PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Early Medical Intervention”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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

At least 19 recordsLinked to original sources
PubMed1995

Is intermittent, early intervention medication an alternative for neuroleptic maintenance treatment?

Neuroleptic maintenance medication is clearly effective for relapse prevention in schizophrenia. However, besides benefits for the majority of patients, there are also failures and/or risks for some patients (e.g. tardive dyskinesia). Since the risk-benefit ratio is often difficult to predict in the individual case, this has stimulated the search for modifications and alternatives to maintenance treatment. In particular, neuroleptic low-dose treatment strategies compare favorably with standard-dose treatment concerning relapse prevention and side effects. Alternatively, based on prodromal symptoms preceding a relapse, early intervention, intermittent neuroleptic treatment strategies have been developed. However, all recently completed controlled 2 year studies have not confirmed this strategy to be as effective as maintenance treatment in preventing relapse. Therefore, for the majority of patients intermittent treatment cannot be recommended.

Antipsychotic Agents↗
PubMed1998

First-episode schizophrenia. Early intervention and medication discontinuation in the context of course and treatment.

BACKGROUND: The concept that early intervention with antipsychotic medications improves the long-term course of schizophrenia is discussed. METHOD: This report reviews the literature concerning early intervention with antipsychotic medications for people with first episodes, and how it affects long-term morbidity. It also studies the effects of discontinuing antipsychotic medications on relapse for people with first episodes. RESULTS: Early intervention with antipsychotic medications appears to decrease the long-term morbidity of schizophrenia. CONCLUSIONS: Early intervention with antipsychotic medications should be encouraged for people experiencing their first episode of schizophrenia. This report proposes that studying the various phases of subject response to treatment can be helpful in elucidating when antipsychotic medications should be tapered or withdrawn.

Antipsychotic Agents↗
PubMed1996

Predictors of developmental outcomes for medically fragile early intervention participants.

Little is documented about the determinants of developmental outcomes for medically fragile infants who receive early intervention. In this controlled longitudinal study 65 premature infants with intraventricular hemorrhage (IVH) were randomly assigned to intervention groups beginning at 3 months adjusted age (Early) or 12 months adjusted age (Delayed). The sample was 65% African American and 35% Caucasian, and over half the youngsters were being raised by single mothers. Although cost analyses revealed that it was almost twice as expensive to begin sensorimotor intervention at the earlier age, annual comprehensive assessments revealed no significant differences in developmental outcomes based on age at start. Stepwise multiple regression analyses revealed that Maternal Education and Neonatal Medical Problems were significant predictors of outcomes at years 1, 3, 5, and 7 regardless of age at start. Related findings from other studies are discussed along with implications for policy and future research.

Cerebral Hemorrhage↗
PubMed1989

Economic and policy implications of early intervention in HIV disease.

Early medical intervention in human immunodeficiency virus disease has far-reaching implications for the health care system of the United States. Several factors are enabling the medical community to begin intervention prior to a patient's diagnosis of acquired immunodeficiency syndrome. These factors include an understanding of the biologic markers of disease progression; advances in antiviral therapeutics; and an improved ability to control the most common presenting opportunistic infection, Pneumocystis carinii pneumonia. Providing adequate ambulatory care for large numbers of asymptomatic human immunodeficiency virus-infected individuals and coordinating inner-city health care facilities will become critical. Important questions regarding service provision need to be adequately addressed. The cost of yearly treatment, estimated to be $5 billion per year, will require a major financial commitment at all levels of government and the private sector. Effective early intervention in human immunodeficiency virus disease may alter the course of one of the most devastating epidemics in modern history. Planning for its implementation should begin immediately.

Federal Government↗
PubMed1987

Diagnostic sonography of the fetal genitourinary tract.

Fetal diagnosis has vastly improved over the last decade. Ultrasound has become the imaging modality of choice. As real-time equipment has improved technologically, the ability to deduce subtle abnormalities has greatly increased. The fetal genitourinary tract may be evaluated for renal dysplasias, anomalies, or obstruction. Points of obstruction and, at times, the exact cause of obstruction may be deduced. Abnormalities of the ureter, bladder, urethra, scrotum, or reproductive system can be detected. Early diagnosis allows for proper individual or family counseling for hereditable disorders and chromosomal abnormalities. The perinatology team can be alerted to an abnormality that may require early neonatal surgical or medical intervention. Early treatment can prevent significant deterioration of renal function. The possibilities of prenatal intervention may be considered.

Amniotic Fluid↗
PubMed1995

Onset of otitis media in the first eight weeks of life in aboriginal and non-aboriginal Australian infants.

Otitis media (OM) is highly prevalent among Aboriginal Australians, in whom eardrum perforations with discharge have been reported in the first 3 months of life. Only one published study, however, has described middle ear status at birth or prior to eardrum perforation in young Aboriginal infants. This prospective study used otoscopy, tympanometry, and hearing tests to compare middle ear status and hearing sensitivity in Aboriginal and non-Aboriginal neonates. Immobile eardrums were observed immediately after birth, but mobility generally appeared within the first week. At examinations at 6 to 8 weeks of age, OM with effusion or acute OM was observed in 95% of 22 Aboriginal infants, but OM with effusion was seen in only 30% of 10 non-Aboriginal infants. There was a clinic record of unilateral perforation in 1 Aboriginal infant only. Hearing impairment was demonstrated by auditory brain stem response in 5 ears, all with evidence of middle ear abnormalities. Improved knowledge and diagnosis of the signs and symptoms of OM will contribute to improvements in the provision of early medical intervention to populations at high risk for early OM.

Acoustic Impedance Tests↗
PubMedDate not supplied

Sudden hearing loss and autoimmune inner ear disease.

This case report describes the audiologic and medical diagnostic evaluations, results, and treatment options in a patient with a classic presentation of immune-mediated sensorineural hearing loss, commonly called autoimmune inner ear disease (AIED). It reviews findings of the basic battery, immittance audiometry, transient otoacoustic emissions, and auditory brainstem response measures and medical findings over more than 2 years. AIED generally causes asymmetric bilateral sensorineural hearing loss with atypical configuration. Although hearing loss is generally fluctuant, the overall pattern is usually rapid progression, particularly in the absence of early medical intervention. Word recognition is usually disproportionately poor. In our case, otoacoustic emissions and auditory brainstem responses suggest both cochlear and retrocochlear involvement and may initially appear to be inconsistent with pure-tone thresholds. Audiologists must be familiar with AIED because early identification is critical. Additionally, an immunologic basis may be a factor in other disorders, including many cases of Meniere's disease.

Adult↗
PubMed2000

Molecular detection of Mycobacterium tuberculosis in tissues showing granulomatous inflammation without demonstrable acid-fast bacilli.

Early diagnosis of tuberculosis (TB) is important for early medical intervention and prevention of spread of the bacteria. It is not uncommon to observe granulomatous inflammation but without demonstrable acid-fast bacilli (AFB) on Ziehl-Neelsen (ZN) staining in tissues sent for histologic examination, and the definitive diagnosis of TB cannot be made because no concurrent tissue is sent for TB culture. In this study, the authors explored the feasibility of using polymerase chain reaction (PCR) for early detection of Mycobacterium tuberculosis (Mtb) in formalin-fixed, paraffin-embedded tissues where a definite diagnosis of TB cannot be made. One hundred fifteen patients (131 paraffin blocks of biopsy specimens) with granulomatous inflammation but ZN-negative for AFB were studied. DNA was extracted from paraffin sections and amplified by PCR with the IS6110 primers (specific for the Mtb complex) and the specific 122-base pairs (bp) PCR product was detected by agarose gel electrophoresis. Sixty-eight of the 115 (59%) patients were TB-PCR positive, thus enabling definite diagnosis of TB in significant numbers of these patients in 3 days. The authors conclude that molecular diagnosis by PCR is useful for early detection of TB in histologic material where morphologic features are suggestive but not confirmatory because of negative staining for AFB.

Adolescent↗
PubMedDate not supplied

[Care for the HIV-infected person].

Early medical intervention in patients with HIV infection is beneficial even in asymptomatic individuals. Medical care in these patients consists of the use of antiretroviral drugs, drugs to prevent opportunistic infections, vaccines and comprehensive psychosocial support. It is important to determine the stage of the natural history of the disease at any given moment. Besides clinical data, the determination of CD4+ T-lymphocytes is useful to make decisions related to the institution of antiretroviral drugs and preventive therapy for opportunistic infections. Present evidence shows a clear benefit of starting antiretroviral drugs in every patient with AIDS or AIDS related complex and also supports the use of these drugs in early stages of the disease. Preventive therapy against Pneumocystis carinii has to be instituted in every patient with CD4 lymphocyte counts below 200/mm3. Prophylactic therapy may also be necessary to prevent tuberculosis, toxoplasmosis and M. avium. It is likely that future studies will show some benefit with the use of additional preventive strategies for other frequent infections such as Cytomegalovirus and Cryptosporidium.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Morbidity and mortality of dialysis.

The National Institutes of Health Consensus Development Conference on Morbidity and Mortality of Dialysis brought together experts in general medicine, nephrology, pediatrics, biostatistics, and nutrition as well as the public to address the following questions: (1) How does early medical intervention in predialysis patients influence morbidity and mortality? (2) What is the relationship between delivered dialysis dose and morbidity/mortality? (3) Can co-morbid conditions be altered by non-dialytic interventions to improve morbidity/mortality in dialysis patients? (4) How can dialysis-related complications be reduced? and (5) What are the future directions for research in dialysis? Following 1 1/2 days of presentations by experts and discussion by the audience, a consensus panel weighted the evidence and prepared their consensus statement. Among their findings, the consensus panel concluded that (1) patients in the predialysis phase, including children, should be referred to a renal team in an effort to reduce the morbidity and mortality incurred both during the predialysis period and when receiving subsequent dialysis therapy; (2) the social and psychological welfare and the quality of life of the dialysis patient are favorably influenced by the early predialytic and continued involvement of a multidisciplinary renal team; (3) attempts should be made to avoid a catastrophic onset of dialysis by instituting predialytic intervention and the appropriate initiation of dialysis access; (4) quantitative methods now available to objectively evaluate the relationship between delivered dose of dialysis and patient morbidity and mortality suggest that the dose of hemodialysis and peritoneal dialysis has been suboptimal for many patients in the United States; (5) factors contributing to underdialysis of some patients include problems with vascular and peritoneal access, nonadherence to dialysis prescription, and underprescription of the dialysis dose; (6) cardiovascular mortality accounts for approximately 50 percent of deaths in dialysis patients, and relative risk factors such as hypertension, smoking, and chronic anemia should be treated as soon as possible after diagnosis of chronic renal failure; (7) early detection and treatment of malnutrition contribute to improved survival of patients on dialysis; and (8) until prospective, randomized, controlled trials have been completed, a delivered hemodialysis dose at least equal to a measured fractional urea clearance of Kdrt/V of 1.2 (single pool) and a delivered peritoneal dialysis dose at least equal to a measured Kprt/V of 1.7 (weekly) are recommended.

Adult↗
PubMed1996

Delayed entry into health care for women with HIV disease.

OBJECTIVE: The primary objective was to evaluate factors that might influence delayed entry into health care for women with HIV. Implications of time of diagnosis for early medical intervention was a focused aspect. PROCEDURE: Structured clinical interviews were conducted with HIV-positive women (n = 48); these data were supplemented by medical chart reviews. MEASURES: Delayed entry into health care was operationalized as a difference of more than 3 months between diagnosis and entry into care. Measures of race, social class, risk behavior circumstances of HIV testing, and health status were included. RESULTS: Of women, 58% delayed entry into care following an HIV diagnosis. Upon entry into health care, 65% of women were symptomatic and 40% were severely immunocompromised (CD4 cells/mm3 < 200). Results from the logistic regression indicated that those who learned their HIV status prenatally were four times more likely to delay entry into care compared to those who self-referred for HIV testing, even after controlling for symptom status. CONCLUSIONS: HIV diagnosis is not enough to ensure that women with HIV will get adequate and timely health care. Counseling and testing recommendations should highlight the intrinsic value of early diagnosis.

Adolescent↗
PubMed1997

Multidisciplinary predialysis programs: quantification and limitations of their impact on patient outcomes in two Canadian settings.

A 1993 National Institutes of Health Consensus statement stressed the importance of early medical intervention in predialysis populations. Given the need for evidence-based practice, we report the outcomes of predialysis programs in two major Canadian cities. The purpose of this report was to determine whether the institution of a multidisciplinary predialysis program is of benefit to patients, and to analyze those factors that are important in actualizing those benefits. Data from two different studies is presented: (1) a prospective, nonrandomized cohort study comparing patients who were or were not exposed to an ongoing multidisciplinary predialysis team (St Paul's Hospital) and (2) a retrospective review of outcomes before and after the institution of a predialysis program (The Toronto Hospital). Although created independently in major academic centers in Canada, the programs both aimed to reduce urgent dialysis starts, improve preparedness for dialysis, and improve resource utilization. The Vancouver study was able to demonstrate significantly fewer urgent dialysis starts (13% v 35%; P < 0.05), more outpatient training (76% v 43%; P < 0.05), and less hospital days in the first month of dialysis (6.5 days v 13.5 days; P < 0.05). Cost savings of the program patients in 1993 are conservatively estimated to be $173,000 (Canadian dollars) or over $4,000 per patient. The Toronto study demonstrated success in predialysis access creation (86.3% of patients), but could not realize any benefit in terms of elective dialysis initiation due to well-documented hemodialysis resource constraints. We conclude that an approach to predialysis patients involving a multidisciplinary team can have a positive impact on quantitative outcomes, but essential elements for success include (1) early referral to a nephrology center, (2) adequate resources for dedicated predialysis program staff and infrastructure, and (3) available resources for patients with end-stage renal disease (ESRD) (dialysis stations). In times of economic constraints, objective data are necessary to justify resource-intensive proactive programs for patients with ESRD. Future studies should confirm and extend our observations so that optimum and cost-effective care for patients approaching ESRD is uniformly available.

Canada↗
PubMed2004

Genotype-phenotype correlations for a wide spectrum of mutations in the Wilson disease gene (ATP7B).

Wilson disease (WND) is caused by mutations in the ATP7B gene and exhibits substantial allelic heterogeneity. In this study we report the results of molecular analyses of 20 WND families not described previously. When combined with our prior results, the cohort includes 93 index patients from 69 unrelated families. Twenty different mutations accounted for 86% of the WND chromosomes. The most frequent were p.H1069Q (35%), p.R969Q (12%), c.2530delA (7%), p.L936X (7%), p.Q289X (7%), and p.I1148T (3%). We also present here a detailed phenotypic assessment for patients whose molecular result was previously reported. Thirty cases were homozygous for 9 different mutations, 13 of which were homozygous for p.H1069Q, and 7 for p.R969Q. Mutations p.H1069Q and p.R969Q appeared to confer a milder disease as patients showed disease onset at a later age, and were associated with milder severity when found in trans with severe mutations. Predicted nonsense and frameshift mutations were associated with severe phenotypic expression with earlier disease onset and lower ceruloplasmin values. WND can be treated by copper-chelation therapy, particularly if the disease is diagnosed before irreversible tissue damage occurs. Our results on the effect of predicted nonsense and frameshift mutations are especially important for early medical intervention in presymptomatic infants and children with these genotypes.

Adenosine Triphosphatases↗
PubMed1985

Triage success in disasters: dynamic victim-tracking cards.

A dynamic victim-tracking card developed for use in community or hospital disaster exercises was tested during two hospital and two airport disaster drills. Use of the card in 375 "patients" allowed testing of the ability to evaluate the decisions of triage, the early medical intervention for "victims," and the ongoing treatment of patients with a changing medical status. The card was successful in simulating realistic changes that may occur in critically ill and injured patients. Of the 126 "patients" evaluated in an actual exercise, 55 (43.6%) were placed in the proper triage category. Four patients "died" as a result of poor initial evaluation and treatment. Medical decisions during hospital and community disaster exercises can be more realistically tested and more accurately documented with the use of the dynamic victim-tracking card.

Abdominal Injuries↗
PubMed1994

Is the BCG test of diagnostic value in tuberculosis?

SETTING: In developing countries including Turkey, tuberculosis is still a major problem. Rapid diagnosis and early medical intervention are the two most important considerations in preventing the spread of the disease. OBJECTIVE: This study was carried out to determine the diagnostic value of BCG test in childhood tuberculosis and compare it with tuberculin test in this regard. DESIGN: 50 patients and 20 healthy children without any evidence of previous BCG vaccination and aged 80 days-15 years were simultaneously tested with purified protein derivative (PPD) and BCG vaccine. RESULTS: In pulmonary tuberculosis BCG test was positive in 100% of cases and the PPD test in 44.5%. Similarly, BCG test was positive in 100% of military tuberculosis and tuberculous meningitis cases but PPD test was negative in all of them. Out of 22 patients with malnutrition 18 (82%) had positive BCG test and 4 had positive PPD test. BCG test showed uniformly high positivity in all grades of malnutrition. CONCLUSION: BCG is more reliable and sensitive than the tuberculin test in the diagnosis of tuberculosis. It is still valuable in the diagnosis of tuberculosis especially in developing countries where the disease is still a major public health problem and where sophisticated methods such as rapid culture with BACTEC and demonstration of bacilli with DNA probes are not widely available.

Adolescent↗
PubMed2005

Screening of newborns and high-risk group of children for inborn metabolic disorders using tandem mass spectrometry in South Korea: a three-year report.

BACKGROUND: Mass screening using tandem mass spectrometry(MS/MS) was initiated to determine if the incidence of metabolic disorder is sufficiently high to meet the criteria for newborn screening, and whether or not early medical intervention might be beneficial to the patients. METHODS: Newborns and children in a high-risk group were screened using MS/MS from April 2001 to March 2004. Blood spots of newborns were collected between 48 and 72 h after birth. The dried blood spots was extracted with 150 microl of methanol, and analyzed by MS/MS. RESULTS: From April 2001 to March 2004, 79,179 newborns were screened for organic, amino and fatty acid metabolism disorders, which account for approximately 5.4% of annual births in South Korea. Twenty-eight newborns were diagnosed with one of the metabolic disorders and the collective estimated prevalence amounted to 1 in 2800 with a sensitivity of 97.67%, a specificity of 99.28%, a recall rate of 0.05%, and a positive predictive value of 6.38%. 6795 infants/children at high risk were screened and 20 were confirmed to have metabolic disorders. CONCLUSION: The collective total prevalence of 1:2800 in newborns indicates an underestimation of the incidence of metabolic disorders prior to implementing MS/MS screening in South Korea.

Acidosis↗
PubMed2004

New insights into degenerative mitral valve disease in dogs.

Degenerative mitral valve disease (DMVD) is the most common cardiac disease in dogs. Although the disease is frequently described in the veterinary literature, many aspects are still unknown or controversial. Based on recent research findings, this article addresses the etiology, pathogenesis, inheritance, diagnosis of early DMVD, diagnosis of mild decompensated heart failure, and efficacy of early medical intervention in clinically compensated dogs.

Animals↗