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PubMedDate not supplied

[The late results of short-term chemotherapy in benign forms of tuberculosis in children].

The study included 359 cases of primary tuberculosis (benign forms) in children aged 0-14 years, out of which 181 non-complicated and 178 complicated forms. The therapeutical regimens were: 3HEZ2/3HE2 (study subgroup) and 6HE2/3H2 (control) for non-complicated forms, and 3HRZ2/3HR2 (study subgroup) and 3HES2/3HE2/3H2 (control) for complicated ones. Late results (5 years after treatment end) were very good (from clinical, radiological, bacteriological points of view) in 100% of cases. Thus, short-course regimens are preferable to longer ones (over 6 months) in the chemotherapy of the benign forms of pulmonary tuberculosis in children.

Adolescent↗
PubMed1990

Long-term management of panic disorder.

The high-potency benzodiazepines have been effective in short-term treatment of panic disorder, but systematic investigation of their long-term efficacy and safety is necessary. In a 1-year follow-up study of patients continuing treatment with clonazepam, 90% maintained a positive response without developing significant tolerance. In a 2.5-year follow-up study of alprazolam therapy, little evidence of tolerance emerged and initial therapeutic gains were maintained, even among patients who decreased or discontinued medication. As with antidepressants, many patients remain on high-potency benzodiazepine medication after short-term treatment; the choice of maintenance agent should reflect side effects of treatment as well as the ease of discontinuation. The high-potency benzodiazepines are a reasonable alternative to antidepressants, which involve problems of morbidity, noncompliance, and risk for overdose. Discontinuation may be less difficult with the longer-acting high-potency benzodiazepines, which thus may be advantageous for long-term treatment. It is necessary to determine the contributions of all aspects of treatment, both behavioral and pharmacologic, to the longitudinal course of patients with panic disorders.

Alprazolam↗
PubMed1990

The clinical course and long-term management of generalized anxiety disorder.

Evidence suggests that generalized anxiety disorder (GAD) has a fairly chronic course marked by significant long-term distress and comorbidity. Research has focused on short-term treatment of GAD, and long-term outcome studies after either short- or long-term treatment have been relatively neglected. The authors discuss the benefits and risks of various drug and nondrug therapies used in the long-term management of generalized anxiety disorder and suggest avenues for future research.

Anti-Anxiety Agents↗
PubMedDate not supplied

The effect of moderate non-hemolytic jaundice and phototherapy on newborn behavior.

To study the effects of moderate non-hemolytic jaundice and phototherapy (PT) on newborn behavior, initially 29 full-term infants with serum bilirubin (SB) 12-15 mg/dl were randomly assigned to PT (n = 14) or non-PT (n = 15) group. PT was done until SB less than 12 mg/dl. One infant in the PT group was excluded because of G-6-PD deficiency and evidence of hemolysis. Four infants in the non-PT group were excluded because their serum bilirubin concentrations finally exceeded 15 mg/dl and they were put on phototherapy for ethical concern. Two more infants were then added to the non-PT group to make a total number of 13. Additional 14 infants with serum bilirubin levels less than 12 mg/dl were studied as controls. Neonatal Behavioral Assessment Scales (NBAS) were performed 4 times: just before PT, right after termination of PT, 24 hrs after termination of PT and at 2 wks of age in PT group, and at comparable ages with the non-PT and control groups. The course of jaundice was measured in terms of SB levels at entry into study, peak SB levels, duration from entry into study to the time when SB levels dropped below 12 mg/dl and age when SB levels dropped below 12 mg/dl. The values did not differ significantly between the PT and non-PT groups. Therefore, phototherapy did not change the clinical course of jaundice in the majority of infants with bilirubin levels between 12 and 15 mg/dl. The 7 cluster scores of 1st NBAS did not differ significantly among the 3 groups of infants. On the 2nd and 3rd examinations, the infants in the PT group performed poorer in some of the orientation items than the infants in the non-PT and control groups (p less than 0.05) whereas the non-PT groups showed similar performance as the control group. At 2 wks of age, no significant differences of the NBAS scores were found in 3 groups. We conclude that moderate non-hemolytic jaundice (serum bilirubin 12-15 mg/dl) does not affect the behavior of full-term infants in this study. Phototherapy has some short-term adverse effects on visual, auditory orientation and alertness of the infants which may impair infant-caregiver interaction.

Female↗
PubMed1990

[Follow-up study of short course chemotherapy of pulmonary tuberculosis complicated with diabetes mellitus].

A retrospective analysis was made for 644 patients with pulmonary tuberculosis newly diagnosed during the time of 1977 to 1985 to evaluate the influence of diabetes mellitus (DM) on the drug response rate and the long-term relapse rate in the treatment of tuberculosis. These patients were divided into four groups: (1) 123 patients with DM on 9- to 12-month short course regimens; (2) 79 with DM on 13- to 36-month long-term regimens; (3) 379 nondiabetic patients on short-term regimens; and (4) 63 nondiabetics on long-term regimens. Bacteriological relapse after chemotherapy was defined as positive cultures growing at least 20 or more colonies. 1) Bacteriological negative conversion rates were similar in both diabetic and nondiabetic patients who had received combination regimens including INH and RFP. The degree of control of DM did not affect the conversion rate. 2) Of 297 patients who had received short-course chemotherapy and the information for analysis were available as of August 1989, 8 (10.3%) had relapses in 78 diabetic, and patients 23 (10.5%) in 219 non-diabetic patients; the difference was not statistically significant. There were also no discernible differences in the relapse rates between patients on the short-course regimens and those on the long-term regimens. 3) Most of the relapses occurred around 6 months and 30 months after completing the short-course chemotherapy. Similar pattern of relapses was observed also in the long-term therapy group. 4) Pretreatment radiographic findings and quantity of the acid-fast bacilli in the sputum, and the presence of cavitary lesions at the completion of therapy bore no significant relation to the development of relapse. 5) In the diabetic patients the degree of control of DM contributed little to the development of recurrence. 6) Although most of the patients without DM relapsed with sensitive strains and achieved a good response to retreatment, diabetic patients frequently relapsed with resistant strains and had a grave prognosis. 7) Of 41 patients who died after having been on the short-course regimens, two were attributed to tuberculosis. Only one was attributed to tuberculosis of 25 patients who died after receiving the long-term regimens. 8) The data obtained here confirmed that the 12-month regimen for diabetic patients could achieve favorable results in the response rate and the long-term relapse rate, as that for nondiabetic patients. However the cases of tuberculosis complicated with DM frequently showed a poor prognosis once the relapse took place. These results suggest that pyrazinamide-containing 4-drug combination regimens in an initial intensive phase is the preferred treatment for the patients with DM.

Adult↗
PubMedDate not supplied

Catamnestic study of cases with tardive decompensated hydrocephalus.

One hundred patients with decompensated hydrocephalus (60 operated, 40 nonoperated) were studied both retrospectively and prospectively at 3 moments of the disease course. The indicators were clinical: neurologic, psychic and social, and paraclinical: results of pneumoencephalography, encephalography, radioisotope cisternography. The effects of surgical treatment (ventriculocardiac derivation) and of medical treatment were evaluated at short and long term. In surgical treatment, favourable short-term outcome (headache, gait and micturition disorders, improved consciousness, psychomotor activity, social behaviour) was found in 88% of the patients; long-term favourable outcome was present in 60% of the patients and implied only the psychic and social indicators. In medical treatment the favourable short-term outcome was nonsignificant and the long-term outcome was favourable in only 32% of the patients. In the remaining cases evaluated as unfavourable, the cognitive disorders increased progressively. The predictors for favourable therapeutic outcome were: early diagnosis, early surgical intervention, the clinical form of hydrocephalus, the sequelae and short-term effects of surgical treatment.

Adult↗
PubMed1990

Long-term graft survival.

1. Long-term graft survival is characterized by failure rates that are essentially constant after about a year or 2. The rate has not varied appreciably among cohorts defined in terms of transplant year. 2. Transplants with an excellent clinical course throughout the first 3 months (about 2-thirds of cadaver-donor first transplants) have substantially better long-term graft survival than those with a less favorable early course. 3. Having an excellent early clinical course did not remove the effects of the several factors related to long-term survival. 4. Use of cyclosporine did not relate to long-term survival. 5. Factors related to short-term graft survival (1 year), generally related to long-term survival and in the same direction. Cyclosporine use was a major exception. 6. The dominant factor for long-term survival was tissue matching as reflected in donor categories: HLA-identical sibling, parent, and cadaver. 7. Black recipients had a decidedly poorer long-term survival than recipients of other races/ethnicities. 8. Transplant center was a dominant factor in long-term graft survival. 9. Multivariable analysis did not materially alter the findings obtained from factors considered separately. This was attributable to the sensitivity associated with small standard errors resulting from the large number of cadaver-donor transplants and the combination of smaller numbers and longer survival of living-related transplants.

Age Factors↗
PubMed1990

[The effect of polyclorinated biphenyls in chickens: the effect of short-term administration of high doses of Delor 103 on the levels of thyroxine, triiodothyronine, sodium, potassium and calcium in the blood].

The trial with a short-time receiving (7 days) of high doses of the preparation Delor 103 (PCB) to chickens (1000 mg.kg-1 feed stuffs) had a long-run negative effect on their state of health. Clinical picture of intoxication resembled an involution syndrome. A defect persistence of the conversion of thyroid hormone T4 to T3 was found. Regeneration of T4 hormone production was rather fast. Supplement of hormones T4 and T3 to feed had no significant influence on the course of intoxication, but it caused changes in concentrations of K+, Ca++, and the total calcium in the blood serum of the birds. Simultaneous supplement of Delor 103 moderated the intensity of changes induced by exogenous flow of thyroid hormones. Histological changes were demonstrated in the primary lymph organs, which supported of findings of immunosuppressive effect in PCB. Supplement of the thyreostatic Carbimazol (Carbimazolum/1-carbaetoxy-3-methyl-2-thioimidazolin um) caused no symptoms testifying to hypofunction of thyroid gland in chickens.

Animals↗
PubMed1990

[An assessment of the efficacy of a course of using different forms of prolonged-action nitrates in patients with stable stenocardia with the help of repeated daily ECG monitoring].

A study was made of the antianginal and anti-ischemic effects of sustac (ST) and trinitrolong (TNL) during their cross continuous use in patients with stable angina pectoris, functional class II-III (according to the classification of the Canadian Association of Cardiologists). In accordance with the daily ECG monitoring data, the three-month treatment with the effective doses of ST and TNL produced a significant lowering of the frequency and the total intensity of the episodes of ST segment depressions of the ischemic type as compared to the continuous administration of placebo. The use of criteria for evaluating the efficacy of the antianginal drugs (the decrease of the total number of ST segment depression episodes during one day by 3 and over and/or reduction of the total intensity of ST segment depression by 50% and over) made it possible to reveal varying effects of the nitrates on painful episodes (PE) and painless episodes of ST segment depression. Both the dosage forms of nitroglycerin administered in the effective amounts (in short- and long-term continuous treatment) significantly lowered the rate and total intensity of myocardial ischemia episodes at the expense of a significant decrease of the frequency and total intensity of PE. They produced no material effect on the number of painless episodes. Provided ST and TNK turned out ineffective, there was a significant rise of the frequency and total intensity of painless episodes in short-term continuous treatment while ST produced the above effect in long-term treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Results of intersomatic arthrodeses in essential lumbalgia].

The results of 50 intersomatic arthrodeses, performed via an anterior approach, because of chronic, disabling low back pain with degenerative disc disease, was evaluated with a mean follow-up of 7 years (revision rate = 74.5 p. cent). Preoperative exploratory discography of the overlying and underlying vertebrae was systematic. The overall functional results evaluated according to an original quotation scale, show that only less than half of the patients who were operated upon are markedly improved at maximum follow-up. The clinical course of pain radiating to the lower extremities and associated with disabling lumbalgias, seems to be on a par with the course of lumbalgias and does not require a posterior surgical approach. Factors improving the success rates are an effective fusion (in first intention in 80 p. cent of the cases) and a healthy neo-joint from a discographic standpoint; factors that deteriorate the long-term success rate (and not short-term), essentially socio-professional ones (work related accidents). The contribution of the discographic data is emphasized: they anticipate the deterioration of the neo-joint discs, which, when present, causes most of the functional failures. Although these results are imperfect, arthrodesis (the authors remain faithful to the intersomatic arthrodesis), may not be completely excluded as treatment of essential disabling lumbalgias, resisting to medical and physiotherapeutic treatments.

Adult↗
PubMed1990

Cutaneous reactive hyperemia in short-term and long-term type I diabetes--continuous monitoring by a combined laser Doppler and transcutaneous oxygen probe.

Using a recently designed combined laser Doppler/transcutaneous oxygen probe postocclusive reactive hyperemia response was investigated in 10 healthy subjects and 33 patients with type I diabetes mellitus. From the foot dorsum sensing site simultaneous recordings of the red cell flux of the superficial skin microvasculature and cutaneous PO2 were obtained at identical measuring position and conditions. Whereas cutaneous PO2 response exhibited an uniform monophasic curve with a significantly reduced percentage increase of PO2 in short-term (p less than 0.05) and in long-term type I diabetic patients (p less than 0.001), four different laser Doppler hyperemic flux patterns were observed. Hyperemia types A and B were biphasic, type C had only a monophasic course. Apparently in type C the initial fast component of the myogenic response is missing; in type D no increase in flux or PO2 could be measured. Comparison of prevalence of these hyperemia types showed a significantly (p less than 0.05) higher prevalence of the monophasic or even absent hyperemic response in type I diabetes. The reduction in viscoelastic properties of the small arteries and arterioles in patients with type I diabetes may account for these changes which is most likely cofactor in the pathogenesis of diabetic microangiopathy.

Adult↗
PubMed1990

The Medical Research Council trial of short-term high-dose alternate day prednisolone in idiopathic membranous nephropathy with nephrotic syndrome in adults. The MRC Glomerulonephritis Working Party.

We have assessed the medium-term effect of a short course of high-dose, alternate-day prednisolone on adult nephrotic patients with membranous nephropathy, using a randomized, prospective, double-blind, controlled trial. Patients were entered over the period 1981 to 1984 and were observed for a minimum of three years. One hundred and seven adult patients who had not previously received immunosuppressive treatment were included in the trial. One hundred and sixty further patients, excluded from the trial, but with membranous nephropathy were identified, followed and assessed retrospectively at the end of the trial. At 36 months there was no significant difference between control and treatment groups in plasma creatinine, creatinine clearance or 24-h excretion of protein. At between three and six months serum albumin concentrations were higher and protein excretions lower in the treatment group compared to controls. No significant benefit was therefore observed on renal function in the medium term.

Adult↗
PubMed1990

[Integration and reintegration of first admission psychiatric patients].

In the framework of a prospective follow-up study, development and outcome of the occupational and social status in 258 first-admission psychiatric patients was investigated. Interviews were made at the time of discharge, 1 year and 5 years later. For that reason prospective data exist on the prehospital and hospital time as well as on short-term and long-term course. Social adjustment, occupational rehabilitation, early retirement, social status and pre- and post-hospital occupational integration were investigated. It must be placed on record, that psychiatric patients are subjected to severe negative changes in their occupational and social life even after the first hospital treatment. Type and quantity of disintegration depended on the diagnostic group. Schizophrenic patients differed from the other patients in every intergration area.

Alcoholism↗
PubMed1985

Intensive short-term chemotherapy for patients with acute myelogenous leukemia: long-term follow-up.

Our pilot study addresses the problem of early relapse from complete remission in young adults with acute myelogenous leukemia (AML). Twelve patients with AML, 16-58 years of age, were entered in a study of four intense courses of cytotoxic chemotherapy using the following drugs: cytarabine, daunorubicin, 5-azacitidine, and 6-thioguanine. They received no maintenance therapy. Nine of 12 patients achieved complete response. With a minimum follow-up of 35 months, the observed disease-free survival at 2 years was 67% (14 +/- SE) and the actuarial disease-free survival at 4 years was 38% (17 +/- SE). It appears that brief intensive chemotherapy early in the management of AML can produce prolonged remission without the need for maintenance therapy.

Actuarial Analysis↗
PubMed1989

Eicosanoid production and glucocorticoid regulatory mechanisms in cultured human trabecular meshwork cells.

The techniques we developed to propagate HTM cells in serial cell culture have provided an opportunity to investigate the spectrum of endogenous PGs and other eicosanoids that are produced by these cells. PGE2 and PGF2 alpha were the major cyclooxygenase products detected by both radioimmunoassay and thin-layer chromatography. A small amount of 6-keto PGF1 alpha was also detected, indicating that these cells are able to produce prostacyclin. The observation of a substantial increase in the proportion of PGF2 alpha relative to PGE2 at later time periods after a media change suggests a metabolic conversion of PGE2 to PGF2 alpha by these cells. Bradykinin, thrombin, platelet activating factor, and serum were found to be effective stimulators of PG production by HTM cells, whereas calcium ionophore produced only a minor effect. Using high pressure liquid chromatography, elution profiles of radiolabeled metabolites of AA suggested the presence of certain lipoxygenase products, including LTB4, 12-HETE, 15-HETE, and a small amount of 5-HETE in HTM cells. The formation of these products was inhibited by both DEX and BW 755c, reinforcing the view that metabolic conversions of AA through the lipoxygenase pathway were possible in the trabecular meshwork. We also examined the effects of glucocorticoids on specific protein synthesis in the HTM cells, using 35S-methionine labeling and SDS-PAGE techniques. Short-term (1 day) DEX treatment revealed a major induction of a protein band at approximately 30 kDa. Longer treatments (1 to 3 weeks) resulted in major inductions at approximately 55 kDa inside the cells, with the presence of secreted forms (probably glycoproteins) between 55 and 72 kDa. The short-term DEX effect on protein synthesis a phospholipase inhibitor regulating eicosanoid production within the HTM. The longer-term induction may, on the other hand, be related more directly to the development of steroid glaucoma, based on our findings that the inductions of these proteins correlate with the observed time course and dose-dependence topical glucocorticoid effects on IOP. Continued in vitro and in vivo evaluations of the eicosanoid pathways in cultured HTM cells obtained from normal and glaucomatous human eyes may help to delineate their relationship to IOP regulation and the pathogenesis and treatment of glaucoma. Glucocorticoid-induced proteins may be key participants in the regulation of phospholipase activity and hence may represent a major control mechanism of the AA cascade.(ABSTRACT TRUNCATED AT 400 WORDS)

Cells, Cultured↗
PubMed1989

[Preoperative intensive chemotherapy of operable breast cancer].

Eighty-one patients with operable breast cancers received the short-term and intensive preoperative chemotherapy, followed by radical mastectomy are presented. The total response rate in the primary tumor to chemotherapy was 59%. Seven patients (8.6%) had complete remission, 41 (50.6%) partial remission and 33 (40.7%) stable lesions. No cancer cells were found histopathologically by serial sections from two primary lesions after chemotherapy. The authors found that tumor with small size, short course and regular shape had a better response rate. Histopathological type, firmness and boundary of tumor, menopausal status, and estrogen receptor (ER) status were not related to the chemotherapeutic effect. No obvious toxicity and side effects were found during the chemotherapy. The chemotherapy did not influence the wound healing. The results indicate that the chemotherapy has a favorable effect on breast cancer and is safe and valid. The response rate of breast cancer to chemotherapy before operation can be used as breast cancer chemosensitivity test in vivo.

Adult↗
PubMed1989

Untreated bacteriuria in asymptomatic girls with renal scarring.

Recurrences of bacteriuria after treatment occur in 50% to 80% of asymptomatic patients. Previous experience with short-term treatment as well as long-term prophylaxis has been disappointing, with a significant risk of infections, ie, development of symptoms after treatment. Results with nontreatment are described in this report with reference to clinical course, renal growth, and glomerular filtration rate in 26 asymptomatic girls with established renal scarring and bacteriuria. Acute pyelonephritis was not seen in those with continuing bacteriuria or spontaneous clearance. Neither in scarred nor in unscarred kidneys did the duration of bacteriuria influence renal growth or glomerular filtration rate. Asymptomatic patients with bacteriuria may gain from nontreatment and may have a reduced risk of pyelonephritic attacks.

Adolescent↗
PubMed1989

[Comparison of conventional chemotherapy and short-term intensive chemotherapy in adult acute myeloid leukemia].

We designed a short term intensive chemotherapy (DCMP-85 regimen) that completed 4 courses of postremission therapy without maintenance therapy in an effort to improve remission durations for adult patients with AML. Twenty six patients aged 14-65 yr were entered into this study. The rate of complete remission is 76.9%. A Kaplan-Meier analysis of patients entering remission predicts that 56% of patients will remain in remission at 3 years (median follow-up is 12 mo). Comparison three different conventional chemotherapies (DC(M)P, DCMP Two Step and BH-AC DMP), DCMP-85 has achieved higher CR rate and 3-year leukemia-free survival rate, so far. Therefore, we conclude short term intensive chemotherapy is getting better results.

Adolescent↗