Treatment progress

治疗进展
  • 文章类型: Journal Article
    肺癌一直是恶性肿瘤发病和死亡的主要原因。近年来,肺腺癌的患病率显着增加。尽管靶向疗法已显示出治疗非小细胞肺癌(NSCLC)的某些亚群,相当比例的患者仍然面临着不理想的治疗结果.神经调节蛋白-1(NRG1),NRG基因家族的重要成员,最初由于其在新生心室心内膜中的分布而引起了兴趣,展示了在心内膜和心肌微血管中的排他性存在。最近的研究强调了NRG1在一系列肿瘤的发生和进展中的关键作用,影响各种肿瘤相关信号通路的分子扰动。这篇综述提供了NRG1的简要概述,包括其表达模式,配置,和聚变伙伴。此外,我们探讨了NSCLC中NRG1融合阳性发生的独特特征和潜在治疗策略.
    Lung cancer persistently leads as the primary cause of morbidity and mortality among malignancies. A notable increase in the prevalence of lung adenocarcinoma has become evident in recent years. Although targeted therapies have shown in treating certain subsets of non-small cell lung cancers (NSCLC), a significant proportion of patients still face suboptimal therapeutic outcomes. Neuregulin-1 (NRG1), a critical member of the NRG gene family, initially drew interest due to its distribution within the nascent ventricular endocardium, showcasing an exclusive presence in the endocardium and myocardial microvessels. Recent research has highlighted NRG1\'s pivotal role in the genesis and progression across a spectrum of tumors, influencing molecular perturbations across various tumor-associated signaling pathways. This review provides a concise overview of NRG1, including its expression patterns, configuration, and fusion partners. Additionally, we explore the unique features and potential therapeutic strategies for NRG1 fusion-positive occurrences within the context of NSCLC.
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  • 文章类型: Journal Article
    急性肾损伤(AKI)是最常见和严重的临床肾脏综合征之一,具有较高的发病率和病死率。Ferroptosis是程序性细胞死亡(PCD)的一种形式,以铁过载为特征,活性氧积累,和脂质过氧化。随着近年来对铁死亡的研究越来越多,与AKI的病理生理过程密切相关,为AKI的治疗提供了靶点。这篇综述提供了铁死亡的调节机制的全面概述,总结了它在各种AKI模型中的作用,并探索其与其他形式的细胞死亡的相互作用,它还介绍了AKI向其他疾病进展中的铁死亡的研究。此外,这篇综述重点介绍了通过铁凋亡透镜检测和评估AKI的方法,并描述了铁凋亡治疗AKI的潜在抑制剂.最后,这篇综述提出了对临床AKI治疗未来的看法,旨在刺激对AKI中铁蛋白的进一步研究。
    Acute kidney injury (AKI) is one of the most common and severe clinical renal syndromes with high morbidity and mortality. Ferroptosis is a form of programmed cell death (PCD), is characterized by iron overload, reactive oxygen species accumulation, and lipid peroxidation. As ferroptosis has been increasingly studied in recent years, it is closely associated with the pathophysiological process of AKI and provides a target for the treatment of AKI. This review offers a comprehensive overview of the regulatory mechanisms of ferroptosis, summarizes its role in various AKI models, and explores its interaction with other forms of cell death, it also presents research on ferroptosis in AKI progression to other diseases. Additionally, the review highlights methods for detecting and assessing AKI through the lens of ferroptosis and describes potential inhibitors of ferroptosis for AKI treatment. Finally, the review presents a perspective on the future of clinical AKI treatment, aiming to stimulate further research on ferroptosis in AKI.
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  • 文章类型: Journal Article
    糖尿病,慢性代谢性疾病,通常会导致许多慢性并发症,显着促进全球发病率和死亡率。高葡萄糖水平引发与炎症等病理生理过程相关的表观遗传修饰,豁免权,氧化应激,线粒体功能障碍,衰老和各种细胞死亡。尽管血糖控制,短暂性高血糖会持续伤害器官,组织,和细胞,一种称为“代谢记忆”的潜在效应,有助于慢性糖尿病并发症。了解代谢记忆的机制可以提供一种新的方法来减轻这些并发症。然而,代谢记忆的关键分子和网络仍未完全了解。这篇综述追溯了代谢记忆研究的历史,突出了它的关键特征,讨论了最近涉及其机制的分子,并总结了证实的和潜在的治疗化合物。此外,我们概述了代谢记忆的体外和体内模型。我们希望这项工作将为未来代谢记忆调节机制的研究提供信息,并促进开发有效的治疗化合物来预防糖尿病并发症。
    Diabetes mellitus, a chronic metabolic disease, often leads to numerous chronic complications, significantly contributing to global morbidity and mortality rates. High glucose levels trigger epigenetic modifications linked to pathophysiological processes like inflammation, immunity, oxidative stress, mitochondrial dysfunction, senescence and various kinds of cell death. Despite glycemic control, transient hyperglycemia can persistently harm organs, tissues, and cells, a latent effect termed \"metabolic memory\" that contributes to chronic diabetic complications. Understanding metabolic memory\'s mechanisms could offer a new approach to mitigating these complications. However, key molecules and networks underlying metabolic memory remain incompletely understood. This review traces the history of metabolic memory research, highlights its key features, discusses recent molecules involved in its mechanisms, and summarizes confirmed and potential therapeutic compounds. Additionally, we outline in vitro and in vivo models of metabolic memory. We hope this work will inform future research on metabolic memory\'s regulatory mechanisms and facilitate the development of effective therapeutic compounds to prevent diabetic complications.
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  • 文章类型: Video-Audio Media
    慢性肾脏病(CKD)历来是一个重要的全球健康问题。深刻地影响着生活和幸福。在CKD的过程中,随着肾功能的逐渐丧失,各种危及生命的并发症的发生率,比如心血管疾病,脑血管意外,感染和中风,也在迅速增加。不幸的是,现有的治疗方法在阻止CKD肾损伤进展方面的能力有限,强调迫切需要深入研究控制CKD发生和发展的精确分子机制,同时确定新的治疗靶点。肾纤维化,CKD的典型病理特征,在破坏正常肾脏结构和肾功能丧失中起着关键作用。铁凋亡是最近发现的一种铁依赖性细胞死亡形式,其特征是脂质过氧化物积累。Ferroptosis已成为各种疾病和器官纤维化引发的潜在关键参与者。大量证据表明,铁性死亡可能显著有助于CKD与其进展之间的复杂相互作用。这篇综述从铁代谢和脂质过氧化方面全面概述了CKD与铁死亡之间的复杂关系。并讨论了铁死亡的药理学研究现状,揭示了有希望的干预途径。它进一步说明了与CKD进展有关的铁凋亡相关调节机制的最新突破,从而为CKD治疗提供新的见解。视频摘要。
    Chronic kidney disease (CKD) has historically been a significant global health concern, profoundly impacting both life and well-being. In the process of CKD, with the gradual loss of renal function, the incidence of various life-threatening complications, such as cardiovascular diseases, cerebrovascular accident, infection and stroke, is also increasing rapidly. Unfortunately, existing treatments exhibit limited ability to halt the progression of kidney injury in CKD, emphasizing the urgent need to delve into the precise molecular mechanisms governing the occurrence and development of CKD while identifying novel therapeutic targets. Renal fibrosis, a typical pathological feature of CKD, plays a pivotal role in disrupting normal renal structures and the loss of renal function. Ferroptosis is a recently discovered iron-dependent form of cell death characterized by lipid peroxide accumulation. Ferroptosis has emerged as a potential key player in various diseases and the initiation of organ fibrosis. Substantial evidence suggests that ferroptosis may significantly contribute to the intricate interplay between CKD and its progression. This review comprehensively outlines the intricate relationship between CKD and ferroptosis in terms of iron metabolism and lipid peroxidation, and discusses the current landscape of pharmacological research on ferroptosis, shedding light on promising avenues for intervention. It further illustrates recent breakthroughs in ferroptosis-related regulatory mechanisms implicated in the progression of CKD, thereby providing new insights for CKD treatment. Video Abstract.
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  • 文章类型: Journal Article
    OBJECTIVE: Using a commercial orthodontic treatment planning system, tooth movements were simulated to analyse how precise predefined movements can be determined by three different superimposition methods. Additionally, a retrospective analysis on clinical patient models before and after orthodontic treatment was performed to analyse possible differences in determination of clinical tooth movements with these methods.
    METHODS: (1) A hexapod system was used to perform the tooth movements in physical maxillary dental models (N = 70). The initial and final situations were scanned, superimpositions executed, movements calculated, and their accuracy compared to the predefined movements was determined. (2) Digital three-dimensional (3D) maxillary dental models representing pre- and postorthodontic treatment situations (N = 100 patients) were superimposed. Selected tooth movements were calculated (N = 3600), and the results of the different superimposition methods were compared pairwise.
    RESULTS: (1) The experimental study delivered only small location and scale shifts. Furthermore, concordance correlation coefficients above 0.99 for all three methods. This verified that all methods deliver values corresponding well to the predefined movements. (2) The retrospective analysis of the clinically performed orthodontic tooth movements comparing pairwise the three different methods intraindividually also showed small location and scale shifts. Furthermore, concordance correlation coefficients between 0.68 and 0.98 were observed, with only three of them below 0.8. This verified that the applied superimposition methods delivered values sufficiently close to each other.
    CONCLUSIONS: As the experimental study showed very good agreement between the predefined and determined movements, and as the retrospective clinical study showed that the methods compared pairwise delivered values close to each other for the performed orthodontic tooth movements, it can be concluded that orthodontic tooth movements can be determined adequately correct by each of the examined methods.
    UNASSIGNED: ZIELSETZUNG: Mittels eines kommerziellen Behandlungsplanungssystems wurden Zahnbewegungen simuliert, um zu analysieren, wie präzise vorgegebene Bewegungen mittels 3 verschiedener Überlagerungsmethoden ermittelt werden können. Zusätzlich wurde eine retrospektive Analyse mit Patientenmodellen durchgeführt, um zu analysieren, ob es Unterschiede zwischen diesen Methoden bei der Bestimmung klinischer Zahnbewegungen gibt.
    METHODS: (1) Mithilfe eines Hexapodsystems wurden definierte Zahnbewegungen in Oberkiefermodellen durchgeführt (n = 70). Ausgangs- und Endposition der Zähne wurden gescannt, Überlagerungen durchgeführt, die Bewegungen errechnet und deren Übereinstimmung mit den vorgegebenen Bewegungen ermittelt. (2) Digitale 3‑D-Modelle des Oberkiefers vor und nach durchgeführten kieferorthopädischen Behandlungen (n = 100 Patienten) wurden überlagert, ausgewählte Bewegungen berechnet (n = 3600) und die Ergebnisse der verschiedenen Überlagerungsmethoden paarweise verglichen. ERGEBNISSE: (1) Die experimentelle Studie ergab lediglich kleine Ortsverschiebungen und Maßstabsänderungen. Die Konkordanz-Korrelationskoeffizienten lagen für alle 3 Verfahren über 0,99. Dies verifizierte, dass alle drei Methoden Werte liefern, die gut zu den vorgegebenen Bewegungen passen. (2) Die retrospektive Analyse der kieferorthopädischen Zahnbewegungen mittels intraindividueller paarweiser Vergleiche der unterschiedlichen Methoden zeigte ebenfalls kleine Ortsverschiebungen und Maßstabsänderungen, sowie Konkordanz-Korrelationsoeffizienten zwischen 0,68–0,98, mit nur dreien unter 0,8. Dies verifizierte, dass alle Überlagerungsmethoden hinreichend nahe beieinander liegende Werte liefern.
    UNASSIGNED: Da die experimentelle Studie eine gute Übereinstimmung zwischen den vorgegebenen und den ermittelten Bewegungen zeigte und da die retrospektive Studie beim paarweisen Vergleich der Methoden nahe beieinander liegende Werte für die kieferorthopädischen Zahnbewegungen lieferte, kann geschlussfolgert werden, dass kieferorthopädische Zahnbewegungen mit jeder der untersuchten Methoden hinreichend korrekt ermittelt werden können.
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  • 文章类型: Journal Article
    糖尿病肾病(DKD)是糖尿病(DM)最常见、最严重的微血管并发症之一。并已成为全球终末期肾病(ESRD)的主要原因。虽然DKD的确切致病机制尚不清楚,程序性细胞死亡已被证明参与糖尿病肾损伤的发生和发展,包括铁中毒。Ferroptosis,由脂质过氧化作用驱动的铁依赖性细胞死亡形式,已被确定在各种肾脏疾病的发展和治疗反应中起着至关重要的作用,如急性肾损伤(AKI),肾细胞癌和DKD。在过去的两年里,已经在DKD患者和动物模型中进行了很好的研究,但具体机制和治疗效果尚未完全揭示。在这里,我们回顾了铁凋亡的调控机制,总结了与DKD中铁性凋亡相关的最新发现,并讨论了铁性凋亡作为DKD治疗的有希望的靶标的潜力,从而为DKD的基础研究和临床治疗提供有价值的参考。
    Diabetic kidney disease (DKD) is one of the most common and severe microvascular complications of diabetes mellitus (DM), and has become the leading cause of end-stage renal disease (ESRD) worldwide. Although the exact pathogenic mechanism of DKD is still unclear, programmed cell death has been demonstrated to participate in the occurrence and development of diabetic kidney injury, including ferroptosis. Ferroptosis, an iron-dependent form of cell death driven by lipid peroxidation, has been identified to play a vital role in the development and therapeutic responses of a variety of kidney diseases, such as acute kidney injury (AKI), renal cell carcinoma and DKD. In the past two years, ferroptosis has been well investigated in DKD patients and animal models, but the specific mechanisms and therapeutic effects have not been fully revealed. Herein, we reviewed the regulatory mechanisms of ferroptosis, summarized the recent findings associated with the involvement of ferroptosis in DKD, and discussed the potential of ferroptosis as a promising target for DKD treatment, thereby providing a valuable reference for basic study and clinical therapy of DKD.
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  • 文章类型: Journal Article
    关节表面的部分厚度软骨缺损(PTCD)是软骨退变中最常见的问题,也是骨关节炎(OA)的主要发病机制之一。由于缺乏明确的诊断,当存在全层软骨缺损(FTCD)时,症状通常更为严重.与FTCD和骨软骨缺损(OCD)相反,PTCD不会损伤软骨下骨,没有血液供应和骨髓渗出,附近的微环境不适合干细胞粘附,完全失去了自我修复的能力。一些临床研究表明,部分厚度软骨缺损与全厚度软骨缺损一样有害。由于保守治疗效果不佳,破坏性手术治疗不适用于治疗部分厚度的软骨缺损,目前的组织工程策略并不有效,因此,迫切需要开发新的策略或治疗方法来修复PTCD。近年来,随着生物科学的跨学科发展,力学,材料科学与工程,在修复PTCD方面已经有了许多发现。本文从PTCD的诊断和建模等方面综述了PTCD的治疗现状和研究进展,药物治疗,组织移植修复技术与组织工程(“自下而上”)。
    Partial-thickness cartilage defects (PTCDs) of the articular surface is the most common problem in cartilage degeneration, and also one of the main pathogenesis of osteoarthritis (OA). Due to the lack of a clear diagnosis, the symptoms are often more severe when full-thickness cartilage defect (FTCDs) is present. In contrast to FTCDs and osteochondral defects (OCDs), PTCDs does not injure the subchondral bone, there is no blood supply and bone marrow exudation, and the nearby microenvironment is unsuitable for stem cells adhesion, which completely loses the ability of self-repair. Some clinical studies have shown that partial-thickness cartilage defects is as harmful as full-thickness cartilage defects. Due to the poor effect of conservative treatment, the destructive surgical treatment is not suitable for the treatment of partial-thickness cartilage defects, and the current tissue engineering strategies are not effective, so it is urgent to develop novel strategies or treatment methods to repair PTCDs. In recent years, with the interdisciplinary development of bioscience, mechanics, material science and engineering, many discoveries have been made in the repair of PTCDs. This article reviews the current status and research progress in the treatment of PTCDs from the aspects of diagnosis and modeling of PTCDs, drug therapy, tissue transplantation repair technology and tissue engineering (\"bottom-up\").
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  • 文章类型: Journal Article
    急性肾损伤(AKI),一种常见和严重的临床肾综合征,发病率和死亡率高,是由多种致病因素引起的,如缺血,肾毒性药物,氧化应激,炎症,尿路梗阻.细胞死亡,分为几种类型,对于正常的生长发育和维持动态平衡至关重要。Ferroptosis,铁依赖性非凋亡型细胞死亡,以铁过载为特征,活性氧积累,和脂质过氧化。最近,越来越多的证据表明铁性凋亡在各种肾脏疾病的发展中的重要作用,包括肾透明细胞癌,糖尿病肾病,AKI。然而,铁凋亡参与AKI发生和发展的确切机制尚未完全揭示.在这里,我们的目的是系统地讨论铁中毒的定义,相关机制和关键监管机构,和药理学进展,并总结了铁凋亡在AKI发生发展中的作用和机制的最新发现。我们进一步总结了其在AKI中的潜在治疗策略。
    Acute kidney injury (AKI), a common and serious clinical kidney syndrome with high incidence and mortality, is caused by multiple pathogenic factors, such as ischemia, nephrotoxic drugs, oxidative stress, inflammation, and urinary tract obstruction. Cell death, which is divided into several types, is critical for normal growth and development and maintaining dynamic balance. Ferroptosis, an iron-dependent nonapoptotic type of cell death, is characterized by iron overload, reactive oxygen species accumulation, and lipid peroxidation. Recently, growing evidence demonstrated the important role of ferroptosis in the development of various kidney diseases, including renal clear cell carcinoma, diabetic nephropathy, and AKI. However, the exact mechanism of ferroptosis participating in the initiation and progression of AKI has not been fully revealed. Herein, we aim to systematically discuss the definition of ferroptosis, the associated mechanisms and key regulators, and pharmacological progress and summarize the most recent discoveries about the role and mechanism of ferroptosis in AKI development. We further conclude its potential therapeutic strategies in AKI.
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  • 文章类型: Journal Article
    在美国,在女性和种族/族裔少数群体中,阿片类药物使用障碍(OUD)治疗的高辍学率(75%)需要理解有助于治疗进展的因素.鉴于OUD的咨询和药物(MOUD,例如美沙酮,丁丙诺啡,纳曲酮)被认为是物质使用障碍(SUD)治疗的黄金标准,许多OUD患者接受咨询或美沙酮服务。这项研究评估了美沙酮治疗计划进展中的性别差异-与美国最大的SUD治疗系统之一的咨询计划相比。
    使用在洛杉矶县收集的综合药物滥用治疗消除差异(iSATed)数据集分析了多年和多层次(治疗计划和客户水平)数据,加州样本包括4波:2011年(66个SUD项目,1035个客户),2013(77个SUD计划,3686个客户),2015年(75个SUD项目,4626个客户),和2017年(69个SUD项目,4106个客户)。我们进行了两次多级负二项回归,每个结果(1)在完成治疗计划方面取得进展,(2)完成治疗计划。我们包括在研究的每一年出院的门诊客户(超过所有客户的95%),并考虑人口统计学,波浪,无家可归和先前的治疗事件,以及聚集在程序中的客户端。
    我们在考虑两种门诊项目服务类型(MOUD-美沙酮vs.咨询)。接受美沙酮的客户与咨询完成治疗计划的几率较低(OR=0.366;95%CI=0.163,0.821).与接受咨询的男性客户相比,接受美沙酮的女性客户取得进展(OR=0.668;95%CI=0.481,0.929)和完成治疗计划(OR=0.666;95%CI=0.485,0.916)的几率较低。与非拉丁裔客户相比,拉丁裔客户完成治疗计划的几率较低(OR=0.617;95%CI=0.408,0.934)。
    接受美沙酮的客户,减少阿片类药物使用的最常见和最有效的MOUD,与接受咨询的人相比,他们不太可能取得进展或完成他们的治疗计划。女人,特别是那些被认定为拉丁裔的人,最不可能从美沙酮计划中受益。这些发现对卫生政策和计划设计具有启示意义,这些政策和计划考虑了在基于美沙酮的计划中需要全面和文化上敏感的服务,以改善女性的门诊治疗结果。
    In the United States, the high dropout rate (75%) in opioid use disorder (OUD) treatment among women and racial/ethnic minorities calls for understanding factors that contribute to making progress in treatment. Whereas counseling and medication for OUD (MOUD, e.g. methadone, buprenorphine, naltrexone) is considered the gold standard of care in substance use disorder (SUD) treatment, many individuals with OUD receive either counseling or methadone-only services. This study evaluates gender disparities in treatment plan progress in methadone- compared to counseling-based programs in one of the largest SUD treatment systems in the United States.
    Multi-year and multi-level (treatment program and client-level) data were analyzed using the Integrated Substance Abuse Treatment to Eliminate Disparities (iSATed) dataset collected in Los Angeles County, California. The sample consisted of 4 waves: 2011 (66 SUD programs, 1035 clients), 2013 (77 SUD programs, 3686 clients), 2015 (75 SUD programs, 4626 clients), and 2017 (69 SUD programs, 4106 clients). We conducted two multi-level negative binomial regressions, one per each outcome (1) making progress towards completing treatment plan, and (2) completing treatment plan. We included outpatient clients discharged on each of the years of the study (over 95% of all clients) and accounted for demographics, wave, homelessness and prior treatment episodes, as well as clients clustered within programs.
    We detected gender differences in two treatment outcomes (progress and completion) considering two outpatient program service types (MOUD-methadone vs. counseling). Clients who received methadone vs. counseling had lower odds of completing their treatment plan (OR = 0.366; 95% CI = 0.163, 0.821). Female clients receiving methadone had lower odds of both making progress (OR = 0.668; 95% CI = 0.481, 0.929) and completing their treatment plan (OR = 0.666; 95% CI = 0.485, 0.916) compared to male clients and receiving counseling. Latina clients had lower odds of completing their treatment plan (OR = 0.617; 95% CI = 0.408, 0.934) compared with non-Latina clients.
    Clients receiving methadone, the most common and highly effective MOUD in reducing opioid use, were less likely to make progress towards or complete their treatment plan than those receiving counseling. Women, and in particular those identified as Latinas, were least likely to benefit from methadone-based programs. These findings have implications for health policy and program design that consider the need for comprehensive and culturally responsive services in methadone-based programs to improve outpatient treatment outcomes among women.
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  • 文章类型: Journal Article
    介绍结果问卷(OQ)测量正在成为一种更受欢迎的评估工具,用于在住院和门诊等不同环境下监测精神病学的治疗进展。它也可以用于非临床人群。然而,关于成人部分医院计划(PHP)中对该工具的评估知之甚少。方法我们在成人PHP患者中进行了一项研究,我们从2015年1月1日至7月31日记录的患者OQ分析程序中提取数据,2020年。结果我们共研究了742例患者,其中509例(68.4%)为男性。平均年龄为38.58±14.86岁。大多数患者患有抑郁症(56.9%)。平均入院天数为17.37±25.29天。从初始到最终测量的总分平均OQ得分持续下降,2019年为31.99,其次是2017年(30.05),然后是2020年(29.56),然后是2015/2016年(28.38)和2018年(27.27)p<0.001。此外,对于治疗进展,观察到2015/2016年,71.67%的患者有显著改善;2017年,78.53%的患者有显著改善;2018年,77.71%的患者有显著改善;而2019年,76.05%的患者有显著改善,2020年,70.18%的患者有显著改善。结论OQ措施对患者的直接益处是提供客观的测量,以评估其临床状况的治疗进展中的临床改善或恶化。我们的研究证明,这是在成人PHP中评估这种情况的有用工具。
    Introduction Outcome Questionnaire (OQ) measure is becoming a more popular assessment tool for monitoring treatment progress in psychiatry at different settings including inpatient and outpatient settings. It can also be used in non-clinical populations. However, little is known about the evaluation of this tool in the Adult Partial Hospital Program (PHP). Methods We conducted a study among patients in an Adult PHP where we extracted data from the OQ analysis program recorded for patients from January 1, 2015 to July 31st, 2020. Results We studied a total of 742 patients among which 509 (68.4%) were males. The mean age was 38.58 ± 14.86 years. Most of the patients had depressive disorder (56.9%). The mean numbers of days on admission were 17.37 ± 25.29 days. There is a consistent decrease in the total score average OQ score from initial to final measure with the year 2019 being 31.99 followed by 2017 (30.05) then 2020 (29.56) then 2015/2016 (28.38) and 2018 (27.27) p < 0.001. Also, for treatment progress it was observed that in years 2015/2016, there was significant improvement in 71.67% of the patients; in 2017, there was significant improvement in 78.53% of the patients; in 2018, there was significant improvement in 77.71% of the patients; while in 2019, there was significant improvement in 76.05% of the patients, and in 2020, there was significant improvement in 70.18% of the patients. Conclusion The direct benefit of the OQ measure to patients is to provide objective measurements of assessing clinical improvement or deterioration in the treatment progress of their clinical condition. Our study has proved that this is a useful tool to assess such in the Adult PHP.
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