Sample records for infundibuloneurohypophysitis long-term follow-up

  1. Coats' syndrome: long term follow up

    Microsoft Academic Search

    Devron H Char

    2000-01-01

    AIMTo increase the understanding of the long term results in pseudo-retinoblastoma eyes with infantile Coats' syndrome.METHODSThis study design was a retrospective case review. 10 patients were analysed who were initially referred with a diagnosis of retinoblastoma but had Coats' syndrome on the basis of ocular oncological evaluation. Vision, fundus photography, ultrasonography, and computed tomography scans were obtained and evaluated. Changes

  2. Long-term follow-up of pediatric trachyonychia.

    PubMed

    Kumar, Monique G; Ciliberto, Heather; Bayliss, Susan J

    2015-01-01

    Pediatric trachyonychia is an acquired nail disease that can cause distress to families. It is a poorly understood disease, and long-term follow-up data are lacking. We present an institutional review of 11 children with isolated pediatric trachyonychia followed over time. Children with the diagnosis of pediatric trachyonychia were identified and invited to participate. Pictures were taken on follow-up and a questionnaire was answered. Exclusion criteria include having another diagnosis at the initial visit that causes nail dystrophy. Eleven patients with the diagnosis of pediatric trachyonychia were available for follow-up. The mean age of appearance was 2.7 years (range 2-7 yrs) and the average follow-up was 66 months (range 10-126 mos). Nine patients were treated with potent topical corticosteroids, one used only petrolatum, and one took vitamin supplements. One patient was found to have an additional skin and hair diagnosis of alopecia areata on follow-up. On follow-up, 82% noted improvement of the nails, whereas 18% noted no change. A majority of cases of pediatric trachyonychia are isolated and improve with time, regardless of treatment. PMID:25556756

  3. Long-term Follow-up After Bariatric Surgery

    PubMed Central

    Puzziferri, Nancy; Roshek, Thomas B.; Mayo, Helen G.; Gallagher, Ryan; Belle, Steven H.; Livingston, Edward H.

    2015-01-01

    IMPORTANCE Bariatric surgery is an accepted treatment for obesity. Despite extensive literature, few studies report long-term follow-up in cohorts with adequate retention rates. OBJECTIVE To assess the quality of evidence and treatment effectiveness 2 years after bariatric procedures for weight loss, type 2 diabetes, hypertension, and hyperlipidemia in severely obese adults. EVIDENCE REVIEW MEDLINE and Cochrane databases were searched from 1946 through May 15, 2014. Search terms included bariatric surgery, individual bariatric procedures, and obesity. Studies were included if they described outcomes for gastric bypass, gastric band, or sleeve gastrectomy performed on patients with a body mass index of 35 or greater, had more than 2 years of outcome information, and had follow-up measures for at least 80% of the initial cohort. Two investigators reviewed each study and a third resolved study inclusion disagreements. FINDINGS Of 7371 clinical studies reviewed, 29 studies (0.4%, 7971 patients) met inclusion criteria. All gastric bypass studies (6 prospective cohorts, 5 retrospective cohorts) and sleeve gastrectomy studies (2 retrospective cohorts) had 95% confidence intervals for the reported mean, median, or both exceeding 50% excess weight loss. This amount of excess weight loss occurred in 31% of gastric band studies (9 prospective cohorts, 5 retrospective cohorts). The mean sample-size–weighted percentage of excess weight loss for gastric bypass was 65.7% (n = 3544) vs 45.0% (n = 4109) for gastric band. Nine studies measured comorbidity improvement. For type 2 diabetes (glycated hemoglobin <6.5% without medication), sample-size–weighted remission rates were 66.7% for gastric bypass (n = 428) and 28.6% for gastric band (n = 96). For hypertension (blood pressure <140/90 mm Hg without medication), remission rates were 38.2% for gastric bypass (n = 808) and 17.4% for gastric band (n = 247). For hyperlipidemia (cholesterol <200 mg/dL, high-density lipoprotein >40 mg/dL, low-density lipoprotein <160 mg/dL, and triglycerides <200 mg/dL), remission rates were 60.4% for gastric bypass (n = 477) and 22.7% for gastric band (n = 97). CONCLUSIONS AND RELEVANCE Very few bariatric surgery studies report long-term results with sufficient patient follow-up to minimize biased results. Gastric bypass has better outcomes than gastric band procedures for long-term weight loss, type 2 diabetes control and remission, hypertension, and hyperlipidemia. Insufficient evidence exists regarding long-term outcomes for gastric sleeve resections. PMID:25182102

  4. Long-Term Follow-Up of Iliac Wallstents

    SciTech Connect

    Reyes, Ricardo [Hospital Dr. Negrin, Vascular and Interventional Radiology Unit (Spain); Carreira, Jose Martin [Universidad de, Dept of Radiology (Spain)], E-mail: mrjoseca@usc.es; Gude, Francisco [Hospital Clinico Universitario de Santiago, Clinical Epidemiology Unit (Spain); Gorriz, Elias; Gallardo, Laura; Pardo, Maria Dolores; Hermida, Maria [Hospital Dr. Negrin, Vascular and Interventional Radiology Unit (Spain)

    2004-11-15

    We evaluated the long-term results of the iliac artery stent placement for the treatment of patients with intermittent claudication. From November 1988 to December 1998, 303 legs were treated with metal stents in 259 patients with iliac occlusive arterial disease in a follow-up study approved by the institutional review board. Stenoses (n = 162) were treated after failed angioplasty and occlusions (n = 141) were treated with primary stent placement. According to Fontaine's clinical classification of chronic ischemia, 266 (88%) legs presented stage IIB, 14 (5%) stage III, and 23 (7%) stage IV. In all legs, self-expandable stents (Wallstent) were implanted. The patients were followed up with clinical examination, ankle brachial- index examination measurement and intravenous angiography. The data were analyzed using the univariate analysis (Kaplan-Meier method) and multivariate analysis (Cox proportional model). The primary endpoint of the study was the identification of restenosis or reoclusion of the stenting arterial segment and a secondary endpoint that was an identification of the risk factors of restenosis and reoclusion. The mean {+-} SD ankle-brachial index pre-, post-procedure, and in the last control was 0.58 {+-} 0.18, 0.90 {+-} 0.23, and 0.86 {+-} 0.24, respectively. Primary cumulative patency rates were 70% {+-} 4 after 5 years, and 65% {+-} 5 after 7 years, and secondary patency rates were 92% {+-} 2 after 5 years, and 87% {+-} 4 after 9 years. Immediate complications in the first 24 hours appeared in 12 (4%) legs, thrombosis in 5 legs, 3 legs presented with distal embolism, 2 thrombi at the access site and pseudo aneurysm and artery rupture in 1 leg. A patient died in the first 24 hours. Within 30 days after the procedure seven complications, 3 thromboses and 4 stenosis appeared. During follow-up, 42 (16%) patients died of other causes. The main causes of death were cardiac disease (39%), cerebrovascular disease (15%), cancer (7%), respiratory diseases (4%), and death due to accidents (2%), and other causes (9%). In 24% of the cases there was insufficient information to assign a principal cause of death. Thirty-six patients (13%) were lost to follow-up. Complications arose in 54 (18%) legs due to occlusion of the treated segment (29%), and stenosis due to intimal hyperplasia (27%). Thirteen patients required surgical treatment. Primary and secondary patency mean time was 80 {+-} 3.7 and 102 {+-} 2.4 months, respectively. We found no significant relation between patency and the quality of run-off, but a small vessel diameter and the female gender were negative predictive factors for failure (proportional hazards model). The use of stents for treatment of iliac artery occlusive disease may be considered an effective method with a low complication rate and acceptable long-term follow-up results.

  5. Long-Term Clinical Follow-Up After Successful Repeat Percutaneous Intervention for Stent Restenosis

    Microsoft Academic Search

    Bernhard Reimers; Issam Moussa; Tatsuro Akiyama; Gina Tucci; Massimo Ferraro; Giovanni Martini; Simonetta Blengino; Carlo DI Mario; Antonio Colombo

    1997-01-01

    Objectives. This study evaluated the long-term clinical outcome of successful repeat percutaneous intervention after in-stent restenosis.Background. Recurrence of symptoms and angiographic restenosis after stent implantation are observed in 15% to 35% of cases. Repeat percutaneous treatment for in-stent restenosis has been shown to be safe, with high immediate success, but little is known about the long-term clinical outcome.Methods. Clinical follow-up

  6. Mortality of Women with Polycystic Ovary Syndrome at Long-term Follow-up

    Microsoft Academic Search

    T. Pierpoint; P. M. McKeigue; A. J. Isaacs; S. H. Wild; H. S. Jacobs

    1998-01-01

    Metabolic disturbances associated with insulin resistance are present in most women with polycystic ovary syndrome. This has led to suggestions that women with polycystic ovary syndrome may be at increased risk of cardiovascular disease in later life. We undertook a long-term follow-up study to test whether cardiovascular mortality is increased in these women. A total of 786 women diagnosed with

  7. Factors influencing long-term follow-up clinic attendance among survivors of childhood cancer

    Microsoft Academic Search

    James L. Klosky; Darlene K. Cash; Joanna Buscemi; Shelly Lensing; Danette M. Garces-Webb; Wenyan Zhao; Sally Wiard; Melissa M. Hudson

    2008-01-01

    Introduction  Attendance at long-term follow-up clinic is necessary for survivors of childhood cancer to facilitate education about cancer-related\\u000a health risks, early detection of treatment-related morbidity, and implementation of health-promoting interventions. Despite\\u000a the need for continued care, barriers to clinic attendance exist. The purpose of this prospective study was to identify the\\u000a demographic, medical, and logistic factors impacting clinic attendance and long-term

  8. Long-term follow up of renal anastomosing hemangioma mimicking renal angiosarcoma.

    PubMed

    Heidegger, Isabel; Pichler, Renate; Schäfer, Georg; Zelger, Bernhard; Zelger, Bettina; Aigner, Friedrich; Bektic, Jasmin; Horninger, Wolfgang

    2014-08-01

    Anastomosing hemangioma of the kidney is a very rare neoplasm, currently 19 cases have been reported in the literature. First described in 2009, histopathologically anastomosing hemangioma is similar to aggressive angiosarcoma. No long-term follow-up data of anastomosing hemangioma have been described yet. Here, we present the case of a healthy 56-year-old man diagnosed in 2002 with a 7?×?5-cm anastomosing hemangioma mimicking an aggressive renal angiosarcoma. The patient underwent nephrectomy and has been followed up disease free for 13?years. PMID:24650180

  9. Long-term MR follow-up of cerebral lesions in neuro-Behçet's disease

    Microsoft Academic Search

    S. Gerber; A. Biondi; D. Dormont; B. Wechsler; C. Marsault

    1996-01-01

    To study the long-term evolution of cerebral lesions in neuro-Behçet's disease, MRI was carried out on 12 patients, with\\u000a follow-up from 1.5 to 6 years (mean 3.5 years). On the first MRI, 66 lesions in all were found; each patient had 1–10 lesions\\u000a (mean 5.5). There were 30 (46 %) lesions in the brain stem, 18 (27 %) in the

  10. Using Kid Power to Teach Kids about Mental Retardation: A Long Term Follow-Up

    E-print Network

    Turnbull, Amy; Bronicki, G. J. Buzz

    1987-01-01

    JASH copyright 1987 by 1987, Vol. 12, No. 3, 216-217 The Association for Persons with Severe Handicaps 216 Using Kid Power to Teach Kids about Mental Retardation: A Long-Term Follow-Up Amy..., I gave an attitude test to kids in two second grade classrooms. Then I taught a 50-min lesson about mental retardation to one of the classes. I gave the attitude test to both classrooms again. The kids in the experimental group that I taught had...

  11. Two Acute Radiation Hand Injuries with Long-Term Follow-Up

    Microsoft Academic Search

    Gail L. English

    1996-01-01

    Accidental, excessive radiation exposure of the hands is rare in industry. This report describes two such cases with subsequent long-term follow-up. In the first case, a middle-aged pipefitter received a dose of 2500 rem to the fingers of his left hand and 2000 rem to small areas of his right hand. He was accidentally exposed to this beta radiation while

  12. Long-term follow-up of zonulo-hyaloido-vitrectomy for pseudophakic malignant glaucoma

    PubMed Central

    Madgula, Indira M; Anand, Nitin

    2014-01-01

    Purpose: To report long-term follow-up of zonulo-hyaloido-vitrectomy (ZHV) via anterior approach for pseudophakic malignant glaucoma refractory to medical treatment. Design: Noncomparative case-series. Materials and Methods: Medical records of 9 patients who sought treatment for aqueous humor misdirection refractory to medical treatment were reviewed. All patients underwent anterior vitrectomy, hyaloido-zonulectomy, and peripheral iridectomy (PI) via an anterior approach. Main outcome measures were preoperative and postoperative visual acuity, intraocular pressure, medications, slit-lamp examination, and fundus findings. Results: 10 eyes of 9 patients (7 female, 2 male) who underwent ZHV for refractory pseudophakic malignant glaucoma between 2003 and 2010 were included in this case-series. The mean age of patients was 77.4 ± 9.0 years, mean follow-up duration 50.2 ± 27.2 months. Recurrence of malignant glaucoma was noted in 40% (four cases) after a successful ZHV on long-term follow-up. Conclusions: An anterior segment surgeon can treat malignant glaucoma refractory to medical treatment successfully by vitrectomy, hyaloido-zonulectomy, and PI. This can be done via an anterior approach and patients require long follow-up to rule out a relapse despite a successful outcome in the short term. PMID:25579353

  13. Interventional treatment for portal venous occlusion after liver transplantation: long-term follow-up results.

    PubMed

    Wang, Jianfeng; Yang, Weili; Huang, Qiang; Gao, Kun; Wei, Baojie; Zhai, Renyou; Shi, Yaoping

    2015-01-01

    Portal vein (PV) occlusion after liver transplant is an uncommon clinical situation, and percutaneous interventional treatment for this condition has not been widely described. The aim of this study was to evaluate the long-term treatment effect of interventional treatment for PV occlusion after liver transplantation (LT). Follow-up data of 13 patients who received interventional treatment for PV occlusion after LT between July 2007 and April 2013 were analyzed. Of these, 10 patients had portal hypertension-related signs and symptoms. Percutaneous balloon angioplasty and stent placement were performed, with percutaneous thrombolysis treatment as appropriate. Embolization therapy was required for significant collateral circulation. Technical and clinical success, complications, and patency of PV were analyzed. Both technical and clinical success was achieved in 11 of the 13 patients (84.6%). Direct portogram showed limited PV occlusion in 7 patients and extensive PV occlusion in 4 patients. The former underwent balloon angioplasty followed by stent placement, while the latter underwent balloon angioplasty followed by stent placement and additional percutaneous thrombolysis treatment. Embolization therapy for collateral circulation was performed in all 4 patients with extensive PV occlusion and 1 patient with limited PV occlusion. All stents remained patency during the follow-up (28.5?±?6.8 months). No portal hypertension-related symptoms reoccurred during follow-up. In conclusion, interventional treatment for PV occlusion after LT showed a high success rate and good long-term results. Comprehensive interventional treatment should be used for extensive PV occlusion. PMID:25634164

  14. Long-Term Follow-Up of Patients at High Risk for Nephropathy After Contrast Exposure.

    PubMed

    Abaci, Okay; Harmankaya, Ozlem; Kocas, Betul; Kocas, Cuneyt; Bostan, Cem; Coskun, Ugur; Yildiz, Ahmet; Ersanli, Murat

    2015-07-01

    Contrast medium-induced acute kidney injury (CI-AKI) is associated with morbidity and mortality, but the long-term outcomes of patients who do not develop CI-AKI remain unknown. We assessed clinical end points during long-term follow-up in patients at high risk for nephropathy who did not develop CI-AKI. Patients (n = 135) with impaired renal function (estimated glomerular filtration rate: 30-60 mL/min/1.73 m(2)) were divided into 2 groups according to contrast media (CM) exposure. The primary end point of this study was a composite outcome measure of death or renal failure requiring dialysis. Multivariate analyses identified CM exposure to be independently associated with major adverse long-term outcomes (hazard ratio: 2.3; 95% confidence interval, 1.34-6.52; P = .018). Even when CM exposure does not cause CI-AKI in patients with impaired renal function, in the long term, primary end points occur more frequently in patients exposed to CM than in those with no CM exposure. PMID:25115554

  15. Diastematomyelia: A Surgical Case with Long-Term Follow-Up

    PubMed Central

    Bekki, Hirofumi; Kawano, Osamu; Shiba, Keiichiro; Iwamoto, Yukihide

    2015-01-01

    Few reports have described the involvement of syringomyelia associated with diastematomyelia in the etiology of neurological deficits. We reported a case with syringomyelia associated with diastematomyelia. A female patient with diastematomyelia was followed up clinically over 14 years. At the age of 8, she developed clubfoot deformity with neurological deterioration. Motor function of the right peroneus demonstrated grade 2 in manual muscle tests. Continuous intracanial bony septum and double cords with independent double dura were observed at upper thoracic spine. Magnetic resonance imaging revealed a tethering of the spinal cord and syringomyelia distal to the level of diastematomyelia. Extirpation of the osseum septum and duralplasty were performed surgically. She grew without neurological deterioration during 7 years postoperatively. A long-term followed up case with syringomyelia that was possibly secondary to the tethering of the spinal cord associated with diastematomyelia, and effective treatment with extirpation of the osseum septum and duralplasty was described. PMID:25705341

  16. [Long-term follow-up in patients with spinal cord injury - prevention and comprehensive care].

    PubMed

    Spreyermann, Regula; Michel, Franz

    2014-01-15

    Patients with spinal cord injuries suffer not only from sensory and motor deficits, but from failure of the autonomic nerve system which in consequence involves many organs and metabolic pathways. These deficits lead to a different approach to these patients and their medical, psychological and social problems. Three examples will illustrate the different approaches to typical medical problems of these patients. Regularly ambulatory long term follow up visits in specialized centres in close collaboration with general practitioners help to diminish complications and rehospitalisations. Facing the now ageing population with a spinal cord injury we need evidence based guidelines in follow up and preventive strategies for these patients. We updated these recommendations recently. The brochure is available on the webside oft he swiss society of paraplegia www.ssop.ch. PMID:24425548

  17. Long-Term Follow-Up of Percutaneous Balloon Angioplasty in Adult Aortic Coarctation

    SciTech Connect

    Paddon, Alex J.; Nicholson, Anthony A.; Ettles, Duncan F.; Travis, Simon J.; Dyet, John F. [Radiology Department, Hull Royal Infirmary, Anlaby Road, Kingston upon Hull HU3 2JZ (United Kingdom)

    2000-09-15

    Purpose: To assess long-term outcomes following percutaneous transluminal angioplasty (PTA) of congenital aortic coarctation in adults.Methods: Seventeen patients underwent PTA for symptomatic adult coarctation of the aorta. Sixteen patients, with a mean age of 28 years (range 15-60 years), were reviewed at a mean interval after angioplasty of 7.3 years (range 1.5-11 years). Assessment included magnetic resonance imaging (MRI), Doppler echocardiography, and clinical examination. Current clinical measurements were compared with pre- and immediate post-angioplasty measurements.Results: At follow-up 16 patients were alive and well. The patient not included in follow-up had undergone surgical repair and excision of the coarctation segment following PTA. Mean brachial systolic blood pressure for the group decreased from 174 mmHg before angioplasty to 130 mmHg at follow-up (p 0.0001). The mean gradient had fallen significantly from 50.9 to 17.8 at follow-up (p = 0.001). The average number of antihypertensive drugs required per patient decreased from 0.56 to 0.31 (p = 0.234). No significant residual stenoses or restenoses were seen at MRI. Small but clinically insignificant residual pressure gradients were recorded in all patients using Doppler echocardiography. Complications included one transient ischemic attack at 5 days, one external iliac dissection requiring stent insertion, and a further patient who developed a false aneurysm close to the coarctation site at 12 months which subsequently required surgical excision.Conclusion: PTA of adult coarctation is safe and effective in the long term. Although primary stenting has recently been advocated in the treatment of this condition, our results suggest that PTA remains the treatment of choice.

  18. Clinical and Radiological Long-Term Follow-up After Embolization of Pulmonary Arteriovenous Malformations

    SciTech Connect

    Andersen, Poul Erik [Odense University Hospital, Department of Radiology (Denmark)], E-mail: anders1@dadlnet.dk; Kjeldsen, Anette D. [Odense University Hospital, Department of Otorhinolaryngology (Denmark)

    2006-02-15

    The purpose was to evaluate the clinical and radiological long-term results of embolization of pulmonary arteriovenous malformations (PAVMs) and to assess the quality of life after treatment. A clinical follow-up was undertaken after 67 months (mean) in 35 consecutive patients with 106 PAVMs. Outcome parameters at follow-up were PaO{sub 2} and patients' satisfaction. During follow-up, the patients had a clinical examination, measurement of arterial blood gases, chest X-ray, and contrast echocardiography performed and were asked to fill in a questionnaire exploring experience of the treatment and subjective effect of treatment on physical and social functioning. A significant rise in oxygenation of the blood after embolization was measured. In 77% of the patients symptoms improved, and 71% felt better performance. In eight patients, one of the PAVMs was found insufficiently embolized or recanalized at follow-up angiography and therefore were re-embolized. Endovascular embolization for PAVMs is effective. Clinical parameters and quality of life improved significantly. Regular clinical controls after therapy are necessary to discover insufficiently embolized, recanalized or new PAVMs.

  19. [Objectives and organization for the long-term follow-up after childhood cancer].

    PubMed

    Berger, Claire; El Fayech, Chiraz; Pacquement, Hélène; Demoor-Goldschmidt, Charlotte; Ducassou, Stéphane; Ansoborlo, Sophie; Defachelles, Anne-Sophie

    2015-01-01

    Increased survival of patients with childhood cancer has resulted in a growing population of survivors. In France approximately 50,000 alive people have been treated before 20years old and, as survivors, are at risk for health problems due to disease or cancer therapy (surgery, chemotherapy, radiotherapy). Complications such as cardiovascular or cerebrovascular disease (after radiotherapy or chemotherapy), neurocognitive deficiency, endocrine disorders (hypopituitary axis, or thyroid dysfunction), gonadal function, and second malignancy can be life-threatening and seriously affect quality of life. Upon discharge former patients should be given 'passport', containing a summary of their medical history, treatment (surgery, chemotherapy cumulative doses, characteristics of radiotherapy and organs involved), methods used to preserve fertility, and complications during treatment. Treatments can then be linked to individualized recommendations for follow-up care. The risk of developing long-term complications increases with time and can be aggravated by age-related comorbidity and environmental factors (tobacco, alcohol, obesity). Many regions and treatment centres in France have in place organised long-term follow-up procedures. PMID:26044987

  20. Factors Influencing Long-Term Follow-Up Clinic Attendance Among Survivors of Childhood Cancer

    PubMed Central

    Klosky, James L.; Cash, Darlene K.; Buscemi, Joanna; Lensing, Shelly; Garces-Webb, Danette M.; Zhao, Wenyan; Wiard, Sally; Hudson, Melissa M.

    2009-01-01

    Introduction Attendance at long-term follow-up clinic is necessary for survivors of childhood cancer to facilitate education about cancer-related health risks, early detection of treatment-related morbidity, and implementation of health-promoting interventions. Despite the need for continued care, barriers to clinic attendance exist. The purpose of this prospective study was to identify the demographic, medical, and logistic factors impacting clinic attendance and long-term follow-up care among survivors of childhood cancer. Methods Adherence to clinic attendance was monitored among 941 long-term childhood cancer survivors scheduled for evaluation at our institution. Patients were classified as “attenders” or “non-attenders” based on the outcome of their first scheduled clinic appointment over a one year period. Social work staff contacted non-attenders by telephone to determine reasons for missed appointments. Results Nearly 15% of survivors were classified as non-attenders. Univariate findings revealed that older age, lower SES, being non-white, less medically insured, traveling by car, living shorter distance from clinic, having a scheduled social work consultation, and entering or exiting survivorship clinic were associated with clinic non-attendance (all p values <.05). The final multivariate model indicated that non-whites (OR=1.88, 95% CI=1.19–2.97), patients without insurance (OR=2.36,95% CI=1.98 – 3.79), those traveling by car (OR=12.74, 95% CI=3.97 – 40.86), and those who have not experienced secondary cancer events (OR=1.76, 95% CI=0.94–3.28) were more likely to be non-attenders. Work or school conflicts were the primary reasons cited for missed appointments. Discussion/Conclusions Despite mechanisms designed to reduce financial burdens associated with attending survivorship clinic at our institution, demographic, medical, and logistic barriers exist which impact participation in long-term follow-up. Implications for Cancer Survivors and Providers These results highlight the importance of developing tailored outreach strategies for survivors of childhood cancer at-risk for clinic nonattendance, particularly among underserved populations. PMID:18787958

  1. Long-term follow-up of surgery for gastroesophageal reflux in infants and children.

    PubMed

    Harnsberger, J K; Corey, J J; Johnson, D G; Herbst, J J

    1983-04-01

    Surgery for gastroesophageal reflux in infants and children has been shown to be safe and effective, but long-term results of the surgery have not been investigated. Because studies in adults show objective evidence of recurrent reflux five years postoperatively, we recalled 25 children for long-term follow-up of surgery. The preoperative symptoms of vomiting, apnea, pneumonia, and hematemesis were permanently controlled in all patients. Failure to thrive was reversed in all patients except those with multiple malformations. Extended esophageal pH monitoring revealed only one patient with symptomatic recurrent reflux. As a group, the children had significantly less reflux as measured by extended pH monitoring than did controls. Thirty-six percent of patients had mild to moderate symptoms of gas bloat. Thirty-two percent were described as very slow to finish most meals. Twenty-eight percent were unable to burp or vomit. Twenty-five percent choked on some solids. These symptoms did not correlate with the type of operation performed. Long term outcome of antireflux surgery in children is better than in adults. PMID:6834183

  2. Long-term follow-up of coronary angioplasty in patients with diabetes compared with nondiabetics

    PubMed Central

    Brueren, B.R.G.; ten Berg, J.M.; Kelder, J.C.; Suttorp, M.J.; Mast, E.G.; Bal, E.; Ernst, S.M.P.G.; Plokker, H.W.T.

    2004-01-01

    Background Some reports have indicated that in patients with diabetes mellitus and multivessel disease, coronary artery bypass surgery is preferred over percutaneous coronary intervention (PCI). We retrospectively compared outcome PCI in diabetic and nondiabetic patients. Methods Ninety-seven diabetics and 971 nondiabetics were included and randomised before PCI to aspirin alone or aspirin plus coumadin. Fifty diabetics and 481 nondiabetics underwent follow-up angiography. The primary endpoint comprised all-cause mortality, myocardial infarction or targetvessel revascularisation. Results Baseline characteristics were similar between the groups except for significantly more males and smokers among the nondiabetics. The diabetics had significantly more previous strokes, more left anterior descending coronary artery disease as well as more restenotic lesions and multivessel disease. At 30 days, the primary endpoint had occurred in five diabetics (5.2%) and 47 nondiabetics (4.9%), (p=0.8) and at one year in 17 (17.5%) and in 165 (17.1%), respectively (p=0.9). Event-free survival remained comparable during long-term follow-up (four years). Multivariate analysis showed no differences for the occurrence of any event (p=0.9, 95% CI 0.6-1.7). At six months, the minimal luminal diameter was significantly smaller in the diabetics (1.55±0.76 mm vs. 1.78±0.66 mm, p=0.01). Diabetics also had more restenosis (41% vs. 23%, p=0.003). Conclusion Despite angiographical differences at six months between the diabetics and nondiabetics, both short-term and long-term clinical follow-up appeared to be similar. PMID:25696315

  3. Long-Term Follow-up After Embolization of Pulmonary Arteriovenous Malformations with Detachable Silicone Balloons

    SciTech Connect

    Andersen, Poul Erik [Odense University Hospital, Department of Radiology (Denmark)], E-mail: anders1@dadlnet.dk; Kjeldsen, Anette D. [Odense University Hospital, Department of Otorhinolaryngology (Denmark)

    2008-05-15

    Long-term follow-up results after embolization of 13 pulmonary arteriovenous malformations in 10 patients by use of 14 detachable silicone balloons are given. Patients were followed for a mean of 99 months (range, 63-123 months) with chest x-rays and for a mean of 62 months (range, 3-101 months) with pulmonary angiography. Fifty-four percent of the balloons were deflated at latest radiographic chest film follow-up, but at pulmonary angiographic follow-up all embolized malformations were without flow irrespective of whether or not the balloons were visible. Detachable silicone balloons are not available anymore, but use of these balloons for embolization of pulmonary arteriovenous malformations has been shown to be a safe and precise method, with immediate occlusion of the feeding artery and with long-lasting occlusion, even though many balloons deflate with time, leaving a fibrotic scar replacing the pulmonary arteriovenous malformation. No case of recanalization has been discovered, and these results seem to justify a reduced number of controls of these balloon-embolized malformations.

  4. Long-term follow-up of pediatric cancer survivors: education, surveillance, and screening.

    PubMed

    Landier, Wendy; Wallace, W Hamish B; Hudson, Melissa M

    2006-02-01

    Cancer and its treatment predispose childhood cancer survivors to chronic or late occurring health problems that may not become clinically significant until many years after therapy. Frequently, long-term survivors of childhood cancer report late cancer-related effects that diminish quality of life and increase the risk of early mortality. Risk-based health care that involves a personalized plan for surveillance, screening, and prevention is recommended to reduce cancer-related morbidity in childhood cancer survivors. To implement optimal risk-based care, the survivor and health care provider must have accurate information about cancer diagnosis, treatment modalities, and potential cancer-related health risks to guide screening and risk-reducing interventions. However, previous studies evaluating health knowledge of childhood cancer survivors demonstrate noteworthy deficits and misperceptions about their cancer diagnosis, treatment, and cancer-related health risks. In addition, because of the relative rarity of childhood cancer, many health care providers lack familiarity with cancer-related health risks and risk-reduction methods relevant for this population. To correct these deficits, the Scottish Intercollegiate Guidelines Network (SIGN) and the Children's Oncology Group (COG) developed clinical practice guidelines to foster appropriate risk-based survivor care. Herein, we discuss the development, benefits, and limitations of the SIGN and COG guidelines and the foundation they provide for standardizing long-term follow-up care of the ever-growing vulnerable population of childhood cancer survivors. PMID:16369924

  5. Abdominal aortic aneurysm repair: long-term follow-up of endovascular versus open repair

    PubMed Central

    Mariscalco, Giovanni; Riva, Francesca; Fontana, Federico; Carrafiello, Gianpaolo; Castelli, Patrizio

    2014-01-01

    Introduction To compare early and long-term outcomes of endovascular abdominal aortic aneurysm repair (EVAR) versus open repair (OPEN). Design: Prospective observational, per protocol, non-randomized, with retrospective analyses. Material and methods Between 2000 and 2005, a total of 311 patients having EVAR or OPEN repair of infrarenal abdominal aortic aneurysms were identified and included in this prospective single-center observational study. A propensity score-based optimal-matching algorithm was employed, and 138 patients undergoing EVAR procedures were matched (1: 1) to OPEN repair. Results Open repair showed higher hospital mortality (17% vs. 6%, p = 0.004), respiratory failure (p < 0.026), transfusion requirement (p < 0.001), and intensive care unit admission (27% vs. 7%, p < 0.001), and longer hospitalization (p < 0.001). Median follow-up was 70 months (25th to 75th percentile, 24 to 101). Actuarial survival estimates at 1, 5 and 10 years were 93%, 74%, 49% for the OPEN group compared to 89%, 69%, 59% for the EVAR group (p = 0.465). A significant difference between groups was observed in younger patients (< 75 years) only (p < 0.044). Late complication and re-intervention rates were significantly higher in EVAR patients (p < 0.001 and p = 0.002, respectively). Freedom from late complications at 1, 5 and 10 years was 96%, 92%, 86%, and 84%, 70%, 64% for OPEN and EVAR procedures, respectively. Conclusions Our experience confirms the excellent results of the EVAR procedures, offering excellent early and long-term results in terms of safety and reduction of mortality. Patients < 75 years seem to benefit from EVAR not only in the immediate postoperative period but even in a long-term perspective. PMID:24904660

  6. A long-term follow-up study of schizophrenia: psychiatric course of illness and prognosis.

    PubMed

    Huber, G; Gross, G; Schüttler, R

    1975-07-01

    A systematic psychiatric follow-up study of 502 schizophrenics was carried out using the same well-defined criteria to evaluate the patients throughout the investigation. After an average course of disease of 22.4 years, 22.1% of the patients showed complete psychopathological remission, 43.2% had non-characteristic types of remission and 34.7% suffered from characteristic schizophrenic deficiency syndromes. At the time of the last follow-up investigation, 86.7% of the patients were living at home, while 13.3% were permanently hospitalized. Of the entire sample, 55.9% were found to be "socially recovered". Higher education, psychoreactive provocation, depressive traits, perception of delusions, catatonic agitation, non-characteristic thought disorders and symptoms of depersonalization at the onset of the illness tended to carry with them a favorable prognosis. On the other hand, low intelligence, abnormal primary personality, premorbid disturbances in social behavior, broken homes, prolonged prodromal stages, pneumoence-phalographically measurable atrophic or dysplastic changes in the brain ventricles as well as somatic and auditory hallucinations and predominance of hebephrenic symptoms at the onset of the illness tended to lead to an unfavorable prognosis. The principle of the basic reversibility of typical schizophrenic symptoms and the extensive irreversibility of the non-characteristic defect is important for the psychopathological and social long-term prognosis. PMID:1155202

  7. Renal function in tyrosinaemia type I after liver transplantation: a long-term follow-up.

    PubMed

    Pierik, L J W M; van Spronsen, F J; Bijleveld, C M A; van Dael, C M L

    2005-01-01

    Hereditary tyrosinaemia type I is an autosomal recessive inborn error of tyrosine catabolism caused by a deficiency of the enzyme fumarylacetoacetase that results in liver failure, hepatocellular carcinoma, renal tubular dysfunction and acute intermittent porphyria. When treated with liver transplantation, tyrosinaemia type I was considered to be cured. Some years after the first liver transplantations in these patients, some reports focused on the renal function after transplantation. These reports showed that urinary succinylacetone excretion remained but that tubular function normalized. In this report we discuss the long-term renal follow-up (mean follow-up time 11 years, range 7-14 years) after liver transplantation in 9 patients with tyrosinaemia type I treated by liver transplantation in our centre. An evaluation was made of renal function and succinylacetone excretion in urine. In all patients we found a persistent excretion of succinylacetone in the urine. With respect to the glomerular function, we can conclude that there is no clear change in GFR. At the same time, tubulopathy persisted in some patients. We consider that excretion of metabolites such as succinylacetone will be an important contributing factor to tubular dysfunction after liver transplantation in patients with tyrosinaemia type I. Therefore, notwithstanding the major effect of liver transplantation on tyrosine metabolism, renal tubular dysfunction remains at risk and needs careful monitoring. Progressive tubular dysfunction can cause glomerular damage. The use of low-dose NTBC might be considered after liver transplantation in case of tubulopathy to prevent progression of tubular and glomerular dysfunction. PMID:16435179

  8. Long-term follow-up of patients receiving boceprevir for treatment of chronic hepatitis C.

    PubMed

    Howe, Anita Y M; Long, Jianmin; Nickle, David; Barnard, Richard; Thompson, Seth; Howe, John; Alves, Katia; Wahl, Janice

    2015-01-01

    The durability of sustained virologic response (SVR) following boceprevir-based therapy in patients with hepatitis C virus (HCV) infection has not been reported. Furthermore, in patients receiving protease inhibitor-based therapies, development of resistance can contribute to treatment failure. The aim of the present study was to follow the clinical progression of patients treated with boceprevir after treatment in phase 2/3 clinical trials. This was a 3-year, long-term follow-up analysis of patients enrolled in boceprevir phase 2/3 studies. No treatment was administered during follow-up. Patients with SVR were assessed for durability of viral eradication. Non-SVR patients with on-treatment resistance-associated variants (RAVs) were assessed for longevity of RAVs. A total of 1148 patients (SVR, n=696; virologic failure, n=452) were enrolled in this follow-up analysis. The median duration of follow-up was approximately 3.4 years (range of 0.0-4.1 years). Overall, 3 of 696 patients with SVR had detectable HCV RNA during the follow-up period (relapse rate of 0.4% or 1.3 relapses/1000 person-years). The majority of patients who developed RAVs during the initial treatment study (228/314, 73%) reverted to wild-type (WT) within 3 years (RAVs persisted in 27% of patients). The median time for all RAVs to become undetectable was 1.11 years (95% confidence interval 1.05-1.20 years). V36M, T54A, A156S, I/V170A and V36M+R155K appeared to have a faster rate of return to WT (median times to return to WT of ?0.9 years); whereas, T54S, R155K, V55A and T54S+R155K had a slower rate of return to WT (median times to return to WT of approximately 1.1 years). Return to WT appeared slightly faster in patients with G1b RAVs compared to those with G1a RAVs, and in patients with previous non-response or relapse versus breakthrough or incomplete virologic response. SVR was durable in most patients treated with boceprevir. Furthermore, most RAVs present at the time of virologic failure reverted to WT over time. Time to return to WT was associated with the phenotype of RAV, presumably a reflection of the fitness of the mutant virus, suggesting that HCV RAVs are not permanently archived, but are replaced in the viral population by WT virus. PMID:25446895

  9. The Sugen 5416/hypoxia mouse model of pulmonary hypertension revisited: long-term follow-up

    PubMed Central

    Hansmann, Georg; Rose, Chase; Fernandez-Gonzalez, Angeles; Scheid, Annette; Mitsialis, S. Alex; Kourembanas, Stella

    2014-01-01

    Abstract The combination of a vascular endothelial growth factor receptor antagonist, Sugen 5416 (SU5416), and chronic hypoxia is known to cause pronounced pulmonary hypertension (PH) with angioobliterative lesions in rats and leads to exaggerated PH in mice as well. We sought to determine whether weekly SU5416 injections during 3 weeks of hypoxia leads to long-term development of angioobliterative lesions and sustained or progressive PH in mice. Male C57BL/6J mice were injected with SU5416 (SuHx) or vehicle (VehHx) weekly during 3 weeks of exposure to 10% oxygen. Echocardiographic and invasive measures of hemodynamics and pulmonary vascular morphometry were performed after the 3-week hypoxic exposure and after 10 weeks of recovery in normoxia. SuHx led to higher right ventricular (RV) systolic pressure and RV hypertrophy than VehHx after 3 weeks of hypoxia. Ten weeks after hypoxic exposure, RV systolic pressure decreased but remained elevated in SuHx mice compared with VehHx or normoxic control mice, but RV hypertrophy had resolved. After 3 weeks of hypoxia and 10 weeks of follow-up in normoxia, tricuspid annular plane systolic excursion was significantly decreased, indicating decreased systolic RV function. Very few angioobliterative lesions were found at the 10-week follow-up time point in SuHx mouse lungs. In conclusion, SU5416 combined with 3 weeks of hypoxia causes a more profound PH phenotype in mice than hypoxia alone. PH persists over 10 weeks of normoxic follow-up in SuHx mice, but significant angioobliterative lesions do not occur, and neither PH nor RV dysfunction worsens. The SuHx mouse model is a useful adjunct to other PH models, but the search will continue for a mouse model that better recapitulates the human phenotype. PMID:25610598

  10. Long-term follow-up of Fanconi anemia: clinical manifestation and treatment outcome

    PubMed Central

    Yoon, Byung Gyu; Kim, Hee Na; Han, Ui Joung; Jang, Hae In; Han, Dong Kyun; Baek, Hee Jo; Hwang, Tai Ju

    2014-01-01

    Purpose The aim of this study was to characterize Korean patients with Fanconi anemia (FA), which is a rare but very challenging genetic disease. Methods The medical records of 12 FA patients diagnosed at Chonnam National University Hospital from 1991 to 2012 were retrospectively reviewed. Results The median age at diagnosis was 6.2 years. All patients showed evidence of marrow failure and one or more physical stigmata. Chromosome breakage tests were positive in 9 out of 11 available patients. The median follow-up duration was 69.5 months. The Kaplan-Meier (KM) survival of all patients was 83.3% at 10 years and 34.7% at 20 years, respectively. Seven patients underwent 9 stem cell transplantations (SCTs). Among them, 5 were alive by the end of the study. Ten-year KM survival after SCT was 71.4% with a median follow-up of 3.4 years. All 5 patients treated with supportive treatment alone died of infection or progression at the median age of 13.5 years, except for one with short follow-up duration. Acute leukemia developed in 2 patients at 15.4 and 18.1 years of age. Among 6 patients who are still alive, 3 had short stature and 1 developed insulin-dependent diabetes mellitus. Conclusion We provide information on the long-term outcomes of FA patients in Korea. A nation-wide FA registry that includes information of the genotypes of Korean patients is required to further characterize ethnic differences and provide the best standard of care for FA patients. PMID:24778694

  11. Long-term Follow-up of Acquired Nonaccommodative Esotropia in a Population-based Cohort

    PubMed Central

    Jacobs, Sarah M.; Green-Simms, Amy; Diehl, Nancy N.; Mohney, Brian G.

    2012-01-01

    Purpose To describe the clinical characteristics and long-term outcomes of children diagnosed over a 30-year period with acquired nonaccommodative esotropia (ANAET). Design Retrospective chart review of a population-based cohort. Participants All pediatric (< 19 years of age) residents of Olmsted County, Minnesota, diagnosed with ANAET from January 1, 1965, through December 31, 1994. Methods The medical records of all potential patients identified by the resources of the Rochester Epidemiology Project were reviewed. Main Outcome Measures Incidence, clinical characteristics, and long-term motor and sensory outcomes of children with ANAET. Results A total of 174 children were diagnosed during the 30-year period, yielding an incidence of 1 in 287 live births. The median age at diagnosis for the 174 patients was 4.0 years (range, 11 months to 18.2 years), and 61% (107) were male (p=0.009). Although 11% (8 of 75) of those queried were diplopic, none of the 174 were subsequently diagnosed with an intracranial lesion. During a mean follow-up of 10.9 years (range, 0 days to 37 years), 127 (73%) patients underwent strabismus surgery (mean, 1 surgery; range, 0 to 3 surgeries). Among the 127 who underwent surgery, the median final stereoacuity was 3000 seconds of arc, including 8 (6.3%) patients with 50 seconds of arc or better. Patients who were older (> 44 months) at ANAET diagnosis (p=0.005) and without amblyopia at their initial exam (p, 0.001) were more likely to achieve excellent final stereopsis. Conclusion In this population-based cohort, ANAET occurred in 1 in 287 children and was more prevalent among males. Although diplopia was relatively common, none of the children were found to have an intracranial malignancy. Most patients achieved good motor and sensory outcomes, with the best results among those with a later onset of their deviation and no amblyopia. PMID:21276614

  12. Long-term follow-up of pediatric en bloc renal transplantation.

    PubMed

    Beasley, K A; Balbontin, F; Cook, A; Bloch, M; McAlister, V C; Lawen, J; Luke, P P W

    2003-11-01

    We reviewed the outcomes of pediatric en bloc renal transplantation at two Canadian centers in the cyclosporine era. Between 1984 and 2002, 16 patients received pediatric en bloc renal transplants. Mean recipient age and weight were 45 +/- 17 years and 72.2 +/- 14.4 kg, respectively. En bloc kidneys were procured from donors aged 2.1 +/- 0.8 years (range, 0.7 to 4.0), weighing an average of 14.3 +/- 2.0 kg (range, 12 to 17). All en bloc kidneys were successfully transplanted without thrombosis. All patients received calcineurin inhibitors and corticosteroids. Only three patients received antibody-based induction therapy. Rejection episodes occurring in seven grafts were all successfully treated. Mean follow-up was 3.7 years (range 0.4 to 15.0). Mean serum creatinine values at 3 months and 1 and 3 years were 138.8 +/- 54.5 micromol/L, 118.6 +/- 38.1 micromol/L, and 95.1 +/- 24.4 micromol/L, respectively. The mean creatinine value of five patients with at least 5 years follow-up was 96.8 +/- 12.3 micromol/L. Three-year graft and patient survival rates were 94%. Two deaths with functioning grafts occurred secondary to cardiac and infectious etiologies. None of the grafts were lost independent of death. We conclude that en bloc transplantation has excellent short- and long-term results. Improving graft function after 3 years represented by reduced serum creatinine suggests that these kidneys have excellent renal reserve and growth potential. PMID:14611967

  13. Long-term follow-up of young children with brain tumors after irradiation

    SciTech Connect

    Syndikus, I.; Tait, D.; Ashley, S. [Royal Marsden Hospital, Surrey (United Kingdom)] [and others

    1994-11-15

    Young children with brain tumors are at high risk of developing late sequelae after curative radiotherapy. A retrospective study was undertaken to determine the frequency and severity of neurological deficits, endocrine dysfunction, and intellectual disabilities. One hundred and fifty-six children age {ge} 3 years were treated between 1952 and 1986 with radiotherapy. Of the 57 survivors, 47 had surgery, 12 chemotherapy and 24 children received cranio-spinal radiotherapy. Late radiation side effects were assessed with a clinical examination, blood tests and an interview. The median follow-up was 13 years and the actuarial survival at 5 and 10 years was 49% and 44%, respectively. No, or only a mild, handicap was noted in 24 patients, while 21 had moderately severe and 16 severe disabilities. Children with supratentorial tumors had more abnormal neurological findings compared to those with infratentorial malignancies (p<0.001). Eighty percent of children had endocrine abnormalities, which were more marked in children with parasellar tumors (p<0.001). Twenty-one children were mentally retarded. In a multivariate analysis epilepsy emerged as the only significant variable independently associated with poor cognitive function. Long-term morbidity was found to be disabling in 58% of the surviving children. These findings encourage the development of treatment strategies designed to reduce toxity. 34 refs., 3 figs., 5 tabs.

  14. Improving long-term follow-up studies of immunomodulatory therapies.

    PubMed

    Freedman, Mark S

    2011-01-01

    Goals in the treatment of multiple sclerosis (MS) focus on reducing symptoms and disease progression. Registry data indicate that the accumulation of significant disability can take decades. Therefore, long-term follow-up (LTFU) studies are needed to understand the impact of disease-modifying therapy (DMT) in MS. Based on analyses of available LTFU study data, recommendations for future LTFU studies can be made. A disability milestone may be considered because exploratory data show that DMT may slow the progression of disability. Achievement of the EDSS steps 4 or 6 may be sufficient milestones because, once reached, MS progresses inevitably. Since a placebo control cannot be ethically used in LTFU studies, a standard-of-care comparator could be considered. The ideal LTFU study should be performed according to the highest possible standards. A high-quality LTFU study would achieve high retention rates, capture complete data at prespecified assessment intervals, and be powered to the key outcome measure. In addition, propensity scoring is an approach used to reduce bias in treatment comparisons in observational studies and might be a suitable approach for analyzing LTFU studies. With careful consideration of LTFU limitations and study design, it is possible to attain a high degree of rigor in future studies. PMID:21205681

  15. [Long-term follow-up after intravenous injection of mercury--two cases report].

    PubMed

    Goszcz, Halina; Szczepa?ska, ?ucja; Lech, Teresa; Groszek, Barbara

    2012-01-01

    In this paper we present the long-term follow-up of two patients, after injection of metallic mercury. Case 1. In 1997, 29-years-old man injected himself to left elbow about 20 ml of metallic mercury by mistake (he was heroin abuser for short time). Mercury concentration in the blood was 400 microg/L. X-ray of the chest, abdomen and affected elbow area showed radiopaque foreign material (depots of mercury). Depots of mercury were also visible on the tricuspid valve in echocardiography. Mercury from the soft tissue left elbow pit was partially surgically removed. During 15 years follow-up two times chelating therapy was performed with d-penicyllamine and DMPS. In 2012, he was admitted to hospital next time. The blood and urine mercury concentration was still elevated (55.2 microg/L and 197 microg/L), mercury depots in the lung and abdomen were present. The signs and symptoms of CNS damage, like peripheral polyneuropathy and ataxia, were diagnosed. CT of brain did not revealed any changes, despite head trauma before 6 years. However neurological findings are typical for chronic mercury poisoning, it is not possible to determine whether these changes are directly related to mercury, because head trauma history, Case 2. In 2003, 16-years-old woman injected herself one month before, in suicidal attempts to both elbows several millilitres of metallic mercury. Mercury concentration in the blood was 56.2 microg/L, in urine 906 microg/L and in the hair 1.12 microg/g. Chest Xray showed depots of mercury in the lung. Mercury from the soft tissue was two times surgically removed. During 9 years two times chelating therapy was performed with d-penicyllamine and DMPS. After 9 years there is no symptoms of mercury poisoning. Mercury depots in the lung are still present. The blood and urine mercury concentration is low (13.7 microg/L and 2.53 microg/L). In mean time she gave birth two healthy children. Further patients evaluation is necessary. PMID:23243934

  16. Hepatic cryosurgery for liver metastases. Long-term follow-up.

    PubMed Central

    Korpan, N N

    1997-01-01

    OBJECTIVE: The aim of this prospective study was to evaluate the applicability of cryogenic and conventional surgery in treating liver metastases (LM) with respect to intraoperative tumor reduction and survival rate. SUMMARY BACKGROUND DATA: As have been shown in animal experiments as well as in clinical investigations, cryosurgery has been used for the treatment of many benign and malignant conditions. For the first time, this report summarizes a 10-year follow-up clinical experience with cryosurgery for treatment of LM from 1983 to 1992. METHODS: One hundred twenty-three patients with LM (87 males and 36 females, a ratio 2.4:1.0; age, 41.3 +/- 12.1 years) were stratified and entered into a long-term prospective, randomized clinical trial for cryogenic surgery in group 1 (n = 63) and conventional surgical techniques in group 2 (control subjects, n = 60). Principally, a self-constructed cryogenic clamp was used for hepatic cryoresection with preliminary freezing of the margin resection by a cryosurgical system "Cryoelectronic-2" or "Cryoelectronic-4". Hepatic cryoextirpation (cryoablation) and hepatic cryodestruction were performed by means of probes of different roughly disk design from phi 5 mm to 55 mm by volume of frozen zone of 40 cm3 to 180 cm3 for approximately 7 to 32 minutes. RESULTS: In most cases in group 1 and group 2, LM were based on colorectal cancers (65% vs. 68%). The hepatic cryosurgical procedures in group 1 included cryoextirpation (29 patients, 46%), cryoresection (20 patients, 32%), and cryodestruction (14 patients, 22%) solely. Clinical and laboratory parameters showed that the curative effects were significantly higher in group 1 than in group 2. The 3-year survival rate was in group 1 and group 2 (60% vs. 51%, respectively). The 5-year survival rate was 44% in group 1 and 36% in group 2. Twelve patients (19%) versus 5 patients (8%) in group 1 and group 2, respectively, survived 10 years. The disease-free survival was in group 1 and group 2 (30% vs. 18%, respectively). During a follow-up period, recurrence in the liver was observed in 54 patients (85%) in group 1 and in 57 patients (95%) in control subjects. After a 10-year follow-up period in group 1 and group 2, 9 patients (14%) versus 3 patients (5%) remained disease free, 3 patients (4%) versus 2 patients (3%) were surviving with disease, and 51 patients (81%) versus 55 patients (92%) died. CONCLUSIONS: The data of this 10-year prospective, randomized clinical trial suggest that hepatic cryosurgery is effective in the treatment of resectable and nonresectable LM. The results show intraoperative tumor reduction (> or = 90% < or = 97%) and extended higher survival in these patients. The study indicated a 5-year and 10-year survival rate of 44% and 19% after cryosurgery, respectively. Images Figure 1. Figure 2. PMID:9065296

  17. Long-Term Follow-Up of Spontaneous Development in a Boy with Familial Male Precocious Puberty

    Microsoft Academic Search

    Carl-Joachim Partsch; Nils Krone; Felix G. Riepe; Jörg Gromoll; Wolfgang G. Sippell

    2004-01-01

    Background\\/Aims: Limited data are available about spontaneous growth, pubertal growth spurt and the long-term outcome of patients suffering from familial male precocious puberty (FMPP). We report on a boy with FMPP whose growth pattern and pubertal development was studied longitudinally without treatment. Methods: Long-term prospective follow-up without treatment of a 6.2-year-old boy with FMPP having inherited a mutation of the

  18. Concomitant diseases in a cohort of patients with idiopathic myositis during long-term follow-up

    Microsoft Academic Search

    K. P. Ng; F. Ramos; S. M. Sultan; D. A. Isenberg

    2009-01-01

    This study aims to report the concomitant diseases observed and damage outcome in a cohort of patients with adult idiopathic\\u000a inflammatory myositis (IIM) during long-term follow-up. All patients with IIM were identified from a single centre (follow-up\\u000a between 1979 and 2006) and fulfilled at least three of the four Bohan and Peter criteria. Patients with inclusion body myositis,\\u000a juvenile-onset myositis

  19. Long-term follow-up of atherosclerotic renovascular disease. Beneficial effect of ACE inhibition

    Microsoft Academic Search

    Attilio Losito; Rosa Errico; Paola Santirosi; Tommaso Lupattelli; Giovanni Battista Scalera; Luciano Lupattelli

    2005-01-01

    Background. Patients with atherosclerotic renovascu- lar disease (ARVD) are almost invariably treated by revascularization. However, the long-term outcomes of this approach on survival and progression to renal failure have not been investigated and have not been compared with that of a purely medical treatment. The aim of this observational study was to investigate factors affecting long-term (over 5 years) outcome,

  20. Criminal Activity of Adjudicated Youth Long-term Follow-up of Criminal Activity with Adjudicated Youth in Ontario

    E-print Network

    Rosenthal, Jeffrey S.

    , and Tidd (2004) used a novel approach to estimate the cost of crime, based on the "contingent valuationCriminal Activity of Adjudicated Youth Long-term Follow-up of Criminal Activity with Adjudicated 2K3, dday@psych.ryerson.ca. 1 #12;Criminal Activity of Adjudicated Youth ABSTRACT This article

  1. Image-Guided Biopsy-Diagnosed Renal Cell Carcinoma: Critical Appraisal of Technique and Long-Term Follow-Up

    Microsoft Academic Search

    Bhaskar Kumar Somani; Ghulam Nabi; Peter Thorpe; James N’Dow; Satchi Swami; Sam McClinton

    2007-01-01

    ObjectivesTo critically appraise and determine the impact of image-guided biopsy on the management of indeterminate renal masses. A comparison of long-term follow-up of renal cell carcinoma (RCC) diagnosed by image-guided biopsy and radiologically obvious RCC was also carried out.

  2. Stability and relapse after orthodontic treatment of deep bite cases-a long-term follow-up study.

    PubMed

    Danz, J C; Greuter, C; Sifakakis, I; Fayed, M; Pandis, N; Katsaros, C

    2014-10-01

    The purpose of this long-term follow-up study was twofold-firstly, to assess prevalence of relapse after treatment of deep bite malocclusion and secondly, to identify risk factors that predispose patients with deep bite malocclusion to relapse. Sixty-one former patients with overbite more than 50% incisor overlap before treatment were successfully recalled. Clinical data, morphometrical measurements on plaster casts before treatment, after treatment and at long-term follow-up, as well as cephalometric measurements before and after treatment were collected. The median follow-up period was 11.9 years. Patients were treated by various treatment modalities, and the majority of patients received at least a lower fixed retainer and an upper removable bite plate during retention. Relapse was defined as increase in incisor overlap from below 50% after treatment to equal or more than 50% incisor overlap at long-term follow-up. Ten per cent of the patients showed relapse to equal or larger than 50% incisor overlap, and their amount of overbite increase was low. Among all cases with deep bite at follow-up, gingival contact and palatal impingement were more prevalent in partially corrected noncompliant cases than in relapse cases. In this sample, prevalence and amount of relapse were too low to identify risk factors of relapse. PMID:23197574

  3. Long-term follow-up results of postoperative radiation therapy for Cushing’s disease

    Microsoft Academic Search

    Giuseppe Minniti; Mattia Osti; Marie Lise Jaffrain-Rea; Vincenzo Esposito; Giampaolo Cantore; Riccardo Maurizi Enrici

    2007-01-01

    Objectives  Radiotherapy is currently used in patients with residual or recurrent pituitary adenomas after surgery. However, there is\\u000a little information of long-term outcome of patients with Cushing’s disease following radiotherapy. We assessed the long-term\\u000a efficacy and toxicity of conventional radiotherapy in the control of Cushing’s disease after unsuccessful transsphenoidal\\u000a surgery.\\u000a \\u000a \\u000a \\u000a Patients and Methods  Forty patients with Cushing’s disease were treated with conventional

  4. Long term outcome of unilateral pallidotomy: follow up of 15 patients for 3 years

    Microsoft Academic Search

    P K Pal; A Samii; A Kishore; M Schulzer; E Mak; S Yardley; I M Turnbull; D B Calne

    2000-01-01

    OBJECTIVESWith the advent of new antiparkinsonian drug therapy and promising results from subthalamic and pallidal stimulation, this study evaluated the long term efficacy of unilateral pallidotomy, a technique which has gained popularity over the past decade for the management of advanced Parkinson's disease.METHODSThe 15 patients reported here are part of the original cohort of 24 patients who underwent posteroventral pallidotomy

  5. Intracranial Angioplasty without Stenting for Symptomatic Atherosclerotic Stenosis: Long-Term Follow-up

    Microsoft Academic Search

    Michael P. Marks; Mary L. Marcellus; Huy M. Do; Pamela K. Schraedley-Desmond; Gary K. Steinberg; David C. Tong; Gregory W. Albers

    BACKGROUND AND PURPOSE: Angioplasty and stent placement have been reported for the treatment of intracranial stenosis. This study was undertaken to assess the efficacy and long-term clinical outcome of angioplasty without stent placement for patients with symptom- atic intracranial stenosis. METHODS: A retrospective study was done to evaluate 36 patients with 37 symptomatic atherosclerotic intracranial stenosis who underwent primary balloon

  6. Long-term follow-up and outcome of 39 patients with chronic granulomatous disease

    Microsoft Academic Search

    Johannes Liese; Sibylle Kloos; Verena Jendrossek; Theoni Petropoulou; Uwe Wintergerst; Gundula Notheis; Manfred Gahr; Bernd H. Belohradsky

    2000-01-01

    Objectives: To evaluate the clinical long-term course in patients with chronic granulomatous disease (CGD) with respect to different CGD subtypes and currently used antimicrobial prophylactic measures. Study design: The records of 39 patients with CGD who were monitored during a period of 22 years were reviewed. All infections, infectious complications, and clinical outcomes were documented for a total observation period

  7. Literacy Outcomes for Students with Speech Impairment: Long-Term Follow-Up

    ERIC Educational Resources Information Center

    Leitao, Suze; Fletcher, Janet

    2004-01-01

    Background: Theoretical and empirical support now exists for the finding that many children with expressive phonological impairment experience problems in acquiring phonological awareness and early literacy skills. Few studies, however, have examined the long-term academic and literacy outcomes for this population, in particular as the…

  8. 75 FR 62132 - Proposed Collection; Comment Request; GuLF Worker Study: Gulf Long-Term Follow-Up Study for Oil...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-07

    ...Long-Term Follow-Up Study for Oil Spill Clean-Up Workers and Volunteers...Long-Term Follow-Up Study for Oil Spill Clean-Up Workers and Volunteers...long-term health effects associated with oil spill clean-up activities and...

  9. 75 FR 77880 - Proposed Collection; Comment Request; GuLF Worker Study: Gulf Long-Term Follow-Up Study for Oil...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-14

    ...Long-Term Follow-Up Study for Oil Spill Clean-Up Workers and Volunteers...Long-Term Follow-Up Study for Oil Spill Clean-Up Workers and Volunteers...long-term health effects associated with oil spill clean-up activities and...

  10. Nail lichen planus: response to treatment and long term follow-up.

    PubMed

    Piraccini, Bianca Maria; Saccani, Elena; Starace, Michela; Balestri, Riccardo; Tosti, Antonella

    2010-01-01

    In our twenty years' experience of dermatological visits specifically for nail diseases, we saw 105 patients with pathologically proven nail lichen planus. We prescribed treatment to 75 of these patients and we report here the results of treatment. Twenty-seven of these patients were followed-up for more than 5 years (mean follow-up was 10 years): 9 of them (9/27 = 33.3%) did not respond to treatment with steroids (intramuscular or intralesional), 18 were cured (18/27 = 66.7%), 11 relapsed (11/27 = 40.7%). This study is important for the fact that no one has previously published the results of such a long follow-up of patients with nail lichen planus. PMID:20400392

  11. Long-term 12 year follow-up of X-linked congenital retinoschisis

    PubMed Central

    Kjellström, Sten; Vijayasarathy, Camasamudram; Ponjavic, Vesna; Sieving, Paul A.; Andréasson, Sten

    2010-01-01

    Purpose To investigate the retinal structure and function during the progression of X-linked retinoschisis (XLRS) from childhood to adulthood. Methods Ten patients clinically diagnosed with XLRS were investigated at 6–15 years of age (mean age 9 years) with a follow-up 8 to 14 years later (mean 12 years). The patients underwent regular ophthalmic examination as well as testing of best corrected visual acuity (BCVA), visual field (VF) and assessment of full-field electroretinography (ERG) during their first visit. During the follow-up, the same clinical protocols were repeated. In addition, macular structure and function was examined with multifocal electroretinography (mfERG) and optical coherence tomography (OCT). The patients were 18–25 years of age (mean age 21 years) at the follow-up examination. All exons and exon-intron boundaries of RS1-gene were sequenced for gene mutations in 9 out of the 10 patients. Results Best corrected VA and VF were stable during this follow-up period. No significant progression in cone or rod function could be measured by full-field ERG. Multifocal electroretinography and OCT demonstrated a wide heterogeneity of macular changes in retinal structure and function at the time of follow-up visit. Three different mutations were detected in these nine patients, including a known nonsense mutation in exon 3, a novel insertion in exon 5 and an intronic mutation at 5' splice site of intron 3. Conclusions Clinical follow-up (mean 12 years) of ten young XLRS patients (mean age of 9 years) with a typical congenital retinoschisis phenotype revealed no significant decline in retinal function during this time period. MfERG and OCT demonstrated a wide variety of macular changes including structure and dysfunction. The XLRS disease was relatively stable during this period of observation and would afford opportunity for therapy studies to judge benefit against baseline and against the fellow eye. PMID:20569020

  12. Single-centre long-term follow-up of live kidney donors demonstrates preserved kidney function but the necessity of a structured lifelong follow-up

    PubMed Central

    Berglund, David; Yamamoto, Shinji; Wadström, Jonas

    2014-01-01

    Background The increase of live kidney donation (LKD) demands that we scrutinize its long-term consequences. Socialized medicine in Sweden has allowed us to survey long-term consequences of LKD with a high response rate. Methods Between 1974 and 2008, 455 LKDs were performed; 28 donors were deceased and 14 had moved abroad at the time of the survey. Of the remaining 413, 96% agreed to participate in a retrospective study with laboratory testing and answering a questionnaire. Results Mean age at donation was 49 ± 10 years, and the mean time since nephrectomy was 11 ± 7 years (range 1–33). No death was of renal cause. S-creatinine at follow-up was 93 ± 18 ?mol/L, 28% had treated hypertension, of whom only 52% had BP <140/90. Eleven per cent had spot microalbuminuria, and 1% were diagnosed with diabetes mellitus. Seventy-one per cent had check-ups at least every second year, but 14% had no check-ups. Eighty per cent would be willing to donate again if it were possible, and only 3% regretted the donation. Conclusion Renal function is well preserved in the long term after donation, no case of end-stage renal disease was identified, and a large majority of our donors would donate again if it were possible. Although rates of microalbuminuria and hypertension were at expected levels, a significant number of donors demonstrated elevated blood pressure levels and inadequate antihypertensive treatment. A relatively large number of donors did not receive regular check-ups. Both of these issues demonstrate the need for a better-structured lifelong follow-up. PMID:24646117

  13. Long-term follow-up of a behavioral treatment for stuttering in children.

    PubMed Central

    Wagaman, J R; Miltenberger, R G; Woods, D

    1995-01-01

    We report 3.5-year follow-up data from children who participated in a study that evaluated a behavioral treatment for stuttering. Six of 7 subjects continued to be at or below the criterion of 3% stuttered words. Stuttering increased for 1 subject, but remained far below his baseline level. Social validity data are also reported. PMID:7601808

  14. Long-Term Follow-up Study of Children Developmentally Retarded by Early Environmental Deprivation.

    ERIC Educational Resources Information Center

    Fujinaga, Tamotsu; And Others

    This paper reports on a 14-year follow-up study of two developmentally retarded Japanese children, a brother and sister, who had been kept shut up in a small shack before being rescued (at ages 5 and 6 respectively). Following birth they consistently suffered malnutrition, maternal deprivation, social isolation from adults, language deprivation,…

  15. Complications Following Swedish Adjustable Gastric Banding: A Long-Term Follow-up

    Microsoft Academic Search

    Peter Forsell; Bengt Hallerbäck; Hans Glise; Göran Hellers

    1999-01-01

    Background: The Swedish adjustable gastric band (SAGB) has been in use since 1985. The aim of this study was to analyze short\\u000a and long-term complications linked to the SAGB. Materials and Methods: Between August 1990 and December 1996, we operated\\u000a on a series of 326 patients (78 men and 248 women) at the Huddinge University Hospital and the Norra ?lvsborg

  16. Long term follow up of severely ill patients who underwent urgent cardiac transplantation

    Microsoft Academic Search

    D Mulcahy; M Fitzgerald; C Wright; J Sparrow; J Pepper; M Yacoub; K M Fox

    1993-01-01

    OBJECTIVE--To assess long term survival (> 5 years) and quality of life in severely ill patients referred for urgent cardiac transplantation. SETTING--Tertiary referral centres: before transplantation at the National Heart Hospital (late 1984 to end 1986); after transplantation at Harefield Hospital. SUBJECTS--Eighteen patients (15 men; three women) who had required intensive support in hospital before cardiac transplantation and were alive

  17. Vagus nerve stimulation for medically refractory epilepsy: A long-term follow-up study

    Microsoft Academic Search

    J. J. Ardesch; H. P. J. Buschman; L. J. J. C. Wagener-Schimmel; H. E. van der Aa; G. Hageman

    2007-01-01

    Introduction\\u000aVagus nerve stimulation (VNS) is thought to have a cumulative effect in time on seizure frequency reduction. There also might be other variables than reduction of seizure frequency in order to determine VNS efficacy. In this study we describe the long-term outcome of the first group of vagus nerve stimulation patients with pharmacoresistant epilepsy at the Medisch Spectrum Twente,

  18. Long-term follow-up after bowel resection for necrotizing enterocolitis: Factors affecting outcome

    Microsoft Academic Search

    Alan P Ladd; Frederick J Rescorla; Karen W West; L. R Scherer; Scott A Engum; Jay L Grosfeld

    1998-01-01

    Background: Necrotizing enterocolitis (NEC) is the most common surgical emergency among newborns and is associated with a high morbidity and mortality. This study evaluates the long-term survival of infants requiring surgical intervention for NEC and factors affecting outcome.Methods: A retrospective review of infants requiring surgery for complications of NEC at a tertiary care, pediatric hospital over a 16-year period was

  19. Tension-Free Vaginal Tape (TVT) in Women with Recurrent Stress Urinary Incontinence - A Long-term Follow up

    Microsoft Academic Search

    M. Rezapour; U. Ulmsten

    2001-01-01

    In a prospective long-term follow-up study we evaluated the results of TVT surgery in 34 women with recurrent stress urinary incontinence in whom previous traditional surgical procedures had failed. The women were followed for a mean of 4 years (range 3-5) after TVT surgery. The mean age was 58.9 - 10 years and the mean parity 2 (0-4). Pre- and

  20. Tension-Free Vaginal Tape (TVT) in Women with Mixed Urinary Incontinence - A Long-Term Follow-up

    Microsoft Academic Search

    M. Rezapour; U. Ulmsten

    2001-01-01

    In a prospective long-term study we evaluated the effect of TVT surgery in 80 women suffering from mixed urinary incontinence. Their mean age was 59 - 11 years with a mean parity of 2 (range 0-6). Mean follow-up was 4 years (range 3-5). The preoperative evaluation included a 24-hour pad test, quality of life evaluation, gynecologic examination and urodynamic investigations,

  1. Long-Term Follow-Up Effects of a School-Based Drug Abuse Prevention Program on Adolescent Risky Driving

    Microsoft Academic Search

    Kenneth W. Griffin; Gilbert J. Botvin; Tracy R. Nichols

    2004-01-01

    This study examined long-term follow-up data from a large-scale randomized trial to determine the extent to which participation in a school-based drug abuse prevention program during junior high school led to less risky driving among high school students. Self-report data collected from students in the 7th, 10th, and 12th grades were matched by name to students' department of motor vehicles

  2. Tonsillectomy and the immune system: a long-term follow up comparison between tonsillectomized and non-tonsillectomized children

    Microsoft Academic Search

    A. Böck; W. Popp; K. R. Herkner

    1994-01-01

    Immunological functions of the tonsils and possible effects of their removal are still controversial. One reason for this is the lack of long-term follow-up investigations after tonsillectomy. In the present study selected parameters of the cellular and Immoral immune systems of 160 children 0.5–11 years after tonsillectomy (mean 6.6 ± 2.1 years) were compared to those of 302 age-matched non-tonsillectomized

  3. Long-term follow-up of children conceived through assisted reproductive technology.

    PubMed

    Lu, Yue-hong; Wang, Ning; Jin, Fan

    2013-05-01

    Children conceived via assisted reproductive technologies (ART) are nowadays a substantial proportion of the population. It is important to follow up these children and evaluate whether they have elevated health risks compared to naturally conceived (NC) children. In recent years there has been a lot of work in this field. This review will summarize what is known about the health of ART-conceived children, encompassing neonatal outcomes, birth defects, growth and gonadal developments, physical health, neurological and neurodevelopmental outcomes, psychosocial developments, risk for cancer, and epigenetic abnormalities. Most of the children conceived after ART are normal. However, there is increasing evidence that ART-conceived children are at higher risk of poor perinatal outcome, birth defects, and epigenetic disorders, and the mechanism(s) leading to these changes have not been elucidated. Continuous follow-up of children after ART is of great importance as they progress through adolescence into adulthood, and new ART techniques are constantly being introduced. PMID:23645173

  4. Long-term follow-up of children conceived through assisted reproductive technology*

    PubMed Central

    Lu, Yue-hong; Wang, Ning; Jin, Fan

    2013-01-01

    Children conceived via assisted reproductive technologies (ART) are nowadays a substantial proportion of the population. It is important to follow up these children and evaluate whether they have elevated health risks compared to naturally conceived (NC) children. In recent years there has been a lot of work in this field. This review will summarize what is known about the health of ART-conceived children, encompassing neonatal outcomes, birth defects, growth and gonadal developments, physical health, neurological and neurodevelopmental outcomes, psychosocial developments, risk for cancer, and epigenetic abnormalities. Most of the children conceived after ART are normal. However, there is increasing evidence that ART-conceived children are at higher risk of poor perinatal outcome, birth defects, and epigenetic disorders, and the mechanism(s) leading to these changes have not been elucidated. Continuous follow-up of children after ART is of great importance as they progress through adolescence into adulthood, and new ART techniques are constantly being introduced. PMID:23645173

  5. Psychiatric morbidity in disintegrative psychosis and infantile autism: A long-term follow-up study.

    PubMed

    Mouridsen, S E; Rich, B; Isager, T

    1999-01-01

    In order to study the validity of disintegrative psychosis (DP), the authors compared 13 patients given this diagnosis in childhood with a control group of 39 patients with infantile autism (IA) matched for sex, age, IQ and social class on measures of psychiatric morbidity. Almost the same proportion of the two groups had been admitted to a psychiatric hospital during a 22-year follow-up period. However, there was a slight tendency (statistically nonsignificant) for the DP group to utilize the psychiatric health care system more frequently than the IA group. They had more admissions and stayed longer in hospital than patients with IA suggesting that they had more psychiatric symptoms than the IA group. The original IA diagnoses were confirmed fairly consistently during the follow-up period, while the DP group was given more heterogenous diagnoses. No diagnosis of schizophrenia was made in either group. PMID:10364726

  6. Long-term follow-up after laparoscopic cholecystectomy without routine intraoperative cholangiography.

    PubMed

    Braghetto, I; Debandi, A; Korn, O; Bastias, J

    1998-10-01

    The indications for routine intraoperative cholangiography remain controversial. We present here our recent results concerning the frequency of unknown retained common bile duct stones in 253 consecutive patients who underwent laparoscopic cholecystectomy without intraoperative cholangiography in whom the presence of preoperative choledocholithiasis had been excluded by clinical, biochemical, and ultrasonographic evaluation. These patients were followed up for at least 4 years after surgery with evaluations similar to those made preoperatively. Freedom from symptoms and normal test results were found in 96.8% of patients. Jaundice and abnormal liver function test results were demonstrated in 3.2% of patients, but retained common bile duct stones were found in only 2.3% of patients. We conclude that laparoscopic cholecystectomy without routine intraoperative cholangiography can be performed safely without the discovery of a high percentage of retained common bile duct stones at later follow-up. PMID:9799142

  7. Couples therapy: effectiveness of treatment and long-term follow-up

    Microsoft Academic Search

    Ann-Marie Lundblad; Kjell Hansson

    2006-01-01

    Most couples therapy theories are developed and tested in the USA. In this clinical study, we investigated such therapies in a Swedish context. Over 300 couples were enrolled in the study of whom just under half completed the end-of-treatment assessment and just over 40 per cent a two-year follow-up. At the start, the study group displayed severe problems in marital

  8. Long-term follow-up and late complications following treatment of pediatric urologic disorders.

    PubMed

    Akhavan, Ardavan; Stock, Jeffrey A

    2011-01-01

    Many pediatric urologic disorders have sequelae that may affect patients well into adulthood. Despite adequate treatment, many patients are at risk for progressive urologic deterioration years after surgical reconstruction. While many pediatric urologists follow their patients years after surgery, screening for late complications is a shared responsibility with primary care providers. This article discusses potential late complications and appropriate follow-up for patients who have a history of ureteral reimplantation, pyeloplasty, hypospadias repair, posterior urethral valve ablation, and intestinal interposition. PMID:21095408

  9. Long-Term Follow-Up of Adults with Gender Identity Disorder.

    PubMed

    Ruppin, Ulrike; Pfäfflin, Friedemann

    2015-07-01

    The aim of this study was to re-examine individuals with gender identity disorder after as long a period of time as possible. To meet the inclusion criterion, the legal recognition of participants' gender change via a legal name change had to date back at least 10 years. The sample comprised 71 participants (35 MtF and 36 FtM). The follow-up period was 10-24 years with a mean of 13.8 years (SD = 2.78). Instruments included a combination of qualitative and quantitative methods: Clinical interviews were conducted with the participants, and they completed a follow-up questionnaire as well as several standardized questionnaires they had already filled in when they first made contact with the clinic. Positive and desired changes were determined by all of the instruments: Participants reported high degrees of well-being and a good social integration. Very few participants were unemployed, most of them had a steady relationship, and they were also satisfied with their relationships with family and friends. Their overall evaluation of the treatment process for sex reassignment and its effectiveness in reducing gender dysphoria was positive. Regarding the results of the standardized questionnaires, participants showed significantly fewer psychological problems and interpersonal difficulties as well as a strongly increased life satisfaction at follow-up than at the time of the initial consultation. Despite these positive results, the treatment of transsexualism is far from being perfect. PMID:25690443

  10. Long-Term Follow-Up of Neck Expansion after Endovascular Aortic Aneurysm Repair

    PubMed Central

    Monahan, Thomas S; Chuter, Timothy AM; Reilly, Linda M; Rapp, Joseph H; Hiramoto, Jade S

    2010-01-01

    Objective To determine the rate, extent and clinical significance of neck dilatation after endovascular aneurysm repair (EVAR). Methods Patients who underwent elective EVAR using bifurcated Zenith (Cook, Bloomington, IN) stent-grafts and had at least 48-months of clinical and radiographic follow-up were included in the present study. Computed tomographic images were analyzed on a 3-dimensional workstation (TeraRecon, San Mateo, CA). Neck diameter was measured 10 mm below the most inferior renal artery, in planes orthogonal to the aorta. Nominal stent graft diameter was obtained from implantation records. Results 46 patients met the inclusion criteria. Median follow-up was 59 months (range 48-120 months). Neck dilation occurred in all 46 cases. The rate of neck dilation was greatest at early follow-up intervals. At 48-months, median neck dilation was 5.3 mm (range 2.3-9.8 mm). The extent of neck dilation at 48-months correlated with percentage of stent-graft oversizing (Spearman’s rho 0.61, p<0.001). There were no cases of type I endoleak or migration (> 5 mm). Conclusions Following EVAR with the Zenith stent-graft, the neck dilates until its diameter approximates the diameter of the stent-graft. Neck dilation was not associated with type I endoleak or migration of the stent-graft. PMID:20670774

  11. Long-term follow-up of the effectiveness and safety of inferior turbinectomy.

    PubMed

    Ophir, D; Schindel, D; Halperin, D; Marshak, G

    1992-12-01

    The long-term effectiveness and safety of inferior turbinectomy were assessed in 186 patients who were interviewed and examined 10 to 15 years after surgery (mean 12.3 years). Relief of nasal obstruction was reported by 82 percent of the patients; rhinoscopy showed wide, clean nasal airways in 88 percent. Rhinorrhea was still a problem for 34 percent of patients, and 19 percent were receiving medical treatment for this symptom. Smell acuity had improved in 52 percent of the patients. Before turbinectomy, 32 patients had suffered from bronchial asthma; postoperatively, there was an improvement in 16, and no change in 13; 3 patients reported exacerbation of asthmatic attacks. Atrophic changes of the nasal mucosa and chronic purulent infection were not observed in any of the patients. PMID:1448533

  12. Cured lymphoma patient: guidelines for long-term follow-up

    SciTech Connect

    Connors, J.M.

    1982-07-01

    Successful treatment of lymphoma represents a major achievement of modern medicine. At diagnosis, the major emphasis is placed properly on achieving durable remission. Once treatment has been successful, however, the emphasis must shift to helping the patient resume a normal and productive life. The primary care physician will probably be responsible for the long-term care of these patients. He or she should be alert to the possible disease and therapy-induced problems such patients face (even years after treatment), especially those common problems in which informed intervention is most effective. The approach summarized here can be readily integrated with normal health surveillance measures but should be modified to suit the individual patient and supplemented as new information appears. Use of these guidelines may help the cured lymphoma patient realize maximum benefit from difficult but lifesaving therapy.

  13. Long-term follow-up of the lung transplant patient.

    PubMed

    Laporta Hernández, Rosalía; Lázaro Carrasco, M Teresa; Varela de Ugarte, Andrés; Ussetti Gil, Piedad

    2014-02-01

    Since the outcomes of lung transplants are still poorer than those obtained with others, such as heart, kidney or liver transplants, the challenge for medicine remains focused on prolonging functional graft survival. The procedure triggers significant post-surgical physiopathological changes in the lung parenchyma, the rib cage, the airways and pulmonary circulation. The patient is exposed to risks that must be identified and controlled, such as complications fully or partially attributable to immunosuppressive treatment, including cardiovascular disease, tumors and infections and, of course, chronic graft dysfunction. The patient's prognosis will depend largely on the degree of efficacy in the prevention, early diagnosis and appropriate treatment of possible complications. Accordingly, regardless of how long it is since the transplantation, graft recipients undergo close functional and clinical monitoring. In this article, we will review the functional changes that characterize a lung transplant recipient and the usefulness of the various diagnostic techniques for patient follow-up. PMID:24342666

  14. The Woodlawn mental health studies: tracking children and families for long-term follow-up.

    PubMed Central

    Agrawal, K C; Kellam, S G; Klein, Z E; Turner, J

    1978-01-01

    Elementary school children in a large public urban school system (Chicago) can be tracked into adolescence, together with their families, by using student numbers established by the Chicago Public Schools. This paper reports on the linkage between a psychiatric follow-up study and the data bank of the Chicago Public Schools. The authors were able to find information about the location and grade placement of 87% of an urban ghetto neighborhood's first grade children after a seven to ten-year lapse in contact. The children about whom information was found did not differ from those missing in the early measures of their school achievement and psychological wellbeing. However, first grade measures of school success of failure did relate to grade placement of children ten years later, as did first grade ratings of bizarreness. PMID:626256

  15. Lead intoxication and knee osteoarthritis after a gunshot: long-term follow-up case report

    PubMed Central

    Gameiro, Vinicius Schott; de Araújo, Gabriel Costa Serrão; Bruno, Felipe Motta Moreira

    2013-01-01

    This case is of a man who suffered gunshots and developed saturnism. Projectiles were removed from the abdomen, but one was left in the knee for 14?years. The patient presented with weight loss, headaches, loss of sight, tiredness, cramps, painful joints and trembling. We identified ataxic movements such as intense trembling of the limbs and anaemia. The abdominal pain caused eight internments in different hospitals, and the patient always received the diagnosis of intestinal subocclusion. We removed the bullet and did a wide synovectomy. The patient did not receive a clinical treatment with chelates. The symptoms of lead poisoning ceased, but he developed knee osteoarthritis, during the 7?years of follow-up. PMID:23813998

  16. Long-term follow-up and second malignancies in 487 patients with hairy cell leukaemia.

    PubMed

    Cornet, Edouard; Tomowiak, Cécile; Tanguy-Schmidt, Aline; Lepretre, Stéphane; Dupuis, Jehan; Feugier, Pierre; Devidas, Alain; Mariette, Clara; Leblond, Véronique; Thiéblemont, Catherine; Validire-Charpy, Patricia; Sutton, Laurent; Gyan, Emmanuel; Eisenmann, Jean-Claude; Cony-Makhoul, Pascale; Ysebaert, Loïc; Troussard, Xavier

    2014-08-01

    A large, multicentre, retrospective survey of patients with hairy cell leukaemia (HCL) was conducted in France to determine the frequency of second malignancies and to analyse the long-term effects of the established purine nucleoside analogues (PNAs), cladribine and pentostatin. The survey retrospectively reviewed the medical history of patients and their immediate family, clinical and biological presentation at the time of HCL diagnosis, treatment choice, response to treatment, time to relapse and cause of death. Data were collected for 487 patients with HCL. Of the patients included in the survey, 18% (88/487) had a familial history of cancers, 8% (41/487) presented with malignancies before HCL diagnosis and 10% (48/487) developed second malignancies after HCL was diagnosed. An excess incidence of second malignancies was observed, with a standardized incidence ratio (SIR) of 1·86 (95% confidence interval (CI): 1·34-2·51), with no significant difference between PNAs. For second haematological malignancies alone, the SIR was markedly increased at 5·32 (95% CI: 2·90-8·92). This study highlights the high frequency of cancers in HCL patients and their family members. The frequency of second malignancies is notably increased, particularly for haematological malignancies. The respective role of pentostatin and cladribine in the development of second malignancies is debatable. PMID:24749839

  17. Percutaneous Vertebroplasty in Multiple Myeloma: Prospective Long-Term Follow-Up in 106 Consecutive Patients

    SciTech Connect

    Anselmetti, Giovanni Carlo, E-mail: giovanni.anselmetti@ircc.it; Manca, Antonio, E-mail: anto.manca@gmail.com [Institute for Cancer Research and Treatment, Interventional Radiology Unit (Italy); Montemurro, Filippo, E-mail: filippo.montemurro@ircc.it [Institute for Cancer Research and Treatment, Oncology Unit (Italy); Hirsch, Joshua, E-mail: jahirschmd@yahoo.com [Massachusetts General Hospital, Interventional Neuroradiology (United States); Chiara, Gabriele, E-mail: chiaragabriele@gmail.com [Institute for Cancer Research and Treatment, Interventional Radiology Unit (Italy); Grignani, Giovanni, E-mail: giovanni.grignani@ircc.it; Carnevale Schianca, Fabrizio, E-mail: fabrizio.carnevale@ircc.it; Capaldi, Antonio, E-mail: antonio.capaldi@ircc.it; Rota Scalabrini, Delia, E-mail: delia.rotascalabrini@ircc.it [Institute for Cancer Research and Treatment, Oncology Unit (Italy); Sardo, Elena, E-mail: elena.sardo@ircc.it; Debernardi, Felicino, E-mail: felicino.debernardi@ircc.it [Institute for Cancer Research and Treatment, Anesthesiology Unit (Italy); Iussich, Gabriella, E-mail: gabriellaiussich@yahoo.com [Institute for Cancer Research and Treatment, Interventional Radiology Unit (Italy); Regge, Daniele, E-mail: daniele.regge@ircc.it [Institute for Cancer Research and Treatment, Radiology Unit (Italy)

    2012-02-15

    Purpose: Percutaneous vertebroplasty (PV) is a minimally invasive procedure involving the injection of bone cement within a collapsed vertebral body. Although this procedure was demonstrated to be effective in osteoporosis and metastases, few studies have been reported in cases of multiple myeloma (MM). We prospectively evaluated the safety and efficacy of PV in the treatment of vertebral compression fractures (VCFs) resulting from MM. Materials and Methods: PV was performed in 106 consecutive MM patients who had back pain due to VCFs, the treatment of which had failed conservative therapies. Follow-up (28.2 {+-} 12.1 months) was evaluated at 7 and 15 days as well as at 1, 3, 6, 12, 18, and every 6 months after PV. Visual analog scale (VAS) pain score, opioid use, external brace support, and Oswestry Disability Index (ODI) score were recorded. Results: The median pretreatment VAS score of 9 (range 4-10) significantly (P < 0.001) decreased to 1 (range 0-9) after PV. Median pre-ODI values of 82% (range 36-89%) significantly improved to 7% (range 0-82%) (P < 0.001). Differences in pretreatment and posttreatment use of analgesic drug were statistically significant (P < 0.001). The majority of patients (70 of 81; 86%) did not use an external brace after PV (P < 0.001). Conclusion: PV is a safe, effective, and long-lasting procedure for the treatment of vertebral compression pain resulting from MM.

  18. Long term follow-up of patients with Cushing's disease treated by interstitial irradiation

    SciTech Connect

    Sandler, L.M.; Richards, N.T.; Carr, D.H.; Mashiter, K.; Joplin, G.F.

    1987-09-01

    The first 86 patients with Cushing's disease treated with interstitial irradiation (by needle implantation) as the sole therapy were reviewed. In the 82 patients who were reassessed 1 yr after treatment 63 (77%) achieved remission. This study comprises the outcome and complications in the 54 patients who had a remission and whom we were able to follow. The follow-up period ranged from 3-26 yr (mean, 10.5) from the time of remission. No instance of clinical or radiological relapse has occurred. Of these 54 patients, yttrium-90 alone was used in 32, of whom 12 (37%) required corticosteroid or T4 replacement therapy in a mean time of 3.5 months; in 7 of these 12 we elected to give an ablative dose. Gold-198 alone was used in 15 patients, of whom 7 (47%) developed hypopituitarism in a mean time of 76 months. Both isotopes were used in 7 patients. A diurnal serum cortisol rhythm was found in 28 of the 31 patients who were not receiving corticosteroid therapy. In 5 of the 7 patients with an initially abnormal pituitary fossa, serial radiological studies revealed remodelling in 3. There have been no complications in the last 17 years. Pituitary implantation with yttrium-90 is an effective alternative to transsphenoidal hypophysectomy, with a high remission rate, no recurrence (as yet), no operative complications, and avoidance of hormone replacement in the majority.

  19. Gnathic osteoblastoma: clinicopathologic review of seven cases with long-term follow-up.

    PubMed

    Rawal, Yeshwant B; Angiero, Francesca; Allen, Carl M; Kalmar, John R; Sedghizadeh, Parish P; Steinhilber, Andrew M

    2006-02-01

    The clinical, radiographic and histopathologic features of seven cases of osteoblastoma of the jaw bones were analyzed. The mandible was involved in six cases and a periosteal presentation of the tumor was noted in three cases. Six tumors were symptomatic with pain being the common presentation. The radiographic appearance of the intraosseous tumors varied from well-defined radiolucencies to poorly-defined mixed lesions. A small periosteal tumor was undetectable radiographically. Histopathologically, the tumors exhibited variation in woven bone formation, osteoblastic rimming, lesional maturation as well as interaction of the tumor with surrounding host tissue. Intraosseous tumors were managed with aggressive surgical curettage and periosteal tumors were resected and the underlying bone was curetted down to normal host bone. Follow-up of cases ranged from 2 years to 18 years with no recorded recurrences. Gnathic osteoblastomas offer a unique diagnostic challenge as they resemble other tumors of the jaws including the cementoblastoma, cemento-ossifying fibroma, cemento-osseous dysplasia and most importantly the gnathic osteosarcoma. We stress on the need to correlate the histopathologic findings with clinical and radiographic features to reach an accurate diagnosis. PMID:16129654

  20. Sporadic non-toxic goitre. A long-term follow-up of 36 patients.

    PubMed

    Parker, J L; Ratcliffe, J G; Alexander, W D

    1977-07-01

    Thirty-six patients with non-toxic goitre were reviewed after a mean period of 13 years. Initially 19 patients were iodine deficient (Group I) and 17 had normal plasma inorganic iodine (Group II). In general the iodine deficient patients had larger goitres, developed more complications (26% became hyperthyroid, hypothyroid or required partial thyroidectomy), and required more treatment. There were marked changes in thyroid function tests. In both groups thyroid uptake fell and PII rose though the final PII remained significantly lower in Group I patients. Thyroid and renal iodide clearance fell significantly in Group I patients only. In both groups the final mean total serum T3 levels were abnormally elevated whereas the mean PBI levels did not change significantly during the period of study and the final mean total T4 concentrations were noraml. All goitres became smaller and there were no complications in patients whose goitre became impalpable. No cases of malignancy and no postoperative recurrences of goitre were observed. It is suggested that the incidence of complications in those patients who persist with palpable goitres is sufficent to merit follow-up of this group. PMID:68654

  1. Juvenile Hemochromatosis, Genetic Study and Long-term Follow up after Therapy

    PubMed Central

    Malekzadeh, Masoud M.; Radmard, Amir Reza; Nouroozi, Alireza; Akbari, Mohammad Reza; Amini, Marzie; Navabakhsh, Behrooz; Caleffi, Angela; Pietrangelo, Antonello; Malekzadeh, Reza

    2014-01-01

    BACKGROUND Hereditary hemochromatosis (HH) is a very rare disease in Iran and reported cases are all negative for HFE mutation. We report a family affected by severe juvenile hemochromatosis (JH) with a detailed molecular study of the family members. METHODS We studied a pedigree with siblings affected by juvenile HH and followed them for 3 years. Microsatellite and gene sequencing analysis was performed for all family members. RESULTS Two siblings (the proband and his sister, aged 26 and 30 years, respectively) were found to have clinical findings of JH. The proband’s brother, who presented with hyperpigmentation, died of probable JH at the age of 24 years. Gene sequencing analysis showed that the proband has a homozygote c.265T>C (p.C89R) HJV mutation + a heterozygote c.884T>C (p.V295A) mutation of HFE. The affected proband’s sister presented with the same HJV c.265T>C (p.C89R) homozygote mutation. In addition, we found the HJV c.98-6C>G polymorphic variant in both the sister and proband (homozygote). Sequencing of hepcidin (HAMP), TfR2, and FPN revealed no mutation. CONCLUSION We have shown that molecular analysis of the HH related gene is a powerful tool for reliable diagnosis of JH and, in conjunction with magnetic resonance imaging (MRI) and noninvasive liver stiffness measurement by elastography, is adequate tool for management and follow up of HH. PMID:24872867

  2. The De Vega tricuspid annuloplasty. Perioperative mortality and long term follow-up.

    PubMed

    De Paulis, R; Bobbio, M; Ottino, G; Donegani, E; Di Rosa, E; Casabona, R; Girotto, M; Morea, M

    1990-01-01

    One hundred and fifty-three patients undergoing De Vega tricuspid annuloplasty, with or without other associated cardiac procedures between January, 1979, and June, 1987, were evaluated. There were 136 hospital survivors. The follow-up was 98.1% complete for a mean of 3.7 years/patient. Operative mortality was 11.1%; preoperative NYHA class and length of CPB were significant risk factors of perioperative mortality. The actuarial survival of operative survivors at 9 years was 73.5 +/- 11.8%. There were 7 late cardiac deaths among a total of 12 late deaths. Eleven patients required reoperation (2.1 +/- 0.6% patient-year). In seven patients it was necessary for recurrence of tricuspid regurgitation; six of these had also a mitral prosthesis malfunction or a periprosthetic leak. Residual tricuspid regurgitation was judged as mild, moderate or severe in 29.9%, 11.9% and 4.3% of the patients respectively. De Vega tricuspid annuloplasty is the method of choice for mild and moderate tricuspid insufficiency; in selected cases, with a more severe degree of regurgitation, better results could be achieved with a different surgical approach. PMID:2211807

  3. Liver cirrhosis in cystic fibrosis--therapeutic implications and long term follow up.

    PubMed Central

    Feigelson, J; Anagnostopoulos, C; Poquet, M; Pecau, Y; Munck, A; Navarro, J

    1993-01-01

    Experience gained from liver studies in 450 patients with cystic fibrosis, seen in a 38 year period from 1964 to 1992, is surveyed. Of these, 31 (7%) showed findings that indicated multilobular cirrhosis. There was a slight but not significant male predominance: 19 males against 12 females. Liver disease had its onset during childhood in most cases. The natural course of liver disease and of cirrhosis is protracted. All patients were routinely evaluated by way of: (i) clinical examination, (ii) biochemical studies and specifically estimation of transaminases and gamma glutamyltransferase, and (iii) liver imaging, ultrasonography, and computed tomography. The study aimed to detect early liver disease, that is multilobular cirrhosis and its complications, with a view to optimal introduction of treatment with ursodeoxycholic acid as this drug shows promise for preventing or stabilising the cirrhotic process. Effects of surgical treatment on portal hypertension are surveyed. These include portacaval shunting, partial splenectomy (considered the procedure of choice), liver transplant in the event of liver failure, or a triple transplant (liver, lungs, and heart) if necessary. One triple transplant was successfully performed in a boy of 10 years with a 2 year follow up. Images PMID:8280210

  4. Treatment of band keratopathy by excimer laser phototherapeutic keratectomy: surgical techniques and long term follow up.

    PubMed Central

    O'Brart, D P; Gartry, D S; Lohmann, C P; Patmore, A L; Kerr Muir, M G; Marshall, J

    1993-01-01

    A series of 122 eyes with band keratopathy was treated by excimer laser phototherapeutic keratectomy (PTK), with a mean follow up of over 12.3 months (range 3 to 60 months). A single photoablation zone was used to remove the opacity over the visual axis in smooth surfaced band deposition. In eyes with reduced vision, an improvement was reported in 88% and in a series of 66 eyes mean Snellen visual acuity increased significantly (p < 0.05, t = 2.27). A reduction in glare was reported in 88% and in a series of 17 patients, visual contrast sensitivity (p < 0.01) and measurements of disability glare (p < 0.01) improved postoperatively. The mean hyperopic shift in 32 eyes at 6 months was 1.4 D (range 0-4.25 D). Multiple overlapping ablation zones, with mechanical debulking of large calcium plaques, were used to smooth the irregular corneal surface in eyes with rough bands. Ocular discomfort was improved in 95%. Band keratopathy recurred in nine eyes (8%) within 2 to 30 months (mean 12 months) of surgery, with silicone oil responsible in five eyes. Reablation was necessary in three eyes and performed successfully in all cases. Excimer laser PTK is a safe and effective outpatient treatment for band keratopathy. Images PMID:8280683

  5. [Up-dated ophthalmological screening and follow-up management for long-term antimalarial treatment].

    PubMed

    Rigaudière, F; Ingster-Moati, I; Hache, J-C; Leid, J; Verdet, R; Haymann, P; Rigolet, M-H; Zanlonghi, X; Defoort, S; Le Gargasson, J-F

    2004-02-01

    The early detection of macular toxicity linked to long-term antimalarial treatment requires regular ophthalmological screening based on patients'classification based on their results compared to successive controls. Patients are classified as "low risk" with screening every 18 months if all of the following criteria are met: age under 65 years, no associated renal, hepatic or retinal disease, treatment for less than 5 years, dose less than or equal to 6,5mg/kg/d for hydroxychloroquine and 3mg/kg/d for chloroquine (for a lean patient's weight); "at risk, without fundus findings" with screening every 12 months if one of the following criteria is met: age over 65 years (at the start of or during treatment), antimalarial treatment for more than 5 years, daily dose higher than recommended, presence of renal and/or hepatic disease; "at risk, with fundus findings" with screening every 6 months if a retinal dysfunction has been detected and even if treatment is established or followed. Screening consists of an in-depth clinical examination and at least two complementary tests of macular function: color vision (desaturated-Panel-D15 test) and/or static macular perimetry (central 10 degrees) and/or macular electroretinography (pattern ERG/multifocal ERG). If any changes or anomalies are found between two successive check-ups, the state of the retina can be assessed by angiography and global retinal function by full-field-ERG and electro-oculogram (EOG). The progression from one check-up to the next decides whether a course of treatment will be followed. PMID:15029052

  6. Will time heal? A long-term follow-up of severe disorders of consciousness

    PubMed Central

    Steppacher, Inga; Kaps, Michael; Kissler, Johanna

    2014-01-01

    Objective Little is known about the long-term outcome of patients with disorders of consciousness (DOCs) such as unresponsive wakefulness syndrome (UWS) or minimally conscious state (MCS). We describe the disease course of a large group of DOC patients 2–14 years after brain damage. Methods In 102 patients (59 UWS, 43 MCS), clinical and demographic variables from disorder onset were related to the patients' outcomes 2–14 years after discharge. Etiology, age at event, time since onset, gender, and home care versus institutional care were assessed as predictors and similarities and differences between UWS and MCS determined. Results Seventy-one percent of the patients had passed away or showed no improvement in condition. Twenty-nine percent regained consciousness and developed some communicative capacities. The time a syndrome persisted did not predict clinical outcome in either condition. Six patients regained consciousness after more than 3 years. Of these, five had been UWS (42% of recovered UWS, three traumatic origins, one tumor, one hypoxia) and one MCS (5% of recovered MCS, traumatic origin). In UWS, younger patients, those cared for at home, and in tendency those with traumatic origins, were more likely to recover. In MCS, no reliable outcome predictors were found. Interpretation Current predictors are too vague for single patient predictions. This study identifies a subgroup of late-recovering patients, casting doubt on the 12-month boundary, after which UWS is stated to be permanent. Routine reexamination, use of more reliable outcome predictors and research determining optimal care settings are needed to inform the crucial decisions made for these patients. PMID:25356410

  7. Long-term follow-up of salvage radiotherapy in Hodgkin's lymphoma after chemotherapy failure

    SciTech Connect

    Campbell, Belinda [Department of Radiation Oncology, Peter MacCallum Cancer Centre, St. Andrew's Place, East Melbourne, Victoria (Australia); Wirth, Andrew [Department of Radiation Oncology, Peter MacCallum Cancer Centre, St. Andrew's Place, East Melbourne, Victoria (Australia)]. E-mail: andrew.wirth@petermac.org; Milner, Alvin [Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, St. Andrew's Place, East Melbourne, Victoria (Australia); Di Iulio, Juliana [Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, St. Andrew's Place, East Melbourne, Victoria (Australia); MacManus, Michael [Department of Radiation Oncology, Peter MacCallum Cancer Centre, St. Andrew's Place, East Melbourne, Victoria (Australia); Ryan, Gail M. [Department of Radiation Oncology, Peter MacCallum Cancer Centre, St. Andrew's Place, East Melbourne, Victoria (Australia)

    2005-12-01

    Purpose: To evaluate the long-term results of salvage radiotherapy (SRT) for Hodgkin's lymphoma after chemotherapy failure. Methods and Materials: We reviewed 81 patients undergoing SRT for persistent or recurrent Hodgkin's lymphoma after chemotherapy; 19 also received conventional-dose salvage chemotherapy. Results: At SRT, the median patient age was 31 years. Of the 81 patients, 81% had Stage I-II, 25.9% had B symptoms, 14.8% had bulky disease, and 7.4% had extranodal disease. A less than a complete response (CR) to the last chemotherapy regimen occurred in 47%. SRT was generally limited to one side of the diaphragm, and the median dose was 36 Gy. After SRT, 75% of patients achieved a CR, with 82% retaining durable in-field control. In-field failure was associated with less than a CR to the last chemotherapy regimen (p = 0.0287). Most failures were at distant sites, with 60% in previously involved sites. The 10-year freedom from treatment failure and overall survival rates were 32.8% and 45.7%, respectively. The adverse prognostic factors for freedom from treatment failure were age >50 years (p < 0.001), B symptoms (p < 0.001), extranodal disease (p = 0.012), and less than a CR to the last chemotherapy regimen (p = 0.001). The adverse prognostic factors for overall survival were male gender (p = 0.034), age >50 years (p < 0.001), B symptoms (p = 0.002), and less than a CR to the last chemotherapy regimen (p = 0.002). Favorable cohorts had a 10-year freedom from treatment failure rate of 51% and overall survival rate of 92%. Conclusions: Salvage radiotherapy is effective for selected patients with Hodgkin's lymphoma after chemotherapy failure and should be considered for incorporation into salvage programs.

  8. Atypical regressive corneal endothelial cysts in long-term confocal follow-up: a case report.

    PubMed

    Smedowski, Adrian; Wylegala, Edward; Wojcik, Lukasz; Tarnawska, Dorota

    2015-03-01

    Corneal endothelium is formed of 1 layer of mitochondria-rich cubic cells whose main role is to maintain corneal transparency. Corneal endothelial disorders represent group of both inherited and noninherited and may affect proper vision.A 36-year-old male patient with suspicion of corneal endothelial dystrophy underwent visual acuity, intraocular pressure, the basic slit-lamp examination, anterior segment optical coherence tomography (AS-OCT) (Visante, Carl Zeiss Meditec, Dublin, CA), and corneal confocal microscopy in vivo (Rostock Cornea Module, Heidelberg Engineering Retina Tomograph III, Heidelberg, Germany). During the 3-year observation the patient reported symptoms mainly in the right eye. Slit-lamp examination revealed endothelial changes, much more pronounced in the right eye. Examination by the AS-OCT Visante showed hyperreflective dots within the right corneal endothelium. In order to assess endothelial cell morphology, analysis using corneal confocal microscopy in vivo was performed. Scans revealed presence of single endothelial deposits and severe cell changes of different morphology in both eyes. In the right eye, less pronounced changes of the polymorphic structure-polygonal guttas in different stages, linear and branched loss with "nuclear-like" formations and accompanying sediments. In the left eye, severe homomorphous polygonal "guttas-like" changes with "nuclear-like" formations were observed. Endothelial cysts' features were dynamically changing during follow-up time with different effects on the patient's clinical state.Corneal confocal microscopy allows accurate imaging of the endothelial cells and their detailed characteristics. Structural changes within the endothelial cells are not always proportional to visual acuity and slit-lamp image. The presented case is an example of an unusual corneal endothelial syndrome with probably nondystrophic background due to observed dynamic state with regressive tendency. PMID:25738472

  9. Surgery for tricuspid insufficiency: long-term follow-up after De Vega annuloplasty.

    PubMed

    Holper, K; Haehnel, J C; Augustin, N; Sebening, F

    1993-02-01

    Between 1975 and 1991, 97 consecutive patients underwent De Vega tricuspid annuloplasty either isolated or in combination with mitral, aortic, or mitral and aortic valve procedures. Preoperatively 96.9% of the patients were in New York Heart Association functional class III or IV. Causes of tricuspid insufficiency were functional tricuspid ring dilatation and a combination of dilatation and different organic tricuspid valve lesions. There were 17 early deaths (17.5%), primarily due to cardiac failure, none was related to the tricuspid annuloplasty. 80 perioperative survivors have been followed up for a mean of 4.7 +/- 4.1 years with a total of 462 cumulative patient-years. Actuarial 5-, 10-, and 15-year survival rates, including early deaths, were 64% +/- 5%, 48 +/- 6%, and 26% +/- 10%. Recurrence of tricuspid regurgitation was rated as moderate in 15% and severe in 18.8%. Ten patients required reoperation (2.2%/patient-year), of whom 8 were associated with tricuspid regurgitation (1.7%/patient-year). Although in all patients but one the De Vega annuloplasty was intact, the tricuspid ring was dilated; 4 patients had additional tricuspid organic valve lesions. 6 of the 8 patients had concomitant mitral valve or mitral prosthesis dysfunction. 26 patients died late (5.6%/patient-year) due to chronic cardiac failure in 50% and after reoperation in 7% of the patients. 4 patients had implantation of a permanent pacemaker (0.9%/patient-year). 54 patients (67.5%) are still alive, with 43% having no and 17.5% having only mild residual tricuspid regurgitation. De Vega annuloplasty is indicated with tricuspid insufficiency due to functional ring dilatation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8367851

  10. Seizures and epilepsy in Sotos syndrome: analysis of 19 Caucasian patients with long-term follow-up.

    PubMed

    Nicita, Francesco; Ruggieri, Martino; Polizzi, Agata; Mauceri, Laura; Salpietro, Vincenzo; Briuglia, Silvana; Papetti, Laura; Ursitti, Fabiana; Grosso, Salvatore; Tarani, Luigi; Segni, Maria; Savasta, Salvatore; Parisi, Pasquale; Verrotti, Alberto; Spalice, Alberto

    2012-06-01

    Sotos syndrome (SS) is an overgrowth syndrome characterized by typical facial appearance, learning disability, and macrocephaly as cardinal diagnostic features. Febrile (FS) and afebrile seizures are reported in 9-50% of cases. There is no evidence that patients with SS and FS later develop epilepsy, and no studies have investigated the electroclinical features and the long-term outcome in epileptic SS patients. The authors report a series of 19 SS patients with FS and/or epilepsy during childhood and a long-term follow-up. More than half of FS evolved to epilepsy. Temporal lobe seizures were recorded in 40% of patients with SS. Seizures were easy to control with common antiepileptic drugs in almost all patients. A careful neurologic evaluation is useful for SS patients, since seizures are an important finding among people with this overgrowth syndrome. PMID:22352460

  11. Hepatobiliary complications of alveolar echinococcosis: A long-term follow-up study

    PubMed Central

    Graeter, Tilmann; Ehing, Franziska; Oeztuerk, Suemeyra; Mason, Richard Andrew; Haenle, Mark Martin; Kratzer, Wolfgang; Seufferlein, Thomas; Gruener, Beate

    2015-01-01

    AIM: To determine the long-term hepatobiliary complications of alveolar echinococcosis (AE) and treatment options using interventional methods. METHODS: Included in the study were 35 patients with AE enrolled in the Echinococcus Multilocularis Data Bank of the University Hospital of Ulm. Patients underwent endoscopic intervention for treatment of hepatobiliary complications between 1979 and 2012. Patients’ epidemiologic data, clinical symptoms, and indications for the intervention, the type of intervention and any additional procedures, hepatic laboratory parameters (pre- and post-intervention), medication and surgical treatment (pre- and post-intervention), as well as complications associated with the intervention and patients‘ subsequent clinical courses were analyzed. In order to compare patients with AE with and without history of intervention, data from an additional 322 patients with AE who had not experienced hepatobiliary complications and had not undergone endoscopic intervention were retrieved and analyzed. RESULTS: Included in the study were 22 male and 13 female patients whose average age at first diagnosis was 48.1 years and 52.7 years at the time of intervention. The average time elapsed between first diagnosis and onset of hepatobiliary complications was 3.7 years. The most common symptoms were jaundice, abdominal pains, and weight loss. The number of interventions per patient ranged from one to ten. Endoscopic retrograde cholangiopancreatography (ERCP) was most frequently performed in combination with stent placement (82.9%), followed by percutaneous transhepatic cholangiodrainage (31.4%) and ERCP without stent placement (22.9%). In 14.3% of cases, magnetic resonance cholangiopancreatography was performed. A total of eight patients received a biliary stent. A comparison of biochemical hepatic function parameters at first diagnosis between patients who had or had not undergone intervention revealed that these were significantly elevated in six patients who had undergone intervention. Complications (cholangitis, pancreatitis) occurred in six patients during and in 12 patients following the intervention. The average survival following onset of hepatobiliary complications was 8.8 years. CONCLUSION: Hepatobiliary complications occur in about 10% of patients. A significant increase in hepatic transaminase concentrations facilitates the diagnosis. Interventional methods represent viable management options. PMID:25945006

  12. Impact of diabetes on long term follow-up of elderly patients with chronic total occlusion post percutaneous coronary intervention

    PubMed Central

    Liu, Wei; Wagatsuma, Kenji; Nii, Hideo; Toda, Mikihito; Amano, Hideo; Uchida, Yasuto

    2013-01-01

    Background The prognosis of elderly patients with chronic total occlusion (CTO) and diabetes mellitus (DM) treated with percutaneous coronary intervention (PCI) is not known. Objective To investigate the effect of diabetes on long-term follow-up of CTO after PCI in elderly patients. Methods A total of 153 elderly patients (age > 65 years old) with CTO lesions which were successfully treated with PCI were enrolled. Fifty one patients with diabetes and 102 without diabetes were compared for long-term outcomes (mean follow up: 36 ± 12 months). Major adverse cardiac events (MACE) which include death, myocardial infarction or target lesion revascularization (TLR) were considered as a combined endpoint. Results The combined endpoint occurred in 29.4% of diabetes patients, and 11.3% of the patients without diabetes (P < 0.05). The Cox proportional hazards model identified: drug eluting stent (DES) or bare metal stent (BMS) (HR: 0.13, 95% confidence interval (95% CI): 0.03–0.62, P = 0.004), DM (HR: 6.69, 95% CI: 1.62–15.81, P = 0.01) and final minimal lumen diameter (MLD) (HR: 0.37, 95% CI: 0.13–0.90, P = 0.03 ) as independent predictors of MACE, DM with renal impairment (HR: 6.64, 95% CI: 1.32–33.36, P = 0.02), HBA1C on admission (HR: 1.79, 95% CI: 1.09–2.94, P = 0.02), as independent predictors of MACE at long term follow-up. Conclusions The study demonstrates that DM is a predictive factor for MACE in elderly CTO patients treated with PCI, type of stent, final minimal lumen diameter and DM with renal impairment, and HBA1C level on admission are predictors of MACE. PMID:23610569

  13. Long-term follow-up of thalamic deep brain stimulation for essential tremor – patient satisfaction and mortality

    PubMed Central

    2014-01-01

    Background Ventral intermediate thalamic nucleus (VIM) deep brain stimulation (DBS) is an effective treatment for tremor, but there is limited data on long-term efficacy and mortality after VIM-DBS. Here we report the analysis of patient satisfaction and mortality in all patients treated in our center 1996–2010 with VIM-DBS for essential tremor (ET). Methods Forty-six consecutive patients were included in this study. Medical records were reviewed, and a follow-up questionnaire was sent to all surviving patients. Results Seventy percent of all possible participants (26 patients) answered the questionnaire. Follow-up time for the responding patients was median 6.0 years (2–16). Median self-reported score on visual analogue scale of the initial postoperative effect on tremor was 8.5 (0.1–10), with a significant reduction to 7.4 (0–10) at follow-up (p?=?0.001). Patients reported a median score of 10 (0–10) for overall patient satisfaction with VIM-DBS treatment. Eight patients (17%) died after median 8.9 years (0.6–15) after surgery, at median age 77.4 years (70–89). One patient (2%) committed suicide seven months after the operation. Calculated standard mortality ratio among ET patients was 1.3 (CI 0.6–2.6), similar to the general population. Conclusion We found no significant increase in mortality in this cohort of VIM-DBS operated ET patients compared to the general population in Norway. The patients reported high long-term satisfaction and continuing effect of VIM-DBS on tremor even after many years. VIM-DBS therefore seems to be an effective symptomatic long-term treatment of ET. However, one patient committed suicide. Only one other suicide has previously been reported after VIM-DBS. It is therefore still unclear whether VIM-DBS increases suicide risk. PMID:24903550

  14. PTA of Infrapopliteal Arteries: Long-term Clinical Follow-up and Analysis of Factors Influencing Clinical Outcome

    SciTech Connect

    Peregrin, Jan H., E-mail: jape@medicon.cz; Koznar, Boris; Kovac, Josef; Lastovickova, Jarmila; Novotny, Jiri; Vedlich, Daniel [Institute for Clinical and Experimental Medicine, Department of Diagnostic and Interventional Radiology (Czech Republic); Skibova, Jelena [Institute for Clinical and Experimental Medicine, Department of Statistics (Czech Republic)

    2010-08-15

    This study was a retrospective analysis of patients with CLI who underwent infrapopliteal percutaneous transluminal angioplasty (PTA). The main goal was to evaluate clinical and morphological factors that influence the clinical outcome of PTA in long-term follow-up. A total of 1,445 PTA procedures were performed in 1,268 patients. Main indications for PTA included gangrene, nonhealing ulcers, or rest pain. The mean number of treated arteries was 1.77 artery/limb, and the majority of lesions were type TASC D. The technical success rate of PTA was 89% of intended-to-treat arteries. The main criterion of clinical success was functional limb salvage (LS). One-year follow-up involved 1,069 limbs. Primary and secondary 1-year LS rates were 76.1 and 84.4%, respectively. The effect of clinical and morphological parameters on the 1-year LS was that the only associated disease with an adverse effect on LS rate was DM combined with dialysis. Regarding limb preprocedural status, gangrene was clearly a negative predictor. The most important factor affecting LS was the number of patent arteries post-PTA: patients with 0, 1, 2, and 3 patent arteries had 1-year primary LS rates of 56.4, 73.1, 80.4, and 83%, respectively. Long-term follow-up of LS rates demonstrated secondary LS rates of 84.4, 78.8, and 73.3% at 1, 5, and 10 years. Every effort should be made to perform PTA for as many arteries as possible, even if TASC D type, to improve clinical outcome. Our study shows that repeat PTA is capable of keeping the long-term LS rate close to 75%.

  15. Long-term outcome of slipped capital femoral epiphysis: a 38-year follow-up of 66 patients

    Microsoft Academic Search

    Anders Wensaas; Svein Svenningsen; Terje Terjesen

    2011-01-01

    Purpose  The purpose of this retrospective study was to evaluate the long-term outcome of different methods of treatment in slipped\\u000a capital femoral epiphysis (SCFE), to find risk factors for poor outcome, and to assess whether prophylactic fixation is indicated.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Sixty-six patients (76 hips) treated for SCFE with a mean follow-up of 38 years (range 21–57 years) were evaluated. All except\\u000a seven patients had

  16. Simplified treatment and long term follow-up for stuttering in adults: a study of two cases.

    PubMed

    Miltenberger, R G; Wagaman, J R; Arndorfer, R E

    1996-06-01

    A simplified treatment for stuttering, involving awareness and competing response training, was implemented with two adult stutterers. The procedures resulted in a decrease in stuttering during reading and conversation for both subjects, although only one subject achieved the criterion of less than 3% stuttered words. Long-term follow up (1.5 years and 2 years 3 months) indicated that gains were maintained by one subject while stuttering increased somewhat for the other subject. Both subjects rated the treatment as acceptable and credible and indicated satisfaction with the results. Social validity ratings indicated greatly improved fluency from baseline to post-treatment. PMID:8894917

  17. Clinical conditions of long-term cure in childhood-onset epilepsy: a 45-year follow-up study.

    PubMed

    Sillanpää, Matti; Saarinen, Maiju; Schmidt, Dieter

    2014-08-01

    Clinical conditions of long-term cure in childhood-onset epilepsy, defined as sustained remission off antiepileptic drug (AED) treatment, are not well known. To address that clinically important question, we determined clinical factors predictive of long-term seizure cure in a population-based cohort of 133 patients followed up since their first seizure before the age of 16 years. At the end of the 45-year follow-up (mean=39.8, median=44, range=11-47), 81 (61%) of the 133 patients had entered at least 5-year remission off AEDs, meeting our definition of cure. The 81 patients were seizure-free off AEDs for a mean of 34.4 (median=38, range=6-46) years and 59 (73%) of the 81 patients following the first standard medication until the end of follow-up (mean=36.5, median=39, range=14-46 years). Four independent factors were found to be associated with cure compared with having seizures while on AEDs: seizure frequency less than weekly during the first 12 months of AED treatment (p=0.002), pretreatment seizure frequency less than weekly (p=0.002), higher IQ (>70; p=0.021), and idiopathic or cryptogenic vs. symptomatic etiology (p=0.042). Patients with seizure frequency of less than once a week during early treatment and idiopathic etiology had a ninefold chance to of being cured since the onset of the first adequate antiepileptic therapy until the end of follow-up compared with patients who a symptomatic etiology had at least weekly seizures while on AEDs (RR=8.7, 95% CI=2.0-37.0; p<0.001). In conclusion, IQ, etiology, and seizure frequencies both in the first year of AED treatment and prior to medication appear to be clinical predictors of cure in childhood-onset epilepsy. PMID:24975821

  18. Long-term follow-up of internet-delivered exposure and mindfulness based treatment for irritable bowel syndrome.

    PubMed

    Ljótsson, Brjánn; Hedman, Erik; Lindfors, Perjohan; Hursti, Timo; Lindefors, Nils; Andersson, Gerhard; Rück, Christian

    2011-01-01

    We conducted a follow-up of a previously reported study of internet-delivered cognitive behavior therapy (CBT) for IBS, based on exposure and mindfulness exercises (Ljótsson et al. (2010). Internet-delivered exposure and mindfulness based therapy for irritable bowel syndrome - a randomized controlled trial. Behaviour Research and Therapy, 48, 531-539). Seventy-five participants from the original sample of 85 (88%) reported follow-up data at 15-18 months (mean 16.4 months) after completing treatment. The follow-up sample included participants from both the original study's treatment group and waiting list after it had been crossed over to treatment. Intention-to-treat analysis showed that treatment gains were maintained on all outcome measures, including IBS symptoms, quality of life, and anxiety related to gastrointestinal symptoms, with mainly large effect sizes (within-group Cohen's d=0.78-1.11). A total of fifty participants (59% of the total original sample; 52% of the original treatment group participants and 65% of the original waiting list participants) reported adequate relief of symptoms. Improvements at follow-up were more pronounced for the participants that had completed the full treatment and maintenance of improvement did not seem to be dependent on further treatment seeking. This study suggests that internet-delivered CBT based on exposure and mindfulness has long-term beneficial effects for IBS-patients. PMID:21092934

  19. Long-Term Follow-Up of Nonoperatively and Operatively Treated Acute Primary Patellar Dislocation in Skeletally Immature Patients

    PubMed Central

    Mikkelsen, Christina; Janarv, Per-Mats

    2014-01-01

    Purpose. The present study reports a long-term follow-up of acute primary patellar dislocation in patients with open physes. The purpose of the study was to evaluate knee function and recurrence rates after surgical and nonsurgical treatment of patellar dislocation. Methods. A total of 51 patients, including 29 girls and 22 boys, who were 9–14 years of age at the time of injury, were retrospectively evaluated. The minimum follow-up time was 5 years. Thigh muscle torque, range of motion, the squat test, the knee injury and osteoarthritis outcome score (KOOS), the Kujala score, and the recurrence rate were registered. Radiological predisposing factors at the time of injury were determined. Results. Quality of life and sports/recreation were the most affected subscales, according to KOOS, and a reduced Kujala score was also observed in all treatment groups. The surgically treated patients had a significantly lower recurrence rate. Those patients also exhibited reduced muscle performance, with a hamstring to quadriceps ratio (H/Q) of 1.03. The recurrence rate was not correlated with knee function. Conclusions. Patellar dislocation in children influences subjective knee function in the long term. Surgery appears to reduce the recurrence rate, but subjective knee function was not restored. PMID:25485299

  20. Long-Term Follow-up of Foamy Viral Vector-Mediated Gene Therapy for Canine Leukocyte Adhesion Deficiency

    PubMed Central

    Bauer, Thomas R; Tuschong, Laura M; Calvo, Katherine R; Shive, Heather R; Burkholder, Tanya H; Karlsson, Eleanor K; West, Robert R; Russell, David W; Hickstein, Dennis D

    2013-01-01

    The development of leukemia following gammaretroviral vector-mediated gene therapy for X-linked severe combined immunodeficiency disease and chronic granulomatous disease (CGD) has emphasized the need for long-term follow-up in animals treated with hematopoietic stem cell gene therapy. In this study, we report the long-term follow-up (4–7 years) of four dogs with canine leukocyte adhesion deficiency (CLAD) treated with foamy viral (FV) vector-mediated gene therapy. All four CLAD dogs previously received nonmyeloablative conditioning with 200 cGy total body irradiation followed by infusion of autologous, CD34+ hematopoietic stem cells transduced by a FV vector expressing canine CD18 from an internal Murine Stem Cell Virus (MSCV) promoter. CD18+ leukocyte levels were >2% following infusion of vector-transduced cells leading to ongoing reversal of the CLAD phenotype for >4 years. There was no clinical development of lymphoid or myeloid leukemia in any of the four dogs and integration site analysis did not reveal insertional oncogenesis. These results showing disease correction/amelioration of disease in CLAD without significant adverse events provide support for the use of a FV vector to treat children with leukocyte adhesion deficiency type 1 (LAD-1) in a human gene therapy clinical trial. PMID:23531552

  1. Long-Term Serological Follow-Up of Acute Q-Fever Patients after a Large Epidemic

    PubMed Central

    Wielders, Cornelia C. H.; van Loenhout, Joris A. F.; Morroy, Gabriëlla; Rietveld, Ariene; Notermans, Daan W.; Wever, Peter C.; Renders, Nicole H. M.; Leenders, Alexander C. A. P.; van der Hoek, Wim; Schneeberger, Peter M.

    2015-01-01

    Background Serological follow-up of acute Q-fever patients is important for detection of chronic infection but there is no consensus on its frequency and duration. The 2007–2009 Q-fever epidemic in the Netherlands allowed for long-term follow-up of a large cohort of acute Q-fever patients. The aim of this study was to validate the current follow-up strategy targeted to identify patients with chronic Q-fever. Methods A cohort of adult acute Q-fever patients, diagnosed between 2007 and 2009, for whom a twelve-month follow-up sample was available, was invited to complete a questionnaire and provide a blood sample, four years after the acute episode. Antibody profiles, determined by immunofluorescence assay in serum, were investigated with a special focus on high titres of IgG antibodies against phase I of Coxiella burnetii, as these are considered indicative for possible chronic Q-fever. Results Of the invited 1,907 patients fulfilling inclusion criteria, 1,289 (67.6%) were included in the analysis. At any time during the four-year follow-up period, 58 (4.5%) patients were classified as possible, probable, or proven chronic Q-fever according to the Dutch Q-fever Consensus Group criteria (which uses IgG phase I ?1:1,024 to as serologic criterion for chronic Q-fever). Fifty-two (89.7%) of these were identified within the first year after the acute episode. Of the six patients that were detected for the first time at four-year follow-up, five had an IgG phase I titre of 1:512 at twelve months. Conclusions A twelve-month follow-up check after acute Q-fever is recommended as it adequately detects chronic Q-fever in patients without known risk factors. Additional serological and clinical follow-up is recommended for patients with IgG phase I ?1:512, as they showed the highest risk to progress to chronic Q-fever. PMID:26161658

  2. The Long-Term Clinical Follow-Up and Natural History of Men with Adult-Onset Idiopathic Hypogonadotropic Hypogonadism

    PubMed Central

    Dwyer, Andrew A.; Hayes, Frances J.; Plummer, Lacey; Pitteloud, Nelly; Crowley, William F.

    2010-01-01

    Context and Objective: Adult-onset idiopathic hypogonadotropic hypogonadism (AHH) is a rare disorder characterized by an isolated failure of gonadotropin secretion occurring after an otherwise normal sexual maturation in men. This study aims to examine the etiology and long-term natural history of this disorder. Design and Setting: Long-term follow up, including detailed clinical, biochemical, and genetic examinations, were performed and compared with those at diagnosis. Patients: Patients included 10 men with AHH [serum testosterone (T) <125 ng/dl]. Interventions: Overnight neuroendocrine studies, semen fluid analyses, and genetic screening were performed (KAL1, FGFR1, PROK2, PROKR2, NELF, TAC3, TACR3, and GNRH1) over a decade of longitudinal follow up. Results: Follow-up evaluations were conducted 10.6 ± 5.9 yr after initial studies and revealed that the clinical characteristics and seminal fluid analyses of AHH men (body mass index, 28.8 ± 4.1 vs. 27.0 ± 4.3 kg/m2; testicular volume, 18 ± 6 vs. 19 ± 6 ml) do not change over a decade with no spontaneous reversals. Several men exhibited some variability in their endogenous GnRH-induced LH secretory patterns, including emergence of endogenous pulsatility in three individuals. However, all remained hypogonadal (T ?130 ng/dl). A single heterozygous DNA sequence change in PROKR2 (V317L) was identified, although this rare sequence variant did not prove to be functionally abnormal in vitro. Seven days of pulsatile GnRH therapy in this subject nearly normalized his serum T, supporting that the site of the defect is hypothalamic and not pituitary. Conclusions: 1) AHH in men appears to be a long-lasting condition. 2) Although minor changes in the abnormal pattern of endogenous GnRH-induced LH secretion occurred in some AHH patients, all remained frankly hypogonadal. PMID:20591981

  3. Long-term follow-up of lung biodistribution and effect of instilled SWCNTs using multiscale imaging techniques

    NASA Astrophysics Data System (ADS)

    Faraj, Achraf Al; Bessaad, Amine; Cieslar, Katarzyna; Lacroix, Ghislaine; Canet-Soulas, Emmanuelle; Crémillieux, Yannick

    2010-04-01

    Due to their distinctive properties, single-walled carbon nanotubes (SWCNTs) are being more and more extensively used in nanotechnology, with prospects in nanomedicine. It would therefore appear essential to develop and apply appropriate imaging tools for detecting and evaluating their biological impacts with the prospect of medical applications or in the situation of accidental occupational exposure. It has been shown recently that raw SWCNTs with metallic impurities can be noninvasively detected in the lungs by hyperpolarized 3helium (HP-3He) MRI. Moreover raw and purified SWCNTs had no acute biological effect. The purpose of the present longitudinal study was to investigate long-term follow-up by imaging, as well as chronic lung effects. In a 3-month follow-up study, multiscale imaging techniques combining noninvasive HP-3He and proton (H) MRI to ex vivo light (histopathological analysis) and transmission electron microscopy (TEM) were used to assess the biodistribution and biological effects of intrapulmonary instilled raw SWCNTs. Specific in vivo detection of carbon nanotubes with MRI relied on their intrinsic metal impurities. MRI also has the ability to evaluate tissue inflammation by the follow-up of local changes in signal intensity. MRI and ex vivo microscopy techniques showed that granulomatous and inflammatory reactions were produced in a time and dose dependent manner by instilled raw SWCNTs.

  4. Medulloblastoma: Long-term follow-up of patients treated with electron irradiation of the spinal field

    SciTech Connect

    Gaspar, L.E.; Dawson, D.J.; Tilley-Gulliford, S.A.; Banerjee, P. (London Regional Cancer Centre, Ontario (Canada))

    1991-09-01

    Thirty-two patients with posterior fossa medulloblastoma underwent treatment with electron irradiation to the spinal field. The 5- and 10-year actuarial survival rates were 57% and 50%, respectively. Late complications observed in the 15 patients followed up for more than 5 years were short stature (six patients), decreased sitting-standing height ratio (four patients), scoliosis (two patients), poor school performance (seven patients), xerostomia (one patient), esophageal stricture (one patient), pituitary dysfunction (four patients), primary hypothyroidism (one patient), bilateral eighth-nerve deafness (one patient), and carcinoma of the thyroid (one patient). Complications following treatment with electrons to a spinal field are compared with reported complications following treatment with photons to the spinal field. Although short-term reactions were minimal, the authors found no difference in late complications. More sophisticated treatment planning may show such a long-term benefit in the future.

  5. Idiopathic verapamil-responsive left ventricular tachycardia: clinical characteristics and long-term follow-up of 33 patients.

    PubMed

    Gaita, F; Giustetto, C; Leclercq, J F; Haissaguerre, M; Riccardi, R; Libero, L; Baralis, G; Brusca, A; Coumel, P; Warin, J F

    1994-09-01

    Long-term prognosis, pharmacological prophylaxis and transcatheter ablation in a large group of patients with idiopathic verapamil-responsive left ventricular tachycardia (IVRLVT) are reported in this study. Thirty-three patients with a mean age of 27 +/- 16 years at their first IVRLVT episode, were studied retrospectively. Ventricular tachycardia was of the right bundle branch block morphology in all cases, with left axis deviation in 29 and right axis deviation in five (one patient had the two morphologies). Mitral valve prolapse was present in four patients; no heart disease was found in the remaining 29. Ventricular tachycardia could be electrophysiologically induced in 90% of the patients; Holter monitoring showed only sporadic ventricular extrasystoles in 76%; late potentials were found in 33% of the cases. At the end of a follow-up of 5.7 +/- 4.7 years, no patient had died. Thirty-one patients (94%) received a mean of 2.5 +/- 1.2 drugs; beta-blockers were effective in 71% of the cases, verapamil in 25%, class 1 drugs in 22%, class 3 drugs in 18%. Two patients who never received prophylaxis and four in whom it was stopped, were controlled with verapamil in case of recurrence. Six patients underwent catheter ablation; two with DC shock in whom it was successful in one, and four with radiofrequency energy, with a total success rate. The good prognosis of IVRLVT has been confirmed in a long-term follow-up; a new finding is the high efficacy of beta-blockers for prophylaxis. Radiofrequency transcatheter ablation is an effective and safe therapy for patients with symptoms not controlled by drug treatment. PMID:7982427

  6. Stereotactic LINAC-Radiosurgery for Glomus Jugulare Tumors: A Long-Term Follow-Up of 27 Patients

    PubMed Central

    El Majdoub, Faycal; Hunsche, Stefan; Igressa, Alhadi; Kocher, Martin; Sturm, Volker; Maarouf, Mohammad

    2015-01-01

    Background The optimal treatment of glomus jugulare tumors (GJTs) remains controversial. Due to the critical location, microsurgery still provides high treatment-related morbidity and a decreased quality of life. Thus, we performed stereotactical radiosurgery (SRS) for the treatment of GJTs and evaluated the long-term outcome. Methods Between 1991 and 2011, 32 patients with GJTs underwent SRS using a linear accelerator (LINAC) either as primary or salvage therapy. Twenty-seven patients (median age 59.9 years, range 28.7–79.9 years) with a follow-up greater than five years (median 11 years, range 5.3–22.1 years) were selected for retrospective analysis. The median therapeutic single dose applied to the tumor surface was 15 Gy (range 11–20 Gy) and the median tumor volume was 9.5 ml (range 2.8–51 ml). Results Following LINAC-SRS, 10 of 27 patients showed a significant improvement of their previous neurological complaints, whereas 12 patients remained unchanged. Five patients died during follow-up due to old age or other, not treatment-related reasons. MR-imaging showed a partial remission in 12 and a stable disease in 15 patients. No tumor progression was observed. The actuarial overall survival rates after five, ten and 20 years were 100%, 95.2% and 79.4%, respectively. Conclusions Stereotactic LINAC-Radiosurgery can achieve an excellent long-term tumor control beside a low rate of morbidity in the treatment of GJTs. It should be considered as an alternative therapy regime to surgical resection or fractionated external beam radiation either as primary, adjuvant or salvage therapy. PMID:26069957

  7. Rituximab therapy for chonic and refractory immune thrombocytopenic purpura: a long-term follow-up analysis

    PubMed Central

    Garcia-Chavez, Jaime; Montiel-Cervantes, Laura; Esparza, Miriam García-Ruiz; Vela-Ojeda, Jorge

    2007-01-01

    The aim of this study was to evaluate the long-term response to rituximab in patients with chronic and refractory immune thrombocytopenic purpura (ITP). Adults with ITP fail to respond to conventional therapies in almost 30% of cases, developing a refractory disease. Rituximab has been successfully used in these patients. We used rituximab at 375 mg/m2, IV, weekly for a total of four doses in 18 adult patients. Complete remission (CR) was considered if the platelet count was >100?×?109/l, partial remission (PR) if platelets were >50?×?109/l, minimal response (MR) if the platelet count was >30?×?109/l and <50?×?109/l, and no response if platelet count remained unchanged. Response was classified as sustained (SR) when it was stable for a minimum of 6 months. Median age was 43.5 years (range, 17 to 70). Median platelet count at baseline was 12.5?×?109/l (range, 3.0 to 26.3). CR was achieved in five patients (28%), PR in five (28%), MR in four (22%), and two patients were classified as therapeutic failures (11%). Two additional patients were lost to follow-up. The median time between rituximab therapy and response was 14 weeks (range, 4 to 32). SR was achieved in 12 patients (67%). There were no severe adverse events during rituximab therapy. During follow-up (median, 26 months; range, 12 to 59), no other immunosuppressive drugs were used. In conclusion, rituximab therapy is effective and safe in adult patients with chronic and refractory ITP. Overall response rate achieved is high, long term, and with no risk of adverse events. PMID:17874322

  8. 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

  9. Transanal haemorrhoidal dearterialisation with mucopexy versus stapler haemorrhoidopexy: a randomised trial with long-term follow-up

    PubMed Central

    Lucarelli, R; Caporossi, M; De Angelis, F; Di Filippo, A; Stipa, F; Spaziani, E

    2013-01-01

    Introduction The present study aimed to compare the long-term results of transanal haemorrhoidal dearterialisation (THD) with mucopexy and stapler haemorrhoidopexy (SH) in treatment of grade III and IV haemorrhoids. Methods One hundred and twenty-four patients with grade III and IV haemorrhoids were randomised to receive THD with mucopexy (n=63) or SH (n=61). A telephone interview with a structured questionnaire was performed at a median follow-up of 42 months. The primary outcome was the occurrence of recurrent prolapse. Patients, investigators and those assessing the outcomes were blinded to group assignment. Results Recurrence was present in 21 patients (16.9%). It occurred in 16 (25.4%) in the THD group and 5 (8.2%) in the SH group (p=0.021). A second surgical procedure was performed in eight patients (6.4%). Reoperation was open haemorrhoidectomy in seven cases and SH in one case. Five patients out of six in the THD group and both patients in the SH group requiring repeat surgery presented with grade IV haemorrhoids. No significant difference was found between the two groups with respect to symptom control. Patient satisfaction for the procedure was 73.0% after THD and 85.2% after SH (p=0.705). Postoperative pain, return to normal activities and complications were similar. Conclusions The recurrence rate after THD with mucopexy is significantly higher than after SH at long-term follow-up although results are similar with respect to symptom control and patient satisfaction. A definite risk of repeat surgery is present when both procedures are performed, especially for grade IV haemorrhoids. PMID:23676807

  10. Pancreatic function, quality of life and costs at long-term follow-up after acute pancreatitis

    PubMed Central

    Andersson, Bodil; Pendse, Marie-Louise; Andersson, Roland

    2010-01-01

    AIM: To evaluate long-term endocrine and exocrine pancreatic function, quality of life and health care costs after mild acute pancreatitis and severe acute pancreatitis (SAP). METHODS: Patients prospectively included in 2001-2005 were followed-up after 42 (36-53) mo. Pancreatic function was evaluated with laboratory tests, the oral glucose tolerance test (OGTT), fecal elastase-1 and a questionnaire. Short Form (SF)-36, was completed. RESULTS: Fourteen patients with a history of SAP and 26 with mild acute pancreatitis were included. Plasma glucose after OGTT was higher after SAP (9.2 mmol/L vs 7.0 mmol/L, P = 0.044). Diabetes mellitus or impaired glucose tolerance in fasting plasma glucose and/or 120 min plasma glucose were more common in SAP patients (11/14 vs 11/25, P = 0.037). Sick leave, time until the patients could take up recreational activities and time until they had recovered were all longer after SAP (P < 0.001). No significant differences in SF-36 were seen between the groups, or when comparing with age and gender matched reference groups. Total hospital costs, including primary care, follow-up and treatment of complications, were higher after SAP (median €16 572 vs €5000, P < 0.001). CONCLUSION: Endocrine pancreatic function was affected, especially after severe disease. SAP requires greater resource use with long recovery, but most patients regained a good quality of life. PMID:20954281

  11. The effect of long-term care and follow-up on complications in patients with external fixators.

    PubMed

    Cam, Rahsan; Korkmaz, Fatma Demir

    2014-02-01

    The present study aimed to determine the effect of long-term care and follow-up on complications in patients with external fixators. This study was conducted as a study research. The study sample included a total of 60 patients treated with external fixators for fractures, of whom 30 were in the control and 30 were in the study group. No intervention was made on the control group patients. The patients in the study group received external fixator pin site wound care, pin site massage and neurovascular follow-up. The study group patients were also given discharge training about external fixator pin site care two days before their discharge and were also provided with training manuals to guide their home care. Both groups were visited weekly at their homes to record their complications. Nine complications developed in eight patients (26.7%) in the study group, and 19 complications developed in 19 patients (63.3%) in the control group. Pin site infections were 11.6% of the total sample. The percentage for pin loosening, stiff joint, nerve and vessel injury and pain and swelling was 5%, 25%, 1.7% and 3.3%, respectively. PMID:24580979

  12. Value of thyroid echography in the long-term follow-up of lithium-treated patients.

    PubMed

    Loviselli, A; Bocchetta, A; Mossa, P; Velluzzi, F; Bernardi, F; del Zompo, M; Mariotti, S

    1997-01-01

    Psychiatric patients on long-term lithium (Li) therapy frequently develop goiter and/or hypothyroidism. It has also been suggested that Li may trigger/exacerbate thyroid autoimmunity. Previous studies provided evidence that underlying thyroid diseases represent important predisposing factors for the development of Li-induced thyroid dysfunction. The aim of the present paper was to assess the value of thyroid ultrasound-a simple and reliable tool to detect subtle thyroid abnormalities-in the longitudinal evaluation of 23 Li-treated psychiatric patients without evidence of biochemical thyroid abnormalities before therapy. For this purpose, thyroid ultrasound was associated with a clinical and laboratory (serum thyroxine, serum triiodothyronine, serum TSH, antithyroglobulin (AbTg), antithyroid microsomal (AbM) and antithyroid peroxidase autoantibodies) evaluation prior to and at 6- to 12-month intervals during Li treatment. On the basis of thyroid ultrasound before Li, patients were subdivided into two groups: group A (n = 15, 7 males, 8 females) with a normal echography and group B (n = 8, 5 males, 3 females) with mild ultrasound abnormalities. In group A the development of a small diffuse goiter was confirmed by physical examination during Li therapy; 2 patients displayed a transient increase of serum TSH concentration and none developed detectable serum antithyroid autoantibodies. Beside the small volumetric increase, no other ultrasound abnormalities were observed during the entire follow-up. In all group B patients a mild diffuse goiter was clinically detected before and on Li administration and no significant volumetric changes were observed during follow-up. Two patients developed high titers of AbM and AbTg 12 and 18 months after the beginning of Li, respectively; in 1 a persistent increase of serum TSH concentration was also observed. Thyroid echography before Li displayed different degrees of scattered or diffuse hypoechogenicity and a further decrease in echogenicity was detected during Li therapy in 2 patients. In conclusion, we provided further evidence that long-term Li administration is not associated with de novo appearance of thyroid autoimmune phenomena in humans, but rather with an exacerbation of underlying thyroid autoimmunity. In addition to thyroid autoantibody and TSH measurements, thyroid echography appears to be a sensitive tool in the identification of patients at risk of developing autoimmune hypothyroidism during long-term Li therapy. PMID:9211443

  13. Long-term follow-up study of osteoporotic vertebral compression fracture treated using balloon kyphoplasty and vertebroplasty.

    PubMed

    Liu, Jung-Tung; Li, Cho-Shun; Chang, Cheng-Siu; Liao, Wen-Jui

    2015-07-01

    OBJECT Long-term follow-up study is required for verifying whether the clinical outcomes of kyphoplasty and vertebroplasty are altered. The authors' findings showed only subtle differences between these operations within a 5-year period. However, they still suggest the use of vertebroplasty over kyphoplasty in view of the treatment costs. In their previous study, the authors performed a short-term prospective comparison between vertebroplasty and kyphoplasty. Vertebroplasty was recommended instead of kyphoplasty for the treatment of vertebral compression fractures (VCFs) because of the subtle differences between this procedure and kyphoplasty and the treatment costs. To determine whether these clinical outcomes persist in the long term, they continued to observe the patients from their short-term study over a longer-term period. METHODS One hundred cases of VCF were assigned randomly to either the kyphoplasty or the vertebroplasty group. In cement augmentation, the authors used polymethylmethacrylate as bone filler. Pain was assessed by using a visual analog scale (VAS). For each patient, vertebral body height and wedge angle were measured from reconstructed CT images. RESULTS The duration of the follow-up period was 5 years. Vertebral body height, kyphotic wedge angle, and VAS score were not evidently altered. Eight patients in the kyphoplasty group had an adjacent fracture after the procedure, whereas 7 patients in the vertebroplasty group had an adjacent fracture after the procedure. These adjacent fractures occurred within 1 year of surgery in both treatment groups except in 1 kyphoplasty-treated patient in whom the adjacent fracture was noted 16 months after treatment. Three patients in the vertebroplasty group had a nonadjacent fracture, and 4 patients in the kyphoplasty group had a nonadjacent fracture. The link between angular correction and the occurrence of adjacent fracture was statistically significant in the vertebroplasty group. CONCLUSIONS Excessive angular correction is a critical concern in the risk of adjacent fracture after vertebroplasty. Given the subtle differences between vertebroplasty and kyphoplasty observed over the course of 5 years, vertebroplasty remains the preferred option in view of the costs. PMID:25884343

  14. Cardiac sympathetic denervation in patients with refractory ventricular arrhythmias or electrical storm: Intermediate and long-term follow-up

    PubMed Central

    Vaseghi, Marmar; Gima, Jean; Kanaan, Christopher; Ajijola, Olujimi A.; Marmureanu, Alexander; Mahajan, Aman; Shivkumar, Kalyanam

    2014-01-01

    BACKGROUND Left and bilateral cardiac sympathetic denervation (CSD) have been shown to reduce burden of ventricular arrhythmias acutely in a small number of patients with ventricular tachyarrhythmia (VT) storm. The effects of this procedure beyond the acute setting are unknown. OBJECTIVE The purpose of this study was to evaluate the intermediate and long-term effects of left and bilateral CSD in patients with cardiomyopathy and refractory VT or VT storm. METHODS Retrospective analysis of medical records for patients who underwent either left or bilateral CSD for VT storm or refractory VT between April 2009 and December 2012 was performed. RESULTS Forty-one patients underwent CSD (14 left CSD, 27 bilateral CSD). There was a significant reduction in the burden of implantable cardioverter-defibrillator (ICD) shocks during follow-up compared to the 12 months before the procedure. The number of ICD shocks was reduced from a mean of 19.6 ± 19 preprocedure to 2.3 ± 2.9 postprocedure (P < .001), with 90% of patients experiencing a reduction in ICD shocks. At mean follow-up of 367 ± 251 days postprocedure, survival free of ICD shock was 30% in the left CSD group and 48% in the bilateral CSD group. Shock-free survival was greater in the bilateral group than in the left CSD group (P = .04). CONCLUSION In patients with VT storm, bilateral CSD is more beneficial than left CSD. The beneficial effects of bilateral CSD extend beyond the acute postsympathectomy period, with continued freedom from ICD shocks in 48% of patients and a significant reduction in ICD shocks in 90% of patients. PMID:24291775

  15. Relationship of Baseline Major Risk Factors to Coronary and All-Cause Mortality, and to Longevity: Findings from Long-Term Follow-Up of Chicago Cohorts

    Microsoft Academic Search

    Jeremiah Stamler; Alan R. Dyer; Richard B. Shekelle; James Neaton; Rose Stamler

    1993-01-01

    The focus here is on relationships between major risk factors and long-term mortality from coronary heart disease (CHD) and all causes, and on longevity, in Chicago cohorts: 25-year follow-up for Peoples Gas (PG) men aged 25-39 (n = 1,119), 30-year follow-up for PG men aged 40-59 (n = 1,235), 24-year follow-up for Western Electric (WE) men aged 40-55 (n =

  16. Energy-conserving programming of VVI pacemakers: a telemetry-supported, long-term, follow-up study.

    PubMed

    Klein, H H; Knake, W

    1990-06-01

    Thirty patients with VVI pacemakers (Quantum 253-09, 253-19, Intermedics Inc., Freeport, TX) were observed for a mean of 65 months. Within 12 months after implantation, optimized output programming was performed in 29 patients. This included a decrease in pulse amplitude (22 patients), pulse width (4 patients), and/or pacing rate (11 patients). After 65 months postimplantation, telemetered battery voltage and battery impedance were compared with the predicted values expected when the pulse generator constantly stimulates at nominal program conditions (heart rate 72.3 beats/min, pulse amplitude 5.4 V, pulse width 0.61 ms). Instead of an expected cell voltage of 2.6 V and a cell impedance of 10 k omega mean telemetered values amounted to 2.78 V and 1.4 k omega, respectively. These data correspond to a battery age of 12-15 months at nominal program conditions. This long-term follow-up study suggests that adequate programming will extend battery longevity and thus pulse generator survival in many patients. PMID:2344702

  17. Long-term follow-up and prognostic factor analysis in advanced ovarian carcinoma: the Gynecologic Oncology Group experience.

    PubMed

    Omura, G A; Brady, M F; Homesley, H D; Yordan, E; Major, F J; Buchsbaum, H J; Park, R C

    1991-07-01

    Long-term follow-up was obtained on 726 women with advanced ovarian carcinoma (suboptimal stage III and stage IV) who had received primary chemotherapy on two Gynecologic Oncology Group (GOG) protocols between 1976 and 1982. The first study compared melphalan alone versus melphalan plus hexamethylmelamine versus cyclophosphamide plus doxorubicin (CA). The second study evaluated the same CA regimen with or without cisplatin. Eligibility for the two studies was the same. At last contact, 76 patients were alive. In a multivariate analysis, cell type other than clear cell or mucinous, cisplatin-based treatment, good performance status, younger age, lower stage, clinically nonmeasurable disease, smaller residual tumor volume, and absence of ascites were favorable characteristics for overall survival (P less than .05). Second-look laparotomy was negative significantly more often among those with endometrioid tumors; there were no negative second-look laparotomies among those with mucinous or clear cell tumors. There were 30 patients with suboptimal stage III disease who had a negative second-look laparotomy; 18 (60%) have experienced recurrence, and 13 (43%) have died. Although cisplatin treatment was beneficial, new treatments are clearly needed. PMID:1904477

  18. Correction of pectus excavatum with a self-retaining seagull wing prosthesis. Long-term follow-up.

    PubMed

    Actis Dato, G M; De Paulis, R; Actis Dato, A; Bassano, C; Pepe, N; Borioni, R; Panero, G B

    1995-02-01

    Between June 1958 and December 1991, 315 patients (217 male and 98 female, mean age = 17.8 +/- 5.5 years) affected by pectus excavatum (PE) were surgically treated. Most of the patients required operation for aesthetic reasons only (299 patients; 95 percent). The grade of PE (Chin classification) was I in 72 patients, II in 152, and III in the remaining 91. The surgical technique consisted of a double transversal sternotomy at the level of the lowest and highest part of the depression associated with a longitudinal sternotomy. A wedge resection of the ribs was then performed and the sternum was fixed using a stainless steel strut molded into a seagull wing prosthesis. The strut was removed 12 months postoperatively. There were no operative mortalities. Four patients had sternal wound infection that was successfully treated. The mean follow-up was 15.8 years per patient and was 60 percent complete. From the aesthetic point of view, the postoperative results were excellent in 246 patients (78 percent), good in 57 (18 percent), and poor in 12 (4 percent). All subjective symptoms, when present, disappeared after surgery. The seagull wing prosthesis appears to be safe, easy to implant and to remove, and comfortable for the patient. This technique has shown good long-term results independently of type of deformity and patient age. PMID:7842751

  19. Long-term follow-up of therapeutic ERCP in 78 patients aged 90 years or older.

    PubMed

    Hu, Lianghao; Sun, Xiaotian; Hao, Junfeng; Xie, Ting; Liu, Minghao; Xin, Lei; Sun, Tao; Liu, Muyun; Zou, Wenbin; Ye, Bo; Liu, Feng; Wang, Dong; Cao, Ning; Liao, Zhuan; Li, Zhaoshen

    2014-01-01

    This study aimed to determine the performance and long-term outcomes of therapeutic ERCP in very old patients. Patients aged or over 90 (Group A, n = 78) and consecutive sex-matched controls (Group B, n = 312) under 65 selected were compared. More patients in Group A had chronic concomitant diseases, but the success and complication rates were comparable. The follow-up of 61 patients (78.2%) in Group A were done, with a mean period of 27.5 (3-54) months. Seven patients survived; the main causes of death for the other patients were concomitant diseases (n = 43) and primary diseases (n = 11). In patients with choledocholithiasis, cases with complete extractions of stones in bile ducts survived longer than those without (30 vs. 24 months, P < 0.001). Therapeutic ERCP in patients aged 90 years or older is effective and safe. In patients with choledocholithiasis, complete clearance of stones is associated with longer survival time. PMID:24819780

  20. Respiratory problems in renal transplant recipients admitted to intensive care during long-term follow-up.

    PubMed

    Candan, S; Pirat, A; Varol, G; Torgay, A; Zeyneloglu, P; Arslan, G

    2006-06-01

    Cardiovascular disease, malignancies, and infectious complications are major causes of morbidity and mortality of renal transplant recipients. Mortality rates vary between 16% and 40% in an intensive care unit (ICU). The aims of this study were to identify the types incidences of respiratory problems that affected renal transplant recipients admitted to the ICU during long-term follow-up thereby determining the impact of respiratory problems on mortality. We reviewed the data for 34 recipients who had 39 ICU admissions from January 2000 through December 2003. Twenty-four admissions (61.5%) had at least one respiratory problem at admission or developed at least one during the ICU stay. The most frequent problem was pneumonia (n=18, 46.2% of the 39 readmissions), followed by acute respiratory failure (n=10, 25.6%), atelectasis (n=9, 23.1%), pleural effusion (n=8, 20.5%), and pulmonary edema (n=2, 5.1%). The patients who had respiratory problems showed a significantly higher mortality rate than those who did not have respiratory problems (66.6% versus 26.6%, respectively; P<.05). The overall mortality rate was 58.8% (20 patients). Thus, infectious and respiratory problems are the most frequent indications for admission and the most common problems during an ICU stay. The prognosis for patients who either have a respiratory problem upon admission to the ICU or develop one during the ICU stay is poor. PMID:16797301

  1. MHC class I antigens and tumour-infiltrating leucocytes in laryngeal cancer: long-term follow-up.

    PubMed Central

    Esteban, F.; Redondo, M.; Delgado, M.; Garrido, F.; Ruiz-Cabello, F.

    1996-01-01

    Alteration in MHC class I expression may be used by cancer cells to avoid immune destruction. Much experimental evidence supports this idea, although survival studies are very scarce. To investigate whether the presence or absence of HLA-A, -B and -C antigens in laryngeal carcinoma influences survival, a series of 60 primary laryngeal tumours treated surgically and normal tissues were evaluated in frozen sections for the expression of MHC class I antigens and tumour-infiltrating leucocytes (CD3, CD4, CD8, CD11b, CD1, CD20 and CD16), using monoclonal antibodies and the APAAP, technique. Long-term follow-up from the patients is available, ranging from 6 to 10 years. Thirteen tumours presented total HLA-ABC loss, five selective losses of HLA-A antigens and one absence of HLA-B antigens. Total losses were statistically associated with several clinical and pathological parameters, but there were no differences regarding tumour-infiltrating leucocytes. After conducting a prospective study, only T and N staging and scoring according to Glanz's malignancy classification were found to be independently related to patients' outcome. From our data, we conclude that neither complete loss of HLA class I antigens nor tumour-infiltrating leucocytes appear to influence survival in squamous cell carcinoma of the larynx. PMID:8956796

  2. Long-term follow-up of peripheral blood stem cell transplantation from mismatched related and unrelated donors.

    PubMed

    Blau, I W; Schmidt-Hieber, M; Basara, N; Hopfenmüller, W; Bischoff, M; Günzelmann, S; Kirsten, D; Schmetzer, B; Roemer, E; Kiehl, M G; Thiel, E; Fauser, A A

    2007-01-01

    Allogeneic stem cell transplantation (SCT) is best performed with an HLA-identical sibling donor (matched related donor, MRD) to reduce the risk of early complications such as acute graft-vs.-host disease (aGvHD). However, as only about 30% of recipients have an MRD for this potentially curative approach, the use of family donors with one or two mismatches in the HLA-antigens (mismatch related donor, MMRD) or fully matched unrelated donors (MUD) (''alternative donors'') has been introduced in the allogeneic SCT setting in recent years. To evaluate the feasibility of allogeneic SCT from alternative donors by using peripheral blood stem cells (PBSC) we initiated a prospective, phase II study in 1996. From April 1996 to July 1998, 18 patients with various hematological malignancies underwent allogeneic SCT from alternative donors (two patients with MUD and 16 patients with MMRD). All patients received stable engraftment and none of the patients had graft rejection. The rate of aGvHD (grades II-IV) and the relapse rate at last follow-up (seven to nine yr after SCT) were with 40% and 24%, respectively, comparable with those found in patients receiving allogeneic SCT from MRD. However, five yr after allogeneic SCT only 17% were alive, which was mainly due to the treatment-related mortality (TRM) rate of 59%. We conclude that allogeneic PBSC transplantation by using alternative donors is associated with an unsatisfying long-term TRM rate. The significance of TRM and particular late deaths has to be evaluated further in this transplantation setting. PMID:17302599

  3. Do Nonsteroidal Anti-Inflammatory Drugs Cause Endoprosthetic Loosening? Mid- to Long-Term Follow-Up of 100 Total Hip Arthroplasties after Local NSAID Infiltration

    PubMed Central

    Nizam, Ikram; Kohan, Lawrence; Field, Clarice; Kerr, Dennis

    2015-01-01

    We evaluated the effect of local infiltration of NSAIDs on prosthetic fixation at mid- to long-term follow-up of total hip arthroplasties. Intra-articular local NSAID (ketorolac) was injected into hip joints and surrounding tissues intraoperatively and postoperatively as a part of multimodal pain management protocol. Clinical and radiographic evaluation was performed for any evidence of component loosening or failure and clinical outcomes in 100 total hip joint arthroplasties with a mean follow-up of 7.3 years (4.9 to 11?yrs). Radiographic analysis at the most recent follow-up showed no evidence of loosening, subsidence, or migration and no evidence of impending failure. Clinical outcomes showed improved Harris hip scores. Intra-articular NSAID used in the intraoperative/postoperative period in hip arthroplasty showed no evidence of prosthetic loosening at mid- to long-term follow-up.

  4. Long-Term Follow-Up After Successful Transjugular Intrahepatic Portosystemic Shunt Placement in a Pediatric Patient with Budd-Chiari Syndrome

    SciTech Connect

    Carnevale, Francisco Cesar, E-mail: fcarnevale@uol.com.br; Szejnfeld, Denis, E-mail: denis@cura.com.br; Moreira, Airton Mota [University of Sao Paulo Medical School, Service of Interventional Radiology, Instituto de Radiologia (Brazil); Gibelli, Nelson [University of Sao Paulo Medical School, Service of Pediatric Surgery, Instituto da Crianca Prof. Pedro de Alcantara (Brazil); Gregorio, Miguel Angel De [University of Zaragoza, Interventional Radiology Unit (Spain); Tannuri, Uenis [University of Sao Paulo Medical School, Service of Pediatric Surgery, Instituto da Crianca Prof. Pedro de Alcantara (Brazil); Cerri, Giovanni Guido [University of Sao Paulo Medical School, Service of Interventional Radiology, Instituto de Radiologia (Brazil)

    2008-11-15

    Orthotopic liver transplantation is the standard of care in patients with Budd-Chiari syndrome (BCS), and transjugular intrahepatic portosystemic shunt (TIPS) has become an important adjunct procedure while the patient is waiting for a liver. No long-term follow up of TIPS in BCS patients has been published in children. We report successful 10-year follow-up of a child with BCS and iatrogenic TIPS dysfunction caused by oral contraceptive use.

  5. Persistent inhibition of neointimal hyperplasia after sirolimus-eluting stent implantation: long-term (up to 2 years) clinical, angiographic, and intravascular ultrasound follow-up

    Microsoft Academic Search

    M. Degertekin; P. W. Serruys; K. Tanabe; Brand van den M. J. B. M; Feyter de P. J; W. J. Giessen; Giessen van der W. J; P. J. Feyter; J. J. Popma

    2002-01-01

    BACKGROUND: Early results of sirolimus-eluting stent implantation showed a nearly complete abolition of neointimal hyperplasia. The question remains, however, whether the early promising results will still be evident at long-term follow-up. The objective of our study was to evaluate the efficiency of sirolimus-eluting stent implantation for up to 2 years of follow-up. METHODS AND RESULTS: Fifteen patients with de novo

  6. Long-term follow-up of incomplete stent apposition in patients who received sirolimus-eluting stent for de novo coronary lesions: an intravascular ultrasound analysis

    Microsoft Academic Search

    M. Degertekin; P. W. J. C. Serruys; K. Tanabe; C. H. Lee; J. E. Sousa; A. Colombo; M. C. Morice; J. M. R. Ligthart; Feyter de P. J

    2003-01-01

    BACKGROUND: Incomplete stent apposition (ISA) has been previously documented after sirolimus-eluting stent (SES) implantation. The aim of this study was to investigate the long-term intravascular ultrasound (IVUS) findings of ISA in patients who received SES. METHODS AND RESULTS: A total of 13 patients who received SES and showed ISA at follow-up IVUS (follow-up I) were investigated. IVUS was performed on

  7. Biological Aortic Valve Replacement. Long-Term Follow-Up and Predictors of Mortality, Rehospitalization and Reintervention

    Microsoft Academic Search

    FERNANDO PICCININI; JUAN M. VRANCIC; GUILLERMO VACCARINO; HERNÁN D. RAICH; JORGE THIERER; DANIEL O. NAVIA; Blanco Encalada

    Background Aortic valve replacement is the conventional procedure in aortic valve disease; neverthe- less, choosing the most suitable model of prosthesis is a complex decision. The use of novel biological models specially treated to reduce long-term structural deterioration has been encouraged, even in young populations. Objective To assess long-term survival of biological valve replacement, quality of life, rates of re-

  8. Long-term follow-up of lid surgery for trichiasis in the Gambia: Surgical success and patient perceptions

    Microsoft Academic Search

    R J C Bowman; B Jatta; H Faal; R Bailey; A Foster; G J Johnson

    2000-01-01

    Background Surgery is an important component of the SAFE strategy which has been shown to improve visual acuity. There are limited data on long-term surgical success and patient perceptions and satisfaction. A sample of patients from the Gambia who had undergone previous lid surgery for trichiasis were therefore examined for recurrence of trichiasis and interviewed for patient satisfaction.Methods Health centre

  9. Long-term follow-up of Class II adults treated with orthodontic camouflage: A comparison with orthognathic surgery outcomes

    Microsoft Academic Search

    Colin A. Mihalik; William R. Proffit; Ceib Phillips

    Thirty-one adults who had been treated with orthodontics alone for Class II malocclusions were recalled at least 5 years posttreatment to evaluate cephalometric and occlusal stability and also their satisfaction with treatment outcomes. The data were compared with similar data for long-term outcomes in patients with more severe Class II problems who had surgical correction with mandibular advancement, maxillary impaction,

  10. Long-term follow-up of Class II adults treated with orthodontic camouflage: A comparison with orthognathic surgery outcomes

    Microsoft Academic Search

    Colin A. Mihalik; William R. Proffit; Ceib Phillips

    2003-01-01

    Thirty-one adults who had been treated with orthodontics alone for Class II malocclusions were recalled at least 5 years posttreatment to evaluate cephalometric and occlusal stability and also their satisfaction with treatment outcomes. The data were compared with similar data for long-term outcomes in patients with more severe Class II problems who had surgical correction with mandibular advancement, maxillary impaction,

  11. Long-term follow-up of the CAD\\/CAM patient fitted total temporomandibular joint reconstruction system

    Microsoft Academic Search

    Louis G. Mercuri; Larry M. Wolford; Bruce Sanders; R. Dean White; Anita Giobbie-Hurder

    2002-01-01

    Purpose: The purpose of this study was the assessment of the long-term safety and effectiveness of the Techmedica (Camarillo, CA) CAD\\/CAM Total Temporomandibular Joint Reconstruction System (now called the TMJ Concepts Patient Fitted Total Temporomandibular Joint Reconstruction System, Ventura, CA). Patients and Methods: A survey was mailed to the available addresses of 170 (79%) of the 215 patients who had

  12. Long-Term Follow-Up to a Randomized Clinical Trial of Multisystemic Therapy with Serious and Violent Juvenile Offenders

    ERIC Educational Resources Information Center

    Schaeffer, Cindy M.; Borduin, Charles M.

    2005-01-01

    In this study, the authors examined the long-term criminal activity of 176 youths who had participated in either multisystemic therapy (MST) or individual therapy (IT) in a randomized clinical trial (C. M. Borduin et al., 1995). Arrest and incarceration data were obtained on average 13.7 (range = 10.2-15.9) years later when participants were on…

  13. Long-Term Follow-Up of Workplace and Well Water Manganese Effects on Iron Status Indexes in Manganese Miners

    Microsoft Academic Search

    Massod Mashhadi; Akbar Boojar; Faranak Goodarzi; Mohamad Ali Basedaghat

    2002-01-01

    The authors assessed the effect of water reconstitution in the workplace by evaluating the iron status of manganese mine workers during a long-term study. Subsequent analyses and biological monitoring were performed in a group of 150 manganese miners before, and 2.8 yr after, reconstitution of drinking water in the miners' workplace. The authors found significantly high concentrations of manganese in

  14. Long Term Follow-up of Vocational Education Graduates: A Study Based on Federal Income Tax Data.

    ERIC Educational Resources Information Center

    Ghazalah, I. A.

    A study used federal income tax data to examine the long-term earning, unemployment, and interregional mobility patterns among 15,055 persons who graduated from 14 Ohio vocational education programs in 1979. Income data on the graduates' income earned during the 1983 tax year were also compared with U.S. Census Bureau data on 1983 Money Income of…

  15. Long-Term Follow-Up of Celiac Adults on Gluten-Free Diet: Prevalence and Correlates of Intestinal Damage

    Microsoft Academic Search

    Carolina Ciacci; Massimo Cirillo; Raimondo Cavallaro; Gabriele Mazzacca

    2002-01-01

    Background and Aims: Celiac disease is the most common severe food intolerance in the Western world and is due to gluten ingestion in genetically susceptible children and adults. Intestinal biopsy is the golden standard for evaluation of mucosal damage associated with celiac disease. Gluten-free diet is the key treatment for celiac disease. Data on the long-term control of celiac disease

  16. Long-term follow-up of pediatric sickle cell disease patients with abnormal high velocities on transcranial Doppler

    Microsoft Academic Search

    Françoise Bernaudin; Suzanne Verlhac; Lena Coïc; Emmanuelle Lesprit; Pierre Brugières; Philippe Reinert

    2005-01-01

    Cerebral arteriopathy can be detected in children with sickle cell disease (SCD) by transcranial Doppler (TCD). Abnormally high velocities are predictive of high stroke risk, which can be reduced by transfusion therapy. We report the results of the screening of 291 SCD children followed in our center, including the clinical and imaging follow-up of 35 children with abnormal TCDs who

  17. Auditory-perceptual speech analysis in children with cerebellar tumours: a long-term follow-up study.

    PubMed

    De Smet, Hyo Jung; Catsman-Berrevoets, Coriene; Aarsen, Femke; Verhoeven, Jo; Mariën, Peter; Paquier, Philippe F

    2012-09-01

    Mutism and Subsequent Dysarthria (MSD) and the Posterior Fossa Syndrome (PFS) have become well-recognized clinical entities which may develop after resection of cerebellar tumours. However, speech characteristics following a period of mutism have not been documented in much detail. This study carried out a perceptual speech analysis in 24 children and adolescents (of whom 12 became mute in the immediate postoperative phase) 1-12.2 years after cerebellar tumour resection. The most prominent speech deficits in this study were distorted vowels, slow rate, voice tremor, and monopitch. Factors influencing long-term speech disturbances are presence or absence of postoperative PFS, the localisation of the surgical lesion and the type of adjuvant treatment. Long-term speech deficits may be present up to 12 years post-surgery. The speech deficits found in children and adolescents with cerebellar lesions following cerebellar tumour surgery do not necessarily resemble adult speech characteristics of ataxic dysarthria. PMID:22261078

  18. [Thymic mucosa-associated lymphoid tissue (MALT) lymphoma developing during long-term follow-up for Sjögren's syndrome and idiopathic thrombocytopenic purpura;report of a case].

    PubMed

    Sawada, Takahiro; Machino, Ryusuke; Ishii, Mitsuhisa; Takeji, Miyuki; Maeda, Toshiharu

    2013-11-01

    Mucosa-associated lymphoid tissue (MALT) lymphoma is a rare type of lymphoma that arises in small CD20-positive lymphocytes. We encountered a case of thymic MALT lymphoma treated with surgical intervention during long-term follow-up for Sjögren's syndrome and idiopathic thrombocytopenic purpura (ITP). Although symptomatic remission of Sjögren's syndrome and ITP had already been achieved, the levels of anti-SSA and anti-SSB antibodies remained high. Chronic stimulation by these antibodies may contribute to the development of MALT lymphoma. A careful follow-up may be indicated for this case with a complex immunological background. PMID:24322322

  19. Chronic Aspiration without Pulmonary Complications after Partial Laryngectomy: Long-term Follow-up of Two Cases

    Microsoft Academic Search

    Carlo Bianchi; Giovanna Cantarella

    We report the long-term history of two patients with oropharyngeal dysphagia subsequent to partial resection of the larynx\\u000a (supraglottic and subtotal laryngectomy, respectively). Both fiberendoscopic and videofluoroscopy swallowing studies demonstrated\\u000a aspiration of liquids and solids in the lower respiratory tract. The patients underwent a swallowing rehabilitation program\\u000a and respiratory exercises to improve the efficacy of their cough, and both continued

  20. Sirolimus-Based Therapy With or Without Cyclosporine: Long-Term Follow-up in Renal Transplant Patients

    Microsoft Academic Search

    J. M. Morales; J. M. Campistol; H. Kreis; G. Mourad; J. Eris; F. P. Schena; J. M. Grinyo; G. Nanni; A. Andres; N. Castaing; Y. Brault; J. T. Burke

    2005-01-01

    This open-label, phase 3b, extension trial in renal transplant recipients (Sirolimus Study 311) assessed the long-term safety of sirolimus (SRL) administered with cyclosporine (CsA) (SRL + CsA group, n = 98) or without CsA (SRL group, n = 69). Renal transplant recipients who had either completed one of seven previous SRL studies sponsored by Wyeth Research or had participated for

  1. Urological problems or fecal continence during long-term follow-up of patients with anorectal malformation

    Microsoft Academic Search

    Emrah Senel; Fatih Akbiyik; Halil Atayurt; H. Tugrul Tiryaki

    2010-01-01

    Introduction  Anorectal malformations comprise a wide spectrum of diseases. The main concerns for the surgeon in correcting these anomalies\\u000a are bowel control, urinary control, and sexual function. The aim of this study was to evaluate fecal continence together with\\u000a additional urinary anomalies in patients with anorectal malformations (ARM) and determine which of them is more troublesome\\u000a for life quality in long-term

  2. Intestinal Permeability in Long-Term Follow-up of Patients with Celiac Disease on a Gluten-Free Diet

    Microsoft Academic Search

    D. R. Duerksen; C. Wilhelm-Boyles; D. M. Parry

    2005-01-01

    Intestinal permeability is frequently abnormal in patients with celiac disease. The long-term effect of a gluten-free diet on intestinal permeability and the correlation of intestinal permeability with a gluten-free diet are not known. The objectives of this study were to determine the responses of intestinal permeability and antibody testing to gluten free diet and the degree of correlation of these

  3. Perceived chewing ability and need for long-term care in the elderly: a 5-year follow-up study.

    PubMed

    Moriya, S; Tei, K; Murata, A; Muramatsu, M; Inoue, N; Miura, H

    2012-08-01

    Increasing need for long-term care in older adults is expected with the ageing of Japan's population. The aim of the present study was to show the relationship between perceived chewing ability and long-term care needs for over 5 years in elderly persons. The chewing ability of 812 elderly persons living independently was evaluated at baseline using self-assessed masticatory ability, and it was classified into one of three categories: ability to chew all foods (good masticatory ability), ability to chew only slightly hard food (fair masticatory ability), and ability to only chew soft or pureed food (poor masticatory ability). Participants' care needs were then followed through Japan's long-term care insurance system for over 5 years. The log-rank test and Cox proportional hazard model were used to examine statistical differences in the frequency of care-needs certification between participants with good and fair or poor masticatory ability. Among participants aged 65-79 years, the frequency of care-needs certification was significantly higher in those with fair or poor masticatory ability than in those with good masticatory ability, and the relative hazard ratio was significantly higher in those with fair or poor masticatory ability than in those with good masticatory ability, after adjusting for age, gender, current employment status, educational background, social interaction, chronic medical conditions and dentition status. These relationships were not found among those aged 80-93 years. Impairment in perceived chewing ability may be associated with higher incidence of certification in Japan's long-term care insurance system among elderly persons aged 65-79. PMID:22506492

  4. Abciximab in primary coronary stenting of ST-elevation myocardial infarction: a European meta-analysis on individual patients' data with long-term follow-up

    Microsoft Academic Search

    Gilles Montalescot; David Antoniucci; Adnan Kastrati; Franz Joseph Neumann; Maria Borentain; Angela Migliorini; Carole Boutron; Jean-Philippe Collet; Eric Vicaut

    2007-01-01

    Aims Varying results have been reported in studies evaluating glycoprotein (GP) IIb\\/IIIa inhibition in primary coronary stenting of acute ST-elevation myocardial infarction (STEMI), usually with limited clini- cal follow-up. We performed a meta-analysis on case specific data of primary stenting in STEMI with a long-term evaluation. Methods and results For this meta-analysis, studies of rescue percutaneous coronary intervention (PCI) after

  5. Clinical features, long-term follow-up and outcome of a large cohort of patients with Chronic Granulomatous Disease: An Italian multicenter study

    Microsoft Academic Search

    Baldassarre Martire; Roberto Rondelli; Annarosa Soresina; Claudio Pignata; Teresa Broccoletti; Andrea Finocchi; Paolo Rossi; Marco Gattorno; Marco Rabusin; Chiara Azzari; Rosa M. Dellepiane; Maria C. Pietrogrande; Antonino Trizzino; Paolo Di Bartolomeo; Silvana Martino; Luigi Carpino; Fausto Cossu; Franco Locatelli; Rita Maccario; Paolo Pierani; Maria C. Putti; Achille Stabile; Luigi D. Notarangelo; Alberto G. Ugazio; Alessandro Plebani; Domenico De Mattia

    2008-01-01

    A retrospective clinical and immunological survey was conducted in 60 patients with Chronic Granulomatous Disease. A prospective controlled non-randomized study of the efficacy of long-term IFN? treatment was carried out.The mean age at the time of diagnosis was 4.4 years; mean duration of follow-up was 10.4 years. Lung and skin infections were the most frequent manifestations both prior to diagnosis and during

  6. Long-Term Follow-Up of the Percutaneous Treatment of Hydatid Cyst in the Adrenal Gland: A Case Report and Review of the Literature

    SciTech Connect

    Akhan, Okan [Hacettepe University Hospitals, Department of Radiology (Turkey); Canyigit, Murat, E-mail: mcanyigit@yahoo.com [Ankara Ataturk Education and Research Hospital, Department of Radiology (Turkey); Kaya, Diana; Koksal, Ali; Akgoz, Ayca; Yucesoy, Cuneyt [Bayindir Hospital, Department of Radiology (Turkey); Akinci, Devrim [Hacettepe University Hospitals, Department of Radiology (Turkey)

    2011-02-15

    Although the most involved organs are liver and lung, hydatid cysts occur in adrenal glands, rarely, and constitute only 0.5% of hydatid cysts. Herein, we demonstrate and discuss, for the first time in the literature to the best of our knowledge, the radiological features of adrenal hydatid disease and evaluate the long-term results (57 months of follow-up) of the percutaneous treatment of hydatid cyst in the adrenal gland in a patient.

  7. Management of fused supernumerary teeth in children using guided tissue regeneration: long-term follow up of 2 cases.

    PubMed

    Olsen, Christopher B; Johnston, Timothy; Desai, Mala; Peake, Gregory G

    2002-01-01

    Surgical separation of supernumerary teeth fused to permanent incisor teethhas typically given rise to residual post surgical periodontal defects, induding loss of attachment and deep periodontal pocketing with persistent inflammation. Other complications include devitalisation of the retained tooth section, ankylosis, external and replacement resorption. A unique technique of using guided tissue regeneration has been successfully employed to promote periodontal healing, after 2 cases of surgical removal of a supernumerary tooth fused to a permanent maxillary lateral incisor tooth. In the first case, a 2-stage guided tissue regeneration technique was completed with a nonresorbable Gor-Tex membrane, and was followed up after 9 years. The second case was completed using a resorbable Vicryl membrane, in a single-stage guided tissue regenerative technique; and was followed up after 5 years. PMID:12528950

  8. A long-term follow-up study of Japanese diabetic patients: Mortality and causes of death

    Microsoft Academic Search

    A. Sasaki; M. Uehara; N. Horiuchi; K. Hasagawa

    1983-01-01

    Summary  A systematic 20-year follow-up study of 1,221 diabetic patients was carried out in Osaka, Japan. The mean annual mortality rates were 2.55% for men and 1.64% for women. The ratios of observed to expected numbers of deaths were 1.50 for men and 1.39 for women, indicating an excess mortality for diabetic patients of both sexes, and higher mortality in men

  9. Long-term magnetic resonance imaging follow-up of asymptomatic sellar tumors. -- their natural history and surgical indications.

    PubMed

    Igarashi, T; Saeki, N; Yamaura, A

    1999-08-01

    Serial magnetic resonance (MR) images and clinical symptoms were analyzed in 23 patients with sellar lesions, who were followed up without initial therapy for mass reduction to evaluate their natural history and surgical indication for these lesions. The patients were aged 17 to 78 years (mean 47.3 years) and the follow-up period was 1.5 to 11.6 years (mean 5.1 years). Lesions were divided into two types based on the MR imaging findings, regardless of their histological types. Type C was cystic with or without enhancement of the smooth and thin wall. Type S had enhanced solid components. Ten patients had Type C tumors. Three patients presented with sudden onset of headache. The tumor size spontaneously decreased with intensity change, indicating pituitary apoplexy as the trigger of the onset and intensity change. Four patients presented with the visual disturbance which improved with the reduction of tumor size, but three patients deteriorated and required surgery. The operation revealed Rathke's cleft cyst. The remaining three patients were found incidentally and have been asymptomatic without MR imaging changes. Thirteen patients had Type S tumors. Six patients of nine with 14 mm or larger tumors developed symptomatic tumor enlargement over the follow-up period of 1.2 to 8.6 years (mean 4.9 years) and required treatment. The remainder showed no change. Type C tumors frequently shrink or even disappear spontaneously. We can justify conservative follow-up of Type C tumors in patients with no or only transient symptoms. Type S tumors, larger than 14 mm in size, need closer observation or treatment because they often enlarge and become symptomatic. PMID:10487038

  10. Outcome and knee-related quality of life after anterior cruciate ligament reconstruction: a long-term follow-up

    Microsoft Academic Search

    Eva Möller; Lars Weidenhielm; Suzanne Werner

    2009-01-01

    The aim of the present investigation was to study patient-reported long-term outcome after anterior cruciate ligament (ACL)\\u000a reconstruction. On an average 11.5 years after ACL reconstruction with bone-patellar tendon-bone (BPTB) autograft 56 patients\\u000a were asked to answer four different questionnaires about their knee function and knee-related quality of life. Another aim\\u000a was to study whether there were any correlations between clinical

  11. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia

    Microsoft Academic Search

    Jacobus W. A. Burger; Roland W. Luijendijk; Wim C. J. Hop; Jens A. Halm; Emiel G. G. Verdaasdonk; Johannes Jeekel

    2004-01-01

    OBJECTIVE: The objective of this study was to determine the best treatment\\u000a of incisional hernia, taking into account recurrence, complications,\\u000a discomfort, cosmetic result, and patient satisfaction. BACKGROUND:\\u000a Long-term results of incisional hernia repair are lacking. Retrospective\\u000a studies and the midterm results of this study indicate that mesh repair is\\u000a superior to suture repair. However, many surgeons are still performing\\u000a suture

  12. Very long-term follow-up of cognitive function in adults treated in infancy for hydrocephalus

    Microsoft Academic Search

    Barbro Lindquist; Eva-Karin Persson; Elisabeth Fernell; Paul Uvebrant

    2011-01-01

    Purpose  The aim was to investigate the very long-term cognitive outcome in adults who had been shunt treated for hydrocephalus during\\u000a their first year of life.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  In a population-based series of 72 children born in 1967–1978 and shunt treated for infantile hydrocephalus, 43 were found\\u000a to have a normal cognitive function when assessed at 6–17 years of age. Twenty-five of them agreed

  13. [Clinical and radiologic long-term follow-up of Eden-Lang operation in habitual anterior shoulder dislocation].

    PubMed

    Böni, T; Imhoff, A; Schreiber, A

    1992-01-01

    The incidence of degenerative arthritis after Eden-Lange procedure is judged differently in literature, recently high rates of degenerative arthritis have been reported. 37 patients and the same number of shoulder joints have been evaluated clinically and radiologically after an average follow-up time of 14.9 years. Overall results can be considered as good. Recurrence of dislocation occurred only in one case. Most frequently we observed a limitation of external rotation and overhead performance in sports. The frequency of degenerative arthritis was 17%, clearly less than mentioned elsewhere. The Eden-Lange procedure still can be recommended as a treatment for recurrent anterior shoulder dislocation except for patients with high expectations in physical overhead activities. PMID:1493072

  14. Long term results with the interlocking uncemented long stem in revision hip arthroplasty: a mean 15-year follow-up.

    PubMed

    Kamada, Tomomi; Imai, Hiroshi; Mashima, Naohiko; Takeba, Jun; Okumura, Hideo; Miura, Hiromasa

    2015-05-01

    Stem fixation is difficult to achieve in severe proximal bone loss in revision hip surgery. In this study, we sought to present the results of distally-locked stem with screws (HUCKESTEP HIP stem) in 21 revision hips with mean follow-up period of 15years. The preoperative mean Japanese Orthopaedic Association hip score had improved from 54 to 75 points. Further revisions were required for 2 stems, in one because of infection and the other because of screws fracture and subsidence. With removal of the stem for any reason as an end-point, the cumulative survival at 15years was 90.4%. While this study had small number, the use of this interlocking stem for revision hips with extensive proximal bone defects provided satisfactory 15-year clinical and radiographic results. PMID:25637474

  15. Long-term patterns in interpersonal behaviour amongst psychopathic patients in secure inpatient treatment: A follow-up study.

    PubMed

    Draycott, Simon; Short, Roxanna; Kirkpatrick, Tim

    2015-05-01

    Psychopathy is a disorder that is partly defined by with maladaptive interpersonal behaviour and has significant effects on treatment outcomes. A previous study (Draycott et al., ) found that higher levels of psychopathy led to a specific interpersonal 'trajectory' amongst patients in a secure psychiatric treatment programme during the first 9?months of their admission. In that programme, more psychopathic patients became increasingly dominant over time, and less psychopathic patients became increasingly hostile. This study is a longer-term follow-up and extension of that study, extending the window of observation to 33?months of treatment. It was found that the more psychopathic patients' increased dominance returned to baseline levels by 33?months, as did the less psychopathic patients' increased hostility. This suggests that treatment for this group is not idiopathic but leaves unanswered the question as to what these divergent trajectories represent. Copyright © 2015 John Wiley & Sons, Ltd. PMID:25622564

  16. Long-term follow-up of the residual intracanalicular tumours after subtotal removal of acoustic neurinomas.

    PubMed

    Kameyama, S; Tanaka, R; Kawaguchi, T; Honda, Y; Yamazaki, H; Hasegawa, A

    1996-01-01

    We examined growth potential of residual intracanalicular tumours left from subtotal removal of large acoustic neurinomas. Eleven patients were followed-up by magnetic resonance (MR) imaging. The interval between surgery and MR study ranged from 12 to 29 years (median, 16 years). MR images of two patients showed no evidence of tumour remnant, and in six a small tumour was localized in the internal auditory canal. The other three showed an intracanalicular tumour protruding slightly towards the intracranial portion. This result suggests that the intracanalicular residual tumours have less risk of regrowth after subtotal removal of acoustic neurinomas. It is advisable to choose intracapsular, subtotal removal without opening the internal auditory canal in the treatment of acoustic neurinoma, if it is large in size and there is a high risk of nerve injury. PMID:8686546

  17. Prognostic value of carotid ultrasound lesion morphology in retinal ischaemia: result of a long term follow up.

    PubMed Central

    O'Farrell, C M; FitzGerald, D E

    1993-01-01

    The importance of carotid plaque morphology in the prognosis of retinal ischaemia was investigated in a group of 165 patients followed for 2-7 years (mean 3.3 years). All patients had an initial carotid duplex ultrasound examination, with the results expressed in terms of the degree of stenosis caused by the lesion, and the lesion morphology. Lesions were divided into two groups, (a) combined homogeneous and simple heterogeneous structures, and (b) complex heterogeneous plaques. Complex heterogeneous plaques had a low echo pool within the lesion and/or an irregular surface pattern. A total of 144 (87%) patients were successfully followed, and of these 37 (26%) had cerebrovascular, cardiovascular, or retinal ischaemic events in the follow up period; 14 (10%) cerebrovascular accidents (eight fatal), 17 (12%) myocardial infarctions (10 fatal), two episodes of amaurosis fugax, and one of tunnel vision caused by a retinal embolus were recorded. There was no report of subsequent blindness. The percentage stenosis caused by the carotid lesions, although more severe in the vascular event group, was not significantly different between the groups. However, a significant difference (p < 0.1) was found in the morphological characteristics of the carotid lesions between the groups. Patients who suffered a vascular event in the follow up period had significantly more complex heterogeneous lesions compared with simple heterogeneous/homogeneous lesions, than those patients who remained alive and well. Carotid endarterectomy and antiplatelet therapy were equally distributed between the event and non-event groups. This suggests that the criteria for selection for treatment should be based on the lesion morphology as well as the degree of stenosis. PMID:8110673

  18. Prognostic value of carotid ultrasound lesion morphology in retinal ischaemia: result of a long term follow up.

    PubMed

    O'Farrell, C M; FitzGerald, D E

    1993-12-01

    The importance of carotid plaque morphology in the prognosis of retinal ischaemia was investigated in a group of 165 patients followed for 2-7 years (mean 3.3 years). All patients had an initial carotid duplex ultrasound examination, with the results expressed in terms of the degree of stenosis caused by the lesion, and the lesion morphology. Lesions were divided into two groups, (a) combined homogeneous and simple heterogeneous structures, and (b) complex heterogeneous plaques. Complex heterogeneous plaques had a low echo pool within the lesion and/or an irregular surface pattern. A total of 144 (87%) patients were successfully followed, and of these 37 (26%) had cerebrovascular, cardiovascular, or retinal ischaemic events in the follow up period; 14 (10%) cerebrovascular accidents (eight fatal), 17 (12%) myocardial infarctions (10 fatal), two episodes of amaurosis fugax, and one of tunnel vision caused by a retinal embolus were recorded. There was no report of subsequent blindness. The percentage stenosis caused by the carotid lesions, although more severe in the vascular event group, was not significantly different between the groups. However, a significant difference (p < 0.1) was found in the morphological characteristics of the carotid lesions between the groups. Patients who suffered a vascular event in the follow up period had significantly more complex heterogeneous lesions compared with simple heterogeneous/homogeneous lesions, than those patients who remained alive and well. Carotid endarterectomy and antiplatelet therapy were equally distributed between the event and non-event groups. This suggests that the criteria for selection for treatment should be based on the lesion morphology as well as the degree of stenosis. PMID:8110673

  19. Short- and long-term recidivism prediction of the PCL-R and the effects of age: a 24-year follow-up.

    PubMed

    Olver, Mark E; Wong, Stephen C P

    2015-01-01

    We prospectively examined the short- and long-term prediction of several recidivism outcomes as a function of psychopathy and age in a sample of 273 Canadian federal inmates with an average 24 years post-release follow-up. Offenders were rated using the original 22-item Hare Psychopathy Checklist (PCL: Hare, 1980) based on extensive archival file information, and the ratings were used to compute the Psychopathy Checklist-Revised (Hare, 2003) and the 4 facet scores. PCL-R total scores and the Lifestyle and Antisocial facets, but not the Interpersonal and Affective facets, showed mostly small and some moderate predictive efficacy for general and nonviolent recidivism over 3-, 5-, 10-, and 20-year fixed follow-ups, and predicted violence recidivism at shorter follow-ups. Age at release was negatively correlated with all recidivism outcomes and follow-up periods for both high and low PCL-R rated offenders, and uniquely predicted all recidivism outcomes after controlling for the PCL-R using Cox regression survival analysis. Increased age was consistently linked to recidivism reduction even for psychopathic offenders. The results showed that both PCL-R scores and age contributed to the prediction of recidivism; however, the PCL-R facets made differential contributions that varied with the type of offense (violent vs. nonviolent) and follow-up time (shorter vs. longer). The results have implications for both risk assessment using the PCL-R and potentially for risk reduction interventions. PMID:25364945

  20. Long term follow-up study to evaluate immunogenicity and safety of a single dose of live attenuated hepatitis a vaccine in children.

    PubMed

    Mitra, Monjori; Shah, Nitin; Faridi, Mma; Ghosh, Apurba; Sankaranarayanan, V S; Aggarwal, Anju; Chatterjee, Suparna; Bhattacharyya, Nisha; Kadhe, Ganesh; Vishnoi, Gaurav; Mane, Amey

    2015-05-01

    Worldwide, viral hepatitis continues to be a cause of considerable morbidity and mortality. Mass immunization with a single dose of live attenuated HAV has been shown to significantly reduce disease burden in the community. This was a phase IV, 5-year follow up study carried out at 4 centers (Kolkata, Delhi, Mumbai and Chennai) across India. The subjects with antibody titer <20 mIU/mL at baseline were evaluated for long term immunogenicity. Of the 503 subjects enrolled, 349 subjects were baseline seronegative with an anti-HAV antibody titer <20 mIU/mL. Overall, 343 subjects could be followed up at some point of time during this 5 y post vaccination period. In the last year (60 months) of follow-up, 108 subjects (97.3%) of 111 subjects (who came for follow-up at the end of 5 y) had a protective antibody titer (anti-HAV antibody titer >20 mIU/mL). The seroconversion rates considering seroprotection levels of anti-HAV antibody titer >20 mIU/mL, following vaccination starting from 6 weeks, 6 months, 12 months, 24 months, 36 months, 48 months and 60 months were 95.1%, 97.9%, 98.3%, 96.2%, 97.8%, 92.6% and 97.3%, respectively. The geometric mean concentration (GMC) over the years increased from 64.9 mIU/mL at 6 weeks to 38.1 mIU/mL and 135.2 mIU/mL at 6 months and 12 months, respectively and was maintained at 127.1 mIU/mL at 60 months. In conclusion, the result of this 5-year follow up study showed that the single dose of live attenuated vaccine is well tolerated and provides long-term immunogenicity in healthy Indian children. PMID:26018443

  1. Mid- and Long-Term Effects of Family Constellation Seminars in a General Population Sample: 8- and 12-Month Follow-Up.

    PubMed

    Hunger, Christina; Weinhold, Jan; Bornhäuser, Annette; Link, Leoni; Schweitzer, Jochen

    2015-06-01

    In a previous randomized controlled trial (RCT), short-term efficacy of family constellation seminars (FCSs) in a general population sample was demonstrated. In this article, we examined mid- and long-term stability of these effects. Participants were 104 adults (M = 47 years; SD = 9; 84% female) who were part of the intervention group in the original RCT (3-day FCS; 64 active participants and 40 observing participants). FCSs were carried out according to manuals. It was predicted that FCSs would improve psychological functioning (Outcome Questionnaire OQ-45.2) at 8- and 12-month follow-up. Additionally, we assessed the effects of FCSs on psychological distress, motivational incongruence, individuals' experience in their personal social systems, and overall goal attainment. Participants yielded significant improvement in psychological functioning (d = 0.41 at 8-month follow-up, p = .000; d = 0.40 at 12-month follow-up, p = .000). Results were confirmed for psychological distress, motivational incongruence, the participants' experience in their personal social systems, and overall goal attainment. No adverse events were reported. This study provides first evidence for the mid- and long-term efficacy of FCSs in a nonclinical population. The implications of the findings are discussed. PMID:25264190

  2. Long-term follow-up of children with haemophilia - low incidence of infections with central venous access devices.

    PubMed

    Harroche, A; Merckx, J; Salvi, N; Faivre, J; Jacqmarcq, O; Dazet, D; Makhloufi, M; Clairicia, M; Torchet, M-F; Aouba, A; Rothschild, C

    2015-07-01

    This study reports on 15 years of experience, in a single haemophilia care centre in France, with central venous access devices (VADs) in children with haemophilia. Following the insertion of a central VAD, patients were requested to return to the hospital on a quarterly basis for a multidisciplinary appointment which included clinical examination, chest X-ray, cardiac and major vessels ultrasound and preventive fibrinolysis. The family was urged to return to the Haemophilia Care Centre if complications or problems occurred. The follow-up comprised 50 patients. Data were collected prospectively. The total number of days with a VAD was 86 461 days and the total number of times the VAD was used was 41 192 (approximately every other day). Mean duration of VAD placement was 1269 days (range 113-2794 days). There were 25 complications, of which 9 haematomas and 5 systemic infections. Two VADs, infected with Staphylococcus aureus, had to be replaced. The infection rate was calculated as 0.0578 infections/1000 catheter days. There were no cases of thrombosis. This study concluded that most VAD infections in children can be avoided, even in patients requiring intense, prolonged treatment. The very low infection rate was achieved through the efforts of a multidisciplinary team, combined with extensive training for all individuals involved, adherence to written protocols and specific monitoring measures. PMID:25623936

  3. Noninvasive Transcutaneous Monitoring in Long-Term Follow-Up of Patients With Thromboangiitis Obliterans Treated With Intravenous Iloprost.

    PubMed

    Melillo, Elio; Grigoratos, Chrysanthos; Sanctis, Francesco De; Spontoni, Paolo; Nuti, Marco; Dell'Omodarme, Matteo; Ferrari, Mauro; Balbarini, Alberto

    2015-07-01

    We evaluated the effectiveness of intravenous iloprost (IVI) in outpatients with thromboangiitis obliterans (TAO) and lower limb noninvasive transcutaneous monitoring (TCM) at follow-up (FU). Ten consecutive patients with TAO underwent IVI therapy. Transcutaneous oxygen (TcPo 2) and carbon dioxide (TcPco 2) determination and laser Doppler flowmetry (LDF) were performed before and after IVI at 3, 6, and 12 months of FU. Clinical response was positive in 7 patients, whereas 3 nonresponders underwent a second IVI cycle with 1 showing a late positive clinical response. After 12 months of FU, all patients were alive without amputations. Supine and dependent TcP2 levels significantly improved (P < .005). Hallux LDF values showed significant change with the maximal hyperemic test at 44°C (P < .005). Forefoot maximal hyperemic test at 44°C LDF (P < .005) and improved venous arterial reflex (P < .05) showed statistically significant time evolution. We demonstrated some degree of IVI effectiveness and evaluated TCM in patients with TAO. PMID:25005765

  4. Long-term effects of STN DBS on mood: psychosocial profiles remain stable in a 3-year follow-up

    PubMed Central

    Kaiser, Iris; Kryspin-Exner, Ilse; Brücke, Thomas; Volc, Dieter; Alesch, François

    2008-01-01

    Background Deep brain stimulation of the subthalamic nucleus significantly improves motor function in patients with severe Parkinson's disease. However, the effects on nonmotor aspects remain uncertain. The present study investigated the effects of subthalamic nucleus deep brain stimulation on mood and psychosocial functions in 33 patients with advanced Parkinson's disease in a three year follow-up. Methods Self-rating questionnaires were administered to 33 patients prior to surgery as well as three, six, twelve and 36 months after surgery. Results In the long run, motor function significantly improved after surgery. Mood and psychosocial functions transiently improved at one year but returned to baseline at 36 months after surgery. In addition, we performed cluster and discriminant function analyses and revealed four distinct psychosocial profiles, which remained relatively stable in the course of time. Two profiles featured impaired psychosocial functioning while the other two of them were characterized by greater psychosocial stability. Conclusion Compared to baseline no worsening in mood and psychosocial functions was found three years after electrode implantation. Moreover, patients can be assigned to four distinct psychosocial profiles that are relatively stable in the time course. Since these subtypes already exist preoperatively the extent of psychosocial support can be anticipatory adjusted to the patients' needs in order to enhance coping strategies and compliance. This would allow early detection and even prevention of potential psychiatric adverse events after surgery. Given adequate psychosocial support, these findings imply that patients with mild psychiatric disturbances should not be excluded from surgery. PMID:19014430

  5. Alternate-Day Low-Dose Aspirin and Cancer Risk: Long-term Observational Follow-up of a Randomized Trial

    PubMed Central

    Cook, Nancy R.; Lee, I-Min; Zhang, Shumin M.; Moorthy, M. V.; Buring, Julie E.

    2013-01-01

    Background Observational studies and meta-analyses of trials suggest daily aspirin use may affect cancer risk, particularly for colorectal cancer, but evidence regarding alternate-day use is scant. Objective To examine the association between long-term use of alternate-day low-dose aspirin and cancer incidence in healthy women. Design Observational follow-up of a randomized controlled trial. Setting U.S. female health professionals. Participants 39,876 women aged 45 and over in the Women’s Health Study, 33,682 of whom continued observational follow-up. Intervention 100 mg of aspirin or placebo administered every other day until March 2004, with a median 10-year follow-up. Post-trial observational follow-up continued through March 2012. Measurements Incidence of cancer. Results 5,071 cancers were confirmed throughout follow-up, including 2,070 breast, 451 colorectal, 431 lung cancers, and 1,391 cancer deaths. Over the entire follow-up there was no overall effect of aspirin on total (hazard ratio (HR) = 0.97, 95% confidence interval (CI) = 0.92-1.03, p=0.31), breast (HR=0.98, 95% CI = 0.90-1.07 p=0.65) or lung (HR=1.04, 95% CI = 0.86-1.26, p=0.67) cancer. Incidence of colorectal cancer was lower in the aspirin group (HR=0.80, 95% CI = 0.67-0.97, p=0.021), primarily due to a reduction in proximal colon cancer (HR=0.73, 95% CI = 0.55-0.95, p=0.022), with the effect emerging after 10 years. The post-trial reduction in colorectal cancer was 42% (HR=0.58, 95% CI = 0.42-0.80, p<0.001). There was no extended effect on cancer deaths or colorectal polyps. There were more reported gastrointestinal bleeds (HR=1.14, 95% CI=1.06-1.22, p<0.001) and peptic ulcers (HR=1.17, 95% CI=1.09-1.27, p<0.001) in the aspirin group. Limitations Data were available only for women. Not all women received extended follow-up, and the possibility of ascertainment bias post-trial cannot be ruled out. Gastrointestinal bleeding, peptic ulcer, and polyp information was obtained only from self-report during extended follow-up. Conclusions Long-term use of alternate-day, low-dose aspirin may reduce risk for colorectal cancer in healthy women. PMID:23856681

  6. Long-term follow-up of the residents of the Three Mile Island accident area: 1979-1998.

    PubMed

    Talbott, Evelyn O; Youk, Ada O; McHugh-Pemu, Kathleen P; Zborowski, Jeanne V

    2003-03-01

    The Three Mile Island (TMI) nuclear power plant accident (1979) prompted the Pennsylvania Department of Health to initiate a cohort mortality study in the TMI accident area. This study is significant because of the long follow-up (1979-1998), large cohort size (32,135), and evidence from earlier reports indicating increased cancer risks. Standardized mortality ratios (SMRs) were calculated to assess the mortality experience of the cohort compared with a local population. Relative risk (RR) regression modeling was performed to assess cause-specific mortality associated with radiation-related exposure variables after adjustment for individual smoking and lifestyle factors. Overall cancer mortality in this cohort was similar to the local population [SMRs = 103.7 (male); 99.8 (female)]. RR modeling showed neither maximum gamma nor likely gamma exposure was a significant predictor of all malignant neoplasms; bronchus, trachea, and lung; or heart disease mortality after adjusting for known confounders. The RR estimates for maximum gamma exposure (less than or equal to 8, 8-19, 20-34, greater than or equal to 35 mrem) in relation to all lymphatic and hematopoietic tissue (LHT) are significantly elevated (RRs = 1.00, 1.16, 2.54, 2.45, respectively) for males and are suggestive of a potential dose-response relationship, although the test for trend was not significant. An upward trend of RRs and SMRs for levels of maximum gamma exposure in relation to breast cancer in females (RRs = 1.00, 1.08, 1.13, 1.31; SMRs = 104.2, 113.2, 117.9) was also noted. Although the surveillance within the TMI cohort provides no consistent evidence that radioactivity released during the nuclear accident has had a significant impact on the overall mortality experience of these residents, several elevations persist, and certain potential dose-response relationships cannot be definitively excluded. PMID:12611664

  7. Urinary Symptom Flare in 712 {sup 125}I Prostate Brachytherapy Patients: Long-Term Follow-Up

    SciTech Connect

    Keyes, Mira, E-mail: mkeyes@bccancer.bc.c [Provincial Prostate Brachytherapy Program, British Columbia Cancer Agency, Vancouver, BC (Canada); Miller, Stacy; Moravan, Veronika; Pickles, Tom; Liu, Mitchell; Spadinger, Ingrid; Lapointe, Vincent; Morris, W. James [Provincial Prostate Brachytherapy Program, British Columbia Cancer Agency, Vancouver, BC (Canada)

    2009-11-01

    Purpose: To describe the late transient worsening of urinary symptoms ('urinary symptom flare') in 712 consecutive prostate brachytherapy patients, associated predictive factors, association with rectal and urinary toxicity, and the development of erectile dysfunction. Methods and Materials: Patients underwent implantation between 1998 and 2003 (median follow-up, 57 months). International Prostate Symptom Score (IPSS), Radiation Therapy Oncology Group (RTOG) toxicity, and erectile function data were prospectively collected. Flare was defined as an increase in IPSS of >=5 and of >=8 points greater than the post-treatment nadir. The relationships between the occurrence of flare and the patient, tumor, and treatment characteristics were examined. The Cox proportional hazards method was used to test individual variables and the multivariate models. Results: The incidence of flare was 52% and 30% using the flare definition of an IPSS of >=5 and >=8 points greater than the postimplant nadir, respectively. Of the patients with symptoms, 65% had resolution of their symptoms within 6 months and 91% within 1 year. Flares most commonly occurred 16-24 months after implantation. On multivariate analysis, a greater baseline IPSS and greater maximal postimplant IPSS were the predictors of flare, regardless of the flare definition used. Androgen suppression was a predictor for fewer flares (IPSS >=5). Diabetes and prostate edema predicted for more frequent flares (IPSS >=8). Patients with flare had a greater incidence of RTOG Grade 3 urinary toxicity and RTOG Grade 2 or greater rectal toxicity. No association was found between erectile dysfunction and the occurrence of flare. Conclusion: Urinary symptom flare is a common, transient phenomenon after prostate brachytherapy. A greater baseline IPSS and maximal postimplant IPSS were the strongest predictive factors. Flare was associated with a greater incidence of late RTOG Grade 3 urinary toxicity and greater rate of late RTOG Grade 2 or greater rectal toxicity.

  8. Acute ST-segment elevation myocardial infarction in a young patient with essential thrombocythemia: a case with long-term follow-up report

    PubMed Central

    Bhat, Tariq; Ahmed, Mohammed; Baydoun, Hassan; Ghandour, Zahraa; Bhat, Alina; McCord, Donald

    2014-01-01

    Essential thrombocythemia (ET) is a neoplastic proliferation of mature myeloid cells – in particular, megakaryocytes – leading to persistently elevated platelet count. Usual clinical presentation is related to an increase in the risk of hemorrhage and/or thrombosis. Management of ET consists of antiplatelet therapies – mainly aspirin and cytoreductive therapies. Coronary involvement in patients with ET is rare. The optimal treatment strategies for ET patients presenting with acute myocardial infarction remains unclear. Acute interventions like intracoronary thrombolytic therapy, angioplasty, and coronary-artery bypass grafting have been reported in such patients. However, several questions remain unanswered about the acute and long-term management of these patients. Herein, we report the case of a 47-year-old female who presented with acute myocardial infarction as the first clinical sign of ET, and also present the long-term follow-up of this patient. PMID:25093003

  9. Intensity-modulated radiotherapy versus radical prostatectomy in patients with localized prostate cancer: long-term follow-up

    PubMed Central

    2013-01-01

    Background The objective of this work was to assess the overall survival, cause-specific survival and biochemical failure-free survival of a contemporary cohort of patients with localized prostate cancer (PCa) treated with intensity-modulated radiation therapy (IMRT) or radical prostatectomy (RP). Methods We did a retrospective cohort study of our institution’s registry of patients undergoing either IMRT or RP between January 1999 and March 2010, and assessed Prostate Specific Antigen (PSA), age at diagnosis, Gleason score, and digital rectal examination. Two groups were separated according to RP or IMRT treatment and these groups were in turn divided into risk groups according to the D’Amico classification. Overall survival (OS), cause-specific survival (CSS), mortality from other causes (MOC), and biochemical disease-free survival (BDFS) were assessed. Results Twelve-hundred patients were included: 993 in the RP group and 207 in the IMRT group. The IMRT group had older age, PSA at diagnosis and a significantly higher percentage of cancer on the needle biopsy (p <0.001). Of the 207 patients who underwent IMRT, 54% presented comorbidities. Median follow-up was 91.7 months for the RP group and 76 months for the IMRT group. The OS at 5 and 7 was 96.2, and 93.7 for the RP group respectively and 88.4, and 83.1 for the IMRT group respectively (p <0.001). There were no significant differences in the CSS in relation to treatment received among the low- and high-risk groups, while in the intermediate-risk group, patients who underwent to RP had a higher CSS than patients who underwent IMRT (99.6% vs 94.1%, p?=?0.003). The IMRT group had a significantly better BDFS than the RP group (86.4% vs. 74.3%, respectively, p?=?0.016). Conclusions Patients treated with RP were significantly younger and had a better prognosis than patients treated using IMRT, and according to our results, RP had better outcomes in terms of OS while IMRT had greater MOC. Treatment modality did not affect the CSS. PMID:24209381

  10. Lessons Learned Through the Follow-up of the Long-Term Effects of Over-Exposure to an Ir192 Industrial Radiography Source in Bangladesh

    SciTech Connect

    Jalil, A.; Rabbani, G.; Hossain, M. K.; Alam, M. K.; Koddus, A.

    2003-02-24

    An industrial radiographer was accidentally over-exposed while taking the radiograph of weld-joints of gas pipe-lines in 1985 in Bangladesh. Symptoms of high radiation exposure occurred immediately after the accident and skin erythema developed leading to progressive tissue deterioration. The consequences of this over-exposure is being followed up to assess the long-term effects of ionizing radiation on the victim. Progressive tissue deteriorations have already led to multiple surgeries and successive amputations of the finger-tips so far. Lessons learned from this accident are also reported in this paper.

  11. Nasopharyngeal carcinoma in adults: treatment results after long-term follow-up with special reference to adjuvant interferon-beta in undifferentiated carcinomas

    Microsoft Academic Search

    Hendrik Andreas Wolff; Ralph M. W. Rödel; Bastian Gunawan; Tobias Overbeck; Markus K. A. Herrmann; Steffen Hennies; Andrea Hille; Hilke Vorwerk; Christoph Matthias; Clemens F. Hess; Hans Christiansen

    2010-01-01

    Purpose  Nasopharyngeal carcinomas (NPC) are radiosensitive, and radiotherapy is the standard curative treatment. Furthermore, it has\\u000a been shown that combined radiochemotherapy improves prognosis in locally advanced stages. Further encouraging results have\\u000a been obtained with adjuvant interferon-beta after primary radio(chemo)therapy in childhood undifferentiated NPC. Aim of the\\u000a present study was to evaluate the treatment results after long-term follow-up after radio(chemo)therapy for adult

  12. Family-focused cognitive behaviour therapy versus psycho-education for adolescents with chronic fatigue syndrome: long-term follow-up of an RCT.

    PubMed

    Lloyd, Samantha; Chalder, Trudie; Rimes, Katharine A

    2012-11-01

    The aim of this study was to investigate the long term efficacy of family-focused cognitive behaviour therapy (CBT) compared with psycho-education in improving school attendance and other secondary outcomes in adolescents with chronic fatigue syndrome (CFS). A 24 month follow-up of a randomised controlled trial was carried out. Participants received either 13 one-hour sessions of family-focused CBT or four one-hour sessions of psycho-education. Forty-four participants took part in the follow-up study. The proportion of participants reporting at least 70% school attendance (the primary outcome) at 24 months was 90% in CBT group and 84% in psycho-education group; the difference between the groups was not statistically significant (OR = 1.29, p = 0.80). The proportion of adolescents who had recovered in the family-focused CBT group was 79% compared with 64% in the psycho-education, according to a definition including fatigue and school attendance. This difference was not statistically significant (Fisher's exact test, p = 0.34). Family-focused CBT was associated with significantly better emotional and behavioural adjustment at 24 month follow-up compared to psycho-education, as reported by both adolescents (F = 6.49, p = 0.02) and parents (F = 4.52, P = 0.04). Impairment significantly decreased in both groups between six and 24 month follow-ups, with no significant group difference in improvement over this period. Gains previously observed for other secondary outcomes at six month follow-up were maintained at 24 month follow-up with no further significant improvement or group differences in improvement. In conclusion, gains achieved by adolescents with CFS who had undertaken family-focused CBT and psycho-education generally continued or were maintained at two-year follow-up. The exception was that family-focused CBT was associated with maintained improvements in emotional and behavioural difficulties whereas psycho-education was associated with deterioration in these outcomes between six and 24-month follow-up. PMID:22985998

  13. Neurocognitive and Clinical Predictors of Long-Term Outcome in Adolescents at Ultra-High Risk for Psychosis: A 6-Year Follow-Up

    PubMed Central

    Schothorst, Patricia; Sprong, Mirjam; van Engeland, Herman; Kahn, René; Durston, Sarah

    2014-01-01

    Background Most studies aiming to predict transition to psychosis for individuals at ultra-high risk (UHR) have focused on either neurocognitive or clinical variables and have made little effort to combine the two. Furthermore, most have focused on a dichotomous measure of transition to psychosis rather than a continuous measure of functional outcome. We aimed to investigate the relative value of neurocognitive and clinical variables for predicting both transition to psychosis and functional outcome. Methods Forty-three UHR individuals and 47 controls completed an extensive clinical and neurocognitive assessment at baseline and participated in long-term follow-up approximately six years later. UHR adolescents who had converted to psychosis (UHR-P; n?=?10) were compared to individuals who had not (UHR-NP; n?=?33) and controls on clinical and neurocognitive variables. Regression analyses were performed to determine which baseline measures best predicted transition to psychosis and long-term functional outcome for UHR individuals. Results Low IQ was the single neurocognitive parameter that discriminated UHR-P individuals from UHR-NP individuals and controls. The severity of attenuated positive symptoms was the only significant predictor of a transition to psychosis and disorganized symptoms were highly predictive of functional outcome. Conclusions Clinical measures are currently the most important vulnerability markers for long-term outcome in adolescents at imminent risk of psychosis. PMID:24705808

  14. Empirical pulmonary vein isolation in patients with chronic atrial fibrillation using a three-dimensional nonfluoroscopic mapping system: long-term follow-up.

    PubMed

    Kanagaratnam, L; Tomassoni, G; Schweikert, R; Pavia, S; Bash, D; Beheiry, S; Lesh, M; Niebauer, M; Saliba, W; Chung, M; Tchou, P; Natale, A

    2001-12-01

    The purpose of this study was to assess the feasibility and long-term results of empirical isolation of both superior pulmonary veins in patients with chronic AF. Although localizing and ablating the focal triggers of AF has been proven an effective approach, this strategy is time consuming, often requires multiple procedures, and carries the risk of pulmonary vein stenosis. Whether ostial electrical isolation of the superior pulmonary veins, without initial detailed mapping, is a more efficient approach is not known. The study included 71 consecutive patients who had chronic AF. Using a nonfluoroscopic electroanatomic mapping system, the left and right superior pulmonary veins were ablated circumferentially at the venoatrial junction, with the aim of achieving electrical isolation of the veins. Following ablation, if frequent atrial ectopies were present, mapping and ablation were considered. The patients were periodically followed with 48-hour Holter and loop recorder monitoring. After the ablation of the right and left superior pulmonary veins 59 (83%) of 71 patients maintained sinus rhythm without premature atrial beats. The remaining 12 patients underwent further mapping and ablation including 5 patients who required isolation of the left inferior pulmonary veins. True electrical isolation could be achieved only in 45 (31%) of the 147 targeted veins. At the latest follow-up (mean 29 +/- 8 months), 80% of the patients with upper vein isolation remained in sinus rhythm off medications, 62% of the patients maintained sinus rhythm on previously ineffective medications, and 17% continued to be in AF. Fourteen (20%) patients developed intermittent episodes of left atrial flutter, and mapping in these patients revealed large electrically silent areas in the left atrium. Empirical isolation of pulmonary veins appeared to be an effective approach to help maintain sinus rhythm in patients with chronic AF. True electrical isolation of the pulmonary veins was associated with a higher likelihood of long-term success. Left atrial flutter was seen in a significant number of patients at long-term follow-up. PMID:11817811

  15. Long-term Evolution of Slipped Capital Femoral Epiphysis Treated by in Situ Fixation: A 26 Years Follow-up of 11 Hips

    PubMed Central

    Murgier, Jérôme; de Gauzy, Jérôme Sales; Jabbour, Fouad C.; Iniguez, Xavier Bayle; Cavaignac, Etienne; Pailhé, Régis; Accadbled, Franck

    2014-01-01

    Slipped capital femoral epiphysis (SFCE) may lead to femoro acetabular impingement and long-term function impairment, depending on initial displacement and treatment. There are several therapeutic options which include in situ fixation (ISF). The objective of this study was to evaluate long-term functional and radiographic outcomes of patients with SFCE treated with ISF. We conducted a single-center, retrospective study evaluating the clinical and radiographic outcomes of SCFE in situ fixation with a mean follow-up of 26 years (10-47). Analysis of preoperative and last follow up radiographs was performed. The functional status of the hip was evaluated according to the Oxford hip score-12 and the radiographic osteoarthritis stage was rated according to Tönnis classification. Signs of femoro acetabular impingement were sought. Ten patients (11 hips) were included. The average initial slip was 33.5° (10-62). At final follow up, the average Oxford hip score was 19.3 (12-37), it was good for groups who had a small initial slip (16.7) or moderate (17) and fair for the severe group (27). Average Tönnis grade was 1.3 (0-3). The average alpha angle was 65.3° (50-80°). Femoro acetabular impingement was likely in 100% of patients with severe slip, in 50% of patients with moderate slip and in 33% of patients with a slight slip. In situ fixation generated poor functional results, substantial hip osteoarthritis and potential femoro acetabular impingement in moderate to severe SCFE’s. However, in cases with minor displacement, functional and radiographic results are satisfactory. The cut off seems to be around 30° slip angle, above which other treatment options should be considered. PMID:25002939

  16. Clinical performance of biodegradable versus permanent polymer drug-eluting stents: A meta-analysis of randomized clinical trials at long-term follow-up

    PubMed Central

    WANG, QI; ZHOU, YU; QIAO, TONG; ZHOU, MIN

    2015-01-01

    Several types of biodegradable polymer drug-eluting stents (BPDES) have been used for percutaneous transluminal angioplasty; however, the safety and efficiency of these BPDES have not been fully evaluated. A meta-analysis was, therefore, conducted to compare the clinical performance of BPDES with that of permanent polymer drug-eluting stents (PPDES) in unselected patients with coronary stenosis. PubMed, Web of Science, Medline and The Cochrane Library were searched for randomized clinical trials (RCTs) from January 2005 to January 2014. Trials that compared BPDES with PPDES in patients with coronary stenosis were considered. Twelve RCTs with a total of 15,938 patients with coronary stenosis were included in this meta-analysis. No significant difference was found between the two arms in the incidence of major adverse cardiac events (MACE) and definite or probable stent thrombosis (DpST) at the one-year follow-up (P>0.10). The use of BPDES, however, showed a tendency towards a lower risk of MACE (P=0.09) and a beneficial effect by reducing DpST episodes (P=0.04) at long-term follow-up, particularly when compared with the incidence of DpST at the one-year follow-up. BPDES also tended to be associated with a decreased late lumen loss in patients with coronary stenosis [instrumental variable =?0.04; 95% confidence interval =?0.08–0.00; P=0.05). In conclusion, the one-year outcomes following drug-eluting stent implantation showed BPDES were noninferior to PPDES in unselected patients with coronary stenosis. Long-term clinical outcomes, however, indicated that BPDES appeared to a present a lower risk of MACE and DpST. PMID:25780467

  17. Long-term HPV type-specific risks of high-grade cervical intraepithelial lesions: a 14-year follow-up of a randomized primary HPV screening trial.

    PubMed

    Smelov, Vitaly; Elfström, K Miriam; Johansson, Anna L V; Eklund, Carina; Naucler, Pontus; Arnheim-Dahlström, Lisen; Dillner, Joakim

    2015-03-01

    Quantitative knowledge of the long-term human papillomavirus (HPV) type-specific risks for high-grade cervical intraepithelial neoplasias Grades 2 and 3 (CIN2 and CIN3) is useful for estimating the effect of elimination of specific HPV types and clinical benefits of screening for specific HPV types. We estimated HPV type-specific risks for CIN2 and CIN3 using a randomized primary HPV screening trial followed up for 14.6 years using comprehensive, nationwide registers. Poisson regression estimated cumulative incidences, population attributable proportions (PAR) and incidence rate ratios (IRRs) of high-grade lesions by baseline HPV type, with censoring at date of first CIN2/3 or last registered cytology. Multivariate analysis adjusted for coinfections. IRRs were highest during the first screening round, but continued to be high throughout follow-up (IRRs for CIN3 associated with high-risk (HR) HPV positivity were 226.9, 49.3, 17.7 and 10.3 during the first, second and third screening round and for >9 years of follow-up, respectively). Increased long-term risks were found particularly for HPV Types 16, 18 and 31 and for CIN3+ risks. HPV16/18/31/33 had 14-year cumulative incidences for CIN3+ above 28%, HPV35/45/52/58 had 14 year risks between 14% and 18% and HPV39/51/56/59/66/68 had risks <10%. HPV16 contributed to the greatest proportion of CIN2+ (first round PAR 36%), followed by Types 31, 52, 45 and 58 (7-11%). HPV16/18/31/33/45/52/58 together contributed 73.9% of CIN2+ lesions and all HR types contributed 86.9%. In summary, we found substantial differences in risks for CIN2 and CIN3 between different oncogenic HPV types. These differences may be relevant for both clinical management and design of preventive strategies. PMID:25043476

  18. Long-term follow up after allogeneic stem cell transplantation in patients with severe aplastic anemia after cyclophosphamide plus antithymocyte globulin conditioning

    PubMed Central

    Konopacki, Johanna; Porcher, Raphaël; Robin, Marie; Bieri, Sabine; Cayuela, Jean-Michel; Larghero, Jérôme; Xhaard, Aliénor; Andreoli, Anna Lisa; Dhedin, Nathalie; Petropoulou, Anna; Rodriguez-Otero, Paula; Ribaud, Patricia; Moins-Teisserenc, Hélène; Carmagnat, Maryvonnick; Toubert, Antoine; Chalandon, Yves; Socie, Gérard; Peffault de Latour, Régis

    2012-01-01

    Background Due to increased rates of secondary solid organ cancer in patients with severe aplastic anemia who received an irradiation-based conditioning regimen, we decided some years ago to use the combination of cyclophosphamide and antithymocyte globulin. We report the long-term follow up of patients who underwent hematopoietic stem cell transplantation from an HLA-matched sibling donor after this conditioning regimen. Design and Methods We analyzed 61 consecutive patients transplanted from June 1991 to February 2010, following conditioning with cyclophosphamide (200 mg/kg) and antithymocyte globulin (2.5 mg/kg/day × 5 days). Results Median age was 21 years (range 4–43); 41 of the 61 patients were adults. Median duration of the disease before hematopoietic stem cell transplantation was 93 days. All but 2 patients received bone marrow as the source of stem cells and all but 2 engrafted. Cumulative incidence of acute grade II–IV graft-versus-host disease was 23% (95%CI 13–34) and 18 developed chronic graft-versus-host disease (cumulative incidence 32% at 72 months, 95% CI 20–46). In multivariate analysis, a higher number of infused CD3 cells was associated with an increased risk of developing chronic graft-versus-host disease (P=0.017). With a median follow up of 73 months (range 8–233), the estimated 6-year overall survival was 87% (95% CI 78–97). At 72 months, the cumulative incidence of avascular necrosis was 21% and 12 patients presented with endocrine dysfunction (cumulative incidence of 19%). Only one patient developed a secondary malignancy (Hodgkin’s lymphoma) during follow up. Conclusions Cyclophosphamide and antithymocyte globulin is an effective conditioning regimen for patients with severe aplastic anemia and is associated with low treatment-related mortality. Long-term complications include avascular necrosis and endocrine dysfunction. PMID:22180425

  19. The effectiveness of solution-focused therapy and short- and long-term psychodynamic psychotherapy on self-concept during a 3-year follow-up.

    PubMed

    Lindfors, Olavi; Knekt, Paul; Virtala, Esa; Laaksonen, Maarit A

    2012-11-01

    This study compares the effectiveness of solution-focused therapy (SFT) and short- and long-term psychodynamic psychotherapy (SPP and LPP) on self-concept during a 3-year follow-up. Altogether, 326 patients with mood or anxiety disorder were randomized to SFT, SPP, and LPP in the Helsinki Psychotherapy Study. Outcome was assessed using the Structural Analysis of Social Behavior questionnaire at baseline and 7, 12, 24, and 36 months after. Overall, during the first year of follow-up, self-concept improved more in both SFT and SPP than in LPP, indicated by the primary outcome indicators self-directed affiliation (AF) and self-directed autonomy, as well as by most of the eight secondary cluster scores. After the 3-year follow-up, LPP was more effective than SFT in AF and in the cluster scores self-affirm, self-blame, and self-neglect, whereas no difference was noted between LPP and SPP. Long duration and psychodynamic orientation of therapy may be beneficial for self-concept improvement. PMID:23124178

  20. Prophylactic efficacy of fluoxetine, escitalopram, sertraline, paroxetine, and concomitant psychotherapy in major depressive disorder: outcome after long-term follow-up.

    PubMed

    Peselow, Eric D; Tobia, Gabriel; Karamians, Reneh; Pizano, Demetria; IsHak, Waguih William

    2015-02-28

    The acute efficacy of selective serotonin reuptake inhibitors (SSRIs) in the treatment of major depressive disorder (MDD) is well established; however their role in longer-term prevention of recurrence remains unconfirmed. This study aims at examining: the prophylactic efficacy of four commonly used SSRIs in MDD in a naturalistic setting with long-term follow-up, the effect of concomitant cognitive behavioral therapy (CBT), and the predictors of outcome. In a prospective cohort study, 387 patients who either remitted or responded following treatment with four different SSRIs-fluoxetine, escitalopram, sertraline and paroxetine-were followed up over several years. During an average follow-up period of 34.5 months, 76.5% of patients experienced MDD recurrence. Escitalopram and fluoxetine showed a numerically higher prophylactic efficacy than paroxetine and sertraline but the difference was statistically insignificant. The prophylactic efficacy for SSRI-only treatment was limited, with a recurrence rate of 82.0%, compared to 59.0% of patient recurrence rate in concomitant Cognitive Behavioral Therapy (CBT). The relatively small size of the CBT group and the lack of randomization may undermine the extrapolation of its findings to clinical practice. Nevertheless, the study preliminary data may help in defining the clinical utility of antidepressants and CBT in the prophylaxis from MDD recurrence. PMID:25496869

  1. A method for the geometric standardization of intraoral radiographs for long-term follow up of replanted teeth: a case report.

    PubMed

    Hamanaka, Elizane Ferreira; Poi, Wilson Roberto; Salzedas, Leda Maria Pescinini; Alves, Lucieni Campoli; Panzarini, Sônia Regina; Sonoda, Celso Koogi; Martins, Christine Men

    2013-04-01

    The interpretation of the set of radiographs taken during the follow-up period after tooth replantation might pose several difficulties, especially the inability to adequately reproduce the projection geometry of the exposures. This article describes a method for the geometric standardization of intraoral radiographs using a custom-made apparatus comprising a film-holder attached to an occlusal splint for the long-term follow up of dentoalveolar trauma. The method was applied in a patient who suffered an avulsion of the maxillary central incisors and had the teeth replanted after 4 h in saline storage. Endodontic treatment started 7 days after the trauma with changes of a calcium hydroxide intracanal medication every 15 days in the first 2 months and thereafter at 30-day intervals for 8 months. Root canal filling was carried out after this period. The radiographic exposures taken at the follow-up visits were standardized to identify the possible alterations during the repair process, such as root resorptions. A maxillary arch impression was made with alginate, and the model was cast in stone for fabrication of an acetate occlusal splint. The custom-made apparatus used for standardization of the radiographic exposures was fabricated by fixing a Rinn X-C-P film-holder and a 5-mm-long piece of 0.7-mm orthodontic wire to the occlusal splint with autopolymerized acrylic resin. Radiographs were taken at 4-month intervals, starting 10 months after replantation up to 76 months. The images were digitized and analysed using the Digora system. The length of the central incisors was determined to verify the reproduction of the projection geometry of the exposures and the orthodontic wire served to assess accuracy during length estimations in the radiographs. The method described in this article for geometric standardization of intraoral radiographs provided a consistent reproduction of the geometric exposure parameters, being indicated for use in the radiographic follow up of cases of dentoalveolar trauma. PMID:22554390

  2. Long-term follow-up of invasive ocular surface squamous cell carcinoma treated with excision, cryotherapy, and topical mitomycin C.

    PubMed

    Kashkouli, Mohsen Bahmani; Heirati, Abtin; Pakdel, Farzad; Kiavash, Victoria; Naseripour, Masood; Aghamohammadi, Farzaneh

    2012-02-01

    BACKGROUND: To evaluate the efficacy of surgical excision, cryotherapy and topical Mitomycin C (MMC) for ocular surface squamous cell carcinoma (SCC) with at least 24 months follow-up. METHODS: Seventeen patients with primary and recurrent invasive SCC of ocular surface underwent surgical excision and map biopsy of the margins, and double freeze-thaw cryotherapy of the bed and margins. Topical MMC (0.04%, 4 times daily) was commenced 7-10 days after operation. It was delivered in cycles that consisted of medication 4 times daily for 7 consecutive days followed by 7 consecutive days of no medication. Patients with primary SCC received two cycles (protocol 1) and those with recurrent SCC received three cycles (protocol 2). Patients with intra-ocular and or orbital extension or those with less than 24 months of follow-up were excluded. The frequency of tumor recurrence and complications associated with treatment were measured. RESULTS: Mean age was 70.7 years (SD?=?10, range: 48-80). Mean follow-up time was 48 months (SD?=?21, range: 24-89). There were 12 patients with primary SCC and five with recurrent SCC. Mean largest diameter was 9.7 mm (3-20). Surgical margins were free in 12 cases. One patient with recurrent SCC who received protocol 2 treatment developed recurrence 9 months after excision, and remained free of recurrence 24 months after second treatment. Complications comprised transient mild punctate corneal epithelial erosion (eight), irritation and conjunctival hyperemia (11), corneal scar (six), and scleral thinning (three). All except one responded well to conservative management. One scleral thinning required scleral patch graft 1 year after treatment. CONCLUSION: The combination of surgical excision, cryotherapy, and post-operative topical mitomycin-C was effective treatment for ocular surface invasive SCC in long-term follow-up. PMID:22297537

  3. Primary Infrarenal Aortic Stenting With or Without Iliac Stenting for Isolated and Aortoiliac Stenoses: Single-Centre Experience With Long-Term Follow-Up

    SciTech Connect

    Tapping, C. R.; Ahmed, M.; Scott, P. M.; Lakshminarayan, R.; Robinson, G. J.; Ettles, D. F.; Shrivastava, V., E-mail: vivek.shrivastava@hey.nhs.uk [Hull Royal Infirmary, Hull and East Yorkshire Hospitals NHS Trust, Department of Radiology (United Kingdom)

    2013-02-15

    The purpose of this study was to evaluate the technical success, complications, long-term clinical outcome, and patency after primary infrarenal aortic stenting for aortic and aortoiliac stenosis. Between January 1999 and January 2006, 22 consecutive patients underwent endovascular treatment because of infrarenal aortic stenosis with and without common iliac stenosis (10 men; mean age 64 {+-} 14 years). Eleven (11 of 22) patients had an isolated aortic stenosis, whereas 11 of 22 had aortic stenosis that extended into the common iliac arteries (CIAs). Thirteen patients were Rutherford classification type 3, and 9 patients were type 4. Statistical analysis included paired Student t test and Kaplan-Meier life table analysis; p < 0.05 was considered significant. Technical and initial clinical success was achieved in all patients. There were three (14 %) procedure-related complications, which included two access-point pseudoaneurysms and one non-flow-limiting left external iliac dissection. Patients were followed-up for a mean period of 88 months (range 60-132). Mean preprocedure ankle brachial pressure indexes (ABPI) were 0.60 {+-} -0.15 (right) and 0.61 {+-} -0.16 (left). After the procedure they were 0.86 {+-} -0.07 (right) and 0.90 {+-} -0.09 (left). The increase in ABPI was significant (p < 0.05), and this continued throughout follow-up. Four (18 %) patients had recurrence of symptoms during follow-up. These occurred at 36, 48, 48, and 50 months after the original procedure. All four patients were successfully treated with repeat angioplasty procedures. There was a significant difference in primary patency between isolated aortic stenosis (100 %) and aortoiliac stenosis (60 %) (p = 0.031). Cumulative follow-up was 1920 months yielding a reintervention rate of 0.025/events/year. Primary stenting of infrarenal stenosis is safe and successful with a low reintervention rate. It should be considered as first-line treatment for patients with infrarenal aortic stenotic disease.

  4. NCI, NHLBI/PBMTC First International Consensus Conference on Late Effects after Pediatric Hematopoietic Cell Transplantation: The Need for Pediatric Specific Long Term Follow-up Guidelines

    PubMed Central

    Pulsipher, Michael A.; Skinner, Roderick; McDonald, George B.; Hingorani, Sangeeta; Armenian, Saro H.; Cooke, Kenneth R.; Gracia, Clarisa; Petryk, Anna; Bhatia, Smita; Bunin, Nancy; Nieder, Michael L.; Dvorak, Christopher C.; Sung, Lillian; Sanders, Jean E.; Kurtzberg, Joanne; Baker, K. Scott

    2012-01-01

    Existing standards for screening and management of late effects occurring in children who have undergone hematopoietic cell transplantation (HCT) include recommendations from pediatric cancer networks and consensus guidelines from adult-oriented transplantation societies applicable to all recipients of HCT. While these approaches have significant merit, they are not pediatric-HCT focused and they do not address post-HCT challenges faced by children with complex non-malignant disorders. In this article we discuss the strengths and weaknesses of current published recommendations and conclude that pediatric-specific guidelines for post-HCT screening and management would be beneficial to the long-term health of these patients and would promote late-effects research in this field. Our panel of late effects experts also provides recommendations for follow up and therapy of selected post-HCT organ and endocrine complications in pediatric patients. PMID:22248713

  5. Long-term follow-up of symptomatic patients with lymphoplasmacytic lymphoma/Waldenström macroglobulinemia treated with the anti-CD52 monoclonal antibody alemtuzumab

    PubMed Central

    Soumerai, Jacob D.; Hunter, Zachary R.; Patterson, Christopher J.; Ioakimidis, Leukothea; Kahl, Brad; Boxer, Michael

    2011-01-01

    CD52 is expressed on malignant cells in lymphoplasmacytic lymphoma (LPL), including IgM-secreting Waldenström macroglobulinemia (WM). We examined the activity of alemtuzumab in 28 symptomatic LPL (27 IgM and 1 IgA) patients. The median prior number of therapies for these patients was 2 (range, 0-5) and 43% had refractory disease. Patients received alemtuzumab at 30 mg IV 3 times weekly for up to 12 weeks after test dosing, and also received hydrocortisone, acyclovir, and Bactrim or equivalent prophylaxis. Patients had a complete response (n = 1), a partial response (n = 9), or a MR (n = 11) for an overall and major response rate of 75% and 36%, respectively. Median serum Ig decreased from 3510 to 1460 mg/dL (P < .001 at best response). With a median follow-up of 64 months, the median time to progression was 14.5 months. Hematologic and infectious complications, including CMV reactivation, were more common in previously treated patients and were indirectly associated with 3 deaths. Long-term follow-up revealed late-onset autoimmune thrombocytopenia (AITP) in 4 patients at a median of 13.6 months after therapy, which contributed to 1 death. Alemtuzumab is an active therapy in patients with LPL, but short- and long-term toxicities need to be carefully weighed against other available treatment options. Late AITP is a newly recognized complication of alemtuzumab in this patient population. This study is registered at www.clinicaltrials.gov as NCT00142181. PMID:21566092

  6. Rationale and design of a long term follow-up study of women who did and did not receive HPV 16/18 vaccination in Guanacaste, Costa Rica.

    PubMed

    Gonzalez, Paula; Hildesheim, Allan; Herrero, Rolando; Katki, Hormuzd; Wacholder, Sholom; Porras, Carolina; Safaeian, Mahboobeh; Jimenez, Silvia; Darragh, Teresa M; Cortes, Bernal; Befano, Brian; Schiffman, Mark; Carvajal, Loreto; Palefsky, Joel; Schiller, John; Ocampo, Rebeca; Schussler, John; Lowy, Douglas; Guillen, Diego; Stoler, Mark H; Quint, Wim; Morales, Jorge; Avila, Carlos; Rodriguez, Ana Cecilia; Kreimer, Aimée R

    2015-04-27

    The Costa Rica Vaccine Trial (CVT) was a randomized clinical trial conducted between 2004 and 2010, which randomized 7466 women aged 18 to 25 to receive the bivalent HPV-16/18 vaccine or control Hepatitis-A vaccine. Participants were followed for 4 years with cross-over vaccination at the study end. In 2010 the long term follow-up (LTFU) study was initiated to evaluate the 10-year impact of HPV-16/18 vaccination, determinants of the immune response, and HPV natural history in a vaccinated population. Herein, the rationale, design and methods of the LTFU study are described, which actively follows CVT participants in the HPV-arm 6 additional years at biennial intervals (3 additional study visits for 10 years of total follow-up), or more often if clinically indicated. According to the initial commitment, women in the Hepatitis-A arm were offered HPV vaccination at cross-over; they were followed 2 additional years and exited from the study. 92% of eligible CVT women accepted participation in LTFU. To provide underlying rates of HPV acquisition and cervical disease among unvaccinated women to compare with the HPV-arm during LTFU, a new unvaccinated control group (UCG) of women who are beyond the age generally recommended for routine vaccination was enrolled, and will be followed by cervical cancer screening over 6 years. To form the UCG, 5000 women were selected from a local census, of whom 2836 women (61% of eligible women) agreed to participate. Over 90% of participants complied with an interview, blood and cervical specimen collection. Evaluation of comparability between the original (Hepatitis-A arm of CVT) and new (UCG) control groups showed that women's characteristics, as well as their predicted future risk for cervical HPV acquisition, were similar, thus validating use of the UCG. LTFU is poised to comprehensively address many important questions related to long-term effects of prophylactic HPV vaccines. PMID:25796338

  7. Long-term follow-up from a phase 1/2 study of single-agent bortezomib in relapsed systemic AL amyloidosis.

    PubMed

    Reece, Donna E; Hegenbart, Ute; Sanchorawala, Vaishali; Merlini, Giampaolo; Palladini, Giovanni; Bladé, Joan; Fermand, Jean-Paul; Hassoun, Hani; Heffner, Leonard; Kukreti, Vishal; Vescio, Robert A; Pei, Lixia; Enny, Christopher; Esseltine, Dixie-Lee; van de Velde, Helgi; Cakana, Andrew; Comenzo, Raymond L

    2014-10-16

    CAN2007 was a phase 1/2 study of once- and twice-weekly single-agent bortezomib in relapsed primary systemic amyloid light chain amyloidosis (AL) amyloidosis. Seventy patients were treated, including 18 and 34 patients at the maximum planned doses on the once- and twice-weekly schedules. This prespecified final analysis provides mature response and long-term outcomes data after 3-year additional follow-up since the last report. In the once-weekly 1.6 mg/m(2) and twice-weekly 1.3 mg/m(2) bortezomib groups, final hematologic response rates were 68.8% and 66.7%; 80% of patients in each group sustained their response for ?1 year. One-year progression-free rates were 72.2% and 76.8%. Median overall survival (OS) was 62.1 months and not reached; 4-year OS rates were 75.0% and 63.0%. Low baseline difference in ?/? free light-chain level was associated with higher hematologic complete response rates and longer OS. At data cutoff, 40 (57%) patients had received subsequent therapy, including 19 (27%) retreated with bortezomib, 11 (58%) of whom achieved complete or partial hematologic responses. Four patients received prolonged bortezomib for between 3.5 and 5.6 years, with no new safety concerns, highlighting the feasibility of long-term therapy. Single-agent bortezomib produced durable hematologic responses and promising long-term OS in relapsed AL amyloidosis. This trial was registered at www.clinicaltrials.gov as #NCT00298766. PMID:25202139

  8. Long-term follow-up from a phase 1/2 study of single-agent bortezomib in relapsed systemic AL amyloidosis

    PubMed Central

    Hegenbart, Ute; Sanchorawala, Vaishali; Merlini, Giampaolo; Palladini, Giovanni; Bladé, Joan; Fermand, Jean-Paul; Hassoun, Hani; Heffner, Leonard; Kukreti, Vishal; Vescio, Robert A.; Pei, Lixia; Enny, Christopher; Esseltine, Dixie-Lee; van de Velde, Helgi; Cakana, Andrew; Comenzo, Raymond L.

    2014-01-01

    CAN2007 was a phase 1/2 study of once- and twice-weekly single-agent bortezomib in relapsed primary systemic amyloid light chain amyloidosis (AL) amyloidosis. Seventy patients were treated, including 18 and 34 patients at the maximum planned doses on the once- and twice-weekly schedules. This prespecified final analysis provides mature response and long-term outcomes data after 3-year additional follow-up since the last report. In the once-weekly 1.6 mg/m2 and twice-weekly 1.3 mg/m2 bortezomib groups, final hematologic response rates were 68.8% and 66.7%; 80% of patients in each group sustained their response for ?1 year. One-year progression-free rates were 72.2% and 76.8%. Median overall survival (OS) was 62.1 months and not reached; 4-year OS rates were 75.0% and 63.0%. Low baseline difference in ?/? free light-chain level was associated with higher hematologic complete response rates and longer OS. At data cutoff, 40 (57%) patients had received subsequent therapy, including 19 (27%) retreated with bortezomib, 11 (58%) of whom achieved complete or partial hematologic responses. Four patients received prolonged bortezomib for between 3.5 and 5.6 years, with no new safety concerns, highlighting the feasibility of long-term therapy. Single-agent bortezomib produced durable hematologic responses and promising long-term OS in relapsed AL amyloidosis. This trial was registered at www.clinicaltrials.gov as #NCT00298766. PMID:25202139

  9. A Long-Term Follow-Up Programme for Maintenance of Motor Function after Stroke: Protocol of the life after Stroke—The LAST Study

    PubMed Central

    Askim, Torunn; Langhammer, Birgitta; Ihle-Hansen, Hege; Magnussen, Jon; Engstad, Torgeir; Indredavik, Bent

    2012-01-01

    Background. There are no evidence-based strategies that have been shown to be superior in maintaining motor function for months to years after the stroke. The LAST study therefore intends to assess the effect of a long-term follow-up program for stroke patients compared to standard care on function, disability and health. Design. This is a prospective, multi-site randomised controlled trial, with blinded assessment 18 months after inclusion. A total of 390 patients will be recruited and randomised to a control group, receiving usual care, or to an intervention group 10 to 16 weeks after onset of stroke. Patients will be stratified according to stroke severity, age above 80, and recruitment site. The intervention group will receive monthly coaching on physical activity by a physiotherapist for 18 consecutive months after inclusion. Outcomes. The primary outcome is motor function (Motor Assessment Scale) 18 months after inclusion. Secondary outcomes are: dependency, balance, endurance, health-related quality of life, fatigue, anxiety and depression, cognitive function, burden on caregivers, and health costs. Adverse events and compliance to the intervention will be registered consecutively during follow-up. PMID:23227428

  10. Long-term follow-up of deep brain stimulation of peduncolopontine nucleus in progressive supranuclear palsy: Report of three cases

    PubMed Central

    Servello, Domenico; Zekaj, Edvin; Saleh, Christian; Menghetti, Claudia; Porta, Mauro

    2014-01-01

    Background: Progressive supranuclear palsy (PSP) is a neurodegenerative disease due to mitochondrial dysfunction. The PSP syndrome presents generally with gait disorder, Parkinsonism, ophthalmoparesis and cognitive alteration. Few reports exist on deep brain stimulation (DBS) in patients with atypical Parkinsonism. The aim of our study was to evaluate further the potential role of DBS in PSP. Case Description: We report three patients with PSP with long-term follow up undergoing DBS. Two patients had right peripedunculopontine nucleus (PPN) stimulation and one patient had simultaneous right PPN and bilateral globus pallidus internus DBS. DBS of the PPN alone or combined with globus pallidus internus (GPi) determined an improvement in gait and a reduction in falls sustained over time. Combined target stimulation (GPi-PPN) was correlated with better clinical outcome than single target (PPN) DBS for PSP. Conclusions: Although few data on DBS for PSP exist, reported clinical results are encouraging. DBS might be considered as an alternative therapeutic option for patients with PSP presenting with relevant gait imbalance and frequent falls, who fail to respond to pharmacological treatment. Larger cohorts with longer follow-ups are needed to evaluate more exhaustively the efficacy of DBS in PSP. PMID:25289173

  11. Long-term follow-up analysis after rituximab therapy in children with refractory symptomatic ITP: identification of factors predictive of a sustained response.

    PubMed

    Parodi, Emilia; Rivetti, Elisa; Amendola, Giovanni; Bisogno, Gianni; Calabrese, Roberto; Farruggia, Piero; Giordano, Paola; Matarese, Sofia Maria Rosaria; Nardi, Margherita; Nobili, Bruno; Notarangelo, Lucia D; Russo, Giovanna; Vimercati, Chiara; Zecca, Marco; De Mattia, Domenico; Ramenghi, Ugo

    2009-02-01

    We report the long-term follow-up (median 39.5 months) of 49 paediatric patients (33 females and 16 males) with refractory symptomatic immune thrombocytopenic purpura (ITP) treated with rituximab. The overall response rate was 69% (34/49 patients). Twenty-one responders had a platelet count >50 x 10(9)/l at a median 20.2 months from treatment. Kaplan-Meier analysis showed a probability of relapse-free survival (RFS) of 60% at 36 months from the first rituximab infusion. The number of infusions and a previous splenectomy did not influence overall response rate. Patients who achieved complete response were significantly older at diagnosis and first rituximab infusion than partial responders (P = 0.027). Older children displayed a significantly greater probability of sustained response (RFS) at 36 months than younger children (88.9% vs. 56.7%, P = 0.037). Earlier responses (within 20 d from treatment) were significantly associated with both complete (P = 0.004) and sustained response (P = 0.002). Only mild and transient side-effects were observed in 9/49 children; no major infections nor delayed toxicities were recorded during the follow-up. PMID:19036077

  12. Long-Term Effects of Statin Treatment in Elderly People: Extended Follow-Up of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER)

    PubMed Central

    Lloyd, Suzanne M.; Stott, David J.; de Craen, Anton J. M.; Kearney, Patricia M.; Sattar, Naveed; Perry, Ivan; Packard, Christopher J.; Briggs, Andrew; Marchbank, Laura; Comber, Harry; Jukema, J. Wouter; Westendorp, Rudi G. J.; Trompet, Stella; Buckley, Brendan M.; Ford, Ian

    2013-01-01

    Background The PROspective Study of Pravastatin in the Elderly at Risk (PROSPER), a placebo-controlled trial of pravastatin, demonstrated a 19% reduction in coronary outcomes (p?=?0.006) after a mean of 3.2 years, with no impact on stroke outcomes or all-cause mortality. However, there was a suggestion of increased cancer risk. Our aim is to determine the long-term benefits and safety of pravastatin treatment in older people using post-trial follow-up of the PROSPER participants. Methods 5,804 (2,520 Scottish) men and women aged 70–82 years with either pre-existing vascular disease or increased risk of such disease because of smoking, hypertension or diabetes, were randomised to 40 mg pravastatin or matching placebo. Using record linkage to routinely collected health records, all participants (full cohort) were linked to death and cancer registries, and the Scottish cohort additionally to hospital admissions, to provide composite fatal/non-fatal cardiovascular outcomes (total mean follow-up 8.6 years). Results Pravastatin treatment for 3.2 years reduced CHD death in the full cohort, hazard ratio (HR) 0.80, 95% confidence interval (CI) 0.68–0.95, p?=?0.0091 and fatal coronary events or coronary hospitalisations in the Scottish cohort (HR 0.81, 95% CI 0.69–0.95, p?=?0.0081) over 8.6 years. There was no reduction in stroke or all-cause mortality. Cancer risk was not increased in the full cohort (HR 1.08, 95% CI 0.96–1.21, p?=?0.22). Conclusions Pravastatin treatment of elderly high-risk subjects for 3.2 years provided long-term protection against CHD events and CHD mortality. However, this was not associated with any increase in life expectancy, possibly due to competing mortality with deaths from other causes. There was no evidence of long-term increased risk of cancer. Trial registration ISRCTN40976937. PMID:24023757

  13. Long-term safety of early consumption of Lactobacillus fermentum CECT5716: A 3-year follow-up of a randomized controlled trial.

    PubMed

    Maldonado-Lobón, J A; Gil-Campos, M; Maldonado, J; López-Huertas, E; Flores-Rojas, K; Valero, A D; Rodríguez-Benítez, M V; Bañuelos, O; Lara-Villoslada, F; Fonollá, J; Olivares, M

    2015-01-01

    Lactobacillus fermentum CECT5716 is a probiotic strain originally isolated from human breast milk. Previous clinical studies in infants showed that the early administration of a milk formula containing this probiotic strain was safe and may be useful for the prevention of community-acquired infections. This is a 3-year follow-up study aimed at evaluating the long-term effects produced by the early consumption of an infant formula supplemented with L. fermentum CECT5716 (experimental group, EG) compared with a control formula without the probiotic (control group, CG). The infants included in this follow-up study had previously completed a 5-month randomized double-blind controlled trial (from 1 to 6 months of age), where the safety and tolerance of the probiotic formula was evaluated. The main outcome of the follow-up study was the growth of the children. The secondary outcomes included the incidence of infectious and non-infectious diseases, parameters related with intestinal function and faecal microbiota. At 3 years, the mean values of weight, length and head circumference were similar in children of the EG compared with those of the CG. No differences were observed in the incidence of infectious and non-infectious diseases or disorders related with intestinal function. The pattern of faecal microbiota was also similar between both groups. In conclusion, this 3-year study shows that the early administration of the probiotic of L. fermentum CECT5716 in an infant formula is safe and it does not produce measurable differences in children compared with a control formula. PMID:25697549

  14. Long-term immigrant adaptation: eight-year follow-up study among immigrants from Russia and Estonia living in Finland.

    PubMed

    Jasinskaja-Lahti, Inga

    2008-02-01

    This study was a longitudinal investigation of the three different dimensions of long-term immigrant adaptation (i.e., psychological, sociocultural, and socioeconomic adaptation) and the relationships between them in an 8-year follow-up with panel data. The 282 respondents were immigrants in Finland, born between 1961 and 1976, coming from the former Soviet Union. The results suggest that the adaptation of these immigrants has developed favourably. In 8 years, the respondents had improved their Finnish language skills and their position in the labour market. No differences were observed in their levels of psychological well-being between the two assessments. Of the three adaptation dimensions assessed, sociocultural adaptation, measured as proficiency in understanding, speaking, reading, and writing Finnish, turned out to be the most significant predictor of the two other long-term outcomes of immigrant adaptation (i.e., socioeconomic and psychological). In particular, the better the initial command of the Finnish language, the better were their socioeconomic and psychological adaptation outcomes after 8 years of residence. These results demonstrate the importance of parallel and longitudinal assessments of the different outcomes of immigrant adaptation in order to address which particular dimensions of adaptation are most critical in the beginning of acculturation in terms of determining positive development and long-term immigrant adaptation. This study was supported by City of Helsinki Urban Facts. The author gratefully acknowledges the assistance of Anniina Lahtinen and Riku Perhoniemi in the data collection, and in addition, Riku Perhoniemi for the preliminary data analysis, and advice on the Amos analyses. Cette étude longitudinale a examiné trois différentes dimensions de l'adaptation à long-terme de l'immigré (i.e., adaptation psychologique, socio-culturelle et socio-économique) et de la relation entre elles dans un suivi de 8 ans avec des données de panel. Les 282 répondants étaient des immigrés en Finland provenant de l'ancienne Union Soviétique nés entre 1961 et 1976. Les résultats suggèrent que l'adaptation de ces immigrants s'est développée favorablement. En huit ans, les répondants avaient amélioré leurs habiletés en finlandais sur le marché de travail. Aucune différence n'a été observée dans leurs niveaux de bien-être psychologique entre les deux évaluations. Parmi les trois dimensions de l'adaptation évaluées, l'adaptation socio-culturelle telle que mesurée par la capacité de comprendre, de parler, de lire et d'écrire le finlandais s'est avérée être le prédicteur le plus significatif des deux autres résultats à long-terme de l'adaptation de l'immigré (i.e., socio-économique et psychologique). Particulièrement, meilleure avait été la connaissance initiale du finlandais, meilleurs étaient leurs résultats de l'adaptation socio-économiques et psychologiques après 8 ans de résidence. Ces résultats démontrent l'importance des évaluations parallèles et longitudinales de différents résultats de l'adaptation de l'immigré pour mieux étudier quelles dimensions particulières de l'adaptation sont les plus critiques au début de l'acculturation en matière de la détermination du développement positif et de l'adaptation à long-terme de l'immigré. El estudio consistió en una investigación longitudinal sobre tres diferentes dimensiones de adaptación de inmigrantes a largo plazo (i.e. adaptación psicológica, sociocultural, socioeconómica) y la relación entre ellas en 8 años de seguimiento con los datos de grupo. Los 282 encuestados fueron inmigrantes en Finlandia procedentes de los países de la antigua Union Sovietica, nacidos entre 1961 y 1976. Los resultados sugieren que la adaptación de estos inmigrantes se desarrolló favorablemente. En ocho años, los encuestados han mejorado sus conocimientos del idioma finlandes y su posición en el mercado laboral. No se observó ningunas diferencias en su nivel del bienestar psicológico entre las dos evaluacio

  15. Five year follow-up after a first booster vaccination against tick-borne encephalitis following different primary vaccination schedules demonstrates long-term antibody persistence and safety.

    PubMed

    Beran, Ji?í; Xie, Fang; Zent, Olaf

    2014-07-23

    Long-term vaccination programs are recommended for individuals living in regions endemic for tick-borne encephalitis (TBE). Current recommendations suggest a first booster vaccine be administered 3 years after a conventional regimen or 12-18 months after a rapid regimen. However, the research supporting subsequent booster intervals is limited. The aim of this study was thus to evaluate the long-term persistence of TBE antibodies in adults and adolescents after a first booster dose with Encepur(®). A total of 323 subjects aged 15 years and over, who had received one of four different primary TBE vaccination series in a parent study, participated in this follow-up Phase IV trial. Immunogenicity and safety were assessed for up to five years after a first booster dose, which was administered three years after completion of the primary series. One subset of subjects was excluded from the booster vaccination since they had already received their booster prior to enrollment. For comparison, immune responses were still recorded for these subjects on Day 0 and on an annual basis until Year 5, but safety information was not collected. Following a booster vaccination, high antibody titers were recorded in all groups throughout the study. Neutralization test (NT) titers of ? 10 were noted in at least 94% of subjects at every time point post-booster (on Day 21 and through Years 1-5). These results demonstrated that a first booster vaccination following any primary immunization schedule results in high and long-lasting (>5 years) immune responses. These data lend support to the current belief that subsequent TBE booster intervals could be extended from the current recommendation. NCT00387634. PMID:24950352

  16. Treatment and long-term follow-up of extrahepatic biliary obstruction with bilirubin cholelithiasis in a Somali cat with pyruvate kinase deficiency.

    PubMed

    Harvey, Andrea M; Holt, Peter E; Barr, Frances J; Rizzo, Francesca; Tasker, Séverine

    2007-10-01

    A 2-year-old female neutered Somali cat was presented with vomiting and acute onset jaundice 1 year after diagnosis of pyruvate kinase (PK) deficiency. Diagnostic investigations revealed a moderate regenerative haemolytic anaemia, severe hyperbilirubinaemia and elevated liver enzymes. Ultrasonography revealed marked distension of the gall bladder and common bile duct (CBD), consistent with extrahepatic biliary obstruction (EHBO). At cholecystotomy, the gall bladder contained purulent material, and two obstructive choleliths were removed from the CBD by choledochotomy. The cat recovered from surgery uneventfully, and serum liver enzymes and bilirubin normalised within 10 days. Postoperative treatment consisted of cephalexin, metronidazole and ursodeoxycholic acid (UDCA). Bacterial culture of the gall bladder contents yielded a pure growth of an Actinomyces species. Cholelith analysis revealed that they consisted of 100% bilirubin. Antibiotic treatment was stopped 4 weeks after surgery but UDCA was continued indefinitely. The cat remains clinically well with no recurrence of cholelithiasis 20 months after initial presentation. This is the first report of successful treatment and long-term follow-up of a cat with EHBO due to bilirubin cholelithiasis in association with PK deficiency-induced chronic haemolysis. PMID:17475529

  17. Long-Term Outcome in Patients With Ductal Carcinoma In Situ Treated With Breast-Conserving Therapy: Implications for Optimal Follow-up Strategies

    SciTech Connect

    Shaitelman, Simona F. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Wilkinson, J. Ben [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Kestin, Larry L. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ye Hong [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Goldstein, Neal S. [Advanced Diagnostics Laboratory, Redford, Michigan (United States); Martinez, Alvaro A. [Michigan HealthCare Professionals, Pontiac, Michigan (United States); Vicini, Frank A., E-mail: fvicini@pol.net [Michigan HealthCare Professionals, Pontiac, Michigan (United States)

    2012-07-01

    Purpose: To determine 20-year rates of local control and outcome-associated factors for ductal carcinoma in situ (DCIS) after breast-conserving therapy (BCT). Methods and Materials: All DCIS cases receiving BCT between 1980 and 1993 were reviewed. Patient demographics and pathologic factors were analyzed for effect on outcomes, including ipsilateral breast tumor recurrence (IBTR) and survival. Results: One hundred forty-five cases were evaluated; the median follow-up time was 19.3 years. IBTR developed in 25 patients, for 5-, 10-, 15-, and 20-year actuarial rates of 9.9%, 12.2%, 13.7%, and 17.5%, respectively. One third of IBTRs were elsewhere failures, and 68% of IBTRs occurred <10 years after diagnosis. Young age and cancerization of lobules predicted for IBTR at <10 years, and increased slide involvement and atypical ductal hyperplasia were associated with IBTR at later time points. Conclusions: Patients with DCIS treated with BCT have excellent long-term rates of local control. Predictors of IBTR vary over time, and the risk of recurrence seems highest within 10 to 12 years after diagnosis.

  18. Cyclosporin A response and dependence in children with acquired aplastic anaemia: a multicentre retrospective study with long-term observation follow-up.

    PubMed

    Saracco, Paola; Quarello, Paola; Iori, Anna Paola; Zecca, Marco; Longoni, Daniela; Svahn, Johanna; Varotto, Stefania; Del Vecchio, Gian Carlo; Dufour, Carlo; Ramenghi, Ugo; Bacigalupo, Andrea; Locasciulli, Anna

    2008-01-01

    Immunosuppressive therapy (IST) with antithymocyte globulin and cyclosporin A (CyA) is the standard treatment for children with acquired aplastic anaemia (AAA) lacking a matched donor. Survival rates of more than 80% at 5 years are achieved, but the response is drug-dependent in 15-25% of cases. This study, of 42 consecutive children with AAA treated with IST, assessed the incidence of CyA-dependence, CyA and granulocyte colony-stimulating factor (G-CSF) tapering schedules and the impact of drug accumulation on progression to myelodysplasia/acute myeloid leukaemia (MDS/AML). Overall survival was 83% at 10 years. CyA-dependence without a predictive marker was observed in 18% of responders. Probability of discontinuing CyA was 60.5% at 10 years; a slow CyA tapering schedule was performed in 84% of patients; the cumulative incidence of relapse was 16% at 10 years. Relapse risk was significantly associated with rapid CyA discontinuation: 60% compared to 7.6% in the slow tapering group (P = 0.001). Cumulative incidence of MDS/AML was 8% at 10 years, with a significant correlation with both G-CSF cumulative dose and second IST. This long-term follow-up of children with AAA shows that IST with a slow CyA tapering course is an effective treatment with a low-relapse rate in these cases. PMID:18173756

  19. Mortality and loss to follow-up among HIV-infected persons on long-term antiretroviral therapy in Latin America and the Caribbean

    PubMed Central

    Carriquiry, Gabriela; Fink, Valeria; Koethe, John Robert; Giganti, Mark Joseph; Jayathilake, Karu; Blevins, Meridith; Cahn, Pedro; Grinsztejn, Beatriz; Wolff, Marcelo; Pape, Jean William; Padgett, Denis; Madero, Juan Sierra; Gotuzzo, Eduardo; McGowan, Catherine Carey; Shepherd, Bryan Earl

    2015-01-01

    Introduction Long-term survival of HIV patients after initiating highly active antiretroviral therapy (ART) has not been sufficiently described in Latin America and the Caribbean, as compared to other regions. The aim of this study was to describe the incidence of mortality, loss to follow-up (LTFU) and associated risk factors for patients enrolled in the Caribbean, Central and South America Network (CCASAnet). Methods We assessed time from ART initiation (baseline) to death or LTFU between 2000 and 2014 among ART-naïve adults (?18 years) from sites in seven countries included in CCASAnet: Argentina, Brazil, Chile, Haiti, Honduras, Mexico and Peru. Kaplan-Meier techniques were used to estimate the probability of mortality over time. Risk factors for death were assessed using Cox regression models stratified by site and adjusted for sex, baseline age, nadir pre-ART CD4 count, calendar year of ART initiation, clinical AIDS at baseline and type of ART regimen. Results A total of 16,996 ART initiators were followed for a median of 3.5 years (interquartile range (IQR): 1.6–6.2). The median age at ART initiation was 36 years (IQR: 30–44), subjects were predominantly male (63%), median CD4 count was 156 cells/µL (IQR: 60–251) and 26% of subjects had clinical AIDS prior to starting ART. Initial ART regimens were predominantly non-nucleoside reverse transcriptase inhibitor based (86%). The cumulative incidence of LTFU five years after ART initiation was 18.2% (95% confidence interval (CI) 17.5–18.8%). A total of 1582 (9.3%) subjects died; the estimated probability of death one, three and five years after ART initiation was 5.4, 8.3 and 10.3%, respectively. The estimated five-year mortality probability varied substantially across sites, from 3.5 to 14.0%. Risk factors for death were clinical AIDS at baseline (adjusted hazard ratio (HR)=1.65 (95% CI 1.47–1.87); p<0.001), lower baseline CD4 (HR=1.95 (95% CI 1.63–2.32) for 50 vs. 350 cells/µL; p<0.001) and older age (HR=1.47 (95% CI 1.29–1.69) for 50 vs. 30 years at ART initiation; p<0.001). Conclusions In this large, long-term study of mortality among HIV-positive adults initiating ART in Latin America and the Caribbean, overall estimates of mortality were heterogeneous, generally falling between those reported in high-income countries and sub-Saharan Africa.

  20. Liposomal daunorubicin versus standard daunorubicin: long term follow-up of the GIMEMA GSI 103 AMLE randomized trial in patients older than 60 years with acute myelogenous leukaemia.

    PubMed

    Latagliata, Roberto; Breccia, Massimo; Fazi, Paola; Iacobelli, Simona; Martinelli, Giovanni; Di Raimondo, Francesco; Sborgia, Marco; Fabbiano, Francesco; Pirrotta, Maria Teresa; Zaccaria, Alfonso; Amadori, Sergio; Caramatti, Cecilia; Falzetti, Franca; Candoni, Anna; Mattei, Daniele; Morselli, Monica; Alimena, Giuliana; Vignetti, Marco; Baccarani, Michele; Mandelli, Franco

    2008-12-01

    This randomized phase III clinical trial explored the efficacy of DaunoXome (DNX) versus Daunorubicin (DNR) in acute myeloid leukaemia (AML) patients aged >60 years. Three hundred and one AML patients were randomized to receive DNR (45 mg/m(2) days 1-3) or DNX (80 mg/m(2) days 1-3) plus cytarabine (AraC; 100 mg/m(2) days 1-7). Patients in complete remission (CR) received a course of the same drugs as consolidation and then were randomized for maintenance with AraC+ all trans retinoic acid or no further treatment. Among 153 patients in the DNR arm, 78 (51.0%) achieved CR, 55 (35.9%) were resistant and 20 (13.1%) died during induction. Among 148 patients in the DNX arm, 73 (49.3%) achieved CR, 47 (31.8%) were resistant and 28 (18.9%) died during induction. Univariate analysis showed no difference as to induction results. After CR, DNX showed a higher incidence of early deaths (12.5% vs. 2.6% at 6 months, P = 0.053) but a lower incidence of relapse beyond 6 months (59% vs. 78% at 24 months, P = 0.064), with a cross in overall survival (OS) and disease-free survival (DFS) curves and a later advantage for DNX arm after 12 months from diagnosis. DNX seems to improve OS and DFS in the long-term follow-up, because of a reduction in late relapses. PMID:18950458

  1. Long-term diuretic therapy in patients with coronary disease: increased colon cancer-related mortality over a 5-year follow-up

    Microsoft Academic Search

    A Tenenbaum; E Grossman; EZ Fisman; Y Adler; V Boyko; M Jonas; S Behar; M Motro; H Reicher-Reiss

    2001-01-01

    Objectives: Recent studies have suggested that long-term diuretic therapy may be associated with increased risk of renal cell carcinoma. This carcinoma is not a common malignancy, but it shares risk factors with the considerably more widespread colon cancer (CC). However, there are no data whether or not a relationship between long-term diuretic therapy and CC mortality exists. In this study

  2. Long-term Effects of Nurse Home Visitation on Children's Criminal and Antisocial Behavior 15Year Follow-up of a Randomized Controlled Trial

    Microsoft Academic Search

    David Olds; Charles R. Henderson; Robert Cole; John Eckenrode; Harriet Kitzman; Dennis Luckey; Lisa Pettitt; Kimberly Sidora; Pamela Morris; Jane Powers

    1998-01-01

    Context.— A program of home visitation by nurses has been shown to affect the rates of maternal welfare dependence, criminality, problems due to use of substances, and child abuse and neglect. However, the long-term effects of this program on children's antisocial behavior have not been examined. Objective.— To examine the long-term effects of a program of prenatal and early childhood

  3. An autoimmune myositis-overlap syndrome associated with autoantibodies to nuclear pore complexes: description and long-term follow-up of the anti-Nup syndrome.

    PubMed

    Senécal, Jean-Luc; Isabelle, Catherine; Fritzler, Marvin J; Targoff, Ira N; Goldstein, Rose; Gagné, Michel; Raynauld, Jean-Pierre; Joyal, France; Troyanov, Yves; Dabauvalle, Marie-Christine

    2014-11-01

    Autoimmune myositis encompasses various myositis-overlap syndromes, each being identified by the presence of serum marker autoantibodies. We describe a novel myositis-overlap syndrome in 4 patients characterized by the presence of a unique immunologic marker, autoantibodies to nuclear pore complexes. The clinical phenotype was characterized by prominent myositis in association with erosive, anti-CCP, and rheumatoid factor-positive arthritis, trigeminal neuralgia, mild interstitial lung disease, Raynaud phenomenon, and weight loss. The myositis was typically chronic, relapsing, and refractory to corticosteroids alone, but remitted with the addition of a second immunomodulating drug. There was no clinical or laboratory evidence for liver disease. The prognosis was good with 100% long-term survival (mean follow-up 19.5 yr).By indirect immunofluorescence on HEp-2 cells, sera from all 4 patients displayed a high titer of antinuclear autoantibodies (ANA) with a distinct punctate peripheral (rim) fluorescent pattern of the nuclear envelope characteristic of nuclear pore complexes. Reactivity with nuclear pore complexes was confirmed by immunoelectron microscopy. In a cohort of 100 French Canadian patients with autoimmune myositis, the nuclear pore complex fluorescent ANA pattern was restricted to these 4 patients (4%). It was not observed in sera from 393 adult patients with systemic sclerosis (n?=?112), mixed connective tissue disease (n?=?35), systemic lupus (n?=?94), rheumatoid arthritis (n?=?45), or other rheumatic diseases (n?=?107), nor was it observed in 62 normal adults.Autoantibodies to nuclear pore complexes were predominantly of IgG isotype. No other IgG autoantibody markers for defined connective tissue diseases or overlap syndromes were present, indicating a selective and highly focused immune response. In 3 patients, anti-nuclear pore complex autoantibody titers varied in parallel with myositis activity, suggesting a pathogenic link to pathophysiology. The nuclear pore complex proteins, that is, nucleoporins (nup), recognized by these sera were heterogeneous and included Nup358/RanBP2 (n?=?2 patients), Nup90 (n?=?1), Nup62 (n?=?1), and gp210 (n?=?1). Taken together the data suggest that nup autoantigens themselves drive the anti-nup autoimmune response. Immunogenetically, the 4 patients shared the DQA1*0501 allele associated with an increased risk for autoimmune myositis.In conclusion, we report an apparent novel subset of autoimmune myositis in our population of French Canadian patients with connective tissue diseases. This syndrome is recognized by the presence of a unique immunologic marker, autoantibodies to nuclear pore complexes that react with nups, consistent with an "anti-nup syndrome." PMID:25500708

  4. Quetiapine and classical mood stabilizers in the long-term treatment of Bipolar Disorder: A 4-year follow-up naturalistic study

    Microsoft Academic Search

    A. C. Altamura; E. Mundo; B. Dell'Osso; G. Tacchini; M. Buoli; J. R. Calabrese

    2008-01-01

    BackgroundThe aim of this naturalistic study was to compare the effectiveness of quetiapine and classical mood stabilizers, as mono- or combination therapy, in the long-term treatment of Bipolar Disorder (BD).

  5. 78 FR 66945 - Proposed Collection; 60-Day Comment request: Gulf Long-Term Follow-Up Study (GuLF STUDY)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-07

    ...Exposures range from negligible to potentially significant; however, potential long-term human health consequences are largely unknown due to insufficient research in this area. The study has enrolled 32,762 participants with a range of jobs/...

  6. Long-Term Effects of Enalapril and Nicardipine on Urinary Albumin Excretion in Patients with Chronic Renal Insufficiency: A 1Year Follow-Up

    Microsoft Academic Search

    Stefano Bianchi; Roberto Bigazzi; Giorgio Baldari; Vito M. Campese

    1991-01-01

    The long-term effects of converting enzyme inhibitors and calcium channel blockers on proteinuria and the progression of renal disease in patients with hypertension and chronic renal insufficiency are not well established. We have studied the long-term effects of treating hypertension with an angiotensin-converting enzyme inhibitor, enalapril, and a calcium channel blocker, nicardipine, on urinary albumin excretion (UAE) and on renal

  7. Long-Term Biological and Behavioural Impact of an Adolescent Sexual Health Intervention in Tanzania: Follow-up Survey of the Community-Based MEMA kwa Vijana Trial

    PubMed Central

    Doyle, Aoife M.; Ross, David A.; Maganja, Kaballa; Baisley, Kathy; Masesa, Clemens; Andreasen, Aura; Plummer, Mary L.; Obasi, Angela I. N.; Weiss, Helen A.; Kapiga, Saidi; Watson-Jones, Deborah; Changalucha, John; Hayes, Richard J.

    2010-01-01

    Background The ability of specific behaviour-change interventions to reduce HIV infection in young people remains questionable. Since January 1999, an adolescent sexual and reproductive health (SRH) intervention has been implemented in ten randomly chosen intervention communities in rural Tanzania, within a community randomised trial (see below; NCT00248469). The intervention consisted of teacher-led, peer-assisted in-school education, youth-friendly health services, community activities, and youth condom promotion and distribution. Process evaluation in 1999–2002 showed high intervention quality and coverage. A 2001/2 intervention impact evaluation showed no impact on the primary outcomes of HIV seroincidence and herpes simplex virus type 2 (HSV-2) seroprevalence but found substantial improvements in SRH knowledge, reported attitudes, and some reported sexual behaviours. It was postulated that the impact on “upstream” knowledge, attitude, and reported behaviour outcomes seen at the 3-year follow-up would, in the longer term, lead to a reduction in HIV and HSV-2 infection rates and other biological outcomes. A further impact evaluation survey in 2007/8 (?9 years post-intervention) tested this hypothesis. Methods and Findings This is a cross-sectional survey (June 2007 through July 2008) of 13,814 young people aged 15–30 y who had attended trial schools during the first phase of the MEMA kwa Vijana intervention trial (1999–2002). Prevalences of the primary outcomes HIV and HSV-2 were 1.8% and 25.9% in males and 4.0% and 41.4% in females, respectively. The intervention did not significantly reduce risk of HIV (males adjusted prevalence ratio [aPR] 0.91, 95%CI 0.50–1.65; females aPR 1.07, 95%CI 0.68–1.67) or HSV-2 (males aPR 0.94, 95%CI 0.77–1.15; females aPR 0.96, 95%CI 0.87–1.06). The intervention was associated with a reduction in the proportion of males reporting more than four sexual partners in their lifetime (aPR 0.87, 95%CI 0.78–0.97) and an increase in reported condom use at last sex with a non-regular partner among females (aPR 1.34, 95%CI 1.07–1.69). There was a clear and consistent beneficial impact on knowledge, but no significant impact on reported attitudes to sexual risk, reported pregnancies, or other reported sexual behaviours. The study population was likely to have been, on average, at lower risk of HIV and other sexually transmitted infections compared to other rural populations, as only youth who had reached year five of primary school were eligible. Conclusions SRH knowledge can be improved and retained long-term, but this intervention had only a limited effect on reported behaviour and no significant effect on HIV/STI prevalence. Youth interventions integrated within intensive, community-wide risk reduction programmes may be more successful and should be evaluated. Trial Registration ClinicalTrials.gov NCT00248469 Please see later in the article for the Editors' Summary PMID:20543994

  8. Quality of Life Influenced by Primary Surgical Treatment for Stage I-III Breast Cancer—Long-Term Follow-Up of a Matched-Pair Analysis

    Microsoft Academic Search

    W. Janni; D. Rjosk; Th. Dimpfl; K. Haertl; B. Strobl; F. Hepp; A. Hanke; F. Bergauer; H. Sommer

    2001-01-01

    Background: Breast-conserving therapy has been demonstrated to be just as safe and a less disruptive experience compared with mastectomy for surgically manageable breast cancer. There is, however, no agreement in the literature about the impact of these procedures on several important aspects of quality of life (QOL). The purpose of the present study is to compare the long-term impact of

  9. Long-term cardiovascular consequences of obesity: 20-year follow-up of more than 15 000 middle-aged men and women (the Renfrew-Paisley study)

    Microsoft Academic Search

    N. F. Murphy; K. MacIntyre; S. Stewart; C. L. Hart; D. Hole; J. J. V. McMurray

    2005-01-01

    Aims To examine the long-term cardiovascular consequences of obesity and project the cardiovascular consequences of the recent increase in prevalence of obesity. Methods and results Between 1972 and 1976, 15 402 individuals aged 45-64, living in two towns in the west of Scotland underwent comprehensive cardiovascular screening. We analysed all deaths and hospitalizations for cardiovascular reasons occurring over the subsequent

  10. Levonorgestrel-releasing intrauterine system for the management of heavy menstrual bleeding in women with inherited bleeding disorders: long-term follow-up

    Microsoft Academic Search

    Claudia Chi; Farah Y. Huq; Rezan A. Kadir

    2011-01-01

    BackgroundThere are currently limited data on the use of the levonorgestrel-releasing intrauterine system (LNG-IUS) for the management of heavy menstrual bleeding (HMB) in women with inherited bleeding disorders (IBDs) particularly on its long-term (>12 months) efficacy.

  11. Domiciliary nocturnal intermittent positive pressure ventilation in patients with respiratory failure due to severe COPD: long term follow up and effect on survival

    Microsoft Academic Search

    S E Jones; S Packham; M Hebden; A P Smith

    1998-01-01

    BACKGROUNDThere is increasing interest in the use of non-invasive nocturnal intermittent positive pressure ventilation (NIPPV) in the management of patients with chronic hypercapnoeic (type II) respiratory failure. Although this treatment enables patients requiring mechanical ventilatory support to be treated more readily at home, few studies have been done to demonstrate its long term benefits in chronic obstructive pulmonary disease (COPD)

  12. Does cognitive-behavioural therapy influence the long-term outcome of generalized anxiety disorder? An 8–14 year follow-up of two clinical trials

    Microsoft Academic Search

    R. C. DURHAM; J. A. CHAMBERS; R. R. MACDONALD; K. G. POWER; K. MAJOR

    2003-01-01

    Background. Generalized anxiety disorder is a common condition of excessive worry and tension which tends to run a chronic course associated with significant psychiatric and medical problems. Cognitive behaviour therapy (CBT) has been shown to be of clinical value in about 50% of cases with treatment gains maintained over follow-up periods ranging from 6 to 12 months. The potential value

  13. 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…

  14. Differences in the association between sickness absence and long-term sub-optimal health by occupational position: a 14-year follow-up in the

    E-print Network

    Paris-Sud XI, Université de

    Finnish Institute of Occupational Health, Helsinki, Finland 3 Stress Research Institute, Stockholm by occupational position: a 14-year follow-up in the GAZEL cohort Jane E. Ferrie1 , Mika Kivimäki1,2 , Hugo University, Stockholm, Sweden 4 INSERM, CESP U1018 Occupational and Social Determinants of Health, Villejuif

  15. A Cognitive- Behavioral Therapeutic Program for Patients with Obesity and Binge Eating Disorder: Short- and Long- Term Follow-Up Data of a Prospective Study

    ERIC Educational Resources Information Center

    Vanderlinden, Johan; Adriaensen, An; Vancampfort, Davy; Pieters, Guido; Probst, Michel; Vansteelandt, Kristof

    2012-01-01

    The goal of this study is to investigate the efficacy of a manualized cognitive-behavioral therapeutic (CBT) approach for patients with obesity and binge eating disorder (BED) on the short and longer term. A prospective study without a control group consisting of three measurements (a baseline measurement and two follow-up assessments up to 5…

  16. Long-term follow-up of acute and chronic nonA, non-B post-transfusion hepatitis: evidence of progression to liver cirrhosis

    Microsoft Academic Search

    G Realdi; A Alberti; M Rugge; A M Rigoli; F Tremolada; L Schivazappa; A Ruol

    1982-01-01

    The long-term outcome of non-A, non-B post-transfusion hepatitis was evaluated in 21 patients who developed the illness after open-heart surgery and could be followed thereafter up to five years. Histological chronic sequelae were documented in 13 patients, and consisted of chronic persistent hepatitis in one case, chronic lobular hepatitis in two and chronic active hepatitis in 10, five of whom

  17. Failure of subureteral bovine collagen injection for the endoscopic treatment of primary vesicoureteral reflux in long-term follow-up

    Microsoft Academic Search

    A Haferkamp; H Contractor; K Möhring; G Staehler; J Dörsam

    2000-01-01

    Objectives. To evaluate the long-term efficacy of subureteral glutaraldehyde cross-linked collagen injection (GAX 35) for endoscopic treatment of primary vesicoureteral reflux (VUR).Methods. We prospectively studied 36 patients (58 ureteral renal units), 30 girls and 6 boys with a median age of 6 years (range 2 months to 18 years). All patients had primary VUR and were treated with a single

  18. Tension-Free Vaginal Tape (TVT) in Stress Incontinent Women with Intrinsic Sphincter Deficiency (ISD) - A Long-Term Follow-up

    Microsoft Academic Search

    M. Rezapour; C. Falconer; U. Ulmsten

    2001-01-01

    In a prospective long-term study 49 women with stress incontinence and ISD (intrinsic sphincter deficiency) were followed for a mean of 4 years (range 3-5) after TVT operation. Preoperatively all patients underwent urodynamic investigations, quality of life evaluation, a 24-hour pad test and a gynecologic examination to properly verify the incontinence symptoms. The same protocol was used for postoperative evaluation.

  19. Implantable cardioverter\\/defibrillator therapy in arrhythmogenic right ventricular cardiomyopathy. Single-center experience of long-term follow-up and complications in 60 patients

    Microsoft Academic Search

    Thomas Wichter; Matthias Paul; Christian Wollmann

    2004-01-01

    Background—Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a major cause of ventricular tachycardia (VT) and cardiac arrest in young patients. We hypothesized that treatment with implantable cardioverter\\/defibrillators (ICDs) is safe and improves the long-term prognosis of ARVC patients at high risk of sudden death. Methods and Results—Sixty patients with ARVC (aged 4316 years) were treated with transvenous ICD systems. Despite a

  20. Tacrolimus Is Safe and Effective in Patients with Severe Steroid-Refractory or Steroid-Dependent Inflammatory Bowel Disease—A Long-Term Follow-Up

    Microsoft Academic Search

    Daniel C. Baumgart; Jan P. Pintoffl; Andreas Sturm; Bertram Wiedenmann; Axel U. Dignass

    2006-01-01

    OBJECTIVE:We and others have reported the use of tacrolimus in refractory inflammatory bowel disease (IBD). Little is known about its long-term efficacy and safety.METHODS:In this retrospective, observational single center study the charts of 53 adult patients with steroid-dependent (n = 18) or steroid-refractory (n = 35) IBD, Crohn's disease (CD) (n = 11), ulcerative colitis (UC) (n = 40), or

  1. Higher body mass index at the time of acute myocardial infarction is associated with a favorable long-term prognosis (8-year follow-up)

    Microsoft Academic Search

    Nobutaka IkedaRintaro; Rintaro Nakajima; Makoto Utsunomiya; Masaki Hori; Hideki Itaya; Kunihiko Makino; Tsuyoshi Ono; Masaya Yamamoto; Naohiko Nemoto; Raisuke Iijima; Hidehiko Hara; Takuro Takagi; Hisao Hara; Masato Nakamura; Kaoru Sugi

    Obesity is an important public health problem, especially among patients with cardiovascular disease. However, little is known\\u000a about the impact of obesity on the long-term prognoses of patients with acute myocardial infarction (AMI). Major adverse cardiac\\u000a and cerebrovascular events (MACCE) consist of all causes of death, stroke, target lesion revascularization, target vessel\\u000a revascularization, non-fatal myocardial infarction, and hospitalization. From January

  2. Endovascular Treatment of Pelvic Congestion Syndrome: Visual Analog Scale (VAS) Long-Term Follow-up Clinical Evaluation in 202 Patients

    SciTech Connect

    Laborda, Alicia, E-mail: alaborda@unizar.es; Medrano, Joaquin, E-mail: oauieao@gmail.com [University of Zaragoza, Group of Research in Minimally Invasive Techniques Research (GITMI) (Spain); Blas, Ignacio de, E-mail: deblas@unizar.es [University of Zaragoza, Edificio Hospital Veterinario, Department of Animal Pathology (Unit of Infectious Diseases and Epidemiology) (Spain); Urtiaga, Ignacio, E-mail: info@doctorurtiaga.com [Hospital Clinico Universitario 'Lozano Blesa', Department of Vascular Surgery (Spain); Carnevale, Francisco Cesar, E-mail: fcarnevale@uol.com.br [University of Sao Paulo, Medical School, Interventional Radiology (Brazil); Gregorio, Miguel A. de, E-mail: mgregori@unizar.es [University of Zaragoza, Group of Research in Minimally Invasive Techniques Research (GITMI) (Spain)

    2013-08-01

    PurposeThis study was designed to evaluate the clinical outcome and patients' satisfaction after a 5 year follow-up period for pelvic congestion syndrome (PCS) coil embolization in patients who suffered from chronic pelvic pain that initially consulted for lower limb venous insufficiency.MethodsA total of 202 patients suffering from chronic pelvic pain were recruited prospectively in a single center (mean age 43.5 years; range 27-57) where they were being treated for lower limb varices. Inclusion criteria were: lower limb varices and chronic pelvic pain (>6 months), >6 mm pelvic venous caliber in ultrasonography, and venous reflux or presence of communicating veins. Both ovarian and hypogastric veins were targeted for embolization. Pain level was assessed before and after embolotherapy and during follow-up using a visual analog scale (VAS). Technical and clinical success and recurrence of leg varices were studied. Patients completed a quality questionnaire. Clinical follow-up was performed at 1, 3, and 6 months and every year for 5 years.ResultsTechnical success was 100 %. Clinical success was achieved in 168 patients (93.85 %), with complete disappearance of symptoms in 60 patients (33.52 %). Pain score (VAS) was 7.34 {+-} 0.7 preprocedural versus 0.78 {+-} 1.2 at the end of follow-up (P < 0.0001). Complications were: groin hematoma (n = 6), coil migration (n = 4), and reaction to contrast media (n = 1). Twenty-three cases presented abdominal pain after procedure. In 24 patients (12.5 %), there was recurrence of their leg varices within the follow-up. The mean degree of patients' satisfaction was 7.4/9.ConclusionsCoil embolization of PCS is an effective and safe procedure, with high clinical success rate and degree of satisfaction.

  3. Long-Term Follow-up of a Phase I11 Study of Recombinant Human Granulocyte-Macrophage Colony-Stimulating Factor After Autologous Bone Marrow Transplantation for Lymphoid Malignancies

    Microsoft Academic Search

    Susan N. Rabinowe; Donna Neuberg; Philip J. Bierman; Julie M. Vose; John Nemunaitis; Jack W. Singer; Arnold S. Freedman; Peter Mauch; George Demetri; Nicole Onetto; Steven Gillis; Dagmar Oette; Dean Buckner; John A. Hansen; Jerome Ritz; Lee M. Nadler; Frederick R. Appelbaum

    1993-01-01

    One hundred and twenty-eight patients with non-Hodgkin's lymphoma (NHL), Hodgkin's disease (HD), and acute lym- phoblastic leukemia (ALL) previously reported from a phase 111 trial of rhGM-CSF or placebo following autologous bone marrow transplantation (ABMT) were investigated for the development of late toxicities. Median follow-up is 36 months. No apparent long-term deleterious effects on BM function were observed. Moreover, disease-free

  4. Recombinant human bone morphogenetic protein type 2 in the reconstruction of atrophic maxilla: Case report with long-term follow-up

    PubMed Central

    Zétola, André Luiz; Verbicaro, Thalyta; Littieri, Sahara; Larson, Rafaela; Giovanini, Allan Fernando; Deliberador, Tatiana Miranda

    2014-01-01

    Autologous bone is reported by scientific literature as the gold standard for the replacement of the bone loss in maxillary atrophic area. Notwithstanding, this grafting type shows several disadvantages as: The procedure morbidity, limited size of the graft and longer recovering time. Recombinant human bone morphogenetic protein type 2 (rhBMP-2) has been used as bone substitute for the reconstruction of large bone defects. The aim of this case was to report a clinical case exhibiting the reconstruction of the atrophic maxilla through using rhBMP-2 as grafting material associated with absorbable collagen sponge (ACS). At 8 months of following-up, osseointegrated implants were placed. After 2 years and 5 months of following-up, it could be observed an appropriate aesthetical and functional rehabilitation. PMID:25624638

  5. Long-term follow up of children with head injuries-classified as “good recovery” using the Glasgow Outcome Scale: neurological, neuropsychological and magnetic resonance imaging results

    Microsoft Academic Search

    W. Koelfen; M. Freund; D. Dinter; B. Schmidt; S. Koenig; C. Schultze; J. Runde

    1997-01-01

    The primary issues addressed in this study were: (1) determination of the significance of the classification “good outcome”\\u000a utilizing the Glasgow Outcome Scale (GOS) in children at least 1 year after brain injury; (2) detection of residual lesions\\u000a of brain parenchyma in these children upon follow up MRI scans; and (3) detection of relationships between neuropsychological\\u000a test performance and MRI

  6. Congenital Hypothyroidism Long-Term Follow-up Project: Navigating the Rough Waters of a Multi-Center, Multi-State Public Health Project.

    PubMed

    Wintergerst, Kupper; Gembel, Gina; Kreipe, Tracey; Zeller, Patrick; Eugster, Erica; Young, Bill; Andruszewski, Karen; Kleyn, Mary; Cunningham, Troi; Fawbush, Sandy; Vanderburg, Nancy; Sockalosky, Joe; Menon, Ram; Linard, Sharon; Hoffman, Gary; Gorman, Lisa

    2015-06-01

    The Region 4 Midwest Genetics Collaborative, made up of seven regional states (Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio, and Wisconsin), brought together pediatric endocrinologists, state laboratory experts, public health follow-up specialists, and parents of children with congenital hypothyroidism (CH) to identify the three-year follow-up management and education patterns of primary care clinicians and pediatric endocrinologists in the care of children diagnosed with CH by state newborn screening (NBS) programs. Among a number of challenges, each state had different NBS methods, data systems, public health laws, and institutional review board (IRB) requirements. Furthermore, the diagnosis of CH was complicated by the timing of the NBS sample, the gestational age, weight, and co-morbidities at delivery. There were 409 children with CH identified through NBS in 2007 in the seven state region. The clinician of record and the parents of these children were invited to participate in a voluntary survey. Approximately 64 % of clinician surveys were collected with responses to questions relating to treatment, monitoring practices, educational resources, genetic counseling, and services provided to children with confirmed CH and their families. Nearly one-quarter (24 %) of parents surveyed responded to questions relating to treatment, education, genetic counseling, resources, and services they received or would like to receive. De-identified data from six of the seven states were compiled for analysis, with one state being unable to obtain IRB approval within the study timeline. The data from this collaborative effort will improve state follow-up programs and aid in developing three-year follow-up guidelines for children diagnosed with CH. To aid in the facilitation of similar public health studies, this manuscript highlights the challenges faced, and focuses on the pathway to a successful multi-state public health endeavor. PMID:25403899

  7. Long-Term Outcomes of Microsurgical Nasal Replantation: Review of the Literature and Illustrated 10-Year Follow-Up of a Pediatric Case with Full Sensory Recovery

    PubMed Central

    Marsden, Nicholas J.; Kyle, Amanda; Jessop, Zita M.; Whitaker, Iain S.; Laing, Hamish

    2015-01-01

    We present a case of successful artery only total nose replantation in an 18-month-old child, with 10?years of follow-up and full sensory recovery despite no nerve repair. The common absence of veins for anastomosis does not prevent successful replant, as demonstrated with the use of Hirudo medicinalis use in this unique case. We comprehensively review the literature of this rare and complex injury and advocate microsurgical replantation where possible over other methods of nasal reconstruction. PMID:25759812

  8. Long-Term Results of Tamoxifen Prophylaxis for Breast Cancer — 96Month Follow-up of the Randomized IBIS-I Trial

    Microsoft Academic Search

    Jack Cuzick; John F. Forbes; Ivana Sestak; Simon Cawthorn; Hisham Hamed; Kaija Holli; Anthony Howell

    2007-01-01

    6.82 per 1000 woman-years, respectively; risk ratio (RR) = 0.73, 95% confidence interval (CI) = 0.58 to 0.91, P = .004). The prophylactic effect of tamoxifen was fairly constant for the entire follow-up period, and no diminution of benefit was observed for up to 10 years after randomization. However, side effects in the tamoxifen group were much lower after completion

  9. Treatment of Multidrug?Resistant Tuberculosis during Pregnancy: Long?Term Follow?Up of 6 Children with Intrauterine Exposure to Second?Line Agents

    Microsoft Academic Search

    Peter C. Drobac; Hernan del Castillo; Annika Sweetland; Genaro Anca; J. Keith Joseph; Jennifer Furin; Sonya Shin

    2005-01-01

    Treatment of gestational multidrug-resistant tuberculosis (MDR-TB) is controversial. We describe follow-up of 6 chil- dren exposed to second-line antituberculous agents in utero. Each child (average age, 3.7 years) underwent comprehensive clinical evaluation. One child had MDR-TB diagnosed. There was no evidence of significant late-presentation toxicity among the children. The results suggest that aggressive management of gestational MDR-TB may benefit both

  10. Fifteen Novel EIF2B1-5 Mutations Identified in Chinese Children with Leukoencephalopathy with Vanishing White Matter and a Long Term Follow-Up

    PubMed Central

    Zhang, Haihua; Dai, Lifang; Chen, Na; Zang, Lili; Leng, Xuerong; Du, Li; Wang, Jingmin; Jiang, Yuwu; Zhang, Feng; Wu, Xiru; Wu, Ye

    2015-01-01

    Leukoencephalopathy with vanishing white matter (VWM) is one of the most prevalent inherited childhood white matter disorders, which caused by mutations in each of the five subunits of eukaryotic translation initiation factor 2B (EIF2B1-5). In our study, 34 out of the 36 clinically diagnosed children (94%) were identified to have EIF2B1-5 mutations by sequencing. 15 novel mutations were identified. CNVs were not detected in patients with only one mutant allele and mutation-negative determined by gene sequencing. There is a significantly higher incidence of patients with EIF2B3 mutations compared with Caucasian patients (32% vs. 4%). c.1037T>C (p.Ile346Thr) in EIF2B3 was confirmed to be a founder mutation in Chinese, which probably one of the causes of the genotypic differences between ethnicities. Our average 4.4 years-follow-up on infantile, early childhood and juvenile VWM children suggested a rapid deterioration in motor function. Episodic aggravation was presented in 90% of infantile cases and 71.4% of childhood cases. 10 patients died during the follow-up. The Kaplan-Meier curve showed that the median survival time is 8.83 ± 1.51 years. This is the largest sample of children in a VWM follow-up study, which is helpful for a more depth understanding about the natural course. PMID:25761052

  11. Reversibility of germinative and endocrine testicular function after long-term contraception with a GnRH-agonist implant in the tom-a follow-up study.

    PubMed

    Goericke-Pesch, Sandra; Georgiev, Plamen; Antonov, Anton; Vodenicharov, Angel; Navarro, Christelle; Wehrend, Axel

    2014-04-15

    A significantly reduced gonadotropin and testosterone secretion is a well-described result of long-term administration of GnRH agonists in the male dog and cat. To date, no data are available about the duration of efficacy and the reversibility of treatment-induced effects after long-term treatment with a 4.7 mg deslorelin implant. Seven healthy male European Shorthair cats (3.2 ± 0.5 kg, 1-6 years) were treated with a 4.7 mg deslorelin implant. Blood samples (testosterone, T), testicular volume, penile spines, and mating behavior were recorded once weekly. Considering T > 0.5 ng/mL as the biological endpoint, mean duration of efficacy was 78.8 ± 12.9 weeks (range: 61.7-100.7 weeks) with T concentrations increasing rapidly after the last T less than 0.1 ng/mL (basal) (P < 0.0001), and pretreatment T concentrations being reached after 3 weeks. Testicular volume rapidly increased after the first increase of T (P < 0.001) with pretreatment testicular volume being reached after 6.9 ± 3.4 weeks (5-11 weeks). "Normal" libido reoccurred 88.7 ± 12.4 weeks after treatment, and "normal" mating behavior was observed even later. Fertile matings occurred 7 to 42 weeks after the last T less than 0.1 ng/mL with a mean of 4.0 ± 0.0 kittens, and 13.6 to 47.6 weeks afterwards testicular histology revealed normal spermatogenesis. The present data confirm that the use of slow-release GnRH-agonist implants containing deslorelin in tomcats represents an effective and safe reversible alternative for long-term contraception; however, as number of animals is low, further fertility trials are recommended. PMID:24581586

  12. The Effectiveness of Short- and Long-Term Psychodynamic Group Psychotherapy on Self-Concept: Three Years Follow-Up of a Randomized Clinical Trial.

    PubMed

    Lorentzen, Steinar; Fjeldstad, Anette; Ruud, Torleif; Marble, Alice; Klungs Yr, Ole; Ulberg, Randi; H Glend, Per A

    2015-07-01

    We compared differences in self-concept change across three years after short-(STG) and long-term (LTG) psychodynamic group psychotherapy, in a mixed sample of outpatients. Self-concept was assessed at baseline and three years later, using the Structural Analysis of Social Behavior Questionnaire. Vector scores Affiliation and Autonomy were primary, and the eight cluster scores-self-free, self-affirm, self-love, self-protect, self-control, self-blame, self-attack, and self-neglect-were secondary outcome measures. Within group univariate analyses showed change in LTG across three years on the vector scores Affiliation and Autonomy, while STG only changed on Autonomy. Comparisons between STG and LTG demonstrated a significantly larger improvement in Affiliation in LTG than in STG. This difference was explained by a higher improvement in the cluster scores of self-blame, self-attack, and self-neglect in LTG, dimensions that weight negatively on the Affiliation score. Patients with more serious self-neglect and harsh, punitive self-attack/self-blame may profit more in long-term than in short-term groups. PMID:26076204

  13. The significance of DNA measurements in a histologically defined subset of infiltrating ductal carcinomas of the breast with long-term follow-up.

    PubMed

    Troncoso, P; Dytch, H E; Bibbo, M; Wied, G L; Dawson, P J

    1989-06-01

    The nuclear DNA content and other karyometric parameters were evaluated in a histologically homogeneous group of invasive ductal carcinomas of the breast from 13 patients who survived 25 years after radical mastectomy and from 13 controls matched for histologic tumor grade, lymph node status, tumor size and patient age. The nuclear DNA content and other morphometric features were evaluated by image analysis (using a modified TICAS system) on 12-microns-thick, Feulgen-stained sections. The DNA content of the tumors of both the long-term survivors and the controls varied from the diploid range to highly aneuploid (with a large proportion of the cells having a DNA content above 5N). Overall, the tumors of the controls exhibited a higher ploidy, a greater deviation from the diploid range and a greater variation of nuclear size than did the tumors of the long-term survivors. These results suggest that these measurements may be helpful in yielding prognostic information among sets of histologically identical breast tumors of similar pathologic stage. PMID:2545218

  14. Phenylalanine-restricted diet should be life long. A case report on long-term follow-up of an adolescent with untreated phenylketonuria.

    PubMed

    Merrick, Joav; Aspler, Shoshana; Schwarz, Gerard

    2003-01-01

    The aim of this brief report is to stimulate a debate and to advocate life-long treatment with phenylalanine restricted diet to persons with phenylketonuria. We present a case of an adolescent male who today is a 65 year old with moderate mental retardation. He was previously observed as having severe challenging and self-injurious behaviour, sleeping disorder, hyperactivity, and masturbation. In the last year before reassessment he displayed loss of weight, muscle weakness resulting in wheelchair placement, upper respiratory infections, and fungal skin infections. After reassessment in 1998 the patient was started on treatment with a phenylalanine-restricted diet supplemented with vitamin B12, iron, and folic acid. At follow-up one year later the patient had regained his weight and was walking around freely. The challenging and self-injurious behaviour, and the masturbation, had ceased, and he was participating in social activities which he had previously not been able to participate in. At follow-up four years later he was still at this level of accomplishment. In general, this patient's quality of life had increased. We therefore recommend life-long treatment with phenylalanine restricted diet for persons with previously treated, and also for those with untreated, phenylketonuria. PMID:12955819

  15. Long-term follow-up after transoral laser microsurgery and adjuvant radiotherapy for advanced recurrent squamous cell carcinoma of the head and neck

    SciTech Connect

    Christiansen, Hans [Department of Radiotherapy, University of Goettingen, Goettingen (Germany)]. E-mail: hchrist@gwdg.de; Hermann, Robert Michael [Department of Radiotherapy, University of Goettingen, Goettingen (Germany); Martin, Alexios [Department of Otorhinolaryngology, University of Goettingen, Goettingen (Germany); Florez, Rodrigo [Department of Radiotherapy, University of Goettingen, Goettingen (Germany); Kahler, Elke [Department of Biometry, University of Goettingen, Goettingen (Germany); Nitsche, Mirko [Department of Radiotherapy, University of Goettingen, Goettingen (Germany); Hille, Andrea [Department of Radiotherapy, University of Goettingen, Goettingen (Germany); Steiner, Wolfgang [Department of Otorhinolaryngology, University of Goettingen, Goettingen (Germany); Hess, Clemens F. [Department of Radiotherapy, University of Goettingen, Goettingen (Germany); Pradier, Olivier [Department de Cancerologie, Hopital Morvan, Centre Hospitalier Universitaire de Brest, Brest (France)

    2006-07-15

    Purpose: The aim of this study was to evaluate the efficacy of adjuvant radiotherapy after transoral laser microsurgery for advanced recurrent head-and-neck squamous cell carcinoma (HNSCC). Patients and Methods: Between 1988 and 2000, 37 patients with advanced local recurrences (23 local and 14 locoregional recurrences) of HNSCC without distant metastases were treated in curative intent with organ-preserving transoral laser microsurgery and adjuvant radiotherapy (before 1994 split-course radiotherapy with carboplatinum, after 1994 conventional radiotherapy). Initial therapy of the primary (8.1% oral cavity, 35.1% oropharynx, 13.5% hypopharynx, and 43.3% larynx) before relapse was organ-preserving transoral laser microsurgery without any adjuvant therapy. Results: After a median follow-up of 124 months, the 5-year overall survival rate was 21.3%, the loco-regional control rate 48.3%, respectively. In multivariate analysis, stage of original primary tumor (Stage I/II vs. Stage III/IV), and patient age (<58 years vs. {>=}58 years) showed statistically significant impact on prognosis. In laryngeal cancer, larynx preservation rate after treatment for recurrent tumor was 50% during follow-up. Conclusion: Our data show that organ-preserving transoral laser microsurgery followed by adjuvant radiotherapy is a curative option for patients who have advanced recurrence after transoral laser surgery and is an alternative to radical treatment.

  16. The 10 Year Course of AA Participation and Long-Term Outcomes: A Follow-up Study of Outpatient Subjects in Project MATCH

    PubMed Central

    White, William L.; Kelly, John F.; Stout, Robert L.; Carter, Rebecca R.; Tonigan, J. Scott

    2012-01-01

    This study investigates the 10-year course and impact of AA-related helping (AAH), step-work, and meeting attendance on long-term outcomes. Data were derived from 226 treatment-seeking alcoholics recruited from an outpatient site in Project MATCH and followed for 10 years post-treatment. Alcohol consumption, AA participation, and other-oriented behavior were assessed at baseline, end of the 3-month treatment period, and one year, three years, and 10 years post-treatment. Controlling for explanatory baseline and time-varying variables, results showed significant direct effects of AAH and meeting attendance on reduced alcohol outcomes and a direct effect of AAH on improved other-oriented interest. PMID:23327504

  17. The 10-year course of Alcoholics Anonymous participation and long-term outcomes: a follow-up study of outpatient subjects in Project MATCH.

    PubMed

    Pagano, Maria E; White, William L; Kelly, John F; Stout, Robert L; Tonigan, J Scott

    2013-01-01

    This study investigates the 10-year course and impact of Alcoholics Anonymous (AA)-related helping (AAH), step-work, and meeting attendance on long-term outcomes. Data were derived from 226 treatment-seeking alcoholics recruited from an outpatient site in Project MATCH and followed for 10 years post treatment. Alcohol consumption, AA participation, and other-oriented behavior were assessed at baseline, end of the 3-month treatment period, and 1, 3, and 10 years post treatment. Controlling for explanatory baseline and time-varying variables, results showed significant direct effects of AAH and meeting attendance on reduced alcohol outcomes and a direct effect of AAH on improved other-oriented interest. PMID:23327504

  18. What happens to patients with COPD with long-term oxygen treatment who receive mechanical ventilation for COPD exacerbation? A 1-year retrospective follow-up study

    PubMed Central

    Hajizadeh, Negin; Goldfeld, Keith; Crothers, Kristina

    2015-01-01

    We performed a retrospective cohort study of patients with chronic obstructive lung disease (COPD) on long-term oxygen treatment (LTOT) who received invasive mechanical ventilation for COPD exacerbation. Of the 4791 patients, 23% died in the hospital, and 45% died in the subsequent 12?months. 67% of patients were readmitted at least once in the subsequent 12?months, and 26.8% were discharged to a nursing home or skilled nursing facility within 30?days. We conclude that these patients have high mortality rates, both in-hospital and in the 12?months postdischarge. If patients survive, many will be readmitted to the hospital and discharged to nursing home. These potential outcomes may support informed critical care decision making and more preference congruent care. PMID:24826845

  19. What happens to patients with COPD with long-term oxygen treatment who receive mechanical ventilation for COPD exacerbation? A 1-year retrospective follow-up study.

    PubMed

    Hajizadeh, Negin; Goldfeld, Keith; Crothers, Kristina

    2015-03-01

    We performed a retrospective cohort study of patients with chronic obstructive lung disease (COPD) on long-term oxygen treatment (LTOT) who received invasive mechanical ventilation for COPD exacerbation. Of the 4791 patients, 23% died in the hospital, and 45% died in the subsequent 12 months. 67% of patients were readmitted at least once in the subsequent 12 months, and 26.8% were discharged to a nursing home or skilled nursing facility within 30 days. We conclude that these patients have high mortality rates, both in-hospital and in the 12 months postdischarge. If patients survive, many will be readmitted to the hospital and discharged to nursing home. These potential outcomes may support informed critical care decision making and more preference congruent care. PMID:24826845

  20. Comparative Study of Photodynamic Therapy with Topical Methyl Aminolevulinate versus 5-Aminolevulinic Acid for Facial Actinic Keratosis with Long-Term Follow-Up

    PubMed Central

    Ko, Dong-Yeob; Kim, Ki-Ho

    2014-01-01

    Background Few studies have compared the efficacy, cosmetic outcomes, and adverse events between 5-aminolevulinic acid photodynamic therapy (ALA-PDT) and methyl aminolevulinate-PDT (MAL-PDT) for actinic keratoses (AKs) in Asian ethnic populations with dark-skin. Objective We retrospectively compared the long-term efficacy, recurrence rates, cosmetic outcomes, and safety of ALA-PDT versus MAL-PDT for facial AKs in Koreans. Methods A total of 222 facial AKs in 58 patients were included in this study. A total of 153 lesions (29 patients) were treated with 5-ALA, and 69 lesions (29 patients) with MAL. ALA and MAL creams were applied for 6 hours and 3 hours, respectively; the lesions were then illuminated with a halogen lamp at 150 J/cm2 for ALA-PDT and a diode lamp at 37 J/cm2 for MAL-PDT. Results The complete response rates of ALA-PDT and MAL-PDT were 56.9% and 50.7%, respectively, with no significant difference at 12 months after treatment. No significant difference in recurrence rates was observed between the 2 PDT modalities at either 6 or 12 months after treatment. There was no significant difference in the cosmetic outcomes between the 2 treatment modalities at 12 months after PDT. However, ALA-PDT caused significantly more painful than MAL-PDT (p=0.005). The adverse events were mild to moderate, transient, and self-limiting for both modalities. Conclusion MAL-PDT was similar to ALA-PDT in terms of long-term efficacy, recurrence rates, cosmetic outcomes, and adverse events; however, it was a significantly less painful procedure than ALA-PDT in our study. PMID:24966631

  1. Long-Term Follow-up for Rheumatoid Arthritis Patients in a Multi-center Outcomes Study of Silicone Metacarpophalangeal Joint Arthroplasty

    PubMed Central

    Chung, Kevin C.; Burns, Patricia B.; Kim, H. Myra; Burke, Frank D.; Wilgis, E. F. Shaw; Fox, David A.

    2012-01-01

    Objective Rheumatoid arthritis often results in deformities at the metacarpophalangeal (MCP) joint. Patients with severe deformities can be treated by silicone metacarpophalangeal joint arthroplasty (SMPA). The objective of the study is to prospectively compare long-term outcomes for a SMPA surgical and a non-surgical cohort of rheumatoid arthritis patients. Methods A total of 67 surgical and 95 nonsurgical patients with severe subluxation and/or ulnar drift of the fingers at the MCP joints were recruited from 2004-2008 in this multi-center prospective cohort study. Patients could elect to undergo SMPA or not. Outcomes included the Michigan Hand Outcomes Questionnaire (MHQ), Arthritis Impact Measurement Scales (AIMS2), grip/pinch strength, Jebson-Taylor test and ulnar deviation, extensor lag and arc of motion measurements at the MCP joints. Results There was no significant difference in the mean age, race, education, and income at baseline between the two groups. Surgical subjects had worse MHQ function and functional measurements at baseline. At 3 years, the mean overall MHQ score and the MHQ function, activities of daily living, aesthetics and satisfaction scores showed significant improvement in the surgical group compared to the non-surgical group. Ulnar deviation, extensor lag and arc of motion in the MCP and PIP joints also improved significantly in the surgical group. No improvement was seen in the mean AIMS2 scores and grip/pinch strength. Complications were minimal with a fracture rate of 9.5%. Conclusion RA patients with poor baseline functioning showed long term improvement in hand function and appearance following treatment with SMPA compared to non-surgical controls. PMID:22511483

  2. Long-term follow-up of patients treated by adoptive transfer of melanoma tumor-infiltrating lymphocytes as adjuvant therapy for stage III melanoma.

    PubMed

    Khammari, Amir; Nguyen, Jean-Michel; Pandolfino, Marie Christine; Quereux, Gaëlle; Brocard, Anabelle; Bercegeay, Sylvain; Cassidanius, Alain; Lemarre, Philippe; Volteau, Christelle; Labarrière, Nathalie; Jotereau, Francine; Dréno, Brigitte

    2007-11-01

    The first analysis of our clinical trial on interest of using tumor-infiltrating lymphocytes (TIL) as adjuvant therapy for stage III (regional lymph nodes) melanoma was published in 2002 [5]. The aim of this paper is to update clinical results of 7 years of follow-up after the last treated patient. In the trial conducted between December 1993 and January 1999, patients without any detectable metastases after lymph node excision were randomly assigned to receive either TIL plus interleukin-2 (IL-2) for 2 months, or IL-2 only. The duration of the relapse-free interval was the primary objective. Eighty-eight patients were enrolled in the study. Currently, the last analysis performed in June 2006, after a median follow-up of 114.8 months, did not show change of non-significant extension of the relapse-free interval or overall survival. However, this second analysis strengthens our first hypothesis about the relationship between number of invaded lymph nodes and TIL treatment effectiveness. In the group with only one invaded lymph node, the estimated relapse rate was significantly lower (P (adjusted) = 0.0219) and the overall survival was increased (P (adjusted) = 0.0125) in the TIL+IL-2 arm compared with the IL-2 only arm. No differences between the two arms, either with regard to the duration of disease-free survival (P (adjusted) = 0.38) or overall survival (P (adjusted) = 0.43), were noted in the group with more than one invaded lymph node, whatever the number of invaded lymph nodes. Treatment was compatible with normal daily activity. This study, with a very long follow up (median of almost 10 years), postulates for the first time relationship between TIL efficiency in stage III melanoma (AJCC) and number of invaded lymph nodes, indicating that tumor burden might be a crucial factor in the production of an effective in vitro expansion of T cells specific for autologous tumor antigen, a finding which could be of value in future vaccine development for the treatment of melanoma. PMID:17549472

  3. Clinical Outcomes and Complications after Pedicle Subtraction Osteotomy for Fixed Sagittal Imbalance Patients : A Long-Term Follow-Up Data

    PubMed Central

    Hyun, Seung-Jae

    2010-01-01

    Objective Clinical, radiographic, and outcomes assessments, focusing on complications, were performed in patients who underwent pedicle subtraction osteotomy (PSO) to assess correction effectiveness, fusion stability, procedural safety, neurological outcomes, complication rates, and overall patient outcomes. Methods We analyzed data obtained from 13 consecutive PSO-treated patients presenting with fixed sagittal imbalances from 1999 to 2006. A single spine surgeon performed all operations. The median follow-up period was 73 months (range 41-114 months). Events during perioperative course and complications were closely monitored and carefully reviewed. Radiographs were obtained and measurements were done before surgery, immediately after surgery, and at the most recent follow-up examinations. Clinical outcomes were assessed using the Oswestry Disability Index and subjective satisfaction evaluation. Results Following surgery, lumbar lordosis increased from -14.1° ± 20.5° to -46.3° ± 12.8° (p < 0.0001), and the C7 plumb line improved from 115 ± 43 mm to 32 ± 38 mm (p < 0.0001). There were 16 surgery-related complications in 8 patients; 3 intraoperative, 3 perioperative, and 10 late-onset postoperative. The prevalence of proximal junctional kyphosis (PJK) was 23% (3 of 13 patients). However, clinical outcomes were not adversely affected by PJK. Intraoperative blood loss averaged 2,984 mL. The C7 plumb line values and postoperative complications were closely correlated with clinical results. Conclusion Intraoperative or postoperative complications are relatively common following PSO. Most late-onset complications in PSO patients were related to PJK and instrumentation failure. Correcting the C7 plumb line value with minimal operative complications seemed to lead to better clinical results. PMID:20224706

  4. Combined chemoradiotherapy with local microwave hyperthermia for treatment of T3N0 laryngeal carcinoma: a retrospective study with long-term follow-up.

    PubMed

    Kouloulias, V; Triantopoulou, S; Vrouvas, J; Gennatas, K; Ouzounoglou, N; Kouvaris, J; Karaiskos, P; Aggelakis, P; Antypas, C; Zygogianni, A; Papavasiliou, K; Platoni, K; Kelekis, N

    2014-06-01

    The purpose of our study was to test the efficacy and toxicity of hyperthermia in conjunction with chemoradiotherapy for T3N0 laryngeal cancer. From 1997-2006, 25 patients diagnosed with T3N0 laryngeal carcinoma who denied laryngectomy were selected for this retrospective study. Patients received a total dose of 70 Gy (2 Gy per fraction, 5 days per week) in combination with 6 weekly sessions of hyperthermia, in addition to weekly cisplatin chemotherapy. The hyperthermia device was operated as a 433 MHz microwave heating with water loaded and water-cooled waveguides. The temperature was monitored subcutaneously in the skin under the aperture of the waveguide. The median follow-up was 60 months, while 23 of 25 patients (92%) presented complete response to treatment. The two patients that did not respond to thermoradiotherapy underwent total laryngectomy, and during follow-up were alive and free of disease. According to EORTC/RTOG criteria, toxicity was mild: three patients (12%) presented grade III, eight (32%) presented grade II and 14 (56%) presented grade I acute skin toxicity. Grade III laryngeal late toxicity (vocal cord malfunction due to severe oedema) was noted in two patients (8%) at 6-8 months post-thermo-chemoradiotherapy. Tmin was correlated (Spearman rho, p < 0.05) with response to treatment as well as with acute skin toxicity and laryngeal function. When a patient with T3N0 laryngeal carcinoma denies laryngectomy, an alternative treatment is combined thermo-chemoradiotherapy which seems to be effective and generally tolerable with radiation-induced skin toxicity and/or late side effects. A larger patient cohort is needed to confirm these results. PMID:24882925

  5. Long-Term Follow-Up of Dose-Adapted and Reduced-Field Radiotherapy With or Without Chemotherapy for Central Nervous System Germinoma

    SciTech Connect

    Jensen, Ashley W. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Issa Laack, Nadia N., E-mail: laack.nadia@mayo.ed [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Buckner, Jan C. [Department of Oncology, Mayo Clinic, Rochester, MN (United States); Schomberg, Paula J. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Wetmore, Cynthia J. [Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN (United States); Brown, Paul D. [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States)

    2010-08-01

    Purpose: To update our institutional experience with neoadjuvant chemotherapy and minimized radiotherapy vs. radiation monotherapy for intracranial germinoma. Methods and Materials: We retrospectively reviewed records of 59 patients with diagnosis of primary intracranial germinoma between 1977 and 2007. Treatment was irradiation alone or neoadjuvant platinum-based chemotherapy and local irradiation (initial tumor plus margin) for patients with localized complete response and reduced-dose craniospinal irradiation for others. Results: For the chemoradiotherapy group (n = 28), median follow-up was 7 years. No patient died. The freedom from progression (FFP) rate was 88% at 5 years and 80% at 10 years. In 4 patients, disease recurred 1.1 to 6.8 years after diagnosis. All were young male patients who received 30.6 Gy to local fields after complete response to chemotherapy. The FFP rate was 88% for local irradiation vs. 100% for more extensive fields (p = .06). For the radiotherapy-alone group (n = 31), median follow-up was 15 years. Overall and disease-free survival rates were 93% and 93% at 5 years and 90% and 87% at 15 years. In 5 patients, disease recurred 1.1 to 4.9 years after diagnosis. Most patients in this group were young men 18 to 23 years of age with suprasellar primary disease treated with about 50 Gy to local fields. The FFP rate was 44% for local irradiation vs. 100% for more extensive fields (p < .01). Conclusions: The addition of neoadjuvant chemotherapy to local-field radiotherapy reduced central nervous system cancer recurrence when high-risk patients were excluded by thorough pretreatment staging. There was trend toward improved central nervous system tumor control when larger fields (whole brain, whole ventricle, or craniospinal axis) were used.

  6. Predicting Clinical Outcomes Using Baseline and Follow-up Laboratory Data From The Hepatitis C Long-term Treatment Against Cirrhosis Trial

    PubMed Central

    Ghany, Marc G.; Kim, Hae-Young; Stoddard, Anne; Wright, Elizabeth C.; Seeff, Leonard B.; Lok, Anna S.F.

    2013-01-01

    Background and Aims Predicting clinical outcomes in patients with chronic hepatitis C is challenging. We used the HALT-C Trial database to develop two models, using baseline values of routinely available laboratory tests together with changes in these values during follow-up to predict clinical decompensation and liver-related death/liver transplant in patients with advanced hepatitis C. Methods Patients randomized to no treatment and who had ?2 year follow-up without a clinical outcome were included in the analysis. Four variables (platelet count, AST/ALT ratio, total bilirubin and albumin) with three categories of change (stable, mild or severe) over two years were analyzed. Cumulative incidence of clinical outcome was determined by Kaplan-Meier analysis and Cox regression was used to evaluate predictors of clinical outcome. Results 470 patients with 60 events were used to develop models to predict clinical decompensation. Baseline values of all four variables were predictive of decompensation. There was a general trend of increasing outcomes with more marked worsening of laboratory values over 2 years, particularly for patients with abnormal baseline values. A model that included baseline platelet count, AST/ALT ratio, bilirubin and severe worsening of platelet count, bilirubin and albumin was the best predictor of clinical decompensation. 483 patients with 79 events were used to evaluate predictors of liver-related death or liver transplant. A model that included baseline platelet count and albumin as well as severe worsening of AST/ALT ratio and albumin was the best predictor of liver-related outcomes. Conclusion Both the baseline value and the rapidity in change of the value of routine laboratory variables were shown to be important in predicting clinical outcomes in patients with advanced chronic hepatitis C. PMID:22045670

  7. Long-Term Impact of Battle Injuries; Five-Year Follow-Up of Injured Dutch Servicemen in Afghanistan 2006-2010

    PubMed Central

    Hoencamp, Rigo; Idenburg, Floris J.; van Dongen, Thijs T. C. F.; de Kruijff, Loes G. M.; Huizinga, Eelco P.; Plat, Marie-Christine J.; Hoencamp, Erik; Leenen, Luke P. H.; Hamming, Jaap F.; Vermetten, Eric

    2015-01-01

    Objectives Units deployed to armed conflicts are at high risk for exposure to combat events. Many battle casualties (BCs) have been reported in the recent deployment to Afghanistan. The long-term impact of these combat injuries, at their five-year end point, is currently unknown. To date, no systematic inventory has been performed of an identified group of BCs in comparison to non-injured service members from the same operational theatre. Design Observational cross-sectional cohort study. Setting Open online survey among Dutch BCs that deployed to Afghanistan (2006–2010). Participants The Dutch BCs (n = 62) were compared to two control groups of non-injured combat groups (battle exposed [n = 53], and non-battle exposed [n = 73]). Main Outcome Measures Participants rated their impact of trauma exposure (Impact of Events [IES]), post deployment reintegration (Post Deployment Reintegration Scale [PDRS]), general symptoms of distress (Symptom Checklist 90 [SCL-90]), as well as their current perceived quality of life (EuroQol-6D [EQ-6D]). Also cost effectiveness (Short From health survey [SF-36]) and care consumption were assessed (Trimbos/iMTA questionnaire). Results Over 90% of BCs were still in active duty. The mean scores of all questionnaires (IES, EQ-6D, SF-36, and SCL-90) of the BC group were significantly higher than in the control groups (p<0.05). The PDRS showed a significantly lower (p<0.05) outcome in the negative subscales. The mean consumption of care was triple that of both control groups. A lower score on quality of life was related to higher levels of distress and impact of trauma exposure. Conclusions This study showed a clear long-term impact on a wide range of scales that contributes to a reduced quality of life in a group of BCs. Low perceived cost effectiveness matched with high consumption of care in the BC group in comparison to the control groups. These results warrant continuous monitoring of BCs. PMID:25643003

  8. [Long-term outcome of lipomodeling in Poland's syndrome: about our first case with an eleven-years' follow-up].

    PubMed

    Coudurier, J; Ho Quoc, C; Ismail, M; Dlimi, C; Tourasse, C; Delay, E

    2015-02-01

    Poland's syndrome is a rare congenital malformation with thoracic and breast deformities very difficult to treat. Several techniques can be used involving, sometimes, implant insertion. Most of the classic techniques could not be used in this patient. Particularly, the transfer of the latissimus dorsi flap could not be performed because of the agenesis of the muscle. Lipomodeling is used, in our team, for breast reconstruction since 1998. This case was described and published one year after the end of the reconstruction in 2004. The immediate outcome appeared very satisfying and effective but some surgeons remained skeptical. An important question remains: what about the long-term efficiency and stability of the reconstruction? In this review, we report our first case of severe Poland's syndrome treated eleven years ago with lipomodeling. The patient was twelve years old. She had a severe form of Poland's syndrome. Five fat grafting sessions were performed between 2001 and 2003, for a total transfer of 809 ml. Today, outcome is very satisfying with a natural breast shape, consistency and sensitivity. An increase of volume in the reconstructed breast is noted. It is due to a rapid and significant weight gain by the patient. We performed two shorts movies describing this outcome one year and ten years after the reconstruction. It confirms the stability and the sustainability of the reconstruction. Lipomodeling does not interfere with breast ultrasound surveillance. Fat grafting deeply improved outcomes and management of thoracic and breast deformities in Poland's syndrome. PMID:25001416

  9. A long-term follow up of right ophthalmoplegia and severe right middle cerebral artery stenosis with right herpes zoster ophthalmics: a case report.

    PubMed

    Muramatsu, Tomoko; Hayashi, Hiromi; Kishitani, Toru; Miura, Toyoaki; Arai, Yoshikazu; Kobayashi, Yasutaka

    2015-01-01

    Here we report a case of a 68-year-old man with severe stenosis of the right middle cerebral artery (MCA) following herpes zoster ophthalmicus. He presented with right-sided ptosis and ophthalmoplegia 2 months after herpes zoster ophthalmicus. Cerebrospinal fluid (CSF) analysis revealed monocytosis, increased protein levels, and positivity for herpes zoster virus immunoglobulin M (IgM). Brain magnetic resonance imaging (MRI) revealed a small asymptomatic infarct in the right basal ganglia and severe stenosis of the right MCA (M1 segment). One month later, he presented with muscle weakness of the fingers of the left hand. Repeat CSF analysis revealed similar abnormalities to the previous analysis, and MRI showed a new small infarct in the right-sided motor area corresponding to the left fingers. He was treated with acyclovir (750?mg/day), prednisolone (1?mg/kg/day), and aspirin (100?mg/day). O2-gas positron emission tomography (PET) revealed decreased cerebral blood flow (CBF) after acetazolamide injection and normal cerebral vascular reactivity (CVR). He was on continuous treatment with prednisolone and aspirin for 1 year. The muscle weakness of the fingers of the left hand and right-sided ophthalmoplegia improved, and magnetic resonance angiography revealed considerable decrease in the stenosis of the right middle cerebral artery. CBF before and after acetazolamide injection and CVR on O2-gas PET also normalized. These results suggested that long-term treatment may prevent subsequent infarcts following herpes zoster ophthalmics. PMID:26103813

  10. Long-Term Follow-Up of a Child with Autoimmune Thyroiditis and Recurrent Hyperthyroidism in the Absence of TSH Receptor Antibodies.

    PubMed

    Dunne, Christopher; De Luca, Francesco

    2014-01-01

    Hashitoxicosis is an initial, transient, hyperthyroid phase that rarely affects patients with Hashimoto thyroiditis. We present here an unusual case of a child with Hashimoto thyroiditis and recurrent hyperthyroidism. A 4?yr 6/12 old male was diagnosed by us with autoimmune subclinical hypothyroidism (normal free T4, slightly elevated TSH, and elevated TG antibody titer). Two years and 6/12 later he experienced increased appetite and poor weight gain; a laboratory evaluation revealed suppressed TSH, elevated free T4, and normal TSI titer. In addition, an I(123) thyroid uptake was borderline-low. A month later, the free T4 had normalized. After remaining asymptomatic for 3 years, the patient presented again with increased appetite, and he was found with low TSH and high free T4. Within the following 3 months, his free T4 and TSH normalized. At his most recent evaluation, his TSH was normal and the free T4 was borderline-high; the TG antibody titer was still elevated and the TSI titer was negative. To our knowledge, this is the first patient reported with Hashimoto thyroiditis and recurrent hyperthyroidism. This case exemplifies the variability of the manifestations and natural history of Hashimoto thyroiditis and supports the need for a long-term evaluation of patients with autoimmune thyroid disease. PMID:25114812

  11. Long-Term Follow-Up and Risk of Cancer Death After Radiation for Post-Prostatectomy Rising Prostate-Specific Antigen

    SciTech Connect

    Swanson, Gregory P., E-mail: swansong@uthscsa.ed [Departments of Radiation Oncology, Radiology, and Urology, UT Health Science Center, San Antonio, Texas (United States); Du, Fei; Michalek, Joel E. [Department of Epidemiology and Biostatistics, UT Health Science Center, San Antonio, Texas (United States); Hermans, Michael [Department of Urology, Scott and White Clinic, Temple, Texas (United States)

    2011-05-01

    Purpose: The results of salvage radiation therapy for rising prostate-specific antigen (PSA) levels after radical prostatectomy appear favorable, but the ultimate outcome is uncertain, given the relatively short follow-up in most studies. We report on a group of patients at a median follow-up of 13.9 years after salvage radiation therapy. Methods and Materials: From 1990 to 1995, 92 patients were referred postoperatively for radiation for a rising PSA level. PSA level at the time of referral ranged from 0.1 to 30.5 ng/ml (median, 1.5 ng/ml). The median time from surgery to radiation was 2.1 years (range,, 0.3-7.4 years). Radiation was directed to the prostatic fossa only with a median dose of 6,500 cGy (range, 6,000-7,000 cGy). Results: Eighty-five patients experienced a PSA drop after radiation, as predicted by Gleason score and PSA level at the start of radiation. Five- and 10-year biochemical failure free survival (BFFS) was 35% and 26%, respectively, and overall survival was 86% and 67%, respectively. Median survival was 12.0 years, and median BFF was 2.3 years. The presurgery PSA level was not predictive, but the PSA level at the start of radiation predicted a response. Patients with Gleason 8 to 9 cancers had a significantly higher progression rate than those with lower Gleason scores. There were no significant differences in outcomes based on pathology findings (none vs. positive margins vs. positive seminal vesicles). Overall, 22 (24%) patients died directly from prostate cancer, resulting in a 10-year cancer-specific survival rate of 82%. Multivariate analysis risk factors for dying of cancer were Gleason's score (8 to 9) and PSA at the start of radiation therapy (>1.0 ng/ml). Conclusions: Patients have a good response to salvage radiation therapy. A small but durable subgroup appears to have permanent control. In those for whom therapy fails, radiation delays the need for other salvage therapy, indicating at least a transient benefit to most patients.

  12. Long-term follow up of patients with implantable cardioverter-defibrillators and mild, moderate, or severe impairment of left ventricular function.

    PubMed Central

    Trappe, H. J.; Wenzlaff, P.; Pfitzner, P.; Fieguth, H. G.

    1997-01-01

    OBJECTIVE: To determine whether patients with life threatening ventricular tachyarrhythmias, impaired left ventricular function, and severe heart failure will benefit from implantable cardioverter-defibrillator (ICD) treatment. DESIGN: 410 patients were followed up after ICD implant. Left ventricular function was assessed by the New York Heart Association (NYHA) functional class of heart failure: 50 patients (12%) were in NYHA I-II, 151 (37%) in NYHA II, 117 (29%) in NYHA II-III, and 92 (22%) in NYHA III. Epicardial ICD implantation was performed in 209 patients (51%) and 201 patients (49%) received non-thoracotomy ICDs. RESULTS: Perioperatively, 12 patients (3%) died, more often after epicardial ICD implant (11/209 patients, 5%) than after transvenous implant (1/201 patients, < 1%) (P < 0.05). During a mean (SD) follow up of 28 (24) months (range < 1 to 114 months), 90 patients (23%) died: nine (2%) died from sudden arrhythmia; five (1%) also died suddenly but probably not from arrhythmic causes; 55 (14%) died from cardiac causes (congestive heart failure, myocardial reinfarction); 21 (5%) died from non-cardiac causes. The three year, five year, and seven year survival was 92-96% for arrhythmic mortality in NYHA class I, II and III, compared to a three year survival of 94% and a five year and seven year survival of 84% for patients in NYHA class II-III. 338 patients (82%) received ICD shocks (21 (SD 43) shocks per patient); patients in NYHA class II (83%), class II-III (84%), and class III (90%) received ICD discharges more often than those in class I-II (64%) (P < 0.05). The mean (SD) time interval between ICD implant and the first ICD shock was shorter in NYHA class II (16 (17) months), class II-III (19 (27) months), and class III (16 (19) months) than in class 0-I (22 (24) months) (P < 0.05). CONCLUSIONS: Patients with mild, moderate, and severe left ventricular dysfunction benefit from ICD treatment and these patients survive for a considerable time after the first shock. Survival is influenced by the degree of left ventricular dysfunction; aggressive treatment of heart failure is necessary as well as ICD therapy. PMID:9391285

  13. Long-Term Evaluation of Patients Undergoing Genitoplasty due to Disorders of Sex Development: Results from a 14-Year Follow-Up

    PubMed Central

    Zhang, Heng; Pan, Jinhong; Ji, Huixiang; Wang, Yongquan; Shen, Wenhao; Liu, Limei; Lu, Gensheng; Zhou, Zhansong

    2013-01-01

    Purpose. To summarize the experience in treating patients with genitoplasty due to disorders of sex development in China. Methods. The operative procedures, gender of rearing, surgical outcome, and psychosocial and family adjustments of 262 patients were reviewed retrospectively. Results. At initial diagnosis, the mean age was 14.3 ± 2.8 years (range: 2–38 years). There were 96 children, 133 adolescents, and 33 adults. Follow-up was done every 6 months. Patients with female sex assignment had no urinary incontinence or voiding difficulty. Five patients underwent the second surgery (3%); vaginal dilation was performed in 35 patients with postoperative vaginal stenosis; 12 patients (7.4%) were unsatisfactory with the outcome. For patients with male sex assignment, the median length of penis was 2.2?cm in prepubertal patients, 4.2?cm in pubertal patients, and 5.0?cm in adults; 39 patients developed postvoid dribbling (39%); 21 patients underwent a second surgery (21%); urethral dilation was done in 28 patients (28%) due to urethral stricture; 38 patients were unsatisfactory with the outcome (38%). In addition, 136 patients (83%) with female sex assignment and 54 (54%) with male sex assignment had favorable psychosocial adjustment. Conclusions. Patients with male sex assignment have more surgical complications and difficulties in psychosocial adjustment as compared to those with female sex assignment. PMID:24376381

  14. High-dose immunosuppressive therapy and autologous hematopoietic cell transplantation for severe systemic sclerosis: long-term follow-up of the US multicenter pilot study

    PubMed Central

    McSweeney, Peter A.; Crofford, Leslie J.; Abidi, Muneer; Chen, Chien-Shing; Godwin, J. David; Gooley, Theodore A.; Holmberg, Leona; Henstorf, Gretchen; LeMaistre, C. Fred; Mayes, Maureen D.; McDonagh, Kevin T.; McLaughlin, Bernadette; Molitor, Jerry A.; Nelson, J. Lee; Shulman, Howard; Storb, Rainer; Viganego, Federico; Wener, Mark H.; Seibold, James R.; Sullivan, Keith M.; Furst, Daniel E.

    2007-01-01

    More effective therapeutic strategies are required for patients with poor-prognosis systemic sclerosis (SSc). A phase 2 single-arm study of high-dose immunosuppressive therapy (HDIT) and autologous CD34-selected hematopoietic cell transplantation (HCT) was conducted in 34 patients with diffuse cutaneous SSc. HDIT included total body irradiation (800 cGy) with lung shielding, cyclophosphamide (120 mg/kg), and equine antithymocyte globulin (90 mg/kg). Neutrophil and platelet counts were recovered by 9 (range, 7 to 13) and 11 (range, 7 to 25) days after HCT, respectively. Seventeen of 27 (63%) evaluable patients who survived at least 1 year after HDIT had sustained responses at a median follow-up of 4 (range, 1 to 8) years. There was a major improvement in skin (modified Rodnan skin score, ?22.08; P < .001) and overall function (modified Health Assessment Questionnaire Disability Index, ?1.03; P < .001) at final evaluation. Importantly, for the first time, biopsies confirmed a statistically significant decrease of dermal fibrosis compared with baseline (P < .001). Lung, heart, and kidney function, in general, remained clinically stable. There were 12 deaths during the study (transplantation-related, 8; SSc-related, 4). The estimated progression-free survival was 64% at 5 years. Sustained responses including a decrease in dermal fibrosis were observed exceeding those previously reported with other therapies. HDIT and autologous HCT for SSc should be evaluated in a randomized clinical trial. PMID:17452515

  15. A long-term follow-up of a randomized controlled trial of mother-infant psychoanalytic treatment: outcomes on the children.

    PubMed

    Salomonsson, Majlis Winberg; Sorjonen, Kimmo; Salomonsson, Björn

    2015-01-01

    A randomized controlled trial (RCT) compared two groups of mother-infant dyads in a Stockholm sample. One had received mother-infant psychoanalytic treatment (MIP group) and the other Child Health Center care (CHCC group). Effects were found on mother-reported depression and expert-rated mother-infant relationship qualities and maternal sensitivity. When the children were 4½ years old, they were followed up with assessments of attachment representations, socioemotional development, and global functioning. They also were divided into two types according to individual characteristics and psychological well-being: the "OK" and the "Troubled" children. Of 80 dyads in the mother-infant RCT, data were gathered from 66 cases approximately 3½ years after treatment. The children in the MIP group had better results on global functioning. There were more OK children in the MIP group and more Troubled children in the CHCC group. No other between-group differences were found. A relatively brief mother-infant psychotherapy seemed to help the children function better and be less troubled 3½ years after therapy. PMID:25451617

  16. Effects in Short and Long Term of Global Postural Reeducation (GPR) on Chronic Low Back Pain: A Controlled Study with One-Year Follow-Up

    PubMed Central

    Cecchi, Francesca; Del Canto, Antonio; Paperini, Anita; Boni, Roberta; Pasquini, Guido; Vannetti, Federica; Macchi, Claudio

    2015-01-01

    Objective. Comparing global postural reeducation (GPR) to a standard physiotherapy treatment (PT) based on active exercises, stretching, and massaging for improving pain and function in chronic low back pain (CLBP) patients. Design. Prospective controlled study. Setting. Outpatient rehabilitation facility. Participants. Adult patients with diagnosis of nonspecific, chronic (>6 months) low back pain. Interventions. Both treatments consisted of 15 sessions of one hour each, twice a week including patient education. Measures. Roland Morris Disability Questionnaire to evaluate disability, and Numeric Analog Scale for pain. A score change >30% was considered clinically significant. Past treatments, use of medications, smoking habits, height, weight, profession, and physical activity were also recorded on baseline, on discharge, and 1 year after discharge (resp., T0, T1, and T2). Results. At T0 103 patients with cLBP (51 cases and 52 controls) were recruited. The treatment (T1) has been completed by 79 (T1) of which 60 then carried out the 1-year follow-up (T2). Both GPR and PT at T1 were associated with a significant statistical and clinical improvement in pain and function, compared to T0. At T2, only pain in GPR still registered a statistically significant improvement. PMID:25945360

  17. Topical corticosteroids versus "wait and see" in the management of solitary mastocytoma in pediatric patients: a long-term follow-up.

    PubMed

    Patrizi, Annalisa; Tabanelli, Michela; Neri, Iria; Virdi, Annalucia

    2015-01-01

    Management of patients affected by mastocytoma (MS) includes avoiding triggering factors of mast cell degranulation, and administration of symptomatic treatment. We evaluated topical steroid treatment efficiency on the clinical course of MS in a group of patients, comparing the results with another untreated group.We retrospectively evaluated clinical data of 176 patients under 15 years of age, affected by MS and referred to our Dermatological Pediatric Service from 1996 to 2010. Ninety-one of 176 children were treated with topical steroids. Follow-up was possible in 130 of 176 patients and lasted for 56.3 months on average. We compared 62 treated and 68 untreated patients. There was not statistic difference between the two groups: (i) in the number of healed or partially improved cases; and (ii) in the time of partial regression, although it is quicker with therapy. The time of healing is 16.4 months (on average) with treatment, and 34.7 months (on average, p = 0.001) without any treatment. The resolution of MS is independent of therapy administration, but the time of healing is statistically faster using the local steroids. An appropriate treatment with them is effective and safe, considering the long time needed for spontaneous resolution. PMID:25471152

  18. Comparative study of bulky stage IB and IA cervical cancer patients treated by radical hysterectomy with and without neoadjuvant chemotherapy: long-term follow-up.

    PubMed

    Manusirivithaya, S; Chareoniam, V; Pantusart, A; Isariyodom, P; Srisomboon, J

    2001-11-01

    One hundred and ninety patients with bulky (> 3 cm) stage IB and IIA cervical cancer who underwent radical hysterectomy between 1991 and 1994 at Maharaj Nakorn Chiang Mai Hospital were reviewed to determine whether neoadjuvant chemotherapy (NAC) with MVAC (Methotrexate, Vinblastine, Adriamycin, Cisplatin) improved survival. There were 42 patients treated with pre-operataive NAC (MVAC 1-3 courses) and 148 patients treated by primary surgery (PS). In the NAC group, the overall response rate from MVAC was 88.1 per cent with 31.0 per cent having complete clinical response and 7.1 per cent with complete pathological response. Pelvic lymph node metastasis was not significantly different between the NAC group (16.7%) and the PS group (18.2%). At a median follow-up of 64.5 months, 19.0 per cent in the NAC group and 18.2 per cent in the PS group had tumor recurrence. The 5-year progression free and overall survival was 80.8 per cent and 92.0 per cent respectively for the NAC group which was not significantly different from 80.2 per cent and 92.9 per cent respectively in the PS group. In conclusion, although NAC can decrease the tumor size and produce a high response rate, it does not improve survival in bulky stage IB and IIA cervical cancer patients. PMID:11853297

  19. Long-term follow-up of patients with superficial transitional cell carcinoma of the urinary bladder treated by intravesical mitomycin C.

    PubMed

    Pavlotsky, A; Eidelman, A; Barak, F; Walach, N; Horn, Y

    1995-11-01

    Prophylactic intravesical chemotherapy (IVC) reduces recurrence rates of superficial transitional cell carcinoma (TCC) of the urinary bladder. The patient cohort existed of 86 individuals (stage TaN0M0 or T1N0M0) superficial carcinoma of various grades of malignancy. Following initial transuretheral resection or diagnostic cystoscopy, mitomycin C (MMC), 20 mg dissolved in 50 ml saline, was instilled intravesically by catheter over 1 hr at 2-week intervals, initially and then four more times followed by diagnostic cystoscopy (one course = 12 weeks). Two similar courses were administered thereafter for a total period of 36 weeks. For patients in remission, installations continued in monthly fractionations for 9 more months (cystoscopy every 3 months) and then at 2-month intervals for 12 more months (cystoscopy every 6 months). When cystoscopy revealed recurrence, IVC was repeated from the beginning. No symptoms of MMC-related toxicity were observed. Cystoscopic follow-up evaluations showed a complete response rate of 84% at 3 years and 81% at 5 years after initial therapy. Twenty-seven patients who had not responded to previous treatment with other drugs responded to MMC. PMID:7475070

  20. A pilot study on the relationship between physical impairment and activity restriction in persons with anterior cruciate ligament reconstruction at long-term follow-up.

    PubMed

    Pantano, K J; Irrgang, J J; Burdett, R; Delitto, A; Harner, C; Fu, F H

    2001-11-01

    This study examined the relationship between impairment of the knee and activity restriction during activities of daily living and sports following anterior cruciate ligament reconstruction. Knee range of motion, swelling, pain, instability, ligamentous laxity, isometric and isokinetic muscle function and performance-based measures of activity restriction were measured in 44 subjects. Four measures of patient-reported activity restrictions, including the Activities of Daily Living, Sports Activities Scales of the Knee Outcome Survey, and global ratings of function during activities of daily life and sports, were statistically combined to create a composite variable representing the level of patient-reported activity restrictions for each subject. Hierarchical regression analysis revealed that 17% of the variability in patient-reported activity restrictions was accounted for by age, length of postoperative follow-up, and mechanism of injury. Addition of the one-legged hop, Lachman, anterior drawer, and varus stress tests accounted for an additional 40% of the variability of function. When pain and giving way were added to the model, 79% of the variability was explained. PMID:11734876

  1. Open reduction and internal fixation of extracapsular mandibular condyle fractures: a long-term clinical and radiological follow-up of 25 patients

    PubMed Central

    2014-01-01

    Background During the last 2 decades, many studies on the treatment of mandibular condyle fracture have been published. The incidence of mandibular condyle fractures is variable, ranging from 17.5% to 52% of all mandibular fractures. This retrospective study evaluated the long-term clinical and radiological outcomes after surgical treatment of 25 patients with a total of 26 extracapsular condyle fractures. Methods We used 2 types of surgical approaches, the retromandibular retroparotid or preauricular approach. Three kinds of rigid internal fixation plates were used—single plate, double plate, and trapezoidal plate. The following post-operative clinical parameters were evaluated: dental occlusion, facial nerve functionality, skin scarring, and temporomandibular joint functionality. All patients underwent post-operative orthopanoramic radiography and computed tomography. The patients were also monitored for complications such as Frey’s syndrome, infection, salivary fistula, plate fracture, and permanent paralysis of the facial nerve; the patient’s satisfaction was also recorded. Results Of the 25 patients, 80% showed occlusion recovery, 88% had no facial nerve injury, and 88% presented good surgical skin scarring. The patients showed early complete recovery of temporomandibular joint functionality and 72% of them were found to be asymptomatic. The postoperative radiographs of all patients indicated good recovery of the anatomical condylar region, and 80% of them had no postoperative complications. The average degree of patient satisfaction was 8.32 out of 10. Our results confirm that the technique of open reduction and internal fixation in association with postoperative functional rehabilitation therapy should be considered for treating patients with extracapsular condylar fractures. Conclusion The topic of condylar injury has generated more discussion and controversy than any other topic in the field of maxillofacial trauma. We confirm that open reduction and internal fixation is the treatment of choice for patients with neck and sub-condylar mandibular fractures. PMID:25196114

  2. Long-term Changes in Pulmonary Function After Incidental Lung Irradiation for Breast Cancer: A Prospective Study With 7-Year Follow-up

    SciTech Connect

    Jaen, Javier, E-mail: javier.jaen.sspa@juntadeandalucia.es [Unidad de Atencion Integral al Cancer, Hospital Universitario Puerta del Mar, Cadiz (Spain)] [Unidad de Atencion Integral al Cancer, Hospital Universitario Puerta del Mar, Cadiz (Spain); Vazquez, Gonzalo [Servicio de Oncologia Radioterapica, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid (Spain)] [Servicio de Oncologia Radioterapica, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid (Spain); Alonso, Enrique; De Las Penas, Maria D.; Diaz, Laura [Unidad de Atencion Integral al Cancer, Hospital Universitario Puerta del Mar, Cadiz (Spain)] [Unidad de Atencion Integral al Cancer, Hospital Universitario Puerta del Mar, Cadiz (Spain); De Las Heras, Manuel [Servicio de Oncologia Radioterapica, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid (Spain)] [Servicio de Oncologia Radioterapica, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Madrid (Spain); Perez-Regadera, Jose F. [Servicio de Oncologia Radioterapica, Hospital Universitario Doce de Octubre, Madrid (Spain)] [Servicio de Oncologia Radioterapica, Hospital Universitario Doce de Octubre, Madrid (Spain)

    2012-12-01

    Purpose: To evaluate late pulmonary function changes after incidental pulmonary irradiation for breast cancer. Methods and Materials: Forty-three consecutive female patients diagnosed with breast carcinoma and treated with postoperative radiation therapy (RT) at the same dose (50 Gy) and fractionation (2 Gy/fraction, 5 days/week) were enrolled. Pulmonary function tests (PFT) and ventilation/perfusion scans were performed before RT and 6, 12, 24, and 84 months afterward. Results: Forty-one patients, mean age 55 years, were eligible for the analysis. No differences were found in the baseline PFT values for age, smoking status and previous chemotherapy; women undergoing mastectomy showed baseline spirometric PFT values lower than did women treated with conservative surgery. The mean pulmonary dose was 10.9 Gy, being higher in women who also received lymph node RT (15.8 vs 8.6, P<.01). Only 1 patient experienced symptomatic pneumonitis. All PFT values showed a reduction at 6 months. From then on, the forced vital capacity and forced expiratory volume in 1 second began their recovery until reaching, and even exceeding, their baseline values at 7 years. Diffusing capacity of the lungs for carbon monoxide and ventilation/perfusion scans continued to reduce for 24 months and then partially recovered their baseline values (-3.5%, -3.8%, and -5.5%, respectively). Only the percentage difference at 7 years in the ventilation scan correlated with the dosimetric parameters studied. Other variables, such as age, smoking status, previous chemotherapy, and concomitant tamoxifen showed no significant relation with changes in PFT ({Delta}PFT) values at 7 years. Conclusions: The study of reproducible subclinical parameters, such as PFT values, shows how their figures decrease in the first 2 years but practically recover their baseline values in the long term. The extent of the reduction in PFT values was small, and there was no clear association with several dosimetric and clinical parameters.

  3. The incidence of experimental smoking in school children: an 8-year follow-up of the child and adolescent behaviors in long-term evolution (CABLE) study

    PubMed Central

    2011-01-01

    Background Studies have established that most regular adult smokers become addicted in their adolescent years. We investigated the incidence of and risk factors associated with initial experimental smoking among a group of school children who were followed for 8 years. Methods We used cohort data collected as part of the Child and Adolescent Behaviors in Long-term Evolution (CABLE) study, which selected nine elementary schools each from an urban area (Taipei City) and a rural area (Hsingchu county) in northern Taiwan. From 2002 to 2008, children were asked annually whether they had smoked in the previous year. An accelerated lifetime model with Weibull distribution was used to examine the factors associated with experimental smoking. Results In 2001, 2686 4th-graders participated in the study. For each year from 2002 to 2008, their incidences of trial smoking were 3.1%, 4.0%, 2.8%, 6.0%, 5.3%, 5.0% and 6.0%, respectively. There was an increase from 7th to 8th grade (6.0%). Children who were males, lived in rural areas, came from single-parent families, had parents who smoked, and had peers who smoked were more likely to try smoking earlier. The influence of parents and peers on experimental smoking demonstrated gradient effects. Conclusions This study used a cohort to examine incidence and multiple influences, including individual factors, familial factors, and community factors, on experimental smoking in adolescents. The findings fit the social ecological model, highlighting the influences of family and friends. School and community attachment were associated with experimental smoking in teenagers. PMID:22051222

  4. Higher premenarcheal bone mass in elite gymnasts is maintained into young adulthood after long-term retirement from sport: a 14-year follow-up.

    PubMed

    Erlandson, Marta C; Kontulainen, Saija A; Chilibeck, Phil D; Arnold, Cathy M; Faulkner, Robert A; Baxter-Jones, Adam D G

    2012-01-01

    Sports that impact-load the skeleton during childhood and adolescence increase determinants of bone strength such as bone mineral content and density; however, it is unclear if this benefit is maintained after retirement from the sport. The purpose of this study was to assess whether the previously reported higher bone mass in a group of premenarcheal gymnasts was still apparent 10 years after the cessation of participation and withdrawal of the gymnastics loading stimulus. In 1995, 30 gymnasts 8 to 15 years of age were measured and compared with 30 age-matched nongymnasts. Twenty-five former gymnasts and 22 nongymnasts were measured again 14 years later (2009 to 2010). Gymnasts had been retired from gymnastics training and competition for an average of 10 years. Total body (TB), lumbar spine (LS), and femoral neck (FN) bone mineral content (BMC) was assessed at both measurement occasions by dual-energy X-ray absorptiometry (DXA). Multivariate analysis of covariance (MANCOVA) was used to compare former gymnasts' and nongymnasts' BMC while controlling for differences in body size and maturation (covariates: age, height, weight, and years from menarche [1995] or age at menarche [2009 to 2010]). Premenarcheal gymnasts (measured in 1995) had significantly greater size-adjusted TB, LS, and FN BMC (p?long-term (10 years) removal of the gymnastics loading stimulus. PMID:21956460

  5. Long-Term Exercise Training for an Individual With Mixed Corticobasal Degeneration and Progressive Supranuclear Palsy Features: 10-Year Case Report Follow-up

    PubMed Central

    Boeve, Bradley F.; Petersen, Cheryl M.; Dvorak, Leah; Kantarci, Kejal

    2014-01-01

    Background and Purpose This case report describes the effects of long-term (10-year) participation in a community exercise program for a client with mixed features of corticobasal degeneration (CBD) and progressive supranuclear palsy (PSP). The effects of exercise participation on both functional status and brain volume are described. Case Description A 60-year-old male dentist initially reported changes in gait and limb coordination. He received a diagnosis of atypical CBD at age 66 years; PSP was added at age 72 years. At age 70 years, the client began a therapist-led community group exercise program for people with Parkinson disease (PD). The program included trunk and lower extremity stretching and strengthening, upright balance and strengthening, and both forward and backward treadmill walking. The client participated twice weekly for 1 hour for 10 years and was reassessed in years 9 to 10. Outcomes Falls (self-reported weekly over the 10-year period of the study by the client and his wife) decreased from 1.9 falls per month in year 1 to 0.3 falls per month in year 10. Balance, walking endurance, and general mobility declined slightly. Gait speed (both comfortable and fast) declined; the client was unable to vary gait speed. Quantitative brain measurements indicated a slow rate of whole brain volume loss and ventricular expansion compared with clients with autopsy-proven CBD or PSP. Discussion This client has participated consistently in a regular group exercise program for 10 years. He has reduced fall frequency, maintained balance and endurance, and retained community ambulation using a walker. Combined with the slow rate of brain volume loss, this evidence supports the efficacy of a regular exercise program to prolong longevity and maintain function in people with CBD or PSP. PMID:24114439

  6. Tumor Shrinkage Assessed by Volumetric MRI in Long-Term Follow-Up After Fractionated Stereotactic Radiotherapy of Nonfunctioning Pituitary Adenoma

    SciTech Connect

    Kopp, Christine, E-mail: Christine.Kopp@lrz.tu-muenchen.de [Klinik und Poliklinik fuer Strahlentherapie und Radiologische Onkologie, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich (Germany); Theodorou, Marilena; Poullos, Nektarios; Jacob, Vesna; Astner, Sabrina T.; Molls, Michael [Klinik und Poliklinik fuer Strahlentherapie und Radiologische Onkologie, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich (Germany); Grosu, Anca-Ligia [Klinik fuer Strahlenheilkunde, Universitaet Freiburg, Freiburg (Germany)

    2012-03-01

    Purpose: To evaluate tumor control and side effects associated with fractionated stereotactic radiotherapy (FSRT) in the management of residual or recurrent nonfunctioning pituitary adenomas (NFPAs). Methods and Materials: We assessed exact tumor volume shrinkage in 16 patients with NFPA after FSRT. All patients had previously undergone surgery. Gross tumor volume (GTV) was outlined on contrast-enhanced magnetic resonance imaging (MRI) before and median 63 months (range, 28-100 months) after FSRT. MRI was performed as an axial three-dimensional gradient echo T1-weighted sequence at 1.6-mm slice thickness without gap (3D MRI). Results: Mean tumor size of all 16 pituitary adenomas before treatment was 7.4 mL (3.3-18.9 mL). We found shrinkage of the treated pituitary adenoma in all patients. Within a median follow-up of 63 months (28-100 months) an absolute mean volume reduction of 3.8 mL (0.9-12.4 mL) was seen. The mean relative size reduction compared with the volume before radiotherapy was 51% (22%-95%). Shrinkage measured by 3D MRI was greater at longer time intervals after radiotherapy. A strong negative correlation between the initial tumor volume and the absolute volume reduction after FSRT was found. There was no correlation between tumor size reduction and patient age, sex, or number of previous surgeries. Conclusions: By using 3D MRI in all patients undergoing FSRT of an NFPA, tumor shrinkage is detected. Our data demonstrate that volumetric assessment based on 3D MRI adds additional information to routinely used radiological response measurements. After FSRT a mean relative size reduction of 51% can be expected within 5 years.

  7. Bone marrow fibrosis in 66 patients with immune thrombocytopenia treated with thrombopoietin-receptor agonists: a single-center, long-term follow-up

    PubMed Central

    Ghanima, Waleed; Geyer, Julia Turbiner; Lee, Christina S.; Boiocchi, Leonardo; Imahiyerobo, Allison A.; Orazi, Attilio; Bussel, James B.

    2014-01-01

    Thrombopoietin-receptor agonists increase platelet counts by stimulating the thrombopoietin receptor. Bone marrow fibrosis has been reported in patients receiving thrombopoietin-receptor agonists. This study determined the extent of myelofibrosis, its clinical relevance, and incidence of phenotypic or karyotypic abnormalities in patients with immune thrombocytopenia treated with thrombopoietin-receptor agonists. The grade of myelofibrosis was assessed before (n=15), during (n=117) and after (n=9) treatment in bone marrow biopsies from 66 patients. The proportion of bone marrow biopsies showing no fibrosis (myelofibrosis grade 0) decreased from 67% pre-treatment to 22% at last biopsy, of which 59% had grade 1 myelofibrosis and 18% had grade 2 myelofibrosis. The median duration of treatment with thrombopoietin-receptor agonists to last bone marrow biopsies was 29 months; patients who had two or more biopsies significantly more frequently had myelofibrosis grades 2/3 in the last bone marrow biopsies as compared to the first. Older age was associated with higher grades of fibrosis. No differences in blood counts or lactate dehydrogenase levels were found between patients with myelofibrosis grades 0/1 and those with grade 2. No clonal karyotypic or immunophenotypic abnormalities emerged. This study found that thrombopoietin-receptor agonists induce myelofibrosis grades 2/3 in approximately one-fifth of patients with immume thrombocytopenia, increasingly with >2 years of treatment with thrombopoietin-receptor agonists. Annual/biannual follow-up with bone marrow biopsies is, therefore, recommended in patients being treated with thrombopoietin-receptor agonists in order to enable prompt discontinuation of these drugs should grades 2/3 myelofibrosis develop. Discontinuation of thrombopoietin-receptor agonists may prevent development of clinical manifestations by stopping progression of fibrosis in grade 2/3. PMID:24463212

  8. Bone marrow fibrosis in 66 patients with immune thrombocytopenia treated with thrombopoietin-receptor agonists: a single-center, long-term follow-up.

    PubMed

    Ghanima, Waleed; Geyer, Julia Turbiner; Lee, Christina S; Boiocchi, Leonardo; Imahiyerobo, Allison A; Orazi, Attilio; Bussel, James B

    2014-05-01

    Thrombopoietin-receptor agonists increase platelet counts by stimulating the thrombopoietin receptor. Bone marrow fibrosis has been reported in patients receiving thrombopoietin-receptor agonists. This study determined the extent of myelofibrosis, its clinical relevance, and incidence of phenotypic or karyotypic abnormalities in patients with immune thrombocytopenia treated with thrombopoietin-receptor agonists. The grade of myelofibrosis was assessed before (n=15), during (n=117) and after (n=9) treatment in bone marrow biopsies from 66 patients. The proportion of bone marrow biopsies showing no fibrosis (myelofibrosis grade 0) decreased from 67% pre-treatment to 22% at last biopsy, of which 59% had grade 1 myelofibrosis and 18% had grade 2 myelofibrosis. The median duration of treatment with thrombopoietin-receptor agonists to last bone marrow biopsies was 29 months; patients who had two or more biopsies significantly more frequently had myelofibrosis grades 2/3 in the last bone marrow biopsies as compared to the first. Older age was associated with higher grades of fibrosis. No differences in blood counts or lactate dehydrogenase levels were found between patients with myelofibrosis grades 0/1 and those with grade 2. No clonal karyotypic or immunophenotypic abnormalities emerged. This study found that thrombopoietin-receptor agonists induce myelofibrosis grades 2/3 in approximately one-fifth of patients with immune thrombocytopenia, increasingly with >2 years of treatment with thrombopoietin-receptor agonists. Annual/biannual follow-up with bone marrow biopsies is, therefore, recommended in patients being treated with thrombopoietin-receptor agonists in order to enable prompt discontinuation of these drugs should grades 2/3 myelofibrosis develop. Discontinuation of thrombopoietin-receptor agonists may prevent development of clinical manifestations by stopping progression of fibrosis in grade 2/3. PMID:24463212

  9. Adverse Events in the Long-Term Follow-Up of Patients Treated With Samarium Sm 153 Lexidronam for Osseous Metastases

    SciTech Connect

    Paravati, Anthony J., E-mail: Anthony.J.Paravati@dartmouth.edu [Dartmouth Medical School, Hanover, NH (United States); Russo, Andrea L. [Dartmouth Medical School, Hanover, NH (United States); Aitken, Candice [Dartmouth Medical School, Hanover, NH (United States); Department of Medicine, Section of Radiation Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, NH (Lebanon)

    2011-10-01

    Purpose: To investigate adverse events after samarium Sm 153 lexidronam and the effect of pre- and post-samarium Sm 153 lexidronam external beam radiation therapy (EBRT) and/or chemotherapy on myelosuppression in patients who received samarium Sm 153 lexidronam for osseous metastases. Methods and Materials: We performed a single-institution retrospective review of 139 patients treated with samarium Sm 153 lexidronam between November 1997 and February 2008. New-onset adverse events after samarium Sm 153 lexidronam were reported. The effect of samarium Sm 153 lexidronam on platelet and peripheral white blood cell counts and the duration of myelosuppression after samarium Sm 153 lexidronam plus EBRT and/or chemotherapy were calculated. Differences in the prevalence of adverse events among patients with varying treatment histories were evaluated with the Pearson chi-square test. Results: Hematologic follow-up was available for 103 patients. Chemotherapy and/or EBRT had no effect on the magnitude or duration of myelosuppression. The most common nonhematologic adverse events were acute lower extremity edema (n = 27) and acute and transient neuropathy (n = 29). Patients treated with chemotherapy after samarium Sm 153 lexidronam had a higher prevalence of lower extremity edema (9 of 18 [50%]) than those who were not treated with chemotherapy after samarium Sm 153 lexidronam (18 of 85 [21.2%]) (p = 0.01, chi-square test). No adverse events were correlated with EBRT. Conclusions: Our observation of new-onset, acute and transient edema and neuropathy after samarium Sm 153 lexidronam and of a relationship between edema and post-samarium Sm 153 lexidronam chemotherapy suggests the need for re-examination of patients in past series or for a prospective investigation with nonhematologic adverse events as a primary endpoint.

  10. Piriformis Syndrome: Long-Term Follow-up in Patients Treated with Percutaneous Injection of Anesthetic and Corticosteroid Under CT Guidance

    SciTech Connect

    Masala, Salvatore, E-mail: salva.masala@tiscali.it; Crusco, Sonia, E-mail: sonia.crusco@fastwebnet.it; Meschini, Alessandro, E-mail: a.mesko@libero.it; Taglieri, Amedeo, E-mail: Amedeo.Taglieri@libero.it; Calabria, Eros, E-mail: eros.calabria@libero.it; Simonetti, Giovanni, E-mail: Giovanni.Simonetti@uniroma2.it [Fondazione Policlinico 'Tor Vergata,', Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy (Italy)

    2012-04-15

    Purpose: This study was designed to evaluate the efficacy of CT-guided injection of anesthetic and corticosteroid for the treatment of pain in patients with piriformis syndrome unresponsive to conservative treatment. Methods: We enrolled 23 patients with piriformis syndrome, proposing a percutaneous intramuscular injection of methylprednisone-lidocaine. Among them, 13 patients accepted and 10 refused to undergo the procedure; the second group was used as a control group. Clinical evaluation was performed with four maneuvers (Lasegue sign, FAIR test, Beatty and Freiberg maneuver) and a VAS questionnaire before the injection, after 5-7 days, and after 2 months. A telephonic follow-up was conducted to 3, 6, and 12 months. Results: Procedural success was achieved in all patients who were treated without any complications. After 2 months, among 13 treated subjects, 2 of 13 patients showed positivity to FAIR test (hip flexion, adduction, and internal rotation), 2 of 13 were positive to Lasegue sign, and the Beatty maneuver was positive in 1 patient. Patients who underwent conservative treatment were positive respectively in 7 of 10 (p = 0.01), 6 of 10 (p = 0.03), and 6 of 10 (p = 0.01). The VAS score showed a difference between patients treated with percutaneous approach and those managed with conservative therapy at the baseline evaluation (p = 0.04), after 2 months (p = 0.02), and 12 months (p = 0.002). We observed a significant reduction in pain for patients treated percutaneously, who were evaluated with the VAS scale at 5-7 days, 2 months, 3, 6, and 12 months (p < 0.001). Conclusions: Our findings suggested potential benefit from the percutaneous injection of anesthetics and corticosteroids under CT guidance for the treatment of piriformis syndrome.

  11. Prognostic analysis of Chinese patients with metastasis renal cell cancer receiving sorafenib: results from a multicenter long-term follow-up retrospective study

    PubMed Central

    Guo, Fang; Han, Tao; Liu, Zhaozhe; Song, Xishuang; Zhang, Qifu; Kong, Xiangbo; Li, Changfu; Li, Zhenhua; Li, Chengge; Qu, Shuxian; Zheng, Zhendong; Piao, Ying; Han, Yaling; Xie, Xiaodong

    2015-01-01

    The effects of sorafenib for Chinese patients with metastatic renal cell cancer (mRCC) were evaluated to figure out the relationship between clinical variables and prognosis. The data were analyzed retrospectively from six comprehensive cancer centers in Northeast China. All cases were diagnosed as mRCC histopathologically without exception. Patients were taken 400 mg sorafenib orally twice daily until progression of disease or intolerable toxic reaction occurred. Overall survival (OS), progression-free survival (PFS), and the influence of clinical variables on survival were appointed as main outcome measures. Clinical data were analyzed using SPSS statistical software. P<0.05 was considered as statistically significant. A total of 131 patients were available for survival analysis. The median follow-up periods were 16.9 months, and the median OS and PFS were 16.1 months and 10.5 months, respectively. Univariate analysis showed that Eastern Cooperative Oncology Group performance status (ECOG PS), metastatic sites, and previous therapy were significantly associated with OS, whereas PFS was merely associated with ECOG PS and previous therapy. The multivariate analysis suggested that ECOG PS, metastatic sites, and previous therapy were the independent prognostic factors for OS, and ECOG PS and previous therapy as the independent prognostic factors for PFS. In the subgroup analysis for patients with visceral metastasis, the prognosis of patients with lung metastasis alone was better than those cases with liver metastasis alone or multiple organs metastasis. In our study, sorafenib shows a higher curative activity for patients with mRCC in Northeast China. ECOG PS, metastatic lesions, and previous therapy may be important parameters for OS and PFS prediction. Lung metastases alone may be a more sensitive indicator for sorafenib than other organ metastases.

  12. Prevalence, classification and natural history of gastric varices: a long-term follow-up study in 568 portal hypertension patients.

    PubMed

    Sarin, S K; Lahoti, D; Saxena, S P; Murthy, N S; Makwana, U K

    1992-12-01

    To determine the prevalence and natural history of gastric varices, we prospectively studied 568 patients (393 bleeders and 175 nonbleeders) with portal hypertension (cirrhosis in 301 patients, noncirrhotic portal fibrosis in 115 patients, extrahepatic portal vein obstruction in 117 patients and hepatic venous outflow obstruction in 35 patients). Primary (present at initial examination) gastric varices were seen in 114 (20%) patients; more were present in bleeders than in non-bleeders (27% vs. 4%, respectively; p < 0.001). Secondary (occurring after obliteration of esophageal varices) gastric varices developed in 33 (9%) patients during follow-up of 24.6 +/- 5.3 mo. Gastric varices (compared with esophageal varices) bled in significantly fewer patients (25% vs. 64%, respectively). Gastric varices had a lower bleeding risk factor than did esophageal varices (2.0 +/- 0.5 vs. 4.3 +/- 0.4, respectively) but bled more severely (4.8 +/- 0.6 vs. 2.9 +/- 0.3 transfusion units per patient, respectively). Once a varix bled, mortality was more likely (45%) in gastric varix patients. Gastric varices were classified as gastroesophageal or isolated gastric varices. Type 1 gastroesophageal varices (lesser curve varices) were the most common (75%). After obliteration of esophageal varices, type 1 gastroesophageal varices disappeared in 59% of patients and persisted in the remainder; bleeding from persistent gastroesophageal varices was more common than it was from gastroesophageal varices that were obliterated (28% vs. 2%, respectively; p < 0.001). Type 2 gastroesophageal varices, which extend to greater curvature, bled often (55%) and were associated with high mortality. Type 1 isolated gastric varices patients had only fundal varices, with a high (78%) incidence of bleeding.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1446890

  13. Long-term Follow-up and Survival of Patients Following a Recurrence of Melanoma After a Negative Sentinel Lymph Node Biopsy Result

    PubMed Central

    Jones, Edward L.; Jones, Teresa S.; Pearlman, Nathan W.; Gao, Dexiang; Stovall, Robert; Gajdos, Csaba; Kounalakis, Nicole; Gonzalez, Rene; Lewis, Karl D.; Robinson, William A.; McCarter, Martin D.

    2013-01-01

    Objective To analyze the predictors and patterns of recurrence of melanoma in patients with a negative sentinel lymph node biopsy result. Design Retrospective chart review of a prospectively created database of patients with cutaneous melanoma. Setting Tertiary university hospital. Patients A total of 515 patients with melanoma underwent a sentinel lymph node biopsy without evidence of metastatic disease between 1996 and 2008. Main Outcome Measures Time to recurrence and overall survival. Results Of 515 patients, 83 (16%) had a recurrence of melanoma at a median of 23 months during a median follow-up of 61 months (range, 1-154 months). Of these 83 patients, 21 had melanoma that metastasized in the studied nodal basin for an in-basin false-negative rate of 4.0%. Patients with recurrence had deeper primary lesions (mean thickness, 2.7 vs 1.8 mm; P<.01) that were more likely to be ulcerated (32.5% vs 13.5%; P<.001) than those without recurrence. The primary melanoma of patients with recurrence was more likely to be located in the head and neck region compared with all other locations combined (31.8% vs 11.7%; P<.001). Median survival following a recurrence was 21 months (range, 1-106 months). Favorable characteristics associated with lower risk of recurrence included younger age at diagnosis (mean, 49 vs 57 years) and female sex (9% vs 21% for males; P<.001). Conclusion Overall, recurrence of melanoma (16%) after a negative sentinel lymph node biopsy result was similar to that in previously reported studies with an in-basin false-negative rate of 4.0%. Lesions of the head and neck, the presence of ulceration, increasing Breslow thickness, older age, and male sex are associated with increased risk of recurrence, despite a negative sentinel lymph node biopsy result. PMID:23325294

  14. Single-step transepithelial ASLA (SCHWIND) with mitomycin-C for the correction of high myopia: long term follow-up

    PubMed Central

    Aslanides, Ioannis M; Georgoudis, Panagiotis N; Selimis, Vasilis D; Mukherjee, Achyut N

    2015-01-01

    Purpose We wanted to compare the outcomes of single-step modified transepithelial photorefractive keratectomy (tPRK) termed a SCHWIND all surface laser ablation (ASLA) versus conventional alcohol-assisted photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) for the correction of higher myopia of 6.00 diopters (D) or more, in an area with high risk of haze due to high intensity of sunlight. Methods We used a prospective interventional cohort with matched retrospective control groups. Patients with >6 D myopia and <3.5 D of astigmatism were included. All treatments were performed with the SCHWIND Amaris system using aspheric ablation profiles. Mitomycin C was used in all PRK and ASLA cases. Outcomes were postoperative refraction, visual acuity, stability, and complications. The follow-up period was up to 12 months. Results In total, 101 eyes were included after exclusions. Mean preoperative spherical equivalent refraction was -7.9 D, -8.2 D, and -7.4 D in the ASLA (n=41), PRK (n=29), and LASIK (n=31) groups. Mean postoperative spherical equivalent at 12 months postoperatively was ?0.1 (standard deviation [SD]: 0.34), ?0.2 (SD: 0.59), and ?0.08 (SD: 0.36) in the ASLA, PRK, and LASIK groups, with 91.4%, 85.7%, and 83.9% within 0.5 D of target, respectively. Refractive outcomes and regression at 12 months did not vary among groups (P>0.05). Mean logMAR (logarithm of the minimum angle of resolution) uncorrected distance visual acuity at 12 months was 0.00 (SD: 0.05), 0.06 (SD: 0.1), and 0.05 (SD: 0.09) in the ASLA, PRK, and LASIK groups, with significantly better vision in the tPRK group versus LASIK (P=0.01) and PRK (P=0.01) groups. Conclusion ASLA (SCHWIND) tPRK with mitomycin C for high myopia demonstrates comparable refractive outcomes to LASIK and PRK, with relatively favorable visual acuity outcomes. There was no increased incidence of haze in the ASLA group. PMID:25565766

  15. The Utility of Symptom Checklists in Long-Term Postlaryngectomy Follow-Up of Tracheoesophageal Speakers L'utilité d'une liste des symptômes pour le suivi à long terme après une laryngectomie chez les locuteurs ayant recours à la parole trachéo-œsophagienne

    Microsoft Academic Search

    Philip C. Doyle; Adam M. B. Day; Heather D. Whitney; Candace Myers; Tanya L. Eadie

    2009-01-01

    This study evaluated the application and clinical utility of the Rotterdam Symptom Checklist (RSCL) in the long-term follow up of individuals who had undergone total laryngectomy. The RSCL provides an index of physical, psychological, and activity status in those who experience illness and\\/or disability. Twenty-four adults (12 men and 12 women) served as participants. All 24 speakers used tracheoesophageal (TE)

  16. Long-term Follow-up Results of a Multi-institutional Phase 2 Study of Concurrent Chemoradiation Therapy for Locally Advanced Cervical Cancer in East and Southeast Asia

    SciTech Connect

    Kato, Shingo, E-mail: s_kato@saitama-med.ac.jp [Department of Radiation Oncology, International Medical Center, Saitama Medical University, Saitama (Japan); National Institute of Radiological Sciences of Japan, Chiba (Japan); Ohno, Tatsuya [Gunma University Heavy Ion Medical Center, Gunma University, Gunma (Japan); Thephamongkhol, Kullathorn; Chansilpa, Yaowalak [Division of Radiation Oncology, Department of Radiology, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkok (Thailand); Cao, Jianping [School of Radiation Medicine and Public Health, Soochow University, Soochow (China); Xu, Xiaoting [Department of Radiation Oncology, The First Affiliated Hospital of Soochow University, Soochow (China); Devi, C. R. Beena; Swee, Tang Tieng [Department of Radiotherapy and Oncology, Hospital Umum Sarawak, Kuching (Malaysia); Calaguas, Miriam J.C. [Department of Radiation Oncology, St. Luke's Medical Center, Quezon City, the Philippines (Philippines); Reyes, Rey H. de los [Department of Obstetrics and Gynecology, Dr Jose R. Reyes Memorial Medical Center, Manila, the Philippines (Philippines); Cho, Chul-Koo [Department of Radiation Oncology, Korea Cancer Center Hospital, Seoul (Korea, Republic of); Dung, To Anh [Department of Breast and Gynecology Radiotherapy, National Cancer Institute, Hanoi (Viet Nam); Supriana, Nana [Department of Radiation Therapy, Faculty of Medicine, University of Indonesia, Dr Cipto Mangunkusumo General Hospital, Jakarta (Indonesia); Erawati, Dyah [Division of Radiotherapy, Dr Soetomo General Hospital, Surabaya (Indonesia); Mizuno, Hideyuki [National Institute of Radiological Sciences of Japan, Chiba (Japan); Nakano, Takashi [Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma (Japan); Tsujii, Hirohiko [National Institute of Radiological Sciences of Japan, Chiba (Japan)

    2013-09-01

    Purpose: To report the long-term survival and toxicity of a multi-institutional phase 2 study of concurrent chemoradiation therapy (CCRT) for locally advanced cervical cancer in east and southeast Asia. Methods and Materials: Ten institutions from 8 Asian countries participated in the study. Between April 2003 and March 2006, 120 patients (60 with bulky stage IIB and 60 with stage IIIB) were treated with CCRT. Radiation therapy consisted of pelvic external beam radiation therapy and either high-dose-rate or low-dose-rate intracavitary brachytherapy. Five cycles of weekly cisplatin (40 mg/m{sup 2}) were administered during the course of radiation therapy. Treatment results were evaluated by the rates of local control, overall survival, and late toxicities. Results: Median follow-up was 63.7 months, and the follow-up rate at 5 years was 98%. The 5-year local control and overall survival rates for all patients were 76.8% and 55.1%, respectively. The 5-year rates of major late toxicities of the rectum and bladder were 7.9% and 0%, respectively. Conclusions: The long-term results have suggested that CCRT is safe and effective for patients with locally advanced cervical cancer in east and southeast Asia. However, further efforts are needed to improve overall survival.

  17. Indium-111-monoclonal antimyosin antibody studies after the first year of heart transplantation. Identification of risk groups for developing rejection during long-term follow-up and clinical implications

    SciTech Connect

    Ballester, M.; Obrador, D.; Carrio, I.; Auge, J.M.; Moya, C.; Pons-Llado, G.; Caralps-Riera, J.M. (Hospital de la Santa Creu i Sant Pau, Barcelona (Spain))

    1990-12-01

    The long-term clinical course and results of biopsies in 21 patients studied with monoclonal antimyosin antibodies more than 12 months after heart transplantation according to the presence and degree of antimyosin-antibody uptake is described. Eighteen men and three women aged 20-52 years (39 +/- 9 years) were studied with antimyosin antibodies 12-40 months (mean, 22 +/- 9 months) after heart transplantation, and followed for a mean of 18 months (10-28 months). The number of biopsies performed during follow-up was 102. Results showed normal antimyosin-antibody studies in nine patients and abnormal studies in 12 patients. Myocyte damage was identified in 18 of the 102 biopsies (17.6%), one in the normal antimyosin-antibody group of patients and 17 in those patients with myocardial antimyosin-antibody uptake. Patients who developed rejection comprised 11% and 67% of each respective group; the mean number of rejection episodes per patient was 0.11 +/- 0.33 and 1.41 +/- 1.41, respectively (p less than 0.01). A trend was noted by which higher heart-to-lung ratios were associated with greater probability of rejection. Conclusively, (1) antimyosin-antibody studies performed after more than 1 year after heart transplantation indicate the presence and level of rejection activity, (2) groups of patients at risk for developing rejection at biopsy during long-term follow-up may be detected by antimyosin-antibody study, and (3) surveillance for rejection and the degree of immunosuppression should be tailored to meet individual patient needs.

  18. The use of anatomically drop-shaped bioactive glass S53P4 implants in the reconstruction of orbital floor fractures-A prospective long-term follow-up study.

    PubMed

    Stoor, P; Mesimäki, Karri; Lindqvist, Christian; Kontio, Risto

    2015-07-01

    An isolated fracture of the orbital floor needs reconstruction if there is a clear herniation of adipose tissue or of the rectus inferior muscle into the maxillary sinus. A prospective study was carried out treating 20 patients with an isolated blow-out fracture of the orbital floor or with a combined zygomatico-orbito-maxillary complex fracture, using a newly designed anatomically drop-shaped implants made of bioactive glass (BAG) S53P4. Computed tomography (CT) was performed immediately postoperatively to confirm the correct position of the plate. The patients were followed up for an average of 32 months clinically and radiologically with magnetic resonance imaging (MRI) for an average of 31 months. None of the patients had any signs of complications related to the implant and the clinical outcome was very good. None of the patients had persisting diplopia. The level of the pupillas was normal in 15 of 20 patients. Minor hypo-ophthalmos ranging from 0.5 to 1.0 mm was observed in three patients, and moderate hypo-ophthalmos of 2.0 mm was seen in one patient. Hyperophthalmos of 1.0 mm was seen in one patient. Minor enophthalmos on the operated side ranging from 0.5 to 1.0 mm was seen in eight patients. Mild to moderate paraesthesia of the infraorbital nerve was observed in six patients. The immediate postoperative CT and the long term follow-up MRI revealed that the drop-shaped BAG implants retained their correct position in the orbital floor and did not show any evidence of losing their original shape or material resorption. No adverse tissue reaction was associated with the material. Due to the anatomical drop shape, the implants could successfully maintain the orbital volume and compensate for the retrobulbar adipose tissue atrophy. PMID:25957104

  19. Long-term Follow-up of the RTOG 9501/Intergroup Phase III Trial: Postoperative Concurrent Radiation Therapy and Chemotherapy in High-Risk Squamous Cell Carcinoma of the Head and Neck

    SciTech Connect

    Cooper, Jay S., E-mail: jcooper@maimonidesmed.org [Maimonides Cancer Center, New York, New York (United States); Zhang Qiang; Pajak, Thomas F. [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States)] [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Forastiere, Arlene A. [Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (United States)] [Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (United States); Jacobs, John [Barbara Ann Karmanos Comprehensive Cancer Center, Wayne State University, Detroit, Michigan (United States)] [Barbara Ann Karmanos Comprehensive Cancer Center, Wayne State University, Detroit, Michigan (United States); Saxman, Scott B. [Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, Maryland (United States)] [Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, Maryland (United States); Kish, Julie A. [H. Lee Moffitt Cancer Center, Tampa, Florida (United States)] [H. Lee Moffitt Cancer Center, Tampa, Florida (United States); Kim, Harold E. [Wayne State University Medical Center, Detroit, Michigan (United States)] [Wayne State University Medical Center, Detroit, Michigan (United States); Cmelak, Anthony J. [Vanderbilt Cancer Center, Nashville, Tennessee (United States)] [Vanderbilt Cancer Center, Nashville, Tennessee (United States); Rotman, Marvin [SUNY Health Center at Brooklyn, Brooklyn, New York (United States)] [SUNY Health Center at Brooklyn, Brooklyn, New York (United States); Lustig, Robert [Hospital of University of Pennsylvania, Philadelphia, Pennsylvania (United States)] [Hospital of University of Pennsylvania, Philadelphia, Pennsylvania (United States); Ensley, John F. [Barbara Ann Karmanos Comprehensive Cancer Center, Wayne State University, Detroit, Michigan (United States)] [Barbara Ann Karmanos Comprehensive Cancer Center, Wayne State University, Detroit, Michigan (United States); Thorstad, Wade [Washington University, St. Louis, Missouri (United States)] [Washington University, St. Louis, Missouri (United States); Schultz, Christopher J. [Medical College of Wisconsin, Milwaukee, Wisconsin (United States)] [Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Yom, Sue S. [University of California, San Francisco, California (United States)] [University of California, San Francisco, California (United States); Ang, K. Kian [University of Texas MD Anderson Cancer Center, Houston, Texas (United States)] [University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2012-12-01

    Purpose: Previous analysis of this Intergroup trial demonstrated that with a median follow-up among surviving patients of 45.9 months, the concurrent postoperative administration of cisplatin and radiation therapy improved local-regional control and disease-free survival of patients who had high-risk resectable head-and-neck carcinomas. With a minimum of 10 years of follow-up potentially now available for all patients, these results are updated here to examine long-term outcomes. Methods and Materials: A total of 410 analyzable patients who had high-risk resected head-and-neck cancers were prospectively randomized to receive either radiation therapy (RT: 60 Gy in 6 weeks) or identical RT plus cisplatin, 100 mg/m{sup 2}i.v. on days 1, 22, and 43 (RT + CT). Results: At 10 years, the local-regional failure rates were 28.8% vs 22.3% (P=.10), disease-free survival was 19.1% vs 20.1% (P=.25), and overall survival was 27.0% vs 29.1% (P=.31) for patients treated by RT vs RT + CT, respectively. In the unplanned subset analysis limited to patients who had microscopically involved resection margins and/or extracapsular spread of disease, local-regional failure occurred in 33.1% vs 21.0% (P=.02), disease-free survival was 12.3% vs 18.4% (P=.05), and overall survival was 19.6% vs 27.1% (P=.07), respectively. Conclusion: At a median follow-up of 9.4 years for surviving patients, no significant differences in outcome were observed in the analysis of all randomized eligible patients. However, analysis of the subgroup of patients who had either microscopically involved resection margins and/or extracapsular spread of disease showed improved local-regional control and disease-free survival with concurrent administration of chemotherapy. The remaining subgroup of patients who were enrolled only because they had tumor in 2 or more lymph nodes did not benefit from the addition of CT to RT.

  20. Long-term effectiveness of an ad hoc tailored titanium implant as a spacer for microvascular decompression in the treatment of trigeminal neuralgia caused by megadolichoectatic basilar artery anomaly: 9-year follow-up.

    PubMed

    Banczerowski, Péter; Czigléczki, Gábor; Nyáry, István

    2014-12-01

    An enlarged, elongated, ectatic, and sclerotic aberration of the vertebrobasilar system is known as a megadolichoectatic basilar artery (BA) anomaly. The anomaly is often involved in the pathological process of trigeminal neuralgia by compressing and distorting the trigeminal nerve. First-line medical treatment includes drug therapy, but a second-line surgical procedure could be effective in medication-resistant cases. The authors report the case of a 65-year-old man with a 12-year history of progressing trigeminal neuralgia who underwent microvascular decompression after the first-line drug treatment had failed. This case is unique because an in situ tailored titanium microplate was used as a spacer to alleviate compression by the BA on the trigeminal nerve. The titanium implant provided durable and sufficient retraction for the sclerotic arterial complex when the trigeminal nerve was placed in the tunnel of the implant. The 9-year follow-up examination proves the safety and long-term efficacy of titanium implants in the treatment of trigeminal neuralgia caused by a megadolichoectatic BA anomaly. The method applied in this case was not intended to be and certainly is not an alternative to routine microvascular decompression-this surgical solution may be reserved for some extreme cases. PMID:25259563

  1. New Dimensional Staging of Bisphosphonate-Related Osteonecrosis of the Jaw Allowing a Guided Surgical Treatment Protocol: Long-Term Follow-Up of 266 Lesions in Neoplastic and Osteoporotic Patients from the University of Bari

    PubMed Central

    Franco, Simonetta; Miccoli, Simona; Limongelli, Luisa; Tempesta, Angela; Favia, Giorgio; Maiorano, Eugenio; Favia, Gianfranco

    2014-01-01

    Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is the most serious side effect in patients receiving bisphosphonates (BPs) for neoplastic disease and osteoporosis. The aim of this study is to propose a new dimensional stage classification, guiding the surgical treatment of BRONJ patients, and to evaluate the success rate of this new management. From 2004 to 2013, 203 neoplastic and osteoporotic patients with 266 BRONJ lesions were referred to the Odontostomatology Unit of the University of Bari. All patients underwent surgery after suspension of BPs therapy and antibiotic treatment. The surgical procedure was complemented by piezosurgery and followed by the application of hyaluronate and amino acids. The new dimensional staging suggests the choice of the surgical approach, and allows the prediction of postoperative complications and soft and hard tissues healing time, guiding the surgical treatment protocol. This protocol could be a successful management strategy for BRONJ, considering the low recurrences rate and the good stabilisation of the surgical sites observed after a long-term follow-up. PMID:24995017

  2. Long-term follow-up of tandem high-dose therapy with autologous stem cell support for adults with high-risk age-adjusted international prognostic index aggressive non-Hodgkin Lymphomas: a GOELAMS pilot study.

    PubMed

    Monjanel, Hélène; Deconinck, Eric; Perrodeau, Elodie; Gastinne, Thomas; Delwail, Vincent; Moreau, Anne; François, Sylvie; Berthou, Christian; Gyan, Emmanuel; Milpied, Noël

    2011-06-01

    Single high-dose therapy (HDT) followed by autologous peripheral blood stem cell (PBSC) support improves complete response and overall survival (OS) in untreated aggressive non-Hodgkin's lymphoma (NHL). However, patients with a high age-adjusted international prognostic index (aa-IPI equal to 3) still have poor clinical outcome despite high dose intensity regimen. To improve complete response in this subgroup, the French Groupe Ouest-Est des Leucémies et Autres Maladies du Sang (GOELAMS) conducted a pilot phase II trial (073) evaluating tandem HDT with PBSC support in a series of 45 patients with aa-IPI equal to 3 untreated aggressive non-Hodgkin's lymphoma. After induction with an anthracyclin-containing regimen, responders underwent tandem HDT conditioned by high-dose mitoxantrone plus cytarabine for the first HDT and total-body irradiation (TBI), carmustine, etoposide, and cyclophosphamide for the second HDT. Thirty-one patients out of 41 evaluable patients completed the program. There were 4 toxic deaths. The complete response rate was 49%. With a median follow-up of 114 months for surviving patients, the OS was 51%, and 19 out of the 22 patients (86%) who reached a complete response are alive and relapse-free. Recent prospective evaluation of quality of life and comorbidities of surviving patients does not reveal long-term toxicities of the procedure. In the era of monoclonal antibodies and response-adapted therapy, the role of tandem HDT still need to be determined. PMID:21109011

  3. Long-term Survival Outcomes Following Internal Mammary Node Irradiation in Stage II-III Breast Cancer: Results of a Large Retrospective Study With 12-Year Follow-up

    SciTech Connect

    Chang, Jee Suk [Department of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Park, Won [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Yong Bae; Lee, Ik Jae; Keum, Ki Chang; Lee, Chang Geol [Department of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Choi, Doo Ho [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Suh, Chang-Ok, E-mail: cosuh317@yuhs.ac [Department of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Huh, Seung Jae, E-mail: sjhuh@smc.samsung.co.kr [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2013-08-01

    Purpose: To examine the effect of internal mammary node irradiation (IMNI) on disease-free survival (DFS) and overall survival (OS) in breast cancer patients treated with modified radical mastectomy and postoperative radiation therapy. Methods and Materials: Between 1994 and 2002, 396 patients with stage II-III breast cancer were treated with postmastectomy radiation therapy with (n=197) or without (n=199) IMNI. Patients who received neoadjuvant chemotherapy were excluded. IMNI was administered at the clinical discretion of the treating physician. Median RT dose was 50.4 Gy (range, 45.0-59.4 Gy) in 28 fractions, with inclusion of the supraclavicular fossa in 96% of patients. Adjuvant chemotherapy was administered to 99.7% of the patients and endocrine therapy to 53%. Results: The median follow-up was 149 months (range, 124-202). IMNI patients had more advanced nodal stage and non-high grade tumors than those without IMNI (P<.001). Otherwise, disease and treatment characteristics were well balanced. The 10-year DFS with and without IMNI was 65% and 57%, respectively (P=.05). Multivariate analysis demonstrated that IMNI was an independent, positive predictor of DFS (hazard ratio [HR], 0.70; P=.02). Benefits of IMNI in DFS were seen most apparently in N2 patients (HR, 0.44; 95% confidence interval [CI], 0.26-0.74) and inner/central tumors (HR, 0.55; 95% CI, 0.34-0.90). The 10-year OS with and without IMNI was 72% and 66%, respectively (P=.62). The 10-year DFS and OS were 61%, and 69%, respectively. Conclusions: Internal mammary node irradiation significantly improved DFS in postmastectomy breast cancer patients. Pending long-term results from randomized trials, treatment of internal mammary nodes should be considered in postmastectomy radiation therapy.

  4. Assessment of dexrazoxane as a cardioprotectant in doxorubicin-treated children with high-risk acute lymphoblastic leukaemia: long-term follow-up of a prospective, randomised, multicentre trial

    PubMed Central

    Lipshultz, Steven E; Scully, Rebecca E; Lipsitz, Stuart R; Sallan, Stephen E; Silverman, Lewis B; Miller, Tracie L; Barry, Elly V; Asselin, Barbara L; Athale, Uma; Clavell, Luis A; Larsen, Eric; Moghrabi, Albert; Samson, Yvan; Michon, Bruno; Schorin, Marshall A; Cohen, Harvey J; Neuberg, Donna S; Orav, E John; Colan, Steven D

    2013-01-01

    Summary Background Doxorubicin chemotherapy is associated with cardiomyopathy. Dexrazoxane reduces cardiac damage during treatment with doxorubicin in children with acute lymphoblastic leukaemia (ALL). We aimed to establish the long-term effect of dexrazoxane on the subclinical state of cardiac health in survivors of childhood high-risk ALL 5 years after completion of doxorubicin treatment. Methods Between January, 1996, and September, 2000, children with high-risk ALL were enrolled from nine centres in the USA, Canada, and Puerto Rico. Patients were assigned by block randomisation to receive ten doses of 30 mg/m² doxorubicin alone or the same dose of doxorubicin preceded by 300 mg/m² dexrazoxane. Treatment assignment was obtained through a telephone call to a centralised registrar to conceal allocation. Investigators were masked to treatment assignment but treating physicians and patients were not; however, investigators, physicians, and patients were masked to study serum cardiac troponin-T concentrations and echocardiographic measurements. The primary endpoints were late left ventricular structure and function abnormalities as assessed by echocardiography; analyses were done including all patients with data available after treatment completion. This trial has been completed and is registered with ClinicalTrials.gov, number NCT00165087. Findings 100 children were assigned to doxorubicin (66 analysed) and 105 to doxorubicin plus dexrazoxane (68 analysed). 5 years after the completion of doxorubicin chemotherapy, mean left ventricular fractional shortening and end-systolic dimension Z scores were significantly worse than normal for children who received doxorubicin alone (left ventricular fractional shortening: ?0·82, 95% CI ?1·31 to ?0·33; end-systolic dimension: 0·57, 0·21–0·93) but not for those who also received dexrazoxane (?0·41, ?0·88 to 0·06; 0·15, ?0·20 to 0·51). The protective effect of dexrazoxane, relative to doxorubicin alone, on left ventricular wall thickness (difference between groups: 0·47, 0·46–0·48) and thickness-to-dimension ratio (0·66, 0·64–0·68) were the only statistically significant characteristics at 5 years. Subgroup analysis showed dexrazoxane protection (p=0·04) for left ventricular fractional shortening at 5 years in girls (1·17, 0·24–2·11), but not in boys (?0·10, ?0·87 to 0·68). Similarly, subgroup analysis showed dexrazoxane protection (p=0·046) for the left ventricular thickness-to-dimension ratio at 5 years in girls (1·15, 0·44–1·85), but not in boys (0·19, ?0·42 to 0·81). With a median follow-up for recurrence and death of 8·7 years (range 1·3–12·1), event-free survival was 77% (95% CI 67–84) for children in the doxorubicin-alone group, and 76% (67–84) for children in the doxorubicin plus dexrazoxane group (p=0·99). Interpretation Dexrazoxane provides long-term cardioprotection without compromising oncological efficacy in doxorubicin-treated children with high-risk ALL. Dexrazoxane exerts greater long-term cardioprotective effects in girls than in boys. Funding US National Institutes of Health, Children’s Cardiomyopathy Foundation, University of Miami Women’s Cancer Association, Lance Armstrong Foundation, Roche Diagnostics, Pfizer, and Novartis. PMID:20850381

  5. Excellent survival and low incidence of arrhythmias, stroke and heart failure long-term after surgical ASD closure at young age. A prospective follow-up study of 21-33 years

    Microsoft Academic Search

    J. W. Roos-Hesselink; F. J. Meijboom; S. E. C. Spitaels; E. M. W. J. Utens; A. J. J. C. Bogers; M. L. Simoons; Rijen van E. H. M; Domburg van R. T

    2003-01-01

    AIMS: Although studies have suggested good long-term results, arrhythmias, pulmonary hypertension and left ventricular dysfunction are mentioned as sequelae long-term after surgical atrial septal defect closure at young age. Most studies were performed only by questionnaire and in a retrospective manner. The long-term outcome is very important with regard to future employment and acceptance on insurance schemes. METHODS AND\\u000aRESULTS:

  6. Long-term follow-up in patients with HIV vaccinated with pandemic influenza A(H1N1)/09 AS03-adjuvanted split virion vaccine and seasonal trivalent influenza split virion vaccine

    PubMed Central

    Pauksens, Karlis

    2013-01-01

    Introduction In Sweden in 2009, two doses of the pandemic influenza A(H1N1)/09 AS03-adjuvanted split virion vaccine were recommended for those with HIV infection along with one dose of seasonal trivalent influenza vaccine (TIV). At that time, no data for HIV patients and their response to the adjuvanted vaccine were available. Methods Forty-two HIV-infected individuals were vaccinated with the pandemic vaccine on study days 0 and 28. Twenty-one of them received TIV on day 56 and 21 did not. Serum samples were taken at these time points, and also on day 86 and after 1 year for serologic analyses. Results Before vaccination, none of the 42 patients had putatively protective levels of antibodies (haemagglutination inhibition [HI] titres ?1:40) to the pandemic-like strain A/California/7/2009 H1N1. After dose 1, the seroprotection rate (SPR) and seroconversion rate (SCR) were both 69% (29 of 42). After dose 2, the SPR and SCR were 89 and 86%, respectively. At 1 year, 10 (34%) of 29 had protective antibodies and 16 (62%) of 26 who had had protective antibody levels had lost them. There was a retained factor increase of the geometric mean titre (GMT) of 3.9. Serological analyses could be performed in 19 subjects who were vaccinated with TIV and in 21 who were not. Protective antibodies to the three strains before vaccination were 20–37%. The SCR was 26% to A/Brisbane/59/2007 H1N1, 47% to A/Uruguay/10/2007/ H3N2 and 42% to B/Brisbane/60/2008. At 1 year, the factor increase of GMT was 1.8 to the two influenza A strains. Conclusion Two doses of adjuvanted influenza vaccine improved the SCR and the SPR among HIV-infected subjects. Long-term follow-up indicates revaccination in the next influenza season whether they received an adjuvanted or non-adjuvanted influenza vaccine. PMID:24003363

  7. In vivo study of the kinematics in axial rotation of the lumbar spine after total intervertebral disc replacement: long-term results: a 10–14 years follow up evaluation

    Microsoft Academic Search

    El-hadi SariAli; Jean Philippe Lemaire; Hugues Pascal-Mousselard; Hélène Carrier; Waffa Skalli

    2006-01-01

    Introduction: We did not find any in vivo study of spinal segment kinematics after disc replacement, especially over the long term. In vitro studies did show that it restores almost normal kinematics except for axial rotation. The goal of this study is to develop a new technique in order to analyse axial rotation of a spinal segment, in vivo, after

  8. Radioimmunotherapy with iodine 131I tositumomab for relapsed or refractory B-cell non-Hodgkin lymphoma: updated results and long-term follow-up of the University of Michigan experience

    Microsoft Academic Search

    Mark S. Kaminski; Judith Estes; Kenneth R. Zasadny; Isaac R. Francis; Charles W. Ross; Melissa Tuck; Denise Regan; Susan Fisher; Jeanne Gutierrez; Stewart Kroll; Robert Stagg; George Tidmarsh; Richard L. Wahl

    CD20-targeted radioimmunotherapy is a promising new treatment for B-cell non- Hodgkin lymphoma (NHL). We now pro- vide updated and long-term data on 59 chemotherapy-relapsed\\/refractory pa- tients treated with iodine 131I tositu- momab in a phase I\\/II single-center study. Fifty-three patients received individual- ized therapeutic doses, delivering a speci- fied total-body radiation dose (TBD) based on the clearance rate of a

  9. Effect of integration of supplemental nutrition with public health programmes in pregnancy and early childhood on cardiovascular risk in rural Indian adolescents: long term follow-up of Hyderabad nutrition trial

    Microsoft Academic Search

    Sanjay Kinra; K V Rameshwar Sarma; Ghafoorunissa; Vishnu Vardhana Rao Mendu; Radhakrishnan Ravikumar; Viswanthan Mohan; Ian B Wilkinson; John R Cockcroft; George Davey Smith; Yoav Ben-Shlomo

    2008-01-01

    Objective To determine whether integration of nutritional supplementation with other public health programmes in early life reduces the risk of cardiovascular disease in undernourished populations.Design Approximately 15 years’ follow-up of participants born within an earlier controlled, community trial of nutritional supplementation integrated with other public health programmes.Setting 29 villages (15 intervention, 14 control) near Hyderabad city, south India.Participants 1165 adolescents

  10. Longitudinal Follow-up of Tinnitus Complaints

    Microsoft Academic Search

    Gerhard Andersson; Pernilla Vretblad; Hans C. Larsen; Leif Lyttkens

    2001-01-01

    Objective: To investigate the long-term outcome of patients with tinnitus, the long-term effects of cognitive behavioral therapy, and what properties of tinnitus predict distress at follow-up. Design: A longitudinal follow-up of a consecutive sample of patients with tinnitus initially seen by a clinical psy- chologist.

  11. Does 360° lumbar spinal fusion improve long-term clinical outcomes after failure of conservative treatment in patients with functionally disabling single-level degenerative lumbar disc disease? Results of 5-year follow-up in 75 postoperative patients

    PubMed Central

    Zigler, Jack E.; Delamarter, Rick B.

    2013-01-01

    Background Surgical treatment of patients with mechanical degenerative disc disease has been controversial, but improvements in clinical outcomes have been shown in properly selected patients with disease-specific diagnoses, with fusion arguably now becoming the “gold standard” for surgical management of these patients. No published study thus far has been designed for prospective enrollment of patients with specific inclusion/exclusion criteria in whom at least 6 months of conservative therapy has failed and who are then offered a standardized surgical procedure and are followed up for 5 years. Methods The study group was composed of the patients in the prospective, randomized Food and Drug Administration Investigational Device Exemption trial comparing ProDisc-L (Synthes Spine, West Chester, Pennsylvania) with 360° fusion for the treatment of single-level symptomatic disc degeneration. Of 80 patients randomized to 360° fusion after failure of non-operative care, 75 were treated on protocol with single-level fusions. Follow-up of this treatment cohort was 97% at 2 years and 75% at 5 years and serves as the basis for this report. Patients in the trial were required to have failure of at least 6 months of nonoperative care and in fact had failure of an average of 9 months of nonoperative treatment. The mean Oswestry Disability Index score indicated greater than 60% impairment. The mean entry-level pain score on a visual analog scale was greater than 8 of 10. Results After fusion, not only did patients have significant improvements in measurable clinical outcomes such as the Oswestry Disability Index score and pain score on a visual analog scale but there were also substantial improvements in their functional status and quality of life. Specifically, over 80% of patients in this study had improvements in recreational status that was maintained 5 years after index surgery, indicating substantial improvements in life quality that were not afforded by months of conservative care. The percentage of patients using narcotics at the 5-year follow-up visit was less than half the percentage of patients who had used narcotics as part of their prior conservative treatment. Conclusions The 5-year results of this post hoc analysis of 75 patients involved in a multicenter, multi-surgeon trial support 360° fusion surgery as a predictable and lasting treatment option to improve pain and function in properly selected patients with mechanical degenerative disc disease. These improvements occurred dramatically immediately after surgery and have been maintained through the scope of this follow-up period, with 98% follow-up at 2 years and 75% of patients available at 5 years. PMID:25694895

  12. Effect of Prehospital Induction of Mild Hypothermia on 3?Month Neurological Status and 1?Year Survival Among Adults With Cardiac Arrest: Long?Term Follow?up of a Randomized, Clinical Trial

    PubMed Central

    Maynard, Charles; Longstreth, W. T.; Nichol, Graham; Hallstrom, Al; Kudenchuk, Peter J.; Rea, Thomas; Copass, Michael K.; Carlbom, David; Deem, Steven; Olsufka, Michele; Cobb, Leonard A.; Kim, Francis

    2015-01-01

    Background Randomized trials of prehospital cooling after cardiac arrest have shown that neither prehospital cooling nor targeted temperature management differentially affected short?term survival or neurological function. In this follow?up study, we assess the association of prehospital hypothermia with neurological function at least 3 months after cardiac arrest and survival 1 year after cardiac arrest. Methods and Results There were 508 individuals who were discharged alive from hospitals in King County, Washington; 373 (73%) were interviewed by telephone 123±43 days after the initial event. Overall, 59% of the treatment group and 58% of the control group had Cerebral Performance Category (CPC) 1 or 2 (P=0.70), and 50% of the treatment group and 49% of the control group had slight disability or better by the Modified Rankin Scale (MRS; (P=0.35). One?year survival was 87% in the treatment group and 84% in the control group (P=0.42). Of those with CPC 1 at hospital discharge, 68% had CPC 1 or 2 at follow?up, and 59% had MRS of slight disability or better. Of 41 patients with CPC 3 or 4 at discharge, only 12% had CPC 2 at follow?up, and just 5% had MRS of slight disability or better. One?year survival was 92% for CPC 1 at discharge, but only 40% for CPC 4. Conclusion In addition to excellent survival, patients who had good neurological function at discharge continued to have good function at least 3 months after the event. Clinical Trial Registration URL: Clinicaltrials.gov. Unique identifier: NCT00391469 PMID:25762805

  13. Long-Term Follow-Up of a Prospective Trial of Trimodality Therapy of Weekly Paclitaxel, Radiation, and Androgen Deprivation in High-Risk Prostate Cancer With or Without Prior Prostatectomy

    SciTech Connect

    Hussain, Arif, E-mail: ahussain@som.umaryland.edu [University of Maryland Greenebaum Cancer Center, Baltimore, MD (United States); Department of Medicine, University of Maryland School of Medicine, Baltimore, MD (United States); Baltimore VA Medical Center, Baltimore, MD (United States); Wu, Yin [Department of Medicine, University of Maryland School of Medicine, Baltimore, MD (United States); Mirmiran, Alireza [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD (United States); DiBiase, Steven [Cooper University Hospital, Camden, NJ (United States); Goloubeva, Olga [University of Maryland Greenebaum Cancer Center, Baltimore, MD (United States); Bridges, Benjamin [University of Maryland Greenebaum Cancer Center, Baltimore, MD (United States); Department of Medicine, University of Maryland School of Medicine, Baltimore, MD (United States); Mannuel, Heather [University of Maryland Greenebaum Cancer Center, Baltimore, MD (United States); Department of Medicine, University of Maryland School of Medicine, Baltimore, MD (United States); Baltimore VA Medical Center, Baltimore, MD (United States); Engstrom, Christine [Baltimore VA Medical Center, Baltimore, MD (United States); Dawson, Nancy [Lombardi Cancer Center, Georgetown University, Washington, D.C (United States); Amin, Pradip; Kwok, Young [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD (United States)

    2012-01-01

    Purpose: Weekly paclitaxel, concurrent radiation, and androgen deprivation (ADT) were evaluated in patients with high-risk prostate cancer (PC) with or without prior prostatectomy (RP). Methods and Materials: Eligible post-RP patients included: pathological T3 disease, or rising prostate-specific antigen (PSA) {>=}0.5 ng/mL post-RP. Eligible locally advanced PC (LAPC) patients included: 1) cT2b-4N0N+, M0; 2) Gleason score (GS) 8-10; 3) GS 7 + PSA 10-20 ng/mL; or 4) PSA 20-150 ng/mL. Treatment included ADT (4 or 24 months), weekly paclitaxel (40, 50, or 60 mg/m{sup 2}/wk), and pelvic radiation therapy (total dose: RP = 64.8 Gy; LAPC = 70.2 Gy). Results: Fifty-nine patients were enrolled (LAPC, n = 29; RP, n = 30; ADT 4 months, n = 29; 24 months, n = 30; whites n = 29, African Americans [AA], n = 28). Baseline characteristics (median [range]) were: age 67 (45-86 years), PSA 5.9 (0.1-92.1 ng/mL), GS 8 (6-9). At escalating doses of paclitaxel, 99%, 98%, and 95% of doses were given with radiation and ADT, respectively, with dose modifications required primarily in RP patients. No acute Grade 4 toxicities occurred. Grade 3 toxicities were diarrhea 15%, urinary urgency/incontinence 10%, tenesmus 5%, and leukopenia 3%. Median follow-up was 75.3 months (95% CI: 66.8-82.3). Biochemical progression occurred in 24 (41%) patients and clinical progression in 11 (19%) patients. The 5- and 7-year OS rates were 83% and 67%. There were no differences in OS between RP and LAPC, 4- and 24-month ADT, white and AA patient categories. Conclusions: In addition to LAPC, to our knowledge, this is the first study to evaluate concurrent chemoradiation with ADT in high-risk RP patients. With a median follow-up of 75.3 months, this trial also represents the longest follow-up of patients treated with taxane-based chemotherapy with EBRT in high-risk prostate cancer. Concurrent ADT, radiation, and weekly paclitaxel at 40 mg/m{sup 2}/week in RP patients and 60 mg/m{sup 2}/week in LAPC patients is feasible and well-tolerated.

  14. Incidence of therapy-related myeloid neoplasia after initial therapy for chronic lymphocytic leukemia with fludarabine-cyclophosphamide versus fludarabine: long-term follow-up of US Intergroup Study E2997

    PubMed Central

    Neuberg, Donna; Flinn, Ian W.; Grever, Michael R.; Lazarus, Hillard M.; Rowe, Jacob M.; Dewald, Gordon; Bennett, John M.; Paietta, Elisabeth M.; Byrd, John C.; Hussein, Mohamad A.; Appelbaum, Frederick R.; Larson, Richard A.; Litzow, Mark R.; Tallman, Martin S.

    2011-01-01

    Chemotherapy-related myeloid neoplasia (t-MN) is a significant late toxicity concern after cancer therapy. In the randomized intergroup phase 3 E2997 trial, initial therapy of chronic lymphocytic leukemia with fludarabine plus cyclophosphamide (FC) compared with fludarabine alone yielded higher complete and overall response rates and longer progression-free, but not overall, survival. Here, we report t-MN incidence in 278 patients enrolled in E2997 with a median 6.4-year follow-up. Thirteen cases (4.7%) of t-MN occurred at a median of 5 years from initial therapy for chronic lymphocytic leukemia, 9 after FC and 4 after fludarabine alone. By cumulative incidence methodology, rates of t-MN at 7 years were 8.2% after FC and 4.6% after fludarabine alone (P = .09). Seven of the 9 cases of t-MN after FC occurred without additional therapy. Abnormalities involving chromosomes 5 or 7 were found in 10 cases, which suggests alkylator involvement. These data suggest that FC may induce more t-MN than fludarabine alone. PMID:21803850

  15. Matched related donor hematopoietic stem cell transplantation results in a long-term follow-up of a pediatric acquired severe aplastic anemia subset: A stem cell source perspective.

    PubMed

    Hamidieh, Amir Ali; Mozafari, Mohammad; Noshad, Sina; Alimoghaddam, Kamran; Behfar, Maryam; Ghavamzadeh, Ardeshir

    2015-06-01

    HSCT has substantially improved pediatric acquired SAA patients' outcomes. Retrospectively, we attempted to assess the outcome of MRD HSCT in 65 pediatric patients referred to a single center from 1992 to 2012. We were particularly interested to find out whether source of SC (PB, n = 40 and BM, n = 25) significantly impacts EFS and GVHD incidence. With a median follow-up of 45 months, total EFS was 87.7%; EFS for PB and BM groups was 87.5% and 88%, respectively. Acute GVHD (grades 3-4) occurred in 13 patients (PB, n = 10 [25%] and BM, n = 3 [12%]), acute GVHD (grades 2-4) occurred in 24 (PB, n = 16 [40%] and BM, n = 8 [32%]). Extensive chronic GVHD occurred in five patients (PB, n = 3 [7.5%] and BM, n = 2 [8%]). Cox regression revealed that elapsed time of <10 months between diagnosis and HSCT is associated with improved survival (hazard ratio, 95% CI = 1.204, 1.010-1.434, p = 0.038). SC source did not significantly affect EFS, incidence of acute GVHD (grades 3-4), or extensive chronic GVHD (p = 0.938, 0.121, and 0.487, respectively). Based on our findings, pediatric acquired SAA patients are benefitted most if MRD-HSCT is carried out early in disease process and SC source does not affect outcome of MRD-HSCT in these patients. PMID:25824340

  16. Swedish children with celiac disease comply well with a gluten-free diet, and most include oats without reporting any adverse effects: a long-term follow-up study.

    PubMed

    Tapsas, Dimitrios; Fälth-Magnusson, Karin; Högberg, Lotta; Hammersjö, Jan-Åke; Hollén, Elisabet

    2014-05-01

    The only known treatment for celiac disease is a gluten-free diet (GFD), which initially meant abstention from wheat, rye, barley, and oats. Recently, oats free from contamination with wheat have been accepted in the GFD. Yet, reports indicate that all celiac disease patients may not tolerate oats. We hypothesized that celiac children comply well with a GFD and that most have included oats in their diet. A food questionnaire was used to check our patients; 316 questionnaires were returned. Mean time on the GFD was 6.9 years, and 96.8% of the children reported that they were trying to keep a strict GFD. However, accidental transgressions occurred in 263 children (83.2%). In 2 of 3 cases, mistakes took place when the patients were not at home. Symptoms after incidental gluten intake were experienced by 162 (61.6%) patients, mostly (87.5%) from the gastrointestinal tract. Small amounts of gluten (<4 g) caused symptoms in 38% of the cases, and 68% reported symptoms during the first 3 hours after gluten consumption. Oats were included in the diet of 89.4% of the children for a mean of 3.4 years. Most (81.9%) ate purified oats, and 45.3% consumed oats less than once a week. Among those who did not consume oats, only 5.9% refrained because of symptoms. General compliance with the GFD was good. Only the duration of the GFD appeared to influence adherence to the diet. Most patients did not report adverse effects after long-term consumption of oats. PMID:24916557

  17. Impact of Screening and Risk Factors for Local Recurrence and Survival After Conservative Surgery and Radiotherapy for Early Breast Cancer: Results From a Large Series With Long-Term Follow-Up

    SciTech Connect

    Kunkler, Ian H., E-mail: I.Kunkler@ed.ac.uk [Edinburgh Cancer Centre, Western General Hospital, Edinburgh (United Kingdom); Kerr, Gillian R. [Edinburgh Cancer Centre, Western General Hospital, Edinburgh (United Kingdom); Thomas, Jeremy S. [Department of Pathology, Western General Hospital, Edinburgh (United Kingdom); Jack, Wilma J.L. [Edinburgh Breast Unit, Western General Hospital, Edinburgh (United Kingdom); Bartlett, John M.S. [Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh (United Kingdom); Pedersen, Hans C. [DAKO (Denmark); Cameron, David A. [Edinburgh Cancer Centre, Western General Hospital, Edinburgh (United Kingdom); Dixon, J. Michael; Chetty, Udi [Edinburgh Breast Unit, Western General Hospital, Edinburgh (United Kingdom)

    2012-07-01

    Purpose: To investigate conventional prognostic factors for ipsilateral breast tumor recurrence (IBTR), distant metastasis (DM), and survival after breast-conserving therapy (BCT) in screen-detected and symptomatic cases on surveillance up to 25 years. Patients and Methods: A total of 1812 consecutive patients in three cohorts (1981-1989, 1990-1992, and 1993-1998) with T12N01M0 invasive breast cancer were treated with BCT (median follow-up, 14 years). Tumor type and grade were reviewed by a single pathologist. Hormone receptor status was measured by immunohistochemistry on tissue microarrays. A Cox proportional hazards model was used to assess independent prognostic variables for relapse and survival. Results: A total of 205 IBTR occurred, with 5-, 10-, 15-, and 20-year actuarial relapse rates of 4.5% (95% confidence interval [CI] 3.35-5.5%), 8.4% (95% CI 7.1-9.8%), 14.1% (95% CI 12.0-16%), and 17.4% (95% CI 14.5-20.2%). Number of nodes, young age, pathologic tumor size, and multifocality were significant factors for IBTR. Three hundred seventy-eight patients developed DM. The actuarial metastatic rate was 12% at 5 years and 17.9% at 10 years. Young age, number of positive nodes, pathologic tumor size, and tumor grade were significant factors for DM relapse. When conventional prognostic indices were taken into account screen-detected cancers showed no improvement in overall relapse or survival rate compared with symptomatic cases but did show a reduced risk of DM after IBTR. After 10 years IBTR relapse continued at a constant rate of 0.87% per annum. Conclusions: The Edinburgh BCT series has shown that screen-detected invasive breast cancers do not have significantly different clinical outcomes compared with symptomatic cases when pathologic risk factors are taken into account. This suggests that these patients be managed in a similar way.

  18. Effect of integration of supplemental nutrition with public health programmes in pregnancy and early childhood on cardiovascular risk in rural Indian adolescents: long term follow-up of Hyderabad nutrition trial

    PubMed Central

    2008-01-01

    Objective To determine whether integration of nutritional supplementation with other public health programmes in early life reduces the risk of cardiovascular disease in undernourished populations. Design Approximately 15 years’ follow-up of participants born within an earlier controlled, community trial of nutritional supplementation integrated with other public health programmes. Setting 29 villages (15 intervention, 14 control) near Hyderabad city, south India. Participants 1165 adolescents aged 13-18 years. Intervention Balanced protein-calorie supplementation (2.51 MJ, 20 g protein) offered daily to pregnant women and preschool children aged under 6 years, coupled with integrated delivery of vertical public health programmes. Main outcome measures Height, adiposity, blood pressures, lipids, insulin resistance (homoeostasis model assessment (HOMA) score), and arterial stiffness (augmentation index). Results The participants from the intervention villages were 14 mm (95% confidence interval 4 to 23; P=0.007) taller than controls but had similar body composition. The participants from the intervention villages had more favourable measures of insulin resistance and arterial stiffness: 20% (3% to 39%; P=0.02) lower HOMA score and 3.3% (1% to 5.7%; P=0.008) lower augmentation index. No strong evidence existed for differences in blood pressures and serum lipids. Conclusions In this undernourished population, integrated delivery of supplemental nutrition with other public health programmes in pregnancy and early childhood was associated with a more favourable profile of cardiovascular disease risk factors in adolescence. This pragmatic study provides the most robust evidence to date on this important hypothesis for which classic trials are unlikely. Improved maternal and child nutrition may have a role in reducing the burden of cardiovascular disease in low income and middle income countries. PMID:18658189

  19. [Role of 18FDG-PET/CT in the management and gross tumor volume definition for radiotherapy of head and neck cancer; single institution experiences based on long-term follow-up].

    PubMed

    Hideghéty, Katalin; Cserháti, Adrienne; Besenyi, Zsuzsanna; Zag, Levente; Gaál, Szilvia; Együd, Zsófia; Mózes, Petra; Szántó, Erika; Csenki, Melinda; Rusz, Orsolya; Varga, Zoltán; Dobi, Ágnes; Maráz, Anikó; Pávics, László; Lengyel, Zsolt

    2015-06-01

    célThe purpose of our work is evaluation of the impact of 18FDG-PET/CT on the complex management of locoregionally advanced (T3-4N1-3) head and neck squamous cell cancer (LAHNSC), and on the target definiton for 3D conformal (3DCRT) and intensity-modulated radiotherapy (IMRT). 18FDG-PET/CT were performed on 185 patients with LAHNSC prior to radiotherapy/chemoradiation in the treatment position between 2006 and 2011. Prior to it 91 patients recieved induction chemotherapy (in 20 cases of these, baseline PET/CT was also available). The independently delineated CT-based gross tumor volume (GTVct) and PET/CT based ones (GTVpet) were compared. Impact of PET/CT on the treatment strategy, on tumor response evaluation to ICT, on GTV definition furthermore on overall and disease-specific survival (OS, DSS) was analysed. PET/CT revealed 10 head and neck, 2 lung cancers for 15 patients with carcinoma of unknown primary (CUP) while 3 remained unknown. Second tumors were detected in 8 (4.4%), distant metastasis in 15 (8.2%) cases. The difference between GTVct and GTVpet was significant (p=0.001). In 16 patients (14%) the GTVpet were larger than GTVct due to multifocal manifestations in the laryngo-pharyngeal regions (4 cases) or lymph node metastases (12 cases). In the majority of the cases (82 pts, 72%) PET/CT-based conturing resulted in remarkable decrease in the volume (15-20%: 4 cases, 20-50%: 46 cases, >50%: 32 cases). On the basis of the initial and post-ICT PET/CT comparison in 15/20 patients more than 50% volume reduction and in 6/20 cases complete response were achieved. After an average of 6.4 years of follow-up the OS (median: 18.3±2.6 months) and DSS (median: 25.0±4.0 months) exhibited close correlation (p=0.0001) to the GTVpet. In cases with GTVpet <10 cm3 prior to RT, DSS did not reach the median, the mean is 82.1±6.1 months, while in cases with GTVpet 10-40 cm3 the median of the DSS was 28.8±4.9 months (HR = 3.57; 95% CI: 1.5-8.3), and in those with GTVpet >40 cm3 the median DSS was 8.4±0.96 months (HR= 11.48; 95% CI: 5.3-24.9). Our results suggest that 18FDG-PET/CT plays an important role for patient with LAHNSC, by modifying the treatment concept and improving the target definition for selective RT modalities. Volumetric PET/CT-based assessment of the tumor response after ICT gives valuable contribution to further therapy planning. PMID:26035157

  20. Diode laser and microvascular anastomosis-long term follow up

    NASA Astrophysics Data System (ADS)

    Godlewski, Guilhem; Tang, Jing; Rouy, Simone; Dauzat, Michel; Juan, Jean-Marie; Ovtchnnikoff, Serge; Salathe, Rene-Paul

    1994-02-01

    Direct diode laser assisted carotid end-to-end microanastomosis (LAMA) versus contralateral manual sutures microanastomosis (CMA) were performed in 70 Wistar rats. The laser beam- wavelength 830 nm, maximum power 3 W and continuous wave was transmitted through a micromanipulator and provided a focused spot of 300 micrometers in diameter. After placement of three 10.0 stitches for edge coaptation, LAMA was achieved on left common carotid (0.8 - 1.2 mm) using laser shots (average 3) of 500 mW power, 4.5 s duration and 700 W/cm2 irradiance each. CMA was performed on right carotid by means of six 10.0 stitches. Light and scanning electron microscopy (n equals 82) showed in LAMA that re-endothelialization was complete on day 10 while collagenous fusion of media and adventitia was evident. The patency rate was 93% after LAMA versus 93% after CMA. The intra operative advantages of LAMA versus CMA: shorter operating time minimizing organ ischemia (13 min versus 22 min) and reduced endothelial trauma were evidenced. The technical advantages of diode laser were pointed out: small size of device, absence of water cooling system, no maintenance and decreasing price of diodes.

  1. Long-term follow-up after renal artery stenting

    Microsoft Academic Search

    Robert A. Bucek; Stefan Puchner; Markus Reiter; Albert Dirisamer; Erich Minar; Johannes Lammer

    2003-01-01

    \\u000a Zusammenfassung\\u000a Hintergrund  Nierenarterienstenosen können sekundären arteriellen Bluthochdruck und Niereninsuffizienz verursachen. Die perkutane transluminale\\u000a Stentangioplastie (PTRAS) ermöglicht eine effektive Behandlung mit einer hohen technischen Erfolgsrate. Diese Studie beschäftigt\\u000a sich mit den morphologischen und klinischen Langzeitergebnissen anhand einer Kontrolluntersuchung. Hauptziele waren die Evaluierung\\u000a der Restenoserate sowie die Überprüfung des arteriellen Blutdruckes und der Nierenfunktion.\\u000a \\u000a \\u000a \\u000a Materialien und Methoden  40 Patienten, bei denen eine primär erfolgreiche

  2. Long-term follow up of astronaut health indices

    NASA Technical Reports Server (NTRS)

    Nicogossian, A. E.; Moseley, E.; Leach-Huntoon, C.; Pool, S.

    1988-01-01

    Ground-based research and reevaluation of flight data is currently in progress in order to develop suitable and operationally acceptable medical standards for extended-duration manned space missions. The large amount of data obtained thus far constitutes a unique data base representative of the astronaut population. In this paper, preliminary 10-year findings of prospective studies established in 1977 are described, and results obtained from retrospective studies conducted on data accumulated prior to the 1977 establishment of medical selection standards are summarized.

  3. Long Term Follow-up of Near Earth Objects

    NASA Astrophysics Data System (ADS)

    Trueblood, Mark; Crawford, Robert; Bell, David; Lebofsky, Larry

    2014-02-01

    Recently-discovered Virtual Impactors (VIs) and Potentially Hazardous Asteroids (PHAs) will be observed using the KPNO 2.1-m telescope to add astrometric observations at arcs up to 90 days from discovery. These extended arcs place strong constraints on the orbital solution and can greatly reduce the ephemeris uncertainty at the next recovery opportunity. Many recently-discovered Near Earth Objects (NEOs) will be observable in the range 21

  4. Long Term Follow-up of Near Earth Objects

    NASA Astrophysics Data System (ADS)

    Trueblood, Mark; Crawford, Robert; Lebofsky, Larry

    2012-02-01

    Recently-discovered Near Earth Objects (NEOs) will be observed using the KPNO 2.1-m telescope to add astrometric observations at arcs as long as 50-80 days from discovery. These extended arcs place strong constraints on the orbital solution and can greatly reduce the ephemeris uncertainty at the next recovery opportunity. Many recently-discovered NEOs will be observable in the range 21 < V < 23 on any night during 2012A. We will place the highest priority on Virtual Impactors (VIs) and on Potentially Hazardous Asteroids (PHAs) where long arcs can be created. We will also attempt to recover VI and PHA candidates on a 2- night run. Among the 109 NEOs (excluding small objects) for which the NEODyS system estimates a non-zero risk of Earth impact, all but 26 are unobservable using conventional (non-survey) telescopes. By creating extended arcs, we will reduce the number of VIs and PHAs that accumulate large errors, thereby enabling future recovery efforts and advancing the assessment of impact risk.

  5. Long Term Follow-up of Near Earth Objects

    NASA Astrophysics Data System (ADS)

    Trueblood, Mark; Crawford, Robert; Lebofsky, Larry

    2013-02-01

    We will use the KPNO 2.1-m telescope to recover Near Earth Objects (NEOs) by adding astrometric observations at one or more orbits since discovery. Recovery observations place the strongest constraints on the orbital solution and can be expected to improve the impact risk assessment for Virtual Impactors (VIs). Many NEOs will be observable in the range 21

  6. Long Term Follow-up of Near Earth Objects

    NASA Astrophysics Data System (ADS)

    Trueblood, Mark; Bell, David; Lebofsky, Larry

    2013-08-01

    Recently-discovered Near Earth Objects (NEOs) will be observed using the KPNO 2.1-m telescope to add astrometric observations at arcs as long as 20-80 days from discovery. These extended arcs place strong constraints on the orbital solution and can greatly reduce the ephemeris uncertainty at the next recovery opportunity. Many recently-discovered NEOs will be observable in the range 21

  7. Long-term cardiac follow-up in relapse-free patients after six courses of fluorouracil, epirubicin, and cyclophosphamide, with either 50 or 100 mg of epirubicin, as adjuvant therapy for node-positive breast cancer: French adjuvant study group.

    PubMed

    Bonneterre, Jacques; Roché, Henri; Kerbrat, Pierre; Fumoleau, Pierre; Goudier, Marie-Josèphe; Fargeot, Pierre; Montcuquet, Philippe; Clavère, Pierre; Barats, Jean-Claude; Monnier, Alain; Veyret, Corinne; Datchary, Jean; Van Praagh, Isabelle; Chapelle-Marcillac, Isabelle

    2004-08-01

    PURPOSE To evaluate long-term cardiac function in patients without disease who had received six cycles of fluorouracil 500 mg/m(2), epirubicin 50 mg/m(2), and cyclophosphamide 500 mg/m(2) (FEC 50) or the same regimen with epirubicin 100 mg/m(2) (FEC 100) as adjuvant chemotherapy for node-positive breast cancer in the French Adjuvant Study Group-05 trial. PATIENTS AND METHODS One hundred fifty patients (FEC 50, n = 65; FEC 100, n = 85) who were without disease and who gave their informed consent were enrolled for long-term cardiac assessment. The assessment included cardiac events occurring after the end of chemotherapy, vital signs, concomitant disease, ECG, isotopic left ventricular ejection fraction (LVEF), and echographic parameters. Abnormal files were blindly reviewed by cardiologists and oncologists. Results The median follow-up time was 102 months. After FEC 100, LVEF was less than 50% in five patients (radioisotopic method), and two patients experienced congestive heart failure (CHF) that was possibly related to treatment. Asymptomatic left ventricular dysfunction (LVD) was experienced in 18 patients after FEC 100 and in one patient after FEC 50. In these patients, treatment causality was probable in eight patients. Two additional years after this assessment, all 18 patients were still asymptomatic. CONCLUSION After more than 8 years of follow-up, the cardiac toxicity observed after adjuvant treatment with FEC 100 comprised two cases of well-controlled CHF and 18 cases of asymptomatic LVD. In the majority of women with primary breast cancer, the benefits of treatment with FEC 100 in terms of disease-free and overall survival outweigh the risks, and cardiac risk factors should be carefully evaluated in patient selection. PMID:15284257

  8. Querulent Paranoia: A Follow-Up

    Microsoft Academic Search

    Christian Astrup

    1984-01-01

    This study deals with all querulent paranoias admitted to Gaustad Hospital during 1938–1972. As querulent paranoia is a rare clinical condition, a plea is made for a multicenter study. We had only 22 cases, but most of them have a follow-up over several years, so that we are able to know fairly well the long-term course of illness. The family

  9. Long-Term Care

    MedlinePLUS

    ... this page please turn Javascript on. Long-Term Care What Is Long-Term Care? Long-term care involves a variety of services ... 8 sec Click to watch this video Most Care Provided at Home Click for more information Long- ...

  10. LONG-TERM OUTCOME AFTER PULMONARY ENDARTERECTOMY

    Microsoft Academic Search

    Angelo G. Corsico; Andrea M. D'Armini; Isa Cerveri; Catherine Klersy; Elena Ansaldo; Rosanna Niniano; Elena Gatto; Cristian Monterosso; Marco Morsolini; Salvatore Nicolardi; Corrado Tramontin; Ernesto Pozzi; Mario Viganò

    2008-01-01

    Rationale: There are few follow-up studies on long-term cardiopul- monary function after pulmonary endarterectomy (PEA), the oper- ation of choice for chronic thromboembolic pulmonary hyperten- sion (CTEPH). Objectives: To prospectively evaluate long-term outcome of patients with CTEPH treated with PEA. Methods: Between 1994 and 2006, 157 patients (mean age 55 yr) were treated with PEA at Pavia University Hospital. The

  11. Long Term Ecological Resources

    NSDL National Science Digital Library

    Scott Cooper

    Students analyze data on temperature and precipitation collected from 26 different Long Term Ecological Research sites and compare them with annual net primary productivity. The students then form an ecological rule to explain their results.

  12. Long term physical sequelae after adult-onset cancer

    Microsoft Academic Search

    Sophie D. Fosså; Rena Vassilopoulou-Sellin; Alv A. Dahl

    2008-01-01

    Introduction  With two thirds of cancer patients living for at least 5 years, clinical research has increasingly focused on the long-term\\u000a health of cancer survivors. Contrary to the amount of knowledge on long-term consequences observations on late effects after\\u000a childhood cancer in adult-onset cancer are sparse. Only limited literature is available recommending guidelines for long-term\\u000a follow-up of cancer patients and their implementation

  13. Chronic fatigue syndrome: a follow up study.

    PubMed Central

    Bonner, D; Ron, M; Chalder, T; Butler, S; Wessely, S

    1994-01-01

    Forty-six of 47 patients diagnosed as having chronic fatigue and offered treatment four years previously were followed up. Twenty-nine patients were interviewed, three patients refused an interview, and information on the remaining 14 was obtained from their general practitioners. All the instruments used at interview had been used in the initial study. The long-term prognosis for patients with chronic fatigue syndrome who have initially responded to treatment is good. Spontaneous recovery in those who declined or who did not benefit from treatment is unlikely. Patients who continue to fulfil the criteria for chronic fatigue syndrome four years after they were initially diagnosed are likely to have had more somatic disorders, to have been more fatigued, and to have had a previous psychiatric history when they were initially assessed. PMID:8201336

  14. Long-term conditions.

    PubMed

    2015-03-25

    Technology enabled care services (TECS), which include technologies such as telehealth, telecare, telemedicine and self-care apps, are designed to help people manage long-term conditions and retain as much independence as possible. The NHS Commissioning Assembly has published TECS Resource for Commissioners, a toolkit that raises awareness of the range of TECS available and their benefits to patients and professionals, supports commissioners to collaborate with providers to implement TECS, and advises how to create a TECS strategy, oversee implementation plans and ensure effective evaluation. The publication is at tinyurl.com/khsebyr. PMID:25806457

  15. Long-term Management of Patients After Weight Loss Surgery

    PubMed Central

    Richardson, William S.; Plaisance, Amber M.; Periou, Laura; Buquoi, Jennifer; Tillery, Deanna

    2009-01-01

    Bariatric surgery is becoming very common, and most physicians will have contact with bariatric patients. Many aspects to follow-up are not generally known. The objective of this article is to help other physicians understand what follow-up entails to assist them with the care of these patients. It is expected that patients are followed up by the bariatric team for a lifetime, as care is complicated and lifetime follow-up is the key to long-term success. PMID:21603433

  16. Focal retrograde amnesia: a long term clinical and neuropsychological follow-up.

    PubMed

    Kapur, N; Young, A; Bateman, D; Kennedy, P

    1989-09-01

    A patient (E.D.) who had displayed a selective retrograde amnesia in association with transient amnesic episodes (Kapur et al., 1986) was reexamined five years after initial assessment. At the clinical level, his transient amnesic attacks continued, but some of these had clear epileptic features. In addition, EEG investigation indicated temporal lobe abnormality, more prominent in the left temporal region, and supported a clinical diagnosis of temporal lobe epilepsy. Both CT scanning and magnetic resonance imaging were unable to detect the presence of any structural lesion. At the neuropsychological level, there was no evidence of dementia in the form of generalized cognitive dysfunction nor significant deterioration in cognitive functioning since the earlier assessment. Our patient continued to show marked memory loss for public events over the past 20-30 years, in the context of normal or near normal performance on most tests of anterograde memory functioning. While memory for famous scenes and famous faces was markedly impaired, our patient's memory for famous cars was within normal limits and his memory for autobiographical events showed only patchy impairment. Although E.D. performed at an average or above average level on most standard tests of anterograde memory functioning, our patient did show evidence of significant memory loss for public events which had occurred over the past ten years (i.e. since the onset of his illness). The possibility is raised that E.D.'s memory disorder may represent a form of disconnection syndrome. PMID:2805725

  17. Long-term follow-up of pediatric en bloc renal transplantation

    Microsoft Academic Search

    K. A Beasley; F Balbontin; A Cook; M Bloch; V. C McAlister; J Lawen; P. P. W Luke

    2003-01-01

    We reviewed the outcomes of pediatric en bloc renal transplantation at two Canadian centers in the cyclosporine era. Between 1984 and 2002, 16 patients received pediatric en bloc renal transplants. Mean recipient age and weight were 45 ± 17 years and 72.2 ± 14.4 kg, respectively. En bloc kidneys were procured from donors aged 2.1 ± 0.8 years (range, 0.7

  18. Parathyroid autotransplantation during thyroidectomy. Results of long-term follow-up.

    PubMed Central

    Olson, J A; DeBenedetti, M K; Baumann, D S; Wells, S A

    1996-01-01

    SUMMARY BACKGROUND DATA: Permanent hypoparathyroidism is a recognized complication of thyroidectomy. Operative strategies to prevent this complication include preservation of parathyroid glands in situ and autotransplantation of parathyroid glands resected or devascularized during thyroidectomy. METHODS: An analysis of 194 patients having thyroidectomy and simultaneous parathyroid autotransplantation at Barnes Hospital from 1990 to 1994 was performed. Data were collected regarding patient demographics, indication for thyroidectomy, operative procedure, pathologic diagnoses, and postoperative course, including biochemical assessment of parathyroid autograft function. RESULTS: Of 194 patients having either total, subtotal, or completion thyroidectomy, 104 (54%) experienced a [Ca(+2)]nadir less than or equal to 8.0 mg/dL and had symptoms and signs of hypocalcemia. Parathyroid autotransplantation was successful in 103 (99%) of these 104 cases and resulted in a 1.0% incidence of hypoparathyroidism in this series. CONCLUSIONS: Although preservation of parathyroid glands in situ is desirable, routine parathyroid autotransplantation during thyroidectomy virtually eliminates postoperative hypoparathyroidism. Normal parathyroid glands resected or devascularized during thyroidectomy for well-differentiated thyroid carcinoma or benign disease should be transplanted in the sternocleidomastoid muscle. Patients with Multiple Endocrine Neoplasia type 2A should have parathyroid glands resected at the time of thyroidectomy for medullary thyroid carcinoma and transplanted in the nondominant forearm. Postoperative management in most patients after thyroidectomy and parathyroid autotransplantation involves temporary calcium and vitamin D replacement and close biochemical evaluation. This precautionary measure of parathyroid autotransplantation markedly reduces the incidence of permanent postoperative hypoparathyroidism. PMID:8651738

  19. Long-term follow-up after combined fissurectomy and Botox injection for chronic anal fissures

    Microsoft Academic Search

    Th. Scholz; F. H. Hetzer; D. Dindo; N. Demartines; P. A. Clavien; D. Hahnloser

    2007-01-01

    Background and aims  Chronic anal fissures are difficult to treat. The aim of this retrospective study was to determine the outcome of combined\\u000a fissurectomy and injection of botulinum toxin Type A (BT).\\u000a \\u000a \\u000a \\u000a Materials and methods  Between January 2001 and August 2004, 40 patients (21 women), median age 37 years (range 18 to 57), underwent fissurectomy\\u000a and BT injection. Fissurectomy was performed followed by

  20. Vertebral artery angioplasty in patients younger than 55 years: Long-term follow-up

    Microsoft Academic Search

    Gary Giangola; Anthony M. Imparato; Thomas S. Riles; Patrick J. Lamparello

    1991-01-01

    Since 1964 we have performed 136 vertebral artery reconstructions representing 4% of all operations on extracranial cerebral arteries by our staff. Fifteen of our patients were under age 55 years and had symptoms of dizziness, bilateral visual disturbances, ataxia, presyncopal episodes, and occasionally localized extremity weakness. Dizziness, often severe and incapacitating, has been the most common and consistent symptom. The

  1. Long-term follow-up of whole lung lavage in patients with pulmonary alveolar proteinosis

    PubMed Central

    ZHOU, XIAOYAN; LU, GUOCHU; YU, ZHEN; GAO, FEI; BIAN, TAO

    2014-01-01

    Pulmonary alveolar proteinosis (PAP) is a rare disorder characterized by intra-alveolar accumulation of lipid and proteinaceous material. While a small subset of patients with PAP spontaneously improve or even undergo disease remission, the majority of patients develop persistent or progressive disease. Numerous therapies have been used to treat PAP over the years; however, at present, whole lung lavage (WLL) remains the gold standard treatment for PAP. In the present study, data were accumulated from a cohort of patients with PAP (n=11) between 2003 and 2011 at the Wuxi People’s Hospital Affiliated to Nanjing Medical University. The disease affected males and females with a ratio of 2.7:1 and all the males were current or previous smokers. The disease severity score (DSS) of the patients was mainly distributed in DSS 4 or DSS 5. All the patients underwent WLL at least once, with one patient undergoing WLLs twice and another patient three times. The clinical features, arterial blood gas and pulmonary function of the patients, were assessed prior to and following the lavage. WLL resulted in a significant improvement in symptoms, radiographic features, PaO2, D(A-a)O2 and DLCO in patients with PAP, while pulmonary ventilation function did not significantly improve. WLL appears to be an effective approach for the treatment of PAP and leads to an improvement in survival rate. PMID:25120596

  2. Short? and Long?term Follow?up of Parental Involvement in Reading Projects

    Microsoft Academic Search

    K. J. Topping

    1992-01-01

    Parental involvement in children's reading has received considerable research and media attention over the last decade. This paper considers whether the gains on norm?referenced reading tests widely reported as a result of this activity are maintained over time. The rather limited previous research is reviewed and it is noted that most data relate to the ‘Paired Reading’ technique. Substantial new

  3. GuLF Study: The Gulf Long-Term Follow-Up Study

    MedlinePLUS

    ... Radio Hear about the launch of the largest oil spill health study. Transcript Speaker: Dale Sandler, Ph.D., ... on the potential health effects associated with an oil spill, with nearly 33,000 participants. The GuLF STUDY ...

  4. Long-Term Clinical and Duplex Follow-up After Proximal Vertebral Artery Reconstruction

    Microsoft Academic Search

    Paul E. Y. Van Schil; Robert G. A. Ackerstaff; Freddy E. E. Vermeulen; Bert C. Eikelboom; Marc A. A. Schepens

    1992-01-01

    From 1977 to 1989, 28 patients, 18 men and 10 women, underwent 29 proxi mal vertebral artery reconstructions. Indications were vertebrobasilar insuffi ciency in 17 patients and TIA or stroke in 6. Five were asymptomatic. Procedures performed were endarterectomy in 20, reimplantation in 5, venous bypass in 3, and decompression in 1 case. Concomitant procedures were coro nary artery bypass

  5. Diabetes Prevention Program Long-Term Follow-up Study | Division of Cancer Prevention

    Cancer.gov

    Skip to main content Division of Cancer Prevention Search form Search Main menu Home Major Programs Research Networks Map Alliance of Glycobiologists for Detection of Cancer Barrett's Esophagus Translational Research Network (BETRNet) Cancer Prevention

  6. Long-term follow-up with I-care phakic IOLs

    Microsoft Academic Search

    Sophie Plainer; Elfriede Wenzl; Ali A Saalabian; Christina Wohlfart; Bertram Vidic; Yosuf El-Shabrawi; Navid Ardjomand

    2010-01-01

    AimTo evaluate visual quality and postoperative results as well adverse events in myopic patients undergoing I-CARE anterior-chamber angle-supported phakic intraocular lens (IOL) implantation.DesignA retrospective, non-randomised, case series.ParticipantsData on 29 eyes (16 patients) receiving I-CARE phakic IOL for high myopia (–11.66±3.3) were analysed.MethodsThe IOLs were implanted between 2003 and 2006 at the Department of Ophthalmology, Medical University, Graz, Austria. The mean

  7. A long-term follow-up evaluation of electronic health record prescribing safety

    PubMed Central

    Abramson, Erika L; Malhotra, Sameer; Osorio, S Nena; Edwards, Alison; Cheriff, Adam; Cole, Curtis; Kaushal, Rainu

    2013-01-01

    Objective To be eligible for incentives through the Electronic Health Record (EHR) Incentive Program, many providers using older or locally developed EHRs will be transitioning to new, commercial EHRs. We previously evaluated prescribing errors made by providers in the first year following transition from a locally developed EHR with minimal prescribing clinical decision support (CDS) to a commercial EHR with robust CDS. Following system refinements, we conducted this study to assess the rates and types of errors 2?years after transition and determine the evolution of errors. Materials and methods We conducted a mixed methods cross-sectional case study of 16 physicians at an academic-affiliated ambulatory clinic from April to June 2010. We utilized standardized prescription and chart review to identify errors. Fourteen providers also participated in interviews. Results We analyzed 1905 prescriptions. The overall prescribing error rate was 3.8 per 100 prescriptions (95% CI 2.8 to 5.1). Error rates were significantly lower 2?years after transition (p<0.001 compared to pre-implementation, 12?weeks and 1?year after transition). Rates of near misses remained unchanged. Providers positively appreciated most system refinements, particularly reduced alert firing. Discussion Our study suggests that over time and with system refinements, use of a commercial EHR with advanced CDS can lead to low prescribing error rates, although more serious errors may require targeted interventions to eliminate them. Reducing alert firing frequency appears particularly important. Our results provide support for federal efforts promoting meaningful use of EHRs. Conclusions Ongoing error monitoring can allow CDS to be optimally tailored and help achieve maximal safety benefits. Clinical Trials Registration ClinicalTrials.gov, Identifier: NCT00603070. PMID:23578816

  8. Renal function in tyrosinaemia type I after liver transplantation: A long-term follow-up

    Microsoft Academic Search

    L. J. W. M. Pierik; F. J. van Spronsen; C. M. A. Bijleveld; C. M. L. van Dael

    2005-01-01

    Summary  Hereditary tyrosinaemia type I is an autosomal recessive inborn error of tyrosine catabolism caused by a deficiency of the\\u000a enzyme fumarylacetoacetase that results in liver failure, hepatocellular carcinoma, renal tubular dysfunction and acute intermittent\\u000a porphyria. When treated with liver transplantation, tyrosinaemia type I was considered to be cured. Some years after the first\\u000a liver transplantations in these patients, some reports

  9. Highly cross-linked polyethylene in hip resurfacing arthroplasty: long-term follow-up.

    PubMed

    Amstutz, Harlan C; Takamura, Karren M; Ebramzadeh, Edward; Le Duff, Michel J

    2015-01-01

    Highly cross-linked polyethylene (XLPE) has improved wear properties. This study reports the results of a small series of patients treated over 10 years ago with a metal-on-XLPE hip resurfacing.A total of 21 hips in 20 patients received a hip resurfacing with a cobalt-chromium metal femoral head and metal-backed acetabular cup lined with a XLPE insert and were retrospectively studied. Kaplan-Meier Survivorship was calculated.Five patients who had initial extreme cystic disease in the femoral head failed due to femoral loosening. Survivorship was 95.2% at 5 years and 81.0% at 10 years.We found that XLPE wear was not implicated in these failures, which were primarily attributed to poor bone quality of the femoral head, early bone preparation, cementing technique and excessive head reaming to near the neck diameter, necessitated for the implantation of a thick two-part socket. PMID:25362872

  10. Outcome and long-term follow-up of 36 patients with tetrahydrobiopterin deficiency

    Microsoft Academic Search

    Leandra Jäggi; Marcel R. Zurflüh; Agnes Schuler; Alberto Ponzone; Francesco Porta; Laura Fiori; Marcello Giovannini; René Santer; Georg F. Hoffmann; Hans Ibel; Udo Wendel; Diana Ballhausen; Matthias R. Baumgartner; Nenad Blau

    2008-01-01

    We describe the treatment, the clinical, and biochemical findings and the outcome of 26 patients with 6-pyruvoyl-tetrahydropterin synthase (PTPS) deficiency and 10 patients with dihydropteridine reductase (DHPR) deficiency. These are the two most common forms of the autosomal-recessively inherited tetrahydrobiopterin (BH4) deficiency. Time of diagnosis, dosage of BH4 and neurotransmitter precursors, folinic acid substitution, and levels of 5-hydroxyindoleacetic acid (5HIAA)

  11. Binge Eating Among Gastric Bypass Patients at Long-term Follow-up

    Microsoft Academic Search

    Melissa A. Kalarchian; Marsha D. Marcus; G. Terence Wilson; Erich W. Labouvie; Robert E. Brolin; Lisa B LaMarca

    2002-01-01

    Background: A better understanding of the relationship of eating behavior and attitudes to weight loss following gastric bypass\\u000a (GBP) will enable the development of interventions to improve outcome. Thus, the present study sought to characterize the\\u000a postoperative weight, eating behavior, and attitudes toward body shape and weight in a cross-section of GBP patients. A second\\u000a objective was to examine the

  12. Comparison of long-term follow up of laparoscopic versus open colectomy for transverse colon cancer

    PubMed Central

    Agarwal, Samir; Gincherman, Mikhail; Birnbaum, Elisa; Mutch, Matthew

    2015-01-01

    Clinical Outcomes of Surgical Therapy (COST) was a landmark study demonstrating that laparoscopic-assisted colectomy had oncologic outcomes similar to those of open colectomy for colon cancer, but transverse colon cancers (TCCs) were excluded from that study. Oncologic results of a laparoscopic resection for TCC are unknown. This single-institution retrospective 3:1 case-matched review examined patients treated for TCC from January 1, 1996, to April 15, 2009. Laparoscopic colectomy (LC) and open colectomy (OC; extended right, extended left, and total abdominal) cases completed for Stage I to III adenocarcinoma of the transverse colon (hepatic flexure, transverse colon, and splenic flexure) were analyzed. Patients were matched for age, tumor location, and stage. Primary endpoints were overall survival and disease-free survival. Secondary endpoints were length of stay and pathologic parameters. One hundred and twenty-three OC cases were matched with 41 LC cases. There were four conversions (9.7%) in the LC group. Length of stay was reduced by 28% in the LC group (P = 0.02). Complication rate and severity were similar between the two groups (29% vs 24%; P = 0.68). Lymph node harvest was higher in the LC group than in the OC group (23.3 vs 18.6; P = 0.03). All pathologic margins were clear, and no local recurrence was found in either group. Five-year overall survival (61% vs 59%; P = 0.39) and disease-free survival (88% vs 82%; P = 0.23) were similar in the two groups. Short-term recovery was faster and lymph node harvest was improved in the LC group. Thus, laparoscopic management of TCC is a safe and feasible procedure. PMID:26130871

  13. Long-Term Follow-Up of Patients With Mild Coronary Artery Disease and Endothelial Dysfunction

    Microsoft Academic Search

    Shuichi Hamasaki; Stuart T. Higano; Rick A. Nishimura; David R. Holmes; Amir Lerman

    Background—Coronary endothelial dysfunction is characterized by vasoconstrictive response to the endothelium- dependent vasodilator acetylcholine. Although endothelial dysfunction is considered an early phase of coronary atherosclerosis, there is a paucity of information regarding the outcome of these patients. Thus, this study was designed to evaluate the outcome of patients with mild coronary artery disease on the basis of their endothelial function.

  14. Intellectual development in Apert's syndrome: a long term follow up of 29 patients.

    PubMed Central

    Patton, M A; Goodship, J; Hayward, R; Lansdown, R

    1988-01-01

    Twenty-nine patients with Apert's syndrome were ascertained through hospital records. The mean age was 19.3 years (range eight to 35 years). Further information was obtained on their intelligence, education, and employment records. Fourteen patients (48%) had a normal or borderline IQ (greater than 70), nine patients (31%) were mildly mentally retarded (IQ 50 to 70), four patients (14%) were moderately retarded (IQ 35 to 49), and two patients (7%) were severely retarded (IQ less than 35). Early craniectomy did not appear to improve intellectual outcome. Six of the seven school leavers with normal or borderline intelligence were in full time employment or vocational training. PMID:3351902

  15. Long-term, Clinical and Echocardiographic Results After Successful Mitral Balloon Valvotomy and Predictors of Long-term Outcome

    Microsoft Academic Search

    Mohamed Eid Fawzy; Hesham Hegazy; Mohamed Shoukri

    2005-01-01

    Aims To assess the long-term outcome of mitral balloon valvotomy (MBV) and identify predictors of rest- enosis- and event-free survival. Methods and results We report the immediate and long-term clinical and echocardiographic results in 493 patients, mean age 31+ 11, who underwent successful MBV and were followed-up for 0.5-15 years (median 5+ 3) with clinical and echocardiographic examination. After MBV,

  16. Hepatobiliary cystadenoma exhibiting morphologic changes from simple hepatic cyst shown by 11-year follow up imagings

    Microsoft Academic Search

    Naoto Fukunaga; Masashi Ishikawa; Hisashi Ishikura; Toshihiro Ichimori; Suguru Kimura; Akihiro Sakata; Koichi Sato; Jyunichi Nagata; Yoshiyuki Fujii

    2008-01-01

    BACKGROUND: A long-term follow up case of hepatobiliary cystadenoma originating from simple hepatic cyst is rare. CASE PRESENTATION: We report a case of progressive morphologic changes from simple hepatic cyst to hepatobiliary cystadenoma by 11 – year follow up imaging. A 25-year-old man visited our hospital in 1993 for a simple hepatic cyst. The cyst was located in the left

  17. Long-term symbolic learning

    Microsoft Academic Search

    William G. Kennedy; J. Gregory Trafton

    2007-01-01

    What are the characteristics of long-term learning? We investigated the characteristics of long-term, symbolic learning using the Soar and ACT-R cognitive architectures running cognitive models of two simple tasks. Long sequences of problems were run collecting data to answer fundamental questions about long-term, symbolic learning. We examined whether symbolic learning continues indefinitely, how the learned knowledge is used, and whether

  18. Long-term EEG in children.

    PubMed

    Montavont, A; Kaminska, A; Soufflet, C; Taussig, D

    2015-03-01

    Long-term video-EEG corresponds to a recording ranging from 1 to 24 h or even longer. It is indicated in the following situations: diagnosis of epileptic syndromes or unclassified epilepsy, pre-surgical evaluation for drug-resistant epilepsy, follow-up of epilepsy or in cases of paroxysmal symptoms whose etiology remains uncertain. There are some specificities related to paediatric care: a dedicated pediatric unit; continuous monitoring covering at least a full 24-hour period, especially in the context of pre-surgical evaluation; the requirement of presence by the parents, technician or nurse; and stronger attachment of electrodes (cup electrodes), the number of which is adapted to the age of the child. The chosen duration of the monitoring also depends on the frequency of seizures or paroxysmal events. The polygraphy must be adapted to the type and topography of movements. It is essential to have at least an electrocardiography (ECG) channel, respiratory sensor and electromyography (EMG) on both deltoids. There is no age limit for performing long-term video-EEG even in newborns and infants; nevertheless because of scalp fragility, strict surveillance of the baby's skin condition is required. In the specific context of pre-surgical evaluation, long-term video-EEG must record all types of seizures observed in the child. This monitoring is essential in order to develop hypotheses regarding the seizure onset zone, based on electroclinical correlations, which should be adapted to the child's age and the psychomotor development. PMID:25687590

  19. Long-Term Outcome in Pyridoxine-Dependent Epilepsy

    ERIC Educational Resources Information Center

    Bok, Levinus A.; Halbertsma, Feico J..; Houterman, Saskia; Wevers, Ron A.; Vreeswijk, Charlotte; Jakobs, Cornelis; Struys, Eduard; van der Hoeven, Johan H.; Sival, Deborah A.; Willemsen, Michel A.

    2012-01-01

    Aim: The long-term outcome of the Dutch pyridoxine-dependent epilepsy cohort and correlations between patient characteristics and follow-up data were retrospectively studied. Method: Fourteen patients recruited from a national reference laboratory were included (four males, 10 females, from 11 families; median age at assessment 6y; range 2y…

  20. The Long-Term Impact of Interactive Exhibits.

    ERIC Educational Resources Information Center

    Stevenson, John

    1991-01-01

    Follow-up interviews with 79 adults and children about 6 months after their visit to Launch Pad, the interactive center in London's Science Museum, provide evidence of long-term impact of the visit. Although most of the memories were episodic rather than semantic in nature, over one-quarter of the memories showed evidence that respondents…

  1. Antenatal oligohydramnios of renal origin: long-term outcome

    Microsoft Academic Search

    Ilka Klaassen; Thomas J. Neuhaus; Dirk E. Mueller-Wiefel; Markus J. Kemper

    Background. Prognosis of fetuses with renal oligohy- dramnios (ROH) is often still regarded as poor. Neonatal complications and the long-term follow-up of fetuses with ROH in two pediatric centres are described. Method. 23 fetuses (16 males, 7 females) were included as patients. Primary diseases included congenital anomalies of the kidney and urinary tract (n ¼ 16), autosomal recessive polycystic kidney

  2. Long-term sequelae of electrical injury

    PubMed Central

    Wesner, Marni L.; Hickie, John

    2013-01-01

    Abstract Objective To summarize the current evidence-based knowledge about the long-term sequelae of injuries from electrical current. Quality of evidence MEDLINE was searched for English-language articles published in the past 20 years using the following search terms: electrical, injuries, wound, trauma, accident, sequelae, long-term, follow-up, and aftereffects. For obvious reasons, it is unethical to randomly study electrical injury in controlled clinical trials. By necessity, this topic is addressed in less-rigorous observational and retrospective work and case studies. Therefore, the strength of the literature pertaining to the long-term sequelae of electrical injury is impaired by the necessity of retrospective methods and case studies that typically describe small cohorts. Main message There are 2 possible consequences of electrical injury: the person either survives or dies. For those who survive electrical injury, the immediate consequences are usually obvious and often require extensive medical intervention. The long-term sequelae of the electrical injury might be more subtle, pervasive, and less well defined, but can include neurologic, psychological, and physical symptoms. In the field of compensation medicine, determining causation and attributing outcome to an injury that might not result in objective clinical findings becomes a considerable challenge. Conclusion The appearance of these consequences of electrical injury might be substantially delayed, with onset 1 to 5 or more years after the electrical injury. This poses a problem for patients and health care workers, making it hard to ascribe symptoms to a remote injury when they might not arise until well after the incident event. PMID:24029506

  3. [Follow-up care of living kidney donors].

    PubMed

    Bock, H A; Thiel, G

    1995-09-01

    The follow-up of living kidney donors demands medical as well as psychological competence. In the postoperative period, attention focuses on pain management, early detection of wound complications and the prophylaxis of thromboembolism. Regular visits of the donor who may easily feel neglected should be as much part of the transplant team's post-operative routine as visits of the recipient. The later phase of recovery emphasizes strengthening abdominal wall and lumbar muscles as well as the gradual increase of physical activity. Long-term follow-up focuses on the early detection of arterial hypertension and proteinuria. Antihypertensive therapy in nephrectomized donors should include an ACE inhibitor or an angiotensin-II antagonist. In Switzerland, the long-term course after living donation is prospectively monitored by the Swiss Registry for Living Donors founded in 1993. The registry is responsible for the regular timing of follow-up examinations and assures transparency of the origin of the kidneys used for living donation in Switzerland. The registry heavily relies on the collaboration of the donor's family physicians. PMID:7502264

  4. Glossary (Long-Term Care)

    MedlinePLUS

    ... not as intensive as care offered at a nursing home. Types and sizes of facilities vary, ranging from ... a cognitive impairment. Community Spouse Spouse of a nursing home resident applying for or receiving Medicaid long-term ...

  5. [Childhood liver transplantation. Long-term results].

    PubMed

    Jara, Paloma; Hierro, Loreto

    2010-05-01

    Liver transplantation allows long-term survival (10 years or more) in 75% of children receiving transplants before 2000. The risk of mortality after the first year is 4-10% in the next 10-20 years. Chronic rejection affects 6%. The need for late retransplantation is 3-5%. However, the follow-up of these patients involves the management of diverse problems in the graft (immunological, biliary, vascular) and others related to the use of immunosuppressants (renal dysfunction, lymphoproliferative syndrome). The transition from pediatric to adult care generates special needs. Adolescence and young adulthood are associated with a lack of compliance. Adult specialists should be aware of the special features of the original diagnosis and the surgical techniques used in childhood transplantation. Final quality of life is good overall but is lower than that in healthy young persons. PMID:20122757

  6. Long Term Health Study for Oil Spill Clean-up Workers and Volunteers

    MedlinePLUS

    ... With Us A long term health study for oil spill clean-up workers and volunteers Follow-up underway! ... health study for individuals who helped with the oil spill cleanup, took training, signed up to work, or ...

  7. Long-term outcomes of stapled hemorrhoidopexy

    PubMed Central

    Michalik, Maciej; Bobowicz, Maciej; Witzling, Mieczys?aw

    2013-01-01

    Introduction Hemorrhoidal disease is one of the commonest anorectal disorders worldwide. Stapled hemorrhoidopexy (SH) is a treatment modality associated with low postoperative pain and early mobilization. Aim To assess long-term outcomes after SH. Material and methods All 326 patients who underwent SH in 1999–2003 were invited by mail to participate. For each patient we analyzed their medical records, and conducted a questionnaire survey and a digital rectal examination. Results Only 91 patients attended the final examination and the mean ± SD follow-up time was 8.7 ±1.2 years. Recurrences were diagnosed in one third of the 91 subjects. There were correlations between recurrences and: the duration of disease (p = 0.047); female gender (p = 0.037); and childbirth (vaginal delivery) (p = 0.026). Sixty-seven patients (73.6%) were satisfied with the outcomes. In the group of dissatisfied patients symptoms such as pain (p = 0.0001), burning (p = 0.0002) and itching (p = 0.014) were most common. Long-term outcomes were good with 75% and 88% reductions in pain sensation and severe and moderate hemorrhoidal bleeding. Pruritus, burning and discomfort resolved in more than 50% of patients. Flatus incontinence, fecal incontinence, or soiling occurred in 21%, 11%, and 32% of patients. Conclusions Long-term results of stapled hemorrhoidopexy are satisfactory in most patients. The 36% recurrence rate correlates with the degree of hemorrhoidal prolapse before the operation, duration of the disease, female gender, and previous vaginal delivery. PMID:24729805

  8. Long-term motor cortex stimulation for phantom limb pain.

    PubMed

    Pereira, Erlick A C; Moore, Tom; Moir, Liz; Aziz, Tipu Z

    2015-04-01

    We present the long-term course of motor cortex stimulation to relieve a case of severe burning phantom arm pain after brachial plexus injury and amputation. During 16-year follow-up the device continued to provide efficacious analgesia. However, several adjustments of stimulation parameters were required, as were multiple pulse generator changes, antibiotics for infection and one electrode revision due to lead migration. Steady increases in stimulation parameters over time were required. One of the longest follow-ups of motor cortex stimulation is described; the case illustrates challenges and pitfalls in neuromodulation for chronic pain, demonstrating strategies for maintaining analgesia and overcoming tolerance. PMID:25340991

  9. ? Carinae long-term variability

    NASA Astrophysics Data System (ADS)

    Damineli, Augusto; Teodoro, Mairan; Corcoran, Michael F.; Groh, Jose H.

    2011-07-01

    We present preliminary results of our analysis on the long-term variations observed in the optical spectrum of the LBV star ? Carinae. Based on the hydrogen line profiles, we conclude that the physical parameters of the primary star did not change in the last 15 years.

  10. Follow-up of low-risk patients with differentiated thyroid carcinoma: a European perspective

    Microsoft Academic Search

    Martin Schlumberger; Gertrud Berg; Ohad Cohen; Leonidas Duntas; Francois Jamar; Barbara Jarzab; Eduard Limbert; Peter Lind; Furio Pacini; Christoph Reiners; Franco Sanchez Franco; S. Toft; Wilmar M Wiersinga

    2004-01-01

    Objective: Because differentiated (follicular and papillary) thyroid cancer (DTC) may recur years after initial treatment, the follow-up of patients with DTC is long term. However, this population has chan- ged, with more individuals being discovered at an earlier stage of the disease, so that previous follow-up protocols based mostly on data from high-risk patients no longer apply. We sought to

  11. Follow-up care for cancer survivors: the views of clinicians

    Microsoft Academic Search

    D M Greenfield; K Absolom; C Eiser; S J Walters; G Michel; B W Hancock; J A Snowden; R E Coleman

    2009-01-01

    Background:Evidence for the efficacy of late effects surveillance in adult cancer survivors is lacking and there is little agreement among clinicians on appropriate follow-up care.Methods:We report the views of both cancer experts and general practitioners (GPs) on long-term follow-up provision for cancer survivors, focussing on the 18–45 years age group. A total of 421 cancer experts (36% haematologists, 33% oncologists,

  12. Children's reactions to Hurricane Andrew: A forty-four month follow-up study

    Microsoft Academic Search

    Nicole Renee Vincent

    1997-01-01

    Little is known about children's long-term adjustment following a disaster. Thus, the current study was conducted as a 44-month follow-up investigation, examining children's reactions to Hurricane Andrew over time. Previous data collection was conducted at 3, 7, and 10 months post-hurricane with a sample of 442 children. Subjects at follow-up were a subset of the original sample, consisting of 43

  13. Localized prostate cancer and 30 years of follow-up in a population-based setting

    Microsoft Academic Search

    J Adolfsson; H Oksanen; JO Salo; G Steineck

    2000-01-01

    Some patients with a histopathological diagnosis of prostate cancer have a tumour that behaves benignly during long-term follow-up. The proportion of patients with such a tumour is unknown, as is the fraction who die of prostate cancer between 10 and 20 y of follow-up. All men aged 45–84 y obtaining a diagnosis of prostate cancer between 1965 and 1993 and

  14. Nitinol urethral stents: long-term results in dogs

    Microsoft Academic Search

    D. Latal; J. Mraz; P. Zerhau; M. Susani; M. Marberger

    1994-01-01

    No information has been available to date on the long-term behavior of nitinol (nickel-titanium alloy) urethral stents. In the present study, prostheses of this type were implanted in 18 German shepherd dogs in order to evaluate the reaction of the mucosa, muscles and periurethral tissue. Follow-up examinations performed after 1 week, and 1, 3, 6, 12 and 18 months included

  15. Long-term sequelae of Helicobacter pylori gastritis

    Microsoft Academic Search

    E. J. Kuipers; A. S. Peña; H. P. M. Festen; S. G. M. Meuwissen; A. M. Uyterlinde; R. Roosendaal; G. Pals; G. F. Nelis

    1995-01-01

    Chronic Helicobacter pylori gastritis has been put forward as a risk factor for development of gastric mucosal atrophy and gastric cancer. The purpose of our study was to investigate the long-term effects of H pylori gastritis on the gastric mucosa. We prospectively studied 49 subjects negative for H pylori and 58 positive subjects for a mean follow-up of 11·5 years

  16. Long term function following the central cord syndrome

    Microsoft Academic Search

    M J Bridle; K B Lynch; C M Quesenberry

    1990-01-01

    Follow-up visits were made to persons with central spinal cord injury in order to assess long term functional outcomes. An occupational therapist conducted in-home evaluations of 18 randomly selected subjects at an average time of 4 years 8 months since injury. Evaluation instruments included: the ASIA Motor Index; the Jebsen Hand Function Test; the Klein-Bell Activities of Daily Living Scale;

  17. Strategy for NEO follow-up observations

    NASA Astrophysics Data System (ADS)

    Tichy, Milos; Honkova, Michaela; Ticha, Jana; Kocer, Michal

    2015-03-01

    The Near-Earth Objects (NEOs) belong to the most important small bodies in the solar system, having the capability of close approaches to the Earth and even possibility to collide with the Earth. In fact, it is impossible to calculate reliable orbit of an object from a single night observations. Therefore it is necessary to extend astrometry dataset by early follow-up astrometry. Follow-up observations of the newly discovered NEO candidate should be done over an arc of several hours after the discovery and should be repeated over several following nights. The basic service used for planning of the follow-up observations is the NEO Confirmation Page (NEOCP) maintained by the Minor Planet Center of the IAU. This service provides on-line tool for calculating geocentric and topocentic ephemerides and sky-plane uncertainty maps of these objects at the specific date and time. Uncertainty map is one of the most important information used for planning of follow-up observation strategy for given time, indicating also the estimated distance of the newly discovered object and including possibility of the impact. Moreover, observatories dealing with NEO follow-up regularly have prepared their special tools and systems for follow-up work. The system and strategy for the NEO follow-up observation used at the Klet Observatory are described here. Methods and techniques used at the Klet NEO follow-up CCD astrometric programme, using 1.06-m and 0.57-m telescopes, are also discussed.

  18. Towards sustainability assessment follow-up

    SciTech Connect

    Morrison-Saunders, Angus, E-mail: a.morrison-saunders@murdoch.edu.au [Murdoch University (Australia) [Murdoch University (Australia); North-West University (South Africa); Pope, Jenny, E-mail: jenny@integral-sustainability.net [North-West University (South Africa) [North-West University (South Africa); Integral Sustainability (Australia) [Australia; Curtin University (Australia); Bond, Alan, E-mail: alan.bond@uea.ac.uk [North-West University (South Africa) [North-West University (South Africa); University of East Anglia (United Kingdom); Retief, Francois, E-mail: francois.retief@nwu.ac.za [North-West University (South Africa)] [North-West University (South Africa)

    2014-02-15

    This paper conceptualises what sustainability assessment follow-up might entail for three models of sustainability assessment: EIA-driven integrated assessment, objectives-led integrated assessment and the contribution to sustainability model. The first two are characterised by proponent monitoring and evaluation of individual impacts and indicators while the latter takes a holistic view based around focused sustainability criteria relevant to the context. The implications of three sustainability challenges on follow-up are also examined: contested time horizons and value changes, trade-offs, and interdisciplinarity. We conclude that in order to meet these challenges some form of adaptive follow-up is necessary and that the contribution to sustainability approach is the best approach. -- Highlights: • We explore sustainability follow-up for three different sustainability models. • Long-time frames require adaptive follow-up and are a key follow-up challenge. • Other key challenges include interdisciplinarity, and trade-offs. • Sustainability follow-up should be a direction of travel and not an outcome. • Only the follow-up for contribution to sustainability model addresses sustainability challenges sufficiently.

  19. Long-term data archiving

    SciTech Connect

    Moore, David Steven [Los Alamos National Laboratory

    2009-01-01

    Long term data archiving has much value for chemists, not only to retain access to research and product development records, but also to enable new developments and new discoveries. There are some recent regulatory requirements (e.g., FDA 21 CFR Part 11), but good science and good business both benefit regardless. A particular example of the benefits of and need for long term data archiving is the management of data from spectroscopic laboratory instruments. The sheer amount of spectroscopic data is increasing at a scary rate, and the pressures to archive come from the expense to create the data (or recreate it if it is lost) as well as its high information content. The goal of long-term data archiving is to save and organize instrument data files as well as any needed meta data (such as sample ID, LIMS information, operator, date, time, instrument conditions, sample type, excitation details, environmental parameters, etc.). This editorial explores the issues involved in long-term data archiving using the example of Raman spectral databases. There are at present several such databases, including common data format libraries and proprietary libraries. However, such databases and libraries should ultimately satisfy stringent criteria for long term data archiving, including readability for long times into the future, robustness to changes in computer hardware and operating systems, and use of public domain data formats. The latter criterion implies the data format should be platform independent and the tools to create the data format should be easily and publicly obtainable or developable. Several examples of attempts at spectral libraries exist, such as the ASTM ANDI format, and the JCAMP-DX format. On the other hand, proprietary library spectra can be exchanged and manipulated using proprietary tools. As the above examples have deficiencies according to the three long term data archiving criteria, Extensible Markup Language (XML; a product of the World Wide Web Consortium, an independent standards body) as a new data interchange tool is being investigated and implemented. In order to facilitate data archiving, Raman data needs calibration as well as some other kinds of data treatment. Figure 1 illustrates schematically the present situation for Raman data calibration in the world-wide Raman spectroscopy community, and presents some of the terminology used.

  20. Fifteen-Year Follow-Up of Thyroid Status in Adults with Down Syndrome

    ERIC Educational Resources Information Center

    Prasher, V.; Ninan, S.; Haque, S.

    2011-01-01

    Background: The natural history of thyroid function in adults with Down syndrome is relatively unknown with limited long-term follow-up data. Method: This study investigated annual thyroid function tests in 200 adults with Down syndrome over a 15-year period. Results: For healthy adults with Down syndrome there is a gradual increase in thyroxine…

  1. Early Referral Follow-Up Project. Final Report, October 1, 1983 to September 30, 1986.

    ERIC Educational Resources Information Center

    Robinson, Cordelia C.

    The Early Referral and Follow-up Project of the University of Nebraska Medical Center was designed to facilitate developmental assessment and intervention with long-term or repeatedly hospitalized children from birth to 3 years of age. Developmentally delayed children, handicapped children, and children at risk for delays were eligible for…

  2. A 40Year Follow-up of Patients With Obsessive-compulsive Disorder

    Microsoft Academic Search

    Gunnar Skoog; Ingmar Skoog

    1999-01-01

    Background: The long-term course of obsessive- compulsive disorder is insufficiently known. We stud- ied the course of this disorder in patients who were followed up for 40 years. Methods: Patients admitted with a diagnosis of obsessive- compulsive disorder to the Department of Psychiatry, Sahl- grenska University Hospital, Goteborg, Sweden, between 1947 and 1953 were examined by an experienced psy- chiatrist

  3. Nurse led telephone follow up in ovarian cancer: A psychosocial perspective

    Microsoft Academic Search

    Anna Cox; Ellen Bull; Jane Cockle-Hearne; Wendy Knibb; Claire Potter; Sara Faithfull

    2008-01-01

    Survivorship is a relatively new concept in ovarian cancer due to improvements in diagnosis, surgery and chemotherapy. As more women require long term follow up for ovarian cancer the pressure on these services is increased and the question of how best to care for these women needs to be addressed. This paper considers the results of a pilot study of

  4. Long Term Stability Following Genioplasty: A Cephalometric Study

    PubMed Central

    Kumar, B Lakshman; Raju, G Kranthi Praveen; Kumar, N Dilip; Reddy, G Vivek; Naik, B Ravindra; Achary, C Ravindranath

    2015-01-01

    Background: A receding chin associated with an orthognathic mandible is a common situation and surgical changes in chin position are often required to improve the overall harmony of the face. Genioplasty is one such procedure. Stability of hard and soft tissue changes following genioplasty on a long term basis needs to be assessed. Studies on the stability of hard and soft tissue changes following genioplasty on a short term basis have revealed it as a procedure with good stability. This study is done to assess the stability of hard and soft tissue changes following genioplasty on a long term basis. Materials and Methods: Pre-surgical, postsurgical and long term post-surgical cephalograms of 15 cases treated by vertical reduction augmentation genioplasty were obtained. Paired t-test was used to compare the changes between pre-surgical, postsurgical and long term postsurgical cephalograms. Results: Findings of this study demonstrated that genioplasty is a stable procedure. After long term follow-up period, there was a relapse of 1.5 mm at the pogonion accounting for 24% of the surgical advancement. This is attributed to the remodeling that occurs at the surgical site, but not the instability due to the surgical procedure. Conclusion: With the present study, it can be concluded that vertical reduction and advancement genioplasty can be considered as an adjunctive procedure that produces predictable results and the bony and soft tissue stability were generally very good. PMID:25954070

  5. [Neuromuscular disease: respiratory clinical assessment and follow-up].

    PubMed

    Martínez Carrasco, C; Villa Asensi, J R; Luna Paredes, M C; Osona Rodríguez de Torres, F B; Peña Zarza, J A; Larramona Carrera, H; Costa Colomer, J

    2014-10-01

    Patients with neuromuscular disease are an important group at risk of frequently suffering acute or chronic respiratory failure, which is their main cause of death. They require follow-up by a pediatric respiratory medicine specialist from birth or diagnosis in order to confirm the diagnosis and treat any respiratory complications within a multidisciplinary context. The ventilatory support and the cough assistance have improved the quality of life and long-term survival for many of these patients. In this paper, the authors review the pathophysiology, respiratory function evaluation, sleep disorders, and the most frequent respiratory complications in neuromuscular diseases. The various treatments used, from a respiratory medicine point of view, will be analyzed in a next paper. PMID:24709048

  6. Transconjunctival dacryocystorhinostomy: Long term results

    PubMed Central

    Kaynak, Pelin; Ozturker, Can; Karabulut, Gamze; Çelik, Burcu; Yilmaz, Omer Faruk; Demirok, Ahmet

    2013-01-01

    Purpose To evaluate the outcomes of transconjunctival dacryocystorhinostomy (TRC-DCR) surgery in patients with epiphora due to primary acquired nasolacrimal duct obstruction (PANDO) at second year follow-up. Methods In this retrospective, interventional study, 33 eyes of 29 patients, with epiphora due to PANDO, are included. Lower eyelid conjunctiva is incised at vestibulum inferomedially to access the lacrimal sac and nasal mucosa. Bone is perforated with burr and rongeurs and saccal and nasal flaps are anastomosed. Conjunctival wound edges are apposed and left unsutured. Intraoperative difficulties, surgical time and complications are noted. Average follow-up time was 2 years. Anatomical success was defined as patent lacrimal passages upon irrigation and functional success was defined as relief of epiphora. Results In nineteen (57.6%) eyes the surgeries were completed with the anterior and the posterior flaps sutured. In eight eyes (24.2%) only anterior flaps could be sutured. In 6 eyes (18.2%), the surgical procedure was converted to external dacryocystorhinostomy since the nasal mucosa could not be exposed adequately via transconjunctival route. The mean surgical time was 65.1 min. One patient had a millimeter long lower eyelid margin laceration in one eye (3.7%) intraoperatively due to traction for visualization of the operative site. Epiphora resolved in 25 of 27 eyes (92.5%) in whom TRC-DCR could be completed. Epiphora and failure to irrigation were noted in two eyes (7.4%) at the postoperative 4th and 8th months, respectively and required reoperation. No complications occurred, except granuloma formation at the conjunctival incision site in three eyes (11.1%). Epiphora resolved in all the six eyes of patients who underwent an external DCR (100%). Conclusion Transconjunctival dacryocystorhinostomy is a scarless dacryocystorhinostomy technique which is performed without endoscope and/or laser assistance, with 92.5% success rate comparable to external DCR at the second year follow-up without major complications. PMID:24526861

  7. The Community Follow-up Project (CFUP).

    PubMed

    Sherina, M S; Azhar, M Z; Mohd Yunus, A; Azlan Hamzah, S A

    2005-08-01

    The Community Follow-up Project (CFUP) is a project where medical students choose a hospital in-ward patient during their clinical ward-based attachments and follow-up this patient's progress after discharge from the hospital. The students do a series of home visits and also accompany their patients for some of their follow-ups at the hospital, government clinics, general practitioners' clinics and even to the palliative care or social welfare centres. The students assess the physical, psychological and social impact of the illness on the patient, family and community. By following their patients from the time their patients were in the hospital and back to their homes and community, the students are able to understand in depth the problems faced by patients, the importance of communication skills in educating patients on their illness and the importance of good communication between primary, secondary and tertiary care. PMID:16315625

  8. Diabetic Amyotrophy: A Follow-up Study

    PubMed Central

    Casey, E. B.; Harrison, M. J. G.

    1972-01-01

    A clinical follow-up study of 12 patients with diabetic amyotrophy is reported. Re-examination after an interval indicated that improvement had occurred in all but one instance, and had been maintained over an average follow-up period of four and a half years. Improvement in the neurological syndrome appeared to follow improvement in diabetic control or institution of treatment in those whose diabetes had not previously been diagnosed. Seven patients made a good functional recovery, three no longer having any muscular weakness. Five showed significant residual disability. PMID:5015293

  9. Long-term results of combined approach in parotid sialolithiasis.

    PubMed

    Konstantinidis, I; Chatziavramidis, A; Iakovou, I; Constantinidis, J

    2014-11-12

    Combined sialendoscopic and transcutaneous approach in parotid sialolithiasis is a surgical option for large and impacted stones. The aim of this study is to assess the long-term results regarding postoperative stenosis, recurrent swellings and gland function. Prospective study in a tertiary referral center of patients with parotid sialolithiasis requiring combined approach. A total of 12 patients have been treated within a period of 3 years. Intraductal stents were placed in 9 of 12 cases. Scintigraphic evaluation of salivary glands and follow-up sialendoscopy performed 1 year postoperatively. In total, fourteen stones (two stones in two cases) were successfully removed along with two coexisted inflammatory polyps. Postoperative endoscopic evaluation revealed mild stenosis in 7 out of 12 cases without clinical significance as no recurrent swellings were reported. Scintigraphy showed normal gland function in 11 cases and mild hypofunction in 1 case with long-standing history of sialolithiasis. All patients were free of symptoms within the follow-up period of time (median follow-up 15.5 months). Combined approach is a safe, gland preserving and efficacious procedure in long term. The stenosis in the area of ductal surgical opening when present does not seem to be of clinical value. PMID:25388993

  10. Follow-Up Research on Agoraphobics.

    ERIC Educational Resources Information Center

    Chambless, Dianne L.

    In vivo exposure is the most commonly used and generally the most effective behavioral treatment for agoraphobia. Follow-up studies are difficult to interpret because additional treatment does not necessarily indicate relapse and non-treatment does not necessarily indicate non-relapse. Relapse rates are difficult to estimate because of lack of…

  11. 1975 Graduates: Spring '77 Follow-up.

    ERIC Educational Resources Information Center

    Selgas, James W.

    In 1976, a transfer and employment follow-up survey was conducted of 696 Associate of Arts and certificate students who had graduated between December 1974 and August 1975 from Harrisburg Area Community College (HACC). Responses, which were received from 70% of the graduates, indicated that (1) 93% would recommend HACC; (2) 72% were currently…

  12. Long-term prognosis of depression in primary care.

    PubMed Central

    Simon, G. E.

    2000-01-01

    This article uses longitudinal data from a primary care sample to examine long-term prognosis of depression. A sample of 225 patients initiating antidepressant treatment in primary care completed assessments of clinical outcome (Hamilton Depression Rating Scale and the mood module of the Structured Clinical Interview for DSM-IIIR) 1, 3, 6, 9, 12, 18 and 24 months after initiating treatment. The proportion of patients continuing to meet criteria for major depression fell rapidly to approximately 10% and remained at approximately that level throughout follow-up. The proportion meeting criteria for remission (Hamilton Depression score of 7 or less) rose gradually to approximately 45%. Long-term prognosis (i.e. probability of remission at 6 months and beyond) was strongly related to remission status at 3 months (odds ratio 3.65; 95% confidence interval, 2.81-4.76) and only modestly related to various clinical characteristics assessed at baseline (e.g. prior history of recurrent depression, medical comorbidity, comorbid anxiety symptoms). The findings indicate that potentially modifiable risk factors influence the long-term prognosis of depression. This suggests that more systematic and effective depression treatment programmes might have an important effect on long-term course and reduce the overall burden of chronic and recurrent depression. PMID:10885162

  13. Long-term clinical course of acute pulmonary embolism.

    PubMed

    den Exter, P L; van der Hulle, T; Lankeit, M; Huisman, M V; Klok, F A

    2013-07-01

    The long-term clinical course of acute pulmonary embolism (PE) is complicated by high rates of serious adverse events, both before and after cessation of anticoagulant therapy. These adverse events include recurrent venous thromboembolism, chronic thromboembolic pulmonary hypertension, arterial thrombotic events and increased risk of death, all compared to patients without thromboembolic disease. Several pharmacological options are available that may beneficially influence patients' prognosis. Nonetheless, because of insufficient knowledge of the benefit-to-harm ratio of these pharmacological agents, unambiguous recommendations are scarcely available. This review will cover the epidemiological aspects of the various possible complications in the long-term clinical course of acute PE as well as the latest evidence on preventive strategies. In addition, the unresolved issues regarding frequency, duration and focus of medical follow-up after acute PE are discussed. PMID:23791363

  14. Long-term injectable progestogens.

    PubMed

    Tyler, E T

    1967-01-01

    Prof. Edward T. Tyler, medical director of the Family Planning Clinics of Los Angeles, gave an interim report on a study into the use of unjectable progestogens as a long-term method of contraception. An intramuscular injection of medroxy-progesterone acetate (150 mg.) is given three-monthly, with no supplementary oestrogen. Over the past two years about 150 women began this form of contraception in a continuing study. There have been no pregnancies in the series. The most frequent side-effect has been bleeding. An attempt was made to see how soon the contraceptive effects cease after treatment is stopped. The injections were therefore stopped in 36 women, who were then fitted with various mechanical forms of contraception, including IUDs. Tests for the re-establishment of ovulation were undertaken, including basal temperature studies, frequent pelvic examinations, cervical and vagianl smears, endometrial biopsies, gonadotrophin and pregnanediol estimations. It appeared that the earliest return of ovulation is a little under six months from the time of the last injection. The early results of this study, presented here, suggest that long-acting injectable progestogens are an extremely effective form of contraception. While the delay in return of fertility for some months may be a problem in certain areas, this method may well be of importance in general population control. PMID:12254706

  15. Long-term follow-up of patients who underwent yttrium-90 pituitary implantation for treatment of proliferative diabetic retinopathy

    Microsoft Academic Search

    P. S. Sharp; T. J. Fallon; O. J. Brazier; L. Sandler; G. F. Joplin; E. M. Kohner

    1987-01-01

    Summary  Between 1960 and 1976 117 patients underwent pituitary implantation with yttrium-90 (90Y) for treatment of proliferative retinopathy at the Hammersmith Hospital, London. Mean age at operation was 35±11 years (mean±SD), and mean duration of diabetes 18.6±10.0 years. Mean insulin dosage prior to implant was 67.2±24 units, falling to 30.4±14.9 units post-implant. Thirty-two per cent of patients are still living, 60%

  16. Arthroscopic-Assisted Broström-Gould for Chronic Ankle Instability: A Long-Term Follow-up

    Microsoft Academic Search

    Caio Nery; Fernando Raduan; Angelo Del Buono; Inacio Diogo Asaumi; Moises Cohen; Nicola Maffulli

    2011-01-01

    Background: Lateral ankle sprains account for 85% of ankle lesions.Hypothesis: Combined open and arthroscopic procedures could improve the diagnosis and management of intra-articular lesions and allow surgeons to perform minimally invasive anatomic reconstruction of the lateral ligament complex.Study Design: Case series; Level of evidence, 4.Methods: Forty consecutive patients underwent ankle arthroscopy for recurrent (2 or more episodes) lateral ankle instability

  17. Regret after sex reassignment surgery in a male-to-female transsexual: a long-term follow-up.

    PubMed

    Olsson, Stig-Eric; Möller, Anders

    2006-08-01

    This case report describes a four-decade presentation of a non-homosexual gender dysphoric male patient. The case material was collected from two main sources. One of the authors had weekly therapy sessions with the patient over a period of 2 years almost 15 years after sex reassignment surgery. Information was also gained from the patient's medical records covering the period from the early 1960s to the early 1990s. Over the years, the patient fulfilled the criteria for different diagnoses: overanxious reaction of childhood, fetishism and transvestism during adolescence, and transsexualism during adolescence and early adulthood. The purpose of this report was to shed light on aspects of regret, its manifestation in a male-to-female transsexual with psychiatric co-morbidity, and to show the complexity of the process of adjustment when regret is involved. The present case is an argument for a strict interpretation of the Standards of Care provided by the Harry Benjamin International Gender Dysphoria Association in terms of evaluating patients' mental health, apart from the evaluation of the gender identity disorder, and the patients' subsequent need for treatment interventions. PMID:16900416

  18. Remodeling of epithelial cells and basement membranes in a corneal deficiency model with long-term follow-up.

    PubMed

    Kameishi, Sumako; Sugiyama, Hiroaki; Yamato, Masayuki; Sado, Yoshikazu; Namiki, Hideo; Kato, Takashi; Okano, Teruo

    2015-02-01

    The ocular surface consists of the cornea, conjunctiva, and the limbus that is located in the transitional zone between the cornea and conjunctiva. The corneal epithelial cells are generated through the mitosis of corneal epithelial stem cells in the limbus. This study investigated a rabbit corneal deficiency model prepared by the surgical removal of the corneal and limbal epithelia, which express cytokeratin 12 (K12). After the surgery, K13-expressing conjunctival epithelium migrated onto the corneal surface and completely covered the surface, leading to neovascularization and corneal opacification. However, at 24 and 48 weeks after the surgery, K12-expressing cornea-like cells reappeared on the model ocular surface. These cells formed an island surrounded by invaded conjunctiva and were isolated from the limbus. Interestingly, in the 24-week model surface, ?1(IV) and ?2(IV) collagen chains, which are normally found in the basement membrane of the native limbus and conjunctiva, and not in the cornea, were continuously deposited throughout the entire basement membrane, including the basement membrane under cornea-like cells. By contrast, in the 48-week model surface, ?1(IV) and ?2(IV) collagen chains were absent from the basement membrane beneath the central part of cornea-like cells and were localized below the invaded conjunctiva and the transitional zone between cornea-like cells and the invaded conjunctiva, which had similar distribution to the native ocular basement membrane. Moreover, K12, K14, p63, vimentin, and ?1(IV) and ?2(IV) collagen chains, which are colocalized in the native limbus, were all present at the transitional zone of the 48-week model surface. Therefore, a limbus-like structure appeared to be reconstructed on the surface of the 48-week model as a stem cell niche. This study should aid in the understanding of human corneal deficiency, the correlation between the epithelial cell phenotype and the composition of the basement membrane, and the epithelial stem cell niche. PMID:25531563

  19. Intraoral melanoma: long-term follow-up and implication for dental clinicians. a case report and literature review

    Microsoft Academic Search

    Gao Man Gu; Joel B Epstein; Thomas H Morton

    2003-01-01

    Primary intraoral melanoma is a rare neoplasm with a poor prognosis, accounting for 1% to 8% of all melanoma in Europe and the United States. The incidence (12%) and 5-year survival rate (17.4%) are higher in Japan. We report a case of oral lentiginous melanoma in a Japanese-American man who survived disease-free for more than 5 years after surgery, radiation

  20. Radiofrequency Volumetric Thermal Ablation of Fibroids and Laparoscopic Myomectomy: Long-Term Follow-up From a Randomized Trial

    PubMed Central

    Hahn, M.; Brucker, S.; Kraemer, D.; Wallwiener, M.; Taran, F.-A.; Wallwiener, C. W.; Krämer, B.

    2015-01-01

    Aims: Laparoscopic myomectomy (LM) has been the gold standard treatment for uterine fibroids in women desiring uterine conservation. To evaluate a new fibroid treatment modality – radiofrequency volumetric thermal ablation (RFVTA) – we compare 12-month results in women who had symptomatic uterine fibroids and who were randomized to laparoscopic ultrasound-guided RFVTA or LM. Materials and Methods: Our study is a 1?:?1 parallel, randomized, prospective, single-center, longitudinal, comparative analysis of RFVTA to LM for fibroid treatment in women ??18 years of age who desired uterine conservation. Fifty women were randomized intraoperatively to RFVTA (n?=?25) or to LM (n?=?25) after laparoscopic ultrasound mapping of the uterus. Results: Post surgery, ablation and myomectomy subjects took pain medications for 4 days (range: 1–46) and 7 days (range: 1–83 days) respectively (p?=?0.60). Ablation and myomectomy subjects missed 10.0 workdays (range: 2–86 days) and 17.0 workdays (range: 7–30 days) (p?=?0.28), resumed normal activities in 20.5 days (range: 5–103 days) versus 28.0 days (range: 10–42 days) (p?=?0.86) respectively. Mean symptom severity scores decreased (improved) by ??7.8 for the ablation subjects and by ??17.9 for the myomectomy subjects (p?=?0.16). Health-related quality of life improved (increased) by 7.5 and 13.1, respectively, for the two groups (p?=?0.46). Two myomectomy subjects had pregnancies that ended in a Cesarean delivery and a vaginal delivery of healthy infants. Two pregnancies in the RFVTA group ended in full-term vaginal deliveries of healthy infants. Conclusions: Early postoperative recovery and twelve-month results attest to similar clinical benefits from RFVTA and LM.

  1. Secretory breast carcinoma in a 41-year-old man with long-term follow-up: a special report.

    PubMed

    Li, Guanqiao; Zhong, Xiaojie; Yao, Jia; Chen, Jimin; Wang, Mei; Liu, Haiying; Yang, Shiping

    2015-06-01

    ABSTRACT? Secretory breast carcinoma (SBC) is a rare tumor that is even rare in male adults. To our knowledge, only 28 previous male cases of SBC have been reported. The present case of SBC has the longest symptom duration (40 years) in male until now. The clinical features and treatment of male SBC is similar with female SBC. When compared with the usual type of male breast cancer, patients with male secretory breast cancer are much younger, and have a lower rate of estrogen/progesterone hormone receptor positivity. Modified radical mastectomy has been favored in all female SBC, male SBC and usual type of male breast cancer. ETV6-NTRK3 fusion gene is a specific genetic alteration in SBC. PMID:26075445

  2. Surgical Treatment of Pituitary Tumors in the Elderly: Clinical Outcome and Long-term Follow-up

    Microsoft Academic Search

    Luigi Ferrante; Giuseppe Trillò; Epimenio Ramundo; Paolo Celli; Marie-Lise Jaffrain-Rea; Maurizio Salvati; Vincenzo Esposito; Raffaele Roperto; Mattia Falchetto Osti; Giuseppe Minniti

    2002-01-01

    Pituitary adenomas in the elderly represent an increasing proportion of pituitary tumors, making the surgical management of these patients of special importance. We therefore decided to review our experience with transsphenoidal surgery (TSS) in this age group, in order to better evaluate its efficacy, safety and outcome.

  3. Hemispheric cerebral gliomas in children with NF1: arguments for a long-term follow-up

    Microsoft Academic Search

    Laurent Riffaud; Matthieu Vinchon; Omar Ragragui; Isabelle Delestret; Marie-Madeleine Ruchoux; Patrick Dhellemmes

    2002-01-01

    Background: Neurofibromatosis type 1, or peripheral neurofibromatosis, is the most form of common phakomatosis. In some instances, it can be associated with tumors of the central nervous system. Case report: We describe four cases of hemispheric cerebral glioma in children with NF1. Two of these tumors were pilocytic astrocytomas and two, ependymomas. We reviewed the literature on hemispheric cerebral gliomas

  4. Long-term follow-up and prognostic factors in ovarian carcinoma. The radiumhemmet series 1958 to 1973.

    PubMed

    Björkholm, E; Pettersson, F; Einhorn, N; Krebs, I; Nilsson, B; Tjernberg, B

    1982-01-01

    Between 1958 and 1973, 2412 women with epithelial ovarian carcinoma were treated at Radiumhemmet. Of these tumors, 14.5 per cent were of borderline malignancy. The 5-year relative survival rate was 34 per cent among the patients with true malignant tumor and 93 per cent in the borderline cases. Even in advanced stages (IIb-IV) the 5-year survival rate was 78 per cent in the borderline cases. Advanced stage and high age at diagnosis, true malignancy and tumors of serous, clear cell or anaplastic type were associated with poor prognosis. The 5-year relative survival rate of patients with epithelial ovarian carcinoma in an early stage improved during the period, from 67 to 81 per cent. PMID:6305119

  5. Bobble-head doll syndrome: therapeutic outcome and long-term follow-up in four children.

    PubMed

    Guerreiro, Helena; Vlasak, Ales; Horinek, Daniel; Tichy, Michal; Lisy, Jiri; Vanek, Petr; Liby, Petr; Hoza, David; Beneš, Vladimir; Nimsky, Christopher

    2012-11-01

    Bobble-head doll syndrome (BHDS) is a complex syndrome with the dominant symptom of repetitive anteroposterior head movement. Only 57 patients are quoted in the literature. The etiology of this syndrome remains unknown and no standard treatment has yet been established. We hereby report four cases treated at our department. All the patients presented a psychomotor retardation due to an obstructive hydrocephalus. All the patients were treated using neuroendoscopic techniques: two with ventriculocystostomy, and two with ventriculocystocisternostomy. Cyst decompression was achieved in all four cases and clinical recovery was evident in three of the four patients observed. After surgery, BHDS persisted longer the more the subsequent treatment was delayed. In this article, we provide a concise overview of the theories of pathogenesis, presentation, and management of this syndrome. Based on our own experience, we state that the method of choice should be the neuroendoscopy and this must be performed promptly after diagnosis is made. PMID:22886034

  6. Radiofrequency Ablated Lesion in the Normal Porcine Lung: Long-Term Follow-Up with MRI and Pathology

    SciTech Connect

    Oyama, Yoshimasa, E-mail: yoshimasa519@yahoo.co.jp, E-mail: yoshimasa03155@ych.or.jp; Nakamura, Kenji; Matsuoka, Toshiyuki; Toyoshima, Masami; Yamamoto, Akira; Okuma, Tomohisa [Osaka City University Graduate School of Medicine, Department of Radiology (Japan); Ikura, Yoshihiro; Ueda, Makiko [Osaka City University Graduate School of Medicine, Department of Pathology (Japan); Inoue, Yuichi [Osaka City University Graduate School of Medicine, Department of Radiology (Japan)

    2005-04-15

    Purpose. To evaluate the effectiveness of magnetic resonance imaging (MRI) in reflecting histopathologic changes after radiofrequency ablation (RFA) to the lung and to assess accurately the extent of tissue necrosis for evaluating untreated lesions. Methods. Percutaneous RFA was performed on 72 lung regions in 12 pigs under computed tomographic guidance. After performing MRI, the animals were divided into three experimental phases: in the acute phase, 4 pigs were killed immediately after the procedure; in the subacute phase, 4 pigs were killed at 1 week; and in the chronic phases, 2 pigs were killed at 4 and 8 weeks after the procedure, respectively. MRI-histopathologic correlation was performed. Results. In the acute phase, the inner zone showed hypointensity on T2-weighted images and isointensity on T1-weighted images, with a lack of enhancement on contrast-enhanced T1-weighted images, representing early changes in coagulative necrosis on histopathologic examination. The outer zone showed hyperintensity on T2-weighted images and isointensity on T1-weighted images, with ring-like enhancement on contrast-enhanced T1-weighted images. The histopathologic section showed alveolar fluid collections and congestion. In the subacute phase the MR zone pattern was essentially similar to that of the acute phase, but the ablated lesion showed extensive coagulative necrosis with a fibrovascular rim on histopathologic examination. In the chronic phase, there was no change in the zone pattern on MRI. The lesions showed gradual resorption of coagulative necrosis. The area of coagulative necrosis correlated closely with the histopathologic size (p < 0.05). Conclusions. MRI effectively visualized the histopathologic changes after RFA and accurately determined the extent of the necrotic lesion. MRI is potentially a useful modality for evaluating therapeutic efficacy after RFA to the lung.

  7. Long-Term Effects of Individual Development Accounts on Postsecondary Education: Follow-Up Evidence from a Randomized Experiment

    ERIC Educational Resources Information Center

    Grinstein-Weiss, Michal; Sherraden, Michael; Gale, William G.; Rohe, William M.; Schreiner, Mark; Key, Clinton

    2013-01-01

    This paper presents evidence from a randomized field experiment testing the impact of a 3-year matched savings program on educational outcomes 10 years after the start of the experiment. We examine the effect of an Individual Development Account (IDA) program on (1) educational enrollment, (2) degree completion, and (3) increased education level.…

  8. The Long-Term Outcome of Children by Birth Weight and Gestational Age. High-Risk Follow-Up Study.

    ERIC Educational Resources Information Center

    Colorado Univ., Denver. Medical Center.

    This report is comprised of three separate studies conducted at the University of Colorado Medical Center. In the first study, answers to the following questions were sought: (1) What kinds of late morbidity occur at different birth weights and gestational ages? and (2) Has a vigorous approach to metabolic support in the newborn period changed the…

  9. Long-Term Follow-Up of Chimpanzees Inoculated with the First Infectious Clone for Hepatitis C Virus

    Microsoft Academic Search

    MARIAN E. MAJOR; KATHLEEN MIHALIK; JAVIER FERNANDEZ; JESSICA SEIDMAN; DAVID KLEINER; ALEXANDER A. KOLYKHALOV; CHARLES M. RICE; STEPHEN M. FEINSTONE

    1999-01-01

    Two chimpanzees (Ch1535 and Ch1536) became infected with hepatitis C virus (HCV) following intrahepatic inoculation with RNA transcribed from a full-length cDNA clone of the virus. Both animals were persistently infected and have been followed for 60 weeks. They showed similar responses to infection, with transient liver enzyme elevations and liver inflammatory responses, which peaked at weeks 17 (Ch1535) and

  10. Is Incident Drug-Resistance of Childhood-Onset Epilepsy Reversible? A Long-Term Follow-Up Study

    ERIC Educational Resources Information Center

    Sillanpaa, Matti; Schmidt, Dieter

    2012-01-01

    Given the grave morbidity and mortality of drug-resistant epilepsy, it is of great clinical interest to determine how often prior proven drug-resistant epilepsy is reversible without surgery and whether remission can be predicted by clinical features in children with incident drug-resistant epilepsy. We determined the likelihood of 1-, 2- and…

  11. [Congenital muscular dystrophy with laminin-a2 deficiency in early infancy: diagnosis and long-term follow-up].

    PubMed

    Panteliadis, C; Karatza, E; Xinias, I; Flaris, N; Tzitiridou, M; Ramantani, G

    2005-01-01

    Congenital muscular dystrophy (CMD) is a heterogeneous group of neuromuscular disorders characterized by muscle weakness and hypotonia at birth or within the first few months of life. It is inherited in an autosomal recessive pattern. About half of the patients have a deficiency of the alpha-2-chain of laminin (merosin). We describe a case of congenital muscular dystrophy in an infant with laminin-a2-chain deficiency, which appeared hypotonia in early infancy. Diagnosis was made by clinical features and the histological and immunohistochemical studies on muscle biopsy. PMID:16167276

  12. Successful liver transplantation and long-term follow-up in a patient with MPI-CDG.

    PubMed

    Janssen, Mirian C H; de Kleine, Ruben H; van den Berg, Arie P; Heijdra, Yvonne; van Scherpenzeel, Monique; Lefeber, Dirk J; Morava, Eva

    2014-07-01

    Hepatopathy is the most common feature in the Congenital Disorders of Glycosylation (CDG). More than 70 subtypes have been identified in this growing group of inborn errors. Most defects present as multisystem disease, whereas phosphomannose isomerase deficiency (MPI-CDG) presents with exclusive hepato-intestinal phenotype. MPI-CDG has been considered as one of the very few treatable disorders of glycosylation; several patients showed significant improvement of their life-threatening protein-losing enteropathy and coagulation disorder on oral mannose supplementation therapy. However, patients who have MPI-CDG develop progressive liver insufficiency during a later course of disease. A patient who had MPI-CDG developed progressive liver fibrosis, despite oral mannose supplementation and repeated fractionated heparin therapy. She showed mannose therapy-associated hemolytic jaundice. She developed severe dyspnea and exercise intolerance owing to pulmonary involvement, necessitating liver transplant. After transplantation her physical exercise tolerance, pulmonary functions, and metabolic parameters became fully restored. She is still doing well 2 years after transplantation now. In conclusion, we here report on the first successful liver transplantation in CDG. PMID:24982104

  13. Long-term EXOTIME photometry and follow-up spectroscopy of the sdB pulsator HS 0702+6043

    NASA Astrophysics Data System (ADS)

    Lutz, R.; Schuh, S.; Silvotti, R.; Kruspe, R.; Dreizler, S.

    2009-03-01

    Pulsating subdwarf B (sdB) stars oscillate in short-period p modes or long-period g modes. HS 0702+6043 (DW Lyn) is one of a few objects to show characteristics of both types and is hence classified as a hybrid pulsator. It is one of our targets in the EXOTIME program to search for planetary companions around extreme horizontal branch objects. In addition to the standard exercise in asteroseismology to probe the instantaneous inner structure of a star, measured changes in the pulsation frequencies as derived from an O--C diagram can be compared to theoretical evolutionary time scales. Based on the photometric data available so far, we are able to derive a high-resolution frequency spectrum and to report our efforts to construct a multi-season O--C diagram. Additionally, we have gathered time-resolved spectroscopic data in order to constrain stellar parameters and to derive mode parameters as well as radial and rotational velocities.

  14. Cerebral amyloid angiopathy in streptozotocin rat model of sporadic Alzheimer’s disease: a long-term follow up study

    Microsoft Academic Search

    Melita Salkovic-Petrisic; Jelena Osmanovic-Barilar; Martina K. Brückner; Siegfried Hoyer; Thomas Arendt; Peter Riederer

    2011-01-01

    Cerebral amyloid angiopathy is manifested as accumulation of amyloid ? (A?) peptide in the wall of meningeal and cerebral\\u000a arteries, arterioles and capillaries and is frequently found postmortem in sporadic Alzheimer’s disease (sAD) patients. It\\u000a is difficult to assess when and how cerebral amyloid angiopathy develops and progresses in humans in vivo, which is why animal\\u000a AD models are used.

  15. Bone marrow transplantation for chronic granulomatous disease: long-term follow-up and review of literature

    Microsoft Academic Search

    TF Leung; KW Chik; CK Li; MMK Shing; PMP Yuen

    1999-01-01

    Chronic granulomatous disease (CGD) is a heterogeneous group of disorders with defective respiratory burst activity in phagocytes which results in recurrent pyogenic infections. We report an 8-year-old boy with X-linked CGD who received an HLA-identical BMT from his sister. The nitroblue tetrazolium test returned to normal 3 months post transplant. Neutrophil engraftment has been stable for 7 years post BMT.

  16. Long-term gonioscopy follow-up of eyes with posterior chamber lens implants and no iridectomy.

    PubMed

    Murphy, G E

    1986-04-01

    One hundred eyes which had undergone extracapsular cataract extraction with no iridectomy followed by insertion of a posterior chamber lens were examined gonioscopically 1 to 4.7 years postoperatively to determine the prevalence of asymptomatic angle closure from pupillary block. Since no peripheral anterior synechiae (PAS) characteristic of pupillary block were found, there seems to be little risk that these eyes will develop angle-closure glaucoma. During the study small PAS were noted adjacent to many haptics implanted in the ciliary sulcus. PMID:3714191

  17. Long-term follow up of HIV-1-infected Korean haemophiliacs, after infection from a common source of virus.

    PubMed

    Kim, B-R; Kim, J-E; Sung, H; Cho, Y-K

    2015-01-01

    In the early 1990s, 20 haemophiliacs (HPs) were infected with a common source of HIV-1 viruses through the contaminated clotting factor IX. The aim of this study is to review 20 HPs infected with a common source of virus. The enrolled patients have been consecutively treated with Korean red ginseng (KRG), zidovudine (ZDV) or two-drug therapy and highly active antiretroviral therapy (HAART). We determined full-length pol gene over 20 years and human leukocyte antigen (HLA) class I with peripheral blood mononuclear cells and reviewed medical records. Eighteen HPs experienced various opportunistic infections or clinical manifestations. There were significant inverse correlations between the HLA prognostic score and the annual decrease in CD4+ T-cell counts prior to HAART (AD) (P < 0.05) and the amount of KRG and the AD (P < 0.01). From 1998, the HPs had been treated with HAART. Each of the two patients died without and with HAART regimen respectively. At present, 16 HPs have been alive with HAART. Among the 16 HPs, 12 and 4 are on HAART-plus-KRG and HAART only respectively. Eleven HPs including 2 HPs with G-to-A hypermutations had revealed resistance mutations. Ten and two HPs have shown poor adherence and incomplete viral suppres-sion on HAART respectively. Virological failure based on WHO guidelines was not observed on KRG-plus-HAART. Two HPs revealed additional resistance mutations against two classes on KRG-plus-HAART. As a nationwide study, we first report overall features on clinical course of Korean haemophiliacs. Further education on the importance of drug adherence is needed. PMID:25545303

  18. Bronchial artery embolization for hemoptysis: Immediate and long-term results

    Microsoft Academic Search

    Katsumi Hayakawa; Fumiko Tanaka; Tatsuo Torizuka; Michihide Mitsumori; Yoshishige Okuno; Akira Matsui; Yoshikazu Satoh; Kazuhisa Fujiwara; Takashi Misaki

    1992-01-01

    The purpose of this study was to evaluate the immediate and long-term results in 63 patients who underwent transarterial embolization\\u000a for control of hemoptysis. Overall immediate success rate was 86.1%. At long-term follow-up 50% of patients showed complete\\u000a remission, 22% partial remission, and 28% recurrent hemoptysis. Hemoptysis remained controlled for a mean of 22 months and\\u000a a median of 14

  19. Chronic inflammatory demyelinating polyradiculoneuropathy: long-term course and treatment of 60 patients

    Microsoft Academic Search

    A. Sghirlanzoni; A. Solari; C. Ciano; C. Mariotti; E. Fallica; D. Pareyson

    2000-01-01

    The objective of this study was to assess the long-term course and treatment of chronic inflammatory demyelinating polyradiculoneuropathy\\u000a (CIDP). We evaluated, according to a predefined protocol, a series of 60 CIDP patients who received a long-term course of\\u000a steroids and immunosuppressants. Eighteen of them also had monoclonal gammopathy of undetermined significance (MGUS). Mean\\u000a follow-up was 4.4 years and was similar

  20. Over 20-year follow-up of Miura reconstruction of cleft hand.

    PubMed

    Beck, John D; Chang, Benjamin; Jones, Neil F

    2015-06-01

    Several techniques have been described for cleft hand closure and web space reconstruction in patients with central deficiency; however, long-term documentation of results is rare. We present a 23-year follow-up of a patient who underwent the Miura procedure for a Manske type IIb cleft hand exhibiting long-term aesthetic and functional success. In addition, early skin flap necrosis and late web space contracture, which have been seen after the Snow-Littler procedure, did not occur in this case. PMID:26034452

  1. Long-Term Safety and Adverse Events of Risperidone in Children, Adolescents, and Adults with Pervasive Developmental Disorders

    ERIC Educational Resources Information Center

    Hellings, Jessica A.; Cardona, Alicia M.; Schroeder, Stephen R.

    2010-01-01

    The objective of this study was to examine long-term adverse events of risperidone in 19 children, adolescents, and adults with Pervasive Developmental Disorders and intellectual disability, continuing risperidone for a mean of 186.5 weeks, following a 46-week risperidone study. Nineteen individuals continued long-term follow-up after our…

  2. Lithium prophylaxis of recurrent bipolar affective disorder: Long-term outcome and its psychosocial correlates

    Microsoft Academic Search

    Parmanand Kulhara; Debasish Basu; Surendra K Mattoo; Pratap Sharan; Rajni Chopra

    1999-01-01

    Background: Discrepancy between efficacy of prophylactic lithium and its effectiveness in ordinary clinical practice necessitates long-term follow-up data from specialised lithium clinics. Also, role of psychosocial factors in influencing the outcome is unclear. Methods: One hundred and eighteen patients of bipolar affective disorder attending a lithium clinic were followed-up for ?11 years (range 2–27 years). Demographic and clinical data, measures

  3. Long-term impact of functional endoscopic sinus surgery on asthma

    Microsoft Academic Search

    BRENT A. SENIOR; DAVID W. KENNEDY; JIRAYU TANABODEE; HANS KROGER; MOHAMMED HASSAB; DONALD C. LANZA

    1999-01-01

    Using objective and subjective criteria, we performed a study to assess the long-term impact of functional endoscopic sinus surgery (FESS) in patients with chronic rhinosinusitis and asthma at an average follow-up of 6.5 years. One hundred twenty patients who underwent FESS for chronic rhinosinusitis were followed up for an average of 6.5 years (range 6.0 to 10.6 years). Seventy-two (60%)

  4. 838. 10 Year Follow-Up of 146 Advanced Stage NSCLC Patients Who Received Adenoviral Based Therapy

    Microsoft Academic Search

    John Nemunaitis; Been Pappen; Rosemarie Arzaga; Casey Cunningham; Neil Senzer

    2006-01-01

    We report the first long-term follow-up of adenoviral vector based therapeutics patients who previously received anticancer therapy. Over the period of 10\\/26\\/95 to 8\\/15\\/05 146 patients with stage IIIB\\/ IV NSCLC were treated as out patients. Patients participated in 1 of 8 adenoviral based therapeutic trials involving 6 different agents. All were evaluable for long term unexpected toxic effect and

  5. [Follow-up problems in scoliosis patients].

    PubMed

    Schumpe, G; Hofmann, P; Rössler, H

    1984-01-01

    With reference to 4 different methods - theoretical derivation, computed model, recent radiological analysis based on 120 scoliosis patients and measurement of the posterior median line in 40 scoliosis patients - the unreliability of follow-up in scoliosis patients is illustrated. The results are compared with previous publications by other authors and discussed. A method of determining spinal geometry three-dimensionally by means of topometric methods (5) is described. The validity of this measuring method is demonstrated in the patient by geometrical measurement of the posterior median line without treatment, under halo gravity extension and in movement. PMID:6475210

  6. Follow-up study of pseudoephedrine users.

    PubMed

    Porta, M; Jick, H; Habakangas, J A

    1986-11-01

    A follow-up study of over 100,000 persons below age 65 years who filled a total of 243,286 prescriptions for pseudoephedrine indicated that there were no hospitalizations among users that could be attributed to the drug. There were no admissions within 15 days of filling a prescription for pseudoephedrine for cerebral hemorrhage, thrombotic stroke, or hypertensive crisis. There were a small number of hospitalizations for myocardial infarction, seizures and neuropsychiatric disorders, but the rate of such admissions among the pseudoephedrine users was close to the expected rate in the population at large. PMID:3777533

  7. Laparoscopic Adjustable Gastric Banding: A Prospective 4Year Follow-up Study

    Microsoft Academic Search

    K. Miller; E. Hell

    1999-01-01

    Background: A body mass index of ?40 kg\\/m2 represents clinically severe obesity and warrants operative treatment if requested. The adjustable silicone gastric band\\u000a and the Swedish adjustable gastric band are recently produced laparoscopic gastric restrictive devices. The aim of this study\\u000a was to assess all complications linked to both the available gastric bands in a long-term follow-up. Methods: In a

  8. Follow-up of an Exercise-Based Treatment for Children with Reading Difficulties

    ERIC Educational Resources Information Center

    Reynolds, David; Nicolson, Roderick I.

    2007-01-01

    This study reports the results of a long-term follow-up of an exercise-based approach to dyslexia-related disorders (Reynolds, Nicolson, & Hambly, "Dyslexia," 2003; 9(1): 48-71). In the initial study, children at risk of dyslexia were identified in 3 years of a junior school. One half then undertook a 6 month, home-based exercise programme.…

  9. Vagus nerve stimulation in patients with catastrophic childhood epilepsy, a 2-year follow-up study

    Microsoft Academic Search

    H. J. M. Majoie; M. W. Berfelo; A. P. Aldenkamp; W. O. Renier; A. G. H. Kessels

    2005-01-01

    Purpose: To establish the long-term efficacy and tolerability of vagus nerve stimulation (VNS) in children with a Lennox-like syndrome. Method: This study was a longitudinal observational prospective cohort analysis. Baseline: 6 months. Follow-up: 24 months. Screening (baseline and every 6 months): MRI (baseline only), EEG, neuropsychological evaluation, ECG and blood sampling for antiepileptic drug levels. Nineteen children are included. Results:

  10. Vogt–Koyanagi–Harada syndrome associated with cutaneous malignant melanoma: an 11-year follow-up

    Microsoft Academic Search

    Sabine Aisenbrey; Christoph Lüke; Helen D. Ayertey; Salvatore Grisanti; Andreas Perniok; Richard Brunner

    2003-01-01

    Purpose To report a case of Vogt–Koyanagi–Harada (VKH) syndrome associated with cutaneous pigmented malignant melanoma (MM) and non-pigmented nodular metastasis after a 10-year recurrence-free interval. Methods Case report with long-term follow-up of 11 years. Ocular examinations included best-corrected visual acuity (ETDRS charts), fundus photography, fluorescein angiography, and computer-assisted perimetry. In addition, human leukocyte antigen (HLA) typing was performed. Results A

  11. Fifteen-Year Follow-Up of Hand Eczema: Predictive Factors

    Microsoft Academic Search

    Birgitta Meding; Karin Wrangsjö; Bengt Järvholm

    2005-01-01

    The aim of this study was to identify factors of importance for the long-term prognosis of hand eczema in the general population. In a 15-y follow-up, 868 (78%) individuals with hand eczema, diagnosed and clinically examined in a previous population-based study, answered a postal questionnaire with questions concerning persistence of the disease. In a logistic regression model, the extent of

  12. Evaluation of penile revascularization for erectile dysfunction: a 10-year follow-up

    Microsoft Academic Search

    Y Vardi; I Gruenwald; U Gedalia; S Nassar; A Engel; Y Har-Shai

    2004-01-01

    The objective of this study was to report long-term success rates for penile revascularization (PR) and investigate factors responsible for failures. During the past 10 y, data were obtained on 52 patients who underwent PR. Surgical technique was selected according to preoperative arteriographic findings. The mean age was 28.5 y and the mean follow-up was 70.8 months. Success was defined

  13. Hemospermia: long-term outcome in 165 patients.

    PubMed

    Zargooshi, J; Nourizad, S; Vaziri, S; Nikbakht, M R; Almasi, A; Ghadiri, K; Bidhendi, S; Khazaie, H; Motaee, H; Malek-Khosravi, S; Farshchian, N; Rezaei, M; Rahimi, Z; Khalili, R; Yazdaani, L; Najafinia, K; Hatam, M

    2014-01-01

    Long-term course of hemospermia has not been addressed in the sexual medicine literature. We report our 15 years' experience. From 1997 to 2012, 165 patients presented with hemospermia. Mean age was 38 years. Mean follow-up was 83 months. Laboratory evaluation and testis and transabdominal ultrasonography was done in all. Since 2008, all sonographies were done by the first author. One patient had urinary tuberculosis, one had bladder tumor and three had benign lesions at verumontanum. One patient had bilateral partial ejaculatory duct obstruction by stones. All six patients had persistent, frequently recurring or high-volume hemospermia. All pathologies were found in young patients. In the remaining 159 patients (96%), empiric treatment was given with a fluoroquinolone (Ciprofloxacin) plus an nonsteroidal anti-inflammatory drug (Celecoxib). In our 15 years of follow-up, no patient later developed life-threatening disease. Diagnostic evaluation of hemospermia is not worthwhile in the absolute majority of cases. Advanced age makes no difference. Only high-risk patients need to be evaluated. The vast majority of cases may be safely and effectively treated with empiric therapy. Almost all patients do well in long term. PMID:24305611

  14. Two to 4Year Follow-up to a Comparison of Home Versus Physical Therapy-Supervised Rehabilitation Programs After Anterior Cruciate Ligament Reconstruction

    Microsoft Academic Search

    John A. Grant; Nicholas G. H. Mohtadi

    2010-01-01

    Background: There have been no long-term follow-up studies comparing a predominantly home-based rehabilitation program with a standard physical therapy program after anterior cruciate ligament (ACL) reconstruction. Demonstrating the long-term success of such a cost-effective program would be beneficial to guide future rehabilitation practice.Purpose: To determine whether there were any differences in long-term outcome between recreational athletes who performed a physical

  15. Survival with congenital heart disease and need for follow up in adult life

    PubMed Central

    Wren, C; O'Sullivan, J

    2001-01-01

    OBJECTIVE—To predict the growth in demand for long term follow up of adults with congenital heart disease.?DESIGN—Observed diagnoses of congenital heart disease in infancy and childhood were adjusted for observed infant survival, predicted further survival to age 16 years, underascertainment in older childhood, and predicted need for long term follow up.?SETTING—The resident population of one health region in the UK.?PATIENTS—All confirmed cardiovascular malformations diagnosed in 1985 to 1999 in children born in 1985 to 1994.?RESULTS—1942 cases of congenital heart disease were diagnosed in infancy in a population of 377 310 live births (5.2/1000). 1588 (82%) survived to 1 year and 1514 were predicted to survive to age 16. 605 further diagnoses were made in childhood—678 when adjusted for underascertainment. Thus, 2192 children were predicted to reach age 16, of whom 784 would require long term follow up in adult life. The adult population would comprise 28% complex, 54% significant, and 18% minor congenital heart disease. These figures predict the need for adult follow up of congenital heart disease of over 200 extra cases per 100 000 live births each year or over 1600 extra cases a year every year in the UK.?CONCLUSIONS—The need for follow up of congenital heart disease in adult life is likely to grow linearly, with increasing complexity and increasing need for reinvestigation and reintervention with time. Appropriate provision should be made for adequate manpower, resources, and facilities for care of these patients.???Keywords: adult congenital heart disease; resources; patient survival PMID:11250973

  16. Long-term efficacy and safety of human papillomavirus vaccination

    PubMed Central

    De Vincenzo, Rosa; Conte, Carmine; Ricci, Caterina; Scambia, Giovanni; Capelli, Giovanni

    2014-01-01

    In this paper, we review the published evidence about the long-term efficacy of the available human papillomavirus (HPV) vaccines and their safety profile. Two prophylactic HPV vaccines – bivalent (bHPV) and quadrivalent (qHPV) – are now available, and vaccination programs are being widely implemented, primarily targeting adolescent girls. Efficacy has been widely demonstrated for both vaccines. Since the risk of HPV exposure potentially persists throughout a woman’s sexual life, vaccine duration of protection is critical to overall effectiveness. Interpreting the results of long-term efficacy studies for the two HPV vaccines can be puzzling, due to the heterogeneity of studies, different methods used in the assessment of immunogenicity, histopathological and virological end points, and statistical power issues. Moreover, an immunologic correlate of protection has not yet been established, and it is unknown whether higher antibody levels will really result in a longer duration of protection. Disease prevention remains the most important measure of long-term duration of vaccine efficacy. To date, the longest follow-up of an HPV vaccine has been 9.4 years for the bHPV vaccine. Long-term follow-up for qHPV vaccine goes up to 8 years. The vaccine continues to be immunogenic and well tolerated up to 9 years following vaccination. All randomized controlled clinical trials of the bHPV and the qHPV vaccines provide evidence of an excellent safety profile. The most common complaint reported is pain in the injection site, which is self-limiting and spontaneously resolved. The incidence of systemic adverse events (AEs), serious AEs, and discontinuations due to a serious AE reported in clinical studies are similar between the two vaccines and their control groups. In particular, no increased risk of autoimmune disease has been shown among HPV-vaccinated subjects in long-term observation studies. As these are crucial topics in HPV vaccination, it is important to establish systems for continued monitoring of vaccine immunogenicity, efficacy, and safety over time. PMID:25587221

  17. Follow-up of differentiated thyroid carcinoma.

    PubMed

    Pagano, L; Klain, M; Pulcrano, M; Angellotti, G; Pasano, F; Salvatore, M; Lombardi, G; Biondi, B

    2004-12-01

    Thyroid cancer is the most common endocrine malignancy. More than 90% of primary thyroid cancers are differentiated papillary or follicular types. The treatment of differentiated thyroid carcinoma (DTC) consists of total thyroidectomy and radioactive iodine ablation therapy, followed by L-thyroxine therapy. The extent of initial surgery, the indication for radioiodine ablation therapy and the degree of TSH-suppression are all issues that are still being debated cancers are in relation to the risk of recurrence. Total thyroidectomy reduces the risk of recurrence and facilitates (131)I ablation of thyroid remnants. The aim of radioiodine ablation is to destroy any normal or neoplastic residuals of thyroid tissue. These procedures also improve the sensitivity of thyroglobulin (Tg) as a marker of disease, and increase the sensitivity of (131)I total body scan (TBS) for the detection of persistent or recurrent disease. The aim of TSH-suppressive therapy is to restore euthyroidism and to decrease serum TSH levels, in order to reduce the growth and progression of thyroid cancer. After initial treatment, the objectives of the follow-up of DTC is to maintain adequate thyroxine therapy and to detect persistent or recurrent disease through the combined use of neck ultrasound (US) and serum Tg and (131)I TBS after TSH stimulation. The follow-up protocol should be adapted to the risk of recurrence. Recent advances in the follow-up of DTC are related to the use of recombinant human TSH (rhTSH) in order to stimulate Tg production and the ultrasensitive methods for Tg measurement. Undetectable serum Tg during TSH suppressive therapy with L-T4 does not exclude persistent disease, therefore serum Tg should be measured after TSH stimulation. The results of rhTSH administration and L-thyroxine therapy withdrawal are equivalent in detecting recurrent thyroid cancer, but the use of rhTSH helps to avoid the onset of hypothyroid symptoms and the negative effects of acute hypothyroidism on cardiovascular, hepatic, renal and neurological function. In low-risk DTC patients serum Tg after TSH stimulation, together with ultrasound of the neck, should be used to monitor persistent disease, avoiding diagnostic TBS which has a poor sensitivity. These recommendations do not apply when Tg antibodies are present in the serum, in patients with persistent or recurrent disease or limited thyroid surgery. Low-risk patients may be considered to be in remission when undetectable Tg after TSH stimulation and negative US evaluation of the neck are present. On the contrary, detectable Tg after TSH stimulation is an indicator in selecting patients who are candidates for further diagnostic procedures. PMID:15765026

  18. Long-term treatment with recombinant

    E-print Network

    Steinbach, Joe Henry

    Long-term treatment with recombinant nerve growth factor for HIV-associated sensory neuropathy. No effective treatment is available. The au- thors investigated the long-term effect (48 weeks and significantly im- proved pain symptoms. However, there was no improvement of neuropathy severity as assessed

  19. LONG-TERM MONITORING SENSOR NETWORK

    Microsoft Academic Search

    Stephen P. Farrington; John W. Haas; Neal Van Wyck

    2003-01-01

    Long-term monitoring (LTM) associated with subsurface contamination sites is a key element of Long Term Stewardship and Legacy Management across the Department of Energy (DOE) complex. However, both within the DOE and elsewhere, LTM is an expensive endeavor, often exceeding the costs of the remediation phase of a clean-up project. The primary contributors to LTM costs are associated with labor.

  20. Long-Term Care Ombudsman Program

    MedlinePLUS

    Long-Term Care Ombudsman Program (OAA, Title VII, Chapter 2, Sections 711/712) The Purpose of the Program and How it ... Services Provided to Persons Living in Long-Term Care Facilities Program data for FY 2013 indicate that ...

  1. Veterans Affairs Benefits (Long-Term Care)

    MedlinePLUS

    ... to obtain information about services available in your area. LTC PathFinder Long-term care is a big topic. Use the PathFinder to get to the information most relevant and useful to you now. Please fill out all questions How old are you? Less than 50 51-64 65+ Do you currently require long-term ...

  2. Long-Term Space Astrophysics Program

    NASA Technical Reports Server (NTRS)

    Nowark, Michael A.

    2001-01-01

    This is the final report for our Long-Term Space Astrophysics Program (NRA 94-OSS-12) grant NAG 5-3225. The proposal is entitled 'Spectral and Temporal Properties of Black Hole Candidates', and began funding in May 1995, and ran through 31 Aug 2000. The project summary from the original proposal was as follows: 'We will study the spectral and temporal properties of black hole candidates (BHC) by using data from archival sources (e.g., EXOSAT, Ginga, ROSAT) and proposed follow-up observations with modern instruments (e.g., ASCA, XTE). Our spectral studies will focus on identifying the basic characteristics and luminosities of the emission components in the various 'states' of BHC. We hope to understand and quantify the global energetics of these states. Our temporal studies will focus on expanding and classifying our knowledge of BHC variability properties in each state. We will explore the nature of quasi-periodic oscillations in BHC. We will combine our spectral and temporal studies by analyzing time lags and variability coherence between energy channels. In addition, we will investigate ways of correlating observed variability behavior with specific emission components.' We have accomplished many of these goals laid out within the original proposal. As originally proposed, we have utilized both archival and proprietary satellite data. In terms of archival data, we have utilized data from the Advanced Satellite for Cosmology and Astrophysics (ASCA), ROSAT, and the Rossi X-ray Timing Explorer (RXTE). We also obtained proprietary data from ASCA, RXTE, and the Extreme Ultraviolet Explorer (EUVE). In terms of sources, we have examined a wide variety of both galactic black hole candidates and extra-galactic black holes. For the galactic black holes we have observed and analyzed both the low/hard state and the high/soft state. We have performed both spectral and timing analyses on all of these objects. In addition, we have also examined a number of neutron stars or potential neutron stars. All of our research on the above mentioned objects has resulted in one or more publications in peer-reviewed journals. Attached is a list of refereed publications of research results which have been funded by this grant over approximately the past five and a half years. In addition, we have included a list of conference proceedings and other similar reports that have been associated with this grant.

  3. Long-term physical, psychological and social consequences of severe injuries

    Microsoft Academic Search

    C. K. van der Sluis; W. H. Eisma; J. W. Groothoff; H. J. ten Duis

    1998-01-01

    This 6 year follow-up study was designed to evaluate the long-term physical, psychological and social outcomes of severely injured patients (Injury Severity Score of ?16). Patients were treated at the University Hospital Groningen, the Netherlands, between January 1989 and December 1989. Outcomes were assessed using a postal questionnaire. After injury, the 55 respondents had predominantly complaints of the extremities, the

  4. Long-term outcome of endoscopic dilation of nonmalignant pyloric stenosis

    Microsoft Academic Search

    Scott K. Kuwada; Glenn L. Alexander

    1995-01-01

    Although the immediate success of endoscopic balloon dilation of nonmalignant and noncongenital pyloric stenosis is known, little information is available on the long-term results of such therapy. Of 19 patients who underwent this treatment at our institution for gastric outlet obstruction, 3 (16%) experienced sustained relief and 16 (84%) had a recurrence of symptoms during a median follow-up period of

  5. The Long-term Course of Rapid-Cycling Bipolar Disorder

    Microsoft Academic Search

    William Coryell; David Solomon; Carolyn Turvey; Martin Keller; Andrew C. Leon; Jean Endicott; Pamela Schettler; Lewis Judd; Timothy Mueller

    2003-01-01

    Background: Rapid cycling among patients with bipo- lar affective disorders is important because of its impli- cations for long-term prognosis and for the use of anti- depressants. To our knowledge, no prospective study has, as yet, described the course of this phenomenon beyond 5 years. Methods: From 345 patients with bipolar I or bipolar II disorder followed up for a

  6. Prediction of long-term outcome of tibial osteotomy in medial gonarthrosis

    Microsoft Academic Search

    B. Tjörnstrand; K. Svensson; K. G. Thorngren

    1985-01-01

    To predict the long-term outcome after tibial osteotomy for medial gonarthrosis, multivariate statistical techniques were used and prognostic equations were defined. A comparison between different evaluation systems was also performed. Clinical and radiographic data from 81 patients followed up for more than 7 years were used. Twenty-eight preoperative variables were analysed in relation to the outcome at 7 years with

  7. Occup Environ Med . Author manuscript Differences in the association between sickness absence and long-term

    E-print Network

    Paris-Sud XI, Université de

    London WC1E 6BT,GB Finnish Institute of Occupational Health2 Helsinki, FI Stress Research Institute3Occup Environ Med . Author manuscript Page /1 7 Differences in the association between sickness absence and long-term sub-optimal health by occupational position: a 14-year follow-up in the GAZEL cohort

  8. Long-term results of valve replacement with the St. Jude Medical prosthesis

    Microsoft Academic Search

    Eugene M. Baudet; Vincent Puel; John T. McBride; Jean-Philippe Grimaud; François Roques; Frederic Clerc; Xavier Roques; Nadine Laborde

    1995-01-01

    To assess with truly long follow-up the long-term results of valve replacement with the St. Jude Medical prosthesis (St. Jude Medical, Inc., St. Paul, Minn.), we reviewed the case histories of the first 1112 patients undergoing 1244 valve replacements with this valve between June 12, 1978, and June 12, 1987: 690 male (62%) and 422 female patients, mean age 56

  9. Long-Term Evaluation of Children with Nephrotic Syndrome and Focal Segmental Glomerular Sclerosis

    Microsoft Academic Search

    Amir Tejani; Anthony D. Nicastri; Dilip Sen; C. K. Chen; Kishore Phadke; Orlando Aäamson; Khalid M. H. Butt

    1983-01-01

    We studied the long-term outcome of a group of children with the nephrotic syndrome who showed the histological lesion of focal segmental glomerular sclerosis (FSGS) during the course of their illness. Of 25 such children studied, a complete follow-up ranging from 3 to 19 years was available in 24. Two distinct groups could be identified. Patients in the first group

  10. Management and long-term outcome of partial glossectomy in 2 horses

    PubMed Central

    Lang, Hayley M.; Panizzi, Luca; Smyth, Travis T.; Plaxton, Andrea E.; Lohmann, Katharina L.; Barber, Spencer M.

    2014-01-01

    Records were reviewed for 2 horses with partial glossectomy, 1 traumatic and 1 elective. According to long-term follow-up by telephone, both horses had recovered well, experiencing only temporary difficulty while eating, and went on to be ridden successfully using mouth bits. Partial glossectomy, therefore, had a favorable prognosis in 2 performance horses. PMID:24587510

  11. Psychosocial Disability During the Long-term Course of Unipolar Major Depressive Disorder

    Microsoft Academic Search

    Lewis L. Judd; Hagop S. Akiskal; Pamela J. Zeller; Martin Paulus; Andrew C. Leon; Jack D. Maser; Jean Endicott; William Coryell; Jelena L. Kunovac; Timothy I. Mueller; John P. Rice; Martin B. Keller

    2000-01-01

    Background: The goal of this study was to investigate psychosocial disability in relation to depressive symp- tom severity during the long-term course of unipolar ma- jor depressive disorder (MDD). Methods: Monthly ratings of impairment in major life functions and social relationships were obtained during an average of 10 years' systematic follow-up of 371 pa- tients with unipolar MDD in the

  12. Long-Term Outcome and Quality of Care of Patients with Staphylococcus aureus Bacteremia

    Microsoft Academic Search

    G. Fätkenheuer; M. Preuss; B. Salzberger; N. Schmeißer; O. A. Cornely; H. Wisplinghoff; H. Seifert

    2004-01-01

    To assess the long-term outcome and influence of clinical management of patients with Staphylococcus aureus bacteremia (SAB), 229 patients with blood cultures positive for Staphylococcus aureus between January 1997 and December 2000 were retrospectively identified and followed up. Risk factors, source of infection, treatment, clinical course, and outcome were recorded by chart review. For the assessment of 1-year survival, a

  13. Long-Term Results of Ultrapulsed Carbon Dioxide Laser Resurfacing of the Mediterranean Face

    Microsoft Academic Search

    Ömer ?ensöz; Cihat Nazmi Baran; Murat ?ahin Alagöz; Ahmet Ça?ri Uysal; Ramazan Erkin Ünlü

    2004-01-01

    Background In Mediterranean countries, increased exposure to sunlight accelerates aging of the skin and the formation of wrinkles. The long-term follow-up results for the patients who underwent resurfacing with ultrapulsed carbon dioxide (CO 2) laser are presented. Methods All 47 patients who underwent ultrapulsed CO 2 laser between 1994 and 1996 were included in the study. The patients were photographed

  14. Diagnosis, treatment and follow up of neonatal arrhythmias

    PubMed Central

    Binneto?lu, Fatih Köksal; Babao?lu, Kadir; Altun, Gürkan; Türker, Gülcan

    2014-01-01

    Summary Objective This study aimed to evaluate the aetiology, spectrum, course and outcomes of neonates with arrhythmias observed in a tertiary neonatal intensive care unit from 2007 to 2012. Methods Neonates with rhythm problems were included. The results of electrocardiography (ECG), Holter ECG, echocardiography and biochemical analysis were evaluated. The long-term results of follow up were reviewed. Results Forty-five patients were male (68%) and 21 (32%) were female. Fifty-five patients (83.3%) were term, 11 (16.6%) were preterm, and 34% were diagnosed in the prenatal period. Twenty cases (30.3%) had congenital heart disease. Twenty-three patients (34.8%) were diagnosed during the foetal period. The most common arrhythmias were supraventricular ectopic beats and supraventricular tachycardia (SVT) at 39.3 and 22.7%, respectively. SVT recurred in five patients after the neonatal period. Conclusion Supraventricular ectopic beats and SVT were the most common arrhythmias during the neonatal period. Although the prognosis of arrhythmias in the neonatal period is relatively good, regular monitoring is required. PMID:24844549

  15. Development and evaluation of a follow up assessment of preterm infants at 5 years of age

    PubMed Central

    de Kleine, M J K; den Ouden, A L; Kollee, L; van der Sanden, M W G N.; Sondaar, M; van Kessel-Feddem..., B J M; Knuijt, S; van Baar, A L; Ilsen, A; Breur-Pieterse, R; Briet, J; Brand, R; Verloove-Vanhoric..., S

    2003-01-01

    Background: Long term follow up shows a high frequency of developmental disturbances in preterm survivors of neonatal intensive care formerly considered non-disabled. Aims: To develop and validate an assessment tool that can help paediatricians to identify before 6 years of age which survivors have developmental disturbances that may interfere with normal education and normal life. Methods: A total of 431 very premature infants, mean gestational age 30.2 weeks, mean birth weight 1276 g, were studied at age 5 years. Children with severe handicaps were excluded. The percentage of children with a correctly identified developmental disturbance in the domains cognition, speech and language development, neuromotor development, and behaviour were determined. Results: The follow up instrument classified 67% as optimal and 33% as at risk or abnormal. Of the children classified as at risk or abnormal, 60% had not been identified at earlier follow up assessments. The combined set of standardised tests identified a further 30% with mild motor, cognitive, or behavioural disturbances. The paediatrician's assessment had a specificity of 88% (95% CI 83–93%), a sensitivity of 48% (95% CI 42–58%), a positive predictive value of 85% (95% CI 78–91%), and a negative predictive value of 55% (95% CI 49–61%). Conclusions: Even after standardised and thorough assessment, paediatricians may overlook impairments for cognitive, motor, and behavioural development. Long term follow up studies that do not include detailed standardised tests for multiple domains, especially fine motor domain, may underestimate developmental problems. PMID:14500304

  16. Long-term cognitive effects of Lyme disease in children.

    PubMed

    Adams, W V; Rose, C D; Eppes, S C; Klein, J D

    1999-01-01

    Most studies of adults infected with Lyme disease (LD) have found adverse cognitive effects from the disease. In contrast, the only controlled study investigating cognitive effects of LD in a pediatric population found no effects after a 2-year follow-up. However, it was questioned whether the negative effects might take longer than 2 years to emerge. Therefore, this investigation reports a 4-year follow-up of the original sample. Twenty-five children with strictly defined LD were compared with 17 sibling control children. A neuropsychological battery was utilized, including assessment of the cognitive areas of IQ, information processing speed, fine-motor dexterity, novel problem solving and executive functioning, short-term and intermediate memory, and acquisition of new learning. In addition, parents' subjective ratings were obtained on the disease's impact on their child's participation in everyday activities. No between-group differences were found for 17 of the 18 neuropsychological test measures, nor were there differences in parents' subjective ratings. Therefore, in contrast with studies of adults with LD, the results of long-term follow-up of the pediatric population continue to strongly support the finding that children treated appropriately for LD have an excellent prognosis for normal cognitive functioning. PMID:10382570

  17. The importance of follow-up and distance from centre in weight loss after laparoscopic adjustable gastric banding

    Microsoft Academic Search

    Piriyah Sivagnanam; Michael Rhodes

    2010-01-01

    Background  In this study we examine the importance of regular postoperative follow-up and the effect of geographical distance from the\\u000a centre of follow-up on long-term weight loss after laparoscopic adjustable gastric banding (LAGB).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Between 1997 and 2009, 150 patients underwent LAGB. Postoperatively, patients were invited to attend a monthly nurse-led follow-up\\u000a clinic to assess weight loss and make necessary band adjustments.

  18. Influence of College Peers on Disordered Eating in Women and Men at 10-Year Follow-up

    PubMed Central

    Keel, Pamela K.; Forney, K. Jean; Brown, Tiffany A.; Heatherton, Todd F.

    2013-01-01

    Research supports both concurrent and prospective associations between peer behaviors and disordered eating levels in late adolescent and young adult men and women. However, no study has examined peer influence after a follow-up duration over which peer groups change dramatically. This study examined how college roommates’ dieting predicted disordered eating levels in women (n=566) and men (n=233) at 10-year follow-up. For women, college roommate dieting significantly predicted Drive for Thinness, Bulimia scores, and purging at 10-year follow-up. Findings highlight the potential for school-based, peer-led interventions to have long-term benefits in women. PMID:23025666

  19. Influence of college peers on disordered eating in women and men at 10-year follow-up.

    PubMed

    Keel, Pamela K; Forney, K Jean; Brown, Tiffany A; Heatherton, Todd F

    2013-02-01

    Research supports both concurrent and prospective associations between peer behaviors and disordered eating levels in late adolescent and young adult men and women. However, no study has examined peer influence after a follow-up duration over which peer groups change dramatically. This study examined how college roommates' dieting predicted disordered eating levels in women (n = 566) and men (n = 233) at 10-year follow-up. For women, college roommates' dieting significantly predicted Eating Disorder Inventory Drive for Thinness and Bulimia scores and purging at 10-year follow-up. Findings highlight the potential for school-based, peer-led interventions to have long-term benefits in women. PMID:23025666

  20. Long term results of lumbar sequestrectomy versus aggressive microdiscectomy.

    PubMed

    Kotil, Kadir; Köksal, Neslihan Sutpideler; Kayaci, Selim

    2014-10-01

    It remains unknown whether aggressive microdiscectomy (AD) provides a better outcome than simple sequestrectomy (S) with little disc disruption for the treatment of lumbar disc herniation with radiculopathy. We compared the long term results for patients with lumbar disc herniation who underwent either AD or S. The patients were split into two groups: 85 patients who underwent AD in Group A and 40 patients who underwent S in Group B. The patients were chosen from a cohort operated on by the same surgeon using either of the two techniques between 2003 and 2008. The demographic characteristics were similar. The difference in complication rates between the two groups was not statistically significant. During the first 10 days post-operatively, the Visual Analog Scale score for back pain was 4.1 in Group A and 2.1 in Group B, and the difference was statistically significant (p<0.005). The Oswestry Disability Index score was 11% in Group A and 19% in Group B at the last examination. The reherniation rate was 1.5% in Group A and 4.1% in Group B (p<0.005). We argue that reherniation rates are much lower over the long term when AD is used with microdiscectomy. AD increases back pain for a short time but does not change the long term quality of life. To our knowledge this is the first study with a very long term follow-up showing that reherniation is three times less likely after AD than S. PMID:24890447

  1. Effect of Long-Term Castration and Long-Term Androgen Treatment on Sexually Dimorphic

    E-print Network

    Crews, David

    Effect of Long-Term Castration and Long-Term Androgen Treatment on Sexually Dimorphic Estrogen be modified by steroid hormone manipulation. We castrated male whiptail lizards for 1 week (short term) or 6 that in male whiptail lizards, long-term castration increases sensitivity to estradiol as measured by induction

  2. Vibration white finger: a follow up study.

    PubMed Central

    Ekenvall, L; Carlsson, A

    1987-01-01

    To study the course of vibration white finger (VWF) 55 men were re-examined three and a half to six years after the first examination. The patients were interviewed and finger systolic pressure after general body and local finger cooling was measured. The test results at the two examinations were compared. At the follow up examination some patients experienced a subjective improvement of VWF symptoms but not until more than three years had passed after they had stopped working with vibrating tools. To study the effect of diminished cold exposure on subjective symptoms, vibration exposed outdoor workers who changed to unexposed indoor work were studied separately. In this subgroup also improvement was reported only when more than three years has passed after the change of work, indicating that diminished cold exposure is not the primary explanation for the improvement. The cold provocation test, however, showed no tendency towards a diminished reaction of the vessels to cooling. Patients who continue to work with vibrating tools report a subjective increase in symptoms. This subjective impairment was reflected in an increased reaction to cold as measured in the cold provocation test. PMID:3620371

  3. Long-term care and the elderly

    E-print Network

    Coe, Norma B

    2005-01-01

    Long-term care expenditures represent one of the largest uninsured financial risks facing the elderly. Medicaid provides incomplete insurance against these costs: unlimited nursing home benefits with a deductible equal to ...

  4. Long Term TOA - M Data and Information

    Atmospheric Science Data Center

    2014-08-06

    ... 30 years to date.   The proposed project utilizes knowledge gained in the last 10 years through CERES data analyses and apply the knowledge to existing data to develop long-term (nearly 30 years) consistent ...

  5. CHAPTER FOUR COLLABORATIVE LONG-TERM ETHNOGRAPHY

    E-print Network

    White, Douglas R.

    for the Tzintzuntzan project was begun in 1998 and is still in progress (see the Tzintzuntzan website, currently available at www.santafe.edu/tarasco/Mexican.html). Through longitudinal analysis, long-term field sites

  6. Long-term broadband technology forecasting

    Microsoft Academic Search

    KJELL STORDAHL

    The paper gives an overview of the relevant broadband technologies, describes their market positions and possibilities. Diffusion models are used to make long-term broadband forecasts for the Western European residential market. The forecasts are separated for the main broadband technologies ADSL, ADSL2+\\/VDSL, Cable modem and other technologies (FTTx, BWA) based on market share predictions for each technology. The long-term forecasts

  7. MR Angiography Follow-Up 10 Years after Cryptogenic Nonperimesencephalic Subarachnoid Hemorrhage

    PubMed Central

    Wenz, Holger; Wenz, Ralf; al Mahdi, Mohamad-Motaz; Scharf, Johann; Groden, Christoph; Schmiedek, Peter; Seiz-Rosenhagen, Marcel

    2015-01-01

    Objectives Long-term magnetic resonance angiography (MRA) follow-up studies regarding cryptogenic nonperimesencephalic subarachnoid hemorrhage (nSAH) are scarce. This single-centre study identified all patients with angiographically verified cryptogenic nSAH from 1998 to 2007: The two main objectives were to prospectively assess the incidence of de novo aneurysm with 3.0-MRI years after cryptogenic nSAH in patients without evidence for further hemorrhage, and retrospectively assess patient demographics and outcome. Methods From prospectively maintained report databases all patients with angiographically verified cryptogenic nSAH were identified. 21 of 29 patients received high-resolution 3T-MRI including time-of-flight and contrast-enhanced angiography, 10.2 ± 2.8 years after cryptogenic nSAH. MRA follow-up imaging was compared with initial digital subtraction angiography (DSA) and CT/MRA. Post-hemorrhage images were related to current MRI with reference to persistent lesions resulting from delayed cerebral ischemia (DCI) and post-hemorrhagic siderosis. Patient-based objectives were retrospectively abstracted from clinical databases. Results 29 patients were identified with cryptogenic nSAH, 17 (59%) were male. Mean age at time of hemorrhage was 52.9 ± 14.4 years (range 4 – 74 years). 21 persons were available for long-term follow-up. In these, there were 213.5 person years of MRI-follow-up. No de novo aneurysm was detected. Mean modified Rankin Scale (mRS) during discharge was 1.28. Post-hemorrhage radiographic vasospasm was found in three patients (10.3%); DCI-related lesions occurred in one patient (3.4%). Five patients (17.2%) needed temporary external ventricular drainage; long-term CSF shunt dependency was necessary only in one patient (3.4%). Initial DSA retrospectively showed a 2 x 2 mm aneurysm of the right distal ICA in one patient, which remained stable. Post-hemorrhage siderosis was detected 8.1 years after the initial bleeding in one patient (4.8%). Conclusion Patients with cryptogenic nSAH have favourable outcomes and do not exhibit higher risks for de novo aneurysms. Therefore the need for long-term follow up after cryptogenic nSAH is questionable. PMID:25688554

  8. Atrophy and Other Potential Factors Affecting Long Term Deep Brain Stimulation Response: A Case Series

    PubMed Central

    Martinez-Ramirez, Daniel; Morishita, Takashi; Zeilman, Pamela R.; Peng-Chen, Zhongxing; Foote, Kelly D.; Okun, Michael S.

    2014-01-01

    Objective To describe three DBS cases which presented with new side effects or loss of benefit from stimulation after long-term follow-up and to discuss the potential contributing factors. Methods A University of Florida (UF) database (INFORM) search was performed, identifying three patients, two Parkinson's disease (PD) and one Essential Tremor (ET), with an unexpected change in long-term programming thresholds as compared to initial evaluation. Clinical follow-up, programming, imaging studies, and lead measurements were reviewed. The UF Institutional Review Board (IRB) approved this study. Results A substantial increase in the 3rd ventricular width (120%), Evans index (6%), ventricular index (5%), and cella media index (17%) was uncovered. A change in thresholds across lead contacts with a decrease in current densities as well as a relative lateral change of lead location was also observed. Hardware-related complications, lead migration, and impedance variability were not identified. Conclusions Potential factors contributing to long-term side effects should be examined during a DBS troubleshooting assessment. Clinicians should be aware that in DBS therapy there is delivery of electricity to a changing brain, and atrophy may possibly affect DBS programming settings as part of long-term follow-up. PMID:25360599

  9. Asthma increase among farmers: a 12-year follow-up

    PubMed Central

    2011-01-01

    Respiratory disease is a well known health hazard for farmers, but the long-term prognosis is less well known. This is a 12-year follow-up of an investigation of Swedish farmers, most of them dairy farmers. A questionnaire was mailed to all 418 farmers who were alive of the farmers originally participating in 1982. They were invited to an interview, spirometry, and blood sampling. Ninety-one per cent (380) of the farmers, 321 men and 59 women, responded to the questionnaire. The mean age was 56 years for the men and 55 years for the women. Of the group, 10% were smokers, 25% ex-smokers, and 65% had never smoked. The population estimate for asthma in the farmers was 8.9% in 1994 compared to 2% in 1982, and to 5.4%–6.6% in the general population in the region in 1982. Of the asthmatic subjects, one-third had positive RAST tests (radioallergosorbent tests). Almost 90% of the new onset asthma cases since 1982 had non-IgE-mediated asthma. Most of the IgE-mediated asthmatics had had symptoms for many years, while 70% of the non-IgE-mediated asthmatic farmers had no or only wheezing with colds 1982. Two new cases of hypersensitivity pneumonitis were identified, and 7.3% had experienced inhalation fever during the last 12 years. In general, individuals with asthma and chronic bronchitis who had left farming were in better health in 1994 as compared to 1982. In conclusion, farmers have an enhanced risk to develop asthma increasing with age. Asthma in farmers is often non-IgE-mediated. PMID:20812893

  10. Long-term patient-reported outcomes following Bennett's fractures.

    PubMed

    Middleton, S D; McNiven, N; Griffin, E J; Anakwe, R E; Oliver, C W

    2015-07-01

    We define the long-term outcomes and rates of further operative intervention following displaced Bennett's fractures treated with Kirschner (K-) wire fixation between 1996 and 2009. We retrospectively identified 143 patients (127 men and 16 women) with a mean age at the time of injury of 33.2 years (18 to 75). Electronic records were examined and patients were invited to complete the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire in addition to a satisfaction questionnaire. The time since injury was a mean of 11.5 years (3.4 to 18.5). In total 11 patients had died, one had developed dementia and 12 patients were lost to follow-up. This left 119 patients available for recruitment. Of these, 57 did not respond, leaving a study group of 62 patients. Patients reported excellent functional outcomes and high levels of satisfaction at follow-up. Median satisfaction was 94% (interquartile range 91.5 to 97.5) and the mean DASH score was 3.0 (0 to 38). None of the patients had undergone salvage procedures and none of the responders had changed occupation or sporting activities. Long-term patient reported outcomes following displaced Bennett's fractures treated by closed reduction and K-wire fixation show excellent functional results and a high level of patient satisfaction. The rate of infection is low and similar to other surgical procedures with percutaneous K-wires. Cite this article: Bone Joint J 2015;97-B:1004-6. PMID:26130360

  11. Long-term outcome of abusive head trauma.

    PubMed

    Chevignard, Mathilde P; Lind, Katia

    2014-12-01

    Abusive head trauma is a severe inflicted traumatic brain injury, occurring under the age of 2 years, defined by an acute brain injury (mostly subdural or subarachnoidal haemorrhage), where no history or no compatible history with the clinical presentation is given. The mortality rate is estimated at 20-25% and outcome is extremely poor. High rates of impairments are reported in a number of domains, such as delayed psychomotor development; motor deficits (spastic hemiplegia or quadriplegia in 15-64%); epilepsy, often intractable (11-32%); microcephaly with corticosubcortical atrophy (61-100%); visual impairment (18-48%); language disorders (37-64%), and cognitive, behavioral and sleep disorders, including intellectual deficits, agitation, aggression, tantrums, attention deficits, memory, inhibition or initiation deficits (23-59%). Those combined deficits have obvious consequences on academic achievement, with high rates of special education in the long term. Factors associated with worse outcome include demographic factors (lower parental socioeconomic status), initial severe presentation (e.g., presence of a coma, seizures, extent of retinal hemorrhages, presence of an associated cranial fracture, extent of brain lesions, cerebral oedema and atrophy). Given the high risk of severe outcome, long-term comprehensive follow-up should be systematically performed to monitor development, detect any problem and implement timely adequate rehabilitation interventions, special education and/or support when necessary. Interventions should focus on children as well as families, providing help in dealing with the child's impairment and support with psychosocial issues. Unfortunately, follow-up of children with abusive head trauma has repeatedly been reported to be challenging, with very high attrition rates. PMID:25501726

  12. Unconventional Implant Placement IV. Implant Placement through Impacted Teeth to Avoid Invasive Surgery. Long-term Results of 3 Cases

    PubMed Central

    Mithridade, Davarpanah; Serge, Szmukler-Moncler; Keyvan, Davarpanah; Nedjoua, Capelle-Ouadah; Georgy, Demurashvili; Philippe, Rajzbaum

    2015-01-01

    This paper presents the long-term data of patients that have been treated with an unconventional implant placement protocol to avoid an invasive surgery when edentulism was caused by an impacted tooth. In 2009, the follow-up of this unconven-tional protocol was 2 to 3.5 years; this article documents now the long-term 5- to 8-year follow-up of 3 patients and 5 im-plants. Over this period of time, implant stability was maintained without complications. This unconventional protocol opens intriguing possibilities; however, more patients with long-term follow-up are warranted before endorsing it in routine appli-cation. Nonetheless, it might suggest that there is still room to revisit one of the leading concepts in dental implantology. PMID:25674167

  13. Improving long-term renal allograft survival via a road less traveled by.

    PubMed

    Stegall, M D; Park, W D; Dean, P G; Cosio, F G

    2011-07-01

    It has become cliché to state that improvements in early renal allograft survival over the past two decades have not led to increased long-term renal allograft survival. However, it is not clear how long-term graft survival can be improved. Here, we present the viewpoint that the road forward does not involve searching for new and more ideal immunosuppressive regimens, but rather detailed patient follow-up to identify specific causes of late renal allograft loss and the development of new therapy designed to address these problems before allograft damage becomes irreversible. PMID:21564533

  14. Factors that influence follow-up after an abnormal mammogram 

    E-print Network

    Copeland, Valerie Anne

    2009-05-15

    The focus of this study was to explore women’s experiences with follow-up after an abnormal mammogram, and factors that influence follow-up. Factors, including health status, found in the cancer screening and treatment ...

  15. Bariatric surgery for treatment of sleep apnea syndrome in 15 morbidly obese patients: Long-term results

    Microsoft Academic Search

    Michael Scheuller; Dudley Weider

    2001-01-01

    Objective: To evaluate the long-term outcomes of bariatric surgery with respect to respiratory disturbance index (RDI) in sleep apnea syndrome (SAS). Design: Case series with long-term follow-up (1 to 12 years). Setting: Private clinic in an academic tertiary referral center. Patients: Fifteen morbidly obese patients (10 men, 5 women) who were referred for the treatment of severe SAS. Intervention: For

  16. 49 CFR 577.10 - Follow-up notification.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...2013-10-01 2013-10-01 false Follow-up notification. 577.10 Section 577...NONCOMPLIANCE NOTIFICATION § 577.10 Follow-up notification. (a) If, based...direct the manufacturer to send a follow-up notification in accordance with this...

  17. 33 CFR 179.15 - Follow-up report.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...2013-07-01 2013-07-01 false Follow-up report. 179.15 Section 179.15...DEFECT NOTIFICATION § 179.15 Follow-up report. (a) Each manufacturer who...required by § 179.13 shall submit a follow-up report to the Commandant by certified...

  18. 49 CFR 577.10 - Follow-up notification.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...2010-10-01 2010-10-01 false Follow-up notification. 577.10 Section 577...NONCOMPLIANCE NOTIFICATION § 577.10 Follow-up notification. (a) If, based...direct the manufacturer to send a follow-up notification in accordance with this...

  19. 33 CFR 179.15 - Follow-up report.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...2014-07-01 2014-07-01 false Follow-up report. 179.15 Section 179.15...DEFECT NOTIFICATION § 179.15 Follow-up report. (a) Each manufacturer who...required by § 179.13 shall submit a follow-up report to the Commandant by certified...

  20. 29 CFR 99.315 - Audit findings follow-up.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...2011-07-01 false Audit findings follow-up. 99.315 Section 99.315 Labor ...Auditees § 99.315 Audit findings follow-up. (a) General. The auditee is responsible for follow-up and corrective action on all...

  1. 7 CFR 3052.315 - Audit findings follow-up.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...2014-01-01 false Audit findings follow-up. 3052.315 Section 3052.315 Agriculture...Auditees § 3052.315 Audit findings follow-up. (a) General. The auditee is responsible for follow-up and corrective action on all...

  2. 7 CFR 3052.315 - Audit findings follow-up.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...2012-01-01 false Audit findings follow-up. 3052.315 Section 3052.315 Agriculture...Auditees § 3052.315 Audit findings follow-up. (a) General. The auditee is responsible for follow-up and corrective action on all...

  3. 33 CFR 179.15 - Follow-up report.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...2012-07-01 2012-07-01 false Follow-up report. 179.15 Section 179.15...DEFECT NOTIFICATION § 179.15 Follow-up report. (a) Each manufacturer who...required by § 179.13 shall submit a follow-up report to the Commandant by certified...

  4. 38 CFR 41.315 - Audit findings follow-up.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...2012-07-01 false Audit findings follow-up. 41.315 Section 41.315 Pensions...Auditees § 41.315 Audit findings follow-up. (a) General. The auditee is responsible for follow-up and corrective action on all...

  5. 49 CFR 577.10 - Follow-up notification.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...2012-10-01 2012-10-01 false Follow-up notification. 577.10 Section 577...NONCOMPLIANCE NOTIFICATION § 577.10 Follow-up notification. (a) If, based...direct the manufacturer to send a follow-up notification in accordance with this...

  6. 29 CFR 99.315 - Audit findings follow-up.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...2013-07-01 false Audit findings follow-up. 99.315 Section 99.315 Labor ...Auditees § 99.315 Audit findings follow-up. (a) General. The auditee is responsible for follow-up and corrective action on all...

  7. 7 CFR 3052.315 - Audit findings follow-up.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...2011-01-01 false Audit findings follow-up. 3052.315 Section 3052.315 Agriculture...Auditees § 3052.315 Audit findings follow-up. (a) General. The auditee is responsible for follow-up and corrective action on all...

  8. 38 CFR 41.315 - Audit findings follow-up.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...2013-07-01 false Audit findings follow-up. 41.315 Section 41.315 Pensions...Auditees § 41.315 Audit findings follow-up. (a) General. The auditee is responsible for follow-up and corrective action on all...

  9. 49 CFR 382.311 - Follow-up testing.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...2012-10-01 2012-10-01 false Follow-up testing. 382.311 Section 382.311 Transportation...TESTING Tests Required § 382.311 Follow-up testing. The requirements for follow-up testing must be performed in accordance with...

  10. 29 CFR 99.315 - Audit findings follow-up.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...2012-07-01 false Audit findings follow-up. 99.315 Section 99.315 Labor ...Auditees § 99.315 Audit findings follow-up. (a) General. The auditee is responsible for follow-up and corrective action on all...

  11. 49 CFR 577.10 - Follow-up notification.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...2014-10-01 2014-10-01 false Follow-up notification. 577.10 Section 577...NONCOMPLIANCE NOTIFICATION § 577.10 Follow-up notification. (a) If, based...direct the manufacturer to send a follow-up notification in accordance with this...

  12. 49 CFR 382.311 - Follow-up testing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...2010-10-01 2010-10-01 false Follow-up testing. 382.311 Section 382.311 Transportation...TESTING Tests Required § 382.311 Follow-up testing. The requirements for follow-up testing must be performed in accordance with...

  13. 49 CFR 382.311 - Follow-up testing.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...2011-10-01 2011-10-01 false Follow-up testing. 382.311 Section 382.311 Transportation...TESTING Tests Required § 382.311 Follow-up testing. The requirements for follow-up testing must be performed in accordance with...

  14. 7 CFR 3052.315 - Audit findings follow-up.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...2013-01-01 false Audit findings follow-up. 3052.315 Section 3052.315 Agriculture...Auditees § 3052.315 Audit findings follow-up. (a) General. The auditee is responsible for follow-up and corrective action on all...

  15. 49 CFR 382.311 - Follow-up testing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...2014-10-01 2014-10-01 false Follow-up testing. 382.311 Section 382.311 Transportation...TESTING Tests Required § 382.311 Follow-up testing. The requirements for follow-up testing must be performed in accordance with...

  16. 49 CFR 382.311 - Follow-up testing.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...2013-10-01 2013-10-01 false Follow-up testing. 382.311 Section 382.311 Transportation...TESTING Tests Required § 382.311 Follow-up testing. The requirements for follow-up testing must be performed in accordance with...

  17. 38 CFR 41.315 - Audit findings follow-up.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...2014-07-01 false Audit findings follow-up. 41.315 Section 41.315 Pensions...Auditees § 41.315 Audit findings follow-up. (a) General. The auditee is responsible for follow-up and corrective action on all...

  18. 33 CFR 179.15 - Follow-up report.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 2010-07-01 false Follow-up report. 179.15 Section 179.15...DEFECT NOTIFICATION § 179.15 Follow-up report. (a) Each manufacturer who...required by § 179.13 shall submit a follow-up report to the Commandant by certified...

  19. 33 CFR 179.15 - Follow-up report.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...2011-07-01 2011-07-01 false Follow-up report. 179.15 Section 179.15...DEFECT NOTIFICATION § 179.15 Follow-up report. (a) Each manufacturer who...required by § 179.13 shall submit a follow-up report to the Commandant by certified...

  20. 29 CFR 99.315 - Audit findings follow-up.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...2013-07-01 true Audit findings follow-up. 99.315 Section 99.315 Labor ...Auditees § 99.315 Audit findings follow-up. (a) General. The auditee is responsible for follow-up and corrective action on all...

  1. 49 CFR 577.10 - Follow-up notification.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...2011-10-01 2011-10-01 false Follow-up notification. 577.10 Section 577...NONCOMPLIANCE NOTIFICATION § 577.10 Follow-up notification. (a) If, based...direct the manufacturer to send a follow-up notification in accordance with this...

  2. 2 CFR 200.511 - Audit findings follow-up.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...2014-01-01 false Audit findings follow-up. 200.511 Section 200.511 Grants...Auditees § 200.511 Audit findings follow-up. (a) General. The auditee is responsible for follow-up and corrective action on all...

  3. Long Term Results in Refractory Tennis Elbow Using Autologous Blood

    PubMed Central

    Gani, Naseem ul; Khan, Hayat Ahmad; Kamal, Younis; Farooq, Munir; Jeelani, Hina; Shah, Adil Bashir

    2014-01-01

    Tennis elbow (TE) is one of the commonest myotendinosis. Different treatment options are available and autologous blood injection has emerged as the one of the acceptable modalities of treatment. Long term studies over a larger group of patients are however lacking. The purpose of this study was to evaluate these patients on longer durations. One-hundred and twenty patients of TE, who failed to respond to conventional treatment including local steroid injections were taken up for this prospective study over the period from year 2005 to 2011 and were followed up for the minimum of 3 years (range 3-9 years). Two mL of autologous blood was taken from the ipsilateral limb and injected into the lateral epicondyle. The effectiveness of the procedure was assessed by Pain Rating Sscale and Nirschl Staging, which was monitored before the procedure, at first week, monthly for first three months, at 6 months and then 3 monthly for first year, six monthly for next 2 years and then yearly. Statistical analysis was done and a P value of <0.05 was taken as significant. The patients (76 females and 44 males) were evaluated after procedure. The mean age group was 40.67±8.21. The mean follow up was 5.7±1.72 (range 3 to 9 years). The mean pain score and Nirschl stage before the procedure was 3.3±0.9 and 6.2±0.82 respectively. At final follow up the pain score and Nirschl were 1.1±0.9 and 1.5±0.91 respectively. Autologous blood injection was found to be one of the modalities for treatment of TE. Being cheap, available and easy method of treatment, it should be considered as a treatment modality before opting for the surgery. Universal guidelines for the management of tennis elbow should be made as there is lot of controversy regarding the treatment. PMID:25568727

  4. Long-term effectiveness of electroconvulsive therapy in adolescents with schizophrenia spectrum disorders.

    PubMed

    Flamarique, Itziar; Baeza, Inmaculada; de la Serna, Elena; Pons, Alexandre; Bernardo, Miguel; Castro-Fornieles, Josefina

    2015-05-01

    To compare a sample of adolescents with schizophrenia spectrum disorders (SSD) treated with either ECT or antipsychotics (AP) alone at long-term follow-up. Patients diagnosed with SSD (n = 21) treated with ECT due to resistance to AP or catatonia under the age of 18 years (ECT group), were compared to a randomly selected group of patients with SSD treated only with AP (non-ECT group) (n = 21) and matched for age, gender, diagnosis and duration of illness. Baseline data were gathered retrospectively from medical records. Subjects were assessed at follow-up (mean of follow-up period = 5.5 years; range 2-9 years) using several clinical scales such as the Positive and Negative Syndrome Scale (PANSS), the Clinical Global Impression Scale (CGI) and the Global Assessment of Functioning (GAF). Improvement in PANSS positive, negative, general, total and CGI and GAF scores between baseline and follow-up assessment did not differ significantly between groups. At follow-up, no differences were observed for the PANSS negative, CGI and GAF scores between groups, but patients in the ECT group still had higher PANSS total, positive and general scores. ECT treatment followed by AP medication in treatment-resistant SSD or catatonia is at least as effective in the long term as AP alone in non-resistant patients. PMID:25183368

  5. Four years follow-up after clavicle reconstruction in a child: a case report.

    PubMed

    Heidt, Christoph; Ziebarth, Kai; Erni, Dominique; Slongo, Theddy; Joeris, Alexander

    2014-12-01

    Clavicle reconstruction is a rare operation. In most cases a mid-shaft defect of the clavicle is bridged by using different grafting techniques or musculo-osteous flaps. In some clinical situations where reconstruction is not a suitable option claviculectomy as a salvation procedure has proven to be an acceptable solution. In the paediatric population the challenge of both the cosmetic and the functional result attempting reconstruction of large bone defects is of higher demand. To our knowledge, this is the first case of a successful clavicle reconstruction with a sufficient follow-up using a free vascularised fibula graft in a child. This case provides a technique description, considerations in the paediatric population, an overview of other techniques used, and a long-term follow-up. PMID:25201718

  6. Four-year follow-up of megalencephaly, polymicrogyria, postaxial polydactyly and hydrocephalus (MPPH) syndrome.

    PubMed

    Zamora, Tara G; Roberts, Kari D

    2013-01-01

    A male infant was born by emergent caesarean section at 39 weeks gestational age secondary to maternal and fetal distress. Initial physical examination was notable for macrocephaly (greater than+2SD), postaxial polydactyly of the hands and facial dysmorphism. Head imaging demonstrated diffuse polymicrogyria without hydrocephalus. All findings were consistent with a diagnosis of megalencephaly, polymicrogyria, postaxial polydactyly and hydrocephalus (MPPH) syndrome. At the 4-year follow-up, megalencephaly persisted without evidence of hydrocephalus. The child was severely delayed with a stable seizure disorder controlled with dual antiepileptic therapy. This case meets the classic criteria for MPPH syndrome, adding to the limited experience with this disease. The 4-year follow-up and absence of hydrocephalus, once thought to be a key diagnostic criterion, adds to our understanding of the long-term sequelae. PMID:24092603

  7. Long-term results of cementless anatomic total hip replacement in dysplastic hips

    Microsoft Academic Search

    Matteo Bruzzone; Massimo La Russa; Giacomo Garzaro; Andrea Ferro; Paolo Rossi; Filippo Castoldi; Roberto Rossi

    2009-01-01

    This perspective study analyzes the long-term outcomes of cementless anatomic total hip arthroplasty (THA) in patients with\\u000a developmental dysplasia of the hip (DDH). Between 1990 and 2004, 100 ABG total hip prosthesis were implanted in 87 patients\\u000a with DDH. The average follow-up was 9 years (range 4–18 years). The mean Harris Hip Score was 87.13 (SD = 14.6) at the last\\u000a follow-up. Radiographic analysis

  8. Long Term Forecast ofLong Term Forecast of TsunamisTsunamis

    E-print Network

    Model comparisons: · Inundation field data at Seaside, Oregon · Tide gage measurement at Hilo, Hawaii 3 (Seaside Pilot Study) Long-term Forecast: #12;1- Validated Numerical Code #12;Relocation of emergency Approach (Seaside Pilot Study) Long-term Forecast: #12;2- Development of a high resolution Digital

  9. Long Term Capability Requirements as derived from the Long Term Requirements Study

    Microsoft Academic Search

    J. Brownlee

    2010-01-01

    Of the 38 Long Term Capability Requirements indentified by NATO in the 2009 Long Term Requirements Study, at least four can be directly applied to waterside security research and technology. First, Area Access Control, the capability of controlling access to designated unattended areas and borders, denying or allowing access to appropriate personnel and equipment. It must be capable of monitoring

  10. Long term ground movement of TRISTAN synchrotron

    Microsoft Academic Search

    K. Endo; Y. Ohsawa; M. Miyahara

    1989-01-01

    The long-term ground movement was estimated in a geological survey done in connection with the siting of the TRISTAN-MR (main ring). The movement of the synchrotron magnet mainly results from the structure of the tunnel. If the movement of an individual magnet exceeds a certain threshold limit, it exerts a significant influence on the particle behavior in a synchrotron. The

  11. Long-Term Oxygen Therapy in Ioannina

    Microsoft Academic Search

    Stamatis Katsenos; Marios E. Froudarakis; Alexandros Charisis; Miltiadis P. Vassiliou; Stavros H. Constantopoulos

    2004-01-01

    Background: Long-term oxygen treatment (LTOT) is very important, especially in patients with severe chronic obstructive pulmonary disease (COPD), but its efficacy is closely related to patient compliance. Objectives: The aim of the present study was to investigate the compliance of patients under LTOT in the Prefecture of Ioannina (north-western Greece) and to identify factors that might be involved. Methods: The

  12. Long term ecological research and information management

    Microsoft Academic Search

    William K. Michener; John Porter; Mark Servilla; Kristin Vanderbilt

    2011-01-01

    The United States Long Term Ecological Research (LTER) Program has supported research in the ecological and environmental sciences for more than three decades. The Program has grown from six to 26 sites and has been the precursor to a worldwide network of International LTER sites. Extracting knowledge from the massive volume of disparate data collected across ecosystems and decades depends

  13. Dynamics of long-term genomic selection

    Microsoft Academic Search

    Jean-Luc Jannink

    2010-01-01

    BACKGROUND: Simulation and empirical studies of genomic selection (GS) show accuracies sufficient to generate rapid gains in early selection cycles. Beyond those cycles, allele frequency changes, recombination, and inbreeding make analytical prediction of gain impossible. The impacts of GS on long-term gain should be studied prior to its implementation. METHODS: A simulation case-study of this issue was done for barley,

  14. LONG TERM HYDROLOGICAL IMPACT ASSESSMENT (LTHIA)

    EPA Science Inventory

    LTHIA is a universal Urban Sprawl analysis tool that is available to all at no charge through the Internet. It estimates impacts on runoff, recharge and nonpoint source pollution resulting from past or proposed land use changes. It gives long-term average annual runoff for a lan...

  15. Long-Term Memory and Learning

    ERIC Educational Resources Information Center

    Crossland, John

    2011-01-01

    The English National Curriculum Programmes of Study emphasise the importance of knowledge, understanding and skills, and teachers are well versed in structuring learning in those terms. Research outcomes into how long-term memory is stored and retrieved provide support for structuring learning in this way. Four further messages are added to the…

  16. Long-Term Stability of Tutor Performance.

    ERIC Educational Resources Information Center

    Dolmans, Diana H. J. M.; And Others

    1996-01-01

    Examined the extent to which tutor ratings remained stable in the long term by evaluating 291 ratings of 140 tutors at Maastricht University in the Netherlands between 1992 and 1995. The results indicated that, if the aggregated score and overall judgement are used to interpret the precision of individual scores, four and two occasions,…

  17. Neonatal desensitization allows long-term

    E-print Network

    Cai, Long

    for long-term immune protection of human fetal and stem cell­derived neural cells transplanted into the adult rat brain, by desensitizing the host rat to similar cells in the neonatal period, without the need appropriate immunosuppression, neural xenografts in the adult rat or mouse brain are rejected within 2­4 weeks

  18. Foundation work in long-term care.

    PubMed

    LeRoy, Lauren; Treanor, Katherine; Art, Emily

    2010-01-01

    Health foundations have invested in services, research, and advocacy to improve the financing and delivery of long-term services and supports. This article describes some of the broad array of approaches they have taken--in such areas as aging in place, assisted living, "culture change" in nursing homes, quality improvement, augmenting the workforce, and paying for care. PMID:20048379

  19. NATIONAL LONG TERM CARE SURVEY (NLTCS)

    EPA Science Inventory

    National Long Term Care Surveys (NLTCS) are surveys of the entire aged population with a particular emphasis on the functionally impaired. Longitudinal study of the health and well-being of elderly Americans. Information about the population of chronically disabled elderly person...

  20. TOXIC MODELING SYSTEM LONG-TERM (TOXLT)

    EPA Science Inventory

    The Toxic Modeling System Long-Term (TOXLT) is a personal-computer- based model that has been developed in conjunction with the release of the new version of the EPAs Industrial Source Complex (ISC2) Dispersion Models (EPA, 1992) and the promulgation of the EPAs A Tiered Modeling...