Childhood abuse, nonadherence, and medical outcome in pediatric liver transplant recipients.

Childhood abuse, nonadherence, and medical outcome in pediatric liver transplant recipients. Research Abstract Details 

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Childhood abuse, nonadherence, and medical outcome in pediatric liver transplant recipients. Abstract Text:

Eyal Shemesh,Rachel A Annunziato,Rachel Yehuda,Benjamin L Shneider,Jeffrey H Newcorn,Carolyn Hutson,Judith A Cohen,John Briere,Jack M Gorman,Sukru Emre,

OBJECTIVE: The study assessed the relationship between a history of child abuse, nonadherence to medications, and medical outcome in children who had a liver transplant. METHOD: Abuse history for children and adolescents ages 8 to 21 who underwent a liver transplantation at Mount Sinai Medical Center in New York was obtained in interviews in 2002. Adherence to tacrolimus was assessed from January 1 to December 31, 2003 by computing the SD of a series of medication blood levels for each patient. Biopsy-proven rejection episodes, degree of fluctuation of alanine aminotransferase (ALT), and maximal ALT levels were recorded as indicators of medical outcome. RESULTS: Of 72 eligible patients, 56 were evaluated. Five had documented abuse. Abused children were less adherent to their medication regimen (p = .02; 95% confidence interval [CI] -2.66 to -0.24), had poor disease control (higher maximal ALT, p <.01; 95% CI -613.72 to -249.55), had greater fluctuation in ALT levels (p <.01; 95% CI -151.19 to -65.91), and suffered more biopsy-proven rejection episodes (two episodes in the abused cohort versus none in the rest) in 2003. CONCLUSIONS: A history of child abuse is a significant risk factor for poor outcome posttransplantation and should be evaluated routinely. Adherence to medications can be a target for intervention in patients with a history of abuse.

Childhood abuse, nonadherence, and medical outcome in pediatric liver transplant recipients. Publishing Authors By Initials

E Shemesh,RA Annunziato,R Yehuda,BL Shneider,JH Newcorn,C Hutson,JA Cohen,J Briere,JM Gorman,S Emre,

For similar behavior and behavior mechanisms: behavior: health behavior: treatment refusal research abstracts see: behavior and behavior mechanisms: behavior: health behavior: treatment refusal research

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Childhood abuse, nonadherence, and medical outcome in pediatric liver transplant recipients. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: Journal of the American Academy of Child and Adole

VOLUME: 46

Page Numbers: 1280-9

Journal Abbreviation:

ISSN: 0890-8567

DAY: 3

MONTH: Oct

YEAR: 2007

Childhood abuse, nonadherence, and medical outcome in pediatric liver transplant recipients. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 8704565

Childhood abuse, nonadherence, and medical outcome in pediatric liver transplant recipients. Keywords Mesh Terms:

KEYWORDS: Treatment Refusal

MESH TERMS: statistics & numerical data

Chemical & Substance for Abstract: Childhood abuse, nonadherence, and medical outcome in pediatric liver transplant recipients. Information

Substance Name: Alanine Transaminase

Registry Number: EC 2.6.1.2

Grant and Affiliation Information for Childhood abuse, nonadherence, and medical outcome in pediatric liver transplant recipients.

AFFILIATION: Department of Psychiatry, Recanati-Miller Transplant Institute at Mount Sinai Medical Center, New York, NY, USA. shemesh@email.chop.edu

Country: United States

AGENCY: United States NIMH

GRANT: MH63755

ACRONYM: MH

MEDLINETA: J Am Acad Child Adolesc Psychi

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