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Lemorzsolódási kockázat az orvostanhallgatók körében
Dropout risk among medical students
: 13. 4 Arulampalam W, Naylor RA, Smith JP. Hazard model of the probability of medical school drop-out in the UK. J Royal Stat Soc. Series A 2004; 167
-based methodologies continues to perplex both researchers and clinicians ( Lilienfeld, Ritschel, Lynn, Cautin, & Latzman, 2013 ). These evidence-based treatments for PTSD, like many treatments, are not free of shortcomings, however. Drop-out rates average 14–16% and
into the non-adherence ( n = 77) and control (those who did not begin any at all treatment, n = 17) groups. The high number of drop-outs made it impossible to analyze any post-treatment evaluation in Phase 3. Table 3 shows the number of
relatively high drop-out. HFrEF: heart failure with reduced ejection fraction; HTX: heart transplantation; MVR: mitral valve regurgitation; RV: right ventricular Twenty-four patients met the primary endpoint
The first choice and most efficient therapy for chronic hepatitis C is pegylated interferon + ribavirin treatment. The introduction and application of the STOP rule (pegylated interferon + ribavirin treatment should be stopped in cases without sufficient virological response to therapy at Week 12 or 24) is motivated by the very high cost of this treatment. The application of the STOP rule has the disadvantage of ‘dropping out’ these patients from the proven benefits of one year interferon treatment (it arrests or decreases inflammation, delays or prevents progression to cirrhosis, and reduces the risk of a developing hepatocellular carcinoma), observed even in virologically slow, partial, or non-responder patients who received one year interferon therapy. Based on these data, the official Hungarian treatment protocol allows and recommends the continuation of antiviral treatment by natural interferon for patients whose pegylated interferon + ribavirin treatment should have been stopped because of the STOP rule. In 15 patients whose pegylated interferon + ribavirin treatment should have been stopped because of the STOP rule (8 men, 7 women, age: 35 to 63 years, mean: 48.8 years; HCV genotype: 1b; HAI: mean: 6.7; SD: ±5.03; stage: mean: 1.75; SD: ±0.9), the treatment was continued with natural interferon for further 16 to 36 (mean: 23.7) weeks. The total duration of treatment was 48 to 52 weeks, and the duration of follow-up was at least 6 months. The control group consisted of 18 patients whose pegylated interferon + ribavirin treatment had to be stopped because of the STOP rule (7 men, 11 women, age: 32 to 63 years, mean: 48.7 years; HCV genotype: 1b; HAI: mean: 10.1; SD: ±4.8; stage: mean: 2.0; SD: ±0.6). The duration of follow-up was at least 6 months. There was no significant difference between the two groups. Due to the treatment with pegylated interferon + ribavirin, ALT levels showed a marked decrease (73.4 U/L; SD: ±25.5 versus 45.9 U/L; SD: ±22.1) and this reduction remained unchanged also during the treatment with natural interferon and the follow-up period (45.7 U/L; SD: ±15.1 and 49.3 U/L; SD: ±19.4; p < 0.001). The difference is significant. In the control group, ALT levels decreased (108.5 U/L; SD: ±69.8 versus 86.0 U/L; SD: ±82.8) due to the treatment with pegylated interferon + ribavirin, but increased after cessation of the therapy (99.7 U/L; SD: ±60.9). The biochemical response (significant reduction of ALT level) which was detected during the pegylated interferon + ribavirin treatment remained permanent during the continuation and after the cessation of the therapy in the natural interferon treated group, while relapse occurred in every case in the control group. The viral load increased at least 1 log 10 after cessation of the therapy in pegylated interferon + ribavirin treatment non-responder patients. Natural interferon therapy was able to control viral replication (it prevents the increase of viral load), but after the withdrawal of natural interferon dosage, similar elevation of viral load was observed. The subjective side effects of natural interferon treatment were milder. Leukopenia and thrombocytopenia occurred more rarely and to a lesser extent than during the combined antiviral therapy. Patients have no difficulty in the application of natural interferon; probably the positive psychic effect of not being debarred from treatment compensated for the technical hardness (three injections weekly). The authors suggest widespread application of this therapeutic possibility and further studies with larger a number of patients.
Drop-out rates of patients with hepatocellular cancer listed for liver transplantation: Outcome with chemoembolization Liver Transpl 10 449 455
A tanulmány bemutatja a „Pannónia” dunántúli serdülőpszichiátriai multicentrikus, keresztmetszeti felmérés célkitűzéseit és eredményeit. A tervezett hét megyéből ötben sikerült a dunántúli régióban klinikai vizsgálatot végezni, s így felmérni minden új, egy év alatt a gondozóban jelentkező serdülő pszichiátriai beteget. A szerzők ismertetik a beteganyag diagnosztikai megoszlását, az elutasítási és lemorzsolódási arányt, a pszichiátriai betegségek kumulatív és egyes incidenciáit, továbbá közölnek néhány kisebbségre vonatkozó és egyéb demográfiai adatot is.
Thase et al., 2020 ). Efficacy is far from perfect even when health professionals combine both approaches. Some medications help as few as 1 in 9 patients ( Citrome, 2016 ). Standard psychotherapies can have drop-out rates that exceed 50% ( Pentaraki
being inspired by Leary to “drop out” and experiment with LSD, became a leading activist in the famous antipsychiatry movement and what developed into “acid anarchism” (see also chapter thirteen). In summary, this fantastic collection accomplishes the
d = 0.91 ( Mitchell et al., 2021 ). The treatment itself makes sense. Alternative treatments lead to challenging drop-out rates and limited success. MDMA, when administered over multiple sessions as part of a manualized treatment lasting 18 weeks
