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Sample records for 1-year follow-up results

  1. Changes in Sexual Function in Benign Prostatic Hyperplasia Patients Taking Dutasteride: 1-Year Follow-Up Results

    PubMed Central

    Chi, Byung Hoon

    2011-01-01

    Purpose Sexual adverse events (AEs), a major cause for discontinuing 5α-reductase inhibitor (5ARI) therapy for benign prostatic hyperplasia (BPH), are known to occur most frequently early in therapy and appear to decline over time. The aim of this study was to investigate the changes in sexual function occurring with dutasteride treatment during a 1-year follow-up period in Korean men. Materials and Methods Using the International Index of Erectile Function, we prospectively evaluated, after 1, 3, 6, 9, and 12 months of treatment, the changes in sexual function of 55 outpatients (mean age 62.3±7.2 years) with BPH (mean volume 48.9±16.0 g) who had relatively good erectile function (EF) and were treated with dutasteride for at least 1 year. Results EF scores showed the most significant decrease at 1 month (p<0.01). Function gradually recovered thereafter but was still significantly decreased after 12 months of treatment (p<0.05). The scores for orgasmic function and sexual desire also showed the most significant reduction at 1 month but were restored to the baseline level at 6 months. No significant correlation was observed between changes in sexual function and prostate-specific antigen level, prostate volume, or International Prostate Symptom Scores. Conclusions After 1 month of treatment, dutasteride therapy resulted in a significant reduction in all investigated sexual functions. Overall, recovery in sexual function was noted at 3 months, and orgasmic function and sexual desire were restored to baseline levels at 6 months. However, EF was still significantly reduced at 12 months. PMID:22025960

  2. Lumbar disc replacement: preliminary results with ProDisc II after a minimum follow-up period of 1 year.

    PubMed

    Tropiano, Patrick; Huang, Russel C; Girardi, Federico P; Marnay, Thierry

    2003-08-01

    Total disc replacement has the potential to replace fusion as the gold standard surgical treatment of degenerative disc disease. Potential advantages of disc replacement over fusion include avoidance of pseudarthrosis, postoperative orthoses, and junctional degeneration. After observing satisfactory clinical results at 7-11 years' follow-up with the ProDisc first-generation implant, a second-generation prosthesis was designed. This study is a prospective analysis of the early results of total disc replacement with the ProDisc II total disc prosthesis. Fifty-three patients had single-level or multilevel disc replacement and were evaluated clinically and radiographically preoperatively and at mean 1.4-year follow-up. There were clinically and statistically significant improvements in back and leg pain Visual Analog Scale and Oswestry disability scores that were maintained at final follow-up. The clinical results of patients with single- and multilevel surgery were equivalent. Satisfactory results were achieved in 90% of patients who had previous lumbar surgery. Complications occurred in 9% of patients and included vertebral body fracture, transient radicular pain, implant malposition, and transient retrograde ejaculation. Three patients (6%) required reoperation to address complications. No mechanical failure of the implants or loosening was observed, and the prostheses retained motion. Randomized, prospective, long-term studies will be necessary to compare the effectiveness of arthrodesis with total disc replacement. PMID:12902952

  3. Does cognitive impairment influence outcomes from cataract surgery? Results from a 1-year follow-up cohort study

    PubMed Central

    Jefferis, Joanna Mary; Taylor, John-Paul; Clarke, Michael Patrick

    2015-01-01

    Background/aims To assess the impact of impaired cognition on visual outcomes 1 year following cataract surgery in a cohort of older people. Methods Participants aged 75 years or more with bilateral cataract and scheduled for cataract surgery were recruited consecutively. Cognition was assessed using the revised Addenbrooke's cognitive examination (ACE-R). Participants were divided into two groups: normal (ACE-R ≥88) and impaired cognition (ACE-R <88). Visual quality of life (VQOL) and logarithm of minimum angle of resolution visual acuity (VA) were assessed at baseline and 1 year following cataract surgery. Results Of 112 participants, 48 (43%) had normal cognition and 64 (57%) had impaired cognition. One year following cataract surgery participants in both groups had significant improvements in VQOL and VA. Visual outcomes at 1 year were significantly better in participants with normal cognition than in those with impaired cognition (95% CIs for difference 0.4–7.0 and 0.02–0.1, for VQOL and VA, respectively). Regression analyses correcting for potential confounders showed a relationship between baseline cognition and VA at 1 year (R2=0.30, p=0.001) and a possible relationship between baseline cognition and VQOL at 1 year (R2=0.41, p=0.01, this became insignificant after removal of outliers). Conclusions Patients with impaired cognition benefit from cataract surgery, but not to the same extent as patients with normal cognition. PMID:25287367

  4. Single-Center Experience and 1-Year Follow-up Results of 'Sandwich Technique' in the Management of Common Iliac Artery Aneurysms During EVAR

    SciTech Connect

    Ricci, Carmelo; Ceccherini, Claudio Cini, Marco; Vigni, Francesco; Leonini, Sara; Tommasino, Giulio; Muzzi, Luigi; Tucci, Enrico; Benvenuti, Antonio; Neri, Eugenio

    2012-10-15

    Purpose: Abdominal aortic aneurysm (AAA) accompanied by common iliac artery (CIA) aneurysms requires a more demanding procedure owing to the difficulties in obtaining an adequate distal landing zone for the stent-graft limb(s), a potential site of endoleak. The 'sandwich technique' is a procedure to increase EVAR feasibility in the setting of adverse or challenging CIA anatomy. Its main advantages include no restrictions in terms of CIA diameter or length or internal iliac artery (IIA) diameter, no need to wait for a specific stent-graft. Our purpose is to describe our single-center experience and one year follow-up results of this new procedure. Materials and Methods: From April 2009 to June 2010, the sandwich technique was performed in our institution in 7 patients treated for AAA and unilateral CIA aneurysms (n. 5) or bilateral CIA aneurysms (n. 2). Inclusion criteria were the presence of unilateral or bilateral CIA aneurysm (independently from its diameter), IIA artery measuring up to 9 mm in its maximum diameter, not dilatation of IIA and EIA. Results: The mean follow-up length was 15 months (range: 14-20 months). All stent-implanted iliac branches remained patent on 1 year follow-up and IIA flow was preserved. None of the patients had symptoms of pelvic ischemia. CT scan follow-up showed aneurysm shrinkage in five patients, without any sign of endoleaks in all cases. Conclusions: In selected cases, the 'sandwich technique' showed good outcomes confirming to be a safe and easy to perform way to overcome anatomical constraints and expanding the limits of EVAR.

  5. Intracranial idiopathic hypertension: 1-year follow-up study.

    PubMed

    D'Amico, D; Curone, M; Erbetta, A; Farago', G; Bianchi-Marzoli, S; Ciasca, P; Bussone, G; Chiapparini, L

    2014-05-01

    Standard guidelines for ongoing management, as well as definitive data about the long-term course of idiopathic intracranial hypertension (IIH) are not available. The aim of this study was to compare several clinical and instrumental variables as assessed at the time of diagnosis and then after 1 year in a sample of IIH patients. A total of 21 patients were studied. Our results confirmed that headache and TVO are the most frequent symptoms in IIH patients, and that overweight is a very common feature. A trend towards a favorable outcome in patients followed for 1 year and treated by usual medical therapy was found: intracranial pressure was lower at follow-up; improvement of headache and transient visual obscurations, as well as of papilledema, was reported in most patients. On the other hand, neuroradiological findings (such as empty sella, perioptic subarachnoid space distension, narrowing of the transverse sinuses) were substantially stable at follow. These findings may be relevant for future research as far as understanding the role of different clinical and instrumental findings as diagnostic items as well as predictors of outcome in IIH. PMID:24867861

  6. Short-Term Clinical Result of Cortical Bone Trajectory Technique for the Treatment of Degenerative Lumbar Spondylolisthesis with More than 1-Year Follow-Up

    PubMed Central

    Nishizawa, Kazuya; Nakamura, Akira; Imai, Shinji

    2016-01-01

    Study Design Retrospective follow-up study on the result of surgical treatment for patients with degenerative lumbar spondylolisthesis (DLS) using cortical bone trajectory (CBT) technique. Purpose To evaluate the capability of CBT to manage patients with DLS. Overview of Literature CBT is a recently advocated, novel, less-invasive technique of lumbar pedicle screw, which provides enhanced screw purchase by maximizing the thread contact with higher density bone surface. Despite the frequent use of CBT technique in the lumbar spine surgery, little is known of the capability of this technique to manage patients with DLS. Methods Thirty two consecutive patients (5 males, 27 females) surgically treated with single-level DLS in our institute using CBT were included. All patients were followed up at least 12 months (mean 24 months). Their clinical and radiological features were measured. Results Good leg pain relief was achieved in all patients. The mean postoperative percentage slip demonstrated significant reduction with significant neurological recovery when compared with preoperative percentage slip, and it was maintained until the latest follow-up. Loss of correction of more than 3 mm during the follow-up period was observed in 3 cases. Surgical site infection was observed in one case; however, pull-out of PSs or neurological deterioration was not found. No patient needed additional surgery during the follow-up period. Conclusions These preliminary results confirmed that CBT is useful for the treatment for patients with DLS. This technique allows good reduction of spondylolisthesis and neurological improvement. PMID:27114763

  7. Remission in schizophrenia: results of cross-sectional with 6-month follow-up period and 1-year observational therapeutic studies in an outpatient population

    PubMed Central

    2012-01-01

    Background A standardized definition of remission criteria in schizophrenia was proposed by the International group of NC Andreasen in 2005 (low symptom threshold for the eight core Positive and Negative Syndrome Scale (PANSS) symptoms for at least 6 consecutive months). Methods A cross-sectional study of remission rate, using a 6-month follow-up to assess symptomatic stability, was conducted in two healthcare districts (first and second) of an outpatient psychiatric service in Moscow. The key inclusion criteria were outpatients with an International Classification of Diseases, 10th edition (ICD-10) diagnosis of schizophrenia or schizoaffective disorder. Remission was assessed using modern criteria (severity and time criteria), PANSS and Global Assessment of Functioning (GAF). Patients who were stable but did not satisfied the symptomatic criteria were included in a further 1-year observational study, with the first group (first district) receiving risperidone (long-acting, injectable) (RLAI) and the second group (second district) continuing to receiving routine treatment. Symptoms were assessed with PANSS, social functioning with the personal and social performance scale, compliance with rating of medication influences scale, and extrapyramidal side effects with the Simpson-Angus scale. Results Only 64 (31.5%) of 203 outpatients met the criteria for symptomatic remission in the cross-sectional study, but at the end of the 6-month follow-up period, 158 (77.8%) were stable (irrespective of remission status). Among these only 53 (26.1%) patients fulfilled the remission criteria. The observational study had 42 stable patients in the RLAI group and 35 in the routine treatment group: 19.0% in the RLAI group and 5.7% in the control group met remission criteria after 12 months of therapy. Furthermore, reduction of PANSS total and subscale scores, as well as improvement in social functioning, was more significant in the first group. Conclusions Only around one-quarter of

  8. Use of Percutaneous Aspiration Thrombectomy vs. Anticoagulation Therapy to Treat Acute Iliofemoral Venous Thrombosis: 1-year Follow-up Results of a Randomised, Clinical Trial

    SciTech Connect

    Cakir, Volkan; Gulcu, Aytac; Akay, Emrah; Capar, Ahmet E.; Gencpinar, Tugra; Kucuk, Banu; Karabay, Ozalp; Goktay, A. Yigit

    2014-08-15

    PurposeThe purpose of this study was to compare the efficacy of percutaneous aspiration thrombectomy (PAT) followed by standard anticoagulant therapy, with anticoagulation therapy alone, for the treatment of acute proximal lower extremity deep vein thrombosis.MethodsIn this randomised, prospective study, 42 patients with acute proximal iliofemoral deep vein thrombosis documented via Doppler ultrasound examination, were separated into an interventional treatment group (16 males, 5 females, average age 51 years) and a medical treatment group (13 males, 8 females, average age 59 years). In the interventional group, PAT with large-lumen 9-F diameter catheterisation was applied, after initiation of standard anticoagulant therapy. Balloon angioplasty (n 19) and stent implementation (n: 14) were used to treat patients with residual stenosis (>50 %) after PAT. Prophylactic IVC filters were placed in two patients. The thrombus clearance status of the venous system was evaluated by venography. In both the medical and interventional groups, venous patency rates and clinical symptom scores were evaluated at months 1, 3, and 12 after treatment.ResultsDeep venous systems became totally cleared of thrombi in 12 patients treated with PAT. The venous patency rates in month 12 were 57.1 and 4.76 % in the interventional and medical treatment groups, respectively. A statistically significant improvement was observed in clinical symptom scores of the interventional group (PAT) with or without stenting (4.23 ± 0.51 before treatment; 0.81 ± 0.92 at month 12) compared with the medical treatment group (4.00 ± 0.63 before treatment; 2.43 ± 0.67 at month 12). During follow-up, four patients in the medical treatment and one in the interventional group developed pulmonary embolisms.ConclusionsFor treatment of acute deep vein thrombosis, PAT with or without stenting is superior to anticoagulant therapy alone in terms of both ensuring venous patency and improving clinical

  9. Tocilizumab in systemic juvenile idiopathic arthritis in a real-world clinical setting: results from 1 year of postmarketing surveillance follow-up of 417 patients in Japan

    PubMed Central

    Yokota, Shumpei; Itoh, Yasuhiko; Morio, Tomohiro; Origasa, Hideki; Sumitomo, Naokata; Tomobe, Minako; Tanaka, Kunihiko; Minota, Seiji

    2016-01-01

    Objectives To evaluate the safety and effectiveness of tocilizumab (TCZ) in patients with systemic juvenile idiopathic arthritis (sJIA) in real-world clinical settings in Japan. Methods Paediatric patients with sJIA initiating TCZ between April 2008 and February 2012 and those previously enrolled in clinical trials who initiated TCZ before April 2008 were enrolled in a Japanese registry surveillance programme. Safety and effectiveness parameters were collected for 52 weeks. Results Of 417 patients enrolled, mean age was 11.2 years and 48.0% were female. TCZ exposure was 407.0 patient-years (PYs). Baseline corticosteroid use was higher than in clinical trials. Rates of total adverse events (AEs) and serious AEs (SAEs) were 224.3/100 PYs and 54.5/100 PYs, respectively, with SAEs higher than previously reported. The most frequent AEs and SAEs were infections and infestations (69.8/100 PYs and 18.2/100 PYs, respectively). 74 serious infections occurred in 55 patients (18.2/100 PYs); higher than previously reported. 26 macrophage activation syndrome events were reported in 24 patients (6.4/100 PYs). Fever and rash symptoms improved from baseline to week 52 (54.6% to 5.6% and 43.0% to 5.6%, respectively). At 4 weeks, 8 weeks and 52 weeks, 90.5%, 96.2% and 99.0% of patients achieved normal C reactive protein levels (<0.3 mg/dL), respectively. Conclusions These first real-world data demonstrated that TCZ was well tolerated, with acceptable safety and effectiveness in patients with sJIA. Higher incidences of SAEs and serious infections may be due to differences, such as corticosteroid use and concomitant diseases, between patient populations enrolled in previously reported clinical trials and this study. PMID:26644233

  10. Endoscopic sleeve gastroplasty with 1-year follow-up: factors predictive of success

    PubMed Central

    Lopez-Nava, G.; Galvao, M.; Bautista-Castaño, I.; Fernandez-Corbelle, J. P.; Trell, M.

    2016-01-01

    Background and study aims: Bariatric endoscopy has emerged as an aid in the nonsurgical treatment of obesity. The objective of this study is to critically provide the results and follow-up of endoscopic sleeve gastroplasty 1 year after the procedure. Patients and methods: Prospective single-center follow-up study of 25 patients (5 men, 20 women) who underwent flexible endoscopic suturing for endoluminal gastric volume reduction. A multidisciplinary team provided post-procedure care. Patient outcomes were recorded at 1 year after the procedure. Linear regression analysis was done to evaluate the variables associated with best results at 1 year of follow-up. Results: Mean body mass index (BMI) was 38.5 ± 4.6 kg/m2 (range 30 – 47) and mean age 44.5 ± 8.2 years (range 29 – 60). At 1 year, 22 patients continued with the follow-up (2 dropped out at 6 months and 1 at 3 months). There were no major intra-procedural, early, or delayed adverse events. Mean BMI loss was 7.3 ± 4.2 kg/m2, and mean percentage of total body weight loss was 18.7 ± 10.7 at 1 year. In the linear regression analysis, adjusted by initial BMI, variables associated with %TBWL involved the frequency of nutritional (β = 0.563, P = 0.014) and psychological contacts (β = 0.727, P = 0.025). The number of nutritional and psychological contacts were predictive of good weight loss results. Conclusions: Endoscopic sleeve gastroplasty is a feasible, reproducible, and effective procedure to treat obesity. Nutritional and psychological interaction are predictive of success. PMID:26878054

  11. A Comparison of the Transradial and Transfemoral Approaches for the Angiography and Intervention in Patients with a History of Coronary Artery Bypass Surgery: In-hospital and 1-year Follow-up Results

    PubMed Central

    He, Pei-Yuan; Yang, Yue-Jin; Qiao, Shu-Bin; Xu, Bo; Yao, Min; Wu, Yong-Jian; Yuan, Jin-Qing; Chen, Jue; Liu, Hai-Bo; Dai, Jun; Tang, Xin-Ran; Wang, Yang; Li, Wei; Gao, Run-Lin

    2015-01-01

    Background: Percutaneous coronary intervention (PCI) through transradial approach (TRA) has shown to be safe and effective as transfemoral approach (TFA) among unselected patients. However, very few studies have compared the outcomes between TRA and TFA specifically in patients with a history of coronary artery bypass grafting surgery (CABG). Methods: A total of 404 post-CABG patients who had undergone angiography or PCI were included in the study. The primary endpoint was defined as angiographic success and procedure success. The secondary endpoint was defined as in-hospital net adverse clinical events (NACEs), which included all cause of death, myocardial infarction (MI), stroke, repeat revascularization, and major bleeding. Patients were followed-up for 1-year. Major adverse cardiovascular events (MACEs), which included death, MI, and repeat revascularization, at 1-year follow-up were also compared. Results: The angiographic success was reached by 97.4% in the TRA group compared with 100% in the TFA group (P = 0.02). The procedure success was achieved in 99.1% in the TRA group and 97.9% in the TFA group (P = 0.68). The incidence rates of in-hospital NACE (2.7% vs. 2.7%, P = 1.00) and 1-year MACE (11.5% vs. 12.0%, P = 0.88) were similar between TRA and TFA. Meanwhile, TRA was associated with a lower rate of Bleeding Academic Research Consortium ≥2 bleeding (P = 0.02). In patients undergoing graft PCI, the procedure success was similar between TRA and TFA (100.0% vs. 98.7%, P = 1.00). The procedure time (25.0 min vs. 27.5 min, P = 0.53) was also similar. No significant difference was detected between TRA and TFA in terms of in-hospital NACE (0 vs. 0, P = 1.00) and 1-year MACE (21.4% vs. 10.3%, P = 0.19). Conclusions: Compared with TFA, TRA had lower angiographic success but had a similar procedure success in post-CABG patients. TRA was also associated with decreased bleeding and shortened hospital stay. PMID:25758269

  12. Participation as a leader in immersion weight loss treatment: a 1-year follow-up study.

    PubMed

    Anderson, L M; Schaumberg, K; Anderson, D A; Kirschenbaum, D S

    2016-02-01

    Non-overweight individuals may follow aggressive weight management approaches alongside overweight/obese friends or family members; thus, research has begun to evaluate subsequent effects among non-overweight populations. A prior study evaluated the short-term effects of an immersion weight loss programme on healthy young adult staff leaders. Results indicated that participation seemed to benefit, not harm, the young adults. The current investigation examined 1-year eating disorder and weight trajectories in this sample. The total sample (N = 244) consisted of staff leaders (44.3%) and demographically similar comparison participants who completed eating disorder and weight assessments across four time points: baseline, end of summer, 6-week follow-up and 1-year follow-up. Forty-seven per cent of the original sample responded to all time points (staff leaders n = 60; comparison n = 55). Over the course of 1 year, risk trajectories did not differ between groups. Staff leaders did not report significant changes in body mass index, suggesting that they maintained healthy weight over the course of 1 year. Participation as an immersion weight loss programme leader appeared to be protective against weight gain, without increasing eating disorder risk, for healthy young adults. This provides further support for using weight management interventions across a wide range of individuals. PMID:26638779

  13. Factors Associated with Caregiver Burden in Dementia: 1-Year Follow-Up Study

    PubMed Central

    Shim, Sang Hong; Kang, Hyo Shin; Kim, Ji Hae

    2016-01-01

    Objective Dementia symptoms (cognitive function, daily-living function, and neuropsychiatric symptoms) become more serious over time, which is likely to increase caregiver burden. The aim of this study is to investigate which dementia-related symptoms, and how the progression of these symptoms, have influenced caregiver burden during a 1-year follow-up assessment. Methods A total of 110 patients with dementia were assessed for their cognitive function, daily-living function, and neuropsychiatric symptoms. Caregivers were assessed for their caregiver burden. Bivariate analyses were conducted between caregiver burden and dementia patients' symptoms, in order to examine which particular symptoms were significantly associated with caregiver burden at the baseline. A multiple regression analysis was then conducted with each significantly associated variable with a view to identifying determinants, influencing caregiver burden. Additionally, bivariate analyses were conducted between the changes in caregiver burden and the changes in patients' symptoms, to investigate which patient variable could best describe caregiver burden from baseline to the 1-year follow-up. A multiple regression analysis was conducted with each significantly-associated change in symptom, in order to identify determinants that influence a change in caregiver burden. Results Neuropsychiatric symptoms, such as irritability, aberrant motor-behavior, delusions and disinhibition were found to be significant predictors of caregiver burden at baseline, according to multiple regression analysis. In addition, changes in neuropsychiatric symptoms, such as delusions, agitation and memory-related functioning in daily-living significantly predict a change in caregiver burden. Conclusion Our results demonstrate that neuropsychiatric symptoms and memory impairment in daily-living functions are significant predictors of an increase in caregiver burden. PMID:26766945

  14. Robot-assisted laparoscopic pyeloplasty: minimum 1-year follow-up

    NASA Astrophysics Data System (ADS)

    Patel, Vipul; Thaly, Rahul; Shah, Ketul

    2007-02-01

    Objectives: To evaluate the feasibility and efficacy of robotic-assisted laparoscopic pyeloplasty. Laparoscopic pyeloplasty has been shown to have a success rate comparable to that of the open surgical approach. However, the steep learning curve has hindered its acceptance into mainstream urologic practice. The introduction of robotic assistance provides advantages that have the potential to facilitate precise dissection and intracorporeal suturing. Methods: A total of 50 patients underwent robotic-assisted laparoscopic dismembered pyeloplasty. A four-trocar technique was used. Most patients were discharged home on day 1, with stent removal at 3 weeks. Patency of the ureteropelvic junction was assessed in all patients with mercaptotriglycylglycine Lasix renograms at 1, 3, 6, 9, and 12 months, then every 6 months for 1 year, and then yearly. Results: Each patient underwent a successful procedure without open conversion or transfusion. The average estimated blood loss was 40 ml. The operative time averaged 122 minutes (range 60 to 330) overall. Crossing vessels were present in 30% of the patients and were preserved in all cases. The time for the anastomosis averaged 20 minutes (range 10 to 100). Intraoperatively, no complications occurred. Postoperatively, the average hospital stay was 1.1 days. The stents were removed at an average of 20 days (range 14 to 28) postoperatively. The average follow-up was 11.7 months; at the last follow-up visit, each patient was doing well. Of the 50 patients, 48 underwent one or more renograms, demonstrating stable renal function, improved drainage, and no evidence of recurrent obstruction. Conclusions: Robotic-assisted laparoscopic pyeloplasty is a feasible technique for ureteropelvic junction reconstruction. The procedure provides a minimally invasive alternative with good short-term results.

  15. The Effect of Clozapine on Hematological Indices: A 1-Year Follow-Up Study.

    PubMed

    Lee, Jimmy; Takeuchi, Hiroyoshi; Fervaha, Gagan; Powell, Valerie; Bhaloo, Amaal; Bies, Robert; Remington, Gary

    2015-10-01

    Clozapine is the antipsychotic of choice for treatment-resistant schizophrenia and is linked to a need for mandatory hematological monitoring. Besides agranulocytosis, other hematological aberrations have resulted in premature termination in some cases. Considering clozapine's role in immunomodulation, we proceeded to investigate the impact of clozapine on the following 3 main hematological cell lines: red blood cells, platelets, white blood cells (WBCs), and its differential counts. Data were extracted from patients initiated on clozapine between January 2009 and December 2010 at a single hospital. Patients with a preclozapine complete blood count, who were receiving clozapine during the 1-year follow-up period, were included in the present investigation. Counts of red blood cells, platelets, WBC, and its differential including neutrophils, lymphocytes, monocytes, eosinophils, and basophils were extracted and trajectories plotted. One hundred one patients were included in this study and 66 remained on clozapine at the end of 1 year. There was a synchronized but transient increase in WBC, neutrophils, monocytes, eosinophils, basophils, and platelets beginning as early as the first week of clozapine treatment. There were no cases of agranulocytosis reported in this sample, and five developed neutropenia. A spike in neutrophils immediately preceded the onset of neutropenia in three of the five. The cumulative incidence rates were 48.9% for neutrophilia, 5.9% for eosinophilia, and 3% each for thrombocytosis and thrombocytopenia. Early hematological aberrations are visible across a range of cell lines, primarily of the myeloid lineage. These disturbances are transient and are probably related to clozapine's immunomodulatory properties. We do not suggest discontinuing clozapine as a consequence of the observed aberrations. PMID:26267420

  16. Induction of Maturogenesis by Partial Pulpotomy: 1 Year Follow-Up

    PubMed Central

    Bacaksiz, A.; Alaçam, A.

    2013-01-01

    In cariously exposed immature permanent teeth, the treatment choice is controversial in pediatric dentistry. Radical root canal treatment usually appears to be the solution for these teeth. Even partial pulpotomy is a vital treatment for traumatically exposed immature permanent teeth; extending the borders of indication towards cariously exposed immature permanent teeth with reversible pulpitis may abolish the necessity of pulpectomy. This article describes the partial pulpotomy of a cariously affected immature permanent teeth and the follow-up for 1 year. A healthy 11-year-old male patient was referred to Gazi University Faculty of Dentistry Department of Pediatric Dentistry. The patient had reversible pulpitis symptoms on teeth numbered 45. At radiographic examination, immature apex and deep caries lesion were observed and partial pulpotomy was performed by using calcium hydroxide to maintain vitality of the pulp and allow continued development of root dentin expecting the root will attain full maturity. Clinical and radiographic follow-up demonstrated a vital pulp besides not only closure of the apex (apexogenesis), but also physiologic root development (maturogenesis) after 1 year. Partial pulpotomy is an optional treatment for cariously exposed immature permanent teeth for preserving vitality and physiological root development. PMID:24324899

  17. Trajectories of Depressive Symptomatology in Rural Memory Clinic Patients between Baseline Diagnosis and 1-Year Follow-Up

    PubMed Central

    Kosteniuk, Julie G.; Morgan, Debra G.; O'Connell, Megan E.; Kirk, Andrew; Crossley, Margaret; Stewart, Norma J.; Karunanayake, Chandima P.

    2016-01-01

    Background/Aims To investigate the prevalence and trajectories of depressive symptomatology at 1-year follow-up, and the severity of depressive symptoms, by dementia diagnostic group, as well as to determine the predictors of depressive symptomatology at 1-year follow-up. Methods In rural and remote patients of an interdisciplinary memory clinic between 2004 and 2014, 144 patients diagnosed with no cognitive impairment (NCI), mild cognitive impairment, dementia due to Alzheimer's disease (AD), or non-AD dementia completed the Center for Epidemiologic Studies of Depression Scale to assess depressive symptomatology at both time points. Results Among patients with data at both time points, persistence of depressive symptomatology at follow-up occurred in 22.2%, remission in 17.4%, incidence in 13.2%, and absence in 47.2%. The prevalence of depressive symptomatology at baseline and persistence at follow-up were significantly greater in the NCI group than in the other diagnostic groups, but there were no differences in severity. Depressive symptomatology at follow-up was independently associated with depressive symptomatology, lower independence in activities of daily living, and lower self-rating of memory at baseline, as well as with decreased independence in activities of daily living between time points. Conclusion Future studies should further examine short-term postdiagnostic trajectories in depressive symptomatology in multiple dementia diagnostic groups to inform prognoses and treatment decisions. PMID:27350776

  18. Outcomes of minimally 1 year follow-up for the arthroscopic Remplissage technique with Hill–Sachs lesion

    PubMed Central

    Ko, Sang-Hun; Shin, Seung-Myeong; Jo, Beom-Geon

    2013-01-01

    Purpose We evaluated minimal 1 year follow-up results for the Remplissage technique to fill a Hill–Sachs lesion with anterior instability. Methods The subjects were 12 patients, who could be followed-up for more than 12 months after the ”Remplissage” procedures in our hospital from August 2008 to May 2010. Their mean age was 28.6 years old and the mean follow-up was 19 months. The evaluations included the ROM, the ASES score, the KSSI score, the ROWE score and postoperative MRI. Results On the postoperative functional evaluation after an average 16 months, the ASES score improved 51.4 in preoperative to 86.6 in postoperatively, the KSSI score improved from 46.6 preoperatively to 84.9 postoperatively and the ROWE score improved from 43.6 preoperatively to 91.4 postoperatively. After an average 14 months for all the cases, the range of movement was nearly in the normal range which is 174.3 ± 5.04 (170–180) degrees in foreward flexion, and 56.4 ± 9.60 (50–60) degrees in external rotation. Conclusion For recurrent shoulder instability with a large Hill–Sachs lesion, the Remplissage technique has a good outcome after more than 1 year follow-up in terms of shoulder stability, and the clinical and functional results. Level of evidence Level IV, therapeutic case series PMID:24403747

  19. Uterine Leiomyomas: Safety and Efficacy of US-guided Suprapubic Transvaginal Radiofrequency Ablation at 1-year Follow-up.

    PubMed

    Wu, Xiang-Jun; Guo, Qing; Cao, Bing-Sheng; Tan, Li-Xia; Zhang, Hong-Yu; Cai, Yu-Ru; Gao, Bu-Lang

    2016-06-01

    Purpose To assess the safety and efficacy of ultrasonography (US)-guided suprapubic transvaginal (ST) radiofrequency ablation (RFA) in the treatment of symptomatic uterine leiomyomas at 1-year follow-up. Materials and Methods The institutional review board approved this prospective study, and all patients provided informed consent. ST RFA was performed as an outpatient procedure 3 days after menstruation in 51 women (age range, 32-52 years; mean age, 42.2 years) with 62 leiomyomas. The leiomyomas were assessed with conventional and contrast material-enhanced US before and after ST RFA for leiomyoma size, location, and blood flow. All patients were evaluated for postoperative complications, including abdominal pain, injury to surrounding tissues and organs, vaginal bleeding, increased vaginal discharge, fever, dyspnea, and menorrhagia, after ST RFA and at follow-up visits. The leiomyoma volumes, improvement in leiomyoma-related symptoms, effect on quality of life (QOL), and patient satisfaction were assessed and compared before and after ST RFA and at follow-up visits by using statistical analyses. Results Sixty-two leiomyomas were successfully treated with ST RFA until 90% of the leiomyoma was echogenic. At 1-month follow-up, 46 (74%) leiomyomas had no contrast enhancement, five (8%) had peripheral enhancement, eight (13%) had focal enhancement, and three (5%) had scattered enhancement at contrast-enhanced US. At 6-month follow-up, the number of leiomyomas that had no enhancement, peripheral enhancement, focal enhancement, or scattered enhancement was 43 (69%), seven (11%), nine (15%), and three (5%), respectively. The leiomyoma volumes were significantly (P < .05) reduced at 1-, 3-, 6-, and 12-month follow-up (from 33.0 cm(3) ± 25.1 [standard deviation] before treatment to 6.8 cm(3) ± 7.7 at 12-month follow-up). The mean percentage volume reduction at 1-, 3-, 6-, and 12-month follow-up was 28%, 57%, 63%, and 78%, respectively. The scores for symptoms and QOL

  20. Use of collagen scaffold and autologous bone marrow concentrate as a one-step cartilage repair in the knee: histological results of second-look biopsies at 1 year follow-up.

    PubMed

    Gigante, A; Calcagno, S; Cecconi, S; Ramazzotti, D; Manzotti, S; Enea, D

    2011-01-01

    Chondral articular defects are a key concern in orthopaedic surgery. To overcome the disadvantages of autologous chondrocyte implantation (ACI) and to improve the outcomes of autologous matrix-induced chondrogenesis (AMIC), the latter technique is currently augmented with bone marrow concentrate injected under or seeded onto the scaffold. However, to date, only a little is known about histological outcomes of either the AMIC technique or AMIC associated with bone marrow concentrate. This study aimed to evaluate the quality of the repair tissue obtained from biopsies harvested during second-look arthroscopy after arthroscopic AMIC augmented with bone marrow concentrate. We analysed five second-look core biopsies harvested at 12 months follow-up. At the time of biopsy the surgeon reported the quality of the repair tissue using the standard ICRS Cartilage Repair Assessment (CRA). Every biopsy together with patient data was sent to our centre to undergo blind histological evaluation (ICRS II Visual Histological Assessment Scale) and data analysis. Five asymptomatic patients (mean age 43.4 years) had isolated lesions (mean size was 3.7 cm2) at the medial femoral condyle. All the implants appeared nearly normal (ICRS CRA) at arthroscopic evaluation and had a mean overall histological (ICRS II) of 59.8±14,5. Hyaline-like matrix was found in only one case, a mixture of hyaline/fibrocartilage was found in one case and fibrocartilage was found three cases. Our clinical and histological data suggest that this procedure achieved a nearly normal arthroscopic appearance and a satisfactory repair tissue, which was possibly still maturing at 12 months follow-up. Further studies are needed to understand the true potential of one-step procedures in the repair of focal chondral lesions in the knee. PMID:21669141

  1. Low-dose acitretin in Papillon-Lefèvre syndrome: treatment and 1-year follow-up.

    PubMed

    Sarma, Nilendu; Ghosh, Chiranjit; Kar, Sudipta; Bazmi, Badruddin Ahmed

    2015-01-01

    The Papillon-Lefèvre syndrome (PLS) is a rare, autosomal recessive disease that manifests with palmoplantar keratoderma and destructive periodontitis resulting in early onset periodontal breakdown in deciduous and permanent dentition. Management of this condition is difficult. Here we report one 11-year-old consanguineous Muslim boy suffering from PLS. After failing to get any benefit from methotrexate, three cycles of acitretin, each for 2 months, were given 1 month apart. In each cycle, acitretin (25 mg) was given every other day. At the end of the third cycle, treatment was stopped for 4 months to observe the extent of relapse. Thereafter, acitretin (25 mg) was given twice weekly for 4 months and then the patient was followed up for 1 year. Treatment with acitretin resulted in excellent improvement of periodontitis, increase in the alveolar bone height, and periodontal attachment. Improvement remained stable at the end of 1-year follow-up. There was excellent (>75%) improvement in keratoderma at the end of active therapy. Mild worsening of palmoplantar keratoderma was noticed whenever the drug was stopped. It improved when the drug was restarted. Other areas remained stable. At the end of 1-year follow-up, good improvement (50%) in palmoplantar keratoderma was achieved. PMID:25313946

  2. Vertebral Augmentation with Nitinol Endoprosthesis: Clinical Experience in 40 Patients with 1-Year Follow-up

    SciTech Connect

    Anselmetti, Giovanni Carlo; Manca, Antonio; Marcia, Stefano; Chiara, Gabriele; Marini, Stefano; Baroud, Gamal; Regge, Daniele; Montemurro, Filippo

    2013-05-08

    PurposeThis study was designed to assess the clinical outcomes of patients treated by vertebral augmentation with nitinol endoprosthesis (VNE) to treat painful vertebral compression fractures.MethodsForty patients with one or more painful osteoporotic VCF, confirmed by MRI and accompanied by back-pain unresponsive to a minimum 2 months of conservative medical treatment, underwent VNE at 42 levels. Preoperative and postoperative pain measured with Visual Analog Scale (VAS), disability measured by Oswestry Disability Index (ODI), and vertebral height restoration (measured with 2-dimensional reconstruction CT) were compared at last follow-up (average follow-up 15 months). Cement extravasation, subsequent fractures, and implant migration were recorded.ResultsLong-term follow-up was obtained in 38 of 40 patients. Both VAS and ODI significantly improved from a median of 8.0 (range 5–10) and 66 % (range 44–88 %) to 0.5 (range 0–8) and 6 % (range 6–66 %), respectively, at 1 year (p < 0.0001). Vertebral height measurements comparing time points increased in a statistically significant manner (ANOVA, p < 0.001). Overall cement extravasation rate was 9.5 %. Discal and venous leakage rates were 7.1 and 0 % respectively. No symptomatic extravasations occurred. Five of 38 (13.1 %) patients experienced new spontaneous, osteoporotic fractures. No device change or migration was observed.ConclusionsVNE is a safe and effective procedure that is able to provide long-lasting pain relief and durable vertebral height gain with a low rate of new fractures and cement leakages.

  3. Elevated Patient Body Mass Index Does Not Negatively Affect Self-Reported Outcomes of Thoracolumbar Surgery: Results of a Comparative Observational Study with Minimum 1-Year Follow-Up

    PubMed Central

    Manson, Neil A.; Green, Alana J.; Abraham, Edward P.

    2015-01-01

    Study Design Retrospective study. Objective Quantify the effect of obesity on elective thoracolumbar spine surgery patients. Methods Five hundred consecutive adult patients undergoing thoracolumbar spine surgery to treat degenerative pathologies with minimum follow-up of at least 1 year were included. Primary outcome measures included Numerical Rating Scales for back and leg pain, the Short Form 36 Physical Component Summary and Mental Component Summary, the modified Oswestry Disability Index, and patient satisfaction scores collected preoperatively and at 3, 6, 12, and 24 months postoperatively. Secondary outcome measures included perioperative and postoperative adverse events, postoperative emergency department presentation, hospital readmission, and revision surgeries. Patients were grouped according to World Health Organization body mass index (BMI) guidelines to isolate the effect of obesity on primary and secondary outcome measures. Results Mean BMI was 30 kg/m2, reflecting a significantly overweight population. Each BMI group reported statistically significant improvement on all self-reported outcome measures. Contrary to our hypothesis, however, there was no association between BMI group and primary outcome measures. Patients with BMI of 35 to 39.99 visited the emergency department with complaints of pain significantly more often than the other groups. Otherwise, we did not detect any differences in the secondary outcome measures between BMI groups. Conclusions Patients of all levels of obesity experienced significant improvement following elective thoracolumbar spine surgery. These outcomes were achieved without increased risk of postoperative complications such as infection and reoperation. A risk–benefit algorithm to assist with surgical decision making for obese patients would be valuable to surgeons and patients alike. PMID:26933611

  4. Elevated Patient Body Mass Index Does Not Negatively Affect Self-Reported Outcomes of Thoracolumbar Surgery: Results of a Comparative Observational Study with Minimum 1-Year Follow-Up.

    PubMed

    Manson, Neil A; Green, Alana J; Abraham, Edward P

    2016-03-01

    Study Design Retrospective study. Objective Quantify the effect of obesity on elective thoracolumbar spine surgery patients. Methods Five hundred consecutive adult patients undergoing thoracolumbar spine surgery to treat degenerative pathologies with minimum follow-up of at least 1 year were included. Primary outcome measures included Numerical Rating Scales for back and leg pain, the Short Form 36 Physical Component Summary and Mental Component Summary, the modified Oswestry Disability Index, and patient satisfaction scores collected preoperatively and at 3, 6, 12, and 24 months postoperatively. Secondary outcome measures included perioperative and postoperative adverse events, postoperative emergency department presentation, hospital readmission, and revision surgeries. Patients were grouped according to World Health Organization body mass index (BMI) guidelines to isolate the effect of obesity on primary and secondary outcome measures. Results Mean BMI was 30 kg/m(2), reflecting a significantly overweight population. Each BMI group reported statistically significant improvement on all self-reported outcome measures. Contrary to our hypothesis, however, there was no association between BMI group and primary outcome measures. Patients with BMI of 35 to 39.99 visited the emergency department with complaints of pain significantly more often than the other groups. Otherwise, we did not detect any differences in the secondary outcome measures between BMI groups. Conclusions Patients of all levels of obesity experienced significant improvement following elective thoracolumbar spine surgery. These outcomes were achieved without increased risk of postoperative complications such as infection and reoperation. A risk-benefit algorithm to assist with surgical decision making for obese patients would be valuable to surgeons and patients alike. PMID:26933611

  5. Strategy and results of East Asian GRB FOllow-up Network (EAFON) follow-up observations

    NASA Astrophysics Data System (ADS)

    Urata, Y.; Eafon Team

    We have established Japan-Taiwan-China collaboration on GRBs study in the East-Asian region since 2004 This serves as valuable additions to the world-wide optical and infrared follow-up network because the East-Asia region is otherwise blank for the network We have been carrying out imaging and spectroscopic follow-up observations by Lulin Taiwan Kiso Japan WIDGET Japan and Xinglong China Using Xinglong and Kiso we can locate candidates and obtain early time spectra of afterglows While WIDGET provides early time observations before the burst the high-time resolution for multi-band light curves will be obtained by Lulin With the data from these sites we will obtain detailed information of light curve and redshift of GRBs which are important to understand the mechanism of afterglows Utilizing East Asian GRB Follow-up Observation Network EAFON we have observed 56 GRB optical afterglows and detected 15 early optical afterglow behavior including two short GRBs in multi-bands Based on these observations we have obtained 3 major results 1 first long term monitoring of short GRB afterglow from sim 0 1 days after the burst 2 two components in early optical afterglow 3 catch about 30 high redshift GRB candidates In this meeting we will present mainly report early a common feature of long GRB early afterglow We have found a common feature in long GRB early afterglow light curves These early light curves show re-brightening and or plateau phase around 0 1 days 2 4hours after bursts Combined with other prompt

  6. A randomized double-blind clinical trial of posterior composite restorations with or without bevel: 1-year follow-up

    PubMed Central

    COELHO-DE-SOUZA, Fábio Herrmann; CAMARGO, Junara Cristina; BESKOW, Tiago; BALESTRIN, Matheus Dalmolin; KLEIN-JÚNIOR, Celso Afonso; DEMARCO, Flávio Fernando

    2012-01-01

    Objective This randomized double-blind clinical trial compared the performance of posterior composite restorations with or without bevel, after 1-year follow-up. Material and Methods Thirteen volunteers requiring at least two posterior composite restorations were selected. Twenty-nine cavities were performed, comprising 14 without bevel (butt joint) and 15 with bevel preparation of the enamel cavosurface angle. All cavities were restored with simplified adhesive system (Adper Single Bond) and composite resin (Filtek P60). A halogen light curing unit was used through the study. Restorations were polished immediately. Analysis was carried out at baseline, after 6 months and after 1 year by a calibrated evaluator (Kappa), according to the FDI criteria. Data were statistically analyzed by Mann-Whitney test (p<0.05). Results Beveled and non-beveled cavities performed similarly after 1 year follow-up, regarding to fractures and retention, marginal adaptation, postoperative hypersensitivity, recurrence of caries, surface luster and anatomic form. However, for surface and marginal staining, beveled cavities showed significantly better performance (p<0.05) than butt joint restorations. Conclusions It was concluded that the restorations were acceptable after 1 year, but restorations placed in cavities with marginal beveling showed less marginal staining than those placed in non-beveled cavities. PMID:22666833

  7. The Assessment of the Magnitude of Frontal Plane Postural Changes in Breast Cancer Patients After Breast-Conserving Therapy or Mastectomy - Follow-up Results 1 Year After the Surgical Procedure.

    PubMed

    Głowacka, Iwona; Nowikiewicz, Tomasz; Siedlecki, Zygmunt; Hagner, Wojciech; Nowacka, Krystyna; Zegarski, Wojciech

    2016-01-01

    Breast cancer is the most common malignancy in Polish women. Management of breast cancer includes surgical treatment as well as adjuvant chemotherapy, radiotherapy, hormonal therapy, and combination regimens. One of the adverse consequences of oncological management of breast cancer may involve changes in frontal plane body posture. The objective of the study was to assess the frontal plane body posture changes in women treated for breast cancer. A prospective study including 101 of female breast cancer patients subjected to surgical treatment in the period from October 2011 to October 2012 (mastectomy was performed in 51 cases while breast conserving therapy was administered in the remaining 50 cases). The body posture in the frontal plane was assessed using the computer-assisted postural assessment system with Moiré fringe analysis. No statistically significant differences were observed in pre-operational postural parameters of interest. Exam II revealed highly significant differences in SLA values; results suggesting more pronounced dysfunction were observed in the MAS group. Exam III revealed highly significant differences in PIA, SH, SD and SLA values; results suggesting more pronounced dysfunction were observed in the MAS group. Undesirable postural changes occur both in women who were treated with radical mastectomy and in those who underwent breast-conserving surgery; breast-conserving surgery is associated with decreased severity in postural abnormalities. PMID:26510430

  8. Self-management of chronic pain in Malaysian patients: effectiveness trial with 1-year follow-up.

    PubMed

    Cardosa, Mary; Osman, Zubaidah Jamil; Nicholas, Michael; Tonkin, Lois; Williams, Amanda; Abd Aziz, Khuzaimah; Mohd Ali, Ramli; Dahari, Norhana Mohd

    2012-03-01

    Self-management of chronic illnesses has been widely recognised as an important goal on quality of life, health service utilisation and cost grounds. This study describes the first published account on the application of this approach to people suffering from chronic pain conditions in a Southeast Asian country, Malaysia. A heterogeneous sample of chronic pain patients in Malaysia attended a 2-week cognitive-behavioural pain management programme (PMP) aimed at improving daily functional activities and general psychological well-being. Complete datasets from 70 patients out of 102 patients who attended 11 programmes conducted from 2002 to 2007, as well as the 1-month and 1-year follow-up sessions at the hospital clinic, are reported. The pre- to post-treatment results on self-report measures indicate that significant gains were achieved on the dimensions of pain, disability and psychological well-being. These gains were maintained at both 1-month and 1-year follow-ups. The results mirror those reported from similar interventions in Europe and North America and indicate the concept of self-management of a chronic illness is acceptable and meaningful to Asian patients. Importantly, the achieved outcomes were independent of gender and ethnic group status. PMID:22448204

  9. Impact of Renal Sympathetic Denervation on Left Ventricular Structure and Function at 1-Year Follow-Up

    PubMed Central

    de Sousa Almeida, Manuel; de Araújo Gonçalves, Pedro; Branco, Patricia; Mesquita, João; Carvalho, Maria Salomé; Dores, Helder; Silva Sousa, Henrique; Gaspar, Augusta; Horta, Eduarda; Aleixo, Ana; Neuparth, Nuno; Mendes, Miguel; Andrade, Maria João

    2016-01-01

    Background Catheter-based sympathetic renal denervation (RDN) is a recent therapeutic option for patients with resistant hypertension. However, the impact of RDN in left ventricular (LV) mass and function is not completely established. Our aim was to evaluate the effects of RDN on LV structure and function (systolic and diastolic) in patients with resistant hypertension (HTN). Methods and Results From a single centre prospective registry including 65 consecutive patients with resistant HTN submitted to RDN between July-2011 and April-2015, 31 patients with baseline and 1-year follow-up echocardiogram were included in this analysis. Mean age was 65±7 years, 48% were males, 71% had type 2 diabetes. Most had hypertension lasting for more than 10 years (90%), and were being treated with a median number of 6 anti-hypertensive drugs, including 74% on spironolactone. At 1-year, there was a significant decrease both on office SBP (176±24 to 149±13mmHg, p<0.001) and DBP (90±14 to 79±11mmHg, p<0.001), and also in 24h ABPM SBP (150±20 to 132±14mmhg, p<0.001) and DBP (83±10 to 74±9mmHg, p<0.001). There was also a significant decrease in LV mass from 152±32 to 136±34g/m2 (p<0.001), an increase in LV end diastolic volume (93±18 to 111±27 mL, p = 0.004), an increase in LV ejection fraction (65±9 to 68±9%, p = 0.001) and mitral valve E deceleration time (225±49 to 247±51ms, p = 0.015) at 1-year follow up. There were no significant changes in left atrium volume index or in the distribution of patients among the different left ventricle geometric patterns and diastolic function subgroups. Conclusions In this single centre registry of patients with resistant hypertension, renal denervation was associated with significant reduction in both office and ABPM blood pressure and a significant decrease in left ventricle mass evaluated by transthoracic echocardiogram at 1 year follow-up. PMID:26934735

  10. The Stability and Structure of Career Decision-Making Profiles: A 1-Year Follow-Up

    ERIC Educational Resources Information Center

    Gati, Itamar; Levin, Nimrod

    2012-01-01

    The Career Decision-Making Profile (CDMP) questionnaire is a multidimensional measure of the way individuals make career decisions, developed as an alternative to the single, most-dominant trait approach. Using a sample of freshmen students, the 2-week reliability (N = 273) and 1-year stability (N = 182) of the CDMP was tested for each of the 12…

  11. A Program To Promote Positive Body Image: A 1-Year Follow-Up Evaluation.

    ERIC Educational Resources Information Center

    McVey, Gail L.; Davis, Ron

    2002-01-01

    Evaluated the effectiveness of a program designed to promote body image satisfaction and prevent eating problems in young adolescent girls over a 1-year period. Found no program effect. Found instead, significant increases in body image satisfaction and decreases in eating problem scores over time for participants in both the prevention and…

  12. A GP's duty to follow up test results.

    PubMed

    Bird, Sara

    2003-01-01

    Medical negligence claims alleging 'failure to diagnose' are a common cause of claims against general practitioners. In these claims there is often an underlying weakness in the GP's test result and patient tracking systems. This article discusses the duty of care of a GP to follow up patients and their test results. Guidance is provided on how to establish an effective test result tracking system in order to minimise the possibility of a claim arising from 'failure to diagnose'. PMID:12647659

  13. A longitudinal study on the osteoarthritic change of the temporomandibular joint based on 1-year follow-up computed tomography.

    PubMed

    Lee, Jeong-Yun; Kim, Dae-Jung; Lee, Sang-Goo; Chung, Jin-Woo

    2012-12-01

    This study aims to report the results of a 1-year computed tomographic (CT) follow up of 54 temporomandibular joints (TMJs) affected by osteoarthritis (OA) and to provide longitudinal information on changes in OA and its relationship with clinical signs and symptoms. TMJ OA was diagnosed by history, clinical and CT examinations. The second CT examination was done after about 1 year of conservative treatment. Joints were divided into three groups labeled as no change, improved CT, and worsened CT groups depending on the longitudinal bony change of OA observed in the CT. The sex distribution, mean age, joint noise, subjective pain, joint tenderness, masticatory muscle tenderness, and improvement of subjective symptoms were not different between the groups at the first and second examination, while maximum (p < 0.01) and painless mouth opening range (p < 0.001) at the first examination were both smaller in the worsened CT group. Although the clinical signs and symptoms of OA were improved in 40 joints, 74.1%, at 7.2 ± 4.6 months, the amount if improvement did not differ between the groups. The extent of the destructive change of the condyle was highest in the improved CT group at the first (p < 0.001) and in the worsened CT group at the second examination (p < 0.001). These results imply that the prognosis of OA changes may be independent of the clinical signs and symptoms. More specific longitudinal information as regards OA changes of the TMJ based on a larger sample and a longer follow-up period would be likely to provide a better understanding of TMJ OA. PMID:22075324

  14. A 1-year follow-up of implants of differing surface roughness placed in rabbit bone.

    PubMed

    Wennerberg, A; Ektessabi, A; Albrektsson, T; Johansson, C; Andersson, B

    1997-01-01

    Screw-shaped implants were prepared with three different surface topographies: One was left as machined, ie, a turned surface, and two were blasted surfaces with differing degrees of surface roughness. The surface topography was measured with a confocal laser scanning profilometer and the surface roughness was characterized using height and spatial descriptive parameters. The turned surface had an average surface roughness of 0.96 micron and an average peak spacing of 8.6 microns. The two blasted surfaces had surface roughness values of 1.16 microns and 1.94 microns, respectively; the corresponding values for the peak spacing parameter were 10.00 microns and 13.22 microns, respectively. After 1 year in rabbit bone, the bone response to the turned implants was compared with the response to the two blasted implant surfaces. Firmer bone fixation was found for the two blasted surfaces, with statistically significant increases in removal torque and percentage of bone-to-metal contact. Furthermore, about 2 mm from the implant surface, the titanium release was similar for the turned and the 25-micron aluminum oxide-blasted implants. PMID:9274077

  15. Outcomes after thrombus aspiration for ST elevation myocardial infarction: 1-year follow-up of the prospective randomised TOTAL trial

    PubMed Central

    Jolly, Sanjit S; Cairns, John A; Yusuf, Salim; Rokoss, Michael J; Gao, Peggy; Meeks, Brandi; Kedev, Sasko; Stankovic, Goran; Moreno, Raul; Gershlick, Anthony; Chowdhary, Saqib; Lavi, Shahar; Niemela, Kari; Bernat, Ivo; Cantor, Warren J; Cheema, Asim N; Steg, Philippe Gabriel; Welsh, Robert C; Sheth, Tej; Bertrand, Olivier F; Avezum, Alvaro; Bhindi, Ravinay; Natarajan, Madhu K; Horak, David; Leung, Raymond C M; Kassam, Saleem; Rao, Sunil V; El-Omar, Magdi; Mehta, Shamir R; Velianou, James L; Pancholy, Samir; Džavík, Vladimír

    2016-01-01

    Summary Background Two large trials have reported contradictory results at 1 year after thrombus aspiration in ST elevation myocardial infarction (STEMI). In a 1-year follow-up of the largest randomised trial of thrombus aspiration, we aimed to clarify the longer-term benefits, to help guide clinical practice. Methods The trial of routine aspiration ThrOmbecTomy with PCI versus PCI ALone in Patients with STEMI (TOTAL) was a prospective, randomised, investigator-initiated trial of routine manual thrombectomy versus percutaneous coronary intervention (PCI) alone in 10 732 patients with STEMI. Eligible adult patients (aged ≥18 years) from 87 hospitals in 20 countries were enrolled and randomly assigned (1:1) within 12 h of symptom onset to receive routine manual thrombectomy with PCI or PCI alone. Permuted block randomisation (with variable block size) was done by a 24 h computerised central system, and was stratified by centre. Participants and investigators were not masked to treatment assignment. The trial did not show a difference at 180 days in the primary outcome of cardiovascular death, myocardial infarction, cardiogenic shock, or heart failure. However, the results showed improvements in the surrogate outcomes of ST segment resolution and distal embolisation, but whether or not this finding would translate into a longer term benefit remained unclear. In this longer-term follow-up of the TOTAL study, we report the results on the primary outcome (cardiovascular death, myocardial infarction, cardiogenic shock, or heart failure) and secondary outcomes at 1 year. Analyses of the primary outcome were by modified intention to treat and only included patients who underwent index PCI. This trial is registered with ClinicalTrials.gov, number NCT01149044. Findings Between Aug 5, 2010, and July 25, 2014, 10 732 eligible patients were enrolled and randomly assigned to thrombectomy followed by PCI (n=5372) or to PCI alone (n=5360). After exclusions of patients who did not

  16. A prospective randomized study of 1- and 2-stage sinus inlay bone grafts: 1-year follow-up.

    PubMed

    Wannfors, K; Johansson, B; Hallman, M; Strandkvist, T

    2000-01-01

    The purpose of the present study was to compare the success of and surgical differences between 1- and 2-stage sinus inlay bone grafts and implants after 1 year in function. The individual risk for implant failure in grafted areas among 1-stage patients was about twice the risk in 2-stage patients (odds ratio 2.3, CI 0.6; 8.5). The risk for implant failure in non-grafted areas was significantly lower (P < .05) than in grafted areas, regardless of the technique used. Forty edentulous patients, selected according to strict inclusion criteria from consecutive referrals, were allocated to one or other of the 2 sinus-inlay procedures. Twenty patients received bone blocks fixed by implants to the residual alveolar crest in a 1-stage procedure (group 1). In another 20 patients, particulated bone was condensed against the antral floor and left to heal for 6 months before implants were placed (group 2). An almost equal number of implants was placed in the patients of each group, 76 in the 1-stage procedure and 74 in the 2-stage procedure. Additionally, 72 and 66 implants were placed in the anterior non-grafted regions of group 1 and group 2 patients, respectively. After 1 year in function, a total of 20 implants failed in 1-stage patients, versus 11 in 2-stage patients. Sixteen and 8 implants, respectively, of these were placed in grafted bone. All but one 1-stage patient received the planned fixed prosthetic restorations, but 1 restoration was redesigned after the first year in function because of a functionally unacceptable prosthetic design. At the 1-year follow-up, one 2-stage patient lost her prosthesis as the result of multiple implant failures. Bruxism and postoperative infections were the only parameters that could be related to implant failure, however, depending on the statistical method used. PMID:11055129

  17. Cryoplasty for Occlusive Disease of the Femoropopliteal Arteries: 1-Year Follow-Up

    SciTech Connect

    Korteweg, Mies A.; Gils, Marjon van; Hoedt, Marco T.; Valk, Pieter H. M. van der; Tutein Noltenius, Rudolf P.; Avontuur, Jurgen A.; Bronswijk-Monster, Krien F.; Elgersma, Otto E. H.

    2009-03-15

    Atherosclerosis of femoropopliteal arteries is an important cause of morbidity and mortality. Percutaneous transluminal angioplasty (PTA) has only limited success in treating these arteries, mainly because of the high rate of recurrent stenosis. Cryoplasty has been proposed as a technique which might improve treatment outcome. This study reports our single-center experience with cryoplasty. Thirty-two claudicants, 33 arteries, in whom conservative therapy failed, were consecutively included. Duplex ultrasound (US), angiography, and ankle-brachial index (ABI) measurement were performed before the procedure; ABI and duplex US, 2 weeks and 3, 6, and 12 months after the procedure. Patients' symptoms were categorized according to the Rutherford classification. Lesions were classified as TASC A, B, or C according to angiographic appearance. Differences in ABI before and after the procedure were defined as significant at p < 0.05 by paired t-test. Patency was evaluated using duplex US by determining the peak systolic velocity ratio. Sixteen TASC A lesions, 13 TASC B lesions, and 4 TASC C lesions were included. ABI improved significantly for TASC A lesions 2 weeks and 3 months postprocedure. Patency after 2 weeks, 6 months, and 12 months was 93%, 67%, and 64% for TASC A lesions, 83%, 31%, and 31% for TASC B lesions, and 100%, 50%, and 33% for TASC C lesions, respectively. In conclusion, cryoplasty has good immediate success rates and patency rates similar to the results of conventional PTA in the literature.

  18. A comparison of outcome of medical and surgical treatment of migraine headache: In 1 year follow-up

    PubMed Central

    Omranifard, Mahmood; Abdali, Hossein; Ardakani, Mehdi Rasti; Talebianfar, Mohsen

    2016-01-01

    Background: This study was designed to compare the efficacy of the medical treatment versus the surgical treatment approach to decompression of trigger point nerves in patients with migraine headaches. Materials and Methods: Fifty volunteers were randomly assigned to the medical treatment group (n = 25) or the surgical treatment group (n = 25) after examination by the team neurologist to ensure a diagnosis of migraine headache. All patients received botulinum toxin type A to confirm the trigger sites. The surgical treatment group underwent surgical deactivation of the trigger site(s). The medical treatment group underwent prophylactic pharmacologic interventions by the neurologist. Pretreatment and 12-month posttreatment migraine headache frequency, duration, and intensity were analyzed and compared to determine the success of the treatments. Results: Nineteen of the 25 patients (76%) in the surgical treatment group and 10 of the 25 patients (40%) in the medical treatment group experienced a successful outcome (at least a 50% decrease in migraine frequency, duration, or intensity) after 1 year from surgery. Surgical treatment had a significantly higher success rate than medical treatment (P < 0.001). Nine patients (36%) in the surgical treatment group and one patient (4%) in the medical treatment group experienced cessation of migraine headaches. The elimination rate was significantly higher in the surgical treatment group than in the medical treatment group (P < 0.001). Conclusions: Based on the 1-year follow-up data, there is strong evidence that surgical manipulation of one or more migraine trigger sites can successfully eliminate or reduce the frequency, duration, and intensity of migraine headaches in a lasting manner. PMID:27563631

  19. Endoscopic minimally invasive transforaminal interbody fusion without general anesthesia: initial clinical experience with 1-year follow-up.

    PubMed

    Wang, Michael Y; Grossman, Jay

    2016-02-01

    OBJECTIVE One of the principal goals of minimally invasive surgery has been to speed postoperative recovery. In this case series, the authors used an endoscopic technique for interbody fusion combined with percutaneous screw fixation to obviate the need for general anesthesia. METHODS The first 10 consecutive patients treated with a minimum of 1 year's follow-up were included in this series. The patients were all treated using endoscopic access through Kambin's triangle to allow for neural decompression, discectomy, endplate preparation, and interbody fusion. This was followed by percutaneous pedicle screw and connecting rod placement using liposomal bupivacaine for long-acting analgesia. No narcotics or regional anesthetics were used during surgery. RESULTS All patients underwent the procedure successfully without conversion to open surgery. The patients' average age was 62.2 ± 9.0 years (range 52-78 years). All patients had severe disc height collapse, and 60% had a Grade I spondylolisthesis. The mean operative time was 113.5 ± 6.3 minutes (range 105-120 minutes), and blood loss was 65 ± 38 ml (range 30-190 ml). The mean length of hospital stay was 1.4 ± 1.3 nights. There were no intraoperative or postoperative complications. Comparison of preoperative and final clinical metrics demonstrated that the Oswestry Disability Index improved from 42 ± 11.8 to 13.3 ± 15.1; the 36-Item Short Form Health Survey (SF-36) Physical Component Summary improved from 47.6 ± 3.8 to 49.7 ± 5.4; the SF-36 Mental Component Summary decreased from 47 ± 3.9 to 46.7 ± 3.4; and the EQ-5D improved from 10.7 ± 9.5 to 14.2 ± 1.6. There were no cases of nonunion identified radiographically on follow-up imaging. CONCLUSIONS Endoscopic fusion under conscious sedation may represent a feasible alternative to traditional lumbar spine fusion in select patients. Larger clinical series are necessary to validate that clinical improvements are sustained and that arthrodesis rates are

  20. Visual and refractive outcomes of small incision lenticule extraction for the correction of myopia: 1-year follow-up

    PubMed Central

    Kamiya, Kazutaka; Shimizu, Kimiya; Igarashi, Akihito; Kobashi, Hidenaga

    2015-01-01

    Objective To assess the 1 year clinical outcomes of small incision lenticule extraction (SMILE) for the correction of myopia and myopic astigmatism using a 500 kHz femtosecond laser system. Methods This prospective study evaluated 52 eyes of 39 consecutive patients (31.8±6.9 years, mean age±SD) with spherical equivalents of −4.11±1.73 D (range, −1.25 to −8.25 D) who underwent SMILE for myopia and myopic astigmatism. Preoperatively, 1 week, and 1, 3, 6 and 12 months postoperatively, we assessed the safety, efficacy, predictability, stability, corneal endothelial cell loss and the adverse events of the surgery. Results The logarithm of the minimal angle of resolution (logMAR) uncorrected distance visual acuity and LogMAR corrected distance visual acuity were −0.16±0.11 and −0.22±0.07, respectively, 1 year postoperatively. At 1 year, all eyes were within±0.5 D of the targeted correction. Manifest refraction changes of −0.05±0.32 D occurred from 1 week to 1 year postoperatively (p=0.20, Wilcoxon signed-rank test). The endothelial cell density was not significantly changed from 2804±267 cells/mm2 preoperatively to 2743±308 cells/mm2 1 year postoperatively (p=0.12). No vision-threatening complications occurred during the observation period. Conclusions SMILE performed well in the correction of myopia and myopic astigmatism, and no significant change in endothelial cell density or any other serious complications occurred throughout the 1-year follow-up period, suggesting its viability as a surgical option for the treatment of such eyes. PMID:26610755

  1. Changes in Candida spp., mutans streptococci and lactobacilli following treatment of early childhood caries: a 1-year follow-up.

    PubMed

    Klinke, T; Urban, M; Lück, C; Hannig, C; Kuhn, M; Krämer, N

    2014-01-01

    Early childhood caries (ECC) is closely related to high numbers of mutans streptococci, lactobacilli and Candida albicans. Oral colonization of these microorganisms was monitored in a prospective clinical study in order to investigate the effect of comprehensive treatment under general anesthesia and the sustainability of microbial changes. Saliva samples were collected from 50 healthy infants with ECC before and in regular intervals up to 12 months after treatment. Microorganisms were detected by cultivation on selective agars (CRT® bacteria and Sabouraud/CandiSelect™) and scored. Additionally, plaque on upper front teeth and the dmft were recorded. Parents were repeatedly interviewed regarding the children's diet and oral hygiene, accompanied by corresponding advice. Plaque frequency and the numbers of mutans streptococci, lactobacilli and yeasts were significantly reduced as a result of treatment (p < 0.0001, Wilcoxon test). Nevertheless, this effect was not permanent. An ordinal regression model on the follow-up period revealed that the odds for bacteria and yeasts to reach a higher score increased linearly over time (p < 0.01) with an odds ratio of 2.244 per year. One third (34%) of the children developed new dentinal lesions within 1 year postoperatively. High scores of lactobacilli before treatment predicted caries relapse (p < 0.05). Nutritional and oral hygiene habits changed only slightly despite advising. Elimination and restoration of ECC lesions under general anesthesia proved to be an effective procedure in reducing cariogenic bacteria and yeasts. A satisfactory and sustainable success, however, could be achieved neither regarding microbiologic parameters nor with respect to the relapse rate. More suitable strategies are needed. PMID:24216710

  2. Physiologic status at 1-year follow-up of obese women engaged in a supervised conditioning program.

    PubMed

    Tanaka, K; Nakadomo, F; Kitao, H; Watanabe, H; Sumida, S

    1991-07-01

    A follow-up study was conducted to re-evaluate a group of obese middle-aged women (n = 13), eight of whom had completed an 18-wk supervised (3 d/wk) plus unsupervised (2 d/wk) conditioning intervention program (at least 90 min per day) as the exercise plus diet group; while five of the remainder served as the control group. Each session had included a 25- to 45-min jog/run at intensities between the heart rate (HR) corresponding to lactate threshold (LT) and that slightly above the HR @ LT. During 1 year following the program, the women participated in self-controlled training such as running, aerobic dancing, or jazz dancing 2.6 +/- 1.1 d/wk. Dietary intake averaged approximately 1736 +/- 152 kcal/d at the pre-treatment, 1404 +/- 124 kcal/d at the post-treatment, and 1645 +/- 147 kcal/d 1 year after the post-treatment. Interestingly however, oxygen uptake corresponding to LT (VO2 @ LT), maximal oxygen uptake (VO2max), weight, systolic blood pressure, and the ratio of high-density lipoprotein cholesterol to total cholesterol (HDLC/TC) observed 1 year after the post-treatment were significantly different from the original pre-treatment and/or mid-treatment values. For instance, the significant 42% increase (14.7 +/- 2.4----21.3 +/- 4.2 ml/kg/min) in VO2 @ LT and 18% increase (0.284 +/- 0.106----0.335 +/- 0.093) in HDLC/TC from the pre-test to post-test were maintained throughout the 1-year follow-up period, suggesting no detrimental effect either on a cardiorespiratory fitness factor or on an anti-atherogenic factor. These findings indicate that physiologic status of obese middle-aged women engaged in a conditioning intervention program may not regress to pre-treatment status for at least one year after completion; provided they continue to participate in a 2.6-d/wk self-controlled training program with dietary intake of 1600-1700 kcal/d. Another interesting finding was that significant relationships existed between individual changes (delta) in training frequency

  3. Socioeconomic status and duration and pattern of sickness absence. A 1-year follow-up study of 2331 hospital employees

    PubMed Central

    2010-01-01

    Background Sickness absence increases with lower socioeconomic status. However, it is not well known how this relation depends on specific aspects of sickness absence or the degree to which socioeconomic differences in sickness absence may be explained by other factors. The purpose of the study was to examine differences in sickness absence among occupational groups in a large general hospital; how they depend on combinations of frequency and duration of sickness absence spells; and if they could be explained by self-reported general health, personal factors and work factors. Methods The design is a 1-year prospective cohort study of 2331 hospital employees. Baseline information include job title, work unit, perceived general health, work factors and personal factors recorded from hospital administrative files or by questionnaire (response rate 84%). Sickness absence during follow-up was divided into short (1-3 days), medium (4-14 days) and long (>14 days) spells, and into no absence, "normal" absence (1-3 absences of certain durations) and "abnormal" absence (any other absence than "normal"). Socioeconomic status was assessed by job titles grouped in six occupational groups by level of education (from doctors to cleaners/porters). Effects of occupational group on sickness absence were adjusted for significant effects of age, gender, general health, personal factors and work factors. We used Poisson or logistic regression analysis to estimate the effects of model covariates (rate ratios (RR) or odds ratios (OR)) and their 95% confidence intervals (CI). Results With a few exceptions sickness absence increased with decreasing socioeconomic status. However, the social gradient was quite different for different types of sickness absence. The gradient was strong for medium spells and "abnormal" absence, and weak for all spells, short spells, long spells and "normal" absence. For cleaners compared to doctors the adjusted risk estimates increased 4.2 (95% CI 2.8-6.2) and

  4. Results of Medium Seventeen Years' Follow-Up after Laparoscopic Choledochotomy for Ductal Stones

    PubMed Central

    Quaresima, Silvia; Balla, Andrea; Guerrieri, Mario; Campagnacci, Roberto; D'Ambrosio, Giancarlo; Lezoche, Emanuele; Paganini, Alessandro M.

    2016-01-01

    Introduction. In a previously published article the authors reported the long-term follow-up results in 138 consecutive patients with gallstones and common bile duct (CBD) stones who underwent laparoscopic transverse choledochotomy (TC) with T-tube biliary drainage and laparoscopic cholecystectomy (LC). Aim of this study is to evaluate the results at up to 23 years of follow-up in the same series. Methods. One hundred twenty-one patients are the object of the present study. Patients were evaluated by clinical visit, blood assay, and abdominal ultrasound. Symptomatic patients underwent cholangio-MRI, followed by endoscopic retrograde cholangiopancreatography (ERCP) as required. Results. Out of 121 patients, 61 elderly patients died from unrelated causes. Fourteen patients were lost to follow-up. In the 46 remaining patients, ductal stone recurrence occurred in one case (2,1%) successfully managed by ERCP with endoscopic sphincterotomy. At a mean follow-up of 17.1 years no other patients showed signs of bile stasis and no patient showed any imaging evidence of CBD stricture at the site of choledochotomy. Conclusions. Laparoscopic transverse choledochotomy with routine T-tube biliary drainage during LC has proven to be safe and effective at up to 23 years of follow-up, with no evidence of CBD stricture when the procedure is performed with a correct technique. PMID:26880900

  5. Mortality in primary angioplasty patients starting antiplatelet therapy with prehospital prasugrel or clopidogrel: a 1-year follow-up from the European MULTIPRAC Registry

    PubMed Central

    Goldstein, Patrick; Grieco, Niccolò; Ince, Hüseyin; Danchin, Nicolas; Ramos, Yvonne; Goedicke, Jochen; Clemmensen, Peter

    2016-01-01

    Aim MULTIPRAC was designed to provide insights into the use and outcomes associated with prehospital initiation of antiplatelet therapy with either prasugrel or clopidogrel in the context of primary percutaneous coronary intervention. After a previous report on efficacy and safety outcomes during hospitalization, we report here the 1-year follow-up data, including cardiovascular (CV) mortality. Methods and results MULTIPRAC is a multinational, prospective registry of patients with ST-elevation myocardial infarction (STEMI) from 25 hospitals in nine countries, all of which had an established practice of prehospital start of dual antiplatelet therapy in place. The key outcome was CV death at 1 year. Among 2,036 patients followed-up through 1 year, 49 died (2.4%), 10 during the initial hospitalization and 39 within 1 year after hospital discharge. The primary analysis was based on the P2Y12-inhibitor, used from prehospital loading dose through hospital discharge. Prasugrel (n=824) was more commonly used than clopidogrel (n=425). The observed 1-year rates for CV death were 0.5% with prasugrel and 2.6% with clopidogrel. After adjustment for differences in baseline characteristics, treatment with prasugrel was associated with a significantly lower risk of CV death than treatment with clopidogrel (odds ratio 0.248; 95% confidence interval 0.06–0.89). Conclusion In STEMI patients from routine practice undergoing primary angioplasty, who were able to start oral antiplatelet therapy prehospital, treatment with prasugrel as compared to clopidogrel was associated with a lower risk of CV death at 1-year follow-up. PMID:27143908

  6. After the diabetes care trial ends, now what? A 1-year follow-up of the RxING study

    PubMed Central

    Al Hamarneh, Yazid N; Sauriol, Luc; Tsuyuki, Ross T

    2015-01-01

    Introduction There is strong evidence that pharmacist care improves patients’ glycaemic control. However, the sustainability and durability of such interventions beyond the research period is not known. RxING was the first trial of pharmacist prescribing in diabetes and it showed an improvement in glycated haemoglobin (HbA1c) of 1.8% over 6 months. Objective 1° objective: To evaluate glycaemic control in the RxING study patients 12 months after the end of the formal study follow-up. 2° objective: To assess the patients’ risk of cardiovascular events in the next 10 years. Methods We contacted the participating pharmacists to check if the patients who participated in the RxING study are still taking insulin, the dose of insulin they are taking, and their HbA1c. There were no mandated follow-up visits with the pharmacist after the study completion. Results A total of 100 patients with poorly controlled type 2 diabetes were enrolled in the original RxING study; 93 of them completed the study, while 83 participated in the 12-month follow-up. Seventy-five patients were still taking insulin, with the average dose increasing from 31.1 units (SD 18.4) at study completion to 37.4 units (SD 30.8) (95% CI −13.3 to 0.88, p=0.085). HbA1c was reduced from 9.1% (SD 1) at baseline to 7.3% (SD 0.9) at study completion (95% CI 1.4 to 2, p <0.001), and increased to 8.1% (SD 1.3) 12 months later (95% CI −1.1 to −0.5, p <0.001 vs study completion). Conclusions Twelve months after completing the intervention, approximately half of the glycaemic control gains were lost. This highlights the importance of structured follow-up with the pharmacist in this patient population. Trial registration number clinicaltrials.gov; Identifier: NCT01335763. PMID:26270946

  7. Summary of follow-up results from potential tuberculosis exposures

    NASA Technical Reports Server (NTRS)

    Weirich, Stephen A.

    1993-01-01

    There were two isolated episodes of LeRC workers who were diagnosed with pulmonary tuberculosis (TB) during the fall of 1990. The specifics surrounding each case were very different, and it is clear that the two episodes were completely unrelated. The fact that the final diagnoses of pulmonary tuberculosis came within three weeks of each other was purely coincidental. The Occupational Medicine Service (OMS) conducted separate informational sessions and offered free PPD skin testing to all employees, both NASA and contractors, who felt that they were at risk of having been exposed to tuberculosis from either individual. The procedures and results of these are briefly discussed.

  8. [Aberration corrected intraocular lens for microincision cataract surgery (MICS). Intraindividual comparison with a conventional lens - 1-year follow-up].

    PubMed

    Möglich, M; Häberle, H; Pham, D T; Wirbelauer, C

    2009-10-01

    Microincision cataract surgery (MICS) is an important advancement in the field of cataract surgery. This article compares an aberration corrected hydrophilic acrylic intraocular lens (IOL) having a hydrophobic surface for MICS with a one-piece hydrophobic acrylic IOL with respect to capsule sac stability, image quality, and after-cataract formation over the course of 1 year. The operations were performed as bimanual MICS or coaxial phacoemulsification. Overall the results after implantation of the IOL by MICS can be regarded as positive in comparison to the standard operation. PMID:18836727

  9. Longitudinal Changes in Resting-State Cerebral Activity in Patients with First-Episode Schizophrenia: A 1-Year Follow-up Functional MR Imaging Study.

    PubMed

    Li, Fei; Lui, Su; Yao, Li; Hu, Junmei; Lv, Peilin; Huang, Xiaoqi; Mechelli, Andrea; Sweeney, John A; Gong, Qiyong

    2016-06-01

    Purpose To determine whether the brain functional abnormalities of drug-naive first-episode schizophrenia are reduced after 1 year of undergoing antipsychotic treatment and whether pretreatment resting-state functional magnetic resonance (MR) imaging parameters are associated with longitudinal changes in clinical symptoms. Materials and Methods This prospective study was approved by the local ethical committee, and written informed consent was obtained from all participants. Twenty antipsychotic-naive first-episode patients with schizophrenia and 16 healthy individuals were recruited and underwent resting-state functional MR imaging at baseline and again at 1-year follow-up, by which time significant clinical improvement was seen. The amplitude of low-frequency fluctuation (ALFF) and seed-based functional connectivity (FC) were analyzed with analysis of covariance. Results The amount of ALFF in the right inferior parietal lobule (IPL) and orbitofrontal cortex (OFC) and the amount of FC between the bilateral IPLs significantly increased over the follow-up period, and the amount of ALFF in the right occipital gyrus was reduced (P < .050, AlphaSim corrected [ http://afni.nimh.nih.gov/pub/dist/doc/manual/AlphaSim.pdf ]), returning toward normal levels. Furthermore, the degree of alteration in ALFF values in the right OFC (P = .037) and occipital gyrus (P = .002) at baseline was significantly correlated with the magnitude of the normalization in those regions at 1-year follow-up. In contrast, abnormalities of ALFF in the bilateral thalamus, ventral medial prefrontal cortex, precuneus, and right amygdala and of FC between the right OFC and the dorsal medial prefrontal cortex at baseline did not improve in patients at 1-year follow-up. Conclusion These findings show that some, but not all, neurophysiologic alterations that occur during the acute phase of schizophrenia are normalized in the context of clinical improvement and suggest therapeutic implications for

  10. Treatment of Adjustment Disorder with Anxiety: A September 11, 2001, Case Study with a 1-Year Follow-Up

    ERIC Educational Resources Information Center

    Powell, Shawn; McCone, Dave

    2004-01-01

    This article describes the application of cognitive behavioral therapy in the treatment of a 20-year-old White male manifesting an adjustment disorder with anxiety, who initially presented on September 11, 2001, following the terrorist attacks. The initial treatment regime lasted 8 weeks. In addition, follow-up sessions at 6, 11, and 12 months…

  11. PEEK Cages versus PMMA Spacers in Anterior Cervical Discectomy: Comparison of Fusion, Subsidence, Sagittal Alignment, and Clinical Outcome with a Minimum 1-Year Follow-Up

    PubMed Central

    Krüger, Marie T.; Sircar, Ronen; Kogias, Evangelos; Scholz, Christoph; Volz, Florian; Scheiwe, Christian; Hubbe, Ulrich

    2014-01-01

    Purpose. To compare radiographic and clinical outcomes after anterior cervical discectomy in patients with cervical degenerative disc disease using PEEK cages or PMMA spacers with a minimum 1-year follow-up. Methods. Anterior cervical discectomy was performed in 107 patients in one or two levels using empty PEEK cages (51 levels), Sulcem PMMA spacers (49 levels) or Palacos PMMA spacers (41 levels) between January, 2005 and February, 2009. Bony fusion, subsidence, and sagittal alignment were retrospectively assessed in CT scans and radiographs at follow-up. Clinical outcome was measured using the VAS, NDI, and SF-36. Results. Bony fusion was assessed in 65% (PEEK cage), 57% (Sulcem), and 46% (Palacos) after a mean follow-up of 2.5 years. Mean subsidence was 2.3–2.6 mm without significant differences between the groups. The most pronounced loss of lordosis was found in PEEK cages (−4.1°). VAS was 3.1 (PEEK cage), 3.6 (Sulcem), and 2.7 (Palacos) without significant differences. Functional outcome in the PEEK cage and Palacos group was superior to the Sulcem group. Conclusions. The substitute groups showed differing fusion rates. Clinical outcome, however, appears to be generally not correlated with fusion status or subsidence. We could not specify a superior disc substitute for anterior cervical discectomy. This trial is registered with DRKS00003591. PMID:25110734

  12. The Effect of Exposure to Persistent Organic Pollutants on Metabolic Health among KOREAN Children during a 1-Year Follow-Up

    PubMed Central

    Lee, Hye Ah; Park, Su Hyun; Hong, Young Sun; Ha, Eun Hee; Park, Hyesook

    2016-01-01

    Previous evidence suggests the potential for adverse effects of persistent organic pollutants (POPs) on metabolic health even at low-dose exposure levels common among the general population, but there is less evidence of these associations among children. Therefore, as part of a prospective cohort study, 214 children were measured for POPs exposure. After the 1-year follow-up, we assessed the effect of circulating POPs exposure among 158 children aged 7–9 years (at baseline) on the change of metabolic components of metabolic syndrome using multiple regression analysis. In addition, we calculated the continuous metabolic syndrome (cMetS) score and assessed the variation among individuals by POPs exposure. The concentrations of marker polychlorinated biphenyls (PCBs) were significantly associated with increased change in diastolic blood pressure (BP) and triglyceride levels during a 1-year follow-up, after controlling for sex, age, household income, and change in body mass index. Total PCBs also showed a marginal association with increasing cMetS score from the baseline. Of the metabolic components, change in diastolic BP over time showed a notable association with specific PCBs, but no association with organochlorine pesticides. Here, we found that low-dose exposures to PCBs among children in the general population could negatively influence metabolic health, particularly diastolic BP. Increased disease sensitivity during childhood can continue to adulthood, thus, these results support the need for continuous assessment of the health impact of POPs. PMID:26938545

  13. Risk and protective factors for peer victimization: a 1-year follow-up study of urban American students.

    PubMed

    Karlsson, Elisabeth; Stickley, Andrew; Lindblad, Frank; Schwab-Stone, Mary; Ruchkin, Vladislav

    2014-09-01

    This study examined whether internalizing problems, parental warmth and teacher support were associated with adolescents' experience of future peer victimization in school. Data were drawn from two rounds of the longitudinal Social and Health Assessment (SAHA). Study subjects comprised 593 US urban adolescents (aged 13.8 ± 0.8 years; 56 % female). Results showed that there was a substantial degree of continuity in peer victimization over a 1-year period. The presence of internalizing (anxiety, depressive and somatic) symptoms at baseline was associated with an increased risk of peer victimization over time. Both parental warmth and teacher support were uniquely associated with a lower risk for peer victimization. Implications of these findings for prevention efforts are discussed. PMID:24346176

  14. Does multicomponent physical exercise with simultaneous cognitive training boost cognitive performance in older adults? A 6-month randomized controlled trial with a 1-year follow-up

    PubMed Central

    Eggenberger, Patrick; Schumacher, Vera; Angst, Marius; Theill, Nathan; de Bruin, Eling D

    2015-01-01

    Background Cognitive impairment is a health problem that concerns almost every second elderly person. Physical and cognitive training have differential positive effects on cognition, but have been rarely applied in combination. This study evaluates synergistic effects of multicomponent physical exercise complemented with novel simultaneous cognitive training on cognition in older adults. We hypothesized that simultaneous cognitive–physical components would add training specific cognitive benefits compared to exclusively physical training. Methods Seniors, older than 70 years, without cognitive impairment, were randomly assigned to either: 1) virtual reality video game dancing (DANCE), 2) treadmill walking with simultaneous verbal memory training (MEMORY), or 3) treadmill walking (PHYS). Each program was complemented with strength and balance exercises. Two 1-hour training sessions per week over 6 months were applied. Cognitive performance was assessed at baseline, after 3 and 6 months, and at 1-year follow-up. Multiple regression analyses with planned comparisons were calculated. Results Eighty-nine participants were randomized to the three groups initially, 71 completed the training, while 47 were available at 1-year follow-up. Advantages of the simultaneous cognitive–physical programs were found in two dimensions of executive function. “Shifting attention” showed a time×intervention interaction in favor of DANCE/MEMORY versus PHYS (F[2, 68] =1.95, trend P=0.075, r=0.17); and “working memory” showed a time×intervention interaction in favor of DANCE versus MEMORY (F[1, 136] =2.71, trend P=0.051, R2=0.006). Performance improvements in executive functions, long-term visual memory (episodic memory), and processing speed were maintained at follow-up in all groups. Conclusion Particular executive functions benefit from simultaneous cognitive–physical training compared to exclusively physical multicomponent training. Cognitive–physical training programs

  15. Evaluation of the Mandibular Function, after Nonsurgical Treatment of Unilateral Subcondylar Fracture: A 1-Year Follow-Up Study.

    PubMed

    K M, Sudheesh; Desai, Rajendra; K Sn, Siva Bharani; S, Subhalakshmi

    2016-09-01

    There are no clearly defined guidelines for when an open or closed treatment is indicated for treatment of mandibular condylar fractures. The aim of the study is to analyze the mandibular function after nonsurgical treatment of unilateral subcondylar fractures, in a prospective study. A prospective study was conducted on 30 patients with unilateral mandibular subcondylar fracture undergoing nonsurgical treatment. Clinical and radiographic examinations were done prior to treatment and at 12-month follow-up. Pain, perceived occlusion, mouth opening, protrusion, and horizontal movements of the mandible were evaluated by clinical examination. Radiologic evaluation was done using Panoramic and Reverse Towne's radiographs. At 12-month follow-up, there was minimal pain in the temporomandibular joint region, there was an improvement in the perceived occlusion, and mouth opening did not reduce. There was insignificant absolute difference between left and right lateral mandibular movements. The amount of increase in the protrusion of mandible was insignificant. On radiographic evaluation, the degree of coronal and sagittal displacement was insignificant at follow-up. Mean ramus height pretreatment and 12 months posttreatment were 0.98 ± 0.50 and 0.87 ± 0.47, respectively. Based on this study, patients had adequate mandibular function and minimal pain after nonsurgical treatment. Unilateral subcondylar fractures of the mandible can be treated nonsurgically in patients with minimal occlusal discrepancies, adequate mouth opening, minimal displacement of condyle, and minimal ramus height shortening. PMID:27516838

  16. No evidence of persistent parvovirus B19 viremia among Iranian patients with HIV after a 1-year follow-up.

    PubMed

    Aghakhani, Arezoo; Mohraz, Minoo; Azadmanesh, Kayhan; Moayedi-Nia, Saeedeh; Kazemimanesh, Monireh; Mamishi, Setareh; Banifazl, Mohammad; Ramezani, Amitis

    2016-05-01

    Recent studies have demonstrated that, in common with other latent viruses, parvovirus B19 infection can be controlled by the host immune response but may persist in some places such as the bone marrow. Persistent B19 infection has been found in both immunocompetent and immunocompromised individuals, such as patients infected with human immunodeficiency virus (HIV). However, there is limited data regarding long-term B19 viremia in HIV patients. In this study, we investigated virological and hematological findings, and also the clinical outcome, of seven cases of HIV/B19 coinfection (confirmed by PCR) after one year. These cases were provided from a previous study on patients with HIV infection that found B19 DNA in 13 cases. Seven of these 13 patients were available after 1 year, and we retested them for B19 viremia and B19-specific antibodies. B19 IgG was tested by ELISA, and B19 DNA was assessed by nested PCR. Anemia was not observed in these cases. All subjects had cleared viremia, but B19 IgG seroconversion occurred in two cases. No significant changes in CD4 and hemoglobin occurred. The results of this study indicate that B19 infection in HIV patients is a subtle infection and that B19 viremia is not a long-term event. PMID:26860911

  17. Functional and muscle morphometric effects of ACL reconstruction. A prospective CT study with 1 year follow-up.

    PubMed

    Lindström, M; Strandberg, S; Wredmark, T; Felländer-Tsai, L; Henriksson, M

    2013-08-01

    Computed tomography (CT) was used to explore if changes in muscle cross-sectional area and quality after anterior cruciate ligament (ACL) injury and reconstruction would be related to knee function. Fourteen females and 23 males (16-54 years) underwent clinical tests, subjective questionnaires, and CT 1 week before and 1 year after ACL surgery with semitendinosus-gracilis (STG) graft and rehabilitation. Postoperatively, knee laxity was decreased and functional knee measures and subjective patient scores improved. The most obvious remaining deficit was the quadriceps atrophy, which was significantly larger if the right leg was injured. Right-leg injury also tended to cause larger compensatory hypertrophy of the combined knee flexor and tibial internal rotator muscles (preoperatively). The quadriceps atrophy was significantly correlated with the scores and functional tests, the latter also being related to the remaining size of the gracilis muscle. Biceps femoris hypertrophy and, in males only, semimembranosus hypertrophy was observed following the ACL reconstruction. The lack of semimembranosus hypertrophy in the women could, via tibial internal rotation torque deficit, contribute to the less favorable functional and subjective outcome recorded for the women. The results indicate that the quadriceps, the combined knee flexor/tibial internal rotator muscles, side of ACL injury, and sex are important to consider in rehabilitation after STG graft. PMID:22107159

  18. A prevention program for disturbed eating and body dissatisfaction in adolescent girls: a 1 year follow-up.

    PubMed

    Paxton, S J

    1993-03-01

    This study evaluated an intervention program to reduce moderate and extreme weight loss behaviors, disordered eating and low body image. The Body Image and Eating Behavior Intervention Program consisted of five specialized classes addressing media images of women, determinants of body size, healthy and unhealthy weight control methods, and emotional eating. The program was conducted in year 9 in Schools 1 (n = 80) and 2 (n = 27), while students from the same year in School 3 (n = 29) were control subjects. Participants completed self-report questionnaires assessing eating behavior and body image attitudes prior to the program, 1 months after the program and at 12 months follow-up, while control subjects completed the questionnaires at the same time but did not receive the program. Data were analyzed using groups (Schools 1, 2 and 3) by testing occasion (pre, post and follow-up) analyses of variance with repeated measures on testing occasion. Measures of disordered eating and frequency of use of extreme weight loss behaviors were constant over testing occasion and showed no effect of the intervention program. Body dissatisfaction was consistently lower in School 1 but increased across all subjects over the year. The implications of these data for school-based intervention programs in this area are examined. PMID:11067184

  19. Deep Brain Stimulation of the Globus Pallidus Internus in Patients with Intractable Tourette Syndrome: A 1-year Follow-up Study

    PubMed Central

    Zhang, Xiao-Hua; Li, Jian-Yu; Zhang, Yu-Qing; Li, Yong-Jie

    2016-01-01

    Background: Deep brain stimulation (DBS) has been a promising treatment for patients with refractory Tourette syndrome (TS) for more than a decade. Despite successful DBS treatment of TS in more than 100 patients worldwide, studies with a large patient sample and long-term follow-up assessments are still scarce. Accordingly, we investigated the clinical efficacy and safety of globus pallidus internus (GPi) DBS in the treatment of intractable TS in 24 patients with a 1-year follow-up assessment. Methods: Bilateral/unilateral GPi-DBS was performed in 24 patients with TS. We evaluated symptoms of tics and obsessive-compulsive disorder (OCD) through the Yale Global Tic Severity Scale (YGTSS) and Yale-Brown Obsessive-compulsive Scale (Y-BOCS). We used the Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC) to evaluate the safety of the treatment. We conducted follow-up assessments of all patients for at least 12 months (12–99 months). Results: Symptoms of tics and OCD were significantly relieved at a 12-month follow-up assessment. The mean YGTSS score was 74.04 ± 11.52, 49.83 ± 10.91, 32.58 ± 7.97, and 31.21 ± 8.87 at baseline, 3, 6, and 12 months, respectively. The mean YGTSS scores obtained at the follow-up assessments were significantly different from the baseline (P < 0.05). The improvement in motor tics was superior to that in phonic tics. The mean Y-BOCS scores were 21.61 ± 4.97, 18 ± 4.58, 14.39 ± 3.99, and 13.78 ± 4.56 at baseline, 3, 6, and 12 months, respectively (P < 0.05). We observed a remarkable improvement in psychiatric comorbidities, such as OCD and attention-deficit hyperactivity disorder, after the procedure. WAIS-RC scores were comparable before and after the operation. There were no severe postoperative complications. Conclusion: GPi-DBS appears to comprehensively alleviate tic symptoms and psychiatric comorbidities in patients with TS, thus significantly improving patients’ quality of life. PMID:27098785

  20. Dynamics of resilience in forced migration: a 1-year follow-up study of longitudinal associations with mental health in a conflict-affected, ethnic Muslim population

    PubMed Central

    Siriwardhana, Chesmal; Abas, Melanie; Siribaddana, Sisira; Sumathipala, Athula; Stewart, Robert

    2015-01-01

    Objective The concept of ‘resilience’ is of increasing interest in studies of mental health in populations facing adversity. However, lack of longitudinal data on the dynamics of resilience and non-usage of resilience-specific measurements have prevented a better understanding of resilience-mental health interactions. Hence, the present study was conducted to investigate the stability of levels of resilience and its associations with sociodemographic and mental health exposures in a conflict-affected internal-migrant population in Sri Lanka. Design A prospective follow-up study of 1 year. Setting Puttalam district of North Western province in postconflict Sri Lanka (baseline in 2011, follow-up in 2012). Participants An ethnic Muslim population internally displaced 20 years ago (in 1990) from Northern Sri Lanka, aged 18 or above and currently in the process of return migration. Measures It was hypothesised that levels of resilience would be associated with mental health outcomes. Resilience was measured on both occasions using the 14-item Resilience Scale (RS-14), social support by the Multidimensional Social Support Scale and Lubben Social Network Scale and common mental disorders by the Patient Health Questionnaire (PHQ). Results Of 450 participants interviewed at baseline in 2011, 338 (75.1%) were re-interviewed in 2012 after a 1-year follow-up. The mean resilience scores measured by RS-14 were 80.2 (95% CI 78.6 to 81.9) at baseline and 84.9 (83.5 to 86.3) at follow-up. At both time points, lower resilience was independently associated with food insecurity, lower social support availability and social isolation. At both time points, there were significant associations with common mental disorders (CMDs) in unadjusted analyses, but they only showed independence at baseline. The CMD prevalence, maintenance and incidence at follow-up was 8.3%, 28.2% and 2.2%, respectively. Conclusions In this displaced population facing a potential reduction in adversity

  1. Endovascular Treatment of a Bleeding Secondary Aorto-Enteric Fistula. A Case Report with 1-Year Follow-up

    SciTech Connect

    Brountzos, Elias N. Vasdekis, Spyros; Kostopanagiotou, Georgia; Danias, Nikolaos; Alexopoulou, Efthymia; Petropoulou, Konstantina; Gouliamos, Athanasios; Perros, Georgios

    2007-09-15

    We report a patient with life-threatening gastrointestinal bleeding caused by a secondary aorto-enteric fistula. Because the patient had several comorbid conditions, we successfully stopped the bleeding by endovascular placement of a bifurcated aortic stent-graft. The patient developed periaortic infection 4 months later, but he was managed with antibiotics. The patient is well 1 year after the procedure.

  2. Decrease in Television Viewing Predicts Lower Body Mass Index at 1-Year Follow-Up in Adolescents, but Not Adults

    ERIC Educational Resources Information Center

    French, Simone A.; Mitchell, Nathan R.; Hannan, Peter J.

    2012-01-01

    Objective: To examine associations between television viewing, sugar-sweetened beverage consumption, eating out, physical activity, and body weight change over 1 year. Design: Secondary data analysis from randomized intervention trial. Setting: Households in the community. Participants: Adults (n = 153) and adolescents (n = 72) from the same…

  3. Consultation-Based Academic Interventions for Children with Attention Deficit Hyperactivity Disorder: Effects on Reading and Mathematics Outcomes at 1-Year Follow-Up

    ERIC Educational Resources Information Center

    Volpe, Robert J.; DuPaul, George J.; Jitendra, Asha K.; Tresco, Katy E.

    2009-01-01

    The purpose of this follow-up study was to evaluate the effectiveness of two consultation-based models to enhance the educational functioning of children with attention deficit hyperactivity disorder (ADHD) after 1 year of no treatment. Children (N = 167) meeting "Diagnostic Statistical Manual" (4th ed., text revision; 2000) criteria for attention…

  4. Follow-up of a 1-year media campaign on delay times and ambulance use in suspected acute myocardial infarction.

    PubMed

    Herlitz, J; Blohm, M; Hartford, M; Karlson, B W; Luepker, R; Holmberg, S; Risenfors, M; Wennerblom, B

    1992-02-01

    In order to reduce the delay times from onset of symptoms to arrival in hospital, and increase the use of ambulance in patients with suspected acute myocardial infarction (AMI), a media campaign was initiated in an urban area. An initial 3-week intense campaign was followed by a maintenance phase of 1 year. Delay times and ambulance use during the campaign were compared with the previous 21 months. Among patients admitted to a coronary care unit (CCU) due to suspected AMI, the median delay time was reduced from 3 h to 2 h 40 min and the mean delay time was reduced from 11 h 33 min to 7 h 42 min (P less than 0.001). Among patients with confirmed AMI the median delay time was reduced from 3 h to 2 h 20 min and the mean delay time from 10 h to 6 h 27 min (P less than 0.001). We conclude that a 1-year media campaign can reduce delay times in suspected AMI, and that this effect appears to continue at 1 year, but ambulance use seems to be more difficult to influence. PMID:1555612

  5. Transcatheter aortic valve implantation in very elderly patients: immediate results and medium term follow-up

    PubMed Central

    Pascual, Isaac; Muñoz-García, Antonio J; López-Otero, Diego; Avanzas, Pablo; Jimenez-Navarro, Manuel F; Cid-Alvarez, Belén; del Valle, Raquel; Alonso-Briales, Juan H; Ocaranza-Sanchez, Raimundo; Hernández, José M; Trillo-Nouche, Ramiro; Morís, César

    2015-01-01

    Objective To evaluate immediate transcatheter aortic valve implantation (TAVI) results and medium-term follow-up in very elderly patients with severe and symptomatic aortic stenosis (AS). Methods This multicenter, observational and prospective study was carried out in three hospitals. We included consecutive very elderly (> 85 years) patients with severe AS treated by TAVI. The primary endpoint was to evaluate death rates from any cause at two years. Results The study included 160 consecutive patients with a mean age of 87 ± 2.1 years (range from 85 to 94 years) and a mean logistic EuroSCORE of 18.8% ± 11.2% with 57 (35.6%) patients scoring ≥ 20%. Procedural success rate was 97.5%, with 25 (15.6%) patients experiencing acute complications with major bleeding (the most frequent). Global mortality rate during hospitalization was 8.8% (n = 14) and 30-day mortality rate was 10% (n = 16). Median follow up period was 252.24 ± 232.17 days. During the follow-up period, 28 (17.5%) patients died (17 of them due to cardiac causes). The estimated two year overall and cardiac survival rates using the Kaplan-Meier method were 71% and 86.4%, respectively. Cox proportional hazard regression showed that the variable EuroSCORE ≥ 20 was the unique variable associated with overall mortality. Conclusions TAVI is safe and effective in a selected population of very elderly patients. Our findings support the adoption of this new procedure in this complex group of patients. PMID:26345138

  6. Predictors of poststroke health-related quality of life in Nigerian stroke survivors: a 1-year follow-up study.

    PubMed

    Hamza, Ashiru Mohammad; Al-Sadat, Nabilla; Loh, Siew Yim; Jahan, Nowrozy Kamar

    2014-01-01

    This study aims to identify the predictors in the different aspects of the health-related quality of life (HRQoL) and to measure the changes of functional status over time in a cohort of Nigerian stroke survivors. A prospective observational study was conducted in three hospitals of Kano state of Nigeria where stroke survivors receive rehabilitation. The linguistic-validated Hausa versions of the stroke impact scale 3.0, modified Rankin scale, Barthel index and Beck depression inventory scales were used. Paired samples t-test was used to calculate the amount of changes that occur over time and the forward stepwise linear regression model was used to identify the predictors. A total of 233 stroke survivors were surveyed at 6 months, and 93% (217/233) were followed at 1 year after stroke. Functional disabilities were significantly reduced during the recovery phase. Motor impairment, disability, and level of depression were independent predictors of HRQoL in the multivariate regression analysis. The involvement of family members as caregivers is the key factor for those survivors with improved functional status. Thus, to enhance the quality of poststroke life, it is proposed that a holistic stroke rehabilitation service and an active involvement of family members are established at every possible level. PMID:24982864

  7. Predictors of Poststroke Health-Related Quality of Life in Nigerian Stroke Survivors: A 1-Year Follow-Up Study

    PubMed Central

    Hamza, Ashiru Mohammad; Al-Sadat, Nabilla; Loh, Siew Yim; Jahan, Nowrozy Kamar

    2014-01-01

    This study aims to identify the predictors in the different aspects of the health-related quality of life (HRQoL) and to measure the changes of functional status over time in a cohort of Nigerian stroke survivors. A prospective observational study was conducted in three hospitals of Kano state of Nigeria where stroke survivors receive rehabilitation. The linguistic-validated Hausa versions of the stroke impact scale 3.0, modified Rankin scale, Barthel index and Beck depression inventory scales were used. Paired samples t-test was used to calculate the amount of changes that occur over time and the forward stepwise linear regression model was used to identify the predictors. A total of 233 stroke survivors were surveyed at 6 months, and 93% (217/233) were followed at 1 year after stroke. Functional disabilities were significantly reduced during the recovery phase. Motor impairment, disability, and level of depression were independent predictors of HRQoL in the multivariate regression analysis. The involvement of family members as caregivers is the key factor for those survivors with improved functional status. Thus, to enhance the quality of poststroke life, it is proposed that a holistic stroke rehabilitation service and an active involvement of family members are established at every possible level. PMID:24982864

  8. High Remission Rate of Chronic Immune Thrombocytopenia in Children: Result of 20-Year Follow-Up

    PubMed Central

    Kim, Chae Young; Lee, Eun Hye

    2016-01-01

    Purpose This study examined the outcomes of children with chronic immune thrombocytopenia (ITP). Materials and Methods We retrospectively analyzed the medical records of all patients diagnosed with ITP from January 1992 to December 2011 at our institution. Results A total of 128 patients (64%) satisfied the criteria for newly diagnosed ITP, 31 (15%) for persistent ITP, and 41 (21%) for chronic ITP. The median age at diagnosis was 4.5 years (range, 1 month to 18 years). The median platelet count at diagnosis was 32×109/L. A comparison of the initial treatment data from 2001 to 2011 with those from 1992 to 2000 showed that the number of bone marrow examinations decreased, whereas observation increased. Chronic ITP presented at an older age than newly diagnosed and persistent ITP (6.6 years vs. 3.8 years vs. 4.1 years, respectively); however, the difference did not reach statistical significance (p=0.17). The probability of complete remission of chronic ITP was 50% and 76% at 2 and 5 years after diagnosis, respectively. Patients aged <1 year at diagnosis had a significantly better prognosis than did older patients (hazard ratio, 3.86; p=0.02). Conclusion Children with chronic ITP showed a high remission rate after long-term follow-up. This study suggests that invasive treatments such as splenectomy in children with chronic ITP can be delayed for 4 to 5 years if thrombocytopenia and therapeutic medication do not affect the quality of life. PMID:26632392

  9. ‘Simplicity’ radiofrequency neurotomy of sacroiliac joint: a real life 1-year follow-up UK data

    PubMed Central

    Anjana Reddy, Vinay S; Sharma, Chhaya; Chang, Kuang-Yi; Mehta, Vivek

    2016-01-01

    Background: Sacroiliac joint (SIJ) pain is considered to be the third most common cause of low back pain with the prevalence of 13–25% in all low back pain patients. Its diagnosis and treatment remain a challenge with the poor evidence base for interventional procedures. Patients with SIJ pain experience a low quality of life, worse than some of the chronic health conditions. Simplicity radiofrequency (RF) neurotomy is a novel technique which tackles some of the problems faced by conventional RF neurotomy and may offer better results in managing pain arising from SIJ. Aim: The purpose of this retrospective review of practice was to look into the effectiveness of Simplicity RF neurotomy in terms of pain relief, quality of health improvement in patients suffering from SIJ pain and complications associated with the procedure. Methodology: Retrospective review of the patients undergoing Simplicity RF neurotomy at a tertiary hospital (April 2012 to June 2013). Pain scores and responses to SF (Short Form) 12 questionnaire before and at 12 months after treatment were compared using the Wilcoxon signed-rank test. Results: Out of 26 patients, 16 were considered for analysis. There was statistically significant reduction in both mean pain score (Numerical Rating Scale, NRS from 8.8 pre-intervention to 4.3 post-intervention) and median pain score (NRS from 9 pre-intervention to 5 post-intervention) with a p-value of <0.001 at 12 months. Reduction in the inter-quartile range of pain score was observed from 8–10 to 2.25–6 (p-value of <0.001). Global health as per SF12 scores showed statistically significant improvement, except in some of the psychological subcategories. The procedure-related pain was the only complication noted. Conclusion: From our data, we can conclude that Simplicity RF neurotomy of lateral branches of S1-S3 along with conventional RF denervation of L5 dorsal ramus may improve pain scores and many components of global health in carefully selected

  10. Cognitive behavioural therapy for depression in multiple endocrine neoplasia type IIB: a 1-year follow-up

    PubMed Central

    Mejía-Castrejón, Jessica; Landa-Ramírez, Edgar

    2014-01-01

    This case report describes a 24-year-old man diagnosed with multiple endocrine neoplasia type IIB and major depression. Because cognitive behavioural therapy (CBT) has proven effective in the treatment of major depression in the general population and patients with cancer, we decided to adapt and use this therapy and evaluate its impact on major depression and the patient’s quality of life. The therapy was conducted individually in 15 sessions that were given over a span of 25 weeks. The data show that therapy was a useful treatment that reduced depression according to the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria and self-report instruments. CBT also helped improve the patient’s quality of life, and it was considered to be an acceptable intervention for the patient, with ongoing positive results 1 year after the last psychotherapy session. CBT is a potential option for treating depression in this population but further research is needed. PMID:24898996

  11. Covered Stents in the Treatment of Peripheral Arterial Aneurysms: Procedural Results and Midterm Follow-Up

    SciTech Connect

    Beregi, Jean-Paul; Prat, Alain; Willoteaux, Serge; Vasseur, Marc-Antoine; Boularand, Valerie; Desmoucelle, Frederic

    1999-01-15

    Purpose: To evaluate initial and midterm results of percutaneous treatment of peripheral aneurysms using covered stents. Methods: Between June 1994 and December 1997 we used covered stents (EndoPro System or Passager) on 19 patients with peripheral aneurysms (7 iliac, 5 subclavian, 3 femoral, 3 popliteal, 1 carotid). Results: Successful aneurysm exclusion was achieved in 18 of 19 patients (95%). In the short term (<30 days), one patient died of puncture site hemorrhage complicated by myocardial infarction; two femoral stents were surgically removed because of leakage. At subsequent follow-up (mean 20 months) two further unrelated deaths occurred. At 1 year (intention-to-treat) the stent was patent in 13 of 19 patients (68%) and the aneurysm was excluded in 17 of 19 (89%). Conclusion: Treatment of peripheral aneurysms with covered stents has a high rate of immediate procedural success. Continued exclusion of the aneurysms is achieved in a large proportion of patients but there is a relatively high rate of stent thrombosis.

  12. Virtual Reality-Enhanced Cognitive-Behavioral Therapy for Morbid Obesity: A Randomized Controlled Study with 1 Year Follow-Up.

    PubMed

    Manzoni, Gian Mauro; Cesa, Gian Luca; Bacchetta, Monica; Castelnuovo, Gianluca; Conti, Sara; Gaggioli, Andrea; Mantovani, Fabrizia; Molinari, Enrico; Cárdenas-López, Georgina; Riva, Giuseppe

    2016-02-01

    It is well known that obesity has a multifactorial etiology, including biological, environmental, and psychological causes. For this reason, obesity treatment requires a more integrated approach than the standard behavioral treatment based on dietary and physical activity only. To test the long-term efficacy of an enhanced cognitive-behavioral therapy (CBT) of obesity, including a virtual reality (VR) module aimed at both unlocking the negative memory of the body and to modify its behavioral and emotional correlates, 163 female morbidly obese inpatients (body mass index >40) were randomly assigned to three conditions: a standard behavioral inpatient program (SBP), SBP plus standard CBT, and SBP plus VR-enhanced CBT. Patients' weight, eating behavior, and body dissatisfaction were measured at the start and upon completion of the inpatient program. Weight was assessed also at 1 year follow-up. All measures improved significantly at discharge from the inpatient program, and no significant difference was found among the conditions. However, odds ratios showed that patients in the VR condition had a greater probability of maintaining or improving weight loss at 1 year follow-up than SBP patients had (48% vs. 11%, p = 0.004) and, to a lesser extent, than CBT patients had (48% vs. 29%, p = 0.08). Indeed, only the VR-enhanced CBT was effective in further improving weight loss at 1 year follow-up. On the contrary, participants who received only the inpatient program regained back, on average, most of the weight they had lost. Findings support the hypothesis that a VR module addressing the locked negative memory of the body may enhance the long-term efficacy of standard CBT. PMID:26430819

  13. Handgrip strength, quadriceps muscle power, and optimal shortening velocity roles in maintaining functional abilities in older adults living in a long-term care home: a 1-year follow-up study

    PubMed Central

    Kozicka, Izabela; Kostka, Tomasz

    2016-01-01

    Purpose To assess the relative role of handgrip strength (HGS), quadriceps muscle power (Pmax), and optimal shortening velocity (υopt) in maintaining functional abilities (FAs) in older adults living in a long-term care home over a 1-year follow-up. Subjects and methods Forty-one inactive older institutionalized adults aged 69.8±9.0 years participated in this study. HGS, Pmax, υopt, cognitive function using the Mini-Mental State Examination, depressive symptoms using the Geriatric Depression Scale, nutritional status using the Mini Nutritional Assessment (MNA), and physical activity (PA) using the Seven-Day Physical Activity Recall Questionnaire were assessed at baseline and at 1-year follow-up. FAs were assessed with activities of daily living (ADL), instrumental ADL, and Timed Up & Go test. Results Both at baseline and at follow-up, FAs were related to age, HGS, Pmax/kg, υopt, MNA, and PA. These associations were generally similar in both sexes. As revealed in multiple regression analysis, υopt was the strongest predictor of FA, followed by Pmax/kg, PA, and MNA. FA deteriorated after 1 year as measured by ADL and Timed Up & Go test. Pmax and υopt, but not HGS, also decreased significantly after 1 year. Nevertheless, 1-year changes in FAs were not related to changes in HGS, Pmax, υopt, or PA. Conclusion The 1-year period of physical inactivity among older institutionalized adults was found to have a negative effect on their FAs, Pmax, and υopt. The present study demonstrates that Pmax and, especially, υopt correlated with FAs of older adults more than HGS, both at baseline and at follow-up. Despite this, 1-year natural fluctuations of PA, Pmax, and υopt are not significant enough to influence FAs in inactive institutionalized older adults. PMID:27307720

  14. Early intervention and prevention of anxiety disorders in children: results at 2-year follow-up.

    PubMed

    Dadds, M R; Holland, D E; Laurens, K R; Mullins, M; Barrett, P M; Spence, S H

    1999-02-01

    The Queensland Early Intervention and Prevention of Anxiety Project evaluated a child- and family-focused group intervention for preventing anxiety problems in children. This article reports on 12- and 24-month follow-up data to previously reported outcomes at posttreatment and at 6-month follow-up. A total of 1,786 7- to 14-year-olds were screened for anxiety problems using teacher nominations and children's self-report. After diagnostic interviews, 128 children were selected and assigned to either a 10-week school-based child- and parent-focused psychosocial intervention or a monitoring group. Both groups showed improvements immediately at postintervention and at 6-month follow-up; the improvement was maintained in the intervention group only reducing the rate of existing anxiety disorder and preventing the onset of new anxiety disorders. At 12 months, the groups converged, but the superiority of the intervention group was evident again at 2-year follow-up. Severity of pretreatment diagnoses, gender, and parental anxiety predicted poor initial response to intervention, whereas pretreatment severity was the only predictor of chronicity at 24 months. Overall, follow-up results show that a brief school-based intervention for children can produce durable reductions in anxiety problems. PMID:10028219

  15. Follow-up after gastrectomy for cancer: results of an international web round table.

    PubMed

    Baiocchi, Gian Luca; Kodera, Yasuhiro; Marrelli, Daniele; Pacelli, Fabio; Morgagni, Paolo; Roviello, Franco; De Manzoni, Giovanni

    2014-09-14

    Oncological follow-up after radical gastrectomy for cancer still represents a discrepancy in the field, with many retrospective series demonstrating that early diagnosis of recurrence does not result in an improvement in patient survival; yet, many centers with high quality of care still provide routine patient follow-up after surgery by clinical and instrumental controls. This was the topic for a web round table entitled "Rationale and limits of oncological follow-up after gastrectomy for cancer" that was launched one year before the 10(th) International Gastric Cancer Congress. Authors having specific expertise were invited to comment on their previous publications to provide the subject for an open debate. During a three-month-long discussion, 32 authors from 12 countries participated, and 2299 people visited the dedicated web page. Substantial differences emerged between the participants: authors from Japan, South Korea, Italy, Brazil, Germany and France currently engage in instrumental follow-up, whereas authors from Eastern Europe, Peru and India do not, and British and American surgeons practice it in a rather limited manner or in the context of experimental studies. Although endoscopy is still considered useful by most authors, all the authors recognized that computed tomography scanning is the method of choice to detect recurrence; however, many limit follow-up to clinical and biochemical examinations, and acknowledge the lack of improved survival with early detection. PMID:25232232

  16. Follow-up actions from positive results of in vitro genetic toxicity testing

    EPA Science Inventory

    Appropriate follow-up actions and decisions are needed when evaluating and interpreting clear positive results obtained in the in vitro assays used in the initial genotoxicity screening battery (i.e., the battery of tests generally required by regulatory authorities) to assist in...

  17. Salter-Harris type III and IV displaced fracture of the hallux in young gymnasts: A series of four cases at 1-year follow-up.

    PubMed

    Perugia, Dario; Fabbri, Mattia; Guidi, Marco; Lepri, Marco; Masi, Vincenzo

    2014-12-01

    The purpose of this study was to describe four exceptional cases of Salter-Harris type III and IV fractures of the proximal phalanx of the hallux in young high-level gymnasts. All gymnasts underwent the same mechanism of injury of hyperadduction, which indicates a role of the abductor hallucis muscle in the genesis and displacement of these fractures. An open reduction and internal fixation was performed to achieve an anatomical reduction and avoid chronic disability. At 1-year follow-up, all patients had an excellent American Orthopaedic Foot and Ankle Society (AOFAS) score (100 points), and there was no shortening or angulation of the first ray and no evidence of degenerative joint disease on X-ray. Moreover, all the gymnasts had returned to pre-injury levels of sporting activity. To our knowledge, there are no previous studies that address these types of injuries and how they are handled in gymnasts. PMID:25457317

  18. Arthroscopic treatment of the discoid lateral meniscus: results of long-term follow-up.

    PubMed

    Vandermeer, R D; Cunningham, F K

    1989-01-01

    Twenty-two patients (25 knees) were evaluated at an average follow-up of 54 months for clinical results of arthroscopic treatment of the discoid lateral meniscus syndrome. Discoid lateral menisci were classified arthroscopically as incomplete (92%) or complete (8%); no Wrisberg-type lesions were noted. Three patients (14%) had bilateral lesions. Symptomatic torn discoid menisci (20 knees) and torn discoid menisci with other significant symptomatic lesions (3 knees) underwent arthroscopic partial lateral meniscectomy utilizing the saucerization technique. Asymptomatic intact discoid menisci (2 knees) were left unresected. Using the knee scale of Ikeuchi, 55% of the symptomatic torn lesions were rated as excellent or good, 30% were rated as fair, and 15% were rated as poor at follow-up. Two of the 3 asymptomatic torn lesions were rated as excellent or good, as were both of the intact discoid lesions. Factors associated with an unsatisfactory rating at follow-up included preexistent degenerative changes, age, and sex. Duration of symptoms, type of discoid tear, and length of follow-up were not necessarily related to outcome results. Seven knees (28%) required arthroscopic reevaluation at a postoperative average of 23 months, documenting apparent physiologic function of the saucerized rim in 4 patients and failure of saucerization in 3 patients (12%). Overall, 14 of the 22 patients in this study (64%) resumed a normal activity level postoperatively, including 61% of those with symptomatic torn discoid lateral menisci. PMID:2736005

  19. Effects of interleukin-6, interleukin-18, and statin use, evaluated at acute stroke, on post-stroke depression during 1-year follow-up.

    PubMed

    Kang, Hee-Ju; Bae, Kyung-Yeol; Kim, Sung-Wan; Kim, Joon-Tae; Park, Man-Seok; Cho, Ki-Hyun; Kim, Jae-Min

    2016-10-01

    Proinflammatory cytokines are associated with the development of post-stroke depression (PSD). Statins are thought to possess anti-inflammatory properties but their interactions with cytokines regarding the risk of PSD have yet to be investigated. Thus, the present study aimed to determine whether interleukin (IL)-6 and IL-18 were associated with the development of depression at 2 weeks and 1year after stroke using a longitudinal post-stroke cohort. Furthermore, this study examined the potential interactions between statin use and cytokines on PSD. For this study, 286 patients were evaluated 2 weeks after stroke and 222 patients were followed-up 1year later. Depression was diagnosed using criteria from the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) and then categorized into no PSD or any PSD, which included diagnoses of both major and minor depression. The effects of IL-6 and IL-18 on PSD as well as their interaction with a statin at both examination time-points were investigated using a multivariate logistic regression model. Higher IL-6 and IL-18 levels were independently associated with depressive disorders within 2 weeks and at 1year after stroke. When stratified by statin use, these significant associations were more evident in patients who did not use a statin. Furthermore, there was a significant interaction between statin use and IL-6 on the presence of a depressive disorder at 1year. The present findings support the cytokine hypothesis of PSD and indicate that the preventive effects of statin use against PSD may be mediated by its interactions with IL-6. PMID:27428088

  20. A Comparison of Acellular Dermal Matrix Allograft and Periosteal Pedicle Graft Covered by Coronally Advanced Flap in the Treatment of Gingival Recession: 1-Year Follow-Up Study.

    PubMed

    Godavarthi, Lalasa; Murthy, K Raja; Pavankumar, Sandhya

    2016-01-01

    The objective of this study was to evaluate and compare the clinical efficacy of periosteal pedicle graft (PPG) and acellular dermal matrix allograft (ADMA) in conjunction with coronally advanced flap (CAF) in the treatment of gingival recession during a 1-year follow-up. A sample of 14 patients, each with two similar Miller Class I or II gingival recession (28 recession sites), was selected. Each recession site was randomly assigned to the experimental site (PPG + CAF) or the control site (ADMG + CAF). The clinical parameters recorded at baseline and 12 months postoperatively were probing pocket depth, width of keratinized gingiva, and clinical attachment level, whereas full-mouth and site-specific plaque and gingival index and vertical recession depth and width were recorded at baseline and at 1, 3, 6, 9, and 12 months. Analysis was performed to determine if treatment differences were present. The mean recession depth in experimental sites decreased from 2.89 ± 0.40 mm at baseline to 0.25 ± 0.50 mm at 12 months, corresponding to a mean root coverage of 92.79% ± 14.25%. In control sites, recession shrank from 2.93 ± 0.55 mm at baseline to 0.32 ± 0.46 mm at 12 months follow-up, demonstrating a mean root coverage of 89.79% ± 14.73%. Compared to the use of ADMA, the PPG technique uses similar incision design and flap management at the graft site, is equivalent in technique sensitivity, and has a perceived improvement in esthetic outcome. PMID:27333020

  1. Long-term results of viscocanalostomy and phacoviscocanalostomy: a twelve-year follow-up study

    PubMed Central

    Gunenc, Uzeyir; Ozturk, Taylan; Arikan, Gul; Kocak, Nilufer

    2015-01-01

    AIM To evaluate the long-term efficacy and safety results of viscocanalostomy and phacoviscocanalostomy. METHODS The charts of 49 glaucoma patients who underwent viscocanalostomy or phacoviscocanalostomy surgery between February 1999 and August 2004 were reviewed retrospectively. Thirty-one eyes of 21 glaucoma patients who underwent filtering procedure with a postoperative follow-up of at least 5y were included in the study. Results of complete ophthalmologic examinations were recorded and statistically analyzed. Long-term surgical outcome was defined as an overall success when intraocular pressure (IOP) was found as ≤20 mm Hg with or without antiglaucomatous medication at the last follow-up visit, while it was defined as a complete success when IOP was measured ≤20 mm Hg without antiglaucomatous medication. RESULTS Mean age was 68.1±9.6y (range: 32-81y). Mean follow-up time was 101.5±27.3mo (range: 60-144mo). Viscocanalostomy was performed in 8 eyes (25.8%) and phacoviscocanalostomy was performed in 23 eyes (74.2%). The mean preoperative IOP was 23.1±7.6 mm Hg with 2.1±1.0 medications, while mean IOP was 16.8±3.8 mm Hg with 0.9±1.1 medication at the last follow-up visit. Both the IOP decrease and the reduction in the antiglaucomatous medication were statistically significant (P<0.001 and P<0.001). No case required further glaucoma surgery. Overall success and complete success were found as 87.1% and 51.6%, respectively. Complete success rate was statistically higher in phacoviscocanalostomy group compared with the viscocanalostomy group (P=0.031), however there was no significant difference in overall success rate between two groups (P=0.072). CONCLUSION Both viscocanalostomy and phacoviscocanalostomy provide good IOP reduction in the long-term period. PMID:26682166

  2. One-year follow-up results of the STARS for Families alcohol prevention program.

    PubMed

    Werch, C E; Owen, D M; Carlson, J M; DiClemente, C C; Edgemon, P; Moore, M

    2003-02-01

    This study examined the 1-year follow-up effects of the STARS (Start Taking Alcohol Risks Seriously) for Families program, a 2-year preventive intervention based on a stage of acquisition model, and consisting of nurse consultations and parent materials. A randomized controlled trial was conducted, with participants receiving either the intervention or a minimal intervention control. Participants included a cohort of 650 sixth-grade students from two urban middle schools-one magnet (bused) and one neighborhood. Trained project staff administered questionnaires to students following a standardized protocol in the schools. For the magnet school sample, significantly fewer intervention students (5%) were planning to drink in the next 6 months than control students (18%), chi2 = 11.53, 1 d.f., P = 0.001. Magnet school intervention students also had less intentions to drink in the future, greater motivation to avoid drinking and less total alcohol risk than control students, Ps < 0.05. For the neighborhood school, intervention students (m = 7.90, SD = 1.87) had less total alcohol risk than control students (m = 8.42, SD = 1.83), F(1,205) = 4.09, P = 0.04. These findings suggest that a brief, stage and risk/protective factor tailored program holds promise for reducing risk for alcohol use among urban school youth 1 year after intervention, and has the unique advantage of greater 'transportability' over classroom-based prevention programs. PMID:12608685

  3. Follow-up results of isoniazid chemoprophylaxis during biological therapy in Colombia.

    PubMed

    Cataño, Juan Carlos; Morales, Milena

    2015-09-01

    The use of biological therapy has been linked with an increased risk of tuberculosis (TB) reactivation. The aim of this study was to present the follow-up results for isoniazid (INH) chemoprophylaxis in patients receiving different biological therapies. In this prospective observational study, patients with latent tuberculosis infection (LTBI) were given INH chemoprophylaxis between 2 and 9 months prior to the beginning of biological therapy. All patients were followed up monthly for any signs or symptoms of active TB or INH toxicity. A total of 221 patients, 122 females (55.2 %), with a mean age of 46.8 ± 11.3 years (16-74) were enrolled. LTBI was identified in 218 patients (98.7 %), all of whom received INH chemoprophylaxis. Seven patients (3.2 %) developed active tuberculosis, and 32 (17.2 %) patients developed intolerance or toxicity related to INH. Chemoprophylaxis with INH seems to be effective and safe for the prevention of most TB reactivation in individuals with LTBI, but toxicity must be monitored during follow-up. PMID:25763992

  4. EVALUATION OF GLASS IONOMER SEALANTS PLACED ACCORDING TO THE ART APPROACH IN A COMMUNITY WITH HIGH CARIES EXPERIENCE: 1-YEAR FOLLOW-UP

    PubMed Central

    Vieira, Ana Luiza Falavinha; Zanella, Nildiceli Leite Melo; Bresciani, Eduardo; Barata, Terezinha de Jesus Esteves; da Silva, Salete Moura Bonifácio; Machado, Maria Aparecida de Andrade Moreira; Navarro, Maria Fidela de Lima

    2006-01-01

    The aim of this study was to investigate the retention rates and effect on occlusal caries incidence of two glass ionomers used as sealants, placed according to the Atraumatic Restorative Treatment (ART) approach, in a high caries-risk community. A total of 150 newly erupted first molars of 42 schoolchildren, between 6-8 years of age were selected. The teeth were divided into two groups: experimental and control groups. In the experimental group, 76 teeth were sealed using Vidrion R-SS White (conventional GIC) and in the control group, 74 teeth were sealed using ChemFlex–Dentsply (high-viscosity conventional GIC). The sealants were applied by one operator following the "press finger technique", described in the ART-WHO manual. Two calibrated independent examiners carried out the evaluation according to the ART criteria. The intra and inter-examiner agreements were 0.84 and 0.81, respectively. Data were submitted to Mann-Whitney and Chi-square tests (p<0.05). At the 1-year follow-up, 136 (90.7%) sealants were evaluated. In the control group: 28 (41.8%) of the sealants were partially or completely retained, 38 (56.7%) completely lost, and 1 (1.5%) was replaced by another treatment. In the experimental group, 30 (43.5%) of the sealants were partially or completely retained, 38 (55.1%) were clinically scored as complete loss and 1 (1.4%) were replaced by another treatment. Seven sealants in both groups were not evaluated. Secondary caries was not observed in both groups. There was no statistically significant difference between the retention (p=0.49) and effect on caries incidence rates for both groups (p=0.84). The clinical performance of the glass ionomer sealants of both groups was considered satisfactory with a high success rate (98.5%). Although the sealants placed according to the ART approach showed retention rates lower than 50% after 1 year in newly erupted first molars, this approach seems to be appropriate for communities with high caries experience. PMID

  5. Recovery of brachial plexus lesions resulting from heavy backpack use: A follow-up case series

    PubMed Central

    2011-01-01

    Background Brachial plexus lesions as a consequence of carrying a heavy backpack have been reported, but the typical clinical course and long-term consequences are not clear. Here we evaluated the clinical course and pattern of recovery of backpack palsy (BPP) in a large series of patients. Methods Thirty-eight consecutive patients with idiopathic BPP were identified from our population of 193,450 Finnish conscripts by means of computerised register. A physiotherapist provided instructions for proper hand use and rehabilitative exercises at disease onset. The patients were followed up for 2 to 8 years from the diagnosis. We also searched for genetic markers of hereditary neuropathy with pressure palsies. Mann-Whitney U-test was used to analyze continuous data. The Fischer's exact test was used to assess two-way tables. Results Eighty percent of the patients recovered totally within 9 months after the onset of weakness. Prolonged symptoms occurred in 15% of the patients, but daily activities were not affected. The weight of the carried load at the symptom onset significantly affected the severity of the muscle strength loss in the physiotherapeutic testing at the follow-up. The initial electromyography did not predict recovery. Genetic testing did not reveal de novo hereditary neuropathy with pressure palsies. Conclusions The prognosis of BPP is favorable in the vast majority of cases. Electromyography is useful for diagnosis. To prevent brachial plexus lesions, backpack loads greater than 40 kg should be avoided. PMID:21429232

  6. Hypothyroidism is common in turner syndrome: results of a five-year follow-up.

    PubMed

    El-Mansoury, Mostafa; Bryman, Inger; Berntorp, Kerstin; Hanson, Charles; Wilhelmsen, Lars; Landin-Wilhelmsen, Kerstin

    2005-04-01

    Turner syndrome (TS) is caused by a sex chromosome aberration. The aim was to study the prevalence and incidence of thyroid disease in adults with TS. Women with TS (n = 91; mean age, 37.7 +/- 11 yr) were compared with an age-matched female random population sample (n = 228). At baseline, 15 (16%) TS women were treated for hypothyroidism, and elevated serum TSH was found in another eight (9%). As a result, hypothyroidism was more common in women with TS (25%) than in controls (2%; P < 0.0001). Serum free T4 was lower (P = 0.02), and serum TSH was higher (P < 0.0001) in TS women than in age-matched controls. Of all TS women with hypothyroidism, 10 (43%) had an elevated thyroid peroxidase antibody titer vs. 15 (22%) of those without hypothyroidism (P < 0.05), evenly distributed between the karyotype 45,X and mosaicism. A high body mass index, but not a family history or blood lipids, was associated with hypothyroidism in TS. After the 5-yr follow-up, an additional 11 (16%) developed hypothyroidism, of whom four (36%) had elevated thyroid peroxidase. Altogether, 34 (37%) TS women had hypothyroidism after the 5-yr follow-up. Autoimmune hypothyroidism was common, with an annual incidence of 3.2% in TS. Thyroid function should be checked regularly in TS. PMID:15623818

  7. Percutaneous Nucleoplasty Using Coblation Technique for the Treatment of Chronic Nonspecific Low Back Pain: 5-year Follow-up Results

    PubMed Central

    Ren, Da-Jiang; Liu, Xiu-Mei; Du, Sui-Yong; Sun, Tian-Sheng; Zhang, Zhi-Cheng; Li, Fang

    2015-01-01

    Background: This study evaluated the efficacy of percutaneous nucleoplasty using coblation technique for the treatment of chronic nonspecific low back pain (LBP), after 5 years of follow-up. Methods: From September 2004 to November 2006, 172 patients underwent percutaneous nucleoplasty for chronic LBP in our department. Forty-one of these patients were followed up for a mean period of 67 months. Nucleoplasty was performed at L3/4 in 1 patient; L4/5 in 25 patients; L5/S1 in 2 patients; L3/4 and L4/5 in 2 patients; L4/5 and L5/S1 in 7 patients; and L3/4, L4/5, and L5/S1 in 4 patients. Patients were assessed preoperatively and at 1 week, 1 year, 3 years, and 5 years postoperatively. Pain was graded using a 10-cm Visual Analogue Scale (VAS) and the percentage reduction in pain score was calculated at each postoperative time point. The Oswestry Disability Index (ODI) was used to assess disability-related to lumbar spine degeneration, and patient satisfaction was assessed using the modified MacNab criteria. Results: There were significant differences among the preoperative, 1-week postoperative, and 3-year postoperative VAS and ODI scores, but not between the 3- and 5-year postoperative scores. There were no significant differences in age, sex, or preoperative symptoms between patients with effective and ineffective treatment, but there were significant differences in the number of levels treated, Pfirrmann grade of intervertebral disc degeneration, and provocative discography findings between these two groups. Excellent or good patient satisfaction was achieved in 87.9% of patients after 1 week, 72.4% after 1 year, 67.7% after 3 years, and 63.4% at the last follow-up. Conclusions: Although previously published short- and medium-term outcomes after percutaneous nucleoplasty appeared to be satisfactory, our long-term follow-up results show a significant decline in patient satisfaction over time. Percutaneous nucleoplasty is a safe and simple technique, with therapeutic

  8. Results from the LCOGT Near-Earth Object Follow-up Network

    NASA Astrophysics Data System (ADS)

    Greenstreet, Sarah; Lister, Tim; Gomez, Edward; Christensen, Eric; Larson, Steve

    2015-11-01

    Las Cumbres Observatory Global Telescope Network (LCOGT) has deployed a homogeneous telescope network of nine 1-meter and two 2-meter telescopes to five locations in the northern and southern hemispheres, with plans to extend to twelve 1-meter telescopes at 6 locations. The versitility and design of this network allows for rapid response to target of opportunity events as well as the long-term monitoring of slowly changing astronomical phenomena. The network's global coverage and the apertures of telescopes available make LCOGT ideal for follow-up and characterization of Solar System objects (e.g. asteroids, Kuiper Belt Objects, comets, Near-Earth Objects (NEOs)) and ultimately for the discovery of new objects.LCOGT has completed the first phase of the deployment with the installation and commissioning of the nine 1-meter telescopes at McDonald Observatory (Texas), Cerro Tololo (Chile), SAAO (South Africa) and Siding Spring Observatory (Australia). This is complimented by the two 2-meter telescopes at Haleakala (Hawaii) and Siding Spring Observatory. The telescope network has been fully operational since May 2014, and observations are being executed remotely and robotically. Future expansion to sites in the Canary Islands and Tibet are planned for 2016.The LCOGT near-Earth object group is using the network to confirm newly detected NEO candidates produced by the major sky surveys such as Catalina Sky Survey (CSS), PanSTARRS (PS1) and NEOWISE, with several hundred targets being followed per year. Follow-up astrometry and photometry of radar-targeted objects and those on the Near-Earth Object Human Space Flight Accessible Targets Study (NHATS) or Asteroid Retrieval Mission (ARM) lists are improving orbits, producing light curves and rotation periods, and better characterizing these NEOs. Recent results include the first period determinations for several of the Goldstone-targeted NEOs. In addition, we are in the process of building a NEO portal that will allow

  9. MEDIUM-TERM FOLLOW-UP RESULTS WITH LAPAROSCOPIC SLEEVE GASTRECTOMY

    PubMed Central

    RAMOS, Almino Cardoso; BASTOS, Eduardo Lemos de Souza; RAMOS, Manoela Galvão; BERTIN, Nestor Tadashi Suguitani; GALVÃO, Thales Delmondes; de LUCENA, Raphael Torres Figueiredo; CAMPOS, Josemberg Marins

    2015-01-01

    Background : The indications for sleeve gastrectomy in the surgical treatment of morbid obesity have increased worldwide. Despite this, several aspects related to results at medium and long term remain in constant research. Aim : To present the experience of sleeve gastrectomy in a center of excellence in bariatric surgery by analyzing clinical outcomes, complications and follow-up in the medium term. Methods : The study included 120 morbidly obese patients who underwent sleeve gastrectomy and who were followed for at least 24 months. Aspects related to surgical technique, surgical complications and clinical outcome were analyzed. Results : Seventy-five patients were women (62.5%) and the average age was 36 years. The body mass index preoperatively ranged from 35.5 to 58 kg/m2(average of 40.2 kg/m2). The length of stay ranged from 1 to 4 days (mean 2.1 days). Comorbidities observed were hypertension (19%), type 2 diabetes mellitus (6.6%), dyslipidemia (7.5%), sleep apnea (16.6%), reflux esophagitis (10%) and orthopedic diseases (7.5%). The mean body mass index and total weight loss percentage with 3, 12, 18 and 24 months were 32.2 kg/m2-19,9%; 29.5 kg/m2-26,5%; 28.2 kg/m2-30,3% and 26.9 kg/m2-32,7%, respectively. Remission of diabetes and dyslipidemia occurred in all patients. In relation to hypertension, there was improvement or remission in 86%. There were only two complications (bronchial pneumonia and dehydration), with good response to clinical treatment. There was no evidence digestive fistula and mortality was zero. Eleven patients (9.1%) had regained weighing more than 5 kg. Conclusion : The sleeve gastrectomy is surgical technique that has proven safe and effective in the surgical treatment of obesity and control of their comorbidities in postoperative follow-up for two years. PMID:26537277

  10. Endovascular Aortic Aneurysm and Dissection Repair (EVAR) in Iran: Descriptive Midterm Follow-up Results

    PubMed Central

    Haji Zeinali, Ali Mohammad; Marzban, Mehrab; Zafarghandi, Mohammadreza; Shirzad, Mahmood; Shirani, Shapour; Mahmoodian, Roshanak; Sheikhvatan, Mehrdad; Lotfi-Tokaldany, Masoumeh

    2016-01-01

    Background: Endovascular repair of aorta in comparison to open surgery has a low early operative mortality rate, but its long-term results are uncertain. Objectives: The current study describes for the first time our initial four-year experience of elective endovascular aortic repair (EVAR) at Tehran heart center, the first and a major referral heart center in Iran, as a pioneer of EVAR in Iran. Patients and Methods: A total of 51 patients (46 men) who had the diagnosis of either an abdominal aortic aneurysm (AAA) (n = 36), thoracic aortic aneurysm (TAA) (n = 7), or thoracic aortic dissection (TAD) (n = 8) who had undergone EVAR by Medtronic stent grafts by our team between December 2006 and June 2009 were reviewed. Results: The rate of in-hospital aneurysm-related deaths in the group with AAA stood at 2.8% (one case), while there was no in-hospital mortality in the other groups. All patients were followed up for 13-18 months. The cumulative death rate in follow-up was nine cases from the total 51 cases (18%), out of which six cases were in the AAA group (four patients due to non-cardiac causes and two patients due to aneurysm-related causes), one case in the TAA group (following a severe hemoptysis), and two cases in the TAD group (following an expansion of dissection from re-entrance). The major event-free survival rate was 80.7% for endovascular repair of AAA, 85.7% for endovascular repair of TAA, and 65.6% for endovascular repair of TAD. Conclusion: The endovascular stent-graft repair of the abdominal and thoracic aortic aneurysm and aortic dissection had high technical success rates in tandem with low-rate early mortality and morbidity, short hospital stay, and acceptable mid-term free symptom survival among Iranian patients. PMID:27110330

  11. Fourteen years follow up after Lisfranc fracture-dislocation: functional and radiological results.

    PubMed

    Marín-Peña, Oliver R; Viloria Recio, Fernando; Sanz Gómez, Tomas; Larrainzar Garijo, Ricardo

    2012-12-01

    Injuries to the Lisfranc joint have a high potential for chronic disability. Posttraumatic arthritis remains the most common complication but not all patients who develop degenerative radiographic changes are symptomatic. A cohort of 32 patients with a Lisfranc fracture dislocation was reviewed. Initial reduction and secondary displacement were measured by the Myerson scale. Radiographic evidence of osteoarthritis (OA) was also investigated. Long-term radiographical data were classified as good, fair or poor results. Functional outcome was measured using several different scales. Mean follow up was 14 years. Seventeen patients with anatomic close reduction but instability were treated with closed reduction and K-wire fixation followed by cast immobilisation. Eight patients with stable anatomic close reduction were treated with closed reduction and cast. Seven patients with unacceptable closed reduction were treated with open reduction and K-wire stabilisation. The analysis of radiological long-term data showed 15 patients with good results, 8 with fair results and 9 with poor results. Final mean AOFAS score was 91.7/100. There was no statistically significant difference between overall PFS scores and different type of treatment, Hardcastle long-term radiological scores or Hardcastle type of fracture (p >0.05). Overall, there was a poor association between the extent of radiological arthritis and clinical scores. We advocate that for the evaluation of long-term outcome of these injuries functional parameters should be the focus of assessment, instead of radiological changes. PMID:23622999

  12. Preoperative evaluation, surgical procedure, follow up and results of 150 cochlear implantations

    PubMed Central

    Kyriafinis, G; Vital, V; Psifidis, A; Constantinidis, J; Nikolaou, A; Hitoglou-Antoniadou, M; Kouloulas, A

    2007-01-01

    Background: The cochlear implantation is among the most important achievements of medicine and biotechnology in the last 20 years, because it allows individuals who had never heard or had lost their hearing to perceive sound and improve their quality of life. Selection criteria for candidates are strict and are evaluated in each individual by a scientific committee specially trained for implantations which includes Ear Nose and Throat (ENT) surgeon, audiologist, psychiatrist and speech therapist. Patients and methods: In our department, the first cochlear implantation was performed in 1995. During the last ten years more than 250 individuals have been evaluated due to profound hearing loss and 170 of them were found to be suitable candidates for cochlear implantation. One hundred and fifty (150) have already been operated and most of them are children with congenital hearing loss. No major or permanent complications were recorded in any of our 150 patients. Activation and fitting/mapping of the cochlear implant is initiated three weeks post-operatively. Regular follow- up and mapping of the implant are held, more frequently in children, along with specialized speech therapy. Each new mapping is evaluated according to the record of the patient with regard to the acoustic perception of sounds and speech and the discrimination of individual elements of phonation based on a protocol that we have created for the needs of Greek language. Results: Speech discrimination (AHEPA Hospital protocol), before the Implantation, at the activation of the cochlear implant and till 4 years of the follow-up showed that in our patients, we obtained better and faster results in post-speech acquisition adults with recent or chronic deafness and in children with congenital deafness operated before the 5th year of age, who underwent special preoperative speech therapy programme, fact which is in agreement with current literature. Patient satisfaction evaluated by "Sanders" psychometrics

  13. Free thyroxine levels are associated with cognitive changes in individuals with a first episode of psychosis: A prospective 1-year follow-up study.

    PubMed

    Labad, J; Barbero, J D; Gutiérrez-Zotes, A; Montalvo, I; Creus, M; Cabezas, Á; Solé, M; Algora, M J; Garcia-Parés, G; Vilella, E

    2016-03-01

    The results of previous cross-sectional studies suggest that free thyroxine (FT4) levels are associated with cognitive abilities (particularly attention/vigilance) during the early stages of psychosis. We aimed to explore whether hypothalamic-pituitary-thyroid hormones predict cognitive changes in a 1-year longitudinal study following first episodes of psychosis (FEP). We studied 36 FEP patients and a control group of 50 healthy subjects (HS). Plasma levels of thyroid-stimulating hormone (TSH) and FT4 were measured. Cognitive assessment was performed with the MATRICS Cognitive Consensus Cognitive Battery (MCCB). FEP patients were assessed twice (baseline and after 1year), whereas HS were assessed only once. We compared cognitive changes at 1year between three groups based on baseline FT4 levels: 1) lowest quartile (Q1, FT4<1.16ng/dL); 2) medium quartiles (Q2-Q3, FT4 1.16-1.54ng/dL); and 3) highest quartile (Q4, FT4>1.54ng/dL). No differences in TSH or FT4 levels were found between HS and FEP patients. All participants had FT4 levels within the normal range. HS outperformed FEP patients in all cognitive tasks. In relation to the relationship between FT4 levels and cognitive changes, a U-shaped pattern was observed: FEP patients from the middle quartiles (Q2-Q3) improved in attention/vigilance, whereas both extreme quartiles (Q1 and Q4) showed a worsening in this cognitive domain over time. Patients with lower FT4 (Q1) showed poorer baseline attention; therefore, lower baseline FT4 levels predicted a poorer prognosis in terms of attention performance. Our study suggests that baseline FT4 levels are associated with changes in attention and vigilance performance over one year in FEP patients. PMID:26805411

  14. Astrometric Results of NEOs from the Characterization and Astrometric Follow-up Program at Adler Planetarium

    NASA Astrophysics Data System (ADS)

    Nault, Kristie A.; Brucker, Melissa J.; Hammergren, Mark; Gyuk, Geza; Solontoi, Mike R.

    2015-11-01

    We present astrometric results of near-Earth objects (NEOs) targeted in fourth quarter 2014 and in 2015. This is part of Adler Planetarium’s NEO characterization and astrometric follow-up program, which uses the Astrophysical Research Consortium (ARC) 3.5-m telescope at Apache Point Observatory (APO). The program utilizes a 17% share of telescope time, amounting to a total of 500 hours per year. This time is divided up into two hour observing runs approximately every other night for astrometry and frequent half-night runs approximately several times a month for spectroscopy (see poster by M. Hammergren et. al.) and light curve studies (see poster by M. J. Brucker et. al.).Observations were made using Seaver Prototype Imaging Camera (SPIcam), a visible-wavelength, direct imaging CCD camera with 2048 x 2048 pixels and a field of view of 4.78’ x 4.78’. Observations were made using 2 x 2 binning.Special emphasis has been made to focus on the smallest NEOs, particularly around 140m in diameter. Targets were selected based on absolute magnitude (prioritizing for those with H > 25 mag to select small objects) and a 3σ uncertainty less than 400” to ensure that the target is in the FOV. Targets were drawn from the Minor Planet Center (MPC) NEA Observing Planning Aid, the JPL What’s Observable tool, and the Spaceguard priority list and faint NEO list.As of August 2015, we have detected 670 NEOs for astrometric follow-up, on point with our goal of providing astrometry on a thousand NEOs per year. Astrometric calculations were done using the interactive software tool Astrometrica, which is used for data reduction focusing on the minor bodies of the solar system. The program includes automatic reference star identification from new-generation star catalogs, access to the complete MPC database of orbital elements, and automatic moving object detection and identification.This work is based on observations done using the 3.5-m telescope at Apache Point Observatory

  15. Respiratory disease mortality among US coal miners; results after 37 years of follow-up

    PubMed Central

    Graber, Judith M; Stayner, Leslie T; Cohen, Robert A; Conroy, Lorraine M; Attfield, Michael D

    2015-01-01

    Objectives To evaluate respiratory related mortality among underground coal miners after 37 years of follow-up. Methods Underlying cause of death for 9033 underground coal miners from 31 US mines enrolled between 1969 and 1971 was evaluated with life table analysis. Cox proportional hazards models were fitted to evaluate the exposure-response relationships between cumulative exposure to coal mine dust and respirable silica and mortality from pneumoconiosis, chronic obstructive pulmonary disease (COPD) and lung cancer. Results Excess mortality was observed for pneumoconiosis (SMR=79.70, 95% CI 72.1 to 87.67), COPD (SMR=1.11, 95% CI 0.99 to 1.24) and lung cancer (SMR=1.08; 95% CI 1.00 to 1.18). Coal mine dust exposure increased risk for mortality from pneumoconiosis and COPD. Mortality from COPD was significantly elevated among ever smokers and former smokers (HR=1.84, 95% CI 1.05 to 3.22; HRK=1.52, 95% CI 0.98 to 2.34, respectively) but not current smokers (HR=0.99, 95% CI 0.76 to 1.28). Respirable silica was positively associated with mortality from pneumoconiosis (HR=1.33, 95% CI 0.94 to 1.33) and COPD (HR=1.04, 95% CI 0.96 to 1.52) in models controlling for coal mine dust. We saw a significant relationship between coal mine dust exposure and lung cancer mortality (HR=1.70; 95% CI 1.02 to 2.83) but not with respirable silica (HR=1.05; 95% CI 0.90 to 1.23). In the most recent follow-up period (2000–2007) both exposures were positively associated with lung cancer mortality, coal mine dust significantly so. Conclusions Our findings support previous studies showing that exposure to coal mine dust and respirable silica leads to increased mortality from malignant and non-malignant respiratory diseases even in the absence of smoking. PMID:24186945

  16. Visual, refractive, and keratometric results of epikeratophakia in children. A two-year follow-up.

    PubMed

    Uusitalo, R J; Lehtosalo, J

    1989-03-01

    Fifty-two patients under the age of 16 years (68 eyes) received epikeratophakia grafts for the correction of aphakia. In 27 eyes, epikeratophakia was a primary procedure combined with lensectomy. Fifteen children underwent bilateral surgery. Overall, the success rate was 91%, and with repeated surgery it was 94%. The average change in refractive error was 15.9 diopters (D) and the average spectacle overcorrection was +0.3 D. Sixty-one percent (35/57) of the eyes were within 1 D of emmetropia and 97% (55/57) were within 3 D of emmetropia. Overall, the refraction was stable in the follow-up between six months and 1 1/2 years following surgery. However, a myopic shift of 2.0 D occurred between six months and 1 1/2 years in very young children following refractive surgery. The corneal curvature was measured only in older children and showed an average increase of 10.7 D. Visual acuity results in verbal patients were comparable to those in patients with contact lenses. The majority of smaller children demonstrated improvement in visual acuity with a combination of epikeratophakia and amblyopia therapy. PMID:2647066

  17. RESULTS FROM CLINICAL AND RADIOLOGICAL FOLLOW-UP, AFTER SURGICAL TREATMENT OF CHONDROBLASTOMA

    PubMed Central

    Penna, Valter; Toller, Eduardo Areas; Ferreira, Adriano Jander; Dias, Dante Palloni Costa

    2015-01-01

    Objectives: To evaluate the long-term clinical and radiological results from patients who underwent surgical treatment of chondroblastoma, between 2003 and 2009, by the same surgical team, using the same operative technique. Methods: A retrospective study was conducted on 12 patients with histological diagnoses of chondroblastoma, who were attended between 2003 and 2009 at the Pius XII Foundation (Barretos Cancer Hospital, Barretos, State of São Paulo). These patients underwent surgical treatment with intralesional resection of the tumor, adjuvant electrocauterization and replacement with methyl methacrylate (11 cases) or an autologous graft from the iliac crest (one case). The preoperative evaluation included physical examination, plain radiographs of the site, magnetic resonance imaging, computed axial tomography and bone scintigraphy. The patients were assessed clinically and radiologically according to a predefined protocol, with a series of plain radiographs, and a functional assessment in accordance with the Enneking functional score. Results: The average age at the time of diagnosis was 14 years and 4 months. The most frequent location affected was the distal femoral epiphysis (75%), followed by the proximal tibial epiphysis (16.6%) and the calcaneus (8.4%). There was higher prevalence among the female patients than among the male patients (3:1). In three cases, preoperative biopsy was necessary. During the follow-up, there was no evidence of local tumor recurrence, and all the patients presented an excellent functional result from the surgical technique used, with Enneking scores ranging from 20 to 30. Conclusion: Surgical treatment of chondroblastoma, using intralesional resection, adjuvant electrocauterization and replacement with methyl methacrylate or bone graft produced good results. PMID:27027054

  18. Effectiveness of Comprehensive Health Education Combining Lifestyle Education and Hot Spa Bathing for Male White-Collar Employees: A Randomized Controlled Trial with 1-Year Follow-Up

    PubMed Central

    Kamioka, Hiroharu; Nakamura, Yosikazu; Okada, Shinpei; Kitayuguchi, Jun; Kamada, Masamitsu; Honda, Takuya; Matsui, Yuzuru; Mutoh, Yoshiteru

    2009-01-01

    Background Physical activity is known to prevent obesity and metabolic syndrome in middle-aged and elderly people; however, the effectiveness of a comprehensive health education program for male white-collar employees is uncertain. Methods Forty-three men volunteered to participate in this study and were randomly assigned into 2 groups. The intervention group participated in a 2-hour program comprising comprehensive health education and hot spa bathing, offered once every 2 weeks, in addition to individualized programs once a week, for 24 weeks. The control group received only general health guidance. We compared their lifestyle characteristics and physical and mental health criteria at baseline, immediately after the intervention, and 1 year after the end of the intervention. Results Rates of adherence to individualized programs were 60.0 ± 27.2% and 30.5 ± 29.6% at the end of the intervention and at 1 year after the end of the intervention, respectively. Significant (P < 0.05) interaction of criteria was observed for cluster of differentiation 4+ (CD4+) cells and the ratio of cluster of differentiation 4+ to 8+ (CD4/8) cells, which were used to represent the participants' immunological function. We divided the intervention group into 2 subgroups on the basis of their attendance. Among the resulting 3 groups, significant interaction of criteria was observed for CD4+ and CD4/8 cells. In addition, the high attendance group had the highest CD4+ count and CD4/8 ratio. Conclusions Participants who attended classes and/or performed the supplementary individualized programs tended to maintain their immunological function and to experience a decrease in body fat percentage. However, few effects were noted in participants with poor adherence, even in the intervention group. PMID:19687610

  19. Depletion of B Lymphocytes in Idiopathic Membranous Glomerulopathy: Results from Patients with Extended Follow-Up

    PubMed Central

    Lionaki, Sophia; Marinaki, Smaragdi; Nakopoulou, Lydia; Skalioti, Chrysanthi; Iniotaki, Aliki; Sfikakis, Petros P.; Siamopoulos, Costas; Boletis, John

    2013-01-01

    Aims To assess the long-term therapeutic benefit of temporary depletion of B lymphocytes in patients with idiopathic membranous glomerulopathy (MGN) and search for potential predictors of response. Patients and Methods The patients included had been diagnosed with biopsy-proven MGN in the absence of secondary causes. Estimated glomerular filtration rate should be above 30 ml/min/1.73 m2 and 24-hour proteinuria 3 g/day or more. Patients who had been treated with cyclosporine or cytotoxic agents the year prior to study entry were excluded. Depletion of B cells was achieved with rituximab, which was administered intravenously for 4 consecutive weeks. Partial remission was defined as a >50% decrease in proteinuria with absolute proteinuria <3 g/day, while complete remission was defined as a >50% decrease in proteinuria and an absolute protein excretion <0.3 g/day. Results Twelve patients were studied (4 females/8 males) with a mean age of 51.3 years. No major adverse effects were observed. During a median follow-up time of 48 months, 11/12 (91.6%) patients achieved remission [7/12 (58.3%) complete remission and 4/12 (33.3%) partial remission], while 1 patient did not respond to therapy. Twelve months after therapy, 68.8% (p = 0.003) of cases had achieved partial and 28.4% complete remission. Measurements of lymphocyte subpopulations did not reveal any changes except for the B cell depletion. B cell infiltrates captured per mm3 of renal tissue in the diagnostic biopsy did not correlate with subsequent response. Conclusion Depletion of B cells in idiopathic MGN was well tolerated and resulted in significant and long-lasting response rates in a series of 12 patients. PMID:23573072

  20. Initial healthcare and coping preferences are associated with outcome 1 year after whiplash trauma: a multicentre 1-year follow-up study

    PubMed Central

    Myrtveit, Solbjørg Makalani; Carstensen, Tina; Kasch, Helge; Ørnbøl, Eva; Frostholm, Lisbeth

    2015-01-01

    Objective Individuals exposed to whiplash collisions have to cope with the stressful event as well as early physical symptoms. As in other chronic pain conditions, coping has been associated with outcome after whiplash. In this study, our aim was to examine whether initial coping preferences were associated with the development of chronic whiplash. Design Prospective study. Setting Primary care. Methods 740 acute whiplash patients were recruited from emergency units and general practitioners after car collisions in Denmark. Within 10 days postinjury, participants were asked what they believed could help them get better. At 12-month follow-up, the level of neck pain and capability to work was obtained. Whether coping preferences (baseline) were associated with outcome was investigated using multiple regression analyses. Results Persistent neck pain was most strongly associated with preferring medications (mean difference=1.24 (95% CI 0.67 to 1.82)) and sickness absence (mean difference=1.18 (95% CI 0.53 to 1.82)). Reduced work capability was most strongly associated with preferring medications (OR=3.53 (95% CI 2.13 to 5.86)), sickness absence (OR=3.05 (95% CI 1.80 to 5.17)) and being referred to a physiotherapist/chiropractor (OR=3.03 (95% CI 1.33 to 6.91)). Active coping was associated with better outcomes: Participants preferring to change their lifestyle were protected against reduced work capability (OR=0.11 (95% CI 0.01 to 0.78)). Individuals who wanted to keep living as usual only (no other preference reported) were protected against neck pain (mean difference −1.62 (95% CI −2.39 to −0.84)) and reduced work capability (OR=0.09 (95% CI 0.01 to 0.64)). Conclusions A simple nine-item measure of coping preferences is associated with the development of chronic neck pain and reduced capability to work following whiplash trauma and may be used to identify individuals at risk of poor recovery. PMID:25795697

  1. Recent Results from Follow-up Astrometric Observations of KBOs and NEOs

    NASA Astrophysics Data System (ADS)

    Tholen, D. J.; Connelley, M. S.

    2001-11-01

    As of the abstract deadline, 481 Kuiper belt objects have been discovered, but only 50 have four-opposition or greater orbits. Historically, some of the three-opposition orbits still had assumed eccentricities, indicating the relative level of inaccuracy in the orbit determination. Meanwhile, several authors have published eccentricity versus semimajor axis plots for Kuiper belt objects without attaching error bars to the symbols. Caution should therefore be exercised when looking at the relative populations of resonant, classical, and scattered objects, or when reaching conclusions about mechanisms at work that shape the Kuiper belt. We have been working to ameliorate this situation by securing follow-up astrometric observations of Kuiper belt objects with shorter arc orbit solutions, thereby extending the arcs and improving the accuracy of their semimajor axis and eccentricity determinations. Approximately 30 objects have been recovered to date, including a serendipitous observation of the satellite of 1998 WW31. We will be presenting improved estimates of the relative populations of resonant, classical, and scattered objects at the DPS meeting. Emphasis has also been given to astrometric observations of faint near-Earth objects to prevent their ephemeris uncertainties from growing large enough to warrant being tagged as "lost". In some cases, arcs have been extended by a factor of more than sixty. Virtually all of our observations are the last available for these objects. The number one reason for failure to recover an object has been low galactic latitude, where the field star density is so high that after non-sidereal tracking is taken into account, the field of view is nearly completely covered by star trails. Notable recoveries include 2000 SG344 at magnitude 26 in 2001 August using the CFHT (this object had been identified as having a 1 in 1000 chance of colliding with the Earth in 2071), 2000 GD147 at magnitude 24.5 in 2001 September using the UH 2.24-m

  2. Comparison of lumbar spine stabilization exercise versus general exercise in young male patients with lumbar disc herniation after 1 year of follow-up

    PubMed Central

    Ye, Chaoqun; Ren, Jixin; Zhang, Jianzheng; Wang, Chongwei; Liu, Zhi; Li, Fang; Sun, Tiansheng

    2015-01-01

    Objective: The safest and most effective conservative treatment for patients with lumbar disc herniation (LDH) has not been established. The purpose of this study was to evaluate the effect of lumbar spine stabilization exercise (LSSE) and general exercise (GE) on pain intensity and functional capacity in young male patients with LDH. Methods: Sixty-three young male adults aged 20 to 29 years with the diagnosis of LDH were enrolled and divided into an LSSE group (n=30) and a GE group (n=33). Patients in both groups received low-power laser (LPL) therapy during the first week of the onset of LDH. Patients in the GE group underwent a GE program. Patients in the LSSE group followed an LSSE program for 3 months. All of the patients were subjected to pain intensity and functional capacity evaluations four times: at pre-and post-LPL therapy, and at 3 months and 1 year post-exercise. Pain intensity of the lower back and legs was evaluated with the visual analogue scale (VAS), and functional capacity was evaluated with the Oswestry Disability Index (ODI). Results: Both groups showed a significant reduction in VAS and ODI scores at 3 and 12 months post-exercise compared with before treatment (P<0.001). The LSSE group showed a significant reduction in the average score of the VAS for low back pain (P=0.012) and the ODI (P=0.003) at 12 months post-exercise compared with the GE group. Conclusions: LSSE and GE are considered as effective interventions for young male patients with LDH. Moreover, LSSE is more effective than GE, and physical therapy, such as LPL, is required during acute LDH. PMID:26309670

  3. Incidence of thyroid disorders in mixed cryoglobulinemia: Results from a longitudinal follow-up.

    PubMed

    Fallahi, Poupak; Ferrari, Silvia Martina; Ruffilli, Ilaria; Elia, Giusy; Giuggioli, Dilia; Colaci, Michele; Ferri, Clodoveo; Antonelli, Alessandro

    2016-07-01

    No study has evaluated the incidence of new cases of thyroid autoimmunity (AT) and dysfunction (TD) in hepatitis C-associated mixed cryoglobulinemia (MC) patients. We aimed to evaluate the incidence of new cases of AT and TD in a wide group of MC patients vs. age- and gender-matched controls from the same geographic area. After exclusion of MC patients with TD at the initial evaluation, the appearance of new cases of TD was evaluated in 112 MC patients and 112 matched controls, with similar iodine intake (median follow-up 67months in MC vs. 78 in controls). A high incidence (P<0.05) of new cases of hypothyroidism, TD, anti-thyroperoxidase antibody (AbTPO) positivity, appearance of a hypoechoic thyroid pattern, and thyroid autoimmunity in MC patients vs. controls was shown. A logistic regression analysis showed that in MC, the appearance of hypothyroidism was related to female gender, a borderline high initial thyroid-stimulating hormone (TSH), AbTPO positivity, a hypoechoic, and small thyroid. In conclusion, we show a high incidence of new cases of AT and TD in MC patients. MC patients at high risk (female gender, a borderline high initial TSH, AbTPO positivity, a hypoechoic, and small thyroid) should have periodically thyroid function follow-up. PMID:26970485

  4. Are early MRI findings correlated with long-lasting symptoms following whiplash injury? A prospective trial with 1-year follow-up

    PubMed Central

    Sorensen, Joan S.; Andersen, Hans; Keseler, Bjarne; Jensen, Troels S.; Bendix, Tom

    2008-01-01

    Neck pain is the cardinal symptom following whiplash injuries. The trauma mechanism could theoretically lead to both soft tissue and bone injury that could be visualised by means of MRI. From previous quite small trials it seems that MRI does not demonstrate significant tissue damage. Large prospectively followed cohorts are needed to identify possible clinically relevant MRI findings. The objective of this trial was to evaluate (1) the predictive value of cervical MRI after whiplash injuries and (2) the value of repeating MRI examinations after 3 months including sequences with flexion and extension of the cervical spine. Participants were included after rear-end or frontal car collisions. Patients with fractures or dislocations diagnosed by standard procedures at the emergency unit were not included. MRI scans of the cervical spine were performed at baseline and repeated after 3 months. Clinical follow-ups were performed after 3 and 12 months. Outcome parameters were neck pain, headache, neck disability and working ability. A total of 178 participants had a cervical MRI scan on average 13 days after the injury. Traumatic findings were observed in seven participants. Signs of disc degeneration were common and most frequent at the C5–6 and C6–7 levels. Findings were not associated with outcome after 3 or 12 months. The population had no considerable neck trouble prior to the whiplash injury and the non-traumatic findings represent findings to be expected in the background population. Trauma-related MRI findings are rare in a whiplash population screened for serious injuries in the emergency unit and not related to a specific symptomatology. Also, pre-existing degeneration is not associated with prognosis. PMID:18512085

  5. Patterns of shoulder pain during a 14-year follow-up: results from a longitudinal population study in Norway

    PubMed Central

    Grotle, Margreth; Natvig, Bård

    2014-01-01

    Background Population studies have reported that shoulder pain is the third most frequently reported musculoskeletal pain. Long duration, pain intensity and high level of disability predict persistent complaints. The present study aimed to describe the prevalence of shoulder pain in a general population and follow this over a long period (1990 to 2004). The objective was also to describe the stability of shoulder pain and patterns of co-occurrence with neck and upper back pain. Methods Data were obtained from a self-reported questionnaire in a population in Ullensaker muncipality, north-east of Oslo. The Standard Nordic Questionnaire was sent in 1990, 1994 and 2004 to inhabitants belonging to six birth cohorts from 1918–20 to 1968–70. Results The 1-year prevalence of shoulder pain was 46.7% (95% CI, 44.9% to 48.6%) in 1990, 48.7% (95% CI, 46.8% to 50.5%) in 1994, and 55.2% (95% CI, 53.5% to 56.9%) in 2004. Approximately three-quarters of the persons with shoulder pain at one given time also reported shoulder pain at the next follow-up. Conclusions Prevalence of shoulder pain during a 14-year period was high and slightly increasing. Shoulder pain was reported most frequently in co-occurrence with neck pain. Classification models should include neck pain as well as other co-occurring pain sites.

  6. Completeness of Follow-Up Determines Validity of Study Findings: Results of a Prospective Repeated Measures Cohort Study

    PubMed Central

    Tevaearai, Hendrik T.; Kuemmerli, Christoph; Tinner, Christian; Carrel, Thierry P.; Schmidli, Juerg; Dick, Florian

    2015-01-01

    Background Current reporting guidelines do not call for standardised declaration of follow-up completeness, although study validity depends on the representativeness of measured outcomes. The Follow-Up Index (FUI) describes follow-up completeness at a given study end date as ratio between the investigated and the potential follow-up period. The association between FUI and the accuracy of survival-estimates was investigated. Methods FUI and Kaplan-Meier estimates were calculated twice for 1207 consecutive patients undergoing aortic repair during an 11-year period: in a scenario A the population’s clinical routine follow-up data (available from a prospective registry) was analysed conventionally. For the control scenario B, an independent survey was completed at the predefined study end. To determine the relation between FUI and the accuracy of study findings, discrepancies between scenarios regarding FUI, follow-up duration and cumulative survival-estimates were evaluated using multivariate analyses. Results Scenario A noted 89 deaths (7.4%) during a mean considered follow-up of 30±28months. Scenario B, although analysing the same study period, detected 304 deaths (25.2%, P<0.001) as it scrutinized the complete follow-up period (49±32months). FUI (0.57±0.35 versus 1.00±0, P<0.001) and cumulative survival estimates (78.7% versus 50.7%, P<0.001) differed significantly between scenarios, suggesting that incomplete follow-up information led to underestimation of mortality. Degree of follow-up completeness (i.e. FUI-quartiles and FUI-intervals) correlated directly with accuracy of study findings: underestimation of long-term mortality increased almost linearly by 30% with every 0.1 drop in FUI (adjusted HR 1.30; 95%-CI 1.24;1.36, P<0.001). Conclusion Follow-up completeness is a pre-requisite for reliable outcome assessment and should be declared systematically. FUI represents a simple measure suited as reporting standard. Evidence lacking such information must be

  7. Multicomponent physical exercise with simultaneous cognitive training to enhance dual-task walking of older adults: a secondary analysis of a 6-month randomized controlled trial with 1-year follow-up

    PubMed Central

    Eggenberger, Patrick; Theill, Nathan; Holenstein, Stefan; Schumacher, Vera; de Bruin, Eling D

    2015-01-01

    Background About one-third of people older than 65 years fall at least once a year. Physical exercise has been previously demonstrated to improve gait, enhance physical fitness, and prevent falls. Nonetheless, the addition of cognitive training components may potentially increase these effects, since cognitive impairment is related to gait irregularities and fall risk. We hypothesized that simultaneous cognitive–physical training would lead to greater improvements in dual-task (DT) gait compared to exclusive physical training. Methods Elderly persons older than 70 years and without cognitive impairment were randomly assigned to the following groups: 1) virtual reality video game dancing (DANCE), 2) treadmill walking with simultaneous verbal memory training (MEMORY), or 3) treadmill walking (PHYS). Each program was complemented with strength and balance exercises. Two 1-hour training sessions per week over 6 months were applied. Gait variables, functional fitness (Short Physical Performance Battery, 6-minute walk), and fall frequencies were assessed at baseline, after 3 months and 6 months, and at 1-year follow-up. Multiple regression analyses with planned comparisons were carried out. Results Eighty-nine participants were randomized to three groups initially; 71 completed the training and 47 were available at 1-year follow-up. DANCE/MEMORY showed a significant advantage compared to PHYS in DT costs of step time variability at fast walking (P=0.044). Training-specific gait adaptations were found on comparing DANCE and MEMORY: DANCE reduced step time at fast walking (P=0.007) and MEMORY reduced gait variability in DT and DT costs at preferred walking speed (both trend P=0.062). Global linear time effects showed improved gait (P<0.05), functional fitness (P<0.05), and reduced fall frequency (−77%, P<0.001). Only single-task fast walking, gait variability at preferred walking speed, and Short Physical Performance Battery were reduced at follow-up (all P<0.05 or

  8. Initial and follow-up results of the Tenax coronary stent.

    PubMed

    Carrié, D; Khalifé, K; Hamon, M; Citron, B; Monassier, J P; Sabatier, R; Lipiecky, J; Mourali, S; Sarfaty, L; Elbaz, M; Fourcade, J; Puel, J

    2001-02-01

    The Tenax coronary stent is laser sculpted from high precision 316 L stainless steel using advanced production procedures. An a-SiC: H (hydrogen-rich amorphous silicon carbide) coating reduces its thrombogenicity and improves its biocompatibility. From April to July 1998, 266 stents were implanted in 241 patients (aged 62.7 +/- 10.5 years) in five centers. The clinical indication for intervention was unstable angina (33.2%) and recent myocardial infarction (29.5%) in many cases. Most lesions (53.8%) had complex characteristics (Class B2 or C). The target vessel was the LAD in 42.5% and the right coronary artery in 36.8% of all cases. Four primary stent deployment failures occurred and implantation was successful in 259 (97.4%) of 266 stents. No death and no Q-wave myocardial infarction or emergency CABG occurred during hospital stay. Clinical success, defined as successful deployment without procedural or clinical event, was achieved in 230 (95.4%) of 241 patients. One-year clinical follow-up shows a low need for target lesion revascularization (17/237 [7.1%] patients) and a 15.8% rate of major adverse cardiac events (36/237 patients). The clinical and angiographic outcomes of our study suggest that the hybrid, amorphous hydrogenated silicon carbide coated design is promising and merits further evaluation in larger clinical trials. PMID:12053317

  9. Congenital cloaca: Long-term follow-up results with emphasis on outcomes beyond childhood.

    PubMed

    Rintala, Risto J

    2016-04-01

    Persistent cloaca remains a challenge for pediatric surgeons and urologists. Reconstructive surgery of cloacal malformations aims to repair the anorectum, urinary tract, and genital organs, and achieve fecal and urinary continence as well as functional genital tract capable for sexual activity and pregnancy. Unfortunately, even in most experienced hands these goals are not always accomplished. The endpoint of the functional development of bowel, urinary, and genital functions is the completion of patient's growth and sexual maturity. It is unlikely that there will be any significant functional improvement beyond these time points. About half of the patients with cloaca attain fecal and urinary continence after their growth period. The remaining half stay clean or dry by adjunctive measures such as bowel management by enemas or ACE channel, and continent urinary diversion or intermittent catheterization. Problems related to genital organs such as obstructed menstruations, amenorrhea, and introitus stenosis are common and often require secondary surgery. Encouragingly, most adolescent and adult patients are capable of sexual life despite often complex vaginal primary and secondary reconstructions. Also, cloacal malformation does not preclude pregnancies, although they still are quite rare. Pregnant patients with cloaca require special care and follow-up to guarantee uncomplicated pregnancy and preservation of anorectal and urinary functions. Cesarean section is recommended for cloaca patients. The self-reported quality of life of cloaca patients appears to be comparable to that of female patients with less complex anorectal malformations. PMID:26969236

  10. Currarino triad: surgical management and follow-up results of four [correction of three] cases.

    PubMed

    Isik, Nejat; Elmaci, Ilhan; Gokben, Bekir; Balak, Naci; Tosyali, Nadir

    2010-08-01

    The Currarino syndrome is a rare triad that is a combination of a presacral mass, a congenital sacral bony abnormality and an anorectal malformation. We present 4 children with complete Currarino triad who were diagnosed using MRI. Our aim was to report the neurosurgical management of Currarino syndrome in children. All of the patients had chronic constipation and pain in the lumbosacral region. In the plain radiograph, 3 patients had a sacral scimitar-shaped bony abnormality, and 1 patient had total sacral agenesis. There was a narrow anal canal or narrow ventrally displaced anus in all patients. Their anorectal malformations were characterized as anal stenoses (4 patients), associated with Hirschsprung's disease in 2 cases. In 3 patients, MRI showed tethered cord syndrome in addition to the presacral mass. There was hydrocephalus in 1 patient. Anal stenosis was treated by anal dilatation. In 2 patients, rectal biopsy and temporary colostomy (2 patients) had been performed previously due to Hirschsprung's disease. We performed a posterior procedure via lumbar and sacral partial laminectomy-laminoplasty and transdural ligation of the neck of the meningocele for anterior sacral meningoceles, or alternatively, tumor excision for other types of presacral lesions. Histopathologically, 3 were cases of anterior sacral meningoceles and 1 was a teratoma. One of them also had a spinal abscess. He required reoperation (twice) and appeared at the time to have improved with medical therapy. All patients improved and stabilized. There were no additional neurological deficits and no recurrence of the presacral mass over the follow-up period (6 years, on average). The family pedigree did not reveal any familial transmission pattern. In cases of Currarino triad, MRI can allow the characterization of the presacral masses. If it is an anterior sacral meningocele or a solid tumor without severe anorectal malformation, it can be managed with posterior lumbar and sacral procedures

  11. Ultrasound-guided foam sclerotherapy of great saphenous vein with 2% polidocanol – one-year follow-up results

    PubMed Central

    Osęka, Marcin; Tworus, Robert; Gałązka, Zbigniew

    2016-01-01

    Introduction Ultrasound-guided foam sclerotherapy (UGFS) of varicose veins is a useful treatment option. It is a relatively safe method in the case of limited, small varicose veins. In theory, a justified concern could be raised that the injection of an active drug into the large superficial venous vessels may potentially cause life-threatening consequences. Aim To assess the safety and efficacy of UGFS using a 2% solution of polidocanol (Aethoxysklerol 2%) in the case of great saphenous vein incompetence. Material and methods Fifty-two patients with great saphenous vein incompetence underwent ultrasound-guided foam sclerotherapy. The efficacy criterion was the elimination of reflux measured ultrasonographically and withdrawal or decrease of complaints: 1 week, and 1, 3, 6 and 12 months after the treatment. Complications of sclerotherapy were reported during follow-up. Results Decrease or withdrawal of complaints of chronic venous insufficiency was reported in 96% of cases (50 patients). Disappearance or decrease of varicose veins was noted in all patients (100%). During examination after 12 months, full success of ultrasound was achieved in 38 (73%) cases, and 11 (21%) patients presented a partial desired effect according to the consensus from Tegernsee. Persistence of reflux longer than 1 s in the treated great saphenous vein was reported in 3 (6%) cases. Serious complications, such as deep vein thrombosis, pulmonary embolism, dyspnea, anaphylaxis, or neurological abnormalities, were not recorded. Conclusions Ultrasound-guided foam sclerotherapy of incompetent great saphenous vein and varicosities with 2% polidocanol was found to be an effective and safe method of treatment during 1 year of observation. However, longer observation is necessary. PMID:27458485

  12. Cognitive-Behaviorally-Oriented Group Rehabilitation of Adults with ADHD: Results of a 6-Month Follow-Up

    ERIC Educational Resources Information Center

    Salakari, Anita; Virta, Maarit; Gronroos, Nina; Chydenius, Esa; Partinen, Markku; Vataja, Risto; Kaski, Markus; Iivanainen, Matti

    2010-01-01

    Objective: Recently, novel psychological treatments for adult ADHD have been reported with promising results. However, studies about long-term treatment effects are scanty. The authors study effects of cognitive-behaviorally-oriented group rehabilitation during a 6-month follow-up. Method: Participating in the rehabilitation were 29 adults, of…

  13. [Results from the X-ray and Optical Follow-up Observations of the Swift BAT AGN Survey

    NASA Technical Reports Server (NTRS)

    Mushotzky, R.

    2008-01-01

    I will present results from the x-ray and optical follow-up observations of the Swift BAT ACN survey. I will discuss the nature of obscuration in these objects, the relationship to optical properties and the change of properties with luminosity and galaxy type and how they will influence the design of XO.

  14. The relationship between low back pain and leisure time physical activity in a working population of cleaners - a study with weekly follow-ups for 1 year

    PubMed Central

    2012-01-01

    Background Low back pain (LBP) and leisure time physical activity (LTPA) are considered to be closely related, and clinical guidelines for the treatment of acute LBP recommend patients stay physically active. However, the documentation for this recommendation is sparse and based on studies involving patient populations. The purpose of the study was (1) to investigate the correlation between LBP and LTPA on a weekly basis over the course of a year in a high-risk group of cleaners; and (2) to investigate if maintaining LTPA during an episode of acute LBP has a positive effect on LBP intensity in the subsequent 4 weeks. Methods 188 cleaners consented to participate in a 52-week text message survey about hours of LTPA and intensity of LBP (from 0 to 9) over the previous 7 days. The correlation between LBP and LTPA was calculated by Pearson correlation coefficient. During an episode of acute LBP, a mixed effect logistic regression model was used to investigate whether cleaners who maintain LTPA have a lower pain intensity and higher probability of returning to initial pain intensity within the following four weeks compared with cleaners who decrease LTPA during acute LBP. Results The correlation between weekly LTPA and LBP data was negative, but numerically low (r = -0.069) and statistically insignificant (p = 0.08). Among the 82 cleaners experiencing at least one episode of acute LBP, those maintaining LTPA during an episode of acute LBP did not have a lower pain intensity (average LBP intensity difference between groups of 0.06; 95% confidence interval (95% CI) of -0.417 to 0.539) or higher probability of returning to initial pain level (Odds ratio 1,02; 95% CI of 0.50 to 2.09) in the following four weeks compared with cleaners decreasing LTPA during acute LBP. Conclusions Hours of LTPA and intensity of LBP measured on a weekly basis throughout a year showed no close correlation. Maintaining LTPA during an episode of acute LBP did not result in a positive effect on

  15. Physical and Cognitive Performance of Patients with Acute Lung Injury 1 Year after Initial Trophic versus Full Enteral Feeding. EDEN Trial Follow-up

    PubMed Central

    Dinglas, Victor D.; Morris, Peter E.; Jackson, James C.; Hough, Catherine L.; Mendez-Tellez, Pedro A.; Wozniak, Amy W.; Colantuoni, Elizabeth; Ely, E. Wesley; Rice, Todd W.; Hopkins, Ramona O.

    2013-01-01

    Rationale: We hypothesized that providing patients with acute lung injury two different protein/calorie nutritional strategies in the intensive care unit may affect longer-term physical and cognitive performance. Objectives: To assess physical and cognitive performance 6 and 12 months after acute lung injury, and to evaluate the effect of trophic versus full enteral feeding, provided for the first 6 days of mechanical ventilation, on 6-minute-walk distance, cognitive impairment, and secondary outcomes. Methods: A prospective, longitudinal ancillary study of the ARDS Network EDEN trial evaluating 174 consecutive survivors from 5 of 12 centers. Blinded assessments of patients’ arm anthropometrics, strength, pulmonary function, 6-minute-walk distance, and cognitive status (executive function, language, memory, verbal reasoning/concept formation, and attention) were performed. Measurements and Main Results: At 6 and 12 months, respectively, the mean (SD) percent predicted for 6-minute-walk distance was 64% (22%) and 66% (25%) (P = 0.011 for difference between assessments), and 36 and 25% of survivors had cognitive impairment (P = 0.001). Patients performed below predicted values for secondary physical tests with small improvement from 6 to 12 months. There was no significant effect of initial trophic versus full feeding for the first 6 days after randomization on survivors’ percent predicted for 6-minute-walk distance, cognitive impairment status, and all secondary outcomes. Conclusions: EDEN trial survivors performed below predicted values for physical and cognitive performance at 6 and 12 months, with some improvement over time. Initial trophic versus full enteral feeding for the first 6 days after randomization did not affect physical and cognitive performance. PMID:23805899

  16. Treatment of Visceral Aneurysm Using Multilayer Stent: Two-Year Follow-Up Results in Five Consecutive Patients

    SciTech Connect

    Balderi, Alberto Antonietti, Alberto Pedrazzini, Fulvio Sortino, Davide Vinay, Claudia Grosso, Maurizio

    2013-10-15

    Purpose: The present study was performed to analyze the midterm results (five consecutive patients, 2-year follow-up) of the endovascular management of visceral artery aneurysms using the Cardiatis Multilayer Flow Modulator (CMFM) (Cardiatis, Isnes, Belgium), a self-expandable stent. Materials and Methods: From August 2009 to January 2011, we implanted five CMFMs in five patients (all men; mean age 73 years) to treat two common hepatic artery aneurysms, one celiac trunk aneurysm, one splenic artery aneurysm, and one superior mesenteric artery aneurysm (diameter 25-81 mm). The primary end point was technical success. The secondary end point was stent patency, absence of aneurysm rupture or reperfusion, and shrinking of the sac at 6-, 12-, and 24-month follow-up using computed tomography angiography. Follow-up ranged from 24 to 48 months (mean 31.2). Results: Technical success was achieved in all patients. Complete exclusion of the aneurysm with sac shrinking was achieved in two patients. Two stents became occluded at 6- and 24-month follow-up, respectively; both patients were asymptomatic and were not retreated. One patient developed sac reperfusion due to incomplete aneurysm exclusion. Conclusion: Long-term results in a wider population are needed to validate the effectiveness of the CMFM.

  17. De novo stenting of descending thoracic aorta in Takayasu arteritis: intermediate-term follow-up results.

    PubMed

    Bali, H K; Bhargava, M; Jain, A K; Sharma, B K

    2000-12-01

    We report our intermediate-term follow-up results of de novo stenting of descending thoracic aorta in Takayasu arteritis. Six patients (5 males and 1 female) underwent aortoplasty and stenting (8 Wallstents were deployed in 6 patients). Aortoplasty was performed with conventional balloons in 5 patients and with an Inoue balloon in 1 patient. The mean diameter of the aorta increased from 5.36 +/- 0.62 mm to 13.91 +/- 1.8 mm after stenting while the peak systolic gradient was totally abolished in all cases. These results were significantly better than aortoplasty alone (p < 0.0001). Lower limb claudication improved in all patients. Hypertension was cured in 3 patients and improved in 3 patients. All patients were asymptomatic over 6Eth 30 months (mean, 22.8 +/- 4.0 months) follow-up. All patients underwent angiographic follow-up after 6 months. They continued to have an absence of gradient with excellent flow across the stents. A minimal intimal reaction was observed at the stent margins. On follow-up angiogram at 6 months, one of the patients was noted to have developed a small asymptomatic pseudoaneurysm at the lower margin of the stent, which gradually increased in size over the next year and was treated by percutaneous endovascular deployment of a Wallstent graft. Our series demonstrates the safety and efficacy of stent deployment in stenotic lesions of the aorta in Takayasu arteritis and proves that the results are superior to plain balloon aortoplasty alone. This is also the only study that demonstrates intermediate-term success by angiographic follow-up at 6 months. PMID:11103028

  18. Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year

    PubMed Central

    GARGARI, M.; PRETE, V.; PUJIA, M.; CERUSO, F. M.

    2013-01-01

    SUMMARY Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year. Objective The aim of this study is to compare functional efficiency and patients satisfaction between tooth-supported and implant-supported overdenture through a questionnaire that accurately reflects the real concerns of patients with dental prosthesis. Methods Forty-three patients were selected from the out patient clinic, Department of Dentistry “Fra G.B. Orsenigo Ospedale San Pietro F.B.F.”, Rome, Italy. Their age were ranging from 61 to 83 years. Eighteen patients were rehabilitated with overdentures supported by natural teeth and twenty-five with overdentures implant-supported. Discussion and Result The questionnaire proposed one year after the insertion of the prosthetis has showed that there isn’t difference statistically significant in terms of function, phonetics and aesthetics between overdenture implant-supported and tooth-supported. Conclusions The results of the questionnaire showed that the patients generally had a high level of satisfaction concern to the masticatory function, esthetics and phonetics. In addition, on average, they haven’t difficulty in removal and insertion of the denture and in oral hygiene. They haven’t in both groups problems related to fractures. PMID:23741602

  19. Open Surgical Treatment for Femoroacetabular Impingement in Patients over Thirty Years: Two Years Follow-up Results

    PubMed Central

    2015-01-01

    Purpose We report short term results of open surgical treatment for symptomatic femoroacetabular impingement (FAI) in patients over the age of 30 years. Materials and Methods Between May 2011 and June 2012, thirteen FAI hips (11 patients) with hip pain persisting longer than 6 months were treated by either surgical hip dislocation (SHD) or anterior mini-open. They were followed up for longer than 2 years. The 11 patients included 7 females and 4 males with a mean age of 45 (range, 33-60) years. They were clinically evaluated for modified Harris hip score (MHHS) and University of California at Los Angeles (UCLA) activity level. Their lateral center-edge angle, acetabular index, and alpha angle were measured and compared. Results Acetabuloplasties were performed for seven cases. Femoral osteochondroplasty was performed for all thirteen cases. At minimum follow-up of two year (range, 24-29 months), all patients had substantial relief in preoperative pain with improvement in range of motion. The median MHHS was significantly (P<0.05) improved from 61 points preoperatively to 87 points at the last follow-up. The median UCLA activity level was 7 (range, 5-8) at last follow-up. Radiological indices improved. Two cases showed mild residual pain attributable to adhesion between capsule and reshaped femoral head-neck area. Conclusion Open surgical treatment of FAI was a reliable and effective treatment method in symptomatic FAIs for patients over the age of 30 years without advanced arthritic change of hip joint at short term follow-up.

  20. Early administration of enzyme replacement therapy for Pompe disease: short-term follow-up results.

    PubMed

    Hamdan, M A; Almalik, M H; Mirghani, H M

    2008-12-01

    Pompe disease (glycogen storage disease II, OMIM # 232300), is a hereditary lysosomal disorder. It is characterized by deficiency of acid alpha-glucosidase enzyme (acid maltase, GAA, OMIM *606800, EC 3.1.26.2), secondary to mutations in the GAA gene (HGNC:4065) on chromosome 17q25.2-q25.3. Absent enzyme activity in the infantile form of Pompe disease results in abnormal glycogen deposition in the skeletal, cardiac, and smooth muscles, leading to hypertrophic cardiomyopathy, feeding abnormalities, hypotonia, weakness, respiratory insufficiency, and ultimately death. Prenatal diagnosis is accomplished by enzyme assay, mutation analysis or electron microscopy of amniotic fluid cells or chorionic villus sample. However, these techniques may not always be available, and can result in perinatal morbidity and fetal loss. Early diagnosis of Pompe disease results in early institution of enzyme replacement therapy (ERT), which minimizes morbidity and prolongs survival. We report the case of a 35-week part-of-twin neonate, whose older sibling died earlier because of infantile Pompe disease. At 32 weeks of gestation, fetal echocardiography showed hypertrophic cardiomyopathy in twin 1, which persisted until birth at 35 weeks of gestation. Diagnosis was confirmed after birth by enzyme assay, and mutation analysis showing homozygosity for the sequence change 1327-2A>G (GAA intr 8). Administration of ERT at 18 h of age, resulted in normalization of cardiac abnormalities within 21 weeks of therapy, and normal neurodevelopmental assessment at 46 weeks, using Griffiths Mental Development Scales. To our knowledge, this is the youngest patient reported to receive ERT for Pompe disease, and the first report of prenatal diagnosis of Pompe disease by fetal echocardiography. PMID:19067231

  1. Embolization of Iatrogenic Vascular Injuries of Renal Transplants: Immediate and Follow-Up Results

    SciTech Connect

    Dorffner, Roland; Thurnher, Siegfried; Prokesch, Rupert; Bankier, Alexander; Turetschek, Karl; Schmidt, Alice; Lammer, Johannes

    1998-03-15

    Purpose: To evaluate the outcome in seven patients in whom iatrogenic vascular complications were treated with catheter embolization. Methods: Angiography showed an arteriovenous fistula in six of the seven patients, a pseudoaneurysm in three patients, and an arteriocaliceal fistula in three patients. Embolization was performed with GAW coils or microcoils in all cases. In three patients enbucrilate, polyvinyl alcohol, or absorbable gelatin powder was administered as an adjunct to the coils. Results: Angiographic success with total occlusion of the vascular injury was achieved in five of the seven patients and clinical success was achieved in four of seven cases. In two cases, nephrectomy after embolization was necessary because of renal artery occlusion or acute hemorrhage at the renal artery anastomosis, respectively. Infarction of 30%-50% of the renal parenchyma was seen in two cases. Conclusion: Angiographically successful embolization is not necessarily associated with clinical success. The complication rate is high.

  2. [Psychopathometrical results of follow-up studies of trichloroethylene-exposed persons (author's transl)].

    PubMed

    Triebig, G; Lehrl, S; Kinzel, W; Erzigkeit, H; Galster, J V; Schaller, K H

    1977-01-01

    Seven clinical healthy volunteers were exposed to trichloroethylene concentration in air with 520 mg/m3 (100 ppm) at an average 6 hours a day on 5 consecutive days. Corresponding volunteers were exposed to a placebo for the same period. --The persons were examined psychopathometrically and biochemically at the beginning and after every day of exposure. The trichloroethylene-metabolites in blood and urine were dated in order to quantify the loads. --Purpose of the psychopathometrical testing methods was the observation, whether a psychological impairment in the sense of a "psychoorganic syndrome" may occur under these exposition-conditions. --Standardized achievement-tests and self-report rating scales were used in order to demonstrate reversible physical provable psychosis that may be possible. Comparing the psychopathometrical results of the exposed and non-exposed volunteers no statistical significant difference was visible in spite of the analytically proved considerable incorporation of the solvent. PMID:329621

  3. Experimental results of single screw mechanical tests: a follow-up to SAND2005-6036.

    SciTech Connect

    Lee, Sandwook; Lee, Kenneth L.; Korellis, John S.; McFadden, Sam X.

    2006-08-01

    The work reported here was conducted to address issues raised regarding mechanical testing of attachment screws described in SAND2005-6036, as well as to increase the understanding of screw behavior through additional testing. Efforts were made to evaluate fixture modifications and address issues of interest, including: fabrication of 45{sup o} test fixtures, measurement of the frictional load from the angled fixture guide, employment of electromechanical displacement transducers, development of a single-shear test, and study the affect of thread start orientation on single-shear behavior. A286 and 302HQ, No.10-32 socket-head cap screws were tested having orientations with respect to the primary loading axis of 0{sup 0}, 45{sup o}, 60{sup o}, 75{sup o} and 90{sup o} at stroke speeds 0,001 and 10 in/sec. The frictional load resulting from the angled screw fixture guide was insignificant. Load-displacement curves of A286 screws did not show a minimum value in displacement to failure (DTF) for 60{sup o} shear tests. Tests of 302HQ screws did not produce a consistent trend in DTF with load angle. The effect of displacement rate on DTF became larger as shear angle increased for both A286 and 302HQ screws.

  4. [Cementless total hip arthroplasty--results of 8-year follow-up study].

    PubMed

    Wall, Andrzej; Dragan, Szymon

    2006-01-01

    The subjects of the clinical examinations were 382 patients who from 1994 to 1999 were treated with the method of total cementless arthroplasty. The observation time ranged from 3 to 8 years. In the examined group the secondary cause of degenerative changes was identified in 210 (55%) patients. In the remaining 172 cases (45%) the primary cause of degenerative changes in the hip was diagnosed. Four types of cementless endoprostheses, varied in their construction, structure of their surfaces and material they were made of, were used to carry out the postoperative treatment of the degenerative changes in the hip: Antega, Zweymüller SL PLUS (Endoprosthetic) or Alloclasic type of stem, GSS-CL and PM-Plasmapore. The findings of the clinical investigation made it possible to determine the probability of surviving of an endoprosthesis up to the 8th year after an operation depending on a type of implanted stem, which according to Kaplan-Meier's method, amounted to 0.9603. The results of Harris scale evaluation of the function of the operated joints demonstrated the existence of the relationship between the function and the course of bone osteointegration and growth process. The detailed analysis of the X-ray examinations, and especially of the roentgenometric ones, taking into account stability of the endoprosthesis stem enabled to distinguish two stages of the clinical and roentgenological changes: the early stage (up to 6 months after an operation) characterised by settling and micromotions of the stem and the late stage (starting 6-9 months after an operation) with slowly gradual increasing of the function and holding back of stem settling. PMID:17017478

  5. Comparison of exercise capacity in COPD and other etiologies of chronic respiratory failure requiring non-invasive mechanical ventilation at home: retrospective analysis of 1-year follow-up

    PubMed Central

    Salturk, Cuneyt; Karakurt, Zuhal; Takir, Huriye Berk; Balci, Merih; Kargin, Feyza; Mocin, Ozlem Yazıcıoglu; Gungor, Gokay; Ozmen, Ipek; Oztas, Selahattin; Yalcinsoy, Murat; Evin, Ruya; Ozturk, Murat; Adiguzel, Nalan

    2015-01-01

    Introduction The objective of this study was to compare the change in 6-minute walking distance (6MWD) in 1 year as an indicator of exercise capacity among patients undergoing home non-invasive mechanical ventilation (NIMV) due to chronic hypercapnic respiratory failure (CHRF) caused by different etiologies. Methods This retrospective cohort study was conducted in a tertiary pulmonary disease hospital in patients who had completed 1-year follow-up under home NIMV because of CHRF with different etiologies (ie, chronic obstructive pulmonary disease [COPD], obesity hypoventilation syndrome [OHS], kyphoscoliosis [KS], and diffuse parenchymal lung disease [DPLD]), between January 2011 and January 2012. The results of arterial blood gas (ABG) analyses and spirometry, and 6MWD measurements with 12-month interval were recorded from the patient files, in addition to demographics, comorbidities, and body mass indices. The groups were compared in terms of 6MWD via analysis of variance (ANOVA) and multiple linear regression (MLR) analysis (independent variables: analysis age, sex, baseline 6MWD, baseline forced expiratory volume in 1 second, and baseline partial carbon dioxide pressure, in reference to COPD group). Results A total of 105 patients with a mean age (± standard deviation) of 61±12 years of whom 37 had COPD, 34 had OHS, 20 had KS, and 14 had DPLD were included in statistical analysis. There were no significant differences between groups in the baseline and delta values of ABG and spirometry findings. Both univariate ANOVA and MLR showed that the OHS group had the lowest baseline 6MWD and the highest decrease in 1 year (linear regression coefficient −24.48; 95% CI −48.74 to −0.21, P=0.048); while the KS group had the best baseline values and the biggest improvement under home NIMV (linear regression coefficient 26.94; 95% CI −3.79 to 57.66, P=0.085). Conclusion The 6MWD measurements revealed improvement in exercise capacity test in CHRF patients receiving

  6. Total Knee Arthroplasty Using a Posterior Cruciate Ligament Sacrificing Medial Pivot Knee: Minimum 5-year Follow-up Results

    PubMed Central

    Youm, Yoon-Seok; Lee, Seon-Ho; Cho, Hye-Yong

    2014-01-01

    Purpose To evaluate minimum 5-year follow-up clinical and radiological results of total knee arthroplasty (TKA) using a posterior cruciate ligament sacrificing (PS), non-substituting Advance Medial Pivot Knee. Materials and Methods One hundred and twenty knees in 80 patients who could be followed up for more than 5 years after TKA using the PS Advance Medial Pivot Knee were evaluated retrospectively. The evaluations included the preoperative and postoperative range of motion (ROM), tibiofemoral angle, Knee Society (KS) knee and function scores, and Western Ontario and McMaster Universities Arthritis Index (WOMAC) score. The Kaplan-Meier method was used for survival analysis. Results The ROM increased from a preoperative mean flexion contracture of 7.6° and further flexion of 115.1° to a postoperative mean flexion contracture of 1.5° and further flexion of 120.5°. The tibiofemoral angle was changed from 4.6° varus preoperatively to 5.8° valgus postoperatively. The KS knee and function scores as well as WOMAC score significantly improved after surgery (p<0.05). Complications developed in 4 cases (3.3%): 2 cases of periprosthetic patellar fracture (1.7%) and 2 cases of aseptic loosening (1.7%). The seven-year survival rate was 98.1% in the Kaplan-Meier survival analysis. Conclusions The minimum 5-year follow-up results of TKA using the PS Medial Pivot Knee were satisfactory. PMID:25229042

  7. Retinal nerve fiber layer thickness changes in obstructive sleep apnea syndrome: one year follow-up results

    PubMed Central

    Zengin, Mehmet Ozgur; Tuncer, Ibrahim; Karahan, Eyyup

    2014-01-01

    AIM To investigate the retinal nerve fiber layer (RNFL) thickness changes in patients with obstructive sleep apnea syndrome (OSAS) for one year follow-up. To discuss the possibility of detecting tendency of glaucoma in this population by using spectral domain optical coherence tomography (3D-OCT-2000 Spectral domain). METHODS After polysomnographic study, all subjects (64 OSAS patients and 40 controls) underwent detailed ophthalmological examination. After these examinations, patients with glaucoma and patients who had ophthalmological and/or systemic disease were excluded from the study. Totally, 20 patients in OSAS group and five patients in controls were excluded from the study in the first examination and follow-up period. The RNFL thickness was assessed with OCT. Forty-four OSAS patients and 35 control subjects were followed up 12mo. RNFL thickness change and OSAS patients were evaluated for severity of disease by Apnea-Hypopnea Index (AHI). RESULTS Forty-four OSAS patients and 35 controls were enrolled in the study. Statistically significance was found between OSAS patients and controls at the 12th mo. Average RNFL thickness was found to be significantly lower in last measurements in OSAS patients when compared with first measurements and control subjects (P<0.001, 0.002, respectively). There was a statistically significant correlation among AHI, and RNFL thickness (P<0.05). CONCLUSION The results suggest that the patients with OSAS were related with a proportional decrease in the RNFL thickness. These patients should be followed up regularly for glaucomatous changes. Detecting more RNFL thinning in severe OSAS was important. PMID:25161947

  8. Evaluation of a residential nutrition rehabilitation center in rural Bolivia: Short-term effectiveness and follow-up results

    PubMed Central

    Rebolledo, Paulina A.; Huamani, Katherine Foy; Mues, Katherine E.; Ramakrishnan, Usha; Leon, Juan S.

    2015-01-01

    Background Nutrition rehabilitation centers (NRCs) have shown mixed results in reducing morbidity and mortality among undernourished children in the developing world. Follow-up on children after leaving these programs remains undocumented. Objective To assess the nutritional improvement of children attending the Centro de Rehabilitación Infantil Nutricional (CRIN), a residential NRC in rural Bolivia, from entrance to exit and to a household follow-up visit 1 month to 6 years later, and to identify factors associated with nutritional improvement. Methods A retrospective analysis was conducted of clinical records collected by CRIN staff from 135 children under 3 years of age attending CRIN in rural Cochabamba, Bolivia, from 2003 to 2009, and of clinical records of household follow-up measurements on a subset of 26 children that were taken between 1 month and 6 years postexit. Nutritional status was evaluated by calculating z-scores for weight-for-height (WHZ), weight-for-age (WAZ), and height-for-age (HAZ). Children with z-scores < − 2 were considered to be wasted, underweight, or stunted, respectively. Results The prevalence of wasting decreased significantly, while the prevalence of stunting did not change significantly between entrance and exit from the program. From entrance to exit, the mean changes in WHZ (0.79) and WAZ (1.08) were statistically significant, while the mean change in HAZ (− 0.02) was not significant. Linear regression analysis suggested that nutritional status and diarrhea at entrance had the greatest effect on WHZ and HAZ changes between entrance and exit. Children maintained their nutritional gains from the program between exit and follow-up and showed statistically significant improvement in WAZ (but not HAZ). Conclusions CRIN is effective at rehabilitating nutritional deficits associated with wasting, but not those associated with stunting. PMID:25076769

  9. Long-term occlusion results with SILK flow diversion in 28 aneurysms: Do recanalizations occur during follow-up?

    PubMed Central

    Skalej, Martin; Beuing, Oliver; Eckert, Bernd; Behme, Daniel; Weber, Werner

    2015-01-01

    Background and purpose The purpose of this article is to report on the long-term success rates of Silk flow-diverter (FD) treatment in a multicenter prospective study for the treatment of complex aneurysms. Methods Between May 2008 and January 2011, all consecutive patients featuring complex intracranial aneurysms eligible for FD treatment with the Silk in three neurovascular centers were included. Clinical and imaging data were assessed during hospitalization and follow-up. Results Five patients were initially asymptomatic, 20 patients showed various neurological symptoms. Twenty-eight FDs were implanted in 25 patients treating 28 aneurysms. The immediate procedure-related morbidity was 8% (two of 25), mortality 0%. One procedure-related death was observed during follow-up (in-stent thrombosis). Compared to the immediate result nearly two of three aneurysms improved during follow-up; all angiographically confirmed inflow changes took place within six months after treatment. Final anatomic outcome in 24 aneurysms of 22 patients comprised 14 (59%) with complete occlusion, seven (29%) with a neck remnant, two (8%) with residual filling <50%, none with residual filling >50% and one (4%) unchanged in comparison to its pretreatment status. Postinterventional recanalizations were seen in three of 13 (23%) aneurysms treated with FD alone; none were observed in 15 aneurysms treated with adjunctive coiling. Conclusion Anatomic presentation and location are key for successful FD treatment. The rate of successful occlusion increases during follow-up. Postinterventional monitoring for at least six months is paramount, as anatomic outcome is not reliably predictable and recanalizations may occur in initially completely occluded aneurysms. PMID:26015522

  10. Older workers in the construction industry: results of a routine health examination and a five year follow up.

    PubMed Central

    Arndt, V; Rothenbacher, D; Brenner, H; Fraisse, E; Zschenderlein, B; Daniel, U; Schuberth, S; Fliedner, T M

    1996-01-01

    OBJECTIVE: To describe the health status of older construction workers and the occurrence of early retirement due to disability or of mortality within a five year follow up. METHODS: Firstly, a cross sectional study was performed among 4958 employees in the German construction industry, aged 40-64 years, who underwent standardised routine occupational health examinations in 1986-8. The study population included plumbers, carpenters, painters/varnishers, plasterers, unskilled workers, and white collar workers (control group). Job specific prevalence and age adjusted relative prevalence were calculated for hearing loss, abnormal findings at lung auscultation, reduced forced expiratory volume, increased diastolic blood pressure, abnormalities in the electrocardiogram, increased body mass index, hypercholesterolaemia, increased liver enzymes, abnormal findings in an examination of the musculoskeletal system, and abnormalities of the skin. Secondly, follow up for disability and all cause mortality was ascertained between 1992 and 1994 (mean follow up period = 4.5 y). Job specific crude rates were calculated for the occurrence of early retirement due to disability and for all cause mortality. With Cox's proportional hazards model, job specific relative risks, adjusted for age, nationality, and smoking were obtained. RESULTS: Compared with the white collar workers, a higher prevalence of hearing deficiencies, signs of obstructive lung diseases, increased body mass index, and musculoskeletal abnormalities were found among the construction workers at the baseline exam. During the follow up period, 141 men died and 341 men left the labour market due to disability. Compared with white collar workers, the construction workers showed a 3.5 to 8.4-fold increased rate of disability (P < 0.05 for all occupational groups) and a 1.2 to 2.1-fold increased all cause mortality (NS). CONCLUSIONS: This study shows the need and possibilities for further health promotion in workers

  11. Clinical results and development of heterotopic ossification in total cervical disc replacement during a 4-year follow-up

    PubMed Central

    Suchomel, Petr; Jurák, Lubomír; Brabec, Radim; Bradáč, Ondřej; Elgawhary, Shamel

    2009-01-01

    Cervical total disc replacement (CTDR) aims to decrease the incidence of adjacent segment disease through motion preservation in the operated disc space. Ongoing data collection and increasing number of studies describing heterotopic ossification (HO) resulting in decreased mobility of implants, forced us to carefully evaluate our long-term clinical and morphological results of patients with CTDR. We present the first 54 consecutive patients treated with 65 ProdiscC™ prostheses during a 12-month period (2/2004–3/2005). All patients signed an informed consent and were included in prospective long-term study approved by hospital ethical committee. The 1- and 2-year follow-up analysis were available for all patients included and 4-year results for 50 patients (60 implants). Clinical (neck disability index-NDI, visual analog scale-VAS) and radiological follow-up was conducted at 1-, 2- and 4-years after the procedure. The Mehren/Suchomel modification of McAfee scale was used to classify the appearance of HO. Mean preoperative NDI was 34.5%, VAS for neck pain intensity 4.6 and VAS for arm pain intensity 5.0. At 1-, 2- and 4-year follow-up, the mean NDI was 30.7, 27.2, and 30.4, mean VAS for neck pain intensity 2.5, 2.1 and 2.9 and mean VAS for arm pain intensity pain 2.2, 1.9 and 2.3, respectively. Significant HO (grade III) was present in 45% of implants and segmental ankylosis (grade IV) in another 18% 4 years after intervention. This finding had no clinical consequences and 92% of patients would undergo the same surgery again. Our clinical results (NDI, VAS) are comparable with fusion techniques. Although, advanced non-fusion technology is used, a significant frequency of HO formation and spontaneous fusion in cervical disc replacement surgery must be anticipated during long-term follow-up. PMID:20035357

  12. Hydroxyapatite-coated stems with metaphyseal and diaphyseal press-fit. Eleven-year follow-up results.

    PubMed

    Hernández Cortés, P; Nájera Sagastume, O O; Mesa Ramos, F; Pajares López, M; Hernández Hernández, M A

    2002-02-01

    We report the 11-year follow-up results of 52 unilateral primary hip arthroplasties performed with hydroxyapatite-coated stems. The femoral prosthesis used was a collarless titanium alloy implant, with proximal circumferential hydroxyapatite coating and increased distal thickness to fit the proximal diaphyseal region of the femur. Clinical evaluation was performed using the Merle d'Aubigné Hip Score. Anteroposterior and lateral radiographs were obtained and compared with previous postoperative films. Radiographic evaluation was carried out following Engh's criteria for uncemented implant fixation and using Livermore's method for measurement of polyethylene wear. At the end of the follow-up period, excellent and good clinical results were recorded in 40 arthroplasties (77%). The incidence of thigh pain at one year was 32.7%, but it decreased to 4.2% after the first post-operative year. The 11-year survival rate was 92.3%. Seven arthroplasties were revised because of aseptic loosening of the cup in one case, aseptic loosening of the stem, in one case, septic loosening of the stem in one case, periprosthetic fracture in two cases and polyethylene wear in three cases. Forty-two (87.5%) of the nonrevised stems met the criteria for radiographic osseointegration. Cortical hypertrophy was observed around the mid-part and tip of the stem in 22 patients of the series. This sign tends to be related to thigh pain (p < 0.1). Calcar osteolysis was present in 8 cases. There was only one case of distal femoral osteolysis. We found a strong and significant relationship between long-term wear rates and the occurrence of osteolysis (p < 0.001). We concluded that thigh pain is in relation to the distal diameter of the stems and significantly decreases after the first postoperative year. There was a low incidence of osteolysis in our series in comparison with other series of noncemented implants with 32-mm femoral heads and with similar follow-up. PMID:11915455

  13. Clinical results of meniscus repair with the meniscus arrow: a 4- to 8-year follow-up study.

    PubMed

    Koukoulias, Nikolaos; Papastergiou, Stergios; Kazakos, Konstantinos; Poulios, Georgios; Parisis, Konstantinos

    2007-02-01

    The short-term clinical results of meniscus repair with the meniscus arrow were promising. Unfavorable outcomes were reported in two studies, with longer follow-up, raising concerns about the efficacy of this device. We retrospectively reviewed 62 patients (mean age 23.7 years; range 14-37 years) that underwent all-inside meniscus repair, using the meniscus arrow. Seventeen patients had an isolated meniscus tear (ACL intact group) and 45 patients concomitant ACL rupture that was reconstructed at the same time with the meniscus repair (ACL reconstructed group). All patients followed a non-aggressive rehabilitation protocol. Follow-up was assessed by clinical examination, Lysholm and Tegner score, IKDC knee examination form and KT-2000 arthrometry for the anteroposterior laxity of the reconstructed knees. At an average follow-up of 73 months (range 49-96 months) there were three failures (4.8%), one from the ACL intact group and two from the ACL reconstructed group. One patient developed arthrofibrosis (ACL reconstructed group) that resolved conservatively. Soft tissue irritation at the repair site was noted in three patients. In two patients the symptoms were transient. In the third patient the arrow tip was cut off under local anaesthesia due to saphenous infrapatellar branch irritation and the symptoms resolved (inappropriate arrow size). KT-2000 arthrometry showed that sagittal knee laxity was less than 3 mm in all reconstructed knees. The mean Tegner activity score decreased from 6.7 (pretrauma) to 6.2 (postoperatively). The average Lysholm score was 96, with normal or nearly normal function of all success knees, according to the IKDC knee examination form. Our results show a high clinical success rate of meniscus repair with the meniscus arrow. We found this device both safe and effective. PMID:16858563

  14. Two- to Four-Year Follow-up Results of Total Knee Arthroplasty Using a New High-Flexion Prosthesis

    PubMed Central

    Kim, Man Soo; Koh, In Jun; Jang, Sung Won; Jeon, Neung Han

    2016-01-01

    Purpose The purpose of this study was to evaluate minimum 2-year follow-up results of total knee arthroplasty (TKA) performed using a new high-flexion prosthesis design (LOSPA). Materials and Methods The 2- to 4-year results of 191 consecutive TKAs (177 patients) with the LOSPA posterior-stabilized prosthesis were evaluated. The patients were assessed clinically and radiographically using the Knee Society scoring system (KSS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results The mean range of motion (ROM) increased significantly from 117.4° (range, 75° to 140°) preoperatively to 126.7° (range, 80° to 144°) postoperatively (p<0.001). The mean KSS and WOMAC scores improved significantly from 121.4 (range, 42 to 185) and 56.1 (range, 23 to 88) preoperatively to 174.0 (range, 130 to 200) and 16.4 (range, 0 to 85) postoperatively, respectively (both, p<0.001). One knee required revision for deep infection. No knee had aseptic loosening or osteolysis. Radiolucent lines were noted in 15 knees (7.9%). Conclusions The new high-flexion total knee prosthesis resulted in no early aseptic loosening of the component and improved postoperative ROM comparable to other high-flexion TKA prostheses at 2- to 4-year follow-ups. PMID:26955612

  15. One-year follow-up results of combined use of CO2 laser and cold instrumentation for Reinke's edema surgery in professional voice users.

    PubMed

    Dursun, Gursel; Ozgursoy, Ozan Bagis; Kemal, Ozgur; Coruh, Isil

    2007-09-01

    The purpose of this study was to present our experience with combined use of CO2 laser and cold instrumentation for Reinke's edema surgery and to evaluate 1-year follow-up results of the technique in a series of professional voice users. Fifteen patients with Reinke's edema who underwent microlaryngoscopic surgery were included. Videolaryngostroboscopy, perceptual and acoustic voice analyses were performed before and after surgery. During the 1-year follow-up, no recurrence of Reinke's edema was encountered. Significant postoperative improvement was obtained in the quality of voice, in terms of GRBAS scores, Fo, jitter, shimmer and NHR. No evidence of laryngeal cancer was found on the histological examinations. Combined use of CO2 laser and cold instrumentation provides a reliable and safe method for Reinke's edema surgery, and cessation of smoking, voice rest and control of the laryngopharyngeal reflux contribute to the success of surgery. We consider that the removal of redundant mucosa of the vocal fold reduces the risk of the recurrence of Reinke's edema and provides better quality of voice. However, it does not imply that our method is superior to others', but this procedure constitutes an effective treatment of choice for Reinke's edema patients, including professional voice users. PMID:17431653

  16. Prognostic value of FDG-PET in Hodgkin lymphoma for posttreatment evaluation. Long term follow-up results.

    PubMed

    Molnar, Z; Simon, Z; Borbenyi, Z; Deak, B; Galuska, L; Keresztes, K; Miltenyi, Z; Marton, I; Rosta, A; Schneider, T; Tron, L; Varady, E; Illes, A

    2010-01-01

    Determining the viability of residual tumor masses is a great challenge after primary treatment of Hodgkin lymphoma. FDG-PET may play a crucial role in this procedure. In this study, files of 128 Hodgkin lymphoma patients were reviewed, who were treated in three Hungarian hematology centers between January 1995 and February 2005. CT scan showed residual tumor mass by all of them. Their median follow-up was 75.5 months from PET examination. The number of true-positive, true-negative, false-positive, false-negative subjects were 29, 83, 10, 6, respectively. Sensitivity of post-treatment FDG-PET was 83 %, specificity 93 %, positive predictive value 74 %, negative predictive value 93 %, and accuracy 88 %. The difference between the event free survival of PET positive and negative cases is highly significant (p=0.0000), according to the Mantel-Cox test. Our results in the largest cohort of patients, in accordance with literature, clearly indicates that patients with negative FDG-PET results are unlikely to progress or relapse during the longest follow-up. PMID:20429626

  17. Extracranial Carotid Artery Stenting in Surgically High-Risk Patients Using the Carotid Wallstent Endoprosthesis:Midterm Clinical and Ultrasound Follow-Up Results

    SciTech Connect

    Maleux, Geert Bernaerts, Pauwel; Thijs, Vincent; Daenens, Kim; Vaninbroukx, Johan; Fourneau, Inge; Nevelsteen, Andre

    2003-08-15

    The purpose of this study was to evaluate the feasibility, safety and midterm outcome of elective implantation of the Carotid Wallstent (registered) in patients considered to be at high surgical risk. In a prospective study, 54 carotid artery stenoses in 51 patients were stented over a 24-month period. Three patients underwent bilateral carotid artery stenting. Institutional inclusion criteria for invasive treatment of carotid occlusive disease (carotid endarterectomy or carotid artery stenting) are patients presenting with a 70% or more symptomatic stenosis and those with an 80% or more asymptomatic stenosis having a life-expectancy of more than 1 year. All patients treated by carotid artery stenting were considered at high risk for carotid endarterectomy because of a hostile neck (17 patients-31.5%) or because of severe comorbidities (37 patients-68.5%). No cerebral protection device was used. Of the 54 lesions, 33 (61.1%) were symptomatic and 21 (38.8%) were asymptomatic. Follow-up was performed by physical examination and by duplex ultrasonography at 1 month, 6 months, 1 year and 2 years after the procedure. All 54 lesions could be stented successfully without periprocedural stroke. Advert events during follow-up (mean 13.9 {+-} 5.7 months) were non-stroke-related death in 6 patients (11.1%), minor stroke in 4 stented hemispheres(7.4%), transient ipsilateral facial pain in 1 patient (1.8%),infection of the stented surgical patch in 1 patient (1.8%) and asymptomatic in stent restenosis in 4 patients (7.4%). The percutaneous implantation of the Carotid Wallstent (registered) , even without cerebral protection device, appears to be a safe procedure with acceptable clinical and ultrasonographic follow-up results in patients at high surgical risk. But some late adverse events such as ipsilateral recurrence of non-disabling (minor) stroke or in stent restenosis still remain real challenging problems.

  18. Percutaneous Transcatheter Closure of Ruptured Sinus of Valsalva Aneurysm: Immediate Result and Long-Term Follow-Up.

    PubMed

    Sinha, Sudhir Chandra; Sujatha, Vipperla; Mahapatro, Anil Kumar

    2015-06-01

    There is scarcity of data on closure and long-term follow-up of percutaneous treatment of ruptured sinus of Valsalva aneurysm (RSOVA). In this article, we present our experience in percutaneous closure of this defect. Between December 2009 and July 2014, 11 cases of RSOVA were referred to our hospital. Eight of the 11 cases (72.7%) were considered for percutaneous closure. Seven of the eight (87.5%) patients underwent successful percutaneous closure. There were four females and three males in the age group of 16 to 48 years (mean 24.7 ± 6.1 years). Associated defects were bicuspid aortic valve in one patient, mild preexisting aortic regurgitation in two patients, and healed infective endocarditis in one patient. Echocardiography revealed RSOVA from right coronary sinus (RCS) to right atrium (RA) in one patient (14.3%), RCS to right ventricular outflow in three patients (42.8%), and noncoronary sinus ruptured into RA in three patients (42.8%). All patients were symptomatic in New York Heart Association (NYHA) class II to IV. The defect size ranged from 7 to 10 mm (mean 8.4 ± 1.3 mm). The defects were closed from the venous side with device selection 2 to 4 mm higher than the defect size under fluoroscopy and transesophageal echocardiography guidance. Technical success was 87.5%. The mean device size was 12.0 ± 1.6 mm/10.0 ± 1.6 mm. Six out of seven patients (85.7%) had complete disappearance of shunt before discharge. During 1 to 55 months follow-up, all patients were in NYHA class I. There was no residual shunt, progression of AR or new AR, infective endocarditis or device embolization. Percutaneous closure of RSOVA appears to be a safe alternative to surgical therapy, with high technical success and excellent long-term outcome. PMID:26060380

  19. Effects of a Prekindergarten Educational Intervention on Adult Health: 37-Year Follow-Up Results of a Randomized Controlled Trial

    PubMed Central

    Schweinhart, Lawrence; Montie, Jeanne; Neidell, Matthew

    2009-01-01

    Objectives. We used 37 years of follow-up data from a randomized controlled trial to explore the linkage between an early educational intervention and adult health. Methods. We analyzed data from the High/Scope Perry Preschool Program (PPP), an early school-based intervention in which 123 children were randomized to a prekindergarten education group or a control group. In addition to exploring the effects of the program on health behavioral risk factors and health outcomes, we examined the extent to which educational attainment, income, family environment, and health insurance access mediated the relationship between randomization to PPP and behavioral and health outcomes. Results. The PPP led to improvements in educational attainment, health insurance, income, and family environment Improvements in these domains, in turn, lead to improvements in an array of behavioral risk factors and health (P = .01). However, despite these reductions in behavioral risk factors, participants did not exhibit any overall improvement in physical health outcomes by the age of 40 years. Conclusions. Early education reduces health behavioral risk factors by enhancing educational attainment, health insurance coverage, income, and family environments. Further follow-up will be needed to determine the long-term health effects of PPP. PMID:19542034

  20. Lower Urinary Tract Symptoms and Risk of Bladder Cancer in Men: Results from the Health Professionals Follow-Up Study

    PubMed Central

    Zhou, Jiachen; Kelsey, Karl T.; Smith, Scott; Giovannucci, Edward; Michaud, Dominique S.

    2015-01-01

    Objectives To understand the association between Lower urinary tract symptoms (LUTS) and risk of bladder cancer in a large men's cohort. Methods Using data from the Health Professionals Follow-up Study, we examined risk of bladder cancer in relation to severity of LUTS among 30,183 men. During the follow-up period from 1996 until 2010, 476 newly diagnosed cases of bladder cancer occurred. Cox proportional hazards regression was used to adjust for potential confounders. Results Among men with severe LUTS, risk of bladder cancer was 64% higher (relative risk (RR): 1.64, 95% confidence interval (CI): 0.87, 3.08) compared with men who reported no LUTS. Subjects with both voiding and storage dysfunction had a significantly higher risk of bladder cancer (RR: 1.60, 95% confidence interval: 1.00, 2.56). Among individual urinary symptoms, urinary hesitancy was strongly associated with bladder cancer; those who experienced urinary hesitancy at least 50% of the time had more than twice the risk of bladder cancer (RR: 2.21, 95% CI: 1.29, 3.78). Conclusions Our findings suggest that LUTS, especially urinary hesitancy, are associated with the development of bladder cancer in men. PMID:25863833

  1. Sonoelastography in the evaluation of capsule formation after breast augmentation – preliminary results from a follow-up study

    PubMed Central

    Paczkowska, Katarzyna; Kubasik, Mikołaj; Opala, Tomasz

    2015-01-01

    Introduction There are many indications for breast augmentation, including reconstruction after mastectomy, correction of congenital disorders and cosmetic procedures. The most frequent local complication of this surgery is capsule formation due to fibrosis. The aim of the study was to assess the usefulness of sonoelastography in the evaluation of capsule formation around silicone implants. Material and methods The study group included 13 patients aged 20 to 41, who underwent breast augmentation with silicone implants. Their 26 breasts were examined before surgery, 7 and 14 days and a minimum of 8.5 months after surgery. The breast stiffness was assessed with tonometry and shear wave elastography to evaluate elasticity of the breast tissue and capsule formation after surgery. Results We assessed the correlation between capsular elasticity measured at successive visits and the Baker scale. There were no significant relationships between any pairs of variables (p > 0.05). We also analyzed the correlation between the time of the follow-up and changes in the tissue elasticity of every region – no significant relationship was found. The greatest decrease in pericapsular elasticity was established in lower and inner quadrants. Moreover, there was a significant difference between the elasticity of the tissue before and 1 week after surgery (p < 0.05) and no significant changes in the elasticity before surgery and at the end of the follow-up. Conclusions Sonoelastography is precise in evaluation of capsule formation after breast augmentation. It may show changes that cannot be assessed using palpation. PMID:27478461

  2. Results of a unicentric series of 15 wrist prosthesis implantations at a 5.2 year follow-up.

    PubMed

    Chevrollier, Jérémie; Strugarek-Lecoanet, Clotilde; Dap, François; Dautel, Gilles

    2016-03-01

    Our retrospective study aimed to evaluate functional and radiological results of a unicentric series of 17 total wrist prostheses implanted between 2001 and 2011. Nine women and seven men, mean age 59, underwent wrist joint arthroplasty, bilateral in one case. Universal Total Wrist and Remotion prostheses were used and followed-up at a mean of 5.2 years (1.1-10). Fifteen patients were reviewed. Four patients had postoperative complications, three of whom required arthrodesis. The rest obtained satisfactory pain relief. Grip strength nevertheless decreased compared to the contralateral side and mobility was reduced: flexion/extension=33°, ulnar/radial deviation=20°. The Quick DASH score was 29% and PRWE, 26%. Radiological assessment revealed carpal implant loosening in eight patients. Our series confirms the discordance generally observed between patients' subjective satisfaction and mediocre clinical and radiological results over the medium term. PMID:26984652

  3. What Affects Reintegration of Female Drug Users after Prison Release? Results of a European Follow-Up Study

    ERIC Educational Resources Information Center

    Zurhold, Heike; Moskalewicz, Jacek; Sanclemente, Cristina; Schmied, Gabriele; Shewan, David; Verthein, Uwe

    2011-01-01

    The main objective of this follow-up study is to explore factors influencing the success or failure of women in reintegrating after their release from prison. Female drug users in five European cities were tracked after being released from prison. Out of 234 female prisoners contacted in prisons, 59 were included in the follow-up study. Structured…

  4. Long term results of open reduction management of condylar fracture: a 20 years follow-up. Case report.

    PubMed

    Farronato, G; Giannini, L; Galbiati, G; Maspero, C

    2012-10-01

    Management of condylar fracture may be surgical (open reduction) or non surgical (closed treatment). The age of the patient is a key factor in the choice of treatment. Condylar fracture requires early treatment to avoid ankylosis, to reduce facial deformity, aesthetic problems and functional disturbances. The protocol described in this case report showed excellent results and achieved all the treatment objectives. Early mobilization is the key in treating condylar fractures and to allow functional remodelling. It is important that every specialist should be able to suspect condylar fracture when facial asymmetry, joint problems, muscles pain, occlusion or nerve disorders develop after an injury. An early diagnosis can permit an early treatment that prevents esthetic and functional complications. The purpose of this article is to describe the long term clinical and radiological evaluation of unilateral condylar fracture in a teenager patient treated by condylectomy, physiotherapy and fixed appliance therapy. Twenty years follow-up records are presented. PMID:23076028

  5. Substrate reduction therapy with miglustat in chronic GM2 gangliosidosis type Sandhoff: results of a 3-year follow-up.

    PubMed

    Masciullo, Marcella; Santoro, Massimo; Modoni, Anna; Ricci, Enzo; Guitton, Jerome; Tonali, Pietro; Silvestri, Gabriella

    2010-12-01

    GM2 gangliosidosis type Sandhoff is caused by a defect of beta-hexosaminidase, an enzyme involved in the catabolism of gangliosides. It has been proposed that substrate reduction therapy using N-butyl-deoxynojirimycin (miglustat) may delay neurological progression, at least in late-onset forms of GM2 gangliosidosis. We report the results of a 3-year treatment with miglustat (100 mg t.i.d) in a patient with chronic Sandhoff disease manifesting with an atypical, spinal muscular atrophy phenotype. The follow-up included serial neurological examinations, blood tests, abdominal ultrasound, and neurophysiologic, cognitive, brain, and muscle MRI studies. We document some minor effects on neurological progression in chronic Sandhoff disease by miglustat treatment, confirming the necessity of phase II therapeutic trials including early-stage patients in order to assess its putative efficacy in chronic Sandhoff disease. PMID:20821051

  6. Long-Term Follow-Up Results of Anterior Cervical Inter-Body Fusion with Stand-Alone Cages

    PubMed Central

    Kim, Woong-Beom; Choi, Hoyong; Kim, Ki-Jeong; Jahng, Tae-Ahn; Kim, Hyun-Jib

    2016-01-01

    Objective The purpose of this study was to evaluate long-term follow-up radiologic/clinical outcomes of patients who underwent anterior cervical discectomy and inter-body fusion (ACDF) with stand-alone cages (SAC) in a single academic institution. Methods Total 99 patients who underwent ACDF with SAC between February 2004 and December 2012 were evaluated retrospectively. A total of 131 segments were enrolled in this study. Basic demographic information, radiographic [segmental subsidence rate, fusion rate, C2–7 global angle, and segmental angle changes)/clinical outcomes (by Odom's criteria and visual analog score (VAS)] and complications were evaluated to determine the long-term outcomes. Results The majority were males (55 vs. 44) with average age of 53.2. Mean follow-up period was 62.9 months. The segmental subsidence rate was 53.4% and fusion rate was 73.3%. In the subsidence group, anterior intervertebral height (AIH) had more tendency of subsiding than middle or posterior intervertebral height (p=0.01). The segmental angle led kyphotic change related to the subsidence of the AIH. Adjacent segmental disease was occurred in 18 (18.2%) patients. Total 6 (6%) reoperations were performed at the index level. There was no statistical significance between clinical and radiological outcomes. But, overall long-term clinical outcome by Odom's criteria was unsatisfactory (64.64%). The neck and arm VAS score were increased by over time. Conclusion Long-term outcomes of ACDF with SAC group were acceptable but not satisfactory. For optimal decision making, more additional comparative long-term outcome data is needed between ACDF with SAC and ACDF with plating. PMID:27446521

  7. Combined laparoscopic pyelolithotomy and endoscopic pyelolithotripsy for staghorn calculi: long-term follow-up results from a case series

    PubMed Central

    Pastore, Antonio Luigi; Palleschi, Giovanni; Silvestri, Luigi; Leto, Antonino; Ripoli, Andrea; Fuschi, Andrea; Al Salhi, Yazan; Autieri, Domenico; Petrozza, Vincenzo; Carbone, Antonio

    2016-01-01

    Purpose: Staghorn renal stones are a challenging field in urology. Due to their high recurrence rates, particularly those associated with an infective process, a complete removal is the ultimate goal in their management. We report our experience with a combined approach of laparoscopic pyelolithotomy and endoscopic pyelolithotripsy, the stone clearance rate, and long-term, follow-up outcomes. Methods: From June 2012 to October 2014, nine adult patients with large staghorn renal calculi (mean size, 7.2 cm; range, 6.2–9.0 cm) underwent a combined laparoscopic and endoscopic approach. The technique comprised laparoscopic pyelolithotomy and holmium-YAG laser stone fragmentation with the use of a flexible cystoscope introduced through a 12 mm trocar. Results: The average operative time was 140 min (range, 90–190 min). The mean estimated hemoglobin loss was 0.6 mmol/l (range 0.5–0.7 mmol/l). None of the patients required an open- surgery conversion. The mean hospital stay was 4 days (range, 2–6 days). A computed tomography urogram control at 6 months of follow up did not show any stone recurrence. Conclusions: Laparoscopic pyelolithotomy combined with endoscopic pyelolithotripsy could be a therapeutic option in cases where mini-invasive procedures, that is, extracorporeal shock wave lithotripsy, ureteroscopic lithotripsy, and percutaneous nephrolithotomy (PCNL) have failed. This technique has a high stone-clearance rate (75–100%) comparable with open surgery and PCNL. However, it could be technically demanding and should be performed by skilled laparoscopy surgeons. PMID:26834835

  8. Evaluation of the management of Hr-HPV+/PapTest- women: results at 1-year recall

    PubMed Central

    Chiappetta, Caterina; Puggioni, Chiara; Lendaro, Eugenio; Cacciotti, Jessica; Zaralli, Roberto; Migliore, Giovanna; Bellardini, Paola; Petrozza, Vincenzo; Della Rocca, Carlo; Di Cristofano, Claudio

    2015-01-01

    With cervical cancer screening the choice of 1-year as a period of follow-up in positive high-risk HPV women without cytological lesions is still under discussion. We evaluated the management of these women and the role of HPV genotyping test. We did a cervical cancer screening study of women aged 35-64 with primary high-risk HPV test. Women positive for high-risk HPV with negative cytology were followed-up after 1 year. In this study we selected women with high-risk HPV+/PapTest- resulted high-risk HPV+ at recall and performed the PapTest and HPV genotyping test. The detection rate of squamous high grade (CIN2+) relative to the total screened cohort was 2.1‰, and it was 0.2‰ at the 1-year recall. The colposcopy performed in women referred at the 1-year recall accounted for 48.8% of the total (baseline + 1-year recall), and 84.3% of these women had no cytological lesions. The most frequent hr-HPV genotype detected was HPV16 and 66.7% of co-infections were due to HPV16 and HPV18. 54.5% of women presented a persistent infection at 1-year recall with the same HPV subtype, 50% of persistent infections was due to HPV16 and 16.7% of these were determined to be CIN2+ histological lesions. Our data show that it may be useful to extend the period of follow-up for women hr-HPV+/PapTest- so as to reduce the number of unnecessary colposcopies due to the transitory infections and that the genotyping test could help to identify the persistent infections in which HPV16 is involved. PMID:26884886

  9. Replacement of Vertebral Lamina (Laminoplasty) in Surgery for Lumbar Isthmic Spondylolisthesis: 5-Year Follow-Up Results

    PubMed Central

    2016-01-01

    Study Design A review of clinical and radiological outcomes of lumbar laminoplasty (LL) for the treatment of isthmic spondylolisthesis (ISL). Purpose The single session performance of posterior lumbar interbody fusion with allograft in the anterior column and providing the realignment of the vertebrae was presented as a preliminary report earlier. Overview of Literature Long-term surgical outcome of cervical laminoplasty in patients has been reported. But, outcome of LL in patients is unclear. Methods The long-term (5 years) year follow-up results of the LL technique are reported in this retrospective study. All patients underwent preoperative and postoperative direct X-ray, computed tomography, and magnetic resonance imaging. The patients that did not respond to conservative treatment were operated. Twenty-one (52.5%) female and 19 (47.5%) male patients were included. Results Mean age was 43,5 years (ranges, 22–57 years). The most common symptoms were low back pain (89%), pelvic and leg pain (69%) and reduction in walking distance (65%). A total of 180 pedicle screws were inserted in 40 patients; posterior lumbar interbody fusion and laminoplasty with reduction was performed in 20 patients for L4–L5, 12 patients for L5–S1, 4 patients for L3–L4–L5 and 4 patients for L4–L5-S1. Ten (25%) patients with ILL had accompanying spinal stenosis. The difference between preoperative and postoperative sagittal plane rotation and dislocation degrees and disc space heights were statistically significant in all patients (p<0.05). Solid grade 4 fusion was observed in 38 patients; in only 2 patients grade 2 pseudoarthrosis developed (5%), but these patients were asymptomatic. Visual analog scale, Prolo economical and functional scale was examined with an average follow-up 5.5 years. Conclusions LL technique has the advantages of shorter duration of operation, lack of graft donor site complications, protection of posterior column osseoligamentous structures and

  10. The Primary Prevention of PTSD in Firefighters: Preliminary Results of an RCT with 12-Month Follow-Up

    PubMed Central

    Rees, Clare S.; Mazzucchelli, Trevor G.; Kane, Robert T.

    2016-01-01

    Aim To develop and evaluate an evidence-based and theory driven program for the primary prevention of Post-traumatic Stress Disorder (PTSD). Design A pre-intervention / post-intervention / follow up control group design with clustered random allocation of participants to groups was used. The “control” group received “Training as Usual” (TAU). Method Participants were 45 career recruits within the recruit school at the Department of Fire and Emergency Services (DFES) in Western Australia. The intervention group received a four-hour resilience training intervention (Mental Agility and Psychological Strength training) as part of their recruit training school curriculum. Data was collected at baseline and at 6- and 12-months post intervention. Results We found no evidence that the intervention was effective in the primary prevention of mental health issues, nor did we find any significant impact of MAPS training on social support or coping strategies. A significant difference across conditions in trauma knowledge is indicative of some impact of the MAPS program. Conclusion While the key hypotheses were not supported, this study is the first randomised control trial investigating the primary prevention of PTSD. Practical barriers around the implementation of this program, including constraints within the recruit school, may inform the design and implementation of similar programs in the future. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12615001362583 PMID:27382968

  11. The Results of Long-term Follow-up of Total Hip Arthroplasty Using Hydroxyapatite-coated Cups

    PubMed Central

    Han, Chang-Dong; Shin, Keun-Young; Lee, Hyun-Hee; Park, Kwan-Kyu; Yang, Ick-Hwan

    2015-01-01

    Purpose The aim of this study was to report the long-term outcome and the failure mechanism of cementless total hip arthroplasty (THA) using hydroxyapatite (HA)-coated acetabular cup. Materials and Methods From January 1992 to May 1994, a total of 123 consecutive cementless primary THAs were performed using a HA-coated acetabular cup with metal-on-polyethylene articulation. We retrospectively evaluated 66 hips available for follow-up at a mean 18.3 years (range, 10.4-23.6 years). The survival analysis was performed by the Kaplan-Meier method. We defined end point as any failure that required a reoperation of acetabular component. Results Thirty-nine of 66 hips (59.1%) were defined as a failure for progressive acetabular osteolysis or aseptic loosening of the cup. Acetabular osteolysis was observed in 47 hips (71.2%) and 33 hips (50.0%) were revised because of cup loosening. The Kaplan-Meier method showed the survival rate of the acetabular cup to be 46.3% at 15 years and 34.8% at 20 years for any failure that required a reoperation of acetabular component. Conclusion The long-term survival rate of THA using HA-coated acetabular cup was unsatisfactory, and it was attributed to vulnerable property of HA coating and progressive osteolysis. PMID:27536628

  12. Is hyperglycaemia an independent predictor of poor outcome after acute stroke? Results of a long-term follow up study.

    PubMed Central

    Weir, C. J.; Murray, G. D.; Dyker, A. G.; Lees, K. R.

    1997-01-01

    OBJECTIVE: To determine whether raised plasma glucose concentration independently influences outcome after acute stroke or is a stress response reflecting increased stroke severity. DESIGN: Long-term follow up study of patients admitted to an acute stroke unit. SETTING: Western Infirmary, Glasgow. SUBJECTS: 811 patients with acute stroke confirmed by computed tomography. Analysis was restricted to the 750 non-diabetic patients. MAIN OUTCOME MEASURES: Survival time and placement three months after stroke. RESULTS: 645 patients (86%) had ischaemic stroke and 105 patients (14%) haemorrhagic stroke. Cox's proportional hazards modelling with stratification according to Oxfordshire Community Stroke Project categories identified increased age (relative hazard 1.36 per decade; 95% confidence interval 1.21 to 1.53), haemorrhagic stroke (relative hazard 1.67; 1.22 to 2.28), time to resolution of symptoms > 72 hours (relative hazard 2.15; 1.15 to 4.05), and hyperglycaemia (relative hazard 1.87; 1.43 to 2.45) as predictors of mortality. The effect of glucose concentration on survival was greatest in the first month. CONCLUSIONS: Plasma glucose concentration above 8 mmol/l after acute stroke predicts a poor prognosis after correcting for age, stroke severity, and stroke subtype. Raised plasma glucose concentration is therefore unlikely to be solely a stress response and should arguably be treated actively. A randomised trial is warranted. PMID:9158464

  13. Subcutaneous Direct-to-Implant Breast Reconstruction: Surgical, Functional, and Aesthetic Results after Long-Term Follow-Up

    PubMed Central

    Calabrese, Claudio; Cecconi, Lorenzo; Santi, Caterina; Gjondedaj, Ulpjana; Roselli, Jenny; Nori, Jacopo; Fausto, Alfonso; Orzalesi, Lorenzo; Casella, Donato

    2015-01-01

    Abstract Background: Direct-to-implant breast reconstruction can be achieved more easily by means of soft-tissue replacement devices such as dermal matrices and synthetic meshes. The feasibility of a subcutaneous approach has been recently investigated by some studies with different devices functioning as implant support. Aim of this study is to analyze the long-term results, both objective and subjective, of a previous nonrandomized trial comparing prepectoral (subcutaneous) and retropectoral breast reconstructions. Methods: Patients enrolled in a nonrandomized prospective trial, comparing the standard retropectoral reconstruction and the prepectoral subcutaneous approach, using a titanium-coated mesh in both techniques, were followed up and evaluated for long-term results. Cases were compared in terms of the causes and rate of reinterventions, of the postoperative BREAST-Q questionnaire results, and of an objective surgical evaluation. Results: The subcutaneous group had a rate of implant failure and removal of 5.1% when compared with 0% in the retropectoral group. Aesthetic outcome was significantly better for the subcutaneous group both at a subjective and at an objective evaluation. Capsular contracture rate was 0% in the subcutaneous group. Conclusions: A higher rate of implant failure and removal, although not significant, always because of skin flaps and wound problems, should be taken into account for a careful patients selection. The subcutaneous breast reconstruction shows good long-term results. A coherent subjective and objective cosmetic advantage of this approach emerges. Moreover, no capsular contracture is evident, albeit in a relatively limited number of cases. PMID:26893999

  14. Outcomes observed during a 1-year clinical and radiographic follow-up of patients treated for 1- or 2-level cervical degenerative disease using a biodegradable anterior cervical plate.

    PubMed

    Chen, Mengcun; Yang, Shuhua; Yang, Cao; Xu, Weihua; Ye, Shunan; Wang, Jing; Feng, Yong; Yang, Wen; Liu, Xianzhe

    2016-08-01

    OBJECTIVE The purpose of this study was to present an initial surgical experience in the management of 1- or 2-level degenerative disc disease of the cervical spine using biodegradable anterior cervical plates (bACPs) in anterior cervical discectomy and fusion (ACDF). The authors also aimed to provide insight into this critical and controversial clinical issue by clarifying outcomes for patients receiving bACPs and by comparing their outcomes with those achieved using a traditional metallic anterior cervical plate (mACP) implant. METHODS A retrospective review was conducted for 2 series of patients who had undergone ACDF using either bACP (31 patients, 38 segments) or mACP (47 patients, 57 segments) instrumentation. The patients were followed up for a mean 13.5 ± 0.9 months (range 12-18 months) in the bACP group and 14.8 ± 1.5 months (range 14-22 months) in the mACP group. Clinical outcomes were determined according to scores on the visual analog scale (VAS), the modified Japanese Orthopaedic Association (mJOA) scoring system, and Odom's criteria. Radiological images were used to assess fusion rates, intervertebral height, Cobb's angle, and the width of prevertebral soft tissue. RESULTS Both VAS and mJOA scores were significantly improved at each follow-up in both groups. Excellent or good results according to Odom's criteria were achieved in 93.5% (29/31) of patients in the bACP group and 93.6% (44/47) of patients in the mACP group. At 6 months postoperatively, the fusion rate was 94.7% (36/38) in the bACP group and 96.5% (55/57) in the mACP group, but subsidence of the intervertebral space at the surgical level was more evident in the bACP group. Angulation, as measured by Cobb's angle, demonstrated obvious healing in both groups, while better maintenance was observed in the mACP group. The local inflammatory reaction was uneventful during follow-up. Dysphonia and dysphagia were observed in both groups during the follow-up. CONCLUSIONS The relatively comparable

  15. Eight-Year Follow-Up Results of an Adolescent Smoking Prevention Program: The North Karelia Youth Project.

    ERIC Educational Resources Information Center

    Vartiainen, Erkki; And Others

    1990-01-01

    Discusses an 8-year follow-up study to a smoking prevention program for 13- to 15- year-old students, who were taught the skills to resist pressures to start smoking. Consistent evidence of preventive effects was found among those students who had been non-smokers when the program began. (Author/JS)

  16. Teacher Attrition and Mobility: Results from the 2004-05 Teacher Follow-Up Survey. NCES 2007-307

    ERIC Educational Resources Information Center

    Marvel, John; Lyter, Deanna M.; Peltola, Pia; Strizek, Gregory A.; Morton, Beth A.; Rowland, Renee

    2007-01-01

    The objective of the Teacher Follow-up Survey (TFS) is to provide information about teacher mobility and attrition among elementary and secondary school teachers who teach in grades K-12 in the 50 states and the District of Columbia. In pursuit of this objective, TFS examines the characteristics of those who stay in the teaching profession and…

  17. Combined therapy (intravitreal bevacizumab plus verteporfin photodynamic therapy) versus intravitreal bevacizumab monotherapy for choroidal neovascularization due to age-related macular degeneration: a 1-year follow-up study

    PubMed Central

    Saviano, Sandro; Leon, Pia Easter; Mangogna, Alessandro; Tognetto, Daniele

    2016-01-01

    Purpose To assess the efficacy and safety of combined intravitreal bevacizumab and low-fluency-rate photodynamic therapy (PDT) in the treatment of choroidal neovascularization (CNV) associated with age-related macular degeneration (AMD) and to compare it with intravitreal bevacizumab monotherapy. Methods A total of 62 eyes of 62 patients with angiographic evidence of CNV were divided into 2 groups: the eyes of one group were treated with a combined therapy of 1 intravitreal bevacizumab injection (1.25 mg) and PDT within 7 days; the eyes of the other group received intravitreal bevacizumab monotherapy. Clinical evidence of complications, best-corrected visual acuity (BVCA) and fluorescein leakage were evaluated. Best-corrected visual acuity and optical coherence tomography (OCT) were tested monthly and followed for 12 months. Results In the combined group the mean BCVA increased from 0.61 logMAR before the treatment to 0.54 logMAR at 12 months’ follow-up. In the monotherapy group the mean BCVA increased from 0.65 logMAR to 0.60 logMAR at 12 months’ follow-up. There was no significant difference in visual acuity outcomes between groups (P > 0.05). In the combined group the mean number of treatments was 1.19 per patient; in the monotherapy group, 5.31 per patient (P < 0.01). Conclusions Combined therapy appears to be an effective option for CNV associated with AMD treatment allowing a significant reduction of intravitreal injections. PMID:27582675

  18. Effect of Osteonecrosis Intervention Rod Versus Core Decompression Using Multiple Small Drill Holes on Early Stages of Necrosis of the Femoral Head: A Prospective Study on a Series of 60 Patients with a Minimum 1-Year-Follow-Up

    PubMed Central

    Miao, Haixiong; Ye, Dongping; Liang, Weiguo; Yao, Yicun

    2015-01-01

    Introduction: The conventional CD used 10 mm drill holes associated with a lack of structural support. Thus, alternative methods such as a tantalum implant, small drill holes, and biological treatment were developed to prevent deterioration of the joint. The treatment of CD by multiple 3.2 mm drill holes could reduce the femoral neck fracture and partial weight bearing was allowed. This study was aimed to evaluate the effect of osteonecrosis intervention rod versus core decompression using multiple small drill holes on early stages of necrosis of the femoral head. Method: From January 2011 to January 2012, 60 patients undergoing surgery for osteonecrosis with core decompression were randomly assigned into 2 groups based on the type of core decompression used: (1) a total of 30 osteonecrosis patients (with 16 hips on Steinburg stageⅠ,20 hips on Steinburg stageⅡ) were treated with a porous tantalum rod insertion. The diameter of the drill hole for the intervention rod was 10mm.(2) a total of 30 osteonecrosis patients (with 14 hips on Steinburg stageⅠ,20 hips on Steinburg stageⅡ) were treated with core decompression using five drill holes on the lateral femur, the diameter of the hole was 3.2 mm. The average age of the patient was 32.6 years (20-45 years) and the average time of follow-up was 25.6 months (12- 28 months) in the rod implanted group. The average age of the patient was 35.2 years (22- 43 years) and the average time of follow-up was 26.3 months (12-28 months) in the small drill holes group. Results: The average of surgical time was 40 min, and the mean volume of blood loss was 30 ml in both surgical groups. The average of Harris score was improved from 56.2 ± 7.1 preoperative to 80.2 ± 11.4 at the last follow-up in the rod implanted group (p < 0.05). The mean Harris score was improved from 53.8 ± 6.6 preoperative to 79.7 ± 13.2 at the last follow-up in the small drill holes group (p<0. 05). No significant difference was observed in Harris score

  19. Determination of Effective Factors on Survival of GI Cancers: Results of Five Years Follow up in Iranian Population

    PubMed Central

    Zargar, Ali; Miroliaee, Arash; Gooraji, Somayeh Ahmadi; Hajaghamohammadi, Aliakbar

    2016-01-01

    Background: The gastrointestinal cancers are among the most common cause of cancer-related death and their long term survival is very low. This study was aimed to determine the effective factors on survival of gastrointestinal cancers among Iranian population during 5 years of follow up. Methods: In total, 157 patients diagnosed as gastrointestinal cancers from 2007 to 2009 in the only center of endoscopy in Alvand city, northwest of Qazvin province were included and followed for five years. The univariate and multivariate analysis were done using Kaplan-Meier method and the Cox model respectively. Results: Observations of 146 patients were analyzed (99 (67.8%) males and 47 (32.2%) females). The mean age was 64.73± 13.23 and 58.28±13.91 for females and males respectively. The one and three years survival rates for esophageal cancer were 28% and 9% and the one, three and five years survival rates for gastric cancer were 31%, 26% and 14% and for colorectal cancer were 96%, 86% and 75% respectively. In the univariate analysis, variables of age, educational level, ethnicity, smoking, type of cancer, stage of disease and type of treatment had significant effects on survival. In the multivariate analysis, the type of cancer and type of treatment affected the survival of patients as effective factors (p<005). Conclusion: Patients with esophageal cancer and those who underwent RT &/or CT are exposed to higher risk of death. Combination therapies (Surgery and adjuvant or neoadjuvant therapy) were related to be her survival. Early diagnosis and use of extended cancer screening programs seem necessary to improve survival. PMID:26755479

  20. Postpartum Hemorrhage Treated with Gelfoam Slurry Embolization Using the Superselective Technique: Immediate Results and 1-Month MRI Follow-up

    SciTech Connect

    Pellerin, Olivier; Bats, Anne-Sophie; Primio, Massimiliano Di; Palomera-Ricco, Ana; Pinot de Villechenon, Gabrielle; and others

    2013-02-15

    To evaluate the efficacy and safety of superselective embolization of the uterine arteries in a postpartum hemorrhage. Between November 2004 and January 2011, a total of 44 consecutive women (median {+-} standard deviation age 34 {+-} 3 years, range 23-41 years) were referred to our institution for postpartum intractable hemorrhage management. All patients were embolized with a microcatheter that was placed deep into the uterine arteries upstream of the cervical arteries. The embolic agent was a mixture of contrast medium and 5 Multiplication-Sign 5 Multiplication-Sign 5 cm pieces of gelfoam (Gelita-Spon) modified into a gelatin emulsion as follows: rapid mixing through a three-way stopcock with two 2.5-ml syringes. A 1-ml syringe was used for injection. One month after embolization, all patients underwent magnetic resonance imaging and clinical examination. Technical and clinical success was obtained in all cases. Thirty-five patients experienced bleeding related to poor retraction of the uterus, 7 patients because of a tear of the cervix and 2 because of a vaginal hematoma. Pre- and postembolization red blood cell transfusions were (mean {+-} standard deviation [SD]) 6 {+-} 1.2 (range 3-8) U and 2 {+-} 0.7 (range 2-4) U, respectively. One-month magnetic resonance imaging follow-up revealed no sign of ischemic myometrium or necrosis, and no instances of uterine rupture and no pelvic vein thrombosis. Incidental findings included two small intramyometrial hematic collections. All uterine arteries were patent via magnetic resonance angiography. Seventeen patients had concomitant fibroids, all of which appeared hypovascular. This technique permits good, safe clinical results with no marked damage to the uterine arteries or the uterus itself.

  1. Rheumatoid Arthritis and Mortality Among Women During 36 Years of Prospective Follow-Up: Results From the Nurses’ Health Study

    PubMed Central

    SPARKS, JEFFREY A.; CHANG, SHUN-CHIAO; LIAO, KATHERINE P.; LU, BING; FINE, ALEXANDER R.; SOLOMON, DANIEL H.; COSTENBADER, KAREN H.; KARLSON, ELIZABETH W.

    2016-01-01

    Objective To evaluate rheumatoid arthritis (RA) and mortality risk among women followed prospectively in the Nurses’ Health Study (NHS). Methods We analyzed 119,209 women in the NHS who reported no connective tissue disease at enrollment in 1976. Comorbidity and lifestyle data were collected through biennial questionnaires. Incident RA cases were validated by medical records review. Cause of death was determined by death certificate and medical records review. Cox regression models estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) for all-cause, cardiovascular disease (CVD), cancer, and respiratory disease mortality for women with RA compared to those without RA. Results We validated 964 incident RA cases and identified 28,808 deaths during 36 years of prospective follow-up. Of 307 deaths among women with RA, 80 (26%) were from cancer, 70 (23%) were from CVD, and 44 (14%) were from respiratory causes. Women with RA had increased total mortality (HR 1.40, 95% CI 1.25–1.57) compared to those without RA, independent of mortality risk factors, including smoking. RA was associated with significantly increased respiratory disease mortality (HR 2.06, 95% CI 1.51–2.80) and cardiovascular disease mortality (HR 1.45, 95% CI 1.14–1.83), but not cancer mortality (HR 0.93, 95% CI 0.74–1.15). For women with seropositive RA, respiratory disease mortality was nearly 3-fold higher than among non-RA women (HR 2.67, 95% CI 1.89–3.77). Conclusion Women with RA had significantly increased mortality compared to those without RA. Respiratory disease and cardiovascular disease mortality were both significantly elevated for women with RA. The nearly 3-fold increased relative risk of respiratory disease mortality was observed only for those with seropositive RA. PMID:26473946

  2. Dietary habits and mortality in 11,000 vegetarians and health conscious people: results of a 17 year follow up.

    PubMed Central

    Key, T. J.; Thorogood, M.; Appleby, P. N.; Burr, M. L.

    1996-01-01

    OBJECTIVE: To investigate the association of dietary habits with mortality in a cohort of vegetarians and other health conscious people. DESIGN: Observational study. SETTING: United Kingdom. SUBJECTS: 4336 men and 6435 women recruited through health food shops, vegetarian societies, and magazines. MAIN OUTCOME MEASURES: Mortality ratios for vegetarianism and for daily versus less than daily consumption of wholemeal bread, bran cereals, nuts or dried fruit, fresh fruit, and raw salad in relation to all cause mortality and mortality from ischaemic heart disease, cerebrovascular disease, all malignant neoplasms, lung cancer, colorectal cancer, and breast cancer. RESULTS: 2064 (19%) subjects smoked, 4627 (43%) were vegetarian, 6699 (62%) ate wholemeal bread daily, 2948 (27%) ate bran cereals daily, 4091 (38%) ate nuts or dried fruit daily, 8304 (77%) ate fresh fruit daily, and 4105 (38%) ate raw salad daily. After a mean of 16.8 years follow up there were 1343 deaths before age 80. Overall the cohort had a mortality about half that of the general population. Within the cohort, daily consumption of fresh fruit was associated with significantly reduced mortality from ischaemic heart disease (rate ratio adjusted for smoking 0.76 (95% confidence interval 0.60 to 0.97)), cerebrovascular disease (0.68 (0.47 to 0.98)), and for all causes combined (0.79 (0.70 to 0.90)). CONCLUSIONS: In this cohort of health conscious individuals, daily consumption of fresh fruit is associated with a reduced mortality from ischaemic heart disease, cerebrovascular disease, and all causes combined. PMID:8842068

  3. Intermediate clinical and radiological results of cervical TDR (Mobi-C®) with up to 2 years of follow-up

    PubMed Central

    Beaurain, J.; Bernard, P.; Dufour, T.; Fuentes, J. M.; Hovorka, I.; Huppert, J.; Steib, J. P.; Vital, J. M.; Aubourg, L.

    2009-01-01

    The interest in cervical total disc replacement (TDR) as an alternative to the so-far gold standard in the surgical treatment of degenerative disc disease (DDD), e.g anterior cervical discectomy and fusion (ACDF), is growing very rapidly. Many authors have established the fact that ACDF may result in progressive degeneration in adjacent segments. On the contrary, but still theoretically, preservation of motion with TDR at the surgically treated level may potentially reduce the occurrence of adjacent-level degeneration (ALD). The authors report the intermediate results of an undergoing multicentre prospective study of TDR with Mobi-C® prosthesis. The aim of the study was to assess the safety and efficacy of the device in the treatment of DDD and secondary to evaluate the radiological status of adjacent levels and the occurrence of ossifications, at 2-year follow-up (FU). 76 patients have performed their 2-year FU visit and have been analyzed clinically and radiologically. Clinical outcomes (NDI, VAS, SF-36) and ROM measurements were analyzed pre-operatively and at the different post-operative time-points. Complications and re-operations were also assessed. Occurrences of heterotopic ossifications (HOs) and of adjacent disc degeneration radiographic changes have been analyzed from 2-year FU X-rays. The mean NDI and VAS scores for arm and neck are reduced significantly at each post-operative time-point compared to pre-operative condition. Motion is preserved over the time at index levels (mean ROM = 9° at 2 years) and 85.5% of the segments are mobile at 2 years. HOs are responsible for the fusion of 6/76 levels at 2 years. However, presence of HO does not alter the clinical outcomes. The occurrence rate of radiological signs of ALD is very low at 2 years (9.1%). There has been no subsidence, no expulsion and no sub-luxation of the implant. Finally, after 2 years, 91% of the patients assume that they would undergo the procedure again. These intermediate

  4. Rationale for a 'Male Lumpectomy,' a Prostate Cancer Targeted Approach Using Cryoablation: Results in 21 Patients with at Least 2 Years of Follow-Up

    SciTech Connect

    Onik, Gary

    2008-01-15

    Background. Prostate cancer in men raises many of the same issues that breast cancer does in women. Complications of prostate cancer treatment, including impotence and incontinence, affect the self-image and psyche of a man no less than does the loss of a breast in a woman. We present a pilot study in which 21 patients were treated with a focal cryoablation procedure. Methods. Focal cryoablation was performed using biplane transrectal ultrasound if the tumor was confined to only one prostate lobe. Preoperative PSA values were recorded. Cryoablation was planned to encompass the area of known tumor. PSA values were obtained every 3 months for 2 years and every 6 months thereafter. Potency and continence status was obtained at the same intervals. Routine biopsy was obtained at 1 year. Results. Twenty-one patients had focal cryoablation. Follow-up ranged from 24 to 105 months with a mean of 50 months. Twenty of 21 (95%) patients have stable PSA values with no evidence for cancer, despite 10 patients being at medium to high risk for recurrence. All patients biopsied (n = 19) were negative for tumor. Potency was maintained in 17 of 21 patients (80%). No other complications, including incontinence or fistula formation, were noted. Conclusion. These preliminary results indicate a 'male lumpectomy,' in which the prostate tumor region itself is destroyed, appears to preserve potency in a majority of patients and limits other complications, without compromising cancer control. If these results are confirmed by further studies and long-term follow-up, this treatment approach could have a profound effect on prostate cancer management.

  5. Residential Road Traffic Noise and High Depressive Symptoms after Five Years of Follow-up: Results from the Heinz Nixdorf Recall Study

    PubMed Central

    Orban, Ester; McDonald, Kelsey; Sutcliffe, Robynne; Hoffmann, Barbara; Fuks, Kateryna B.; Dragano, Nico; Viehmann, Anja; Erbel, Raimund; Jöckel, Karl-Heinz; Pundt, Noreen; Moebus, Susanne

    2015-01-01

    Background: Traffic noise affects a large number of people, particularly in urbanized areas. Noise causes stress and annoyance, but less is known about the relationship between noise and depression. Objective: We investigated the association of residential road traffic noise with depressive symptoms using 5-year follow-up data from a German population-based study. Methods: We analyzed data from 3,300 participants in the Heinz Nixdorf Recall study who were between 45 and 75 years old and were without depressive symptoms at baseline (2000–2003). Depressive symptoms were defined based on the Center for Epidemiologic Studies Depression scale (CES-D) 15-item questionnaire (total score ≥ 17) and antidepressant medication intake. Road traffic noise was modeled according to European Parliament/Council Directive 2002/49/EC. High noise exposure was defined as annual mean 24-hr noise levels > 55 A-weighted decibels [dB(A)]. Poisson regression with robust variance was used to estimate relative risks (RRs) a) adjusting for the potential confounders age, sex, socioeconomic status (SES), neighborhood-level SES, and traffic proximity; b) additionally adjusting for body mass index and smoking; and c) additionally adjusting for the potential confounders/intermediates comorbidities and insomnia. Results: Overall, 35.7% of the participants were exposed to high residential road traffic noise levels. At follow-up (mean = 5.1 years after baseline), 302 participants were classified as having high depressive symptoms, corresponding to an adjusted RR of 1.29 (95% CI: 1.03, 1.62; Model 1) for exposure to > 55 versus ≤ 55 dB(A). Adjustment for potential confounders/intermediates did not substantially alter the results. Associations were stronger among those who reported insomnia at baseline (RR = 1.62; 95% CI: 1.10, 2.59 vs. RR = 1.21; 95% CI: 0.94, 1.57) and appeared to be limited to those with ≤ 13 years of education (RR = 1.43; 95% CI: 1.10, 1.85 vs. 0.92; 95% CI: 0.56, 1.53 for

  6. A Qualitative Secondary Evaluation of Statewide Follow-Up Interviews for Abnormal Newborn Screening Results for Cystic Fibrosis and Sickle Cell Hemoglobinopathy

    PubMed Central

    La Pean, Alison; Collins, Jenelle L.; Christopher, Stephanie A.; Eskra, Kerry L.; Roedl, Sara; Tluczek, Audrey; Farrell, Michael H.

    2011-01-01

    Purpose The purpose of this qualitative analysis was to assess parental acceptability of large-scale, telephone follow-up regarding their infants' newborn screening (NBS) results indicating carrier status for sickle cell hemoglobinopathy (SCH) and cystic fibrosis (CF). Methods Analysis of 195 interview transcripts focused on parents' responses to two open-ended questions “What was your reaction to being called by me?” and “What do you think of the state newborn screening program having follow-up people calling parents like you?” Responses were coded using conventional content analysis procedures and non-parametric tests were performed to analyze quantitative data. Results Most parents reported favorable opinions about the follow-up. Favorable opinions were associated with several emotional reactions to receiving follow-up (p<0.001), and three reasons why parents found the interview beneficial (p<0.05): it provided information, clarified NBS results, and answered questions. Seventeen parents of SCH carriers reportedly had not been told their infant's NBS results and received them for the first time during the follow-up interview. Conclusion Parents of CF and SCH carrier infants had favorable opinions and identified specific benefits to receiving follow-up contact. This analysis demonstrates an information deficit among carrier parents and illustrates the importance of NBS follow-up and need for comprehensive communication and counseling. PMID:22261754

  7. Benchmarks for Operative Outcomes of Robotic and Open Radical Prostatectomy: Results from the Health Professionals Follow-up Study

    PubMed Central

    Alemozaffar, Mehrdad; Sanda, Martin; Yecies, Derek; Mucci, Lorelei A.; Stampfer, Meir J.; Kenfield, Stacey A.

    2014-01-01

    Background Robot-assisted laparoscopic radical prostatectomy (RALP) has become increasingly common; however, there have been no nationwide, population-based, non–claims-based studies to evaluate differences in outcomes between RALP and open radical retropubic prostatectomy (RRP). Objective To determine surgical, oncologic, and health-related quality of life (HRQOL) outcomes following RALP and RRP in a nationwide cohort. Design, setting, and participants We identified 903 men in the Health Professionals Follow-up Study diagnosed with prostate cancer between 2000 and 2010 who underwent radical prostatectomy using RALP (n = 282) or RRP (n = 621) as primary treatment. Intervention Radical prostatectomy. Outcome measurements and statistical analysis We compared patients undergoing RALP or RRP across a range of perioperative, oncologic, and HRQOL outcomes. Results and limitations Use of RALP increased during the study period, constituting 85.2% of study subjects in 2009, up from 4.5% in 2003. Patients undergoing RALP compared to RRP were less likely to have a lymph node dissection (51.5% vs 85.4%; p < 0.0001), had less blood loss (207.4 ml vs 852.3 ml; p < 0.0001), were less likely to receive blood transfusions (4.3% vs 30.3%; p < 0.0001), and had shorter hospital stays (1.8 d vs 2.9 d; p < 0.0001). Surgical, oncologic, and HRQOL outcomes did not differ significantly among the groups. In multivariate logistic regression models, there were no significant differences in 3- or 5-yr recurrence-free survival comparing RALP versus RRP (hazard ratios: 0.98 [95% confidence interval (CI), 0.46–2.08] and 0.75 [95% CI, 0.18–3.11], respectively). Conclusions In a nationwide cohort of patients undergoing surgical treatment for prostate cancer, RALP was associated with shorter hospital stay, and lower blood loss and transfusion rates than RRP. Surgical oncologic and HRQOL outcomes were similar between groups. Patient summary We studied men throughout the United States with

  8. Effects of Multidrug Resistant Tuberculosis Treatment on Patients’ Health Related Quality of Life: Results from a Follow Up Study

    PubMed Central

    Ahmad, Nafees; Javaid, Arshad; Syed Sulaiman, Syed Azhar; Basit, Anila; Afridi, Afsar Khan; Jaber, Ammar Ali Saleh; Khan, Amer Hayat

    2016-01-01

    Background At present, within the management of multidrug resistant tuberculosis (MDR-TB) much attention is being paid to the traditional microbiological and clinical indicators. Evaluation of the impact of MDR-TB treatment on patients’ Health Related Quality of Life (HRQoL) has remained a neglected area. Objective To evaluate the impact of MDR-TB treatment on patients HRQoL, and determine the predictors of variability in HRQoL along the course of treatment Methods A prospective follow up study was conducted at the programmatic management unit for drug resistant TB of Lady Reading Hospital Peshawar. Culture confirmed eligible MDR-TB patients were asked to self complete SF-36v2 at the baseline visit, and subsequently after the completion of 12 months of treatment and at the end of treatment. A score of <47 norm-based scoring (NBS) points on component summary measures and health domain scales was considered indicative of function impairment. General linear model repeated measures ANOVA was used examine the change and predictors of change in physical component summary (PCS) and mental component summary (MCS) scores over the time. Results A total of 68 out of enrolled 81 eligible MDR-TB patients completed SF-36v2 questionnaire at the three time points. Patients’ mean PCS scores at the three time points were, 38.2±4.7, 38.6±4.4 and 42.2±5.2 respectively, and mean MCS were 33.7±7.0, 35.5±6.9 and 40.0±6.9 respectively. Length of sickness prior to the diagnosis of MDR-TB was predictive of difference in PCS scores (F = 4.988, Df = 1, 66), whereas patients’ gender (F = 5.638, Df = 1, 66) and length of sickness prior to the diagnosis of MDR-TB (F = 4.400, Df = 1, 66) were predictive of difference in MCS scores. Conclusion Despite the positive impact of MDR-TB treatment on patients' HRQoL, the scores on component summary measures suggested compromised physical and mental health even at the end of treatment. A large multicenter study is suggested to confirm the

  9. Preliminary Light Curve Results of NEOs from the Characterization and Astrometric Follow-Up Program at Adler Planetarium

    NASA Astrophysics Data System (ADS)

    Brucker, Melissa J.; Nault, Kristie A.; Hammergren, Mark; Sieben, Jennifer; Gyuk, Geza; Solontoi, Michael R.

    2015-11-01

    We are nearing the halfway mark of a two-year program for near-Earth object (NEO) astrometric follow-up and characterization utilizing 500 hours of observing time per year with the Astrophysical Research Consortium (ARC) 3.5-meter telescope at Apache Point Observatory (APO). Our observing is divided into two-hour blocks approximately every other night for astrometry (see poster by K. A. Nault et al.) and several half-nights per month for spectroscopy (see poster by M. Hammergren et al.) and light curve studies.We present preliminary results from variable photometry observations as part of the characterization portion of the Adler Planetarium’s NEO program. The frequent scheduling of half-night observing time allows us to capture data for small NEOs near the time when they are closest to Earth before their apparent magnitudes rapidly diminish beyond the range of detectability. We searched for variability in newly discovered NEOs that had close approaches to Earth near the time of observation. These include 2014 RQ17, 2014 SB145, 2014 SF304, 2014 WO4, 2014 WY119, and 2015 BC. In addition, we observed 2340 Hathor and 2007 EC when they each made a close approach to Earth to compare with light curves and magnitude variation constraints from previous apparitions. We will construct light curves for all of the objects listed above and determine rotational periods for those with sufficient temporal coverage.The targets were selected from candidates in the JPL NEO Earth Close Approaches table, Arecibo planetary radar targets, and the Goldstone asteroid radar schedule. Due to the sensitivity of AGILE, we restricted our targets to those with apparent magnitudes in V less than 19 magnitudes.Observations were made using the frame transfer CCD camera AGILE on the ARC 3.5-meter telescope. AGILE has a field-of-view of 2.2'x2.2' and a plate scale of 0.258”/pixel with 2x2 binning.This work is based on observations obtained with the Apache Point Observatory 3.5-meter telescope

  10. [The prevention of allergic diseases with a hypoallergenic formula: a follow-up at 24 months. The preliminary results].

    PubMed

    de Seta, L; Siani, P; Cirillo, G; Di Gruttola, M; Cimaduomo, L; Coletta, S

    1994-01-01

    One hundred-eight infants from atopic families were admitted to the study. Each had at least one first-degree relative affected by asthma or rhinitis, conjunctivitis, eczema, cow's milk protein intolerance. All infants not breast fed were hypoallergenic formula. 46 infants were breast fed, 39 were bottle fed by the ordinary formula and 23 received the hypoallergenic one. No other food was introduced up to 6 months. Cow's milk proteins, egg, poultry and fish were introduced after 6 months. All infants were followed up to 24 months. Incidence of allergic diseases up to 24 months was not significantly different among the 3 groups. PMID:7971447

  11. Results of optical follow-up observations of advanced LIGO triggers from O1 in the southern hemisphere

    NASA Astrophysics Data System (ADS)

    Beroiz, Martin; Colazo, Carlos; Diaz, Mario; Dominguez, Mariano; Garcia Lambas, Diego; Gurovich, Sebastian; Lares, Marcelo; Macri, Lucas; Penuela, Tania; Rodriguez, Horacio; Sanchez, Bruno; Toros Collaboration

    2016-03-01

    We report on observations related to the follow-up of LIGO VIRGO collaboration triggers released to participating astronomers during the First Observation Run 1 (O1) from September 18, 2015 to January 12, 2016, performed by the TOROS collaboration. The Transient Optical Robotic Observatory of the South (TOROS) collaboration operated telescopes located in two different sites in Argentina: one at the Estación Astrofísica Bosque Alegre in Cordoba, and the other one located in Cordón Macón, Salta. In this communication we describe the main characteristics of the campaign sustained during O1 and the plans for continuing observation in the future.

  12. Large Renal Artery Aneurysm Treated with Guglielmi Detachable Coils: Procedural and 4-Year Follow-up Results

    SciTech Connect

    Damascelli, Bruno; Bartorelli, Antonio L.; Ticha, Vladimira; Trabattoni, Daniela; Lanocita, Rodolfo

    2008-07-15

    A large aneurysm of the left renal artery was found incidentally during abdominal ultrasound in a 39-year-old woman with no medical or family history of cardiovascular disease. Vascular pathology with a dysplastic appearance was confirmed by magnetic resonance angiography and the patient was offered transcatheter embolization. Since the position and size of the neck of the aneurysm could not be determined at angiography, detachable platinum coils were used for occlusion. The procedure was performed without complications. During a 4-year follow-up no alterations of renal function, recanalization of the aneurysm, or perfusion defects in the rest of the left renal circulation were noted.

  13. Idiopathic blepharospasm does not lead to a parkinsonian syndrome: results of a questionnaire-based follow-up study.

    PubMed

    Soonawala, N; Bhatia, K P; Yeung, J H; Quinn, N P; Marsden, C D

    1999-04-01

    It has been suggested that a lesion in the dopaminergic neurons of the substantia nigra pars compacta combined with eye irritation is involved in the pathophysiology of idiopathic blepharospasm. If so, these patients might be prone to develop Parkinson's disease or a parkinsonian syndrome. We therefore conducted a validated questionnaire-based follow-up study to estimate (a) the frequency of local eye disorders at onset and (b) frequency of development of parkinsonian symptoms in blepharospasm patients. Ninety-nine patients previously diagnosed with idiopathic blepharospasm were sent a two-part questionnaire to assess parkinsonian and other symptoms associated with their condition. The average period of follow-up was 12.7 years, ranging from 3 to 26 years, with an average age at onset of 53.5 years. Sixty-two patients reported other ocular symptoms prior to or at the onset of blepharospasm, and therefore ocular disease may act as a trigger to produce blepharospasm in those already predisposed. Only two patients had developed a score on the parkinsonism rating scale indicating possible Parkinson's disease, but clinical examination confirmed this not to be the case. If a lesion in the dopaminergic neurons is involved in blepharospasm, it would appear to be relatively minor (and non-progressive), since patients with idiopathic blepharospasm do not seem prone to develop parkinsonian symptoms. PMID:10367696

  14. Oral health follow-up studies in the 1993 Pelotas (Brazil) birth cohort study: methodology and principal results

    PubMed Central

    Peres, Marco A.; Barros, Aluísio Jardim; Peres, Karen Glazer; Araújo, Cora Luiza; Menezes, Ana M. B.; Hallal, Pedro C.; Victora, Cesar G.

    2013-01-01

    The aim of this study was to describe oral health follow-up studies nested in a birth cohort. A population-based birth cohort was launched in 1993 in Pelotas, Rio Grande do Sul State, Brazil. Two oral health follow-up studies were conducted at six (n = 359) and 12 (n = 339) years of age. A high response rate was observed at 12 years of age; 94.4% of the children examined at six years of age were restudied in 2005. The mean DMF-T index at age 12 was 1.2 (SD = 1.6) for the entire sample, ranging from 0.6 (SD = 1.1) for children that were caries-free at age six, 1.3 (SD = 1.5) for those with 1-3 carious teeth at six years, and 1.8 (SD = 1.8) for those with 4-19 carious teeth at six years (p < 0.01). The number of individuals with severe malocclusions at 12 years was proportional to the number of malocclusions at six years. Oral health problems in early adolescence were more prevalent in individuals with dental problems at six years of age. PMID:20963297

  15. Acetabular Reconstruction with the Burch-Schneider Antiprotrusio Cage and Bulk Allografts: Minimum 10-Year Follow-Up Results

    PubMed Central

    Sandri, Andrea

    2014-01-01

    Reconstruction of severe pelvic bone loss is a challenging problem in hip revision surgery. Between January 1992 and December 2000, 97 hips with periprosthetic osteolysis underwent acetabular revision using bulk allografts and the Burch-Schneider antiprotrusio cage (APC). Twenty-nine patients (32 implants) died for unrelated causes without additional surgery. Sixty-five hips were available for clinical and radiographic assessment at an average follow-up of 14.6 years (range, 10.0 to 18.9 years). There were 16 male and 49 female patients, aged from 29 to 83 (median, 60 years), with Paprosky IIIA (27 cases) and IIIB (38 cases) acetabular bone defects. Nine cages required rerevision because of infection (3), aseptic loosening (5), and flange breakage (1). The average Harris hip score improved from 33.1 points preoperatively to 75.6 points at follow-up (P < 0.001). Radiographically, graft incorporation and cage stability were detected in 48 and 52 hips, respectively. The cumulative survival rates at 18.9 years with removal for any reason or X-ray migration of the cage and aseptic or radiographic loosening as the end points were 80.0% and 84.6%, respectively. The use of the Burch-Schneider APC and massive allografts is an effective technique for the reconstructive treatment of extensive acetabular bone loss with long-lasting survival. PMID:24967339

  16. Cementless surface replacement hemiarthroplasty for primary glenohumeral osteoarthritis: results of over 5-year follow-up in patients with or without rotator cuff deficiency

    PubMed Central

    Al-Hadithy, Nawfal; Furness, Nicholas; Patel, Ronak; Jonas, Sam; Jobbagy, Attila; Lowdon, Ian

    2015-01-01

    Background Cementless surface replacement hemiarthroplasty (CSRHA) is an established treatment for glenohumeral osteoarthritis; however, studies evaluating its role in arthritis with rotator cuff deficiency are limited. This study reviews the outcomes of CSRHA for glenohumeral osteoarthritis with and without rotator cuff tears. Methods 41 CSRHA (Mark III Copeland prosthesis) were performed for glenohumeral osteoarthritis with intact rotator cuffs (n = 21) and cuff-deficient shoulders (n = 20). Patients were assessed using Oxford and Constant questionnaires, patient satisfaction, range of motion measurements and by radiography. Results Mean age and follow-up were 75 years and 5.1 years, respectively. Functional gains were significantly higher in patients with intact rotator cuffs compared to cuff-deficient shoulders, with Oxford Shoulder Score improving from 18 to 37.5 and 15 to 27 and forward flexion improved from 60° to 126° and 44° to 77° in each group, respectively. Two patients with deficient cuffs had deficient subscapularis tendons; one of which was dislocated anteriorly. Conclusions CSRHA provides significant improvements in pain and function in patients with glenohumeral osteoarthritis. In patients with deficient cuffs, functional gains are limited, and should be considered in low-demand patients where pain is the primary problem. Caution should be taken in patients with a deficient subscapularis as a result of the risk of dislocation.

  17. Initial Clinical Experience With the Strut-Adjusted Volume Implant (SAVI) Breast Brachytherapy Device for Accelerated Partial-Breast Irradiation (APBI): First 100 Patients With More Than 1 Year of Follow-Up

    SciTech Connect

    Yashar, Catheryn M.; Scanderbeg, Daniel; Kuske, Robert; Wallace, Anne; Zannis, Victor; Blair, Sarah; Grade, Emily; Swenson, Virginia H.; Quiet, Coral

    2011-07-01

    Purpose: The Strut-Adjusted Volume Implant (SAVI; Cianna Medical, Aliso Viejo, CA) is a multichannel single-entry brachytherapy device designed to allow dose modulation to minimize normal tissue dose while simultaneously maximizing target coverage. This is the first report on the initial 102 patients with nearly 2 years of median follow-up. Methods and Materials: One hundred two patients were treated at two institutions. Data were collected on eligibility and dosimetry and followed for toxicity and recurrence. Results: The median follow-up is 21 months. Overall dosimetry is outstanding (median percent of target volume receiving 90% of the prescription dose was 95.9%, volume of target receiving 150% of the prescription dose was 27.8 mL, and volume of target receiving 200% of the prescription dose was 14.0 cm{sup 3}). No devices were pulled prior to treatment completion. For patients with a skin bridge of less than 7 mm, the maximum median skin dose was 280 cGy (median percent of target volume receiving 90% of the prescription dose was 95.2%, volume of target receiving 150% of the prescription dose was 25.8 cm{sup 3} and volume of target receiving 200% of the prescription dose was 12.7 mL). For patients with both chest wall and skin of less than 7 mm, the maximum median lung dose was 205 cGy with simultaneous skin dose of 272 cGy. The rate of telangiectasia was 1.9%. Grade 1 hyperpigmentation developed in 10 patients (9.8%) and Grade 2 fibrosis in 2 patients (1.9%). There were 2 symptomatic seromas and 2 cases of asymptomatic fat necrosis (1.9%). Of the patients, 27% were not eligible for MammoSite balloon brachytherapy (Hologic, Inc., Marlborough, MA) and 5% were not eligible for any balloon brachytherapy. The recurrence rate was 1%. Conclusions: The SAVI appears to safely allow an increase in eligibility for APBI over balloon brachytherapy or three-dimensional conformal radiation, highlighting the outstanding device flexibility to maximize the target dose and

  18. Anticipation resulting in elimination of the myotonic dystrophy gene: a follow up study of one extended family.

    PubMed Central

    de Die-Smulders, C E; Höweler, C J; Mirandolle, J F; Brunner, H G; Hovers, V; Brüggenwirth, H; Smeets, H J; Geraedts, J P

    1994-01-01

    We have re-examined an extended myotonic dystrophy (DM) family, previously described in 1955, in order to study the long term effects of anticipation in DM and in particular the implications for families affected by this disease. This follow up study provides data on 35 gene carriers and 46 asymptomatic at risk family members in five generations. Clinical anticipation, defined as the cascade of mild, adult, childhood, or congenital disease in subsequent generations, appeared to be a relentless process, occurring in all affected branches of the family. The cascade was found to proceed asynchronously in the different branches, mainly because of an unequal number of generations with mild disease. The transition from the mild to the adult type was associated with transmission through a male parent. Stable transmission of the asymptomatic/mild phenotype showed a female transmission bias. We further examined the extent and causes of gene loss in this pedigree. Gene loss in the patient group was complete, owing to infertility of the male patients with adult onset disease and the fact that mentally retarded patients did not procreate. Out of the 46 at risk subjects in the two youngest generations, only one was found to have a full mutation. This is the only subject who may transmit the gene to the sixth generation. No protomutation carriers were found in the fourth and fifth generations. Therefore it is highly probable that the DM gene will be eliminated from this pedigree within one generation. The high population frequency of DM can at present not be explained by the contribution of asymptomatic cases in the younger generations of known families, but is probably caused by the events in the ancestral generations. PMID:7815415

  19. The National Longitudinal Study of the High School Class of 1972: Selected Results from the Base-Year and the First Follow-Up Surveys.

    ERIC Educational Resources Information Center

    Peng, Samuel S.; And Others

    The National Longitudinal Study of the High School Class of 1972 has completed two phases of data collection: the Base-Year and the First Follow-Up Surveys. This paper summarizes some of the findings from cross-sectional and longitudinal analyses of that data. A cross-sectional analysis of the base-year results yielded information on grades, work,…

  20. Developing Software to “Track and Catch” Missed Follow-up of Abnormal Test Results in a Complex Sociotechnical Environment

    PubMed Central

    Smith, M.; Murphy, D.; Laxmisan, A.; Sittig, D.; Reis, B.; Esquivel, A.; Singh, H.

    2013-01-01

    Summary Background Abnormal test results do not always receive timely follow-up, even when providers are notified through electronic health record (EHR)-based alerts. High workload, alert fatigue, and other demands on attention disrupt a provider’s prospective memory for tasks required to initiate follow-up. Thus, EHR-based tracking and reminding functionalities are needed to improve follow-up. Objectives The purpose of this study was to develop a decision-support software prototype enabling individual and system-wide tracking of abnormal test result alerts lacking follow-up, and to conduct formative evaluations, including usability testing. Methods We developed a working prototype software system, the Alert Watch And Response Engine (AWARE), to detect abnormal test result alerts lacking documented follow-up, and to present context-specific reminders to providers. Development and testing took place within the VA’s EHR and focused on four cancer-related abnormal test results. Design concepts emphasized mitigating the effects of high workload and alert fatigue while being minimally intrusive. We conducted a multifaceted formative evaluation of the software, addressing fit within the larger socio-technical system. Evaluations included usability testing with the prototype and interview questions about organizational and workflow factors. Participants included 23 physicians, 9 clinical information technology specialists, and 8 quality/safety managers. Results Evaluation results indicated that our software prototype fit within the technical environment and clinical workflow, and physicians were able to use it successfully. Quality/safety managers reported that the tool would be useful in future quality assurance activities to detect patients who lack documented follow-up. Additionally, we successfully installed the software on the local facility’s “test” EHR system, thus demonstrating technical compatibility. Conclusion To address the factors involved in missed

  1. Osteochondritis dissecans of the elbow: excellent mid-term follow-up results in teenage athletes treated by arthroscopic debridement and microfracture

    PubMed Central

    Bojanić, Ivan; Smoljanović, Tomislav; Dokuzović, Stjepan

    2012-01-01

    Aim To extend the microfracture procedure, which has been proven successful on osteochondritis dissecans (OCD) lesions in the knee and ankle, to OCD lesions in the elbow. Methods Nine young patients were treated by arthroscopic debridement and microfracture by a single surgeon. The average age at operation was 15.0 years (median 15; range 12-19). The average length of the follow-up was 5.3 years (median 5; range 2-9). The follow-up included physical examination and patient interview with elbow function scoring. Success of treatment was determined according to pre-operative and follow-up Mayo Elbow Performance Index scores and the patients’ return to sports. Results Eight patients scored excellent results on the follow-up and 1 scored a good result. Four out of 9 patients were able to increase their training intensity, 2 returned to the same level of activity, 2 changed sports (due to reasons unrelated to the health of their elbow), and 1 left professional sports and started training only recreationally. No patients stopped participating in sports altogether. Conclusions We advocate arthroscopic microfracturing, followed by a strict rehabilitation regime, as a highly effective treatment for OCD of the humeral capitellum. PMID:22351577

  2. Short-term Follow-up US Leads to Higher False-positive Results Without Detection of Structural Recurrences in PTMC.

    PubMed

    Yoon, Jung Hyun; Lee, Hye Sun; Kim, Eun-Kyung; Youk, Ji Hyun; Kim, Hyun Gi; Moon, Hee Jung; Kwak, Jin Young

    2016-01-01

    To investigate the value of the annual follow-up neck ultrasonography (US) for postoperative surveillance in patients with papillary thyroid microcarcinoma (PTMC). This retrospective study has been approved by our institutional review board (IRB) with waiver for informed consent. A total of 375 patients diagnosed as PTMCs, who underwent total thyroidectomy with radioiodine remnant ablation were included, to identify the recurrence rate and the false-positive rate of annual ultrasound. The number, interval, and the results of follow-up US or fine needle aspiration were obtained from electronic medical records. Four (1.1%, 4/375) recurrences were found 3 years after the initial treatment, and only 1 patient (0.3%, 1/375) had a metastatic lymph node larger than 8 mm in the shortest diameter on US found 7.6 years after initial treatment with biochemical abnormalities. Cumulative risk of having at least 1 false-positive exam was 8.3% by the 8th US, and 8.1% by the 8-9 year follow-up. Cox multivariate regression showed shorter interval of follow-up US and presence of lymph node metastasis at initial surgery are independent predictors affecting the cumulative false-positive results (hazard ratio [HR], 0.60; 95% confidence interval [CI]: 0.49-0.73; P < 0.001 and HR, 2.19; 95% CI: 1.01-4.75; P = 0.048, respectively). Short-term follow-up US can result in higher cumulative false-positive results without detection of meaningful recurrences in patients with PTMCs who do not have biochemical abnormalities. PMID:26735548

  3. Short-term Follow-up US Leads to Higher False-positive Results Without Detection of Structural Recurrences in PTMC

    PubMed Central

    Yoon, Jung Hyun; Lee, Hye Sun; Kim, Eun-Kyung; Youk, Ji Hyun; Kim, Hyun Gi; Moon, Hee Jung; Kwak, Jin Young

    2016-01-01

    Abstract To investigate the value of the annual follow-up neck ultrasonography (US) for postoperative surveillance in patients with papillary thyroid microcarcinoma (PTMC). This retrospective study has been approved by our institutional review board (IRB) with waiver for informed consent. A total of 375 patients diagnosed as PTMCs, who underwent total thyroidectomy with radioiodine remnant ablation were included, to identify the recurrence rate and the false-positive rate of annual ultrasound. The number, interval, and the results of follow-up US or fine needle aspiration were obtained from electronic medical records. Four (1.1%, 4/375) recurrences were found 3 years after the initial treatment, and only 1 patient (0.3%, 1/375) had a metastatic lymph node larger than 8 mm in the shortest diameter on US found 7.6 years after initial treatment with biochemical abnormalities. Cumulative risk of having at least 1 false-positive exam was 8.3% by the 8th US, and 8.1% by the 8–9 year follow-up. Cox multivariate regression showed shorter interval of follow-up US and presence of lymph node metastasis at initial surgery are independent predictors affecting the cumulative false-positive results (hazard ratio [HR], 0.60; 95% confidence interval [CI]: 0.49–0.73; P < 0.001 and HR, 2.19; 95% CI: 1.01–4.75; P = 0.048, respectively). Short-term follow-up US can result in higher cumulative false-positive results without detection of meaningful recurrences in patients with PTMCs who do not have biochemical abnormalities. PMID:26735548

  4. Results of Primary Total Hip Arthroplasty with 36-mm Femoral Heads on Highly Cross-linked Polyethylene-Minimum Seven-years Follow-up

    PubMed Central

    Choi, Won-Kee; Lee, Joo-Hwan

    2014-01-01

    Purpose We evaluate the clinical and radiographic midterm results of primary total hip arthroplasty (THA) using a 36 mm diameter femoral head on highly cross-linked polyethylene (minimum 7-year follow-up). Materials and Methods We retrospectively reviewed 73 patients (74 hips) that underwent primary THA with a 36 mm diameter femoral head on highly cross-linked polyethylene between July 2004 and February 2007. Clinical follow-ups included specific measurements like modified Harris hip scores (HHS) and Merle d'Aubigne and Postel score. For radiologic evaluations, together with position of acetabular cup at 6 weeks later of post-operation, we separately calculated the penentrations of femoral heads into polyethylene liners during post-operation and one year later check-ups, and during one year later check-ups and final check-ups. Results There were no complications except for one case of dislocation. Average modified HHS at final follow-up was 88±7.5 (range, 81-96), and Merle d'Aubigne and Postel scores were more than 15 (range, 15-18). Mean acetabular cup inclination and anteversion were 50.1°(range, 35°-58°) and 23.6°(range, 5°-38°), respectively. Average femoral head penetration during the first postoperative year was 0.071±0.034 mm/year, and steady-state wear rate determined using radiographs taken at one-year postoperatively and at latest follow-up was 0.051±0.022 mm/year. Average femoral head penetration during entire follow-ups was 0.058±0.013 mm/year. Conclusion Primary THA with a large diameter femoral head on highly cross-linked polyethylene was found to produce the results comparable to previous in vitro laboratory hip simulation studies. And we also find out good scores in terms of patient's functionality.

  5. Student's Booklet; To Accompany The Career Data Book: Results from Project TALENT'S Five-Year Follow-Up Study.

    ERIC Educational Resources Information Center

    Flanagan, John C.; And Others

    The Student Booklet is a companion document to "The Career Data Book: Results from Project TALENT'S Five-year Followup Study" (CE 000 755). The booklet's purpose is to enable the high school student to compare his abilities, achievements, interests, and background with those of other young people who went into various occupations so he may be…

  6. Surveillance results of depleted uranium-exposed Gulf War I veterans: sixteen years of follow-up.

    PubMed

    McDiarmid, M A; Engelhardt, S M; Dorsey, C D; Oliver, M; Gucer, P; Wilson, P D; Kane, R; Cernich, A; Kaup, B; Anderson, L; Hoover, D; Brown, L; Albertini, R; Gudi, R; Squibb, K S

    2009-01-01

    As part of a longitudinal surveillance program, 35 members of a larger cohort of 77 Gulf War I veterans who were victims of depleted uranium (DU) "friendly fire" during combat underwent a 3-day clinical assessment at the Baltimore Veterans Administration Medical Center (VAMC). The assessment included a detailed medical history, exposure history, physical examination, and laboratory studies. Spot and 24-h urine collections were obtained for renal function parameters and for urine uranium (U) measures. Blood U measures were also performed. Urine U excretion was significantly associated with DU retained shrapnel burden (8.821 mug U/g creatinine [creat.] vs. 0.005 mug U/g creat., p = .04). Blood as a U sampling matrix revealed satisfactory results for measures of total U with a high correlation with urine U results (r = .84) when urine U concentrations were >/=0.1 mug/g creatinine. However, isotopic results in blood detected DU in only half of the subcohort who had isotopic signatures for DU detectable in urine. After stratifying the cohort based on urine U concentration, the high-U group showed a trend toward higher concentrations of urine beta(2) microglobulin compared to the low-U group (81.7 v. 69.0 mug/g creat.; p = .11 respectively) and retinol binding protein (48.1 vs. 31.0 mug/g creat.; p = .07 respectively). Bone metabolism parameters showed only subtle differences between groups. Sixteen years after first exposure, this cohort continues to excrete elevated concentrations of urine U as a function of DU shrapnel burden. Although subtle trends emerge in renal proximal tubular function and bone formation, the cohort exhibits few clinically significant U-related health effects. PMID:18979351

  7. [Results of a follow-up of participants in the liquidation of the effects of the Chernobyl AES accident].

    PubMed

    Oganesian, N M; Ogandzhanian, E A; Melikian, I E; Malikoian, S A; Tiroian, G M; Asrian, K V; Abramian, A K; Batikian, I G

    1991-01-01

    The paper is concerned with the results of analysis of a clinico-laboratory study of persons (residents of Armenia) who took part in the elimination of the effects of the Chernobyl accident. Investigation of general morbidity revealed no correlation with exposure to ionizing radiation. The symptom complex of pathological changes included CNS functional disorders, a transition from the hypokinetic type of a heart response to exercise to the normokinetic one, lowered immune status and tissue peripheral blood flow, unmarked hematological and biochemical shifts, suggesting suppression of the body antioxidant system. PMID:1943550

  8. Role of Demineralized Allograft Subchondral Bone in the Treatment of Shoulder Lesions of the Talus: Clinical Results With Two-Year Follow-Up.

    PubMed

    Galli, Melissa M; Protzman, Nicole M; Bleazey, Scott T; Brigido, Stephen A

    2015-01-01

    Cystic osteochondral lesions of the talus present a considerable challenge for foot and ankle surgeons. The purpose of the present study was to evaluate the effect of a medial malleolar osteotomy and implantation of demineralized allograft subchondral bone on pain and function 2 years after surgery. For inclusion, patients demonstrated radiographic evidence of a medial cystic full-thickness osteochondral defect of the talus and previously failed microfracture (N = 12). We hypothesized that improvements in pain and disability would be maintained across time. Compared with the preoperative values, 2 years after surgery, pain and disability had significantly reduced (p < .001). Significant reductions had occurred in postoperative pain from 6 months to 1 year (p = .001) and from 6 months to 2 years (p = .005). Similarly, significant reductions had occurred in postoperative disability from 6 months to 1 year (p = .008) and from 6 months to 2 years (p = .03). The reductions in postoperative pain and disability were maintained from 1 year to 2 years (p ≥ .79). Multiple regression analyses identified depression as a predictor of 2-year postoperative pain (R(2) = 0.36, p = .04). No variables were identified as significant predictors of postoperative disability at 2 years. Other than 1 previously reported peroneal deep venous thrombosis, no additional complications occurred. With successful graft incorporation, no inflammatory response, and no additional complications, the allograft subchondral plug appears to successfully treat osteochondral lesions of the talus and maintain improvements in pain and disability at intermediate follow-up. PMID:25022615

  9. Gall stone pulverisation strategy in patients treated with extracorporeal lithotripsy and follow up results of maintenance treatment with ursodeoxycholic acid.

    PubMed Central

    Boscaini, M; Piccinni-Leopardi, M; Andreotti, F; Montori, A

    1994-01-01

    Between November 1988 and July 1992 70 patients with radiolucent gall stones were treated with extracorporeal lithotripsy (ESL) and ursodeoxycholic acid (UDCA; mean (SD) dose 11.2 (1.9) mg/kg/day). Fifty three patients have been followed for one year. One week after lithotripsy, 30.6% had completely eliminated all stone fragments from the gall bladder and one year later 93.9% were free of stones. Three factors were considered important in achieving these results. 'Pulverisation' of the stone--that is, its fragmentation into echogenic dust (crystalline aggregates, some few hundred mu in size) or particles similar to grains of sand, smaller than 1 mm in diameter, or both, is required. Secondly, dust and particles were rapidly eliminated, strongly suggesting a mechanical elimination process by physiological gall bladder contractions. Thirdly, there must be chemical dissolution with biliary acids. This therapeutic approach gave excellent results without causing any clinically relevant side effects. The first 20 patients who became free of stones after ESL were given oral bile acid maintenance treatment--300 mg/day of UDCA at bedtime, for two years. All were asymptomatic and none had suffered a recurrence after two years. In four patients, crystalline aggregates, detected in gall bladder bile by ultrasound, were subsequently dissolved between one and three months after resuming a full dose regimen of UDCA. Images Figure 2 Figure 3 PMID:8307431

  10. Association between dairy intake and caries among children and adolescents. results from the Danish EYHS follow-up study.

    PubMed

    Lempert, Susanne M; Christensen, Lisa B; Froberg, Karsten; Raymond, Kyle; Heitmann, Berit L

    2015-01-01

    The aim of this paper was to investigate associations between the intake of dairy products and the development in caries (DMFS, decayed, missing and filled surfaces) among children/adolescents over a period of 3 and 6 years, and to investigate whether dairy intake protects against caries incidence. A total of 68.9% of the children were caries free at the age of 9 compared with 34.0% of the adolescents at the age of 15 (measured as DMFS = 0). A larger percentage of children/adolescents with a dairy intake above the mean were caries free compared with the group of children/adolescents with an intake below the mean (72.8 vs. 65.8% at age 9 and 41.1 vs. 30.7% at age 15). The results from the generalized estimation equation showed that dairy and milk intake, as well as intakes of components of dairy such as dairy calcium, whey and casein, was generally inversely associated with childhood/adolescent caries experience (measured as DMFS). With regard to caries incidence, the same inverse association was found for incidence over a period of 3 years and for incidence over 6 years, but the results were only statistically significant for the 3-year incidence and for the unadjusted models of the 6-year incidence. This study found that previous dairy intake, as well as milk intake or intake of dairy components, may be a predictor of future risk of caries measured by the DMFS count level. This relationship was inverse, meaning that a high intake of dairy products was associated with less future caries development. However, more studies on larger cohorts are needed to confirm these findings. PMID:25825159

  11. Treatment of malreduced pilon fracture: A case report and the result in the long-term follow-up

    PubMed Central

    Balioğlu, Mehmet Bulent; Akman, Yunus Emre; Bahar, Hakan; Albayrak, Akif

    2015-01-01

    Introduction The risk for post-traumatic osteoarthritis (POA) following tibial plafond joint trauma has been reported to be as high as 70–75%. In the treatment of more severe joint pathologies, with incongruity and intra-articular defects, internal or external fixations techniques may be required. Presentation of case We report the orthopedic management of a pilon fracture in a 30-year-old male with malunion and implant failure after initial mal-reduction of the fracture 9-months earlier. Tricortical iliac crest autologous bone grafting (TCG) was used in combination with internal fixation to restore distal tibial articular. The procedure resulted in a pain free ankle, sufficient range of motion for function and patient satisfaction. Discussion Early surgical intervention and anatomical reduction with appropriate fixation are recommended for intra-articular tibial pilon fractures. Autogenous bone grafting is a reliable treatment option to augment structural stability, bone defects and bone-healing. Indications for bone grafting include delayed union or nonunion, malunion, arthrodesis, limb salvage, and reconstruction of bone voids or defects. The application of TCG in the management of a malreduced tibial plafond fracture has not been described before. Conclusion We performed TCG with internal fixation in order to restore stability, congruency and alignment in a young patient in whom a biological restoration was feasible due to good bone quality. In suitable cases, TCG might provide an alternative to arthrodesis or arthroplasty. PMID:26724734

  12. External Beam Radiotherapy With Endocavitary Boost for Nasopharyngeal Cancer: Treatment Results and Late Toxicity After Extended Follow-Up

    SciTech Connect

    Schinagl, Dominic A.X.; Marres, Henri A.M.; Kappelle, Arnoud C.; Merkx, Matthias A.W.; Pop, Lucas A.M.; Verstappen, Suzan M.M.; Kaanders, Johannes H.A.M.

    2010-11-01

    Purpose: To evaluate the long-term outcome after treatment of nasopharyngeal carcinoma and assess late toxicity in a multidisciplinary clinic. Methods and Materials: A retrospective analysis of 117 patients treated for nasopharyngeal cancer in a single institute between 1985 and 2002 was performed. Fifty-one long-term survivors were evaluated for late toxicity by a multidisciplinary team comprising a radiation oncologist, otolaryngologist, neurologist, and oral and maxillofacial surgeon. Results: The 5-year local control rate for T1 to T2 and T3 to T4 tumors was 97% and 76%, respectively. Five-year disease-free survival and overall survival were 82% and 88% for Stage I to IIb disease and 46% and 52% for Stage III to IVb, respectively. Late morbidity evaluation revealed Radiation Therapy Oncology Group (RTOG) Grade III to IV toxicity in 71% of patients. A high incidence of cranial nerve palsies (47%) and mandibular osteolysis (82%) was found, although these complications had limited clinical impact. Conclusions: The multidisciplinary late morbidity clinic revealed an unexpected high incidence of cranial nerve palsies and mandibular osteolysis and overall an RTOG Grade III to IV toxicity in 71% of patients treated for nasopharyngeal cancer. External beam radiotherapy with endocavitary brachytherapy produces excellent rates of local control for T1 to T2 tumors, but the high incidence of late toxicity suggests an overtreatment.

  13. Is the advanced age a contraindication to GERD laparoscopic surgery? Results of a long term follow-up

    PubMed Central

    2013-01-01

    Background In this prospective non randomized observational cohort study we have evaluated the influence of age on outcome of laparoscopic total fundoplication for GERD. Methods Six hundred and twenty consecutive patients underwent total laparoscopic fundoplication for GERD. Five hundred and twenty-four patients were younger than 65 years (YG), and 96 patients were 65 years or older (EG). The following parameters were considered in the preoperative and postoperative evaluation: presence, duration, and severity of GERD symptoms, presence of a hiatal hernia, manometric and 24 hour pH-monitoring data, duration of operation, incidence of complications and length of hospital stay. Results Elderly patients more often had atypical symptoms of GERD and at manometric evaluation had a higher rate of impaired esophageal peristalsis in comparison with younger patients. The duration of the operation was similar between the two groups. The incidence of intraoperative and postoperative complications was low and the difference was not statistically significant between the two groups. An excellent outcome was observed in 93.0% of young patients and in 88.9% of elderly patients (p = NS). Conclusions Laparoscopic antireflux surgery is a safe and effective treatment for GERD even in elderly patients, warranting low morbidity and mortality rates and a significant improvement of symptoms comparable to younger patients. PMID:24267613

  14. Optical Spectroscopic Observations of Gamma-ray Blazar Candidates. IV. Results of the 2014 Follow-up Campaign

    NASA Astrophysics Data System (ADS)

    Ricci, F.; Massaro, F.; Landoni, M.; D'Abrusco, R.; Milisavljevic, D.; Stern, D.; Masetti, N.; Paggi, A.; Smith, Howard A.; Tosti, G.

    2015-05-01

    The extragalactic γ-ray sky is dominated by the emission arising from blazars, one of the most peculiar classes of radio-loud active galaxies. Since the launch of Fermi several methods were developed to search for blazars as potential counterparts of unidentified γ-ray sources (UGSs). To confirm the nature of the selected candidates, optical spectroscopic observations are necessary. In 2013 we started a spectroscopic campaign to investigate γ-ray blazar candidates selected according to different procedures. The main goals of our campaign are: (1) to confirm the nature of these candidates, and (2) whenever possible, determine their redshifts. Optical spectroscopic observations will also permit us to verify the robustness of the proposed associations and check for the presence of possible source class contaminants to our counterpart selection. This paper reports the results of observations carried out in 2014 in the northern hemisphere with Kitt Peak National Observatory and in the southern hemisphere with the Southern Astrophysical Research telescopes. We also report three sources observed with the Magellan and Palomar telescopes. Our selection of blazar-like sources that could be potential counterparts of UGSs is based on their peculiar infrared colors and on their combination with radio observations both at high and low frequencies (i.e., above and below ˜1 GHz) in publicly available large radio surveys. We present the optical spectra of 27 objects. We confirm the blazar-like nature of nine sources that appear to be potential low-energy counterparts of UGSs. Then we present new spectroscopic observations of 10 active galaxies of uncertain type associated with Fermi sources, classifying all of them as blazars. In addition, we present the spectra for five known γ-ray blazars with uncertain redshift estimates and three BL Lac candidates that were observed during our campaign. We also report the case for WISE J173052.85-035247.2, candidate counterpart of the

  15. Follow-Up Testing

    MedlinePlus

    ... the extent to which a celiac is avoiding gluten, and can detect when hidden gluten has entered the diet. How often should follow- ... second should occur after 1 year on the gluten-free diet. After that, a celiac should receive ...

  16. Surgical results of dynamic nonfusion stabilization with the Segmental Spinal Correction System for degenerative lumbar spinal diseases with instability: Minimum 2-year follow-up

    PubMed Central

    Ohta, Hideki; Matsumoto, Yoshiyuki; Morishita, Yuichirou; Sakai, Tsubasa; Huang, George; Kida, Hirotaka; Takemitsu, Yoshiharu

    2011-01-01

    Background When spinal fusion is applied to degenerative lumbar spinal disease with instability, adjacent segment disorder will be an issue in the future. However, decompression alone could cause recurrence of spinal canal stenosis because of increased instability on operated segments and lead to revision surgery. Covering the disadvantages of both procedures, we applied nonfusion stabilization with the Segmental Spinal Correction System (Ulrich Medical, Ulm, Germany) and decompression. Methods The surgical results of 52 patients (35 men and 17 women) with a minimum 2-year follow-up were analyzed: 10 patients with lumbar spinal canal stenosis, 15 with lumbar canal stenosis with disc herniation, 20 with degenerative spondylolisthesis, 6 with disc herniation, and 1 with lumbar discopathy. Results The Japanese Orthopaedic Association score was improved, from 14.4 ± 5.3 to 25.5 ± 2.8. The improvement rate was 76%. Range of motion of the operated segments was significantly decreased, from 9.6° ± 4.2° to 2.0° ± 1.8°. Only 1 patient had adjacent segment disease that required revision surgery. There was only 1 screw breakage, but the patient was asymptomatic. Conclusions Over a minimum 2-year follow-up, the results of nonfusion stabilization with the Segmental Spinal Correction System for unstable degenerative lumbar disease were good. It is necessary to follow up the cases with a focus on adjacent segment disorders in the future. PMID:25802671

  17. Analysis of Personal and Family Factors in the Persistence of Attention Deficit Hyperactivity Disorder: Results of a Prospective Follow-Up Study in Childhood

    PubMed Central

    Fernández, M. Inmaculada; Presentación, M. Jesús; Roselló, Belén

    2015-01-01

    Objectives To study the course of ADHD during childhood and analyze possible personal and family predictor variables of the results. Method Sixty-one children with ADHD who were between 6 and 12 years old at the baseline assessment were evaluated 30 months later (mean age at baseline: 8.70 ± 1.97; mean age at follow-up: 10.98 ± 2.19). Status of ADHD in follow-up was identified as persistent (met DSM-IV-TR criteria according to parents’ and teachers’ ratings), contextually persistent (met ADHD criteria according to one informant, and there was functional impairment) and remitted ADHD (with subthreshold clinical symptomatology). Associated psychological disorders of the three groups were analyzed in the follow-up with the Conners' Rating Scales. The groups were compared on ADHD characteristics (symptoms of ADHD and impairment), child psychopathology, executive functioning (EF; inhibition, working memory) and parenting characteristics (parental stress and discipline styles) at baseline. Results At the follow-up, 55.7% of the children continued to meet the DSM-IV-TR criteria for ADHD, 29.5% showed contextual persistence, and 14.8% presented remission of the disorder. The persistent and contextually persistent ADHD groups showed more associated psychological disorders. Inattention, oppositional problems, cognitive problems and impairment at baseline distinguished the remitted ADHD children from the persistent and contextually persistent ADHD children. Moreover, the persistent groups had significantly more emotional liability and higher parental stress than the group in remission, while no differences in EF where found among the groups. Conclusions ADHD children continue to present symptoms, as well as comorbid psychological problems, during adolescence and early adulthood. These findings confirm that persistence of ADHD is associated with child psychopathology, parental stress and impairment in childhood. PMID:26024216

  18. Comparison of Endodontic Treatment Results Yielded from Using Normal Saline with IKI Final Rinse or NaOCl Irrigation: A 30-Month Follow-up Study

    PubMed Central

    Abbaszadegan, Abbas; Nabavizadeh, Mohammadreza; Hoseini Yekani, Ameneh; Khayat, Akbar

    2013-01-01

    Introduction The aim of this clinical trial was to evaluate and compare the endodontic treatment results of teeth with apical periodontitis after thirty-month recall with two different irrigation regimen: normal saline followed by Iodine Potassium Iodide (IKI) or sodium hypochlorite (NaOCl) irrigation alone. Materials and Methods Twenty seven patients (30 teeth) who had been included in the first part of our antimicrobial survey were recalled. In previous stage, root canal treatments were performed using either normal saline with IKI final rinse (n = 15) or NaOCl (n = 15) as irrigating solutions. Bacterial samples were taken before and after instrumentation. In this stage, three patients (6 teeth) were excluded from the follow-up schedule since they did not respond to the recall requests. The remaining 24 subjects (12 teeth in each NaOCl and IKI group) were examined clinically and radiologically. Post-operative and follow-up images were coded, blindly evaluated and given a periapical score according to PAI scoring system. The outcome was assessed in two ways; first, the changes in PAI score from base line to the follow-up evaluation in each group were assessed by wilcoxon signed rank test. In addition, Mann-Whitney U test was used to compare the differences between the post-operative and follow-up images of treatment groups. Second, the dichotomous variables as “healed” or “not healed” were compared. Results The Median (Min, Max) PAI scores for NaOCl group and IKI group were both 5 (3, 5) for immediate post-operative radiographs and declined to 1 (1, 2) and 2 (1, 2), respectively. A statistically significant decrease in PAI score from the base line to the follow-up evaluation was seen in both groups (P = 0.002). The decrease in NaOCl group was higher significantly in comparison to IKI group (P = 0.036). One hundred percent of the teeth were healed in both groups (PAI ≤ 2) and no teeth showed any abnormal clinical findings. Conclusion Root canal irrigation

  19. Long-term results for the uncemented Zweymuller/Alloclassic hip endoprosthesis. A 15-year minimum follow-up of 320 hip operations.

    PubMed

    Suckel, Andreas; Geiger, Friedrich; Kinzl, Lothar; Wulker, Nikolaus; Garbrecht, Manfred

    2009-09-01

    A follow-up study of 15 (15-17) years of 320 consecutive Zweymuller total hip arthroplasties is presented. Age at surgery was 67 (29-99) years. A total of 164 (51.3%) patients had died. Clinical and radiological examinations were available for 97 (30.3%), phone interviews and radiological examinations for 4 (1.3%) hips, and phone follow-ups for 49 (15.3%). There were 6 (1.9%) patients who were lost to follow-up. The Harris Hip Score results in a median value of 88. According to the Kaplan-Meier method, a survival rate of the cup/inlay of 98% (95% confidence interval, 95%-99%) after 17 years was achieved. For the stem/head, the survival rate was 98% (95% confidence interval, 94%-99%). In 95.2% of patients, no operative revision was required. The rate of aseptic loosening was 2% for the acetabular and 1% for the femoral component. PMID:18789635

  20. Long-Term Effects of Physical Exercise on Verbal Learning and Memory in Middle-Aged Adults: Results of a One-Year Follow-Up Study

    PubMed Central

    Hötting, Kirsten; Schauenburg, Gesche; Röder, Brigitte

    2012-01-01

    A few months of physical exercise have been shown to increase cognition and to modulate brain functions in previously sedentary, mainly older adults. However, whether the preservation of newly gained cognitive capacities requires an active maintenance of the achieved fitness level during the intervention is not yet known. The aim of the present study was to test whether cardiovascular fitness one year after an exercise intervention was linked to cognitive variables. Twenty-five healthy participants (42-57 years of age) took part in a follow-up assessment one year after the end of a supervised exercise intervention. Measurements included a cardiovascular fitness test, psychometric tests of verbal learning and memory and selective attention as well as questionnaires assessing physical activity and self-efficacy beliefs. Recognition scores of participants with higher cardiovascular fitness at follow-up did not change significantly during the follow-up period; however, the scores of participants with lower cardiovascular fitness decreased. One year after the end of the physical training intervention, previously sedentary participants spent more hours exercising than prior to the intervention. The time participants spent exercising correlated with their self-efficacy beliefs. These results demonstrate a direct link between verbal learning and cardiovascular fitness and show that positive effects of physical interventions on learning and memory do need an active maintenance of cardiovascular fitness. PMID:24961197

  1. Views of family physicians about survivorship care plans to provide breast cancer follow-up care: exploration of results from a randomized controlled trial

    PubMed Central

    O’Brien, M.A.; Grunfeld, E.; Sussman, J.; Porter, G.; Mobilio, M. Hammond

    2015-01-01

    Background The U.S. Institute of Medicine recommends that cancer patients receive survivorship care plans, but evaluations to date have found little evidence of the effectiveness of such plans. We conducted a qualitative follow-on study to a randomized controlled trial (rct) to understand the experiences of family physicians using survivorship care plans to support the follow-up of breast cancer patients. Methods A subset of family physicians whose patients were enrolled in the parent rct in Ontario and Nova Scotia were eligible for this study. In interviews, the physicians discussed survivorship care plans (intervention) or usual discharge letters (control), and their confidence in providing follow-up cancer care. Results Of 123 eligible family physicians, 18 (10 intervention, 8 control) were interviewed. In general, physicians receiving a survivorship care plan found only the 1-page care record to be useful. Physicians who received only a discharge letter had variable views about the letter’s usefulness; several indicated that it lacked information about potential cancer- or treatment-related problems. Most physicians were comfortable providing care 3–5 years after diagnosis, but desired timely and informative communication with oncologists. Conclusions Although family physicians did not find extensive survivorship care plans useful, discharge letters might not be sufficiently comprehensive for follow-up breast cancer care. Effective strategies for two-way communication between family physicians and oncologists are still lacking. PMID:26300663

  2. Prospective, Randomized Comparison of One-level Mobi-C Cervical Total Disc Replacement vs. Anterior Cervical Discectomy and Fusion: Results at 5-year Follow-up

    PubMed Central

    Zigler, Jack E.; Jackson, Robert; Nunley, Pierce D.; Bae, Hyun W.; Kim, Kee D.; Ohnmeiss, Donna D.

    2016-01-01

    Introduction There is increasing interest in the role of cervical total disc replacement (TDR) as an alternative to anterior cervical discectomy and fusion (ACDF). Multiple prospective randomized studies with minimum 2 year follow-up have shown TDR to be at least as safe and effective as ACDF in treating symptomatic degenerative disc disease at a single level. The purpose of this study was to compare outcomes of cervical TDR using the Mobi-C® with ACDF at 5-year follow-up. Methods This prospective, randomized, controlled trial was conducted as a Food and Drug Administration regulated Investigational Device Exemption trial across 23 centers with 245 patients randomized (2:1) to receive TDR with Mobi-C® Cervical Disc Prosthesis or ACDF with anterior plate and allograft. Outcome assessments included a composite overall success score, Neck Disability Index (NDI), visual analog scales (VAS) assessing neck and arm pain, Short Form-12 (SF-12) health survey, patient satisfaction, major complications, subsequent surgery, segmental range of motion, and adjacent segment degeneration. Results The 60-month follow-up rate was 85.5% for the TDR group and 78.9% for the ACDF group. The composite overall success was 61.9% with TDR vs. 52.2% with ACDF, demonstrating statistical non-inferiority. Improvements in NDI, VAS neck and arm pain, and SF-12 scores were similar between groups and were maintained from earlier follow-up through 60 months. There was no significant difference between TDR and ACDF in adverse events or major complications. Range of motion was maintained with TDR through 60 months. Device-related subsequent surgeries (TDR: 3.0%, ACDF: 11.1%, p<0.02) and adjacent segment degeneration at the superior level (TDR: 37.1%, ACDF: 54.7%, p<0.03) were significantly lower for TDR patients. Conclusions Five-year results demonstrate the safety and efficacy of TDR with the Mobi-C as a viable alternative to ACDF with the potential advantage of lower rates of reoperation and

  3. Use of Ultrasonic Bone Surgery (Piezosurgery) to Surgically Treat Bisphosphonate-Related Osteonecrosis of the Jaws (BRONJ). A Case Series Report with at Least 1 Year of Follow-Up

    PubMed Central

    Blus, Cornelio; Szmukler-Moncler, Serge; Giannelli, Giulio; Denotti, Gloria; Orrù, Germano

    2013-01-01

    This preliminary work documents the use of a powerful piezosurgery device to treat biphosphonate-related osteonecrosis of the jaw (BRONJ) in combination with classical medication therapy. Eight patients presenting 9 BRONJ sites were treated, 2 in the maxilla and 7 in the mandible. Reason for biphosphonate (BiP) intake was treatment of an oncologic disease for 5 patients and osteoporosis for 3. The oncologic and osteoporosis patients were diagnosed with BRONJ after 35-110 months and 80-183 months of BiP treatment, respectively. BRONJ 2 and 3 was found in 4 patients. Resection of the bone sequestrae was performed with a high power ultrasonic (piezo) surgery and antibiotics were administrated for 2 weeks. Soft tissue healing was incomplete at the 2-week control but it was achieved within 1 month. At the 1-year control, soft tissue healing was maintained at all patients, without symptom recurrence. One patient with paraesthesia had abated; of the 2 pa-tients with trismus, one was healed, severity of the second trismus abated. This case report series suggests that bone resection performed with a high power ultrasonic surgery device combined with antibiotics might lead to BRONJ healing. More patients are warranted to confirm the present findings and assess this treatment approach. PMID:24044030

  4. Adolescent Diet and Subsequent Serum Hormones, Breast Density and Bone Mineral Density in Young Women: Results of the Dietary Intervention Study in Children (DISC) Follow-Up Study

    PubMed Central

    Dorgan, Joanne F.; Liu, Lea; Klifa, Catherine; Hylton, Nola; Shepherd, John A.; Stanczyk, Frank Z.; Snetselaar, Linda G.; Van Horn, Linda; Stevens, Victor J.; Robson, Alan; Kwiterovich, Peter O.; Lasser, Norman L.; Himes, John H.; Gabriel, Kelley Pettee; Kriska, Andrea; Ruder, Elizabeth H.; Fang, Carolyn Y.; Barton, Bruce A.

    2010-01-01

    Background Adolescent diet is hypothesized to influence breast cancer risk. We evaluated the long-term effects of an intervention to lower fat intake among adolescent girls on biomarkers that are related to breast cancer risk in adults. Methods A follow-up study was conducted of 230 girls who participated in the Dietary Intervention Study in Children (DISC), in which healthy, prepubertal 8-10 year olds were randomly assigned to usual care or to a behavioral intervention that promoted a reduced fat diet. Participants were 25-29 years old at follow-up visits. All tests of statistical significance are two-sided. Results In analyses that did not take account of diet at the time of the follow-up visit, the only statistically significant treatment group difference was higher bone mineral content (BMC) in intervention group participants compared to usual care group participants; their mean BMCs were 2,444g and 2,377g, respectively. After adjustment for current diet, the intervention group also had statistically significantly higher bone mineral density and luteal phase serum estradiol concentrations. Serum progesterone concentrations and breast density did not differ by treatment group in unadjusted or adjusted analyses. Conclusion Results do not support the hypothesis that consumption of a lower fat diet during adolescence reduces breast cancer risk via effects on subsequent serum estradiol and progesterone levels, breast density or BMD. Impact Additional research is needed to clarify the association of adolescent diet with breast cancer risk and to determine if the results reported here are specific to the DISC intervention or more broadly applicable. PMID:20501774

  5. [Quality analyses of the development of preterm infants: results of the Lower-Saxonian preterm infant follow-up project and a comparison group of term infants].

    PubMed

    Damm, Gabriele; Macha, Thorsten; Petermann, Franz; Voss, Wolfgang; Sens, Brigitte

    2015-01-01

    Based on perinatal and neonatal quality assurance programmes, a follow-up project for the high-risk group of extremely preterm infants, unparalleled in Germany, was initiated in the federal state of Lower Saxony in 2004. Here we describe the new approach of examining a comparison group of term infants, which, for the first time, allows a valid interpretation of the collection of area-wide long-term outcome data on preterm children. The prospective long-term outcome project investigates the medical care situation for children born at less than 28 weeks of gestation up to school age. Based on the information obtained about the children's development the quality of health care will be optimised. A standardised examining concept with established development tests at defined follow-up intervals (at the age of 6 months, 2, 5 and 10 years) is used. At the age of five years 75 % of the examined premature children exhibited impairments. In order to better assess remarkable results, a comparison group of term infants (n=305) selected by a matched-pairs method was examined at the age of five using an analogous concept in kindergartens in Lower Saxony. The results were compared with the first two age cohorts of the follow-up-project (n=226) and quality analyses performed. As expected, significant differences have been found in the children's motor, cognitive and linguistic development between the preterm and term infants examined. This fact draws attention to the importance of early support for the majority of extremely premature infants. Feedback on the results given to the medical staff involved allows for the implementation of best practices and quality improvements. Identifying potential for improvement in everyday health care will help to develop specific optimisation measures. PMID:25839361

  6. Adolescent Diet and Metabolic Syndrome in Young Women: Results of the Dietary Intervention Study in Children (DISC) Follow-Up Study

    PubMed Central

    Liu, Lea; Barton, Bruce A.; Deshmukh, Snehal; Snetselaar, Linda G.; Van Horn, Linda; Stevens, Victor J.; Robson, Alan M.; Lasser, Norman L.; Himes, John H.; Shepherd, John A.; Pourfarzib, Ray; Pettee Gabriel, Kelley; Kriska, Andrea; Kwiterovich, Peter O.

    2011-01-01

    Context: Childhood diet is hypothesized to influence development of chronic disease in adulthood. Objective: Our objective was to evaluate the long-term effects of a dietary intervention to reduce fat and increase fiber intake during childhood and adolescence on the prevalence of metabolic syndrome in young adult women. Design: A follow-up study was conducted in 2006–2008, 9 yr after termination of the Dietary Intervention Study in Children (DISC). Setting: The study took place at six DISC clinical centers in the United States. Participants: A total of 230 (76%) DISC female participants who were 25–29 yr old and had not been pregnant or breastfeeding in the previous 3 months participated in the follow-up study. Intervention: There was no intervention between the end of the DISC trial and the follow-up visit. Main Outcome Measure: Metabolic syndrome was the primary study endpoint planned before data collection and was hypothesized to be less common in the intervention group participants. Results: Metabolic syndrome was uncommon, and its prevalence did not differ by treatment group. However, after adjustment for nondietary variables, mean systolic blood pressures of intervention and control group participants were 107.7 and 110.0 mm Hg, respectively (P = 0.03), whereas mean fasting plasma glucose levels were 87.0 and 89.1 mg/dl, respectively (P = 0.01). Intervention group participants also had lower concentrations of large very-low-density lipoprotein particles, a marker of hepatic insulin resistance, compared with control group participants. Adjustment for current diet did not materially alter results. Conclusion: Consumption of a diet lower in fat and higher in fiber during childhood and adolescence may benefit glycemic control and blood pressure long term. PMID:21994964

  7. Percutaneous coronary excimer laser angioplasty in patients with stable and unstable angina pectoris. Acute results and incidence of restenosis during 6-month follow-up.

    PubMed

    Karsch, K R; Haase, K K; Voelker, W; Baumbach, A; Mauser, M; Seipel, L

    1990-06-01

    A clinical study was conducted to evaluate the efficacy and safety of percutaneous coronary excimer laser angioplasty in 60 patients with coronary artery disease. Forty-nine patients had stable exertional angina, and 11 patients had unstable angina despite medical therapy. A novel 1.4-mm diameter catheter with 20 quartz fibers of 100-microns diameter each arranged concentrically around a central lumen suitable for a 0.014-in. flexible guide wire was coupled to an excimer laser. A commercial excimer laser emitting energy at a wavelength of 308 nm with a pulse duration of 60 nsec was used. The laser was operated at 20 Hz. Mean energy transmission was 30 +/- 5 mJ/mm2. In five of the 60 patients, laser angioplasty was not attempted. In 23 patients with laser ablation alone, percent stenosis decreased from 76 +/- 14% before to 27 +/- 17% after ablation and was 34 +/- 15% at the early follow-up angiogram. In 32 patients, additional balloon angioplasty was performed because of vessel closure after laser ablation in 11 and an insufficient qualitative result in 21 patients. Of the 11 patients with unstable angina, one patient died due to vessel closure 3 hours after intervention, and two patients developed a myocardial infarction. In 22 of 47 patients with late follow-up angiography, restenosis within the 6-month follow-up period occurred. Rate of restenosis was higher in patients treated with laser ablation and balloon angioplasty (16 of 28) than in patients treated with laser ablation alone (six of 19). These results suggest that coronary excimer laser angioplasty for ablation of obstructive lesions is feasible and safe in patients with stable angina. However, development of new catheter systems is necessary for an improved success rate. PMID:2344680

  8. Results of a Second-generation Constrained Condylar Prosthesis in Complex Primary and Revision Total Knee Arthroplasty: A Mean 5.5-Year Follow-up

    PubMed Central

    Ye, Chen-Yi; Xue, De-Ting; Jiang, Shuai; He, Rong-Xin

    2016-01-01

    Background: The application of second-generation constrained condylar knee (CCK) prostheses has not been widely studied. This retrospective study was carried out to evaluate the clinical and radiographic outcomes of a second-generation CCK prosthesis for complex primary or revision total knee arthroplasty (TKA). Methods: In total, 51 consecutive TKAs (47 patients) were performed between June 2003 and June 2013 using second-generation modular CCK prostheses. The follow-up was conducted at 3rd day, 1st, 6th, and 12th months postoperatively and later annually. Anteroposterior (AP), lateral, skyline, and long-standing AP radiographs of the affected knees were taken. The Hospital for Special Surgery (HSS) Knee Score, the Knee Society Knee Score (KSKS), the Knee Society Function Score (KSFS), and range of motion (ROM) were also recorded. Heteroscedastic two-tailed Student's t-tests were used to compare the HSS score and the Knee Society score between primary and revision TKAs. A value of P < 0.05 was considered statistically significant. Results: Four knees (two patients) were lost to follow-up, and 47 knees (31 primary TKAs and 16 revision TKAs) had a mean follow-up time of 5.5 years. The mean HSS score improved from 51.1 ± 15.0 preoperatively to 85.3 ± 8.4 points at the final follow-up (P < 0.05). Similar results were observed in terms of the KSKS and KSFS, which improved from 26.0 ± 13.0 to 80.0 ± 12.2 and from 40.0 ± 15.0 to 85.0 ± 9.3 points, respectively (P < 0.05). No significant difference in the HSS, KSKS, KSFS, or ROM was found between primary and revision TKAs (P > 0.05). Two complications were observed in the revision TKA group (one intraoperative distal femur fracture and one recurrence of infection) while one complication (infection) was observed in the primary TKA group. No prosthesis loosening, joint dislocation, patella problems, tibial fracture, or nerve injury were observed. Radiolucent lines were observed in 4% of the knees without progressive

  9. Clinical Results and Prognostic Factors of Arthroscopic Surgeries for Discoid Lateral Menisci Tear: Analysis of 179 Cases with Minimum 2 Years Follow-up

    PubMed Central

    Ahn, Ji-Yong; Kim, Tae-Han; Jung, Bong-Sung; Ha, Sang-Ho; Lee, Bum-Sik; Chung, Jong-Won; Kim, Jong-Min

    2012-01-01

    Purpose The purpose of this study was to evaluate the clinical results and prognostic factors of arthroscopic surgeries for tears of the discoid lateral menisci. Materials and Methods From March 1997 to September 2005, 260 patients received arthroscopic surgeries due to discoid lateral menisci tears. Among these patients, 179 knees in 168 patients were followed up for at least 2 years and were enrolled into this study. The following prognostic factors were evaluated: sex, age, symptom duration, and type of meniscal tear. Visual analogue score (VAS), Lysholm score, and Ikeuchi grade were assessed as clinical results of arthroscopic surgeries. Results The mean VAS and Lysholm score improved at the last follow-up. According to the Ikeuchi grade, 104 cases were rated as excellent, 51 cases as good, and 23 cases as fair. Male sex (p<0.033), age younger than 20 years (p=0.0474), and symptom duration less than 12 months (p<0.044) were good prognostic factors. However, there was no correlation between tear types of discoid lateral menisci and clinical results. Conclusions Sex, age, and symptom duration could be significant prognostic factors of arthroscopic surgeries for tears of discoid lateral menisci. PMID:22708112

  10. Twelve-Month Follow-up Results of Photoselective Vaporization of the Prostate With a 980-nm Diode Laser for Treatment of Benign Hyperplasia

    PubMed Central

    Kim, Youngho; Kim, In Gon; Han, Bo Hyun

    2013-01-01

    Purpose This study was conducted with the use of 12 months of follow-up data to evaluate the efficacy of photoselective vaporization of the prostate (PVP) with the 980-nm diode laser for the treatment of symptomatic benign prostatic hyperplasia (BPH). Materials and Methods The clinical data of 84 men with symptomatic BPH who underwent PVP with the 980-nm K2 diode laser between March 2010 and October 2011 were retrospectively analyzed. Postoperative parameters, including International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum urinary flow rate (Qmax), and postvoid residual volume (PVR), were assessed and compared with preoperative baseline values. Results Mean patient age was 72.4±6.5 years, and mean preoperative prostate volume was 47.2±16.3 g. Mean operative time was 23.3±19.1 minutes, and total amount of energy was 128±85 kJ. Mean catheterization time was 23.7±5.9 hours. At 1 month, significant improvements were noted in IPSS (11.5±6.8), QoL score (2.2±1.3), Qmax (12.9±6.5 mL/s), and PVR (41.2±31.3 mL). Three months after surgery, all postoperative follow-up parameters showed significant improvements, and the 6- and 12-month data showed sustained improvement of postoperative follow-up parameters. Bladder neck strictures were observed in 10.7% of the patients and urge incontinence in 16.6%. Conclusions PVP using a K2 diode laser is an effective procedure for the treatment of lower urinary tract symptoms secondary to BPH. PVP leads to an immediate and sustained improvement of subjective and objective voiding parameters. Surgeons should be vigilant for postoperative bladder neck stricture and urge incontinence. PMID:24175041

  11. Percutaneous microwave ablation combined with synchronous transcatheter arterial chemoembolization for the treatment of colorectal liver metastases: results from a follow-up cohort

    PubMed Central

    Wu, Zeng-Bao; Si, Zeng-Mei; Qian, Sheng; Liu, Ling-Xiao; Qu, Xu-Dong; Zhou, Bo; Zhang, Wei; Wang, Guang-Zhi; Liu, Rong; Wang, Jian-Hua

    2016-01-01

    Background The purpose of this study was to retrospectively evaluate the therapeutic efficacy and safety of ultrasound-guided percutaneous microwave ablation (MWA) combined with synchronous transcatheter arterial chemoembolization (TACE) in patients with colorectal liver metastases (CRLM). Patients and methods A retrospective analysis was performed in 30 patients who were treated with ultrasound-guided percutaneous MWA combined with synchronous TACE for colorectal cancer liver metastases from November 2011 to December 2014 in Zhongshan Hospital, Fudan University. The response of the tumor to treatment was evaluated by follow-up computed tomography and/or magnetic resonance imaging. Local tumor control, procedure-related complications, and long-term survival data were analyzed. Results A total of 30 patients with 43 tumors ranging in size from 1.4 cm to 10.0 cm were analyzed. The patients’ mean age was 61.6±10.3 years (range, 44.0–78.0 years). The median follow-up time was 26.5±10.4 months (range, 13.3–50.6 months). The complete ablation rate was 81.4% (35/43 lesions) for CRLM. Complete response was achieved in eight cases (26.7%), and partial response was achieved in 17 cases (56.7%) 1 month after the procedure. The objective response rate (complete response + partial response) was 83.4%. Progression-free survival and overall survival were 5.0 months and 11.0 months, respectively. The 12-month and 24-month survival rates were 46.7% and 25.4%, respectively. A total of 22 patients succumbed during follow-up due to tumor progression. No major complications or perioperative mortalities were recorded. Conclusion Ultrasound-guided percutaneous MWA combined with synchronous TACE therapy is a safe and effective modality for patients with CRLM. PMID:27382314

  12. Establishing the Melbourne injecting drug user cohort study (MIX): rationale, methods, and baseline and twelve-month follow-up results

    PubMed Central

    2013-01-01

    Background Cohort studies provide an excellent opportunity to monitor changes in behaviour and disease transmission over time. In Australia, cohort studies of people who inject drugs (PWID) have generally focused on older, in-treatment injectors, with only limited outcome measure data collected. In this study we specifically sought to recruit a sample of younger, largely out-of-treatment PWID, in order to study the trajectories of their drug use over time. Methods Respondent driven sampling, traditional snowball sampling and street outreach methods were used to recruit heroin and amphetamine injectors from one outer-urban and two inner-urban regions of Melbourne, Australia. Information was collected on participants’ demographic and social characteristics, drug use characteristics, drug market access patterns, health and social functioning, and health service utilisation. Participants are followed-up on an annual basis. Results 688 PWID were recruited into the study. At baseline, the median age of participants was 27.6 years (IQR: 24.4 years – 29.6 years) and two-thirds (67%) were male. Participants reported injecting for a median of 10.2 years (range: 1.5 months – 21.2 years), with 11% having injected for three years or less. Limited education, unemployment and previous incarceration were common. The majority of participants (82%) reported recent heroin injection, and one third reported being enrolled in Opioid Substitution Therapy (OST) at recruitment. At 12 months follow-up 458 participants (71% of eligible participants) were retained in the study. There were few differences in demographic and drug-use characteristics of those lost to follow-up compared with those retained in the study, with attrition significantly associated with recruitment at an inner-urban location, male gender, and providing incomplete contact information at baseline. Conclusions Our efforts to recruit a sample of largely out-of-treatment PWID were limited by drug market

  13. Comparison of volumetric bone mineral density in the operated and contralateral knee after anterior cruciate ligament and reconstruction: A 1-year follow-up study using peripheral quantitative computed tomography.

    PubMed

    Mündermann, Annegret; Payer, Nina; Felmet, Gernot; Riehle, Hartmut

    2015-12-01

    The purpose of this study was to quantify changes in volumetric bone mineral density (vBMD) in the tibial plateau of the operated and contralateral leg measured using peripheral quantitative computed tomography (pQCT) before and 3, 6, and 12 months after anterior cruciate ligament (ACL) reconstruction. The ACL was reconstructed with a hamstring tendon autograft using press-fit fixation. pQCT measurements of the proximal tibia were obtained in 61 patients after ACL reconstruction, and total, cortical, and trabecular vBMD were calculated. vBMD in the operated leg decreased from baseline to 3 months (-12% [total], -11% [cortical], and -12.6% [trabecular]; p<0.001) and remained below baseline for 12 months after surgery (6 months: -9.5%, -9.4%, and -9.6%, p<0.001; 12 months: -8%, -5%, and -11%, p<0.001). vBMD in the contralateral leg was slightly reduced only 6 months after surgery. Including age and sex as covariates into the analysis did not affect the results. ACL reconstruction contributed to loss in bone mineral density within the first year after surgery. The role of factors such as time of weight-bearing, joint mechanics, post-traumatic inflammatory reactions, or genetic predisposition in modulating the development of posttraumatic knee osteoarthritis after ACL injury should be further elucidated. PMID:26123943

  14. Comparison of anterior instrumentation systems and the results of minimum 5 years follow-up in the treatment of tuberculosis spondylitis.

    PubMed

    Benli, I Teoman; Alanay, Ahmet; Akalin, Serdar; Kiş, Mahmut; Acaroğlu, Emre; Ateş, Bülent; Aydin, Erbil

    2004-01-01

    Anterior debridement, strut grafting and instrumentation have an increasing popularity in the treatment of tuberculosis of spine. Anterior fixation can be done either by a plate or a rod system. This study reports on the surgical results of 59 patients with Pott's disease that had anterior radical debridement and anterior fusion and anterior instrumentation with 5 years follow-up. Average age at the time of operation was 46.3+/-13.5 years. Average follow-up was 84.6+/-11.3 months. Local kyphosis was measured as the angle between the upper and lower end plates of the collapsed vertebrae preoperatively, postoperatively and at the last follow-up visit. Vertebral collapse, destruction, cold abscess, and canal compromise were assessed in MR images. The indication for surgery was either one of the deformity, instability or neurological compromise. Surgical treatment included anterior radical debridement followed by grafting with tricortical auto graft and anterior instrumentation at levels just above and below the diseased segment(s) with either plate (Sofamor-Danek, Z plate, Group A) or rod (Sofamor-Danek, CDH, Group B) systems. There were 23 patients in group A and 36 patients in group B. All patients had similar anti tuberculosis chemotherapy. Patients had similar rehabilitation program after the surgery. The deformity in the sagittal and the coronal plane was measured and presence of significant consolidation, along with the absence of implant failure or correction loss was considered as signs of fusion. The two groups were similar according to age (46.9+/-14.2 vs. 45.8+/-13.1), gender, average number of involved levels (1.8+/-0.5 vs. 1.6+/-0.5), location of involved levels, severity of deformity (21.5 degrees+/-9.9 masculine vs. 24.8 degrees+/-11.9 masculine) and type of autografts (p>0.05 for all parameters). 39.1 % of patients in group A and 41.6 % of patients in group B had neurological compromise with improvement in majority at the end of follow-up. Deformities

  15. Thyroid nodules with nondiagnostic results on repeat fine-needle aspiration biopsy: which nodules should be considered for repeat biopsy or surgery rather than follow-up?

    PubMed Central

    2016-01-01

    Purpose: The goal of this study was to assess the clinicopathologic and ultrasonographic features of thyroid nodules with nondiagnostic results on repeat ultrasonography (US)-guided fineneedle aspiration biopsy (FNAB) according to size and the number of suspicious findings and to determine the proper management of nodules with consecutive nondiagnostic results. Methods: This retrospective study included 297 nodules with nondiagnostic results on repeat FNAB that were evaluated by US over the course of at least 12 months of follow-up, a follow-up biopsy, or an operation. We compared clinical and US variables between benign and malignant nodules in thyroid nodules with repeat nondiagnostic results. Results: The comparison of benign and malignant nodules with repeat nondiagnostic results revealed that age, marked hypoechogenicity, irregular or microlobulated margins, microcalcifications, and nonparallel shape were significantly associated with malignancy. Multivariate logistic regression analysis in malignant nodules revealed that microcalcifications and irregular or microlobulated margins were independently associated with malignancy. Among them, only irregular or microlobulated margins were independently significant as a predictor of malignancy in repeatedly nondiagnostic nodules measuring >10 mm. Using receiver operating characteristic analysis, the best cutoff value for the “number of suspicious findings” between benign and malignant nodules was three in nodules of all sizes, three in nodules measuring ≤10 mm, and two in nodules measuring >10 mm. Conclusion: Irregular or microlobulated margins may be the most frequent US features in repeatedly nondiagnostic nodules >10 mm. The presence of “two or more suspicious findings” can be used as the cutoff for distinguishing benign and malignant nodules. PMID:27068131

  16. PROJECT TALENT, 1-YEAR FOLLOW-UP STUDIES.

    ERIC Educational Resources Information Center

    COOLEY, WILLIAM W.; FLANAGAN, JOHN C.

    THE "PROJECT TALENT" FOLLOWUP STUDIES WERE CONCERNED WITH VARIOUS ASPECTS OF CAREER DEVELOPMENT OF AMERICAN YOUTH, CONSISTING PRIMARILY OF THE EDUCATIONAL AND VOCATIONAL PLANS AND DECISIONS WHICH ONE MAKES DURING HIGH SCHOOL AND IMMEDIATELY FOLLOWING HIGH SCHOOL. RELATIONSHIPS WERE SOUGHT BETWEEN TRAITS EXHIBITED BY STUDENTS IN HIGH SCHOOL AND…

  17. Teacher Attrition and Mobility: Results from the 2008-09 Teacher Follow-Up Survey. First Look. NCES 2010-353

    ERIC Educational Resources Information Center

    Keigher, Ashley

    2010-01-01

    The Teacher Follow-up Survey (TFS) is a follow-up of a sample of the elementary and secondary school teachers who participated in the previous year's Schools and Staffing Survey (SASS). The TFS sample includes teachers who leave teaching in the year after the SASS data collection and those who continue to teach. The objective of TFS is to provide…

  18. Primary Total Hip Arthroplasty Using Third Generation Ceramic-Ceramic Articulation: Results after a Minimum of Three-years of Follow-up

    PubMed Central

    Lee, Dong Woo

    2014-01-01

    Purpose This study assessed the short term clinicoradiological results of primary total hip arthroplasty using third generation ceramic-ceramic articulation Accolade TMZF femoral stems. Materials and Methods Two hundred and seventy two patients (294 hips) with primary total hip arthroplasty using third generation ceramic-ceramic articulation Accolade TMZF femoral stems who had been followed-up for a minimum of 3 years were included. Clinicoradiological results were analyzed and postoperative complications were observed. Results At final follow-up, mean Harris hip score was increased from 52 to 94 points. On radiogical evaluation, the average acetabular inclination was 42 degrees and the average acetabular anteversion was 15 degrees. Neither osteolysis nor loosening were observed around the acetabulum or proximal femur. Among 294 acetabular cups, 293 cups (99.66%) achieved stable fixation. Regarding the 294 femoral stems, 286 (97.28%) had bony fixation, 7 (2.38%) had fibrous fixation, and none were found to have unstable stem fixation. Proximal bone resorption was observed in 17 hips (5.78%; only Grade 1) and radiolucent lines were observed in 88 hips (29.93%), however, all were around the distal smooth portion of the stems. Postoperative complications included dislocation in 6 hips (2.04%), heterotopic ossification in 3 hips (1.02%), ceramic fractures in 4 hips (1.36%), superficial infection in 1 hip (0.34%), and squeaking in 8 hips (2.72%). Conclusion The short term clinicoradiological results of primary total hip arthroplasty using third generation ceramic-ceramic articulation and Accolade TMZF femoral stems together with Secur-Fit acetabular cups were satisfactory. However, problems such as ceramic fractures and squeaking after arthroplasty were observed. Additional studies are necessary in order to develop methods that may reduce or eliminate these complications.

  19. Silicon Matrix Calcium Phosphate as a Bone Substitute: Early Clinical and Radiological Results in a Prospective Study With 12-Month Follow-up

    PubMed Central

    Pesántez, Carlos Fernando Arias; Oliveira, Leonardo

    2008-01-01

    Introduction Autograft has been the “gold standard” for orthopedic bone grafting applications, but with some clinical challenges. Here we present the rationale and clinical outcomes supporting the use of a bone substitute material that consists of a mixture of two calcium phosphates (HA and ß-TCP), which are integrated into a silicon xerogel matrix, promoting nanocrystalline apatite layers on the surface of the material following implantation into a physiological environment. Methods Twenty-four patients with a median age of 53.80 (36–81) years underwent lumbar spinal fusion for degenerative disease, selected by clinical presentation, X-rays, and MRI findings. Subjects were evaluated preoperatively and postoperatively at 1, 3, 6, and 12 months. The outcome assessment consisted of visual analog scale (VAS), Oswestry Disability Index (ODI), and radiological assessment analyzing the state of fusion on X-ray and CT evaluation by 3 independent radiologists. Results All patients completed 12-month follow-up. The mean VAS decreased from 9.3 (± 0.9) to 2.4 (± 1.6) and the mean ODI decreased from 55.0 (± 9.2) to 19.3 (± 11.4) at 12-month follow-up. Three months after surgery, 10 patients (41.67%) had solid fusion based on analysis of CT scans and dynamic radiographs. At 6 months postoperatively, the fusion rate had increased to 75% (18 patients). Twelve months after surgery, 95.83% of patients had solid fusion (23 patients). Conclusions The clinical results from this study of silicon matrix calcium phosphate are consistent with previous in vitro studies indicating that this material stimulates formation of a bioactive layer and provides an effective bone graft material for lumbar fusion applications. In comparison with previous studies involving rhBMP-2, silicon matrix calcium phosphate provided a lower fusion rate at 3- and 6-month follow-up points, but after 12 months, the fusion rate was similar, with no statistical differences and lower overall costs. No

  20. Ceramic Femoral Components in Total Knee Arthroplasty - Two Year Follow-Up Results of an International Prospective Multi-Centre Study

    PubMed Central

    Bergschmidt, Philipp; Bader, Rainer; Ganzer, Dirk; Hauzeur, Christian; Lohmann, Christoph; Rüther, Wolfgang; Tigani, Domenico; Rani, Nicola; Prats, Fernando Lopez; Zorzi, Claudio; Madonna, Vincenzo; Rigotti, Stefano; Benazzo, Francesco; Rossi, Stefano Marco Paolo; Kundt, Guenther; Bloch, Hans Rudolf; Mittelmeier, Wolfram

    2012-01-01

    Background: Total knee arthroplasty can be considered as a reliable surgical procedure with a good long-term clinical result. However, implant failure due to particle induced aseptic loosening as well as the aspect of hypersensitivity to metal ions still remains an emerging issue. Methods: The purpose of this prospective international multi-centre study was to evaluate the clinical and radiological outcomes and the reliability of the unconstrained Multigen Plus Total Knee System with a new BIOLOX® delta ceramic femoral component. Cemented total knee arthroplasty was performed on 108 patients (110 knees) at seven hospitals in three countries. Clinical and radiological evaluations were performed preoperatively, and after 3, 12 and 24 months postoperatively using the HSS-, WOMAC-, SF-36-score and standardised X-rays. Results: The mean preoperative HSS-Score amounted to 55.5 ± 11.5 points and improved significantly in all postoperative evaluations (85.7 ± 11.7 points at 24 months). Furthermore, improvements in WOMAC- and SF-36-score were evaluated as significant at all points of evaluation. Radiolucent lines around the femoral ceramic component at 24 months were found in four cases. Progression of radiolucent lines was not seen and no implant loosening was observed. During the 24 month follow-up eight patients underwent subsequent surgery due to reasons unrelated to the implant material. Conclusions: The observed clinical and radiological results are encouraging for a long-term survival of the ceramic femoral component. Therefore, ceramic implants could be a promising solution not only for patients with allergies against metallic implant materials, but also for the osteoarthritic knee joint. Long-term follow-up is necessary to draw conclusions regarding the superiority of the ceramic knee implants concerning in vivo wear and long-term survivorship. PMID:22582104

  1. The enzymology of mitochondrial fatty acid beta-oxidation and its application to follow-up analysis of positive neonatal screening results

    PubMed Central

    Ruiter, Jos P. N.; IJlst, Lodewijk; Waterham, Hans R.; Houten, Sander M.

    2010-01-01

    Oxidation of fatty acids in mitochondria is a key physiological process in higher eukaryotes including humans. The importance of the mitochondrial beta-oxidation system in humans is exemplified by the existence of a group of genetic diseases in man caused by an impairment in the mitochondrial oxidation of fatty acids. Identification of patients with a defect in mitochondrial beta-oxidation has long remained notoriously difficult, but the introduction of tandem-mass spectrometry in laboratories for genetic metabolic diseases has revolutionalized the field by allowing the rapid and sensitive analysis of acylcarnitines. Equally important is that much progress has been made with respect to the development of specific enzyme assays to identify the enzyme defect in patients subsequently followed by genetic analysis. In this review, we will describe the current state of knowledge in the field of fatty acid oxidation enzymology and its application to the follow-up analysis of positive neonatal screening results. PMID:20490924

  2. Long-Term Follow-Up Results of Photoselective Vaporization of the Prostate with the 120 W Greenlight HPS Laser for Treatment of Benign Prostatic Hyperplasia

    PubMed Central

    Kang, Se-Hee; Choi, Yong Sun; Kim, Su Jin; Cho, Hyuk Jin; Hong, Sung-Hoo; Lee, Ji Youl; Hwang, Tae-Kon

    2011-01-01

    Purpose With the use of 12 months of follow-up data, this study was conducted to evaluate the efficacy of photoselective vaporization of the prostate (PVP) with the 120 W Greenlight high performance system (HPS) laser for the treatment of symptomatic benign prostatic hyperplasia. Materials and Methods Data were collected from 104 patients who were diagnosed with benign prostatic hyperplasia and who underwent PVP with the 120 W Greenlight HPS Laser. Postoperative parameters, including International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum urinary flow rate (Qmax), and postvoid residual volume (PVR), were assessed and compared with preoperative baseline values. Results The mean age of the patients was 71.1±7.7. The baseline mean prostate-specific antigen level was 3.8±2.7 ng/ml, the mean prostate size was 43.9±20.6 g, the mean preoperative IPSS was 18.4±8.5, the mean QoL score was 4.1±1.0, the mean Qmax was 9.9±5.5 ml/sec, and the mean PVR was 89.6±207.1 ml. During surgery, the mean operation time was 21.8±11.3 minutes, the mean lasing time was 16.9±10.5 minutes, and the mean total applied energy was 170,068±63,181 J. At 1 month, significant improvements were observed in total IPSS (11.5±6.7, p<0.05), voiding symptom score (6.1±5.4, p<0.05), and QoL score (2.2±1.5, p<0.05); however, there were no significant improvements in storage symptom score (4.8±3.8, p=0.06), Qmax (12.6±10.2, p=0.06), and PVR (40.1±30.5, p=0.41). However, 3 months after surgery, all postoperative follow-up parameters showed significant improvements, and the 6- and 12-month data showed sustained improvement of postoperative follow-up parameters. Conclusions Significant improvements were observed in subjective and objective voiding parameters, which were evident at 3 months after PVP and were sustained throughout a period of 12 months after PVP. PMID:21556212

  3. Intervention Effects on Diurnal Cortisol Rhythms of CPS-Referred Infants Persist into Early Childhood: Preschool Follow-up Results of a Randomized Clinical Trial

    PubMed Central

    Bernard, Kristin; Hostinar, Camelia; Dozier, Mary

    2015-01-01

    Importance A number of interventions for at-risk children have shown benefits immediately after treatment. However, the present study shows persistent long-term effects of a parenting intervention on children's hypothalamic-pituitary-adrenal (HPA) activity, a physiological stress system that is implicated in numerous psychological and physical health problems across the lifespan. Objective To examine whether differences in diurnal cortisol production between children receiving the active parenting intervention and children in the control group persisted at a preschool follow-up (approximately 3 years post-intervention). Design Between-subject comparison of cortisol patterns among 2 groups of children (experimental and control groups). Setting Children involved with Child Protective Services following allegations of neglect. Participants A sample of 115 children (43.5% female) between 46.5 and 69.6 months of age (M = 50.73, SD = 4.98), who had been previously randomly assigned to either the ABC intervention (n = 54) or the control intervention (n = 61). Intervention The Attachment and Biobehavioral Catch-up Intervention (ABC) was the experimental intervention and it focused on three aims: increasing parental nurturance to child distress, increasing synchronous interactions, and decreasing frightening parental behavior. The control intervention provided educational information about child development to parents. Both interventions were manualized and involved 10 sessions implemented by a trained parent coach in the families' homes or other places of residence. Main Outcome Measure Salivary cortisol samples collected at waking and bedtime for children on 3 separate days. Results Analyses revealed significant differences in cortisol production at the preschool follow-up, such that children in the ABC intervention group exhibited a typical pattern with higher morning levels and a steep decline across the day, whereas the control group showed a flatter cortisol rhythm

  4. Use of glucosamine and chondroitin supplements in relation to risk of colorectal cancer: Results from the Nurses' Health Study and Health Professionals follow-up study.

    PubMed

    Kantor, Elizabeth D; Zhang, Xuehong; Wu, Kana; Signorello, Lisa B; Chan, Andrew T; Fuchs, Charles S; Giovannucci, Edward L

    2016-11-01

    Recent epidemiologic evidence has emerged to suggest that use of glucosamine and chondroitin supplements may be associated with reduced risk of colorectal cancer (CRC). We therefore evaluated the association between use of these non-vitamin, non-mineral supplements and risk of CRC in two prospective cohorts, the Nurses' Health Study and Health Professionals Follow-up Study. Regular use of glucosamine and chondroitin was first assessed in 2002 and participants were followed until 2010, over which time 672 CRC cases occurred. Cox proportional hazards regression was used to estimate relative risks (RRs) within each cohort, and results were pooled using a random effects meta-analysis. Associations were comparable across cohorts, with a RR of 0.79 (95% CI: 0.63-1.00) observed for any use of glucosamine and a RR of 0.77 (95% CI: 0.59-1.01) observed for any use of chondroitin. Use of glucosamine in the absence of chondroitin was not associated with risk of CRC, whereas use of glucosamine + chondroitin was significantly associated with risk (RR: 0.77; 95% CI: 0.58-0.999). The association between use of glucosamine + chondroitin and risk of CRC did not change markedly when accounting for change in exposure status over follow-up (RR: 0.75; 95% CI: 0.58-0.96), nor did the association significantly vary by sex, aspirin use, body mass index, or physical activity. The association was comparable for cancers of the colon and rectum. Results support a protective association between use of glucosamine and chondroitin and risk of CRC. Further study is needed to better understand the chemopreventive potential of these supplements. PMID:27357024

  5. Time and Resources Needed to Document Patients with Breast Cancer from Primary Diagnosis to Follow-upResults of a Single-center Study

    PubMed Central

    Lux, M. P.; Sell, C. S.; Fasching, P. A.; Seidl-Ertel, J.; Bani, M. R.; Schrauder, M. G.; Jud, S. M.; Loehberg, C. R.; Rauh, C.; Hartmann, A.; Schulz-Wendtland, R.; Strnad, V.; Beckmann, M. W.

    2014-01-01

    Aim: Certification of breast centers helps improve the quality of care but requires additional resources, particularly for documentation. There are currently no published data on the actual staff costs and financial resources required for such documentation. The aim of this study was to determine the time and resources required to document a patient with primary breast cancer from diagnosis to the end of follow-up, to establish a database for future strategic decisions. Material and Methods: All diagnostic and therapeutic procedures of patients with primary breast cancer were recorded at the University Breast Center of Franconia. All time points for documentation were evaluated using structured interviews. The times required to document a representative number of patients were determined and combined with the staff costs of the different professional groups, to calculate the financial resources required for documentation. Results: A total of 494 time points for documentation were identified. The study also identified 21 departments and 20 different professional groups involved in the documentation. The majority (54 %) of documentation was done by physicians. 62 % of all documentation involved outpatients. The results of different scenarios for the diagnosis, therapy and follow-up of breast cancer patients in a certified breast center showed that the time required for documentation can be as much as 105 hours, costing € 4135. Conclusion: This analysis shows the substantial staffing and financial costs required for documentation in certified centers. A multi-center study will be carried out to compare the costs for certified breast centers of varying sizes with the costs of non-certified care facilities. PMID:25221342

  6. Follow-up Results of 71 Patients Undergoing Metallic Stent Placement for the Treatment of a Malignant Obstruction of the Superior Vena Cava

    SciTech Connect

    Nagata, Takeshi Makutani, Shiro; Uchida, Hideo; Kichikawa, Kimihiko; Maeda, Munehiro; Yoshioka, Tetsuya; Anai, Hiroshi; Sakaguchi, Hiroshi; Yoshimura, Hitoshi

    2007-09-15

    Purpose. To retrospectively clarify the utility of metallic stent placement for the treatment of the malignant obstruction of the superior vena cava (SVC) in 71 patients with VC syndrome (SVCS) on the basis of long-term follow-up data. Materials and Methods. Seventy-one patients underwent stent placement and were followed until death. The applicability of the spiral Z-stent (S-Z-stent) mainly used the initial and follow-up results, stent placement for bilateral BCV obstruction and the value of concurrent anticancer therapy were studied. Results. The technical success rate was 100%, the initial clinical success rate was 87% (62/71), the primary clinical patency rate was 88% (57/65), and the secondary clinical patency rate was 95% (62/65). The obstruction rate of the stent was 12% (8/65), and an additional stent was useful for relief of recurrent SVCS. Survival of 57 patients in whom there was no recurrence of SVCS until death ranged from 1 week to 29 months (mean, 5.4 months and the S-Z-stent appeared to be suitable for the treatment of the malignant obstruction of SVC. Unilateral stent placement was effective for relief of SVCS with bilateral BCV obstruction. Patients who received concurrent anticancer therapy survived 2 months longer than those who did not. Conclusion. Stent placement is an effective treatment for SVCS. Further, the utility of S-Z-stent for SVCS, an additional stent for recurrence, unilateral stent for patients with bilateral BCV obstruction, and anticancer therapy after stent placement were verified.

  7. Randomized, Multicenter Trial on the Effect of Radiation Therapy on Plantar Fasciitis (Painful Heel Spur) Comparing a Standard Dose With a Very Low Dose: Mature Results After 12 Months' Follow-Up

    SciTech Connect

    Niewald, Marcus; Micke, Oliver; Graeber, Stefan; Schaefer, Vera; Scheid, Christine; Fleckenstein, Jochen; Licht, Norbert; Ruebe, Christian

    2012-11-15

    Purpose: To conduct a randomized trial of radiation therapy for painful heel spur, comparing a standard dose with a very low dose. Methods and Materials: Sixty-six patients were randomized to receive radiation therapy either with a total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy twice weekly (standard dose) or with a total dose of 0.6 Gy applied in 6 fractions of 0.1 Gy twice weekly (low dose). In all patients lateral opposing 4- to 6-MV photon beams were used. The results were measured using a visual analogue scale, the Calcaneodynia score, and the SF12 health survey. The fundamental phase of the study ended after 3 months, and the follow-up was continued up to 1 year. Patients with insufficient pain relief after 3 months were offered reirradiation with the standard dosage at any time afterward. Results: Of 66 patients, 4 were excluded because of withdrawal of consent or screening failures. After 3 months the results in the standard arm were highly significantly superior compared with those in the low-dose arm (visual analogue scale, P=.001; Calcaneodynia score, P=.027; SF12, P=.045). The accrual of patients was stopped at this point. Further evaluation after 12 months' follow-up showed the following results: (1) highly significant fewer patients were reirradiated in the standard arm compared with the low-dose arm (P<.001); (2) the results of patients in the low-dose arm who were reirradiated were identical to those in the standard arm not reirradiated (reirradiation as a salvage therapy if the lower dose was ineffective); (3) patients experiencing a favorable result after 3 months showed this even after 12 months, and some results even improved further between 3 and 12 months. Conclusions: This study confirms the superior analgesic effect of radiation therapy with 6-Gy doses on painful heel spur even for a longer time period of at least 1 year.

  8. Association of extraintestinal manifestations of inflammatory bowel disease in a province of western Hungary with disease phenotype: Results of a 25-year follow-up study

    PubMed Central

    Lakatos, Laszlo; Pandur, Tunde; David, Gyula; Balogh, Zsuzsanna; Kuronya, Pal; Tollas, Arpad; Lakatos, Peter Laszlo

    2003-01-01

    AIM: IBD is a systemic disease associated with a large number of extraintestinal manifestations (EIMs). Our aim was to determine the prevalence of EIMs in a large IBD cohort in Veszprem Province in a 25-year follow-up study. METHODS: Eight hundred and seventy-three IBD patients were enrolled (ulcerative colitis/UC/: 619, m/f: 317/302, mean age at presentation: 38.3 years, average disease duration: 11.2 years; Crohn’s disease/CD/: 254, m/f: 125/129, mean age at presentation: 32.5 years, average disease duration: 9.2 years). Intestinal, extraintestinal signs and laboratory tests were monitored regularly. Any alteration suggesting an EIMs was investigated by a specialist. RESULTS: A total of 21.3% of patients with IBD had EIM (UC: 15.0%, CD: 36.6%). Age at presentation did not affect the likelihood of EIM. Prevalence of EIMs was higher in women and in CD, ocular complications and primary sclerosing cholangitis (PSC) were more frequent in UC. In UC there was an increased tendency of EIM in patients with a more extensive disease. Joint complications were more frequent in CD (22.4% vs UC 10.2%, P < 0.01). In UC positive family history increased the risk of joint complications (OR: 3.63). In CD the frequency of type-1 peripheral arthritis was increased in patients with penetrating disease (P = 0.028). PSC was present in 1.6% in UC and 0.8% in CD. Dermatological complications were present in 3.8% in UC and 10.2% in CD, the rate of ocular complications was around 3% in both diseases. Rare complications were glomerulonephritis, autoimmune hemolytic anaemia and celiac disease. CONCLUSION: Prevalence of EIM in Hungarian IBD patients is in concordance with data from Western countries. The high number of EIM supports a role for complex follow-up in these patients. PMID:14562397

  9. Follow-up imaging after pediatric pyeloplasty

    PubMed Central

    Kumar, Manoj; Singh, Sanjeet Kumar; Arora, Sohrab; Mittal, Varun; Patidar, Nitesh; Sureka, Sanjoy Kumar; Ansari, M. S.

    2016-01-01

    Introduction: The duration, methods and frequency of radiographic follow-up after pediatric pyeloplasty is not well-defined. We prospectively evaluated a cohort of children undergoing pyeloplasty to determine the method for follow-up. Methods: Between 2000 and 2008, children undergoing pyeloplasty for unilateral ureteropelvic junction obstruction were evaluated for this study. All patients were evaluated preoperatively with protocol ultrasound (USG) and diuretic renal scan (RS). On the basis of preoperative split renal function (SRF), these patients were divided into four groups – Group I: SRF > 40%, Group II: SRF 30–39%, Group III: SRF 20–29%, and Group IV: SRF 10–19%. In follow-up, USG and RS were done at 3 months and repeated at 6 months, 1 year, and then yearly after surgery for a minimum period of 5 years. Improvement, stability, or worsening of hydronephrosis was based on the changes in anteroposterior (AP) diameter of pelvis and caliectasis on USG. Absolute increase in split renal function (SRF) >5% was considered significant. Failure was defined as increase in AP diameter of pelvis and decrease in cortical thickness on 3 consecutive USG, t½ >20 min with obstructive drainage on RS and/or symptomatic patient. Results: 145 children were included in the study. Their mean age was 3.26 years and mean follow-up was 7.5 years. Pre- and post-operative SRF remain unchanged within 5% range in 35 of 41 patients (85%) in Group I. While 9 of 20 patients (45%) in Group II, 23 of 50 patients (46%) in Group III, and 14 of 34 patients (41%) in Group IV exhibited changes >5% after surgery. 5 patients failed, 2 in Group III, and 3 in Group IV. None of the patients deteriorated in Group I and II. Conclusion: After pyeloplasty in children with a baseline split GFR >30%, if a diuretic renogram and USG performed 3 months postoperatively shows nonobstructive drainage with t½ <20 min and decreased hydronephrosis, no further follow-up is required. PMID:27555681

  10. Long-term follow-up for bimanual microincision cataract surgery: comparison of results obtained by surgeons in training and experienced surgeons

    PubMed Central

    Cavallini, Gian Maria; Verdina, Tommaso; Forlini, Matteo; Volante, Veronica; De Maria, Michele; Torlai, Giulio; Benatti, Caterina; Delvecchio, Giancarlo

    2016-01-01

    Purpose To determine the efficacy of bimanual microincision cataract surgery (B-MICS) performed by surgeons in training, evaluating clinical results, posterior capsule opacification (PCO) incidence, and clear corneal incision (CCI) architecture in a long-term follow-up and comparing results with those obtained by experienced surgeons. Patients and methods Eighty eyes of 62 patients operated on by three surgeons in training who used B-MICS technique for the first time were included in the study (Group A). Eighty eyes of 59 patients who underwent B-MICS by three experienced surgeons were included as a control group (Group B). Best corrected visual acuity, astigmatism, corneal pachymetry, and endothelial cell count were evaluated before surgery and at 1 month and 18 months after surgery. Anterior segment optical coherence tomography images were obtained to study the morphology of CCIs. PCO incidence was evaluated using EPCO2000 software. Results Out of 160 surgeries included in the study, mean best-corrected visual acuity improvement at 18 months was 0.343±0.246 logMAR for Group A, and 0.388±0.175 logMAR for Group B, respectively. We found no statistically significant induced astigmatism nor corneal pachymetry changes in either group, while we noticed a statistically significant endothelial cell loss postoperatively in both groups (P<0.05). In Group A, mean PCO score was 0.163±0.196, while for Group B, it was 0.057±0.132 (P=0.0025). Mean length and inclination of the CCIs for Group A and Group B were, respectively, 1,358±175 µm and 1,437±256 µm and 141.8°±6.4° and 148.7°±5.1°. As regards corneal architecture in the 320 CCIs considered, we found posterior wound retractions and endothelial gaps, respectively, 9.8% and 11.6% for Group A and 7.8% and 10.8% for Group B. Conclusion B-MICS performed by surgeons in training is an effective surgical technique even when assessed after a long-term follow-up. PCO incidence resulted in being higher for less

  11. Extracorporeal detoxification for hepatic failure using molecular adsorbent recirculating system: depurative efficiency and clinical results in a long-term follow-up.

    PubMed

    Donati, Gabriele; La Manna, Gaetano; Cianciolo, Giuseppe; Grandinetti, Valeria; Carretta, Elisa; Cappuccilli, Maria; Panicali, Laura; Iorio, Mario; Piscaglia, Fabio; Bolondi, Luigi; Colì, Luigi; Stefoni, Sergio

    2014-02-01

    Acute liver failure and acute-on-chronic liver failure still show a poor prognosis. The molecular adsorbent recirculating system (MARS) has been extensively used as the most promising detoxifying therapy for patients with these conditions. Sixty-four patients with life-threatening liver failure were selected, and 269 MARS treatments were carried out as a bridge for orthotopic liver transplantation (OLT) or for liver function recovery. All patients were grouped according to the aim of MARS therapy. Group A consisted of 47 patients treated for liver function recovery (median age 59 years, range 23-82). Group B consisted of 11 patients on the waiting list who underwent OLT (median age 47 years, range 32-62). Group C consisted of 6 patients on the waiting list who did not undergo OLT (median age 45.5 years, range 36-54, P = 0.001). MARS depurative efficiency in terms of liver toxins, cytokines, and growth factors was assessed together with the clinical outcome of the patients during a 1-year follow-up. Total bilirubin reduction rate per session (RRs) for each MARS session was 23% (range 17-29); direct bilirubin RRs was 28% (21-35), and indirect bilirubin RRs was 8% (3-21). Ammonia RRs was 34% (12-86). Conjugated cholic acid RRs was 58% (48-61); chenodeoxycholic acid RRs was 34% (18-48). No differences were found between groups. Hepatocyte growth factor (HGF) values on starting MARS were 4.1 ng/mL (1.9-7.9) versus 7.9 ng/mL (3.2-14.1) at MARS end (P < 0.01). Cox regression analysis to determine the risk factors predicting patient outcomes showed that age, male gender, and Sequential Organ Failure Assessment score (but not Model for End-stage Liver Disease score) were factors predicting death, whereas the number of MARS sessions and the ΔHGF proved protective factors. Kaplan-Meier survival analysis was also used; after 12 months, 21.3% of patients in Group A survived, while 90.9% were alive in Group B and 16.7% in Group C (log rank = 0.002). In

  12. Femoral press-fit fixation in ACL reconstruction using bone-patellar tendon-bone autograft: results at 15 years follow-up

    PubMed Central

    2012-01-01

    Background If anterior cruciate ligament (ACL) reconstruction is to be performed, decision regarding graft choice and its fixation remains one of the most controversial. Multiple techniques for ACL reconstruction are available. To avoid disadvantages related to fixation devices, a hardware-free, press-fit ACL reconstruction technique was developed. The aim of this study was to evaluate clinical outcome and osteoarthritis progression in long term after ACL reconstruction with central third patellar-tendon autograft fixed to femur by press-fit technique. Methods Fifty two patients met inclusion/excusion criteria for this study. The patients were assessed preoperatively and at 15 years after surgery with International Knee Documentation Committee Knee Ligament Evaluation Form, Lysholm knee score, Tegner activity scale and radiographs. Results Good overall clinical outcomes and self-reported assessments were documented, and remained good at 15 years. The mean Lysholm and Tegner scores improved from 59.7 ± 18.5 and 4.2 ± 1.0 preoperatively to 86.4 ± 5.6 (p = 0.004) and 6.9 ± 1.4 (p = 0.005) respectively at follow-up. The IKDC subjective score improved from 60.1 ± 9.2 to 80.2 ± 8.1 (p = 0.003). According to IKDC objective score, 75% of patients had normal or nearly normal knee joints at follow-up. Grade 0 or 1 results were seen in 85% of patients on laxity testing. Degenerative changes were found in 67% of patients. There was no correlation between arthritic changes and stability of knee and subjective evaluation (p > 0.05). Conclusions ACL reconstruction with patellar tendon autograft fixed to femur with press-fit technique allows to achieve good self-reported assessments and clinical ligament evaluation up to 15 years. Advantages of the bone-patellar-tendon-bone (BPTB) press-fit fixation include unlimited bone-to-bone healing, cost effectiveness, avoidance of disadvantages associated with hardware, and ease for

  13. Two-Year Follow-Up Results of Fluoroscopic Cervical Epidural Injections in Chronic Axial or Discogenic Neck Pain: A Randomized, Double-Blind, Controlled Trial

    PubMed Central

    Manchikanti, Laxmaiah; Cash, Kimberly A.; Pampati, Vidyasagar; Malla, Yogesh

    2014-01-01

    Study Design: A randomized, double-blind, active-controlled trial. Objective: To assess the effectiveness of cervical interlaminar epidural injections of local anesthetic with or without steroids for the management of axial or discogenic pain in patients without disc herniation, radiculitis, or facet joint pain. Summary of Background Data: Cervical discogenic pain without disc herniation is a common cause of suffering and disability in the adult population. Once conservative management has failed and facet joint pain has been excluded, cervical epidural injections may be considered as a management tool. Despite a paucity of evidence, cervical epidural injections are one of the most commonly performed nonsurgical interventions in the management of chronic axial or disc-related neck pain. Methods: One hundred and twenty patients without disc herniation or radiculitis and negative for facet joint pain as determined by means of controlled diagnostic medial branch blocks were randomly assigned to one of the 2 treatment groups. Group I patients received cervical interlaminar epidural injections of local anesthetic (lidocaine 0.5%, 5 mL), whereas Group II patients received 0.5% lidocaine, 4 mL, mixed with 1 mL or 6 mg of nonparticulate betamethasone. The primary outcome measure was ≥ 50% improvement in pain and function. Outcome assessments included numeric rating scale (NRS), Neck Disability Index (NDI), opioid intake, employment, and changes in weight. Results: Significant pain relief and functional improvement (≥ 50%) was present at the end of 2 years in 73% of patients receiving local anesthetic only and 70% receiving local anesthetic with steroids. In the successful group of patients, however, defined as consistent relief with 2 initial injections of at least 3 weeks, significant improvement was illustrated in 78% in the local anesthetic group and 75% in the local anesthetic with steroid group at the end of 2 years. The results reported at the one-year follow-up

  14. Comparison of Retrograde Balloon Dilatation and Laparoscopic Pyeloplasty for Treatment of Ureteropelvic Junction Obstruction: Results of a 2-Year Follow-Up

    PubMed Central

    Xue, Xue-Yi; Zheng, Qing-Shui; Wei, Yong; Jiang, Tao; Li, Xiao-Dong; Huang, Jin-Bei; Cai, Hai

    2016-01-01

    Objective To evaluate the efficacy of laparoscopic pyeloplasty relative to retrograde balloon dilatation for the treatment of ureteropelvic junction obstruction (UPJO). Methods This retrospective study enrolled UPJO patients with stricture length < 2 cm who had been treated with laparoscopic pyeloplasty (LP; 44 cases) or balloon dilatation (BD; 38 cases) from Jan 2010 to Jan 2012, according to patients’ preference after consultation. Demographics and clinical parameters were collected. Patients were followed-up at 3, 6, 12, and 24 months. Ultrasonography, intravenous urography, and diuretic renography were applied to evaluate the remission of hydronephrosis. Results Both groups were comparable with respect to age, UPJO location, gender, and other baseline parameters. Compared to the LP group, patients receiving BD experienced significantly shorter operative time, analgesia time, hospital stay, and urethral catheter indwelling time, and less cost (P<0.001). Three and 6 months after their respective procedures, the success rates of the LP (97.7%, both) and BD (94.7% and 86.8%) groups were similar, and at 12 and 24 months the long-term success rate of LP (95.5%, both) was better than that of BD (78.9% and 71.0%). Conclusions LP showed better long-term success rate than did BD in the management of UPJO with length of stricture < 2 cm. Considering that BD is more minimally invasive, simpler and easier to perform, and costs less, we recommend it for some selective UPJO patients as the first-line therapy. PMID:27019289

  15. Immediate and midterm follow-up results of excimer laser application in complex percutaneous coronary interventions: Report from a single center experience

    PubMed Central

    Tarsia, Giandomenico; Viceconte, Nicola; Takagi, Kensuke; Biscione, Carmine; Del Prete, Giuseppe; Polosa, Domenico; Osanna, Roccoaldo; Lisanti, Pasquale

    2013-01-01

    Objective To assess the efficacy and safety of laser-assisted percutaneous coronary interventions (PCI) in an unselected population. Methods One hundred consecutive patients, who underwent a laser assisted PCI between January 2008 and March 2012, were included in the present study. Fifty-one patients underwent laser ablation for thrombus vaporization (Group 1), 36 patients for neointima/plaque debulking (Group 2) and 13 patients for lesion compliance modification in calcified lesions (Group 3). Results The rate of in-hospital serious events was 2%. The cumulative laser success was 82%, and it was significantly higher for Group 1 and Group 2 in comparison with Group 3 (p = 0.001). Furthermore, the need for repeat revascularization was significantly higher in the Group 3 compared with the others two groups (46% vs. 8% for Group 1 and 11% for Group 2, p = 0.03). The MACE rate was 14%. There was a trend toward a higher MACE rate in the Group 3 compared with others two groups (p = 0.05). Conclusions Laser ablation is an effective and safe tool for complex PCI. Patients underwent laser for thrombus vaporization or for neointima/plaque debulking had better immediate success and better outcome at follow-up than patients underwent laser for lesion compliance modification. PMID:24265882

  16. Cirrhosis mortality among former American prisoners of war of World War II and the Korean conflict: results of a 50-year follow-up.

    PubMed

    Page, W F; Miller, R N

    2000-10-01

    In our earlier, 30-year follow-up of American prisoners of war (POWs) of World War II and the Korean conflict, we found evidence of increased cirrhosis mortality. Using federal records, we have now extended our follow-up to 50 years (42 years for Korean conflict veterans) and have used proportional hazards analysis to compare the mortality experience of POWs with that of controls. Compared with their controls, World War II POWs had a 32% higher risk of cirrhosis mortality (statistically significant), and mortality risk was higher in the first 30 years of follow-up and also among those aged 51 years and older. Korean POWs had roughly the same risk of cirrhosis mortality as their controls. Neither self-reported data on alcohol consumption nor supplemental morbidity data satisfactorily explained the differences in risk between POWs and controls, although there was evidence that POWs tended to have higher rates of hepatitis, helminthiasis, and nutritional deprivation. PMID:11050876

  17. Coparenting Conflict, Nonacceptance, and Depression Among Divorced Adults: Results From a 12-Year Follow-Up Study of Child Custody Mediation Using Multiple Imputation

    PubMed Central

    Sbarra, David A.; Emery, Robert E.

    2010-01-01

    Using statistically imputed data to increase available power, this article reevaluated the long-term effects of divorce mediation on adults’ psychological adjustment and investigated the relations among coparenting custody conflict, nonacceptance of marital termination, and depression at 2 occasions over a decade apart following marital dissolution. Group comparisons revealed that fathers and parents who mediated their custody disputes reported significantly more nonacceptance at the 12-year follow-up assessment. Significant interactions were observed by gender in regression models predicting nonacceptance at the follow-up; mothers’ nonacceptance was positively associated with concurrent depression, whereas fathers’ nonacceptance was positively associated with early nonacceptance and negatively associated with concurrent conflict. PMID:15709851

  18. Percutaneous transluminal rotational atherectomy in the treatment of peripheral vascular disease using a transluminal endatherectomy catheter (TEC): Initial results and angiographic follow-up

    SciTech Connect

    Rilinger, Norbert; Goerich, Johannes; Scharrer-Pamler, Reinhard; Vogel, Jochen; Tomczak, Reinhard; Merkle, Elmar; Sokiranski, Roman; Brambs, Hans-Juergen

    1997-07-15

    Purpose. To evaluate the clinical results of percutaneous transluminal rotational atherectomy in the treatment of peripheral vascular disease. Methods. Rotational atherectomy was performed in 39 patients aged 39-87 years (mean 66.6 years). A total of 71 lesions (43 stenoses and 28 occlusions) were treated in 40 limbs. Additional balloon angioplasty was required in 54% of lesions. Fifteen patients (37.5%) presented in Fontaine stage II, 10 patients (25%) in Fontaine stage III and 15 patients (37.5%) in Fontaine stage IV. Rotational atherectomy at 750 rpm was carried out over a 0.014-inch guidewire with continuous aspiration into a vacuum, bottle. Follow-up angiography and color flow Doppler examinations were performed in 22 patients (23 limbs) after a mean period of 6 months (range 2-14 months). Results. There was one primary technical failure. In 36 of 40 lesions there was a good angiographic result with residual stenoses in less than 30%. In 70 lesions treated by rotational atherectomy, however, 54% showed residual stenoses of 30%-50% and these cases required additional balloon angioplasty. The mean ankle-brachial index improved significantly (p<0.001), from 0.49 before the procedure to 1.01 after the procedure. A single distal embolus, related to primary recanalization, occurred and there were two large inguinal hematomas. Cumulative clinical patency after 6 months was 83.8% and cumulative angiographic patency after 6 months was 79.1%. Conclusion. Percutaneous rotational atherectomy is a promising approach for the treatment of chronic peripheral vascular disease. Further prospective, randomized studies are necessary to compare percutaneous transluminal angioplasty with this new technical approach.

  19. Teacher Attrition and Mobility: Results from the 2012-13 Teacher Follow-Up Survey. First Look. NCES 2014-077

    ERIC Educational Resources Information Center

    Goldring, Rebecca; Taie, Soheyla; Riddles, Minsun

    2014-01-01

    This report presents selected findings from the Current Teacher and Former Teacher Data Files of the 2012-13 Teacher Follow-up Survey (TFS). TFS is a nationally representative sample survey of public and private school K-12 teachers who participated in the previous year's Schools and Staffing Survey (SASS). First fielded in school year 1988-89,…

  20. Impact of eLearning course on nurses' professional competence in seclusion and restraint practices: 9-month follow-up results of a randomized controlled study (ISRCTN32869544).

    PubMed

    Kontio, R; Hätönen, H; Joffe, G; Pitkänen, A; Lahti, M; Välimäki, M

    2013-04-01

    eLearning may facilitate continuing vocational education, but data on the long-term effects of an eLearning course are lacking. The aim of this study was to explore the long-term impact of an eLearning course entitled ePsychNurse.Net on psychiatric nurses' professional competence in practicing seclusion and restraint and on their job satisfaction and general self-efficacy at 9-month follow-up. In a randomized controlled study, 12 wards were randomly assigned to the ePsychNurse.Net (intervention) or training as usual (control). Baseline and 9-month follow-up data on nurses' knowledge of coercion-related legislation, physical restraint and seclusion, their attitudes towards physical restraint and seclusion, job satisfaction and general self-efficacy were analysed for 137 completers (those who participated in the 9-month follow-up assessment). No between-group differences were found on any variable, with the exception of a change in attitude to seclusion in favour of the control group. The findings of the long-term effects did not differ from the immediate outcomes (3-month follow-up) and the improved level of knowledge acquired and further consolidation of that knowledge did not take place in the 6-month period after the 3-month ePsychNurse.Net course. The ePsychNurse.Net should be further developed and its future modifications will require additional studies, probably with some new outcome measures. PMID:22672441

  1. Swift follow-up of gravitational wave triggers: results from the first aLIGO run and optimisation for the future

    NASA Astrophysics Data System (ADS)

    Evans, P. A.; Kennea, J. A.; Palmer, D. M.; Bilicki, M.; Osborne, J. P.; O'Brien, P. T.; Tanvir, N. R.; Lien, A. Y.; Barthelmy, S. D.; Burrows, D. N.; Campana, S.; Cenko, S. B.; D'Elia, V.; Gehrels, N.; Marshall, F. E.; Page, K. L.; Perri, m.; Sbarufatti, B.; Siegel, M. H.; Tagliaferri, G.; Troja, E.

    2016-08-01

    During its first observing run, in late 2015, the advanced LIGO facility announced 3 gravitational wave (GW) triggers to electromagnetic follow-up partners. Two of these have since been confirmed as being of astrophysical origin: both are binary black hole mergers at ˜ 500 Mpc; the other trigger was later found not to be astrophysical. In this paper we report on the Swift follow up observations of the second and third triggers, including details of 21 X-ray sources detected; none of which can be associated with the GW event. We also consider the challenges that the next GW observing run will bring as the sensitivity and hence typical distance of GW events will increase. We discuss how to effectively use galaxy catalogues to prioritise areas for follow up, especially in the presence of distance estimates from the GW data. We also consider two galaxy catalogues and suggest that the high completeness at larger distances of the 2MASS Photometric Redshift Catalogue (2MPZ) makes it very well suited to optimise Swift follow-up observations.

  2. Principal Attrition and Mobility: Results from the 2008-09 Principal Follow-Up Survey. First Look. NCES 2010-337

    ERIC Educational Resources Information Center

    Battle, Danielle

    2010-01-01

    While the National Center for Education Statistics (NCES) has conducted surveys of attrition and mobility among school teachers for two decades, little was known about similar movements among school principals. In order to inform discussions and decisions among policymakers, researchers, and parents, the 2008-09 Principal Follow-up Survey (PFS)…

  3. Heterogeneity of follow-up procedures in French and Belgian patients with treated hereditary tyrosinemia type 1: results of a questionnaire and proposed guidelines.

    PubMed

    Schiff, Manuel; Broue, Pierre; Chabrol, Brigitte; De Laet, Corinne; Habes, Dalila; Mention, Karine; Sarles, Jacques; Spraul, Anne; Valayannopoulos, Vassili; Ogier de Baulny, Hélène

    2012-09-01

    The 1991 introduction of 2-(2-nitro-4-trifluoro-methylbenzyol)-1,3 cyclohexanedione (NTBC) as a treatment for hereditary tyrosinemia type 1 (HT-1), a disorder of tyrosine catabolism, has radically modified the natural history of this disorder. Despite the dramatic improvements in survival, outcomes and quality of life seen with NTBC treatment, HT-1 remains a chronic disorder with several long-term complications, including, a persistent (albeit low) risk of hepatocellular carcinoma and suboptimal neuropsychological outcomes. There remain unsolved key-questions concerning the long-term outcomes of patients with HT-1, which closely depend on the quality of follow-up in these patients. In the absence of published guidelines, we investigated the follow-up methods used for French and Belgian patients with HT-1. A simple questionnaire providing a rapid overview of follow-up procedures was sent to the 19 physicians in charge of HT-1 patients treated with NTBC and low-tyrosine diet in France and Belgium. Several areas of heterogeneity (especially liver imaging, slit lamp examination, neuropsychological evaluation and maximal plasma tyrosine level accepted) were observed. In an attempt to improve long-term management and outcome of patients with HT-1, we proposed follow-up recommendations. PMID:22167277

  4. Assessing the Long-Term Effects of EMDR: Results from an 18-Month Follow-Up Study with Adult Female Survivors of CSA

    ERIC Educational Resources Information Center

    Edmond, Tonya; Rubin, Allen

    2004-01-01

    This 18-month follow-up study builds on the findings of a randomized experimental evaluation that found qualified support for the short-term effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) in reducing trauma symptoms among adult female survivors of childhood sexual abuse (CSA). The current study provides preliminary evidence…

  5. Principal Attrition and Mobility: Results from the 2012-13 Principal Follow-Up Survey. First Look. NCES 2014-064

    ERIC Educational Resources Information Center

    Goldring, Rebecca; Taie, Soheyla

    2014-01-01

    This report presents selected findings from the Public School Principal Status and Private School Principal Status Data Files of the 2012-13 Principal Follow-up Survey (PFS). The PFS is a nationally representative sample survey of public and private K-12 schools in the 50 states and District of Columbia and was initiated to inform discussions and…

  6. Teacher Attrition and Mobility: Results from the 2012-13 Teacher Follow-Up Survey. First Look. NCES 2014-077

    ERIC Educational Resources Information Center

    Goldring, Rebecca; Taie, Soheyla; Riddles, Minsun

    2014-01-01

    This report presents selected findings from the Current Teacher and Former Teacher Data Files of the 2012-13 Teacher Follow-up Survey (TFS). TFS is a nationally representative sample survey of public and private school K-12 teachers who participated in the previous year's Schools and Staffing Survey (SASS). First fielded in school year…

  7. Providing prescheduled appointments as a strategy for improving follow-up compliance after community-based glaucoma screening: results from an urban underserved population.

    PubMed

    van Zyl, Tavé; Su, Zhuo; Zhou, Elaine; Wong, Ryan K; Mohsenin, Amir; Rogers, Spencer; Tsai, James C; Forster, Susan H

    2015-02-01

    To determine if receiving a prescheduled appointment is associated with an increased likelihood of complying with follow-up eye care among individuals identified as at risk for glaucoma during community-based glaucoma screening in an urban underserved population. This study sampled 362 individuals aged ≥30 years without known glaucoma from low-income, predominantly black/Hispanic neighborhoods in New Haven, Connecticut presenting to one of twelve community-based glaucoma screening events from May 2010 to October 2012. A quasi-experimental design systematically assigned 63 individuals identified as at risk for glaucoma into either intervention or control group with a 1:2 ratio. Individuals in the control group (n = 41) received counseling on glaucoma and a recommendation for obtaining a follow-up appointment at the eye department of a local community health center, which offers affordable health services with income-adjusted fee discounts to uninsured, low-income patients. Those in the intervention group (n = 22) received the same counseling and a prescheduled appointment at the community health center. The overall rate of follow-up compliance within 3 months of screening was 30 % (41 % in the intervention group; 24 % in the control group). Multivariate logistic regression analysis adjusting for sex, age, ethnicity, health insurance status, car access, living situation, and smoking status found that follow-up compliance was significantly associated with intervention (adjusted odds ratio 4.8; 95 % confidence interval 1.1-20.9). Providing prescheduled appointments can improve follow-up compliance after community-based glaucoma screening. This finding may be potentially applicable to community-based health screening for other preventable diseases. PMID:24880821

  8. Cancer follow-up care. Patients' perspectives.

    PubMed Central

    Miedema, Baukje; MacDonald, Ian; Tatemichi, Sue

    2003-01-01

    OBJECTIVE: To assess family physicians' and specialists' involvement in cancer follow-up care and how this involvement is perceived by cancer patients. DESIGN: Self-administered survey. SETTING: A health region in New Brunswick. PARTICIPANTS: A nonprobability cluster sample of 183 participants. MAIN OUTCOME MEASURES: Patients' perceptions of cancer follow-up care. RESULTS: More than a third of participants (36%) were not sure which physician was in charge of their cancer follow-up care. As part of follow-up care, 80% of participants wanted counseling from their family physicians, but only 20% received it. About a third of participants (32%) were not satisfied with the follow-up care provided by their family physicians. In contrast, only 18% of participants were dissatisfied with the follow-up care provided by specialists. Older participants were more satisfied with cancer follow-up care than younger participants. CONCLUSION: Cancer follow-up care is increasingly becoming part of family physicians' practices. Family physicians need to develop an approach that addresses patients' needs, particularly in the area of emotional support. PMID:12901486

  9. Ablation for atrial fibrillation during mitral valve surgery: 1-year results through continuous subcutaneous monitoring.

    PubMed

    Bogachev-Prokophiev, Alexandr; Zheleznev, Sergey; Romanov, Alexander; Pokushalov, Evgeny; Pivkin, Alexey; Corbucci, Giorgio; Karaskov, Alexander

    2012-07-01

    Continuous monitoring of cardiac rhythm may play an important role in measuring the true symptomatic/asymptomatic atrial fibrillation (AF) burden and improve the management of anti-arrhythmic and anti-thrombotic therapies. Forty-seven patients with mitral valve disease and longstanding persistent AF (LSPAF) underwent a left atrial maze procedure with bipolar radiofrequency and valve surgery. The follow-up data recorded by an implanted loop recorder were analysed after 3, 6 and 12 months. On discharge, 40 (85.1%) patients were in stable sinus rhythm, as documented by in-office electrocardiography (ECG), 4 (8.5%) were in pacemaker rhythm and 3 (6.4%) were in AF. One (2.1%) patient died after 7 months. On 12-month follow-up examination, 30 (65.2%) patients had an AF burden <0.5% and were classified as responders. Three (6.5%) of the 16 non-responders had atrial flutter and 13 (27.7%) had documented AF recurrences with an AF burden >0.5%. Two (4.3%) patients with AF recurrences were completely asymptomatic. Among the symptomatic events stored by the patients, only 27.6% was confirmed as genuine AF recurrences according to the concomitant ECG recorded by the implanted loop recorder. A concomitant bipolar maze procedure during mitral valve surgery is effective in treating AF, as proved by detailed 1-year continuous monitoring. PMID:22514258

  10. Initial results and long-term clinical follow-up of an amorphous hydrogenated silicon-carbide-coated stent in daily practice.

    PubMed

    Hanekamp, Clara EE; Bonnier, Hans JRM; Michels, Rolf H; Peels, Kathinka H; Heijmen, Eric PCM; Hagen Ev, Eduard van; Koolen, Jacques J

    1998-01-01

    The hemocompatibility and biocompatibility of a stent are determined by the physical and electrochemical properties of the stent surface. The aim of this study was to determine the feasibility, safety and efficacy of implantation of a stent coated with silicon carbide. Baseline characteristics were collected prospectively. The occurrence of cardiac adverse events and the angina score were assessed at clinical follow-up. A total of 193 Tensum stents were implanted in 174 patients. In hospital, one patient experienced stent thrombosis and in 6% of the patients a creatinine kinase elevation to 240 U/l or more occurred. Long-term follow-up was performed in 172 patients, with a mean follow-up of 454 +/- 181 days. Ninety-seven per cent were still alive, 15% had undergone target-vessel revascularization, and 2% had angiographic restenosis and were treated with medication only. Seventy-one per cent of the patients were free of anginal complaints, and 20% had anginal complaints in Canadian Cardiac Society class I or II. The Tensum coronary stent showed to be a safe and efficacious device in this study, with a high primary success rate and favorable long-term clinical followup. PMID:12623396