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Books on the topic 'Cohorts Treatment'

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Author: Grafiati
Published: 10 December 2022
Last updated: 28 January 2023

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1

M, Bray Robert, Hubbard Robert L, National Institute on Drug Abuse. Division of Clinical Research., Research Triangle Institute, and Treatment Outcome Prospective Study, eds. Drug use before and during drug abuse treatment: 1979-1981 TOPS admission cohorts. Rockville, Md: U.S. Dept. of Health and Human Services, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, National Institute on Drug Abuse, Division of Clinical Research, 1985.

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2

Ambros, Uchtenhagen, ed. Prescription of narcotics for heroin addicts: Main result of the Swiss national cohort study. Basel: Karger, 1999.

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3

D, Nelson Heidi, United States. Agency for Healthcare Research and Quality., and Oregon Health & Science University. Evidence-based Practice Center., eds. Management of menopause-related symptoms. [Rockville, Md.]: Agency for Healthcare Research and Quality, U.S. Dept. of Health and Human Services, 2005.

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4

Drug abuse treatment client characteristics and pretreatment behaviors: 1979-1981 TOPS admission cohorts. Rockville, Md: U.S. Dept. of Health and Human Services, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, National Institute on Drug Abuse, Division of Clinical Research, 1986.

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5

Rosell, Daniel R., and Larry J. Siever. The Neurobiology and Genetics of Schizotypal Personality Disorder. Edited by Christian Schmahl, K. Luan Phan, Robert O. Friedel, and Larry J. Siever. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199362318.003.0012.

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This chapter focuses on the neurobiology of schizotypal personality disorder (SPD) as well as schizotypy or attenuated schizophrenia-spectrum traits present among the general population, as opposed to clinical cohorts. It can be assumed that a better understanding of the neurobiology of SPD will hopefully lead to enhancements of the diagnosis and treatment of this complex, impairing, yet understudied, condition and the assessment of novel therapeutics. The chapter first characterizes the SPD construct, then turns to the genetics and development of SPD, followed by a review of studies employing nonimaging, laboratory measures. Then anatomical, functional, and neurochemical imaging findings are discussed.
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6

Hobbs, Richard. Primary Prevention of Coronary Heart Disease. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199544769.003.0002.

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• Coronary heart disease (CHD) is the leading cause of death and disability in the world• The evidence base for the causes of CHD and for the interventions which reduce CHD risk is huge• Since CHD is multi-factorial, risk factors tend to co-exist in many patients, and are multiplicative in their influence on overall risk, making identifying people at highest risk clinically difficult• CHD risk scores have been developed, based on observed CHD rates amongst well-phenotyped patient cohorts followed up over years. These express absolute risk over a defined period and are the most practical method for determining which people have the most to gain from treatment interventions• Evidence-based interventions include smoking cessation, lifestyle modification in terms of diet and exercise, anti-hypertensives for elevated blood pressure, and ‘statins’ for hyperlipidaemia• Clinical guidelines for CHD prevention provide recommendations on specific targets for blood pressure and lipid-lowering therapy.
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7

Guo, Yong, and Claudia F. Lucchinetti. Taking a Microscopic Look at Multiple Sclerosis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199341016.003.0005.

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The pathology of multiple sclerosis is complex, extends beyond the white matter plaque, and is influenced by stage of demyelinating activity, clinical course, disease duration, and treatment. Technological advances in immunology, molecular biology, and “omic” biology have provided novel insights into the mechanisms for development of white matter plaques, axonal damage, cortical demyelination, and disease progression. Detailed, systematic, and statistically rigorous pathological studies on clinically well-characterized MS cohorts have helped define the heterogeneous pathological substrates of MS and unravel the complex molecular pathogenic mechanisms, with the ultimate goal of identifying targets for therapeutic interventions. It is increasingly clear that the use of human tissues is imperative to improve current diagnostic, prognostic, and therapeutic modalities. Preclinical animal models have been invaluable for discovery of key immune processes, basic disease mechanisms, and candidate immune targeting strategies, but the conclusions have yet be reconciled with the essential features of the human disease.
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8

Neisius, Andreas, Michael E. Lipkin, and Glenn M. Preminger. Kidney stone treatment. Edited by John Reynard. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0022.

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Following the first large cohort of percutaneous nephrolithotomy (PCNL) reported by Alken in 1981, PCNL has subsequently become the preferred treatment method for large and/or complex renal and large proximal ureteral calculi. Current guidelines recommend PCNL as first-line therapy for all renal calculi ≥20 mm and for lower pole stones ≥15 mm. In this chapter we review the current indications, techniques, and outcomes of PCNL. Nowadays stone-free rates of approximately 70% overall can be achieved with PCNL, while at experienced high-volume centres, stone-free rates can approach 100%. While generally percutaneous nephrolithotomy has low morbidity, nonetheless significant complications can occur and the diagnosis, treatment, and preventative measures of these complications are presented in this chapter.
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9

Sullivan, Maria, and Frances Levin, eds. Addiction in the Older Patient. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199392063.001.0001.

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Addictive disorders in older adults are underdiagnosed and undertreated. An important reason for this lack of recognition of a serious health problem is a paucity of clinical knowledge about how such disorders present in this population. The presentation for alcohol and substance use disorders in the elderly can be confusing, given the metabolic changes and concurrent conditions associated with aging, together with interactions between alcohol and prescribed psychoactive drugs. Further, screening instruments have not been validated for this population. Brief interventions may be effective but should take into account contextual needs such as medical conditions, cognitive decline, and mobility limitations. Treatment strategies, including detoxification regimens, need to be modified for older patients and - in the case of opioid dependence - must address the management of chronic pain in this population. Ironically, benzodiazepines are the most frequently prescribed psychoactive medication in the elderly, despite older individuals' greater sensitivity to side effects and toxicity. Older women are at particularly heightened vulnerability for iatrogenic dependence on sedatives and hypnotics. More clinical research data are needed to inform screening and referral strategies, behavioral therapies, and pharmacological treatment. At the same time, emerging technologies such as communication tools and monitoring devices offer important opportunities to advance addiction treatment and recovery management in older adults. Although research to date has been limited in this population, recent data suggest that treatment outcomes are equal or better to those seen in younger cohorts.
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10

Lawrence, Paszat, and Canadian Coordinating Office for Health Technology Assessment., eds. A population-based cohort study of surveillance mammography after treatment of primary breast cancer. Ottawa: Canadian Coordinating Office for Health Technology Assessment, 2001.

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11

Craven, Beverley Catharine. Oral bisphosphonates for treatment of sublesional osteoporosis after spinal cord injury: A retrospective cohort study. 2007.

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12

Baliunas, Dalia. Empirical versus perceived risk for hepatitis C in a cohort of not in treatment opioid users. 2004.

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13

Nagarajan, Chandramouli. Terminal care in haematological disease. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0292.

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Care of the terminally ill haematology patient presents a unique challenge, due to the complexity of treatment decisions in an era of newly developing therapeutic options, and the speed of change in patient’s condition from a potentially curable to a terminal phase. Terminal illness is defined as progressive disease for which curative treatment is neither possible nor appropriate and from which death is inevitable, although this may not be impending and the prognosis can vary from a few days to many months. The focus of this chapter is to try and bring together various palliative treatment options that should be made available to this cohort of patients with terminal disease.
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14

Pilkington, Clarissa, and Liza McCann. Paediatric polymyositis and dermatomyositis. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0125.

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Juvenile polymyositis and dermatomyositis are inflammatory myopathies that affect muscle. Dermatomyositis also affects skin, and can have many extramuscular manifestations. Inflammatory myopathies are uncommon in childhood, with dermatomyositis occurring more than polymyositis. For this reason, published research has concentrated on juvenile dermatomyositis. The spectrum of disease severity ranges from mild cases that can recover completely without treatment, to multisystem inflammation that can be fatal. Treatments have improved over the decades, reducing mortality from 30% before the era of steroids, to less than 1% in the present day. Juvenile cases of dermatomyositis differ from those seen in adulthood, without tendency for associated malignancy, and a far greater incidence of calcinosis. Calcinosis can be deposited as small calcinotic lumps or as sheets of calcinosis. It is very difficult to treat and causes extensive morbidity, and depending on where the calcinosis is deposited, it can cause severe disability or even death. Over the last decade, international collaborative work has concentrated on developing disease activity and assessment tools for both adult and juvenile forms of myositis. This will enable more subjective study of these rare diseases in multinational cohort studies, and enable clinical trials to investigate drug treatments. This work led to the first international double-blind placebo controlled trial of treatment in both adults and children with dermatomyositis (using rituximab as the drug). Further international collaboration has led to the development of core outcome variables, a definition of disease flare, and ongoing work on classification criteria.
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15

Pilkington, Clarissa, and Liza McCann. Paediatric polymyositis and dermatomyositis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199642489.003.0125_update_002.

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Juvenile polymyositis and dermatomyositis are inflammatory myopathies that affect muscle. Dermatomyositis also affects skin, and can have many extramuscular manifestations. Inflammatory myopathies are uncommon in childhood, with dermatomyositis occurring more than polymyositis. For this reason, published research has concentrated on juvenile dermatomyositis. The spectrum of disease severity ranges from mild cases that can recover completely without treatment, to multisystem inflammation that can be fatal. Treatments have improved over the decades, reducing mortality from 30% before the era of steroids, to less than 1% in the present day. Juvenile cases of dermatomyositis differ from those seen in adulthood, without tendency for associated malignancy, and a far greater incidence of calcinosis. Calcinosis can be deposited as small calcinotic lumps or as sheets of calcinosis. It is very difficult to treat and causes extensive morbidity, and depending on where the calcinosis is deposited, it can cause severe disability or even death. Over the last decade, international collaborative work has concentrated on developing disease activity and assessment tools for both adult and juvenile forms of myositis. This will enable more subjective study of these rare diseases in multinational cohort studies, and enable clinical trials to investigate drug treatments. This work led to the first international double-blind placebo controlled trial of treatment in both adults and children with dermatomyositis (using rituximab as the drug). Further international collaboration has led to the development of core outcome variables, a definition of disease flare, and ongoing work on classification criteria.
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16

Uchtenhagen, Ambros. Prescription of Narcotics for Heroin Addicts: Main Result of the Swiss National Cohort Study (Medical Prescription of Narcotics, Vol. 1). S. Karger Publishers (USA), 1999.

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17

Popeo, Dennis. The Elderly. Edited by Hunter L. McQuistion. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190610999.003.0014.

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Every day, approximately 20,000 Americans turn age 65 years. If the current prevalence of mental illness and substance abuse continues, in 2040 more than 15 million adults older than age 65 years will need services that are specifically tailored to older adults. As it is, the current population of older adults is underserved—a service gap to which public psychiatrists must respond. By presenting one representative case, this chapter addresses some of the specific needs of this cohort of patients, including complex and comorbid health issues, cognitive impairment, caregiver burden, elder abuse, and the unfortunate prevalence of homelessness among the elderly. Age-appropriate mental health treatment is discussed, with the goal of educating mental health practitioners to better serve this diverse and heterogeneous population.
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18

Carlson, Linda E., Janine Giese-Davis, and Barry D. Bultz. Communication about coping as a survivor. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198736134.003.0019.

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With improvements in early detection and cancer treatments, a growing cohort of cancer survivors is emerging. Maintaining communication with survivors poses a host of new challenges to care providers that have not received ample attention in the literature. This chapter covers a number of areas relevant to enhancing communication with survivors, including various definitions of who is considered a cancer survivor (including caregivers); the ever-increasing prevalence of survivors; key issues faced by cancer survivors such as late and long-term effects and transition back to primary care; coping strategies including the use of care plans and clinical practice guidelines; communication challenges with cancer survivors and among medical professionals taking care of survivors; models for survivorship care; and details about communication techniques in the survivorship consultation.
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19

Agarwal, Rajiv, and Andrew S. Epstein. Expectations about Effects of Chemotherapy in Patients with Advanced Cancer (DRAFT). Edited by Nathan A. Gray and Thomas W. LeBlanc. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190658618.003.0033.

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This chapter reviews the Weeks et al. secondary analysis of data from the Cancer Care Outcomes Research and Surveillance (CanCORS) prospective cohort, evaluating the expectations of patients who receive chemotherapy for incurable metastatic lung or colorectal cancer. Patients’ understanding of the effectiveness of chemotherapy for providing cure, life extension, and symptom relief were measured. The researchers also investigated the clinical, sociodemographic, and health system factors that were associated with inaccurate expectations on the curative potential of chemotherapy. The study demonstrated that most patients with metastatic lung or colorectal cancer believed that chemotherapy was likely to cure their disease. Colorectal cancer, non-white race, nonintegrated health care networks, and high physician communication scores were independently associated with inaccurate expectations. These findings highlight that understanding the goals of chemotherapy is both important and necessary for patients with incurable cancers to make informed treatment decisions.
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20

Arthur, Joseph. Palliative Sedation Therapy and Survival (DRAFT). Edited by Nathan A. Gray and Thomas W. LeBlanc. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190658618.003.0045.

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Patients with advanced illness sometimes experience severe and debilitating physical and psychological symptoms at the end of life that may be refractory to all kinds of conventional treatments available for symptom relief. In such situations, palliative sedation therapy (PST) may be indicated. However, its utilization has been subject to debate. One viewpoint is that PST may hasten death. However, some studies have indicated otherwise. This chapter discusses a multicenter, prospective, observational, nonrandomized population-based study that compared the overall survival of a cohort of terminally ill patients who received PST with a similar group of patients who did not. The study showed that PST does not shorten life when used to relieve refractory symptoms. The chapter also presents a clinical case scenario to illustrate who should receive PST.
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21

Wohl, David A., and Jeffrey T. Kirchner. Cardiovascular Disease. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190493097.003.0041.

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There is a growing body of evidence that HIV-infected persons are at increased risk for cardiovascular disease (CVD) and associated complications, including myocardial infarction and stroke. Autopsy studies have noted premature atherosclerosis in HIV-infected adults, and epidemiological studies demonstrate higher rates of CVD among HIV-infected compared to HIV-uninfected patients. These findings are in part due to chronic inflammation and immune activation associated with HIV infection. Traditional CVD risk factors, including hypertension, hyperlipidemia, and cigarette smoking, also play keys roles. There is additional evidence from observational cohort studies that some antiretroviral drugs, including protease inhibitors and nucleoside reverse transcriptase inhibitors, may increase the risk of myocardial infarction. Treatment interventions to reduce the risk of CVD include diet, exercise, smoking cessation, lipid-lowering agents, and antihypertensive medications. For select patients, changing antiretroviral therapy to improve lipid profiles may be appropriate but should not compromise virologic or immunologic control.
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22

Fullerton, James N., and Mervyn Singer. Oxygen in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0032.

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Oxygen therapy is primarily administered to alleviate arterial hypoxaemia and tissue hypoxia, and to facilitate aerobic cellular respiration. Hypoxaemia (PaO2 < 8 kPa [60 mmHg], SaO2 <92%) is associated with end-organ damage and adverse clinical outcomes, serving as a proxy measure for reduced intracellular PO2. Increasing the fraction of inspired oxygen should form part of an overall strategy to maximize tissue oxygen delivery. Permissive hypoxaemia represents a valid treatment strategy in a selected patient cohort. Oxygen is a drug and oxygen therapy is not benign, and oxygen administration at high, sustained doses (FiO2 >0.5, >12 hours) may cause oxygen toxicity. Observational studies in both mechanically-ventilated patients and survivors of non-traumatic cardiac arrest indicate an independent association between increasing hyperoxaemia and mortality. Oxygen therapy may additionally precipitate hypercapnic ventilatory failure in those at risk and oxygen should be administered to achieve a prescribed target SaO2 or PaO2 range, via adjustment of dose and delivery device. If no monitoring is available, hypoxaemia should be avoided by giving high-flow oxygen to achieve a FiO2 of near 1.0 with subsequent titration once oxygenation status is established.
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23

Post, Robert M. Depression as a Recurrent, Progressive Illness. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190603342.003.0003.

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Clinical Highlights and summary of Chapter• Episodes of depression and bipolar illness progress in two ways:faster recurrences as a function of number of prior episodes, andgreater autonomy (decreased need for precipitation by stressors(Episode Sensitization)• Recurrent stressors result in increased reactivity to subsequent stressors(Stress sensitization) and bouts of stimulant abuse increase in severity with repetition(Stimulant-induced behavioral sensitization)• Each type of sensitization cross-sensitizes to the others and drives illness progression• Each type of sensitization involves specific memory-like epigenetic processes as well as nonspecific cellular toxicities• Childhood onset depression and bipolar illness have a more adverse course than adult onset illness and are increasing in incidence via a cohort (year of birth) effect• As opposed to genetic vulnerability, each type of sensitization can be prevented with appropriate clinical intervention and prevention, which should lessen illness severity and progression• Seeing depression and bipolar disorder as progressive illnesses changes the therapeutic emphasis away from acute treatment and instead to long term prophylaxis• Preventing recurrent depressions will likely protect the brain, the body, and the personWord count with Named refs = 6,417>Depression and bipolar disorder are illnesses which tend to progress with each new recurrence. Stressors, mood episodes, and bouts of substance abuse each sensitize (show increased reactivity) upon their repetition and cross-sensitization to the others. These sensitization processes appear to have a memory-like and epigenetic basis, in some instances conveying lifelong increased vulnerability to illness recurrence and progression. Greater numbers of episodes are associated with faster recurrences, lesser need for stress precipitation, cognitive dysfunction, pathological changes in brain, treatment refractoriness, and loss of many years of life expectancy, predominantly from cardiovascular disease. Such a perspective emphasizes the need for greater awareness of higher incidence of psychiatric and medical comorbidities in the United States compared to many European countries, and the need for earlier intervention and more sustained long term prophylaxis to prevent illness progression and its adverse consequences on brain and body.
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