6, CAH 20, cirrhosis 14). HCV genotypes in the cryoglobulinaemic and non-cryoglobulinaemic groups were: 1b 40% and 45%; 2a 40% and 30%; others 20% and 25%, respectively. INTERVENTIONS: Twelve-month course of alpha-IFN 2a, 3 MU, three times weekly. MAIN OUTCOME MEASURES: Disappearance of cryoglobulinaemia and related syndrome, clearance of serum HCV RNA and normalization serum transaminase levels at the end of treatment (response) and after 12 months follow-up (sustained response). RESULTS: Overall, cryoglobulinaemic patients showed a similar response to IFN to those without cryoglobulinaemia (44% vs. 42.5%, respectively). In the cryoglobulinaemic group, symptomatic patients showed a lower response rate than asymptomatic patients (28% vs. 60%, respectively; P<0.05). HCV genotype 2a/c, absence of cirrhosis and a low cryocrit (<9%) were predictive factors of high response rate to IFN. Sustained response in non-cryoglobulinaemic patients (22.5%) tended to be higher than in patients with symptomatic cryoglobulinaemia (4%), as well as among patients carrying genotype 2a/c (67% vs. 10%, respectively; P<0.02). IFN was effective in controlling purpura (80%) but was moderately effective on severe haematuria/proteinuria, renal insufficiency and neuropathy. CONCLUSIONS: A 12-month course of alpha-IFN is effective treatment for HCV-related cryoglobulinaemia. However, patients with CHC associated to symptomatic cryoglobulinaemia have a lower response rate to IFN.

Adult↗
PubMed1994

Epidemiologic background and long-term course of disease in human immunodeficiency virus type 1-infected blood donors identified before routine laboratory screening. Transfusion Safety Study Group.

BACKGROUND: The long-term course of human immunodeficiency virus type 1 (HIV-1)-related disease among seropositive blood donors has not been described. The enrollment and epidemiologic background of HIV-1-infected donors in the Transfusion Safety Study and their immunologic and clinical progression are described. STUDY DESIGN AND METHODS: Through the testing of approximately 200,000 sera from donations made in late 1984 and early 1985, 146 anti-HIV-1-positive donors and 151 uninfected matched donors were enrolled. These two cohorts were followed with 6-month interval histories and laboratory testing. RESULTS: Seropositive donors detected before the institution of routine anti-HIV-1 screening disproportionately were first-time donors and men with exclusively male sexual contacts. The actuarial probability of a person's developing AIDS within 7 years after donation was 40 percent; the probability of a person's dying of AIDS was 28 percent. AIDS developed more often when the donor was p24 antigen-positive at donation. Over a 3-year period, significant decreases occurred in CD4+, CD2+CD26+, CD4+CD29+, and CD20+CD21+ counts, but not in CD8+ subsets, CD20+, or CD14+. CONCLUSION: The high proportions of first-time donations and exclusively homosexual men among seropositive donors suggest that test-seeking may have contributed to the high HIV-1 prevalence in the repository. Implementation of alternative test sites when routine donor screening began in 1985 may have averted many high-risk donations. The disease course in HIV-1-infected donors had the same wide spectrum of immunologic and clinical manifestations as were reported for other cohorts.

Acquired Immunodeficiency Syndrome↗